National Library of Energy BETA

Sample records for blind patient sight

  1. Comparative study of environmental factors influencing motor task learning and memory retention in sighted and

    E-Print Network [OSTI]

    Cooper, Robin L.

    in sighted and blind crayfish Sonya M. Bierbower1 , Zhanna P. Shuranova2 , Kert Viele3 & Robin L. Cooper1 1

  2. MicroSight Optics

    ScienceCinema (OSTI)

    None

    2013-05-28

    MicroSight is an innovative gunsight technology that allows a marksman's eye to focus on both the front gunsight and the intended target. The MicroSight improves both firearm safety and performance by imaging two objects at different focal distances. The MicroSight was developed at Idaho National Laboratory, and has been licensed by Apollo Optical Systems. You can learn more about INL's research programs at http://www.facebook.com/idahonationallaboratory.

  3. Brain Fiber Architecture in the Blind Agatha D. Leea

    E-Print Network [OSTI]

    Thompson, Paul

    Alaryb , Patrice Vossb , Yi-Yu Choua , Caroline Bruna , Marina Baryshevaa , Arthur W. Toga a , Paul M and limbic areas differed in the blind versus sighted subjects. References: [1] Leporé, N., Brun, C., Chou, Y

  4. Cross-modal plasticity for tactile and auditory stimuli within the visual cortex of early blind human subjects

    E-Print Network [OSTI]

    Lewis, Lindsay Burke

    2009-01-01

    metabolism in early blind subjects: neural activity in theM. (1998). Early-blind human subjects localize sound sourcesbetter than sighted subjects. Nature, 395 (6699), 278-280.

  5. Line-of-Sight Networks Alan Frieze

    E-Print Network [OSTI]

    Kleinberg, Jon

    -of-sight restrictions. Here we propose a random-graph model incorporating both range limitations and line-of-sight con- 0329064, CNS-0403340, and BCS-0537606; work done in part while on sabbatical leave at Carnegie Mellon

  6. Sighting optics including an optical element having a first focal length and a second focal length and methods for sighting

    DOE Patents [OSTI]

    Crandall, David Lynn

    2011-08-16

    Sighting optics include a front sight and a rear sight positioned in a spaced-apart relation. The rear sight includes an optical element having a first focal length and a second focal length. The first focal length is selected so that it is about equal to a distance separating the optical element and the front sight and the second focal length is selected so that it is about equal to a target distance. The optical element thus brings into simultaneous focus for a user images of the front sight and the target.

  7. Line-of-sight deposition method

    DOE Patents [OSTI]

    Patten, J.W.; McClanahan, E.D.; Bayne, M.A.

    1980-04-16

    A line-of-sight method of depositing a film having substantially 100% of theoretical density on a substrate. A pressure vessel contains a target source having a surface thereof capable of emitting particles therefrom and a substrate with the source surface and the substrate surface positioned such that the source surface is substantially parallel to the direction of the particles impinging upon the substrate surface, the distance between the most remote portion of the substrate surface receiving the particles and the source surface emitting the particles in a direction parallel to the substrate surface being relatively small. The pressure in the vessel is maintained less than about 5 microns to prevent scattering and permit line-of-sight deposition. By this method the angles of incidence of the particles impinging upon the substrate surface are in the range of from about 45/sup 0/ to 90/sup 0/ even when the target surface area is greatly expanded to increase the deposition rate.

  8. Randomized, Double-Blinded, Placebo-Controlled, Trial of Risedronate for the Prevention of Bone Mineral Density Loss in Nonmetastatic Prostate Cancer Patients Receiving Radiation Therapy Plus Androgen Deprivation Therapy

    SciTech Connect (OSTI)

    Choo, Richard [Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (United States)] [Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (United States); Lukka, Himu [Department of Radiation Oncology, Juravinski Cancer Center, McMaster University, Hamilton (Canada)] [Department of Radiation Oncology, Juravinski Cancer Center, McMaster University, Hamilton (Canada); Cheung, Patrick [Department of Radiation Oncology, Odette Cancer Centre, University of Toronto, Toronto (Canada)] [Department of Radiation Oncology, Odette Cancer Centre, University of Toronto, Toronto (Canada); Corbett, Tom [Department of Radiation Oncology, Juravinski Cancer Center, McMaster University, Hamilton (Canada)] [Department of Radiation Oncology, Juravinski Cancer Center, McMaster University, Hamilton (Canada); Briones-Urbina, Rosario [Department of Medicine, Women's College Hospital, University of Toronto, Toronto (Canada)] [Department of Medicine, Women's College Hospital, University of Toronto, Toronto (Canada); Vieth, Reinhold [Departments of Nutritional Sciences and Laboratory Medicine and Pathology, Mount Sinai Hospital, University of Toronto, Toronto (Canada)] [Departments of Nutritional Sciences and Laboratory Medicine and Pathology, Mount Sinai Hospital, University of Toronto, Toronto (Canada); Ehrlich, Lisa [Department of Radiology, Sunnybrook Health Sciences Center, University of Toronto (Canada)] [Department of Radiology, Sunnybrook Health Sciences Center, University of Toronto (Canada); Kiss, Alex [Department of Health Policy, Management, and Evaluation, Sunnybrook Health Sciences Center, University of Toronto, Toronto (Canada)] [Department of Health Policy, Management, and Evaluation, Sunnybrook Health Sciences Center, University of Toronto, Toronto (Canada); Danjoux, Cyril, E-mail: Cyril.danjoux@sunnybrook.ca [Department of Radiation Oncology, Odette Cancer Centre, University of Toronto, Toronto (Canada)] [Department of Radiation Oncology, Odette Cancer Centre, University of Toronto, Toronto (Canada)

    2013-04-01

    Purpose: Androgen deprivation therapy (ADT) has been used as an adjuvant treatment to radiation therapy (RT) for the management of locally advanced prostate carcinoma. Long-term ADT decreases bone mineral density (BMD) and increases the risk of osteoporosis. The objective of this clinical trial was to evaluate the efficacy of risedronate for the prevention of BMD loss in nonmetastatic prostate cancer patients undergoing RT plus 2 to 3 years of ADT. Methods and Materials: A double-blinded, placebo-controlled, randomized trial was conducted for nonmetastatic prostate cancer patients receiving RT plus 2 to 3 years of ADT. All had T scores > ?2.5 on dual energy x-ray absorptiometry at baseline. Patients were randomized 1:1 between risedronate and placebo for 2 years. The primary endpoints were the percent changes in the BMD of the lumbar spine at 1 and 2 years from baseline, measured by dual energy x-ray absorptiometry. Analyses of the changes in BMD and bone turnover biomarkers were carried out by comparing mean values of the intrapatient changes between the 2 arms, using standard t tests. Results: One hundred four patients were accrued between 2004 and 2007, with 52 in each arm. Mean age was 66.8 and 67.5 years for the placebo and risedronate, respectively. At 1 and 2 years, mean (±SE) BMD of the lumbar spine decreased by 5.77% ± 4.66% and 13.55% ± 6.33%, respectively, in the placebo, compared with 0.12% ± 1.29% at 1 year (P=.2485) and 0.85% ± 1.56% (P=.0583) at 2 years in the risedronate. The placebo had a significant increase in serum bone turnover biomarkers compared with the risedronate. Conclusions: Weekly oral risedronate prevented BMD loss at 2 years and resulted in significant suppression of bone turnover biomarkers for 24 months for patients receiving RT plus 2 to 3 years of ADT.

  9. Tactile measurement with a GelSight sensor

    E-Print Network [OSTI]

    Yuan, Wenzhen, S.M. Massachusetts Institute of Technology

    2014-01-01

    This thesis introduces a method of measuring contact force with GelSight. GelSight is an optical-based tactile sensor that uses a piece of coated elastomer as the contact medium. A camera records the distortion of the ...

  10. ON THE RELATIONSHIP BETWEEN BLIND DECONVOLUTION AND BLIND SOURCE SEPARATION

    E-Print Network [OSTI]

    Douglas, Scott C.

    ON THE RELATIONSHIP BETWEEN BLIND DECONVOLUTION AND BLIND SOURCE SEPARATION S.C. Douglas 1 and S. Haykin 2 1 Dept. of Electrical Engineering, University of Utah, Salt Lake City, UT 84112 USA 2 Communications Research Lab., McMaster University, Hamilton, Ontario L8S 4K1 CANADA ABSTRACT In this paper, we

  11. Blind Deconvolution Friday afternoon lecture

    E-Print Network [OSTI]

    O'Leary, Dianne P.

    Blind Deconvolution Fall 2005 Friday afternoon lecture Dianne P. O'Leary c 2005 Blind Image Deblurring through Structured Total Least Norm Dianne P. O'Leary Computer Science Dept. and Institute a preconditioner. Our contribution: · Pruessner and O'Leary: extended Rosen et al STLN algorithm to include RSTLN

  12. Blind quantum machine learning

    E-Print Network [OSTI]

    Yu-Bo Sheng; Lan Zhou

    2015-07-26

    Blind quantum machine learning (BQML) enables a classical client with little quantum technology to delegate a remote quantum machine learning to the quantum server in such a approach that the privacy data is preserved. Here we propose the first BQML protocol that the client can classify two-dimensional vectors to different clusters, resorting to a remote small-scale photon quantum computation processor. During the protocol, the client is only required to rotate and measure the single qubit. The protocol is secure without leaking any relevant information to the Eve. Any eavesdropper who attempts to intercept and disturb the learning process can be noticed. In principle, this protocol can be used to classify high dimensional vectors and may provide a new viewpoint and application for quantum machine learning.

  13. Sighting optics including an optical element having a first focal length and a second focal length

    DOE Patents [OSTI]

    Crandall, David Lynn (Idaho Falls, ID)

    2011-08-01

    One embodiment of sighting optics according to the teachings provided herein may include a front sight and a rear sight positioned in spaced-apart relation. The rear sight includes an optical element having a first focal length and a second focal length. The first focal length is selected so that it is about equal to a distance separating the optical element and the front sight and the second focal length is selected so that it is about equal to a target distance. The optical element thus brings into simultaneous focus, for a user, images of the front sight and the target.

  14. Blind transmembrane puncture access : design and development of a novel laparoscopic trocar and blade retraction mechanism

    E-Print Network [OSTI]

    Begg, Nikolai David Michael

    2011-01-01

    Blind puncture access procedures are frequent in medicine but can lead to complications due to over-puncture. When tissue membranes yield under applied stress, the device suddenly accelerates forward into the patient. ...

  15. Single line-of-sight dual energy backlighter for mix width experiments...

    Office of Scientific and Technical Information (OSTI)

    Single line-of-sight dual energy backlighter for mix width experiments Citation Details In-Document Search Title: Single line-of-sight dual energy backlighter for mix width...

  16. Temporal and Spatial Analysis of Killer Whale Sightings in the Galapagos Marine Reserve, Ecuador 

    E-Print Network [OSTI]

    Smith, Kerri

    2012-07-16

    -annual seasonality (upwelling versus non-upwelling); (b) correlation between the total annual sightings and the Multivariate El Nino Southern Oscillation Index (MEI); (c) correlation between sightings, the MEI, and seasonality; (d) spatial association between...

  17. A system for optimizing interior daylight distribution using reflective Venetian blinds with independent blind angle control

    E-Print Network [OSTI]

    McGuire, Molly E

    2005-01-01

    An operational algorithm for blind angle control is developed to optimize the daylighting performance of a system of reflective Venetian blinds. Numerical modeling and experiment confirm that independent control of alternating ...

  18. Evaluation of Spatial Displays for Navigation without Sight JAMES R. MARSTON and JACK M. LOOMIS

    E-Print Network [OSTI]

    Loomis, Jack M.

    realities, Evaluation/methodology; Ergonomics, Auditory I/O, User-Centered Design, Voice I/O, Haptic IEvaluation of Spatial Displays for Navigation without Sight JAMES R. MARSTON and JACK M. LOOMIS, Pages 110­124. #12;Evaluation of Spatial Displays for Navigation without Sight · 111 systems, visual map

  19. Blind Source Separation by Sparse Decomposition

    E-Print Network [OSTI]

    Pearlmutter, Barak

    Blind Source Separation by Sparse Decomposition University of New Mexico Technical Report No. CS99 University of New Mexico Albuquerque, NM 87131 USA July 19, 1999 Abstract The blind source separation problem of M unknown \\independent" sources s(t), possibly corrupted by additive noise #24;(t): x(t) = As

  20. UAV PATH FOLLOWING FOR CONSTANT LINE-OF-SIGHT Rolf Rysdyk,

    E-Print Network [OSTI]

    UAV PATH FOLLOWING FOR CONSTANT LINE-OF-SIGHT Rolf Rysdyk, University of Washington, Seattle, WA to a method to model `helmsman behavior'. The UAV control problem typically involves: air- speed, aerodynamic

  1. Accident causation study on roadways with limited sight distance crest vertical curves 

    E-Print Network [OSTI]

    Stoddard, Angela May

    1994-01-01

    reflect the driver and vehicle population currently on the transportation network. An accident causation study was conducted to determine if roadways with limited stopping sight distance present a safety hazard for the transportation network. Rural two...

  2. A review of "Sight and Spirituality in Early Netherlandish Painting." by Bret L. Rothstein, 

    E-Print Network [OSTI]

    Tokumitsu, Miya

    2007-01-01

    SEVENTEENTH-CENTURY NEWS volume includes appendices listing the works included in the Recueil g?n?ral des op?ras, a bibliography, and an index nominum. Bret L. Rothstein. Sight and Spirituality in Early Netherlandish Painting. Cambridge: Cambridge University..., Sight and Spirituality in Early Netherlandish Painting, examines four seminal paintings of the fifteenth-century Low Countries and discusses the conse- quences of representing aspects of Christian spirituality for both artist and viewer. Painterly...

  3. A correlation between hard gamma-ray sources and cosmic voids along the line of sight

    SciTech Connect (OSTI)

    Furniss, A.; Sutter, P. M.; Primack, J. R.; Dominguez, A.

    2014-11-25

    We estimate the galaxy density along lines of sight to hard extragalactic gamma-ray sources by correlating source positions on the sky with a void catalog based on the Sloan Digital Sky Survey (SDSS). Extragalactic gamma-ray sources that are detected at very high energy (VHE; E > 100 GeV) or have been highlighted as VHE-emitting candidates in the Fermi Large Area Telescope hard source catalog (together referred to as “VHE-like” sources) are distributed along underdense lines of sight at the 2.4#27; level. There is also a less suggestive correlation for the Fermi hard source population (1.7#27;). A correlation between 10-500 GeV flux and underdense fraction along the line of sight for VHE-like and Fermi hard sources is found at 2.4#27; and 2.6#27;, calculated from the Pearson correlation coefficients of r = 0.57 and 0.47, respectively. The preference for underdense sight lines is not displayed by gamma-ray emitting galaxies within the second Fermi catalog, containing sources detected above 100 MeV, or the SDSS DR7 quasar catalog. We investigate whether this marginal correlation might be a result of lower extragalactic background light (EBL) photon density within the underdense regions and find that, even in the most extreme case of a entirely underdense sight line, the EBL photon density is only 2% less than the nominal EBL density. Translating this into gamma-ray attenuation along the line of sight for a highly attenuated source with opacity #28;(E, z) #24; 5, we estimate that the attentuation of gamma-rays decreases no more than 10%. This decrease, although non-neglible, is unable to account for the apparent hard source correlation with underdense lines of sight.

  4. A correlation between hard gamma-ray sources and cosmic voids along the line of sight

    DOE Public Access Gateway for Energy & Science Beta (PAGES Beta)

    Furniss, A.; Sutter, P. M.; Primack, J. R.; Dominguez, A.

    2014-11-25

    We estimate the galaxy density along lines of sight to hard extragalactic gamma-ray sources by correlating source positions on the sky with a void catalog based on the Sloan Digital Sky Survey (SDSS). Extragalactic gamma-ray sources that are detected at very high energy (VHE; E > 100 GeV) or have been highlighted as VHE-emitting candidates in the Fermi Large Area Telescope hard source catalog (together referred to as “VHE-like” sources) are distributed along underdense lines of sight at the 2.4? level. There is a less suggestive correlation for the Fermi hard source population (1.7?). A correlation between 10-500 GeV fluxmore »and underdense fraction along the line of sight for VHE-like and Fermi hard sources is found at 2.4? and 2.6?, calculated from the Pearson correlation coefficients of r = 0.57 and 0.47, respectively. The preference for underdense sight lines is not displayed by gamma-ray emitting galaxies within the second Fermi catalog, containing sources detected above 100 MeV, or the SDSS DR7 quasar catalog. We investigate whether this marginal correlation might be a result of lower extragalactic background light (EBL) photon density within the underdense regions and find that, even in the most extreme case of a entirely underdense sight line, the EBL photon density is only 2% less than the nominal EBL density. Translating this into gamma-ray attenuation along the line of sight for a highly attenuated source with opacity ?(E, z) ~ 5, we estimate that the attentuation of gamma-rays decreases no more than 10%. This decrease, although non-neglible, is unable to account for the apparent hard source correlation with underdense lines of sight.« less

  5. DEFINING THE 'BLIND SPOT' OF HINODE EIS AND XRT TEMPERATURE MEASUREMENTS

    SciTech Connect (OSTI)

    Winebarger, Amy R.; Cirtain, Jonathan; Mulu-Moore, Fana [NASA Marshall Space Flight Center, VP 62, Huntsville, AL 35812 (United States); Warren, Harry P. [Space Science Division, Naval Research Laboratory, Washington, DC 20375 (United States); Schmelz, Joan T. [Physics Department, University of Memphis, Memphis, TN 38152 (United States); Golub, Leon [Harvard-Smithsonian Center for Astrophysics, 60 Garden St., Cambridge, MA 02138 (United States); Kobayashi, Ken, E-mail: amy.r.winebarger@nasa.gov [Center for Space Plasma and Aeronomic Research, 320 Sparkman Dr, Huntsville, AL 35805 (United States)

    2012-02-20

    Observing high-temperature, low emission measure plasma is key to unlocking the coronal heating problem. With current instrumentation, a combination of EUV spectral data from Hinode Extreme-ultraviolet Imaging Spectrometer (EIS; sensitive to temperatures up to 4 MK) and broadband filter data from Hinode X-ray Telescope (XRT; sensitive to higher temperatures) is typically used to diagnose the temperature structure of the observed plasma. In this Letter, we demonstrate that a 'blind spot' exists in temperature-emission measure space for combined Hinode EIS and XRT observations. For a typical active region core with significant emission at 3-4 MK, Hinode EIS and XRT are insensitive to plasma with temperatures greater than {approx}6 MK and emission measures less than {approx}10{sup 27} cm{sup -5}. We then demonstrate that the temperature and emission measure limits of this blind spot depend upon the temperature distribution of the plasma along the line of sight by considering a hypothetical emission measure distribution sharply peaked at 1 MK. For this emission measure distribution, we find that EIS and XRT are insensitive to plasma with emission measures less than {approx}10{sup 26} cm{sup -5}. We suggest that a spatially and spectrally resolved 6-24 Angstrom-Sign spectrum would improve the sensitivity to these high-temperature, low emission measure plasma.

  6. Variational Bayesian Blind and Semiblind Channel Estimation

    E-Print Network [OSTI]

    Gesbert, David

    elaborate the details for the case of MIMO OFDM systems. I. INTRODUCTION Blind and semiblind channel, SFR , Orange, STEricsson, Cisco, BMW Group , SAP, Monaco Telecom and Symantec. The research reported herein has also been partially supported by the European FP7 NoE NewCom++ and FET project CROWN

  7. Billiards Digest July, 2011 "Aim, Align, Sight -Part II: Visual Alignment" ILLUSTRATED PRINCIPLES

    E-Print Network [OSTI]

    Alciatore, David G.

    Billiards Digest July, 2011 "Aim, Align, Sight - Part II: Visual Alignment" ILLUSTRATED PRINCIPLES alignment is off. Diagram 1 Changes in visual perception with head position #12;Billiards Digest July, 2011 to the right. Diagram 3 Results of head alignment errors #12;Billiards Digest July, 2011 Human vision

  8. Vision: Cloud-Powered Sight for All Showing the Cloud What You See

    E-Print Network [OSTI]

    Zhong, Lin

    General Terms Algorithms, Design, Human Factors, Languages, Performance, Security Keywords Camera, cloudVision: Cloud-Powered Sight for All Showing the Cloud What You See Paramvir Bahl Matthai Philipose argue that for computers to do more for us, we need to show the cloud what we see and embrace cloud

  9. Geothermal research project sets sights on Grande Prairie By Jenny Oatway May 20, 2015

    E-Print Network [OSTI]

    Wang, Hao "Howard"

    off between the cost of drilling that deep and also much less is known about the reservoirs Geothermal research project sets sights on Grande Prairie By Jenny Oatway May 20, 2015 City Council is excited about an opportunity to explore the potential for harnessing geothermal energy

  10. Motivations Blind Equalisation Main Results Example Conclusions Blind Equalisation of High-Order QAM Channels Using a

    E-Print Network [OSTI]

    Chen, Sheng

    Motivations Blind Equalisation Main Results Example Conclusions Blind Equalisation of High International Conference on Automation & Computing, 2009 #12;Motivations Blind Equalisation Main Results Example Equalisation Signal Model CMA and SDD Equaliser 3 Main Results Fuzzy Step Size CMA Fuzzy-Logic Aided CMA

  11. PROBING THE ROLE OF CARBON IN ULTRAVIOLET EXTINCTION ALONG GALACTIC SIGHT LINES

    SciTech Connect (OSTI)

    Parvathi, V. S.; Babu, B. R. S.; Sofia, U. J.; Murthy, J. E-mail: brsbabu@gmail.com E-mail: jmurthy@yahoo.com

    2012-11-20

    We report previously undetermined interstellar gas and dust-phase carbon abundances along 15 Galactic sight lines based on archival data of the strong 1334.5323 A transition observed with the Space Telescope Imaging Spectrograph. These are combined with previously reported carbon measurements along six sight lines to produce a complete sample of interstellar C II measurements determined with the 1334 A transition. Our data set includes a variety of Galactic disk environments characterized by different extinctions and samples paths ranging over three orders of magnitude in average density of hydrogen ((n(H))). Our data support the idea that dust, specifically carbon-based grains, are processed in the neutral interstellar medium. We, however, do not find that the abundance of carbon in dust or the grain-size distribution is related to the strength of the 2175 A bump. This is surprising, given that many current models have polycyclic aromatic hydrocarbons as the bump-producing dust.

  12. Data Association and Bullet Tracking Algorithms for the Fight Sight Experiment

    SciTech Connect (OSTI)

    Breitfeller, E; Roberts, R

    2005-10-07

    Previous LLNL investigators developed a bullet and projectile tracking system over a decade ago. Renewed interest in the technology has spawned research that culminated in a live-fire experiment, called Fight Sight, in September 2005. The experiment was more complex than previous LLNL bullet tracking experiments in that it included multiple shooters with simultaneous fire, new sensor-shooter geometries, large amounts of optical clutter, and greatly increased sensor-shooter distances. This presentation describes the data association and tracking algorithms for the Fight Sight experiment. Image processing applied to the imagery yields a sequence of bullet features which are input to a data association routine. The data association routine matches features with existing tracks, or initializes new tracks as needed. A Kalman filter is used to smooth and extrapolate existing tracks. The Kalman filter is also used to back-track bullets to their point of origin, thereby revealing the location of the shooter. It also provides an error ellipse for each shooter, quantifying the uncertainty of shooter location. In addition to describing the data association and tracking algorithms, several examples from the Fight Sight experiment are also presented.

  13. Reflective insulating blinds for windows and the like

    DOE Patents [OSTI]

    Barnes, Paul R. (Lenoir City, TN); Shapira, Hanna B. (Oak Ridge, TN)

    1981-01-01

    Energy-conserving window blinds are provided. The blinds are fabricated from coupled and adjustable slats, each slat having an insulation layer and a reflective surface to face outwardly when the blinds are closed. A range of desired light and air transmission may be selected with the reflective surfaces of the slats adapted to direct sunlight upward toward the ceiling when the blinds are open. When the blinds are closed, the insulation of the slats reduces the heat loss or gain produced by the windows. If desired, the reflective surfaces of the slats may be concave. The edges of the slats are designed to seal against adjacent slats when the blinds are closed to ensure minimum air flow between slats.

  14. PARENT Quick Blind Round-Robin Test Report

    SciTech Connect (OSTI)

    Braatz, Brett G.; Heasler, Patrick G.; Meyer, Ryan M.

    2014-09-30

    The U.S. Nuclear Regulatory Commission has established the Program to Assess the Reliability of Emerging Nondestructive Techniques (PARENT) whose goal is to investigate the effectiveness of current and novel nondestructive examination procedures and techniques to find flaws in nickel-alloy welds and base materials. This is to be done by conducting a series of open and blind international round-robin tests on a set of piping components that include large-bore dissimilar metal welds, small-bore dissimilar metal welds, and bottom-mounted instrumentation penetration welds. The blind testing is being conducted in two segments, one is called Quick-Blind and the other is called Blind. The Quick-Blind testing and destructive analysis of the test blocks has been completed. This report describes the four Quick-Blind test blocks used, summarizes their destructive analysis, gives an overview of the nondestructive evaluation (NDE) techniques applied, provides an analysis inspection data, and presents the conclusions drawn.

  15. Tangent length and sight distance effects on accident rates at horizontal curves on two-lane rural highways 

    E-Print Network [OSTI]

    Fink, Kenneth Lee

    1993-01-01

    This thesis documents an evaluation of the relationships between accident rates at horizontal curves and preceding tangent length and sight distance. Data collection and statistical methods used to evaluate this relationship are presented. A base...

  16. Blind Geothermal System Exploration in Active Volcanic Environments...

    Office of Energy Efficiency and Renewable Energy (EERE) Indexed Site

    Multi-phase Geophysical and Geochemical Surveys in Overt & Subtle Volcanic Systems, Hawaii & Maui Blind Geothermal System Exploration in Active Volcanic Environments;...

  17. Change Blindness in Information Visualization: A Case Study

    SciTech Connect (OSTI)

    Nowell, Lucille T.; Hetzler, Elizabeth G.; Tanasse, Theodore E.

    2001-08-20

    AbstractChange blindness occurs when people do not notice changes in visible elements of a scene. If people use an infor-mation visualization system to compare document collec-tion subsets partitioned by their time-stamps, change blind-ness makes it impossible for them to recognize even very major changes, let alone minor ones. We describe theories from cognitive science that account for the change blindness phenomenon, as well as solutions de-veloped for two visual analysis tools, a dot plot (SPIRE Galaxies) and landscape (ThemeView?) visualizations.

  18. BLIND RRT: A PROBABILISTICALLY COMPLETE, DISTRIBUTED RRT 

    E-Print Network [OSTI]

    Rodriguez Villanueva, Cesar Adolfo

    2013-02-06

    touch,” in Proc. IEEE Int. Conf. Robot. Autom. (ICRA), pp. 954–959, 2001. This work was also presented as a poster at RECOMB 2001. [4] H. Chang and T. Y. Li, “Assembly maintainability study with motion planning,” in Proc. IEEE Int. Conf. Robot. Autom.... Stradford, C. Rodriguez, S. Thomas, and N. M. Amato, “A scalable distributed rrt for motion planning.,” in Proc. IEEE Int. Conf. Robot. Autom. (ICRA), To appear May 2013. [10] C. A. Rodriguez, J. Denny, S. A. Jacobs, S. Thomas, and N. M. Amato, “Blind rrt: A...

  19. Blind Geothermal System | Open Energy Information

    Open Energy Info (EERE)

    AFDC Printable Version Share this resource Send a link to EERE: Alternative Fuels Data Center Home Page to someone by E-mail Share EERE: Alternative Fuels Data Center Home Page on Facebook Tweet about EERE: Alternative Fuels Data Center Home Page on Twitter Bookmark EERE: Alternative Fuels Data Center Home Page on Google Bookmark EERE: Alternative Fuels Data Center Home Page on QA:QA J-E-1 SECTION JEnvironmental JumpInformationBio-Gas Technologies,BlackhawkBlauvelt, NewMulti-phaseBlind

  20. Integrate the BlindAid system in a traditional orientation and mobility rehabilitation program

    E-Print Network [OSTI]

    Srinivasan, Mandayam A.

    In the process of becoming blind, newly- blinded people participate in a rehabilitation program, which includes different skills that a newly- blinded person needs to adapt as a result of his or her lost of vision. The ...

  1. BlindBox: Deep Packet Inspection over Encrypted Traffic

    E-Print Network [OSTI]

    International Association for Cryptologic Research (IACR)

    BlindBox: Deep Packet Inspection over Encrypted Traffic Justine Sherry UC Berkeley Chang Lan UC middleboxes perform deep packet inspection (DPI), a set of useful tasks which examine packet payloads that simultaneously provides both of these properties. The approach of Blind- Box is to perform the deep

  2. Signal Processing 88 (2008) 18391851 Multichannel blind seismic deconvolution

    E-Print Network [OSTI]

    Cohen, Israel

    2008-01-01

    Signal Processing 88 (2008) 1839­1851 Multichannel blind seismic deconvolution using dynamic an algorithm for multichannel blind deconvolution of seismic signals, which exploits lateral continuity algorithm, are demonstrated through simulations and real seismic data examples. r 2008 Elsevier B.V. All

  3. Cascade Neural Networks for Multichannel Blind Deconvolution Seungjin CHOI 1

    E-Print Network [OSTI]

    Cichocki, Andrzej

    communications, ar- ray processing, and some biomedical applications. In multichannel blind deconvolution, an m of Bussgang-type blind equalization algorithms 2] that is able to extract multiple source signals from applied to the case when we do not know the number of source signals in advance. Extensive computer

  4. MULTICHANNEL BLIND SEPARATION AND DECONVOLUTION OF SOURCES WITH

    E-Print Network [OSTI]

    Cichocki, Andrzej

    -distributed source signals. I. INTRODUCTION Blind signal separation is useful for numerous problems in biomedical signal analysis, acoustics, communications, and signal and image processing. In blind source separation. The measured sensor signals are processed by a linear single-layer feed-forward network as y(k) = W(k)x(k) (2

  5. Bayesian analysis of joint strong gravitational lensing and dynamic galactic mass in SLACS: evidence of line-of-sight contamination

    E-Print Network [OSTI]

    Antonio C. C. Guimarães; Laerte Sodré Jr.

    2007-06-21

    We readdress the calculation of the mass of early-type galaxies using strong gravitational lensing and stellar dynamics. Our sample comprises 27 galaxies in the Sloan Lens ACS (SLACS) Survey. Comparing the mass estimates from these two independent methods in a Bayesian framework, we find evidence of significant line-of-sight mass contamination. Assuming a power-law mass distribution, the best fit density profile is given by $\\rho \\propto r^{-1.69\\pm0.05}$. We show that neglecting the line-of-sight mass contamination produces an overestimate of the mass attributed to the lens-galaxy by the lensing method, which introduces a bias in favor of a SIS profile when using the joint lensing and dynamic analysis to determine the slope of the density profile. We suggest that the line-of-sight contamination could also be important for other astrophysical and cosmological uses of joint lensing and dynamical measurements.

  6. The Rhetorics of Color-Blind Racism in Racefail 09 

    E-Print Network [OSTI]

    Reid, Robin Anne

    2010-09-01

    stream_source_info The Rhetorics of Color-Blind Racism in Racefail 09.ppt.txt stream_content_type text/plain stream_size 4013 Content-Encoding ISO-8859-1 stream_name The Rhetorics of Color-Blind Racism in Racefail 09.ppt....txt Content-Type text/plain; charset=ISO-8859-1 The Rhetorics of Color-Blind Racism in Racefail 09 Presented at: Amazing, Fantastic, Weird: Science Fiction Studies in Texas Symposium April 15, 2010 Eduardo Bonilla-Silva Schema Anything But Race: It?s...

  7. A new look at lines of sight: using Fourier methods for the wide-angle anisotropic 2-point correlation function

    E-Print Network [OSTI]

    Slepian, Zachary

    2015-01-01

    The anisotropic 2-point correlation function (2PCF) of galaxies measures pairwise clustering as a function of the pair separation's angle to the line of sight. The latter is often defined as either the angle bisector of the observer-galaxy-pair triangle or the vector from the observer to the separation midpoint. Here we show how to accelerate either of these measurements with Fourier Transforms, using a slight generalization of the Yamamoto et al. (2006) estimator in which each member of the pair is used successively as the line of sight. We also present perturbation theory predictions for our generalized estimator including wide-angle corrections.

  8. Single line-of-sight dual energy backlighter for mix width experiments

    SciTech Connect (OSTI)

    Baker, K. L., E-mail: baker7@llnl.gov; Glendinning, S. G.; Martinez, D.; Dittrich, T. R.; MacLaren, S. A.; Felker, S.; Seugling, R.; Doane, D.; Wallace, R. [Lawrence Livermore National Laboratory, Livermore, California 94551 (United States); Guymer, T. M.; Moore, A. S. [AWE, Aldermaston, Reading, Berkshire RG7 4PR (United Kingdom); Whiting, N.; Sorce, C. [Laboratory for Laser Energetics, Rochester, New York 14627 (United States)

    2014-11-15

    We present a diagnostic technique used to spatially multiplex two x-ray radiographs of an object onto a detector along a single line-of-sight. This technique uses a thin, <2 ?m, cosputtered backlighter target to simultaneously produce both Ni and Zn He{sub ?} emission. A Ni picket fence filter, 500 ?m wide bars and troughs, is then placed in front of the detector to pass only the Ni He{sub ?} emission in the bar region and both energies in the trough region thereby spatially multiplexing the two radiographs on a single image. Initial experimental results testing the backlighter spectrum are presented along with simulated images showing the calculated radiographic images though the nickel picket fence filter which are used to measure the mix width in an accelerated nickel foam.

  9. Theoretical Examination of Passing Sight Distance in Three Dimensions with Application to Marking No-Passing Zones 

    E-Print Network [OSTI]

    Azimi, Mehdi 1974-

    2012-12-11

    the process for locating no-passing zones using global positioning system (GPS) data. The author developed a new analytical algorithm to evaluate three-dimensional passing sight distances that will work for any arbitrary alignment of two-lane highway...

  10. Multi-Vehicle Path Planning for Non-Line of Sight Communication Tom Schouwenaars, Eric Feron, and Jonathan How

    E-Print Network [OSTI]

    How, Jonathan P.

    line of sight communication to its ground station is lost. Relay helicopters are therefore introduced formulations to model nonconvex obstacles more efficiently. Simulation, hardware in the loop, and flight test by introducing a set of relay helicopters. Indirect communication with the ground station can then be established

  11. Spacecraft Angular Velocity and Line-of-Sight Control Using A Single-Gimbal Variable-Speed Control

    E-Print Network [OSTI]

    Tsiotras, Panagiotis

    and/or angular velocity control27­29 problem using less than three reaction wheels. Recently, a newSpacecraft Angular Velocity and Line-of-Sight Control Using A Single-Gimbal Variable-Speed Control possible. In this paper, feedback controllers that stabilize the angular velocity vector of a rigid

  12. Three Blind Men and the Elephant

    SciTech Connect (OSTI)

    Long, J S

    2007-02-13

    Just like the blind men in the popular story of perceiving the elephant, the three major constituencies participating in the energy debate have greatly different perceptions of the problem. The constituency that is worried about climate change believes the energy problem is caused by profligate use of fossil fuel that has dramatically changed our atmosphere. The energy security group sees dangerous reliance on foreign sources of oil increasingly held by countries hostile to the US. The economic vitality group sees high energy prices and their effect on the economy and our life-style. Just like the blind men, each of the three constituencies perceives a different problem. And just as with the blind men, while each perspective is right as a piece of the elephant, it takes all the perspectives together to actually solve the problem. Environmentalists focus on solutions responding to the scientific consensus that greenhouse gases are creating rapid climate change. The tipping point has come: it is now a consensus position among scientists the global warming is being affected by anthropogenic activity to 90% certainty according to the last IPCC report. Although they still struggle with the prediction of how much global temperatures will rise if we do nothing--is it 5 deg or 10 under BAU? This group believes that we cannot afford to take a chance because we get only one chance. We can not afford to do this kind of experiment with the Earth. Any choice which decreases our CO{sub 2} footprint is favored, even if it means a decrease in standard of living. The energy security constituency sees the geo-politics of oil becoming increasingly dire. They look at oil money being used to fund anti-American activities of groups such as the Wahabis in Saudi Arabia, Hezbollah in Lebanon and the infamous Al Qaeda. They quip that the Iraq war is the first war where we are paying for both sides. They note Iran and the Shia throughout the Middle East seeing the possibility of controlling 2/3 of the world's oil. They see oil and gas being used by Russia to exert political power using the gas tap and Hugo Chavez in Venezuela clearly anti-American and now a virtual dictator who controls 15% of our oil imports. Conflicts in Nigeria over oil wealth and corruption affected our oil supply. Countries such as China are at best unwilling to join political action against countries such as Sudan that supply them oil, and at worst, selling them arms in order to cement their relationships with respect to importing oil. This security constituency favors ending our vulnerability by ending our ''addiction to foreign oil''. This group thinks that there is no domestic source of energy that is bad. They will be happy to see our corn turned into ethanol; our coal turned into liquid fuel for transportation. No matter that the price of tortillas doubles in Mexico, we expand corn farming at the expense of the environment, our tanks and pipes in gas stations corrode and leak, or we make liquid fuel from coal, thus increasing the carbon footprint by 30% per unit of energy. The economic vitality group sees increasing international demand for oil occurring simultaneously with a peaking supply of light sweet crude. They see an oil market where higher prices drive more production of oil which is heavier and more sour (supply follows demand). However, fast growth in world-wide demand increases even faster and prices will go up. For example, China adds 10,000 cars per month, and there is an uncanny correlation between the price of oil and the amount of oil imported by China. The security contingent also worries about reliability of supply as affected by pipeline leaks in Alaska or hurricanes or potential terrorism. This constituency thinks the problem is one of capacity and favors solutions that will increase oil production, reservoirs, pipelines and refineries. They believe that the energy system will be determined by the market and want solutions that favor investment in capacity. What the environmentalists don't seem to get is climate change by itself will fail to gather b

  13. Measuring line-of-sight dependent Fourier-space clustering using FFTs

    E-Print Network [OSTI]

    Bianchi, Davide; Ruggeri, Rossana; Percival, Will J

    2015-01-01

    Observed galaxy clustering exhibits local transverse statistical isotropy around the line-of-sight (LOS). The variation of the LOS across a galaxy survey complicates the measurement of the observed clustering as a function of the angle to the LOS, as Fast Fourier Transforms (FFTs) based on cartesian grids, cannot individually allow for this. Recent advances in methodology for calculating LOS-dependent clustering in Fourier space include the realisation that power spectrum LOS-dependent moments can be constructed from sums over galaxies, based on approximating the LOS to each pair of galaxies by the LOS to one of them. We show that we can implement this method using multiple FFTs, each measuring the LOS-weighted clustering along different axes. The N log(N) nature of FFTs means that the computational speed-up is a factor of >1000 compared with summing over galaxies. This development should be beneficial for future projects such as DESI and Euclid which will provide an order of magnitude more galaxies than curr...

  14. Universal Single-Server Blind Quantum Computation for Classical Client

    E-Print Network [OSTI]

    Hai-Ru Xu; Bang-Hai Wang

    2014-11-12

    Blind quantum computation allows a client without enough quantum technologies to delegate her quantum computation to quantum server, while keeping her input, output and algorithm secure. In this paper, we propose a universal single-server and classical-client blind quantum computation protocol based on entanglement swapping technology. In our protocol, the client interface with only one server and the only ability of the client requires is to get particles from trusted center and forward them to the server. Moreover, the protocol can be modified to make client completely classical by improving the ability of the trusted center. Numbers of blind quantum computation protocols have been presented in recent years, including single-, double- and triple-server protocols. In the single-server protocol, client needs to prepare single qubits. Though client can be classical in the double-server protocol, the two servers, who share Bell state from trusted center, are not allowed to communicate with each other. Recently, the triple-server protocol solves the noncommunication problem. Three servers, however, make the implementation of the computation sophisticated and unrealistic. Since it is impossible for blind quantum computation with only classical client and single server, blind quantum computation may work in the "Cloud + E-commerce" style in the future. Our protocol might become a key ingredient for real-life application in the first generation of quantum computations.

  15. Alabama Institute for Deaf and Blind Biodiesel Project Green

    SciTech Connect (OSTI)

    Edmiston, Jessica L

    2012-09-28

    Through extensive collaboration, Alabama Institute for Deaf and Blind (AIDB) is Alabama's first educational entity to initiate a biodiesel public education, student training and production program, Project Green. With state and national replication potential, Project Green benefits local businesses and city infrastructures within a 120-mile radius; provides alternative education to Alabama school systems and to schools for the deaf and blind in Appalachian States; trains students with sensory and/or multiple disabilities in the acquisition and production of biodiesel; and educates the external public on alternative fuels benefits.

  16. Safety evaluation of limited sight distance at crest vertical curves on two-lane rural roadways in Texas 

    E-Print Network [OSTI]

    George, Karen Maria

    1990-01-01

    reduction factors. These factors describe the hypothesized relation between accident rate and both the severity of the restriction and the presence of other confounding geometric features within the restriction. Neuman and Glennon's model ~26 included a... controlled database was used to test the hypothesis in order to discriminate between accidents possibly caused by limited sight distance and accidents caused by other geometric features. Multiple-factor analysis of variance was used to test the variation...

  17. SEP Success Story: Alabama Institute for Deaf and Blind to Launch...

    Broader source: Energy.gov (indexed) [DOE]

    and Blind The Alabama Institute for Deaf and Blind is replacing almost 2,900 lights in 19 buildings across its Talladega, Ala., campuses with energy-efficient fixtures, an upgrade...

  18. Blind separation of sources that have spatiotemporal variance dependencies

    E-Print Network [OSTI]

    Hyvärinen, Aapo

    Helsinki Institute for Information Technology, Basic Research Unit, Dept of Computer Science, University of Helsinki£ . Now Helsinki Institute for Information Technology / BRU, P.O.Box 26, FIN-00014 University of HelsinkiBlind separation of sources that have spatiotemporal variance dependencies Aapo Hyv¨arinen a b

  19. Blind separation of sources that have spatiotemporal variance dependencies

    E-Print Network [OSTI]

    Hyvärinen, Aapo

    Institute for Information Technology, Basic Research Unit, Dept of Computer Science, University of Helsinki; Helsinki Institute for Information Technology / BRU, P.O.Box 26, FIN­00014 University of Helsinki, FaxBlind separation of sources that have spatiotemporal variance dependencies Aapo HyvË? arinen a;b;#3

  20. Adaptive Evolution of Eye Degeneration in the Mexican Blind Cavefish

    E-Print Network [OSTI]

    Monteiro, Antónia

    Adaptive Evolution of Eye Degeneration in the Mexican Blind Cavefish W. R. JEFFERY Department degeneration in cave-adapted animals have not been resolved. Opposing hypotheses invoking neural mutation-dwelling forms (cavefish), which shed new light on this problem. The manner of eye development and degeneration

  1. University of Alberta On the Futility of Blind Search

    E-Print Network [OSTI]

    Culberson, Joseph

    University of Alberta On the Futility of Blind Search by Joseph C. Culberson Technical Report TR 96­18 July 1996 DEPARTMENT OF COMPUTING SCIENCE The University of Alberta Edmonton, Alberta, Canada #12 Research Council Grant No. OGP8053. Department of Computing Science, University of Alberta, Edmonton

  2. Convergence Analysis of Local Algorithms for Blind Decorrelation

    E-Print Network [OSTI]

    Cichocki, Andrzej

    in acoustics, communica- tions, biomedical signal analysis, and image processing. In blind source separation(k). The measured sensor signals are processed by a linearsingle-layer feedforward network as y(k) = W(k)x(k) (2 Processing Group Frontier Research Program, RIKEN Wako-Shi, Saitama 351-01 JAPAN Abstract In this paper, we

  3. BLIND EXTRACTION OF SOURCE SIGNALS WITH SPECIFIED STOCHASTIC FEATURES

    E-Print Network [OSTI]

    Vialatte, François

    interestinmanyapplicationssuchas biomedical signal processing (ECG or EEG), speech recog- nition (cocktail party problem), imageBLIND EXTRACTION OF SOURCE SIGNALS WITH SPECIFIED STOCHASTIC FEATURES Ruck THAWONMAS 3 and Andrzej a neural-network approach which allows se- quential extraction of source signals from a linear mixture

  4. BLIND EXTRACTION OF SOURCE SIGNALS WITH SPECIFIED STOCHASTIC FEATURES

    E-Print Network [OSTI]

    Thawonmas, Ruck

    is a problem of interest in many applications such as biomedical signal processing (ECG or EEG), speech recogBLIND EXTRACTION OF SOURCE SIGNALS WITH SPECIFIED STOCHASTIC FEATURES Ruck THAWONMAS 3 and Andrzej a neural­network approach which allows se­ quential extraction of source signals from a linear mixture

  5. AN INDEPENDENT MEASUREMENT OF THE INCIDENCE OF Mg II ABSORBERS ALONG GAMMA-RAY BURST SIGHT LINES: THE END OF THE MYSTERY?

    E-Print Network [OSTI]

    Cucchiara, A.

    In 2006, Prochter et al. reported a statistically significant enhancement of very strong Mg II absorption systems intervening the sight lines to gamma-ray bursts (GRBs) relative to the incidence of such absorption along ...

  6. A concept to collect neutron and x-ray images on the same line of sight at NIF

    SciTech Connect (OSTI)

    Merrill, F. E., E-mail: fmerrill@lanl.gov; Danly, C. R.; Grim, G. P.; Volegov, P. L.; Wilde, C. H. [Los Alamos National Laboratory, Los Alamos, New Mexico 87545 (United States); Izumi, N.; Jedlovec, D.; Fittinghoff, D. N.; Pak, A.; Park, H.-S. [Livermore National Laboratory, Livermore, California 94551 (United States)

    2014-11-15

    Neutron and x-ray images are collected at the National Ignition Facility (NIF) to measure the size and shape of inertial confinement fusion implosions. The x-ray images provide a measure of the size and shape of the hot region of the deuterium-tritium fuel while the neutron images provide a measure of the size and shape of the burning plasma. Although these two types of images are collected simultaneously, they are not collected along the same line of sight (LOS). One 14 MeV neutron image is collected on the NIF equator, and two x-ray images are collected along the polar axis and nearly perpendicular to the neutron imaging line of sight on the equator. Both measurements use pinhole apertures to form the images, but existing x-ray imaging provides time-resolved measurements while the neutron images are time-integrated. Detailed comparisons of the x-ray and neutron images can provide information on the fuel assembly, but these studies have been limited because the implosions are not azimuthally symmetric and the images are collected along different LOS. We have developed a conceptual design of a time-integrated x-ray imaging system that could be added to the existing neutron imaging LOS. This new system would allow these detailed studies, providing important information on the fuel assembly of future implosions. Here we present this conceptual design and the expected performance characteristics.

  7. Blind students "see" math through touch. How would this work in a classroom?

    E-Print Network [OSTI]

    ://research.vuse.vanderbilt.edu/MEDLab/index.htm Nitinol tube under deformation After bending: no permanent deformation Grid/Point Study with Blind

  8. Blind node in peach: environmental and genetic parameters 

    E-Print Network [OSTI]

    Boonprakob, Unaroj

    1991-01-01

    . 61 4. 2 The regression between the section parameter and the percentage of blind nodes of the selected peach genotypes . 62 5. 1 The procedure of Safranin-Fast Green staining used in the anatomical study. . 79 5. 2 Transverse section of 'Earli... for the observation in 1989. These cultivars were at Texas A&M University farm, College Station (CS); and at Texas Agricultural Experiment Station, Yoakum (YM). Two cultivars: 'Flordaprince' and 'EarliGrande, ' at a private orchard in Weslaco (WS) were also...

  9. Dear Patient: Dear Patient

    E-Print Network [OSTI]

    Kunkle, Tom

    the right to: q Obtain a copy of this notice of information of practices upon request q Inspect and request health information by alternative means to other providers We reserve the right to change our practicesDear Patient: Dear Patient: This notice describes how information about you may be used

  10. Turkey Flat Site Effects Test Area The Turkey-Flat strong motion "blind"

    E-Print Network [OSTI]

    Oprsal, Ivo

    Turkey Flat Site Effects Test Area B B' A A' C C' The Turkey-Flat strong motion "blind" prediction Geological Survey Turkey Flat, USA Site Effects Test Area: "Blind" Test of Predicted Ground Response of a Shallow Stiff-Soil Site to the September 28, 2004 M6.0 Parkfield Earthquake Turkey Flat Working Group Stay

  11. Natural Kinds and Induction in the Special [Author Suppressed for Blind Review

    E-Print Network [OSTI]

    Nickel, Bernhard

    Natural Kinds and Induction in the Special Sciences [Author Suppressed for Blind Review] March 10 to investigate concerns a contrast [Acknowledgments suppressed for blind review.] 1See, e.g., Boyd (1988, 1991 conditions is it appropriate to infer that this is so on the basis of the knowledge that a non

  12. Radio self-interference cancellation by transmit beamforming, all-analog cancellation and blind digital tuning$

    E-Print Network [OSTI]

    Hua, Yingbo

    Radio self-interference cancellation by transmit beamforming, all-analog cancellation and blind September 2014 Accepted 17 September 2014 Available online 28 September 2014 Keywords: Radio self-interference cancellation Full-duplex radio Transmit beamforming Receive beamforming All-analog cancellation Blind digital

  13. Zero-Entropy Minimization for Blind Extraction of Bounded Sources (BEBS)

    E-Print Network [OSTI]

    Verleysen, Michel

    Zero-Entropy Minimization for Blind Extraction of Bounded Sources (BEBS) Fr´ed´eric Vrins1 , Deniz, we focus on zero-order Renyi's entropy minimization for the blind extraction of bounded sources (BEBS in the context of BEBS, when the sources have non-convex supports. 1 Introduction Shannon's entropy is a powerful

  14. Fast Monotonic Blind Deconvolution Algorithm for Constrained TV Based Image Restoration

    E-Print Network [OSTI]

    Lu, Wu-Sheng

    Fast Monotonic Blind Deconvolution Algorithm for Constrained TV Based Image Restoration Haiying Liu Kong, P. R. China Abstract--A new fast monotonic blind deconvolution algo- rithmic method. Specifically, the monotone fast iterative shrinkage/thresholding algorithm (MFISTA) combined with the fast

  15. Visual Information Assist System Using 3D SOKUIKI Sensor for Blind People

    E-Print Network [OSTI]

    Ohya, Akihisa

    Visual Information Assist System Using 3D SOKUIKI Sensor for Blind People ­ System Concept'ich YUTA1 1Inteligent Robot Laboratory, University of Tsukuba {t irregular ground. Another ap- proach is to develop an intelligent blind stick which has sensors to help

  16. A VISION SYSTEM FOR PROVIDING THE BLIND WITH 3D COLOUR PERCEPTION OF THE ENVIRONMENT

    E-Print Network [OSTI]

    Ward, Koren

    are attempting to develop bionic vision for the blind, see [1], [2] and [3]. This is comprised of artificial electrodes. The only commercially available artificial vision implant, at present, is the Dobelle Implant [4A VISION SYSTEM FOR PROVIDING THE BLIND WITH 3D COLOUR PERCEPTION OF THE ENVIRONMENT SIMON MEERS

  17. DTorial: An interactive tutorial framework for blind users in a Web 2.0 world

    E-Print Network [OSTI]

    Karahalios, Karrie G.

    DTorial: An interactive tutorial framework for blind users in a Web 2.0 world Joshua Hailpern1 to new Web- Applications. Keywords: Tutorial, Help Systems, Web 2.0, Screen Reader, Blind, Visually such a mental model is a time consuming process. This process is complicated by industry's adoption of Web 2.0

  18. On Jacobi-type methods for blind equalization of paraunitary channels

    E-Print Network [OSTI]

    On Jacobi-type methods for blind equalization of paraunitary channels Mikael Sørensen a,Ã, Lieven deconvolution Tensors Jacobi method a b s t r a c t In this paper a study of the cumulant-based blind algorithms both consist of a Jacobi-type iteration where the Jacobi subproblem is solved by a computationally

  19. A New Frequency Domain Method for Blind Source Separation of Convolutive Audio

    E-Print Network [OSTI]

    Reilly, James P.

    of Electrical & Computer Engineering McMaster University, 1280 Main St. W, Hamilton, Ontario, Canada L8S 4K11 A New Frequency Domain Method for Blind Source Separation of Convolutive Audio Mixtures Kamran to blind source separation (BSS) of audio signals mixed in a reverberant environment. It is first shown

  20. No end in sight for nuclear squabble The decision on a site for a controversial nuclear fusion project has been delayed

    E-Print Network [OSTI]

    No end in sight for nuclear squabble The decision on a site for a controversial nuclear fusion supply, and fusion reactors would not produce fissile materials that could be used in nuclear weapons, with green groups pointing out that in 1950 scientists working on nuclear fusion said they needed another 50

  1. A HUBBLE SPACE TELESCOPE/COSMIC ORIGINS SPECTROGRAPH SEARCH FOR WARM-HOT BARYONS IN THE Mrk 421 SIGHT LINE

    SciTech Connect (OSTI)

    Danforth, Charles W.; Stocke, John T.; Keeney, Brian A.; Penton, Steven V.; Shull, J. Michael; Yao Yangsen; Green, James C., E-mail: danforth@colorado.edu [CASA, Department of Astrophysical and Planetary Sciences, University of Colorado, 389-UCB, Boulder, CO 80309 (United States)

    2011-12-10

    Thermally broadened Ly{alpha} absorbers (BLAs) offer an alternate method to using highly ionized metal absorbers (O VI, O VII, etc.) to probe the warm-hot intergalactic medium (WHIM, T = 10{sup 5}-10{sup 7} K). Until now, WHIM surveys via BLAs have been no less ambiguous than those via far-UV and X-ray metal-ion probes. Detecting these weak, broad features requires background sources with a well-characterized far-UV continuum and data of very high quality. However, a recent Hubble Space Telescope/Cosmic Origins Spectrograph (COS) observation of the z = 0.03 blazar Mrk 421 allows us to perform a metal-independent search for WHIM gas with unprecedented precision. The data have high signal-to-noise ratio (S/N Almost-Equal-To 50 per {approx}20 km s{sup -1} resolution element) and the smooth, power-law blazar spectrum allows a fully parametric continuum model. We analyze the Mrk 421 sight line for BLA absorbers, particularly for counterparts to the proposed O VII WHIM systems reported by Nicastro et al. based on Chandra/Low Energy Transmission Grating observations. We derive the Ly{alpha} profiles predicted by the X-ray observations. The S/N of the COS data is high (S/N Almost-Equal-To 25 pixel{sup -1}), but much higher S/N can be obtained by binning the data to widths characteristic of the expected BLA profiles. With this technique, we are sensitive to WHIM gas over a large (N{sub H}, T) parameter range in the Mrk 421 sight line. We rule out the claimed Nicastro et al. O VII detections at their nominal temperatures (T {approx} 1-2 Multiplication-Sign 10{sup 6} K) and metallicities (Z = 0.1 Z{sub Sun }) at {approx}> 2{sigma} level. However, WHIM gas at higher temperatures and/or higher metallicities is consistent with our COS non-detections.

  2. Using blind source separation techniques to improve speech recognition in bilateral cochlear implant patients

    E-Print Network [OSTI]

    Kokkinakis, Kostas; Loizou, Philipos C.

    2008-06-05

    Bilateral cochlear implants seek to restore the advantages of binaural hearing by improving access to binaural cues. Bilateral implant users are currently fitted with two processors, one in each ear, operating independent ...

  3. Kinemetry: a generalisation of photometry to the higher moments of the line-of-sight velocity distribution

    E-Print Network [OSTI]

    Davor Krajnovic; Michele Cappellari; P. Tim de Zeeuw; Yannick Copin

    2005-12-07

    We present a generalisation of surface photometry to the higher-order moments of the line-of-sight velocity distribution of galaxies observed with integral-field spectrographs. The generalisation follows the approach of surface photometry by determining the best fitting ellipses along which the profiles of the moments can be extracted and analysed by means of harmonic expansion. The assumption for the odd moments (e.g. mean velocity) is that the profile along an ellipse satisfies a simple cosine law. The assumption for the even moments (e.g velocity dispersion) is that the profile is constant, as it is used in surface photometry. We find that velocity profiles extracted along ellipses of early-type galaxies are well represented by the simple cosine law (with 2% accuracy), while possible deviations are carried in the fifth harmonic term which is sensitive to the existence of multiple kinematic components, and has some analogy to the shape parameter of photometry. We compare the properties of the kinematic and photometric ellipses and find that they are often very similar. Finally, we offer a characterisation of the main velocity structures based only on the kinemetric parameters which can be used to quantify the features in velocity maps (abridged).

  4. HST/COS OBSERVATIONS OF GALACTIC HIGH-VELOCITY CLOUDS: FOUR ACTIVE GALACTIC NUCLEUS SIGHT LINES THROUGH COMPLEX C

    SciTech Connect (OSTI)

    Shull, J. Michael; Stevans, Matthew; Danforth, Charles; Penton, Steven V. [CASA, Department of Astrophysical and Planetary Sciences, University of Colorado, 389-UCB, Boulder, CO 80309 (United States); Lockman, Felix J. [National Radio Astronomy Observatory, Green Bank, WV 29444 (United States); Arav, Nahum, E-mail: michael.shull@colorado.edu, E-mail: matthew.stevans@colorado.edu, E-mail: charles.danforth@colorado.edu, E-mail: steven.penton@colorado.edu, E-mail: jlockman@nrao.edu, E-mail: arav@vt.edu [Department of Physics, Virginia Tech, Blacksburg, VA 24061 (United States)

    2011-10-01

    We report ultraviolet spectra of Galactic high-velocity clouds (HVCs) in Complex C, taken by the Cosmic Origins Spectrograph (COS) on the Hubble Space Telescope (HST), together with new 21 cm spectra from the Green Bank Telescope. The wide spectral coverage and higher signal-to-noise ratio, compared to previous HST spectra, provide better velocity definition of the HVC absorption, additional ionization species (including high ions), and improved abundances in this halo gas. Complex C has a metallicity of 10%-30% solar and a wide range of ions, suggesting dynamical and thermal interactions with hot gas in the Galactic halo. Spectra in the COS medium-resolution G130M (1133-1468 A) and G160M (1383-1796 A) gratings detect ultraviolet absorption lines from eight elements in low-ionization states (O I, N I, C II, S II, Si II, Al II, Fe II, P II) and three elements in intermediate- and high-ionization states (Si III, Si IV, C IV, N V). Our four active galactic nucleus sight lines toward Mrk 817, Mrk 290, Mrk 876, and PG 1259+593 have high-velocity H I and O VI column densities, log N{sub Hi}= 19.39-20.05 and log N{sub Ovi}= 13.58-14.10, with substantial amounts of kinematically associated photoionized gas. The high-ion abundance ratios are consistent with cooling interfaces between photoionized and collisionally ionized gas: N(C IV)/N(O VI) {approx} 0.3-0.5, N(Si IV)/N(O VI) {approx} 0.05-0.11, N(N V)/N(O VI) {approx} 0.07-0.13, and N(Si IV)/N(Si III) {approx}0.2.

  5. Line-of-Sight Reddening Predictions: Zero Points, Accuracies, the Interstellar Medium, and the Stellar Populations of Elliptical Galaxies

    E-Print Network [OSTI]

    David Burstein

    2003-08-04

    Revised (B-V)_0-Mg_2 data for 402 elliptical galaxies are given to test reddening predictions which can also tell us both what the intrinsic errors are in this relationship among gE galaxy stellar populations, as well as details of nearby structure in the interstellar medium (ISM) of our Galaxy and of the intrinsic errors in reddening predictions. Using least-squares fits, the explicit 1-sigma errors in the Burstein-Heiles (BH) and the Schlegel et al. (IR) predicted reddenings are calculated, as well as the 1-sigma observational error in the (B-V)_0-Mg_2 for gE galaxies. It is found that, in directions with E(B-V)= 0.100 mag, significantly better than those of the BH predictions (0.024-0.025). Gas-to-dust variations that vary by a factor of 3, both high and low, exist along many lines-of-sight in our Galaxy. The approx 0.02 higher reddening zero point in E(B-V) previously determined by Schlegel et al. is confirmed, primarily at the Galactic poles. Despite this, both methods also predict many directions with E(B-V)<0.015 mag. Independent evidence of reddening at the North Galactic pole is reviewed, with the conclusion that there still exists directions at the NGP that have E(B-V)<<0.01. Two lines of evidence suggest that IR reddenings are overpredicted in directions with high gas-to-dust ratios. As high gas-to-dust directions in the ISM also include the Galactic poles, this overprediction is the likely cause of the E(B-V) = 0.02 mag larger IR reddening zero point.

  6. A FOURTH H I 21 cm ABSORPTION SYSTEM IN THE SIGHT LINE OF MG J0414+0534: A RECORD FOR INTERVENING ABSORBERS

    SciTech Connect (OSTI)

    Tanna, A.; Webb, J. K.; Curran, S. J.; Whiting, M. T.; Bignell, C.

    2013-08-01

    We report the detection of a strong H I 21 cm absorption system at z = 0.5344, as well as a candidate system at z = 0.3389, in the sight line toward the z = 2.64 quasar MG J0414+0534. This, in addition to the absorption at the host redshift and the other two intervening absorbers, takes the total to four (possibly five). The previous maximum number of 21 cm absorbers detected along a single sight line is two and so we suspect that this number of gas-rich absorbers is in some way related to the very red color of the background source. Despite this, no molecular gas (through OH absorption) has yet been detected at any of the 21 cm redshifts, although, from the population of 21 cm absorbers as a whole, there is evidence for a weak correlation between the atomic line strength and the optical-near-infrared color. In either case, the fact that so many gas-rich galaxies (likely to be damped Ly{alpha} absorption systems) have been found along a single sight line toward a highly obscured source may have far-reaching implications for the population of faint galaxies not detected in optical surveys, a possibility which could be addressed through future wide-field absorption line surveys with the Square Kilometer Array.

  7. Wearable-assisted social interaction as assistive technology for the blind

    E-Print Network [OSTI]

    Hayden, David S. (David Scott)

    2014-01-01

    This work presents an end-to-end wearable system designed to learn and assist its (potentially blind) wearers with daily social interactions. In particular, it visually identifies nearby acquaintances and provides timely, ...

  8. BLIND SEPARATION OF SECOND-ORDER NONSTATIONARY AND TEMPORALLY COLORED SOURCES

    E-Print Network [OSTI]

    Cichocki, Andrzej

    , Algeria belouchrani@hotmail.com ABSTRACT This paper presents a method of blind source separation´Øµ is the additive noise vector that is statistically indepen- dent of ״ص. A variety of methods/algorithms for BSS

  9. Of Mice, Cattle, and Humans: The Immunology and Treatment of River Blindness

    E-Print Network [OSTI]

    Allen, Judith

    Review Of Mice, Cattle, and Humans: The Immunology and Treatment of River Blindness Judith E. Allen and Onchocerca ochengi in cattle are placed in the context of how these models can advance our ability to control

  10. A SUBSPACE METHOD FOR THE BLIND IDENTIFICATION OF MULTIPLE TIME-VARYING FIR CHANNELS

    E-Print Network [OSTI]

    Champagne, Benoît

    Champagne, Amr El-Keyi and Chao-Cheng Tu Department of Electrical & Computer Engineering, McGill University University, Giza, Egypt. Despite the limitations imposed by TV channel conditions on the performance of blind

  11. Wildlife Photography for Fun and Profit: Constructing and Installing Wildlife Photography Blinds 

    E-Print Network [OSTI]

    Phillips, Miles

    2006-04-17

    . Occasionally, photographers would like to pho- tograph owls and hawks nesting. This requires an elevated blind. Archery tripod hunting stands work for this. Or, you could construct two or three sec- tions of scaffolding with a portable photo blind on top... in particular. Most photographers want to stay at the ranch or photography site and have the complete outdoor experience?ranch cooking, night sounds (owls, coyotes, paraques, etc.) and stargazing. They want a comfortable bed, a shower, air conditioning...

  12. IEEE TRANSACTIONS ON SIGNAL PROCESSING, VOL. 51, NO. 7, JULY 2003 1905 Bussgang Blind Deconvolution for Impulsive Signals

    E-Print Network [OSTI]

    Douglas, Scott C.

    IEEE TRANSACTIONS ON SIGNAL PROCESSING, VOL. 51, NO. 7, JULY 2003 1905 Bussgang Blind Deconvolution-Gaussian signals. I. INTRODUCTION BLIND deconvolution is a signal processing task that is important for several to appear in the signal processing literature [3]. This algorithm remains quite popular today, having become

  13. High bandwidth-efficiency solar-blind AlGaN Schottky photodiodes with low dark current

    E-Print Network [OSTI]

    High bandwidth-efficiency solar-blind AlGaN Schottky photodiodes with low dark current T. Tut a , N.38Ga0.62N/GaN heterojunction solar-blind Schottky photodetectors with low dark current, high responsivity, and fast pulse response were demonstrated. A five-step microwave compatible fabrication process

  14. 17-Hydroxyprogesterone caproate to prolong pregnancy after preterm rupture of the membranes: early termination of a double-blind, randomized clinical trial

    E-Print Network [OSTI]

    2011-01-01

    of the membranes: early termination of a double-blind,of the membranes: early termination of a double-blind,Because of premature termination, the trial does not have

  15. On the Security of One-Witness Blind Signature Schemes Foteini Baldimtsi and Anna Lysyanskaya

    E-Print Network [OSTI]

    foteini,anna@cs.brown.edu Computer Science Department, Brown University Abstract. Blind signatures have. Therefore, industry leaders such as Microsoft and IBM [35, 42] have been developing, implement- ing in the standard model [14, 3, 24, 28] while some of these have been adapted for practical use by IBM [14]. However

  16. LETTER Communicated by Michael Lewicki Blind Source Separation by Sparse Decomposition in a Signal

    E-Print Network [OSTI]

    Pearlmutter, Barak

    Dictionary Michael Zibulevsky Department of Computer Science, University of New Mexico, Albuquerque, NM 87131, University of New Mexico, Albuquerque, NM 87131, U.S.A. The blind source separation problem is to extract, and possibly corrupted by additive noise (t), x(t) = As(t) + (t). (1.1) We wish to estimate the mixing matrix

  17. Hacking Blind Andrea Bittau, Adam Belay, Ali Mashtizadeh, David Mazi`eres, Dan Boneh

    E-Print Network [OSTI]

    Boneh, Dan

    Hacking Blind Andrea Bittau, Adam Belay, Ali Mashtizadeh, David Mazi`eres, Dan Boneh Stanford. This makes it possible to hack proprietary closed-binary services, or open-source servers manually compiled to find vulnerabilities. Hacking closed-source software is also possible for more motivated attackers

  18. FOURTH-ORDER CONFAC DECOMPOSITION APPROACH FOR BLIND IDENTIFICATION OF UNDERDETERMINED MIXTURES

    E-Print Network [OSTI]

    Paris-Sud XI, Université de

    FOURTH-ORDER CONFAC DECOMPOSITION APPROACH FOR BLIND IDENTIFICATION OF UNDERDETERMINED MIXTURES to the case of third-order derivatives by resorting to a fourth-order CONFAC decomposition. We show how different third-order derivative types can be combined into a single fourth-order CONFAC tensor model

  19. IEEE TRANSACTIONS ON SIGNAL PROCESSING, VOL. 54, NO. 2, FEBRUARY 2006 423 Underdetermined Blind Source Separation

    E-Print Network [OSTI]

    Cichocki, Andrzej

    IEEE TRANSACTIONS ON SIGNAL PROCESSING, VOL. 54, NO. 2, FEBRUARY 2006 423 Underdetermined Blind Source Separation Based on Sparse Representation Yuanqing Li, Shun-Ichi Amari, Fellow, IEEE, Andrzej Cichocki, Member, IEEE, Daniel W. C. Ho, Senior Member, IEEE, and Shengli Xie, Senior Member, IEEE Abstract

  20. Malicious-Client Security in Blind Seer: A Scalable Private DBMS

    E-Print Network [OSTI]

    International Association for Cryptologic Research (IACR)

    Malicious-Client Security in Blind Seer: A Scalable Private DBMS Ben Fisch, Binh Vo, Fernando Krell DBMS that affords both client query privacy and server data protection. It also provides the ability satisfying any query of its choice, thus violating basic security features of any standard DBMS. In sum

  1. Blind Predictions of DNA and RNA Tweezers Experiments with Force and Torque

    E-Print Network [OSTI]

    Dekker, Nynke

    in this paper. HelixMC advances crystallography-derived base-pair level models (BPLMs) to simulate kilobase. These calculations recovered the experimental bending persistence length of dsRNA within the error of the simulations modulus relative to dsDNA. Further blind predictions of helix torsional properties, however, exposed

  2. University of the District of Columbia District of Columbia Drinking Water Blind Taste

    E-Print Network [OSTI]

    District of Columbia, University of the

    University of the District of Columbia District of Columbia Drinking Water Blind Taste Testing University of the District of Columbia Date: May 2005 Prepared for the DC Water Resources Research Institute Funds provided by USGS through the US Department of Interior #12;1 District of Columbia Drinking Water

  3. Tracking @stemxcomet: Teaching Programming to Blind Students via 3D Printing, Crisis Management, and Twitter

    E-Print Network [OSTI]

    Kane, Shaun K.

    r Tracking @stemxcomet: Teaching Programming to Blind Students via 3D Printing, Crisis Management such as 3D printing offer an opportunity for students to write programs that produce tactile objects and suggests future directions for integrating data analysis and 3D printing into programming instruction

  4. IMAGE TAMPERING IDENTIFICATION USING BLIND DECONVOLUTION Ashwin Swaminathan, Min Wu cand K. J. Ray Liu

    E-Print Network [OSTI]

    Liu, K. J. Ray

    IMAGE TAMPERING IDENTIFICATION USING BLIND DECONVOLUTION Ashwin Swaminathan, Min Wu cand K. J. Ray that many tampering operations can be ap- proximated as a combination of linear and non-linear com- ponents. We model the linear part of the tampering process as a filter, and obtain its coefficients using

  5. BLIND SEPARATION OF DELAYED AND SUPERIMPOSED ACOUSTIC SOURCES: LEARNING ALGORITHM AND EXPERIMENTAL STUDY

    E-Print Network [OSTI]

    Cichocki, Andrzej

    Information Systems, Brain Science Institute, RIKEN, JAPAN cia@brain.riken.go.jp ABSTRACT This paper addressesBLIND SEPARATION OF DELAYED AND SUPERIMPOSED ACOUSTIC SOURCES: LEARNING ALGORITHM AND EXPERIMENTAL,sparrowg@engine.chungbuk.ac.kr z Institut de la Communication Parlee/INPG, 46 Av. Felix Viallet, 38301 Grenoble CEDEX, FRANCE

  6. Prediction of visual perceptions with artificial neural networks in a visual prosthesis for the blind

    E-Print Network [OSTI]

    Verleysen, Michel

    Prediction of visual perceptions with artificial neural networks in a visual prosthesis based visual prosthesis in order to restore partial vision to the blind. In this paper, an attempt been published in [1]. We propose to use artificial neural networks (ANNs) for predicting the features

  7. The role of high frequencies in convolutive blind source separation of speech signals

    E-Print Network [OSTI]

    Plumbley, Mark

    The role of high frequencies in convolutive blind source separation of speech signals Maria G load of FD-BSS algorithms, we consider here the role of high frequencies in source separation of speech sig- nals. We show that high frequencies are not as important as low frequencies, This work was funded

  8. Full-waveform static corrections using blind channel identification Robbert van Vossen1

    E-Print Network [OSTI]

    Utrecht, Universiteit

    Full-waveform static corrections using blind channel identification Robbert van Vossen1 and Jeannot for time shifts is generally referred to as residual static corrections, whereas surface to parameterize near-surface perturbations. There- fore, we refer to this method as waveform statics. Important

  9. AN EFFICIENT JACOBI-TYPE ALGORITHM FOR BLIND EQUALIZATION OF PARAUNITARY CHANNELS

    E-Print Network [OSTI]

    AN EFFICIENT JACOBI-TYPE ALGORITHM FOR BLIND EQUALIZATION OF PARAUNITARY CHANNELS Mikael Sørensen of a paraunitary channel. The PA- JOD algorithm applies a Jacobi-type procedure where one of the Jacobi subproblems a 3rd or 24th degree poly- nomial in each of its Jacobi subproblems as will be ex- plained later. Our

  10. Blind Optimization for Exploiting Hardware Dan Knights, Todd Mytkowicz, Peter F. Sweeney,

    E-Print Network [OSTI]

    Mozer, Michael C.

    Blind Optimization for Exploiting Hardware Features Dan Knights, Todd Mytkowicz, Peter F. Sweeney microprocessors. While there has been much work on hardware-aware optimizations, two factors limit their benefit use a simplified model of the hardware (e.g., they may be cache-aware but they may ignore other

  11. TO APPEAR IN JOURNAL OF COMMUNICATIONS AND NETWORKS, 1999 1 An Unsupervised Hybrid Network for Blind

    E-Print Network [OSTI]

    Choi, Seungjin

    ) models arise frequently in digital communication systems, antenna array processing, and biomedical signal processing where multiple sensors are involved. In multiaccess com­ munications, the received signals at an m for Blind Separation of Independent Non­Gaussian Source Signals in Multipath Environment Seungjin CHOI

  12. A Recursive Sparse Blind Source Separation Method and its Application to Correlated Data

    E-Print Network [OSTI]

    Xin, Jack

    process. Applications of BSS include signal analysis and processing of speech, image, and biomedical of source signals from a set of mixture signals with- out knowing the mixing process. Various approaches;1 Introduction Blind source separation (BSS) is a major area of research in signal and image process- ing

  13. TO APPEAR IN JOURNAL OF COMMUNICATIONS AND NETWORKS, 1999 1 An Unsupervised Hybrid Network for Blind

    E-Print Network [OSTI]

    Cichocki, Andrzej

    communication systems, antenna array processing, and biomedical signal processing where multiple sensors vector process with its component rep- resenting the mixture of n independent source signals. We assume for Blind Separation of Independent Non-Gaussian Source Signals in Multipath Environment Seungjin CHOI

  14. The DAFT/FADA survey. I.Photometric redshifts along lines of sight to clusters in the z=[0.4,0.9] interval

    SciTech Connect (OSTI)

    Guennou, L.; Adami, C.; Ulmer, M.P.; LeBrun, V.; Durret, F.; Johnston, D.; Ilbert, O.; Clowe, D.; Gavazzi, R.; Murphy, K.; Schrabback, T.; /Leiden Observ. /Fermilab

    2010-08-01

    As a contribution to the understanding of the dark energy concept, the Dark energy American French Team (DAFT, in French FADA) has started a large project to characterize statistically high redshift galaxy clusters, infer cosmological constraints from Weak Lensing Tomography, and understand biases relevant for constraining dark energy and cluster physics in future cluster and cosmological experiments. Aims. The purpose of this paper is to establish the basis of reference for the photo-z determination used in all our subsequent papers, including weak lensing tomography studies. This project is based on a sample of 91 high redshift (z {ge} 0.4), massive ({approx}> 3 x 10{sup 14} M{sub {circle_dot}}) clusters with existing HST imaging, for which we are presently performing complementary multi-wavelength imaging. This allows us in particular to estimate spectral types and determine accurate photometric redshifts for galaxies along the lines of sight to the first ten clusters for which all the required data are available down to a limit of I{sub AB} = 24./24.5 with the LePhare software. The accuracy in redshift is of the order of 0.05 for the range 0.2 {le} z {le} 1.5. We verified that the technique applied to obtain photometric redshifts works well by comparing our results to with previous works. In clusters, photo-z accuracy is degraded for bright absolute magnitudes and for the latest and earliest type galaxies. The photo-z accuracy also only slightly varies as a function of the spectral type for field galaxies. As a consequence, we find evidence for an environmental dependence of the photo-z accuracy, interpreted as the standard used Spectral Energy Distributions being not very well suited to cluster galaxies. Finally, we modeled the LCDCS 0504 mass with the strong arcs detected along this line of sight.

  15. Field imaging spectroscopy and inferring a blind thrust earthquake history from secondary faulting : 1944 San Juan Earthquake, Argentina

    E-Print Network [OSTI]

    Ragona, Daniel Eduardo

    2007-01-01

    of the world where the earthquake hazard related to blindR.S. Yeats (1989). Hidden earthquakes. Sci. Am. 260(6), 48-paleoseismology, and earthquake hazards in the western

  16. To appear in Proc. the 1997 IEEE Workshop on Nonlinear Signal and Image Processing, Michigan, September, 1997. ONLINE BLIND SIGNAL EXTRACTION METHODS EXPLOITING A PRIORI

    E-Print Network [OSTI]

    Thawonmas, Ruck

    , September, 1997. ON­LINE BLIND SIGNAL EXTRACTION METHODS EXPLOITING A PRIORI KNOWLEDGE OF THE PREVIOUSLY extracted several times. One method employs a deflation tech­ nique which eliminates from the mixture. To extract a single source signal, methods for blind equalization or deconvolution problems [17] can be used

  17. Seismicity increase after the construction of the world's tallest building: An active blind fault beneath the Taipei 101

    E-Print Network [OSTI]

    Lin, Cheng-Horng

    be conducted because the safety of the high-rise building in the Taipei basin be comprehensively assessedSeismicity increase after the construction of the world's tallest building: An active blind fault] Seismic activity began to slightly increase during the construction but rose sharply upon the completion

  18. Cascade Neural Networks for Multichannel Blind Deconvolution Seungjin CHOI \\Lambda 1 and Andrzej CICHOCKI \\Lambda\\Lambda

    E-Print Network [OSTI]

    Choi, Seungjin

    Cascade Neural Networks for Multichannel Blind Deconvolution Seungjin CHOI \\Lambda 1 and Andrzej deconvolution/equalization, neural networks, unsupervised learning algorithms. Appeared in Electronics Letters. In this letter, we present an efficient on­line extraction method using cascade neural networks which can extract

  19. IEEE SIGNAL PROCESSING LETTERS, VOL. 9, NO. 8, AUGUST 2002 233 On a New Blind Signal Extraction Algorithm

    E-Print Network [OSTI]

    Cichocki, Andrzej

    IEEE SIGNAL PROCESSING LETTERS, VOL. 9, NO. 8, AUGUST 2002 233 On a New Blind Signal Extraction Algorithm: Different Criteria and Stability Analysis Sergio A. Cruces-Alvarez, Associate Member, IEEE, Andrzej Cichocki, Member, IEEE, and Shun-Ichi Amari, Fellow, IEEE Abstract--In this letter, we consider

  20. Daylighting: Measuring the Performance of Light Shelves and Occupant-Controlled Blinds on a Dimmed Lighting Systems 

    E-Print Network [OSTI]

    Floyd, D. B.; Parker, D. S.

    1998-01-01

    , and poor shading devices (such as opaque blinds). References Floyd, D. B. and D. S. Parker. 1995. "Feld Commissioning of a Daylight-Dimming Lighting System", Proceedings of the 3d European Conference on Energy-Efficient Lighting, pp. 83- 89...

  1. 694 IEEE TRANSACTIONS ON SIGNAL PROCESSING, VOL. 49, NO. 4, APRIL 2001 Blind Source Separation Using Second-Order

    E-Print Network [OSTI]

    694 IEEE TRANSACTIONS ON SIGNAL PROCESSING, VOL. 49, NO. 4, APRIL 2001 Blind Source Separation it for publication was Prof. Bjorn Ottersten. K. Abed-Meraim is with the Signal and Image Processing Department with the assumption that the source signals are cyclostationary. Identifiability and separability criteria based

  2. IEEE TRANSACTIONS ON SPEECH AND AUDIO PROCESSING, VOL. 5, NO. 6, NOVEMBER 1997 515 Multichannel Blind Signal

    E-Print Network [OSTI]

    Giannakis, Georgios

    00014-93-1-0485. This paper was presented in part at the Sixth Digital Signal Processing WorkshopIEEE TRANSACTIONS ON SPEECH AND AUDIO PROCESSING, VOL. 5, NO. 6, NOVEMBER 1997 515 Multichannel Blind Signal Separation and Reconstruction Sanyogita Shamsunder and Georgios B. Giannakis, Fellow, IEEE

  3. IEEE SIGNAL PROCESSING LETTERS, VOL. 9, NO. 8, AUGUST 2002 233 On a New Blind Signal Extraction Algorithm

    E-Print Network [OSTI]

    Cichocki, Andrzej

    , this is the case in biomedical signal processing applications such as electroencephalographicIEEE SIGNAL PROCESSING LETTERS, VOL. 9, NO. 8, AUGUST 2002 233 On a New Blind Signal Extraction Brain Signal Processing, Brain Science Institute, Riken, Japan, and also with the Department

  4. 646 IEEE TRANSACTIONS ON BIOMEDICAL ENGINEERING, VOL. 56, NO. 3, MARCH 2009 Sequential Blind Source Extraction For

    E-Print Network [OSTI]

    Paris-Sud XI, Université de

    , France. S. Sanei is with the Center of Digital Signal Processing, Cardiff University, Cardiff 44000, U646 IEEE TRANSACTIONS ON BIOMEDICAL ENGINEERING, VOL. 56, NO. 3, MARCH 2009 Sequential Blind Source Extraction For Quasi-Periodic Signals With Time-Varying Period Thato Tsalaile , Member, IEEE, Reza Sameni

  5. IEEE TRANSACTIONS ON IMAGE PROCESSING, VOL. 18, NO. 4, APRIL 2009 753 Variational Bayesian Sparse Kernel-Based Blind

    E-Print Network [OSTI]

    Likas, Aristidis

    this BID methodology to previous ones using both simulated and real data. Index Terms--Bayesian approach a new Bayesian model for the blind image deconvolution (BID) problem. The main novelty of this model PSF shape and support. In the herein proposed approach, a robust model of the BID errors and an image

  6. Topical Hyaluronic Acid vs. Standard of Care for the Prevention of Radiation Dermatitis After Adjuvant Radiotherapy for Breast Cancer: Single-Blind Randomized Phase III Clinical Trial

    SciTech Connect (OSTI)

    Pinnix, Chelsea; Perkins, George H.; Strom, Eric A.; Tereffe, Welela; Woodward, Wendy; Oh, Julia L.; Arriaga, Lisa; Munsell, Mark F.; Kelly, Patrick; Hoffman, Karen E.; Smith, Benjamin D.; Buchholz, Thomas A.; Yu, T. Kuan

    2012-07-15

    Purpose: To determine the efficacy of an emulsion containing hyaluronic acid to reduce the development of {>=}Grade 2 radiation dermatitis after adjuvant breast radiation compared with best supportive care. Methods and Materials: Women with breast cancer who had undergone lumpectomy and were to receive whole-breast radiotherapy to 50 Gy with a 10- to 16-Gy surgical bed boost were enrolled in a prospective randomized trial to compare the effectiveness of a hyaluronic acid-based gel (RadiaPlex) and a petrolatum-based gel (Aquaphor) for preventing the development of dermatitis. Each patient was randomly assigned to use hyaluronic acid gel on the medial half or the lateral half of the irradiated breast and to use the control gel on the other half. Dermatitis was graded weekly according to the Common Terminology Criteria v3.0 by the treating physician, who was blinded as to which gel was used on which area of the breast. The primary endpoint was development of {>=}Grade 2 dermatitis. Results: The study closed early on the basis of a recommendation from the Data and Safety Monitoring Board after 74 of the planned 92 patients were enrolled. Breast skin treated with the hyaluronic acid gel developed a significantly higher rate of {>=}Grade 2 dermatitis than did skin treated with petrolatum gel: 61.5% (40/65) vs. 47.7% (31/65) (p = 0.027). Only 1ne patient developed Grade 3 dermatitis using either gel. A higher proportion of patients had worse dermatitis in the breast segment treated with hyaluronic acid gel than in that treated with petrolatum gel at the end of radiotherapy (42% vs. 14%, p = 0.003). Conclusion: We found no benefit from the use of a topical hyaluronic acid-based gel for reducing the development of {>=}Grade 2 dermatitis after adjuvant radiotherapy for breast cancer. Additional studies are needed to determine the efficacy of hyaluronic acid-based gel in controlling radiation dermatitis symptoms after they develop.

  7. Double-blind test program for astrometric planet detection with Gaia

    E-Print Network [OSTI]

    Casertano, S; Sozzetti, A; Spagna, A; Jancart, S; Morbidelli, R; Pannunzio, R; Pourbaix, D; Queloz, D

    2008-01-01

    We use detailed simulations of the Gaia observations of synthetic planetary systems and develop and utilize independent software codes in double-blind mode to analyze the data, including statistical tools for planet detection and different algorithms for single and multiple Keplerian orbit fitting that use no a priori knowledge of the true orbital parameters of the systems. 1) Planets with astrometric signatures $\\alpha\\simeq 3$ times the single-measurement error $\\sigma_\\psi$ and period $P\\leq 5$ yr can be detected reliably, with a very small number of false positives. 2) At twice the detection limit, uncertainties in orbital parameters and masses are typically $15%-20%$. 3) Over 70% of two-planet systems with well-separated periods in the range $0.2\\leq P\\leq 9$ yr, $2\\leq\\alpha/\\sigma_\\psi\\leq 50$, and eccentricity $e\\leq 0.6$ are correctly identified. 4) Favorable orbital configurations have orbital elements measured to better than 10% accuracy $> 90%$ of the time, and the value of the mutual inclination ...

  8. Double-blind test program for astrometric planet detection with Gaia

    E-Print Network [OSTI]

    S. Casertano; M. G. Lattanzi; A. Sozzetti; A. Spagna; S. Jancart; R. Morbidelli; R. Pannunzio; D. Pourbaix; D. Queloz

    2008-02-04

    We use detailed simulations of the Gaia observations of synthetic planetary systems and develop and utilize independent software codes in double-blind mode to analyze the data, including statistical tools for planet detection and different algorithms for single and multiple Keplerian orbit fitting that use no a priori knowledge of the true orbital parameters of the systems. 1) Planets with astrometric signatures $\\alpha\\simeq 3$ times the single-measurement error $\\sigma_\\psi$ and period $P\\leq 5$ yr can be detected reliably, with a very small number of false positives. 2) At twice the detection limit, uncertainties in orbital parameters and masses are typically $15%-20%$. 3) Over 70% of two-planet systems with well-separated periods in the range $0.2\\leq P\\leq 9$ yr, $2\\leq\\alpha/\\sigma_\\psi\\leq 50$, and eccentricity $e\\leq 0.6$ are correctly identified. 4) Favorable orbital configurations have orbital elements measured to better than 10% accuracy $> 90%$ of the time, and the value of the mutual inclination angle determined with uncertainties $\\leq 10^{\\degr}$. 5) Finally, uncertainties obtained from the fitting procedures are a good estimate of the actual errors. Extrapolating from the present-day statistical properties of the exoplanet sample, the results imply that a Gaia with $\\sigma_\\psi$ = 8 $\\mu$as, in its unbiased and complete magnitude-limited census of planetary systems, will measure several thousand giant planets out to 3-4 AUs from stars within 200 pc, and will characterize hundreds of multiple-planet systems, including meaningful coplanarity tests. Finally, we put Gaia into context, identifying several areas of planetary-system science in which Gaia can be expected to have a relevant impact, when combined with data coming from other ongoing and future planet search programs.

  9. Integrated performance of an automated venetian blind/electric lighting system in a full-scale office environment

    SciTech Connect (OSTI)

    DiBartolomeo, D.L.; Lee, Eleanor; Selkowitz, S.E.; Vine, E.L.

    1998-02-01

    Comprehensive results are presented from a fill-scale testbed of a prototype automated venetian blind lighting system installed in two unoccupied, private offices in Oakland, California. The dynamic system balanced daylight against solar heat gains in real-time, to reduce perimeter zone energy use and to increase comfort. This limited proof-of-concept test was designed to work out practical ''bugs'' and refine design details to increase cost effectiveness and acceptability of this innovative technology for real-world applications. We present results from 14 months of tuning the system design and monitoring energy performance and control system operations. For this southeast-facing office, we found that 1-22% lighting energy savings, 13-28% cooling load reductions, and 13-28% peak cooling load reductions can be achieved by the dynamic system under clear sky and overcast conditions year round, compared to a static, partly closed blind with the same optimized daylighting control system. These energy savings increase if compared to conventional daylighting controls with manually-operated blinds. Monitored data indicated that the control system met design objectives under all weather conditions to within 10% for at least 90% of the year. A pilot human factors study indicated that some of our default control settings should be adjusted to increase user satisfaction. With these adjustments, energy savings will decrease. The final prototype design yielded a 10-year simple payback for this site. If mechanical system downsizing opportunities and qualitative improvements to worker's comfort are included, this innovative technology could be more cost effective. Marketing information for commercializing this technology is given.

  10. To appear in Proc. the 1997 IEEE Workshop on Nonlinear Signal and Image Processing, Michigan, September, 1997. ON-LINE BLIND SIGNAL EXTRACTION METHODS EXPLOITING A PRIORI

    E-Print Network [OSTI]

    Cichocki, Andrzej

    To appear in Proc. the 1997 IEEE Workshop on Nonlinear Signal and Image Processing, Michigan EXTRACTED SIGNALS Andrzej CICHOCKIy, Ruck THAWONMASy3 , and Shun-ichi AMARIy yBrain Information Processing, September, 1997. ON-LINE BLIND SIGNAL EXTRACTION METHODS EXPLOITING A PRIORI KNOWLEDGE OF THE PREVIOUSLY

  11. DISCOVERY OF NINE GAMMA-RAY PULSARS IN FERMI LARGE AREA TELESCOPE DATA USING A NEW BLIND SEARCH METHOD

    SciTech Connect (OSTI)

    Pletsch, H. J.; Allen, B.; Aulbert, C.; Fehrmann, H.; Guillemot, L.; Kramer, M.; Barr, E. D.; Champion, D. J.; Eatough, R. P.; Freire, P. C. C.; Ray, P. S.; Belfiore, A.; Dormody, M.; Camilo, F.; Caraveo, P. A.; Celik, Oe.; Ferrara, E. C.; Hessels, J. W. T.; Keith, M.; Kerr, M. E-mail: guillemo@mpifr-bonn.mpg.de; and others

    2012-01-10

    We report the discovery of nine previously unknown gamma-ray pulsars in a blind search of data from the Fermi Large Area Telescope (LAT). The pulsars were found with a novel hierarchical search method originally developed for detecting continuous gravitational waves from rapidly rotating neutron stars. Designed to find isolated pulsars spinning at up to kHz frequencies, the new method is computationally efficient and incorporates several advances, including a metric-based gridding of the search parameter space (frequency, frequency derivative, and sky location) and the use of photon probability weights. The nine pulsars have spin frequencies between 3 and 12 Hz, and characteristic ages ranging from 17 kyr to 3 Myr. Two of them, PSRs J1803-2149 and J2111+ 4606, are young and energetic Galactic-plane pulsars (spin-down power above 6 Multiplication-Sign 10{sup 35} erg s{sup -1} and ages below 100 kyr). The seven remaining pulsars, PSRs J0106+4855, J0622+3749, J1620-4927, J1746-3239, J2028+3332, J2030+4415, and J2139+4716, are older and less energetic; two of them are located at higher Galactic latitudes (|b| > 10 Degree-Sign ). PSR J0106+4855 has the largest characteristic age (3 Myr) and the smallest surface magnetic field (2 Multiplication-Sign 10{sup 11} G) of all LAT blind-search pulsars. PSR J2139+4716 has the lowest spin-down power (3 Multiplication-Sign 10{sup 33} erg s{sup -1}) among all non-recycled gamma-ray pulsars ever found. Despite extensive multi-frequency observations, only PSR J0106+4855 has detectable pulsations in the radio band. The other eight pulsars belong to the increasing population of radio-quiet gamma-ray pulsars.

  12. Patients Participate! Literature Review

    E-Print Network [OSTI]

    Rzepa, Henry S.

    Patients Participate! Literature Review Usability and human factors in citizen science projects ..............................................What is a citizen science project?! 4 .................................Human factors in citizen science projects! 6 General factors to be considered when carrying out a citizen science

  13. Though Lost to Sight to Memory Dear 

    E-Print Network [OSTI]

    Jack [writer of accompanying material

    2012-03-05

    TRANSCRIPTION; MESSAGE: Come [and] live here till the war is over. How are you all getting along. Rec'd your nice letter in answer to cable [and] I am anxiously looking forward for more. I have written lots of letters to ...

  14. 08/15/2006 04:41 PM A SWAN to guide blind people | Emerging Technology Trends | ZDNet.com Page 1 of 3http://blogs.zdnet.com/emergingtech/index.php?p=323

    E-Print Network [OSTI]

    ;08/15/2006 04:41 PM» A SWAN to guide blind people | Emerging Technology Trends | ZDNet.com Page 2 of 3http://blogs08/15/2006 04:41 PM» A SWAN to guide blind people | Emerging Technology Trends | ZDNet.com Page 1 of 3http://blogs.zdnet.com/emergingtech/index.php?p=323 Education IT Government IT blogs Emerging

  15. Downloads & Patient Materials - HPMC Occupational Health Services

    Broader source: All U.S. Department of Energy (DOE) Office Webpages (Extended Search)

    Health Education & Wellness > Downloads & Patient Materials Health Education & Wellness Downloads & Patient Materials Ergonomics Fitness & Exercise Men's Health Nutrition Health &...

  16. A Blind Hero 

    E-Print Network [OSTI]

    Bridgewater, G. Thornton [author

    2012-03-05

    aluminium, calcium, iron and some traces of potassium and magnetism. On the other hand, ASHRAE and SAE coarse dust contains carbon and they also consist of mainly silica. SAE fine dust contains aluminium, calcium and traces of potassium. From... such chemical analysis, the ASHRAE dust seems to be the closest to the Kuwaiti dust from silica-content standpoint. However, analysis of the ASHRAE dust does not show any presence of aluminium, calcium and traces of potassium which are found in the Kuwaiti...

  17. Blind Modal ID

    Broader source: All U.S. Department of Energy (DOE) Office Webpages (Extended Search)

    AFDC Printable Version Share this resource Send a link to EERE: Alternative Fuels Data Center Home Page to someone by E-mail Share EERE: Alternative Fuels Data Center Home Page on Facebook Tweet about EERE: Alternative Fuels Data Center Home Page on Twitter Bookmark EERE: Alternative Fuels Data Center Homesum_a_epg0_fpd_mmcf_m.xls" ,"Available from WebQuantity ofkandz-cm11 Outreach Home Room News PublicationsAudits & InspectionsBerylliumBiomimetic DyeResearchProduction Judicial

  18. A Randomized Controlled Trial of Lorazepam to Reduce Liver Motion in Patients Receiving Upper Abdominal Radiation Therapy

    SciTech Connect (OSTI)

    Tsang, Derek S.; Voncken, Francine E.M.; Tse, Regina V.; Sykes, Jenna; Wong, Rebecca K.S.; Dinniwell, Rob E.; Kim, John; Ringash, Jolie; Brierley, James D.; Cummings, Bernard J.; Brade, Anthony; Dawson, Laura A.

    2013-12-01

    Purpose: Reduction of respiratory motion is desirable to reduce the volume of normal tissues irradiated, to improve concordance of planned and delivered doses, and to improve image guided radiation therapy (IGRT). We hypothesized that pretreatment lorazepam would lead to a measurable reduction of liver motion. Methods and Materials: Thirty-three patients receiving upper abdominal IGRT were recruited to a double-blinded randomized controlled crossover trial. Patients were randomized to 1 of 2 study arms: arm 1 received lorazepam 2 mg by mouth on day 1, followed by placebo 4 to 8 days later; arm 2 received placebo on day 1, followed by lorazepam 4 to 8 days later. After tablet ingestion and daily radiation therapy, amplitude of liver motion was measured on both study days. The primary outcomes were reduction in craniocaudal (CC) liver motion using 4-dimensional kV cone beam computed tomography (CBCT) and the proportion of patients with liver motion ?5 mm. Secondary endpoints included motion measured with cine magnetic resonance imaging and kV fluoroscopy. Results: Mean relative and absolute reduction in CC amplitude with lorazepam was 21% and 2.5 mm respectively (95% confidence interval [CI] 1.1-3.9, P=.001), as assessed with CBCT. Reduction in CC amplitude to ?5 mm residual liver motion was seen in 13% (95% CI 1%-25%) of patients receiving lorazepam (vs 10% receiving placebo, P=NS); 65% (95% CI 48%-81%) had reduction in residual CC liver motion to ?10 mm (vs 52% with placebo, P=NS). Patients with large respiratory movement and patients who took lorazepam ?60 minutes before imaging had greater reductions in liver CC motion. Mean reductions in liver CC amplitude on magnetic resonance imaging and fluoroscopy were nonsignificant. Conclusions: Lorazepam reduces liver motion in the CC direction; however, average magnitude of reduction is small, and most patients have residual motion >5 mm.

  19. Medical Technology for Superior Patient

    E-Print Network [OSTI]

    Hayden, Nancy J.

    of electromagnetic interference, hazardous vapors, electrical power, and acoustic noise · Medical device integration organizations focus on providing the highest quality of patient care, while supporting them in their never and repair services on all general biomedical equipment and a variety of specialized systems. However, we go

  20. Quality Assurance: Patient Chart Reviews

    SciTech Connect (OSTI)

    Oginni, B. M. [Department of Physics and Astronomy, Ohio University, Athens, OH 45701 (United States); Odero, D. O. [Raleigh Regional Cancer Center, Beckley, West Virginia 25801 (United States)

    2009-07-06

    Recent developments in radiation therapy have immensely impacted the way the radiation dose is delivered to patients undergoing radiation treatments. However, the fundamental quality assurance (QA) issues underlying the radiation therapy still remain the accuracy of the radiation dose and the radiation safety. One of the major duties of clinical medical physicists in the radiation therapy departments still revolves around ensuring the accuracy of dose delivery to the planning target volume (PTV), the reduction of unintended radiation to normal organs and minimization of the radiation exposure to the medical personnel based on ALARA (as low as reasonably achievable) principle. Many of the errors in radiation therapy can be minimized through a comprehensive program of periodic checks. One of the QA procedures on the patient comes in the form of chart reviews which could be in either electronic or paper-based format. We present the quality assurance procedures that have to be performed on the patient records from the beginning and periodically to the end of the treatment, based on the guidelines from the American Association of Physicists in Medicine (AAPM) and American College of Physicians (ACP)

  1. Oral Mucositis Prevention By Low-Level Laser Therapy in Head-and-Neck Cancer Patients Undergoing Concurrent Chemoradiotherapy: A Phase III Randomized Study

    SciTech Connect (OSTI)

    Gouvea de Lima, Aline; Villar, Rosangela Correa; Castro, Gilberto de; Antequera, Reynaldo; Gil, Erlon; Rosalmeida, Mauro Cabral; Federico, Miriam Hatsue Honda; Snitcovsky, Igor Moises Longo

    2012-01-01

    Purpose: Oral mucositis is a major complication of concurrent chemoradiotherapy (CRT) in head-and-neck cancer patients. Low-level laser (LLL) therapy is a promising preventive therapy. We aimed to evaluate the efficacy of LLL therapy to decrease severe oral mucositis and its effect on RT interruptions. Methods and Materials: In the present randomized, double-blind, Phase III study, patients received either gallium-aluminum-arsenide LLL therapy 2.5 J/cm{sup 2} or placebo laser, before each radiation fraction. Eligible patients had to have been diagnosed with squamous cell carcinoma or undifferentiated carcinoma of the oral cavity, pharynx, larynx, or metastases to the neck with an unknown primary site. They were treated with adjuvant or definitive CRT, consisting of conventional RT 60-70 Gy (range, 1.8-2.0 Gy/d, 5 times/wk) and concurrent cisplatin. The primary endpoints were the oral mucositis severity in Weeks 2, 4, and 6 and the number of RT interruptions because of mucositis. The secondary endpoints included patient-reported pain scores. To detect a decrease in the incidence of Grade 3 or 4 oral mucositis from 80% to 50%, we planned to enroll 74 patients. Results: A total of 75 patients were included, and 37 patients received preventive LLL therapy. The mean delivered radiation dose was greater in the patients treated with LLL (69.4 vs. 67.9 Gy, p = .03). During CRT, the number of patients diagnosed with Grade 3 or 4 oral mucositis treated with LLL vs. placebo was 4 vs. 5 (Week 2, p = 1.0), 4 vs. 12 (Week 4, p = .08), and 8 vs. 9 (Week 6, p = 1.0), respectively. More of the patients treated with placebo had RT interruptions because of mucositis (6 vs. 0, p = .02). No difference was detected between the treatment arms in the incidence of severe pain. Conclusions: LLL therapy was not effective in reducing severe oral mucositis, although a marginal benefit could not be excluded. It reduced RT interruptions in these head-and-neck cancer patients, which might translate into improved CRT efficacy.

  2. TITLE: AUTHORIZATION TO DISCLOSE PATIENT INFORMATION PATIENT ACCESS USE AND DISCLOSURE OF MEDICAL

    E-Print Network [OSTI]

    Columbia University

    TITLE: AUTHORIZATION TO DISCLOSE PATIENT INFORMATION PATIENT ACCESS ­ USE AND DISCLOSURE OF MEDICAL INFORMATION POLICY: All information contained within a patient's medical record will be maintained in a confidential manner to protect the patient's right to confidentiality and comply with City, State and Federal

  3. Frequently Asked Questions about Patient Care Costs And a Quick Guide to Patient Care Costs

    E-Print Network [OSTI]

    Janssen, Michel

    Frequently Asked Questions about Patient Care Costs And a Quick Guide to Patient Care Costs questions regarding human research patient care costs. Human research patient care costs are the costs. The costs of these services normally are assigned to specific research projects through the development

  4. Study Protocol: Phase III single-blinded fast-track pragmatic randomised controlled trial of a complex intervention for breathlessness in advanced disease.

    E-Print Network [OSTI]

    Farquhar, Morag C.; Prevost, A. Toby; McCrone, Paul; Higginson, Irene J.; Gray, Jennifer; Brafman-Kennedy, Barbara; Booth, Sara

    2011-05-20

    at University of Cambridge. Patients are allocated to the fast track group or waiting list group with an equal 1:1 allocation ratio using the method of stratified randomisation, with disease group (malignant, non-malig- nant) as the single stratifier. Patients... peer review • No space constraints or color figure charges • Immediate publication on acceptance • Inclusion in PubMed, CAS, Scopus and Google Scholar • Research which is freely available for redistribution Submit your manuscript at www...

  5. Hiding in Plain Sight: Exploiting Broadcast for Practical Host Anonymity

    SciTech Connect (OSTI)

    Shue, Craig A; Gupta, Prof. Minaxi

    2010-01-01

    Users are being tracked on the Internet more than ever before as Web sites and search engines gather pieces of information sufficient to identify and study their behavior. While many existing schemes provide strong anonymity, they are inappropriate when high bandwidth and low latency are required. In this work, we explore an anonymity scheme for end hosts whose performance makes it possible to have it always on. The scheme leverages the natural grouping of hosts in the same subnet and the universally available broadcast primitive to provide anonymity at line speeds. Our scheme is strongly resistant against all active or passive adversaries as long as they are outside the subnet. Even within the subnet, our scheme provides reasonable resistance against adversaries, providing anonymity that is suitable for common Internet applications.

  6. New Hydropower, Hidden in Plain Sight | Department of Energy

    Broader source: Energy.gov (indexed) [DOE]

    AFDC Printable Version Share this resource Send a link to EERE: Alternative Fuels Data Center Home Page to someone by E-mail Share EERE: Alternative Fuels Data Center Home Page on Facebook Tweet about EERE: Alternative Fuels Data Center Home Page on Twitter Bookmark EERE: Alternative Fuels Data Center Homesum_a_epg0_fpd_mmcf_m.xls" ,"Available from WebQuantity of Natural GasAdjustmentsShirleyEnergyTher i nAand DOEDepartment ofProgramImportsEnergyForecastingNew Hampshire.<New

  7. Inexpensive handheld tests for diseases are in sight

    Broader source: All U.S. Department of Energy (DOE) Office Webpages (Extended Search)

    AFDC Printable Version Share this resource Send a link to EERE: Alternative Fuels Data Center Home Page to someone by E-mail Share EERE: Alternative Fuels Data Center Home Page on Facebook Tweet about EERE: Alternative Fuels Data Center Home Page on Twitter Bookmark EERE: Alternative Fuels Data Center Homesum_a_epg0_fpd_mmcf_m.xls" ,"Available from WebQuantity ofkandz-cm11 Outreach Home Room NewsInformation CurrentHenry Bellamy,ImpactScientific andIndividualEventInexpensive handheld

  8. Environmental Management Scientist Sets His Sights on Mars | Department of

    Broader source: Energy.gov (indexed) [DOE]

    AFDC Printable Version Share this resource Send a link to EERE: Alternative Fuels Data Center Home Page to someone by E-mail Share EERE: Alternative Fuels Data Center Home Page on Facebook Tweet about EERE: Alternative Fuels Data Center Home Page on Twitter Bookmark EERE: Alternative Fuels Data Center Homesum_a_epg0_fpd_mmcf_m.xls" ,"Available from WebQuantity of Natural GasAdjustmentsShirley Ann JacksonDepartment ofOffice ofofWind ProjectsEfficiencyPreparedKYA trainedof

  9. Developing Scales to Evaluate Staff Perception of the Effects of the Physical Environment on Patient Comfort, Patient Safety, Patient Privacy, Family Integration With Patient Care, and Staff Working Conditions in Adult Intensive Care Units: A Pilot Study

    E-Print Network [OSTI]

    Rashid, Mahbub

    2007-07-01

    Studies suggest that the physical environment can be important for patient comfort, patient safety, patient privacy, family integration with patient care, and staff working condition in adult intensive care units (ICUs). In the absence of any...

  10. Silver Clear Nylon Dressing is Effective in Preventing Radiation-Induced Dermatitis in Patients With Lower Gastrointestinal Cancer: Results From a Phase III Study

    SciTech Connect (OSTI)

    Niazi, Tamim M. [Segal Cancer Centre, Department of Radiation Oncology, Jewish General Hospital, McGill University (Canada)] [Segal Cancer Centre, Department of Radiation Oncology, Jewish General Hospital, McGill University (Canada); Vuong, Te, E-mail: tvuong@jgh.mcgill.ca [Segal Cancer Centre, Department of Radiation Oncology, Jewish General Hospital, McGill University (Canada)] [Segal Cancer Centre, Department of Radiation Oncology, Jewish General Hospital, McGill University (Canada); Azoulay, Laurant [Department of Epidemiology, Jewish General Hospital, McGill University (Canada)] [Department of Epidemiology, Jewish General Hospital, McGill University (Canada); Marijnen, Corrie [Department of Clinical Oncology, Leiden University Medical Center, Amsterdam (Netherlands)] [Department of Clinical Oncology, Leiden University Medical Center, Amsterdam (Netherlands); Bujko, Kryzstof [Department of Radiotherapy, The Maria Sklodowska-Curie Memorial Cancer Centre, Warsaw (Poland)] [Department of Radiotherapy, The Maria Sklodowska-Curie Memorial Cancer Centre, Warsaw (Poland); Nasr, Elie [Department of Radiation Oncology, Hotel-Dieu de France Hospital (Lebanon)] [Department of Radiation Oncology, Hotel-Dieu de France Hospital (Lebanon); Lambert, Christine; Duclos, Marie; Faria, Sergio; David, Marc [Department of Radiation Oncology, Montreal-General-Hospital, McGill University, Montreal (Canada)] [Department of Radiation Oncology, Montreal-General-Hospital, McGill University, Montreal (Canada); Cummings, Bernard [Department of Radiation Oncology, Princess Margaret Hospital, University of Toronto (Canada)] [Department of Radiation Oncology, Princess Margaret Hospital, University of Toronto (Canada)

    2012-11-01

    Purpose: For patients with anal canal and advanced rectal cancer, chemoradiation therapy is a curative modality or an important adjunct to surgery. Nearly all patients treated with chemoradiation experience some degree of radiation-induced dermatitis (RID). Prevention and effective treatment of RID, therefore, is of considerable clinical relevance. The present phase III randomized trial compared the efficacy of silver clear nylon dressing (SCND) with that of standard skin care for these patients. Methods and Materials: A total of 42 rectal or anal canal cancer patients were randomized to either a SCND or standard skin care group. SCND was applied from Day 1 of radiation therapy (RT) until 2 weeks after treatment completion. In the control arm, sulfadiazine cream was applied at the time of skin dermatitis. Printed digital photographs taken 2 weeks prior to, on the last day, and two weeks after the treatment completion were scored by 10 blinded readers, who used the common toxicity scoring system for skin dermatitis. Results: The radiation dose ranged from 50.4 to 59.4 Gy, and there were no differences between the 2 groups. On the last day of RT, when the most severe RID occurs, the mean dermatitis score was 2.53 (standard deviation [SD], 1.17) for the standard and 1.67 (SD, 1.2; P=.01) for the SCND arm. At 2 weeks after RT, the difference was 0.39 points in favor of SCND (P=.39). There was considerable intraclass correlation among the 10 observers. Conclusions: Silver clear nylon dressing is effective in reducing RID in patients with lower gastrointestinal cancer treated with combined chemotherapy and radiation treatment.

  11. SU-E-J-261: Statistical Analysis and Chaotic Dynamics of Respiratory Signal of Patients in BodyFix

    SciTech Connect (OSTI)

    Michalski, D; Huq, M; Bednarz, G; Lalonde, R; Yang, Y; Heron, D [University of Pittsburgh Medical Center, Pittsburgh, PA (United States)

    2014-06-01

    Purpose: To quantify respiratory signal of patients in BodyFix undergoing 4DCT scan with and without immobilization cover. Methods: 20 pairs of respiratory tracks recorded with RPM system during 4DCT scan were analyzed. Descriptive statistic was applied to selected parameters of exhale-inhale decomposition. Standardized signals were used with the delay method to build orbits in embedded space. Nonlinear behavior was tested with surrogate data. Sample entropy SE, Lempel-Ziv complexity LZC and the largest Lyapunov exponents LLE were compared. Results: Statistical tests show difference between scans for inspiration time and its variability, which is bigger for scans without cover. The same is for variability of the end of exhalation and inhalation. Other parameters fail to show the difference. For both scans respiratory signals show determinism and nonlinear stationarity. Statistical test on surrogate data reveals their nonlinearity. LLEs show signals chaotic nature and its correlation with breathing period and its embedding delay time. SE, LZC and LLE measure respiratory signal complexity. Nonlinear characteristics do not differ between scans. Conclusion: Contrary to expectation cover applied to patients in BodyFix appears to have limited effect on signal parameters. Analysis based on trajectories of delay vectors shows respiratory system nonlinear character and its sensitive dependence on initial conditions. Reproducibility of respiratory signal can be evaluated with measures of signal complexity and its predictability window. Longer respiratory period is conducive for signal reproducibility as shown by these gauges. Statistical independence of the exhale and inhale times is also supported by the magnitude of LLE. The nonlinear parameters seem more appropriate to gauge respiratory signal complexity since its deterministic chaotic nature. It contrasts with measures based on harmonic analysis that are blind for nonlinear features. Dynamics of breathing, so crucial for 4D-based clinical technologies, can be better controlled if nonlinear-based methodology, which reflects respiration characteristic, is applied. Funding provided by Varian Medical Systems via Investigator Initiated Research Project.

  12. Table of Contents Free Patient Parking 1

    E-Print Network [OSTI]

    Chapman, Michael S.

    southeast of the first floor entrance. "The Smart Park meters will be covered in our patient parking area has been a series of "best days ever!" Whether the upbeat, energetic Fremont bridge group leader

  13. Perioperative care of a patient with stroke

    E-Print Network [OSTI]

    Veenith, Tonny; Din, Asmat H.; Eaton, Danielle M. J.; Burnstein, Rowan M.

    2010-11-20

    -optimization is desirable in patients undergoing elective procedures. Following a stroke or TIA all rele- vant secondary prevention strategies should be addressed as per the latest American Heart Association (AHA)/American Stroke Association (ASA) guidelines of October 2010...

  14. Orthopedic Correction of Growing Retrognathic Hyperdivergent Patients 

    E-Print Network [OSTI]

    Carrillo, Roberto

    2014-05-13

    The purpose of this prospective study was to determine whether dental intrusion is effective in treating growing retrognathic hyperdivergent patients without negatively affecting the roots and periodontal structures. The ...

  15. Blunt Trauma Patient with Esophageal Perforation

    E-Print Network [OSTI]

    Colak Oray, Nese; Sivrikaya, Semra; Bayram, Basak; Egeli, Tufan; Dicle, Oguz

    2014-01-01

    JA, Viste A. Esophageal perforation: diagnostic work-up andPatient with Esophageal Perforation clinical decision-makingBMJ. 2013;346:f3095. perforation in South of Sweden: results

  16. Imaging informatics for consumer health: Towards a radiology patient portal

    E-Print Network [OSTI]

    Arnold, CW; McNamara, M; El-Saden, S; Chen, S; Taira, RK; Bui, AAT

    2013-01-01

    the patient internet portal? The PatientSite experience. Jhttp://healthit.hhs.gov/ portal/server.pt? open=512&objID=reports via a patient portal: clinical simulations to

  17. Physician-Patient Communication and Physician Satisfaction: Analysis of Physician and Patient Behavioral Characteristics in the Medical Visit

    E-Print Network [OSTI]

    Miller, Tricia Ann

    2015-01-01

    Institute for Health Care Communication, 2001 Excellent2002). Physician-patient communication in the primary carebetween physician communication style and patient attitudes

  18. Elastoplasty: First Experience in 12 Patients

    SciTech Connect (OSTI)

    Urlings, Thijs A. J. Linden, Edwin van der

    2013-04-15

    Percutaneous vertebroplasty with polymethylmethacrylate (PMMA) is used increasingly for pain relief in symptomatic neoplastic or osteoporotic compression fractures. However, restoration of the stiffness of the treated vertebrae might propagate secondary fracture of adjacent vertebrae. Elastoplasty might prevent these secondary fractures. We assessed retrospectively our experience with elastoplasty in 12 patients, focusing on silicone migration. During the period from July 2011 to January 2012, all patients with an indication for vertebroplasty were treated with elastoplasty. The exclusion criterion was the presence of posterior wall defects. Chest computed tomography (CT) scans were performed to evaluate the presence of perivertebral leakage and pulmonary embolism. The prevalence of leakage was compared with the results obtained for vertebroplasty with PMMA reported in the literature. Other complications during the postprocedural period were recorded. Twenty-one vertebral bodies in 12 patients were treated with elastoplasty. Silicone pulmonary emboli were detected on the postprocedural chest CT in 60 % (6/10) of the patients. Leakage to the perivertebral venous plexus was seen in 67 % (14/21) of the treated vertebrae. One major complication occurred: severe, medication-resistant dyspnea developed in one patient with multiple peripheral silicone emboli. This preliminary evidence suggests that VK100 silicone cement should not be used in elastoplasty because of the increased risk of silicone pulmonary embolism, when compared with the use of PMMA, which occurs worldwide. The major technical disadvantage is that the time taken for the VK100 silicone material to achieve its final strength is too long for practical application.

  19. Noise-Enhanced Balance Control in Patients with Diabetes and Patients with Stroke

    E-Print Network [OSTI]

    Collins, James J.

    Noise-Enhanced Balance Control in Patients with Diabetes and Patients with Stroke Attila A with stroke, resulting in diminished motor performance. Recently, it has been shown that input noise can mechanical noise applied to the soles of the feet via vibrating insoles can be used to improve quiet

  20. Introduction Critically ill patients requiring mechanical venti-

    E-Print Network [OSTI]

    Young, Todd

    Introduction Critically ill patients requiring mechanical venti- lation are at significant risk techniques are generally, invasive, labor inten- sive and slow [1, 9]. The culture delay often pro- motes unnecessary antibiotic exposure with an associated increased risk of both subsequent infectious complications

  1. What Lung Cancer Patients Need to Know

    E-Print Network [OSTI]

    Kaski, Samuel

    What Lung Cancer Patients Need to Know About Bone Health A Publication of The Bone and Cancer Foundation #12;Contents THIS PUBLICATION PROVIDES IMPORTANT INFORMATION ABOUT THE RELATIONSHIP BETWEEN LUNG CANCER AND BONE HEALTH. HOW BONE WORKS (PAGE 2). WHAT LUNG CANCER CAN DO TO BONE (PAGE 2). TREATING BONE

  2. Table of Contents Patient Survey 1

    E-Print Network [OSTI]

    Chapman, Michael S.

    professor of biomaterials and biomechanics. AADR research fellowships are designed to encourage dental of Dentistry/Dental Bites May 2008 SOD 2008-09 Budget Submitted By not filling or delaying open faculty Practices School of Dentistry patients say their dental treatment is better explained and better supervised

  3. Longitudinal Medication Usage in Alzheimer Disease Patients

    E-Print Network [OSTI]

    on ChEIs.1,5­8 In addition to ChEIs and memantine, AD patients are likely to be prescribed other examined in detail patterns of cholinesterase inhibitors (ChEIs) and memantine use and explored characteristics on ChEIs/ memantine use over time. Independent variables included measures of function, cognition

  4. Patient-centric Hurricane Evacuation Management System

    E-Print Network [OSTI]

    Cardei, Mihaela

    Patient-centric Hurricane Evacuation Management System Arny Ambrose, Mihaela Cardei, and Ionut--In the United States, there has been a high incidence of hurricanes over the past decade. Before a hurricane investigate the characteristics and challenges associated with hurricane evacuation of health care centers

  5. RESEARCH PATIENT CARE COSTS --NIH(RC)-11 (a) Research patient care costs are the costs of routine and ancillary services provided to patients

    E-Print Network [OSTI]

    Ungerleider, Leslie G.

    RESEARCH PATIENT CARE COSTS -- NIH(RC)-11 (a) Research patient care costs are the costs of routine) Patient care costs shall be computed in a manner consistent with the principles and procedures used by the Medicare Program for determining the part of Medicare reimbursement based on reasonable costs

  6. Measuring the mechanical properties of the respiratory system in patients

    E-Print Network [OSTI]

    Hayden, Nancy J.

    Measuring the mechanical properties of the respiratory system in patients on mechanical ventilators is currently widely performed by measuring pressure and flow delivered by a mechanical ventilator. However, when a patient is partially breathing for themselves, accurate mechanical parameters cannot

  7. Successful management of elderly breast cancer patients treated without radiotherapy

    E-Print Network [OSTI]

    Valassiadou, Kalliope; Morgan, David A. L.; Robertson, John F. R.; Pinder, Sarah E.; Cheung, Kwok-Leung

    2007-06-03

    -three cancers were ER positive and 26 were ER negative. ER status was not recorded in four patients. Forty of the 53 ER positive patients were treated with adju- vant tamoxifen. The median size of the cancers was 19 mm (range 2 mm – 40 mm). Seventeen patients...

  8. Patient position verification using small IMRT fields

    SciTech Connect (OSTI)

    Bol, G. H.; Heide, U. A. van der; Nederveen, A. J.; Kotte, A. N. T. J.; Lagendijk, J. J. W. [Department of Radiotherapy, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht (Netherlands)

    2006-07-15

    A commonly used approach to quantify and minimize patient setup errors is by using electronic portal imaging devices (EPIDs). The position of the tumor can be verified indirectly by matching the bony anatomy to a reference image containing the same structures. In this paper we present two off-line methods for detecting the position of the bony anatomy automatically, even if every single portal image of each segment of an IMRT treatment beam contains insufficient matching information. Extra position verification fields will no longer be necessary, which reduces the total dose to the patient. The first method, the stack matching method (SMM), stacks the portal image of each segment of a beam to a three dimensional (3D) volume, and this volume is subsequently used during the matching phase. The second method [the averaged projection matching method (APMM)], is a simplification of the first one, since the initially created volume is reduced again to a 2D artificial image, which speeds up the matching procedure considerably, without a significant loss of accuracy. Matching is based on normalized mutual information. We demonstrate our methods by comparing them to existing matching routines, such as matching based on the largest segment. Both phantom and patient experiments show that our methods are comparable with the results obtained from standard position verification methods. The matches are verified by means of visual inspection. Furthermore, we show that when a distinct area of 40-60 cm{sup 2} of the EPID is exposed during one treatment beam, both SMM and APMM are able to deliver a good matching result.

  9. ROC analysis in patient specific quality assurance

    SciTech Connect (OSTI)

    Carlone, Marco; MacPherson, Miller; Cruje, Charmainne; Rangel, Alejandra; McCabe, Ryan; Nielsen, Michelle

    2013-04-15

    Purpose: This work investigates the use of receiver operating characteristic (ROC) methods in patient specific IMRT quality assurance (QA) in order to determine unbiased methods to set threshold criteria for {gamma}-distance to agreement measurements. Methods: A group of 17 prostate plans was delivered as planned while a second group of 17 prostate plans was modified with the introduction of random multileaf collimator (MLC) position errors that are normally distributed with {sigma}{approx}{+-}0.5, {+-}1.0, {+-}2.0, and {+-}3.0 mm (a total of 68 modified plans were created). All plans were evaluated using five different {gamma}-criteria. ROC methodology was applied by quantifying the fraction of modified plans reported as 'fail' and unmodified plans reported as 'pass.'Results: {gamma}-based criteria were able to attain nearly 100% sensitivity/specificity in the detection of large random errors ({sigma} > 3 mm). Sensitivity and specificity decrease rapidly for all {gamma}-criteria as the size of error to be detected decreases below 2 mm. Predictive power is null with all criteria used in the detection of small MLC errors ({sigma} < 0.5 mm). Optimal threshold values were established by determining which criteria maximized sensitivity and specificity. For 3%/3 mm {gamma}-criteria, optimal threshold values range from 92% to 99%, whereas for 2%/2 mm, the range was from 77% to 94%. Conclusions: The optimal threshold values that were determined represent a maximized test sensitivity and specificity and are not subject to any user bias. When applied to the datasets that we studied, our results suggest the use of patient specific QA as a safety tool that can effectively prevent large errors (e.g., {sigma} > 3 mm) as opposed to a tool to improve the quality of IMRT delivery.

  10. Can Big Pharma Behavior Change to Benefit Patients?

    SciTech Connect (OSTI)

    Rosenberg, Saul; Chu, Gilbert

    2005-03-09

    Professors Rosenberg and Chu will discuss how the behavior of large pharmaceutical companies can sometimes compromise the needs of patients. The behavior includes strategies for lobbying Congress, exploiting patent law, targeting large consumer markets, creating demand from patients, and influencing physicians. In some cases, this behavior has created ethical and legal problems. The talk will conclude with a discussion of possible ways to encourage changes that will benefit patients.

  11. Handling and Packaging a Potentially Radiologically Contaminated Patient

    Broader source: Energy.gov [DOE]

    The purpose of this procedure is to provide guidance to EMS care providers for properly handling and packaging potentially radiologically contaminated patients.

  12. Psoriasis disease severity affects patient satisfaction with treatment

    E-Print Network [OSTI]

    Korman, Neil J; Zhao, Yang; Lu, Jackie; Tran, Mary Helen

    2015-01-01

    among patients with psoriasis and psoriatic arthritis in thefindings from the National Psoriasis Foundation surveys,J. Mechanism of disease: psoriasis. N Engl J Med. 2009;361(

  13. Adherence to Adalimumab in Patients with Moderate to Severe Psoriasis

    E-Print Network [OSTI]

    2013-01-01

    with Moderate to Severe Psoriasis Cameron West 1 , MD;and relapsing course of psoriasis is often associated withenrolled patients with psoriasis. J Dermatolog Treatment.

  14. An examination of the relationship among patient factors, patient-physician interaction, and utilization of health services in adults with diabetes 

    E-Print Network [OSTI]

    Rivers, Desiree Avia

    2009-05-15

    In this study, patient-physician interaction, patient socio-demographic factors, health literacy, sources of care, and use of diabetes-related health services, were examined to assess the relationships to patients’ satisfaction with the quality...

  15. Acute Thrombotic Mesenteric Ischemia: Primary Endovascular Treatment in Eight Patients

    SciTech Connect (OSTI)

    Gagniere, Johan [CHU Estaing, Digestive Surgery Department (France); Favrolt, Gregory; Alfidja, Agaiecha; Kastler, Adrian; Chabrot, Pascal; Cassagnes, Lucie [EA 3295 Universite d'Auvergne Clermont 1, Radiology B, Centre Hospitalier Universitaire G Montpied (France); Buc, Emmanuel; Pezet, Denis [CHU Estaing, Digestive Surgery Department (France); Boyer, Louis, E-mail: lboyer@chu-clermontferrand.fr [EA 3295 Universite d'Auvergne Clermont 1, Radiology B, Centre Hospitalier Universitaire G Montpied (France)

    2011-10-15

    Introduction: The purpose of this study was to evaluate our experience with initial percutaneous transluminal angioplasty (PTA) {+-} stenting as valuable options in the acute setting. Methods: Between 2003 and 2008, eight patients with abdominal angio-MDCT-scan proven thrombotic AMI benefited from initial PTA {+-} stenting. We retrospectively assessed clinical and radiological findings and their management. Seven patients presented thrombosis of the superior mesenteric artery, and in one patient both mesenteric arteries were occluded. All patients underwent initial PTA and stenting, except one who had balloon PTA alone. One patient was treated by additional in situ thrombolysis. Results: Technical success was obtained in all patients. Three patients required subsequent surgery (37.5%), two of whom had severe radiological findings (pneumatosis intestinalis and/or portal venous gas). Two patients (25%) died: both had NIDD, an ASA score {>=}4, and severe radiologic findings. Satisfactory arterial patency was observed after a follow-up of 15 (range, 11-17) months in five patients who did not require subsequent surgery, four of whom had abdominal guarding but no severe CT scan findings. One patient had an ileocecal stenosis 60 days after the procedure. Conclusions: Initial PTA {+-} stenting is a valuable alternative to surgery for patients with thrombotic AMI even for those with clinical peritoneal irritation signs and/or severe radiologic findings. Early surgery is indicated if clinical condition does not improve after PTA. The decision of a subsequent surgery must be lead by early clinical status reevaluation. In case of underlying atherosclerotic lesion, stenting should be performed after initial balloon dilatation.

  16. The EPILEPSIAE database: An extensive electroencephalography database of epilepsy patients

    E-Print Network [OSTI]

    Timmer, Jens

    The EPILEPSIAE database: An extensive electroencephalography database of epilepsy patients *yz1. In this article we present the EPILEPSIAE database, which was made publicly available in 2012. We illustrate its content and scope. The EPILEPSIAE database provides long-term EEG recordings of 275 patients as well

  17. Lucile Packard Children's Hospital DEPARTMENT OF PATIENT CARE SERVICES

    E-Print Network [OSTI]

    Kay, Mark A.

    . Overview: Caring for a pediatric patient following heart transplantation requires the nurse to have: Management of the Patient Following Heart Transplantation This guideline is intended to provide the nurse following heart transplantation. The bedside nurse must use proper assessment tools in caring

  18. Lucile Packard Children's Hospital DEPARTMENT OF PATIENT CARE SERVICES

    E-Print Network [OSTI]

    Kay, Mark A.

    : Bedside Nursing Management of the Pediatric Patient Requiring ECMO This guideline is intended to provide the nurse with a description of recommended courses of action to address a specific diagnosis needs and responses. Overview: Caring for a pediatric patient on Extracorporeal Membrane Oxygenation

  19. Les documents et les annotations du dossier patient hospitalier

    E-Print Network [OSTI]

    Paris-Sud XI, Université de

    Les documents et les annotations du dossier patient hospitalier Sandra Bringay* , Catherine Barry hospitalier leur permettant de reproduire toutes les pratiques qu'ils réalisent avec le dossier papier. Nous tools for managing the patient record, allowing them to reproduce all the practices they realised

  20. UPDATE ON THE MODERN TREATMENT OF HYPERTENSION IN PATIENTS WITH

    E-Print Network [OSTI]

    Oliver, Douglas L.

    in nine different classes, an estimated 45% of treated patients in the United States remain uncontrolled cardiovascular disorders. To reduce this unacceptably high rate of prior control, most patients will require Cardiac Death and Heart Failure Studies and Awards 8 #12;he incidence of aortic stenosis (AS

  1. IT Services, University of Aberdeen University of Aberdeen website: Accessibility Policy

    E-Print Network [OSTI]

    Neri, Peter

    central web pages have been designed to be accessible to blind, partially sighted or disabled users.opsi.gov.uk/ACTS/acts2001/ukpga_20010010_en_1 WAI standards Our central web pages are constructed in accordance the principles and guidance detailed in the W3C's Web Content Accessibility Guidelines (WCAG) 2.0 ­ www.w3.org

  2. UVOC-MAC: A MAC Protocol for Outdoor Ultraviolet Networks Yiyang Lia, Jianxia Ningb, Zhengyuan Xua, Srikanth V. Krishnamurthyb, Gang Chena

    E-Print Network [OSTI]

    Krishnamurthy, Srikanth

    communications (UVOC) where solar blind and non- line-of-sight operations are attractive. Light beams from UV LED. Index Terms--Optical wireless communications, UV, MAC I. INTRODUCTION Recently, unlicensed ultraviolet be attractive for achieving low cost and high data rate operations. Meanwhile, communications in UV typically do

  3. Psykologiska institutionen www.psychology.su.se vxl 08-16 20 00

    E-Print Network [OSTI]

    Wohlfarth, Barbara

    . Fredrik Åhs, UU 20 13/5 Kogn The Affect Heuristic in Everyday Decision Making. Daniel Västfjäll, LiU 21 20, SU 22 27/5 Perc Do blind people hear better than sighted people? Mats E. Nilsson, SU 22 To 28/5 PSU

  4. INVERSE SCALE SPACE METHODS FOR BLIND DECONVOLUTION

    E-Print Network [OSTI]

    Ferguson, Thomas S.

    the knowledge of the kernel k, the standard way to solve the problem when noise is not present is to solve was supported by DGICYT project MTM2005-07708, Ayudas Estancias 2006 Generalitat Valenciana, DMS-0312222, ACI

  5. Patrizio Campisi, Karen Egiazarian Blind image

    E-Print Network [OSTI]

    Granada, Universidad de

    , USA. Jaakko Astola Institute of Signal Processing, Tampere University of Technology, Tampere, Finland. Karen Egiazarian Institute of Signal Processing, Tampere University of Technology, Tampere, Finland. 0, Tampere University of Technology, Tampere, Finland. Aggelos K. Katsaggelos Department of EECS

  6. Patient Positioning Based on a Radioactive Tracer Implanted in Patients With Localized Prostate Cancer: A Performance and Safety Evaluation

    SciTech Connect (OSTI)

    Kruijf, Willy J.M. de, E-mail: kruijf.de.w@bvi.nl [Institute Verbeeten, Tilburg (Netherlands); Verstraete, Jan [Department of Radiation Oncology, Leuven Cancer Institute, University Hospitals Leuven, Leuven (Belgium)] [Department of Radiation Oncology, Leuven Cancer Institute, University Hospitals Leuven, Leuven (Belgium); Neustadter, David [Navotek Medical Ltd, Yokneam (Israel)] [Navotek Medical Ltd, Yokneam (Israel); Corn, Benjamin W. [Tel Aviv Medical Center, Tel Aviv (Israel)] [Tel Aviv Medical Center, Tel Aviv (Israel); Hol, Sandra; Venselaar, Jack L.M. [Institute Verbeeten, Tilburg (Netherlands)] [Institute Verbeeten, Tilburg (Netherlands); Davits, Rob J.; Wijsman, Bart P. [TweeSteden Hospital, Tilburg (Netherlands)] [TweeSteden Hospital, Tilburg (Netherlands); Van den Bergh, Laura; Budiharto, Tom [Department of Radiation Oncology, Leuven Cancer Institute, University Hospitals Leuven, Leuven (Belgium)] [Department of Radiation Oncology, Leuven Cancer Institute, University Hospitals Leuven, Leuven (Belgium); Oyen, Raymond [Department of Radiology, University Hospitals Leuven, Leuven (Belgium)] [Department of Radiology, University Hospitals Leuven, Leuven (Belgium); Haustermans, Karin [Department of Radiation Oncology, Leuven Cancer Institute, University Hospitals Leuven, Leuven (Belgium)] [Department of Radiation Oncology, Leuven Cancer Institute, University Hospitals Leuven, Leuven (Belgium); Poortmans, Philip M.P. [Institute Verbeeten, Tilburg (Netherlands)] [Institute Verbeeten, Tilburg (Netherlands)

    2013-02-01

    Purpose: To evaluate the performance and safety of a radiation therapy positioning system (RealEye) based on tracking a radioactive marker (Tracer) implanted in patients with localized prostate cancer. Methods and Materials: We performed a single-arm multi-institutional trial in 20 patients. The iridium-192 ({sup 192}Ir)-containing Tracer was implanted in the patient together with 4 standard gold seed fiducials. Patient prostate-related symptoms were evaluated with the International Prostate Symptom Score (IPSS) questionnaire. Computed tomography (CT) was performed for treatment planning, during treatment, and after treatment to evaluate the migration stability of the Tracer. At 5 treatment sessions, cone beam CT was performed to test the positioning accuracy of the RealEye. Results: The Tracer was successfully implanted in all patients. No device or procedure-related adverse events occurred. Changes in IPSS scores were limited. The difference between the mean change in Tracer-fiducial distance and the mean change in fiducial-fiducial distance was -0.39 mm (95% confidence interval [CI] upper boundary, -0.22 mm). The adjusted mean difference between Tracer position according to RealEye and the Tracer position on the CBCT for all patients was 1.34 mm (95% CI upper boundary, 1.41 mm). Conclusions: Implantation of the Tracer is feasible and safe. Migration stability of the Tracer is good. Prostate patients can be positioned and monitored accurately by using RealEye.

  7. Detecting and molecular profiling cancer cells in patients

    E-Print Network [OSTI]

    Peterson, Vanessa M. (Vanessa Marie)

    2013-01-01

    Although tumor cells obtained from human patients by surgical biopsy, image-guided intervention, blood draws or fluid drainage (paracentesis, thoracentesis) are a valuable source for analyzing tumor cells, conventional ...

  8. Observing Healthcare Interior Environments and the Effect on Patient Behavior 

    E-Print Network [OSTI]

    Rice, Courtney R.

    2010-07-14

    and what aspects influence this feeling? II. What are the independent and dependent variables present in the interior environment that effect patient well-being? The results concluded that by adding simple elements to the interior environments of healthcare...

  9. Appointment Scheduling under Patient Preference and No-Show Behavior

    E-Print Network [OSTI]

    Topaloglu, Huseyin

    and managing per capita cost of care; see Berwick et al. (2008) and Institute for Healthcare Improvement (2012. The service provider collects a "revenue" from each patient who shows up and incurs a "service cost

  10. UCSF Confidentiality of Patient, Employee, and University Business Information Agreement

    E-Print Network [OSTI]

    Yamamoto, Keith

    UCSF Confidentiality of Patient, Employee, and University Business Information Agreement UCSF information, including medical information for clinical or research purposes (referred to here collectively as "Confidential Information"), in accordance with state and federal laws and University policy. Laws controlling

  11. An Intelligent Aide for Interpreting a Patient's Dialysis Data Set

    E-Print Network [OSTI]

    Sleeman, Derek

    4-5 hours per session. A haemodialysis machine pumps blood from the patient through a high surface of statistical, data mining [Hand et al, 2001], and theory refinement [Craw & Sleeman, 1990] approaches

  12. Disease marketing and patient coping : a research study

    E-Print Network [OSTI]

    Lau, Hew Mun

    2012-01-01

    BACKGROUND: There is a high prevalence of disease marketing actions in the United States that are targeted towards patients with chronic illness. However, no study has assessed the direct effects of these marketing actions ...

  13. Köebner phenomenon induced by cupping therapy in a psoriasis patient

    E-Print Network [OSTI]

    Yu, Rui-xing; Hui, Yun; Li, Cheng-rang

    2013-01-01

    The pathogenesis of KP in psoriasis and other diseases isto cupping therapy in a psoriasis patient. To our knowledge,R K. The biology of psoriasis. An experimental study of the

  14. Modeling neuroscience patient flow and inpatient bed management

    E-Print Network [OSTI]

    Hiltrop, Jonas

    2014-01-01

    Massachusetts General Hospital (MGH) experiences consistently high demand for its more than 900 inpatient beds. On an average weekday, the hospital admits about 220 patients, with the emergency department (ED) and the ...

  15. Improving surgical patient flow in a congested recovery area

    E-Print Network [OSTI]

    Schwartz, Trevor A

    2012-01-01

    The recent movement in healthcare reform requires hospitals to care for more patients while simultaneously reducing costs. Medical institutions can no longer afford to simply add beds and hire staff to increase capacity. ...

  16. Acroangiodermatitis of Mali in a patient with congenital myopathy

    E-Print Network [OSTI]

    Jindal, Rashmi; De, Dipankar; Dogra, Sunil; Saikia, Uma Nahar; Kanwar, Amrinder J

    2010-01-01

    Kaposi sarcoma. References 1. Mali JW, Kuiper JP, Hamers AA.S, Schuller-Petrovic S, Kerl H. Mali acroangiodermatitis inAcroangiodermatitis of Mali in a patient with congenital

  17. Les annotations pour grer les connaissances du dossier patient

    E-Print Network [OSTI]

    Paris-Sud XI, Université de

    disposent toujours pas d'outils informatiques de gestion du dossier patient hospitalier leur permettant de rencontrées pour relier les outils de soins aux outils de management et de recherche. En effet, d'un côté

  18. Doctor Patient Conversation Around Breast Cancer | GE Global...

    Broader source: All U.S. Department of Energy (DOE) Office Webpages (Extended Search)

    Doctor Patient Conversation Around Breast Cancer Click to email this to a friend (Opens in new window) Share on Facebook (Opens in new window) Click to share (Opens in new window)...

  19. Active and passive coping strategies in chronic pain patients 

    E-Print Network [OSTI]

    Snow-Turek, Andrea Lynn

    1994-01-01

    This study assessed the validity of an active/passive conceptualization of coping in a sample of chronic pain patients (N = 84). The validity of active and passive coping dimensions was supported. The Coping Strategies ...

  20. Risk stratification of ICU patients using arterial blood pressure waveforms

    E-Print Network [OSTI]

    Sridharan, Mathura J

    2013-01-01

    Identifying patients at high risk for adverse events is very important to the practice of clinical medicine. Non-invasive ECG-based methods of risk stratification such as T wave Alterans, Morphological Variability, and ...

  1. Using patient­identifiable data for observational research and audit 

    E-Print Network [OSTI]

    Al-Shahi, Rustam; Warlow, Charles P

    2000-01-01

    Across the world rapid changes in the law, technology, and society are reshaping the way identifiable information about patients is handled. In Britain, doctors' longstanding common law duty of confidentiality to their ...

  2. Cognitive correlates of gray matter abnormalities in adolescent siblings of patients with childhood-onset schizophrenia

    E-Print Network [OSTI]

    2015-01-01

    al. , 2007) that are present in COS patients. These resultsin adolescent siblings of COS patients relate to performanceNon-psychotic relatives of COS patients also show de?cits in

  3. Modeling and Simulation of Nuclear Medicine Patient Service Management in DEVS

    E-Print Network [OSTI]

    Ntaimo, Lewis

    knowledge) DEVS simulation model for nuclear medicine patient service management. The model representsModeling and Simulation of Nuclear Medicine Patient Service Management in DEVS Eduardo P departments. Furthermore, the characteristics of patient and resource management in nuclear medicine make

  4. Acute bronchodilator responsiveness and health outcomes in COPD patients in the UPLIFT trial

    E-Print Network [OSTI]

    2011-01-01

    in COPD patients in the UPLIFT trial Nicola A Hanania 1*† ,in Function with Tiotropium (UPLIFT ® ) trial, patients hadin Function with Tiotropium (UPLIFT ® ) trial was a 4-year

  5. Development and Validation of the Barriers Questionnaire - Juvenile Idiopathic Arthritis, Patient- and Parent-report Measures

    E-Print Network [OSTI]

    Tsai, Michele

    2013-08-31

    Medication adherence among patients with Juvenile Idiopathic Arthritis (JIA) varies widely, suggesting some patients may not benefit fully from their medication regimens. Assessment of adherence barriers would assist ...

  6. Psoriasis patients with a history of malignancy represent an important but overlooked study population

    E-Print Network [OSTI]

    Persad, Paul; Levender, Michelle M; Feldman, Steven R

    2011-01-01

    Commentary: Psoriasis patients with a history of malignancytreatment of moderate to severe psoriasis often requires thethis patient population. Psoriasis is rarely perceived as a

  7. Case report: Fluocinonide-induced perioral dermatitis in a patient with psoriasis

    E-Print Network [OSTI]

    Kosari, Payman; Feldman, Steven R

    2009-01-01

    and or to decrease compliance. Psoriasis patients are oftencorticosteroid therapy in psoriasis. J Am Acad Dermatolin a patient with psoriasis Payman Kosari 1 , Steven R

  8. Development of the NIH Patient-Reported Outcomes Measurement Information System (PROMIS) Gastrointestinal Symptom Scales

    E-Print Network [OSTI]

    2014-01-01

    FUNCTIONAL GI DISORDERS NIH PROMIS GI Symptom Scalesgroup Development of the NIH Patient-Reported OutcomesInstitutes of Health (NIH) Patient-Reported Outcomes

  9. Automatic detection of patient identification and positioning errors in radiotherapy treatment using 3D setup images

    E-Print Network [OSTI]

    Jani, Shyam

    2015-01-01

    A videogrammetric system for automatic patient setup, fastwith an efficient automatic patient safety system. Journalmutual information for automatic multimodality image fusion

  10. Argonne/iBIO Center partnership sets sights on new teaching methods...

    Broader source: All U.S. Department of Energy (DOE) Office Webpages (Extended Search)

    of pressure and combustion using fire syringes to simulate pistons in combustion engines. Photo credit: Mark Lopez, Argonne National Laboratory. Click to enlarge. Science...

  11. Multitarget region tracking based on short-sight modeling of background and color distribution

    E-Print Network [OSTI]

    Mille, Julien

    as well as non-parametric modeling of color statistics, we develop an energy-minimization based approach of color statistics and shapes of objects over time and space [1][2]. Most often, the energy is derived for tracking in real scenes with cluttered backgrounds, where statistical color data is highly scattered

  12. The classical limit of quantum optics: not what it seems at first sight

    E-Print Network [OSTI]

    Yakir Aharonov; Alonso Botero; Shmuel Nussinov; Sandu Popescu; Jeff Tollaksen; Lev Vaidman

    2013-05-01

    What is light and how to describe it has always been a central subject in physics. As our understanding has increased, so have our theories changed: Geometrical optics, wave optics and quantum optics are increasingly sophisticated descriptions, each referring to a larger class of phenomena than its predecessor. But how exactly are these theories related? How and when wave optics reduces to geometric optics is a rather simple problem. Similarly, how quantum optics reduces to wave optics has been considered to be a very simple business as well. It's not so. As we show here the classical limit of quantum optics is a far more complicated issue; it is in fact dramatically more involved and it requires a complete revision of all our intuitions. The revised intuitions can then serve as a guide to finding novel quantum effects.

  13. Towards Mobile OCR: How To Take a Good Picture of a Document Without Sight

    E-Print Network [OSTI]

    Cutter, Michael; Manduchi, Roberto

    2015-01-01

    and cloud-based visual search engine. In Proceedings of the 15th International ACM SIGACCESS Conference on Computers and

  14. Author's personal copy Murchison's first sighting of the Permian, at Vyazniki in 1841

    E-Print Network [OSTI]

    Benton, Michael

    of European Russia and the Urals, but also to attempt to fill the gap between the well-defined Carboniferous, Ulitsa Profsoyuznaya 123, Moscow 117997, Russia c British Geological Survey, Maclean Building the Permian Period in 1841, based on his fieldwork in Russia (Thackray, 1978; Benton, 2003). This was the last

  15. LOS ALAMOS SCIENCE AND TECHNOLOGY MAGAZINE JUNE 2012 1663Making Sense of Sight

    E-Print Network [OSTI]

    Modeling Extreme Materials Antibody Protein Pipeline Killing Killer Asteroids LOS ALAMOS SCIENCE was the mailing address--P. O. Box 1663, Santa Fe, New Mexico.That box number, still part of our address Matters CAN EXASCALE COMPUTING HELP US UNDERSTAND EXTREME MATERIALS? TAMING THE TEMPEST AGRICULTURAL

  16. Integration of angular rate sensors for line of sight stabilization systems 

    E-Print Network [OSTI]

    Loe, Gregory Ross

    1997-01-01

    . THESIS OUTLINE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . II MODELING . . 1. MODELING OF A RATE GYROSCOPE. 2. MODELING OF MHD SENSORS. 3. NOISE POWER SPECTRAL DENSITIES . . . . 4. SPECTRAL FACTORIZATION 5. CHAPTER SUMMARY...-3 5-4 5-5 Rate gyroscope. . Projection of the disk into the ei-ei plane. Bode plot of scaled gyroscope. Bode plot of scaled MHD. Gyroscope noise power spectral density. . MHD noise power spectral density. Block diagram of the sensors and plant...

  17. Evaluation of sight distance as a criterion for prioritizing rail-highway intersections in Texas 

    E-Print Network [OSTI]

    Pecheux, Kelley Klaver

    1993-01-01

    been effective over the years in identifying particularly hazardous rail-highway intersections based on high vehicle volumes, train volumes, and accident histories, and these crossings have been treated or improved. Many of the remaining crossings...

  18. A line-of-sight voice communication system with optoelectric fibers

    E-Print Network [OSTI]

    Yang, Paul L

    2009-01-01

    Recently developed multi-material optoelectric fibers have showed great potential for use as photodetectors [1]. Such light-sensitive fibers are flexible and can be weaved through clothing with a seamless interface. Our ...

  19. No Solution in Sight : the Problem of Protracted Refugee Situations in Africa

    E-Print Network [OSTI]

    Crisp, Jeff

    2003-01-01

    Changing priorities in refugee protection: the Rwandanfrom Tanzania’, New Issues in Refugee Research, No. 53,The Problem of Protracted Refugee Situations in Africa By

  20. On the Relativity in Configuration Space: A Renewed Physics In Sight

    E-Print Network [OSTI]

    Matej Pavsic

    2011-12-09

    The idea that possible configurations of a physical system can be represented as points in a multidimensional configuration space ${\\cal C}$ is explored. The notion of spacetime, without ${\\cal C}$, does not exist in this theory. Spacetime is associated with the degrees of freedom of a chosen single particle within a considered configuration, and is thus a subspace of ${\\cal C}$. Finite dimensional configuration spaces of point particles, and infinite dimensional configuration spaces of branes are considered. Multidimensionality of a configuration space has for a consequence the existence of extra interactions, besides the 4D gravity, both at macroscopic and microscopic scales.

  1. Out of sight but not out of mind: California refocuses on groundwater

    E-Print Network [OSTI]

    Pasternack, Gregory B.

    streams will be lost; and costs will incur from pump- ing irrigation water from deepening water levels-thirds of the state's water supply will be pumped from wells that are tapping into California aquifers. The economic been overtapped soon after powerful turbine pumps were invented in the early 20th century. Extended

  2. Evaluation of design and operating speeds for crest vertical curves with limited sight distance 

    E-Print Network [OSTI]

    Russell, Charles William

    1994-01-01

    are also being considered. A integrated reservoir characterization technique is used to integrate the geological, engineering, and reservoir performance data to describe the reservoir and to develop an appropriate reservoir management plan. We have...

  3. Losing Sight of Ourselves: Applying Durkheim. Giddens, Baudrillard and Vaknin to Reality Television 

    E-Print Network [OSTI]

    Collins, Megan Elizabeth

    2011-02-22

    An application of theory to various reality television shows in order to discuss the emergence and encouragement of the false self in our society is the focus of this work. Toddlers and Tiaras, Hoarders and Sister Wives ...

  4. Losing Sight of Ourselves: A Theoretical Analysis of Reality Television in the United States 

    E-Print Network [OSTI]

    Collins, Megan E

    2014-06-11

    The focus of this research is the emergence and encouragement of the false self in our society and how this is portrayed through four reality television shows: Toddlers and Tiaras, Hoarders, Sister Wives and Catfish: The ...

  5. Multiferroic heroics put instant-on computing in sight > EMC2 News > The

    Broader source: All U.S. Department of Energy (DOE) Office Webpages (Extended Search)

    AFDC Printable Version Share this resource Send a link to EERE: Alternative Fuels Data Center Home Page to someone by E-mail Share EERE: Alternative Fuels Data Center Home Page on Facebook Tweet about EERE: Alternative Fuels Data Center Home Page on Twitter Bookmark EERE: Alternative Fuels Data Center Homesum_a_epg0_fpd_mmcf_m.xls" ,"Available from WebQuantityBonneville Power Administration wouldMass map shines light on77 PAGEMissionStressMove dataKiel7 Site MapMultifamily

  6. ChemCam laser sets its sights on first martian target

    Broader source: All U.S. Department of Energy (DOE) Office Webpages (Extended Search)

    AFDC Printable Version Share this resource Send a link to EERE: Alternative Fuels Data Center Home Page to someone by E-mail Share EERE: Alternative Fuels Data Center Home Page on Facebook Tweet about EERE: Alternative Fuels Data Center Home Page on Twitter Bookmark EERE: Alternative Fuels Data Center Homesum_a_epg0_fpd_mmcf_m.xls" ,"Available from WebQuantity ofkandz-cm11 Outreach Home Room News PublicationsAudits &BradburyMayARM-0501 Marine StratusChemCam all-women'sChemCam

  7. Single line-of-sight dual energy backlighter for mix width experiments

    Office of Scientific and Technical Information (OSTI)

    AFDC Printable Version Share this resource Send a link to EERE: Alternative Fuels Data Center Home Page to someone by E-mail Share EERE: Alternative Fuels Data Center Home Page on Facebook Tweet about EERE: Alternative Fuels Data Center Home Page on Twitter Bookmark EERE: Alternative Fuels Data Center Homesum_a_epg0_fpd_mmcf_m.xls" ,"Available from WebQuantity of NaturalDukeWakefieldSulfateSciTechtail. (Conference)Feedback System in the CERN SPS (Conference) |Hadronturn-by-turn(Journal

  8. Testing the Probability of Clear Line of Sight Models with ARM Observations

    Broader source: All U.S. Department of Energy (DOE) Office Webpages (Extended Search)

    AFDC Printable Version Share this resource Send a link to EERE: Alternative Fuels Data Center Home Page to someone by E-mail Share EERE: Alternative Fuels Data Center Home Page on Facebook Tweet about EERE: Alternative Fuels Data Center Home Page on Twitter Bookmark EERE: Alternative Fuels Data Center Homesum_a_epg0_fpd_mmcf_m.xls" ,"Available from WebQuantityBonneville Power AdministrationRobust,Field-effectWorking With U.S. CoalMexicoConference Tight09/2011a CloudTesting at NRELofthe

  9. Outcome of Patients With Pilocytic Astrocytoma and Leptomeningeal Dissemination

    SciTech Connect (OSTI)

    Mazloom, Ali; Hodges, Joseph C.; Teh, Bin S. [Department of Radiation Oncology, Methodist Hospital, Houston, TX (United States)] [Department of Radiation Oncology, Methodist Hospital, Houston, TX (United States); Chintagumpala, Murali [Department of Pediatrics, Baylor College of Medicine, Houston, TX (United States)] [Department of Pediatrics, Baylor College of Medicine, Houston, TX (United States); Paulino, Arnold C., E-mail: apaulino@tmhs.org [Department of Radiation Oncology, Methodist Hospital, Houston, TX (United States); Department of Pediatrics, Baylor College of Medicine, Houston, TX (United States)

    2012-10-01

    Purpose: To determine the patient, tumor, and treatment characteristics of patients with pilocytic astrocytoma (PA) and leptomeningeal dissemination (LMD). Methods and Materials: A PubMed search of English-language studies pertaining to PA with LMD was performed using a combination of keywords that included juvenile pilocytic astrocytoma, low-grade astrocytoma, low-grade glioma, leptomeningeal dissemination, neuraxis spread, and radiotherapy. We found 26 studies with 58 patients between 1976 and 2005 that met these criteria. Results: The median survival for PA patients with LMD was 65 months. The 1-, 2-, and 5-year overall survival (OS) rate after the diagnosis of LMD was 81.1%, 75.7%, and 55.5%. The 1-, 2-, and 5-year progression-free survival (PFS) rate after the diagnosis of LMD was 69.3%, 66.5%, and 34.6%, respectively. Age, gender, primary site location, timing of LMD presentation (synchronous vs. metachronous), and LMD location did not significantly influence OS or PFS. No statistically significant difference was found in OS or PFS between the chemotherapy and radiotherapy groups. Likewise, no difference was found in OS or PFS according to the use of craniospinal irradiation vs. less extensive RT fields. Conclusions: Approximately one-half of PA patients were alive 5 years after the diagnosis of LMD. Both chemotherapy and radiotherapy have efficacy against LMD. Although the use of craniospinal irradiation did not have an effect on PFS, the patient numbers were small and a larger number treated with craniospinal irradiation is needed to determine its efficacy.

  10. Baroreflex Sensitivity during Positional Changes in Patients with Traumatic Brain Injury

    E-Print Network [OSTI]

    McNair, Norma Dianne

    2012-01-01

    Heart rate variability (HRV) of patients with traumaticheart rate variability (HRV) and BRS in neurological injury.

  11. Demographic, Operational, and Healthcare Utilization Factors Associated with Emergency Department Patient Satisfaction

    E-Print Network [OSTI]

    Morgan, Matthew W.; Salzman, Joshua G.; LeFevere, Robert C.; Thomas, Avis J.; Isenberger, Kurt M.

    2015-01-01

    Programming staff from our institution electronically abstracted patient demographic information (age, sex, primary language, and

  12. Emergency department management of patients internally contaminated with radioactive material

    SciTech Connect (OSTI)

    Kazzi, Ziad; Buzzell, Jennifer; Bertelli, Luiz; Christensen, Doran

    2014-11-15

    After a radiation emergency that involves the dispersal of radioactive material, patients can become externally and internally contaminated with one or more radionuclides. Internal contamination can lead to the delivery of harmful ionizing radiation doses to various organs and tissues or the whole body. The clinical consequences can range from acute radiation syndrome (ARS) to the long term development of cancer. Estimating the amount of radioactive material absorbed into the body can guide the management of patients. Treatment includes, in addition to supportive care and long term monitoring, certain medical countermeasures like Prussian blue, Calcium DTPA and Zinc DTPA.

  13. Study for Advanced Lung Cancer Patients Guest Expert

    E-Print Network [OSTI]

    O'Hern, Corey S.

    Study for Advanced Lung Cancer Patients Guest Expert: Roy S. Herbst, MD, PhD Ensign Professor message at 888-234-4YCC. This week you will hear a conversation about clinical trials for advanced lung of lung caner at Yale Cancer Center and Smilow Cancer Hospital? Herbst As you probably know, lung cancer

  14. Patient Utility of Diagnostic Information Jeshika Singh, HERG, Brunel University

    E-Print Network [OSTI]

    Oakley, Jeremy

    Patient Utility of Diagnostic Information Jeshika Singh, HERG, Brunel University Background of the utility of the informational aspects of diagnostic tests, where the utility or value has been measured that reported utility estimates of diagnostic informational using methods compatible with NICE ­ such as EQ5D

  15. AMERICAN THORACIC SOCIETY PATIENT HEALTH SERIES Lung Cancer Prevention

    E-Print Network [OSTI]

    Kaski, Samuel

    AMERICAN THORACIC SOCIETY PATIENT HEALTH SERIES Lung Cancer Prevention What are the chances that I will develop lung cancer? The #1 cause of lung cancer is exposure to tobacco smoke. Your chances increase others (second-hand smoke), the greater your chances of developing lung cancer. People who have never

  16. UCSF Confidentiality of Patient, Employee, and University Business Information Agreement

    E-Print Network [OSTI]

    Martin, Gail

    , and disclose information only to persons who have the right to receive that information. When usingUCSF Confidentiality of Patient, Employee, and University Business Information Agreement UCSF information, including medical information for clinical or research purposes (referred to here collectively

  17. CHAPTER: In-Situ Characterization of Stimulating Microelectrode Arrays: Study of an Idealized Structure Based on Argus II Retinal implantsBOOK TITLE: Implantable Neural Prostheses 2: Techniques and Engineering Approaches, D.M. Zhou and E. Greenbaum, Eds., Springer, NY 2009

    SciTech Connect (OSTI)

    Greenbaum, Elias [ORNL; Sanders, Charlene A [ORNL; Kandagor, Vincent [ORNL

    2010-01-01

    The development of a retinal prosthesis for artificial sight includes a study of the factors affecting the structural and functional stability of chronically implanted microelectrode arrays. Although neuron depolarization and propagation of electrical signals have been studied for nearly a century, the use of multielectrode stimulation as a proposed therapy to treat blindness is a frontier area of modern ophthalmology research. Mapping and characterizing the topographic information contained in the electric field potentials and understanding how this information is transmitted and interpreted in the visual cortex is still very much a work in progress. In order to characterize the electrical field patterns generated by the device, an in vitro prototype that mimics several of the physical and chemical parameters of the in vivo visual implant device was fabricated. We carried out multiple electrical measurements in a model 'eye,' beginning with a single electrode, followed by a 9-electrode array structure, both idealized components based on the Argus II retinal implants. Correlating the information contained in the topographic features of the electric fields with psychophysical testing in patients may help reduce the time required for patients to convert the electrical patterns into graphic signals.

  18. Investigation of saliva of patients with periodontal disease using NAA

    SciTech Connect (OSTI)

    Zamboni, C. B.; Metairon, S.; Medeiros, I. M. M. A.

    2013-05-06

    In this study the non-stimulated whole saliva of 26 healthy subjects (mean age 33.9 {+-} 11.0 years, range: 26 to 49 years) and 11 patients with periodontal disease (mean age 41.7 {+-} 11.5 years; range 29 to 55 years) was investigated using Neutron Activation Analysis (NAA) technique. The samples were obtained from donors at Sao Paulo city (Brazil). The analyses were performed in the nuclear reactor IEA-R1 (3.5-4.5MW, pool type) at IPEN/CNEN-SP (Brazil). Considerable changes in Ca and S saliva's level were identified in patients with periodontal disease suggesting they can be used as monitors of periodontal diseases.

  19. Medical data mining : improving information accessibility using online patient drug reviews

    E-Print Network [OSTI]

    Li, Yueyang Alice

    2011-01-01

    We address the problem of information accessibility for patients concerned about, pharmaceutical drug side effects and experiences. We create a new corpus of online patient-provided drug reviews and present our initial ...

  20. The cognitive performance of patients with multiple sclerosis during periods of high and low fatigue.

    E-Print Network [OSTI]

    Parmenter, Brett A.; Denney, Douglas R.; Lynch, Sharon G.

    2003-03-01

    The objective of this study was to examine whether multiple sclerosis (MS)-related fatigue affects patients' cognitive performance. Thirty patients who had substantial fatigue in conjunction with MS and who reported marked diurnal variability...

  1. Quantitative detection of PfHRP2 in saliva of malaria patients in the Philippines

    E-Print Network [OSTI]

    2012-01-01

    Roxas, Palawan, Philippines. 5 Biomedical Engineering IDP,of malaria patients in the Philippines. Malaria Journal 2012of malaria patients in the Philippines Andrew O Fung 1,7* ,

  2. A systems approach to patient safety : preventing and predicting medical accidents using systems theory

    E-Print Network [OSTI]

    Samost, Aubrey

    2015-01-01

    Patient safety has become a critical concept in healthcare as clinicians seek to provide quality healthcare to every patient in a healthcare system that has grown far more complex than the days of the independent doctor ...

  3. Reliability and construct validity of PROMIS® measures for patients with heart failure who undergo heart transplant

    E-Print Network [OSTI]

    2015-01-01

    a community- based sample of heart failure patients. JournalQuality of life in patients with advanced heart failure.Journal of Heart and Lung Transplantation, 11(2 Pt 1), 273–

  4. A Control Flow Prototype for a Dose Recommending Device for Chronic Myeloid Leukemia Patients

    E-Print Network [OSTI]

    De Micheli, Giovanni

    models of insulin infusion pump developed to ease the lifestyle of diabetic patients. The drug dose flow with a feedback of a potential infusion pump for Chronic Myeloid Leukemia patients

  5. Financial and nutrition outcomes for patients placed on enteral nutrition versus oral intake 

    E-Print Network [OSTI]

    Barry, Kristina Marie

    2002-01-01

    , 1997 to December 31, 1999 at Scott & White Memorial Hospital in Temple, TX were evaluated in a retrospective chart review. Malnutrition- and disease-matched patients who received oral nutrition support were selected from the hospital's patient database...

  6. A moral approach to electronic patient records N. B. FAIRWEATHER and S. ROGERSON

    E-Print Network [OSTI]

    De Montfort University

    developments. Developments in the exchange of electronic patient records are a particularly strong theme appropriate balance between the various moral standards that are in tension in the field of Electronic Patient

  7. Salem native invents pillow for post-surgical patients By Meg Hibbert

    E-Print Network [OSTI]

    Duchowski, Andrew T.

    -shaped pillows hospitals often provide for patients to hold onto in order to cough to clear their lungs provided

  8. Radioembolization After Portal Vein Embolization in a Patient with Multifocal Hepatocellular Carcinoma

    SciTech Connect (OSTI)

    Burgmans, Mark C. Irani, Farah G. Chan, Wan Ying Teo, Terence K.; Kao, Yung Hsiang Goh, Anthony S.W.; Chow, Pierce K.; Lo, Richard H.

    2012-12-15

    Radioembolization is an effective locoregional therapy for patients with intermediate or advanced stage hepatocellular carcinoma (HCC). It has been shown that radioembolization is safe in patients with portal vein thrombosis. This case report describes safe radioembolization after portal vein embolization in a patient with multifocal HCC.

  9. TITLE: MARKETING Columbia University Medical Center will not use or disclose a patient's Protected Health

    E-Print Network [OSTI]

    Columbia University

    TITLE: MARKETING POLICY: Columbia University Medical Center will not use or disclose a patient's Protected Health Information (PHI) for marketing purposes without the patient's written authorization or disclosure of a patient's PHI for marketing purposes unless the marketing communication is directly related

  10. Assessing Patient Case Management Services with Adult Congenital Heart Disease Sensed Data

    E-Print Network [OSTI]

    Roussos, George

    1 Assessing Patient Case Management Services with Adult Congenital Heart Disease Sensed Data · Clinicians: Doctors & Nurses 7 How do Patients use Panaceia-iTV? Follow a treatment plan that includes-iTV Pilot Sites Brompton Hospital, London Adult Congenital Heart Center, Congenital Heart Disease Patients

  11. Unfulfilled expectations: a narrative study of individuals’ experiences of being a patient on an acute psychiatric inpatient ward in Scotland 

    E-Print Network [OSTI]

    Stenhouse, Rosemary Clare

    2009-01-01

    This study examines people’s experiences of being a patient on an acute psychiatric inpatient ward in Scotland. Within the existing research base few studies focus on the patient’s experience of acute psychiatric inpatient ...

  12. Maintaining Tumour Heterogeneity in Patient-Derived Tumour Xenografts

    E-Print Network [OSTI]

    Cassidy, John W.; Caldas, Carlos; Bruna, Alejandra

    2015-01-01

    somewhat by the use of NOD scid gamma (NSG) strains lacking MHC I (33). Undoubtedly the reconstitution of a patient-matched immune system in PDX models would be extremely valuable in the development of novel oncological drugs and in particular... . Cell Stem Cell. 2014;15:227–38. 33. King M, Pearson T, Shultz LD, Leif J, Bottino R, Trucco M, et al. A new Hu-PBL model for the study of human islet alloreactivity based on NOD-scid mice bearing a targeted mutation in the IL-2 receptor gamma...

  13. Characteristics associated with comprehensive stool analysis findings in adult integrative medicine patients

    E-Print Network [OSTI]

    Young, Kristin Leigh

    2011-12-31

    sectional study. Data from paper based medical charts were abstracted for each patient by a research assistant, who recorded demographic and general health information from each patient’s initial clinic intake form, clinical data from each patient’s initial.... Marchesi J, Dutilh B, Hall N, and Peters W. 2011. Towards the Human Colorectal Cancer Microbiome. PLoS One 6(5):e20447. McFarland L. 2008. Antibiotic-associated diarrhea: epidemiology, trends and treatment. Future Microbiology 3(5):563-78. 21 Naito...

  14. Impact of Weight Change During the Course of Concurrent Chemoradiation Therapy on Outcomes in Stage IIIB Non-Small Cell Lung Cancer Patients: Retrospective Analysis of 425 Patients

    SciTech Connect (OSTI)

    Topkan, Erkan; Parlak, Cem; Selek, Ugur

    2013-11-15

    Purpose: We retrospectively investigated the impact of weight change (WC) during concurrent chemoradiation therapy (C-CRT) on clinical outcomes of stage 3B non-small cell lung cancer (NSCLC) patients. Methods and Materials: A total of 425 patients treated with C-CRT were included. All patients received 60 to 66 Gy of thoracic radiation therapy concurrently with 1 to 3 cycles of platinum-based chemotherapy. Pre- and posttreatment weight measurements on first and last days of C-CRT were used for WC. Patients were divided into 2 groups: group 1 = weight loss (WL); group 2 = weight preservation/gain (WP) for comparative analyses. Results: Following C-CRT, 252 patients (59.3%) experienced WL, while 89 patients (20.9%) and 84 patients (19.8%) showed WP or WG. At median 24.2 months of follow-up, 142 patients (33.4%) were alive (84 WP [48.6%] and 58 WL [23.0%]), and 58 (13.6%) of them were free of disease progression (41 [23.7%] for WP and 17 [6.7%] for WL). Median overall survival (OS), locoregional progression-free survival (LRPFS), progression-free survival (PFS), and distant metastases-free survival (DMFS) for the entire population were 22.8, 14.4, 10.6, and 11.7 months, respectively. Intergroup comparisons between WP and WL cohorts revealed significantly superior OS, LRPFS, PFS, and DMFS in WP patients (P<.05 for each). On multivariate analyses, only WL and advanced T stage were associated with poor prognosis (P<.05). Conclusions: Present results in 425 stage 3B NSCLC patients demonstrated that WL during C-CRT is strongly associated with inferior survival outcomes compared to WP. This emerging finding might be useful by forming an encouraging basis for future investigations in facilitating a way to improve the outcomes of these patients experiencing WL during C-CRT.

  15. Abstract--During medical procedures, such as surgery, a patient's vital signs are typically monitored using a web of

    E-Print Network [OSTI]

    Ma, Hongshen

    Abstract--During medical procedures, such as surgery, a patient's vital signs are typically unit, patient vital signs are obtained through various wires and adhesive electrodes attached

  16. Radiation pneumonitis in breast cancer patients treated with conservative surgery and radiation therapy

    SciTech Connect (OSTI)

    Lingos, T.I.; Recht, A.; Vicini, F.; Abner, A.; Silver, B.; Harris, J.R. )

    1991-07-01

    The likelihood of radiation pneumonitis and factors associated with its development in breast cancer patients treated with conservative surgery and radiation therapy have not been well established. To assess these, the authors retrospectively reviewed 1624 patients treated between 1968 and 1985. Median follow-up for patients without local or distant failure was 77 months. Patients were treated with either tangential fields alone (n = 508) or tangents with a third field to the supraclavicular (SC) or SC-axillary (AX) region (n = 1116). Lung volume treated in the tangential fields was generally limited by keeping the perpendicular distance (demagnified) at the isocenter from the deep field edges to the posterior chest wall (CLD) to 3 cm or less. Seventeen patients with radiation pneumonitis were identified (1.0%). Radiation pneumonitis was diagnosed when patients presented with cough (15/17, 88%), fever (9/17, 53%), and/or dyspnea (6/17, 35%) and radiographic changes (17/17) following completion of RT. Radiographic infiltrates corresponded to treatment portals in all patients, and in 12 of the 17 patients, returned to baseline within 1-12 months. Five patients had permanent scarring on chest X ray. No patient had late or persistent pulmonary symptoms. The incidence of radiation pneumonitis was correlated with the combined use of chemotherapy (CT) and a third field. Three percent (11/328) of patients treated with a 3-field technique who received chemotherapy developed radiation pneumonitis compared to 0.5% (6 of 1296) for all other patients (p = 0.0001). When patients treated with a 3-field technique received chemotherapy concurrently with radiation therapy, the incidence of radiation pneumonitis was 8.8% (8/92) compared with 1.3% (3/236) for those who received sequential chemotherapy and radiation therapy (p = 0.002).

  17. Portable, space-saving medical patient support system

    DOE Patents [OSTI]

    Bzorgi; Fariborz (Knoxville, TN)

    2011-02-01

    A support platform having a stowed configuration and a deployed configuration on a floor. The support platform is related to stretcher devices that are used for transporting, confining, or conducting medical procedures on medical patients in medical emergencies. The support platform typically includes a work surface that has a geometric extent. A base that typically includes a plurality of frame members is provided, and the frame members are disposed across the geometric extent of, and proximal to, the work surface in the stowed configuration. The frame members are typically disposed on the floor in the deployed configuration. There is a foldable bracing system engaged with the work surface and engaged with the base. At least a portion of the foldable bracing system is disposed substantially inside at least a portion of the plurality of frame members in the stowed configuration. Further, the foldable bracing system is configured for translocation of the work surface distal from the base in the deployed configuration.

  18. Optimal Timing for Assessment of Tumor Response to Neoadjuvant Chemoradiation in Patients With Rectal Cancer: Do All Patients Benefit From Waiting Longer Than 6 Weeks?

    SciTech Connect (OSTI)

    Perez, Rodrigo O.; Angelita and Joaquim Gama Institute, Sao Paulo ; Habr-Gama, Angelita; Sao Juliao, Guilherme P.; Gama-Rodrigues, Joaquim; Sousa, Afonso H.S.; Campos, Fabio Guilherme; Imperiale, Antonio R.; Lynn, Patricio B.; Proscurshim, Igor; Nahas, Sergio Carlos; Ono, Carla Rachel; Buchpiguel, Carlos Alberto; Department of Radiology and Nuclear Medicine, Hospital do Coracao, Sao Paulo

    2012-12-01

    Purpose: To estimate the metabolic activity of rectal cancers at 6 and 12 weeks after completion of chemoradiation therapy (CRT) by 2-[fluorine-18] fluoro-2-deoxy-D-glucose-labeled positron emission tomography/computed tomography ([{sup 18}FDG]PET/CT) imaging and correlate with response to CRT. Methods and Materials: Patients with cT2-4N0-2M0 distal rectal adenocarcinoma treated with long-course neoadjuvant CRT (54 Gy, 5-fluouracil-based) were prospectively studied ( (ClinicalTrials.org) identifier (NCT00254683)). All patients underwent 3 PET/CT studies (at baseline and 6 and 12 weeks from CRT completion). Clinical assessment was at 12 weeks. Maximal standard uptake value (SUVmax) of the primary tumor was measured and recorded at each PET/CT study after 1 h (early) and 3 h (late) from {sup 18}FDG injection. Patients with an increase in early SUVmax between 6 and 12 weeks were considered 'bad' responders and the others as 'good' responders. Results: Ninety-one patients were included; 46 patients (51%) were 'bad' responders, whereas 45 (49%) patients were 'good' responders. 'Bad' responders were less likely to develop complete clinical response (6.5% vs. 37.8%, respectively; P=.001), less likely to develop significant histological tumor regression (complete or near-complete pathological response; 16% vs. 45%, respectively; P=.008) and exhibited greater final tumor dimension (4.3 cm vs. 3.3 cm; P=.03). Decrease between early (1 h) and late (3 h) SUVmax at 6-week PET/CT was a significant predictor of 'good' response (accuracy of 67%). Conclusions: Patients who developed an increase in SUVmax after 6 weeks were less likely to develop significant tumor downstaging. Early-late SUVmax variation at 6-week PET/CT may help identify these patients and allow tailored selection of CRT-surgery intervals for individual patients.

  19. Radiofrequency Ablation of Lung Tumours with the Patient Under Thoracic Epidural Anaesthesia

    SciTech Connect (OSTI)

    Pouliquen, Cassiopee; Kabbani, Youssef, E-mail: kabbani@bergonie.org; Saignac, Pierre; Gekiere, Jean-Pierre [Institut Bergonie, Department of Anesthesiology and Intensive Care, Regional Cancer Centre (France); Palussiere, Jean [Institut Bergonie, Department of Interventional Radiology, Regional Cancer Centre (France)

    2011-02-15

    Radiofrequency ablation of lung tumours is a curative technique that is newly considered being offered to nonsurgical patients. It is of major interest because it enables local destruction of the tumour without surgery and spares healthy parenchyma. However, some patients have previous serious respiratory failure, thus ruling out mechanical ventilation. To operate with the patient under thoracic epidural is an answer to this problem. Our experience shows that the procedure is able to be performed completely without converting to general anaesthesia.

  20. Patient-Physician Communication About Complementary and Alternative Medicine in a Radiation Oncology Setting

    SciTech Connect (OSTI)

    Ge Jin; Fishman, Jessica; Annenberg School for Communication at University of Pennsylvania, University of Pennsylvania Health System, Philadelphia, Pennsylvania ; Vapiwala, Neha; Department of Radiation Oncology, University of Pennsylvania Health System, Philadelphia, Pennsylvania ; Li, Susan Q.; Desai, Krupali; Xie, Sharon X.; Mao, Jun J.

    2013-01-01

    Purpose: Despite the extensive use of complementary and alternative medicine (CAM) among cancer patients, patient-physician communication regarding CAM therapies remains limited. This study quantified the extent of patient-physician communication about CAM and identified factors associated with its discussion in radiation therapy (RT) settings. Methods and Materials: We conducted a cross-sectional survey of 305 RT patients at an urban academic cancer center. Patients with different cancer types were recruited in their last week of RT. Participants self-reported their demographic characteristics, health status, CAM use, patient-physician communication regarding CAM, and rationale for/against discussing CAM therapies with physicians. Multivariate logistic regression was used to identify relationships between demographic/clinical variables and patients' discussion of CAM with radiation oncologists. Results: Among the 305 participants, 133 (43.6%) reported using CAM, and only 37 (12.1%) reported discussing CAM therapies with their radiation oncologists. In multivariate analyses, female patients (adjusted odds ratio [AOR] 0.45, 95% confidence interval [CI] 0.21-0.98) and patients with full-time employment (AOR 0.32, 95% CI 0.12-0.81) were less likely to discuss CAM with their radiation oncologists. CAM users (AOR 4.28, 95% CI 1.93-9.53) were more likely to discuss CAM with their radiation oncologists than were non-CAM users. Conclusions: Despite the common use of CAM among oncology patients, discussions regarding these treatments occur rarely in the RT setting, particularly among female and full-time employed patients. Clinicians and patients should incorporate discussions of CAM to guide its appropriate use and to maximize possible benefit while minimizing potential harm.

  1. Effect of an Emergency Department Fast Track on Press-Ganey Patient Satisfaction Scores

    E-Print Network [OSTI]

    Hwang, Calvin E.; Lipman, Grant S.; Kane, Marlena

    2015-01-01

    also have improved these Press-Ganey metrics. CONCLUSION Thein seven dimensions of Press-Ganey patient satisfaction25, 2014. 3. Who we serve. Press Ganey website. Available

  2. Telephone-administered psychotherapy for depression in MS patients: moderating role of social support

    E-Print Network [OSTI]

    Beckner, Victoria; Howard, Isa; Vella, Lea; Mohr, David C.

    2010-01-01

    in coping with multiple sclerosis. Journal of Consulting and1996). Depression and multiple sclerosis. Neurology, 46(3),Increased depression in multiple sclerosis patients. A meta-

  3. Potential immunological consequences of pharmacological suppression of gastric acid production in patients with multiple sclerosis

    E-Print Network [OSTI]

    Biswas, Sangita; Benedict, Stephen H; Lynch, Sharon G; LeVine, Steven M

    2012-01-01

    in patients with multiple sclerosis. BMC Medicine 2012 10:adverse effects in multiple sclerosis. Ann Neurol 2011, 69:cytotoxicity in multiple sclerosis by central nervous system

  4. Generalized skin drug eruption to natalizumab in a patient with multiple sclerosis

    E-Print Network [OSTI]

    André, Marisa C; Pacheco, David; Antunes, Joana; Silva, Raquel; Filipe, Paulo; Almeida, L M Soares de

    2010-01-01

    International Natalizumab Multiple Sclerosis Trial Group.Natalizumab for Relapsing Multiple Sclerosis. 2003. N Engl Jin a patient with multiple sclerosis Marisa C André MD,

  5. Appendix VI Selected Self-Help Books For Patients/Clients

    E-Print Network [OSTI]

    to patients with sexual and marital problems: a bibli- ography, J Sex Marital Ther 18(1):70-79, 1992. Aging

  6. Reduced complexity of activity patterns in patients with Chronic Fatigue Syndrome: a case control study 

    E-Print Network [OSTI]

    Burton, C.; Knoop, H.; Popovic, N.; Sharpe, M.; Bleijenberg, G.

    ABSTRACT: BACKGROUND: Chronic fatigue syndrome (CFS) is an illness characterised by pervasive physical and mental fatigue without specific identified pathological changes. Many patients with CFS show reduced physical ...

  7. Understanding Why Patients Return to the Emergency Department after Mild Traumatic Brain Injury within 72 Hours

    E-Print Network [OSTI]

    2015-01-01

    patients with minimal brain injury and small intracranialelements for traumatic brain injury: a population study. Intcenter for mild traumatic brain injury. Neurosurgical Focus.

  8. Mycobacterium porferae infection in a psoriasis patient on anti-tnf-a therapy

    E-Print Network [OSTI]

    Laquer, Vivian; Ta, Tuan; Nguyen, Tien; Tan, Belinda

    2013-01-01

    biologic therapy for psoriasis. J Dermatolog Treat 2012. [porferae infection in a psoriasis patient on anti-tnf-aIrvine, CA USA Introduction Psoriasis is a chronic, auto-

  9. Even well-controlled psoriasis patients have unmet treatment needs regardless of disease severity

    E-Print Network [OSTI]

    Vaidya, Toral S; Anderson, Kathryn L; Feldman, Steven R

    2015-01-01

    A. Understanding the Psoriasis Patient. East Hanover,A, Gordon K, Gottlieb A. Psoriasis treatment: current andthe course of an 8-week psoriasis clinical trial: commonly

  10. Crusted scabies of the scalp in a patient with systemic lupus erythematosus

    E-Print Network [OSTI]

    Yee, Brittany E; Carlos, Casey A; Hata, Tissa

    2014-01-01

    in a patient with severe psoriasis. J Am Acad Dermatol. 201311. Goyal NN, Wong GA. Psoriasis or crusted scabies. Clindiagnoses included psoriasis or impetiginized psoriasis; the

  11. Prevalence and patterns of multimorbidity among tuberculosis patients in Brazil: a cross-sectional study

    E-Print Network [OSTI]

    Reis-Santos, Bárbara; Gomes, Teresa; Macedo, Laylla R; Horta, Bernardo L; Riley, Lee W; Maciel, Ethel L

    2013-01-01

    tuberculosis patients in Brazil: a cross-sectional study.cases of tuberculosis in Brazil. Revista brasileira dediabetes mellitus in Brazil - a multivariate analysis. PLoS

  12. Prevalence and Treatment Management of Oropharyngeal Candidiasis in Cancer Patients: Results of the French Candidoscope Study

    SciTech Connect (OSTI)

    Gligorov, Joseph [APHP Tenon, APREC, University Paris VI, Paris (France); Bastit, Laurent [Centre Frederic Joliot, Rouen (France); Gervais, Honorine [Hopital Saint Antoine, Paris (France); Henni, Mehdi [Hopital Europeen Georges Pompidou, Paris (France); Kahila, Widad [Centre Jean Perrin, Clermont-Ferrand (France); Lepille, Daniel [Clinique Chirurgicale Pasteur, Evreux (France); Luporsi, Elisabeth [Centre Alexis Vautrin, Vandoeuvre-les-Nancy (France); Sasso, Giuseppe [Centre Medical Forcilles, Ferolles-Attily (France); Varette, Charles [Centre Hospitalier Prive Claude Galien, Quincy-sous-Senart (France); Azria, David, E-mail: David.Azria@valdorel.fnclcc.f [Crlc Val d'Aurelle, Inserm U860, Universite Montpellier I, Montpellier (France)

    2011-06-01

    Purpose: The aim of this pharmaco-epidemiological study was to evaluate the prevalence of oropharyngeal candidiasis (OPC) in cancer patients treated with chemotherapy and/or radiotherapy. Methods and Materials: Signs and symptoms of OPC were noted for all patients. Antifungal therapeutic management was recorded in OPC patients. Patients receiving local antifungal treatments were monitored until the end of treatment. Results: Enrolled in the study were 2,042 patients with solid tumor and/or lymphoma treated with chemotherapy and/or another systemic cancer treatment and/or radiotherapy. The overall prevalence of OPC was 9.6% (95% confidence interval, 8.4%-11.0%]in this population. It was most frequent in patients treated with combined chemoradiotherapy (22.0%) or with more than two cytotoxic agents (16.9%). Local antifungal treatments were prescribed in 75.0% of OPC patients as recommended by guidelines. The compliance to treatment was higher in patients receiving once-daily miconazole mucoadhesive buccal tablet (MBT; 88.2%) than in those treated with several daily mouthwashes of amphotericin B (40%) or nystatin (18.8%). Conclusion: OPC prevalence in treated cancer patients was high. Local treatments were usually prescribed as per guidelines. Compliance to local treatments was better with once-daily drugs.

  13. Effectiveness of Patient Adherence Groups as a Model of Care for Stable Patients on Antiretroviral Therapy in Khayelitsha, Cape Town, South Africa

    E-Print Network [OSTI]

    Hernan, Miguel Angel

    Abstract: Background: Innovative models of care are required to cope with the ever-increasing number of patients on antiretroviral therapy in the most affected countries. This study, in Khayelitsha, South Africa, evaluates ...

  14. Patient dose estimation from CT scans at the Mexican National Neurology and Neurosurgery Institute

    SciTech Connect (OSTI)

    Alva-Sánchez, Héctor

    2014-11-07

    In the radiology department of the Mexican National Institute of Neurology and Neurosurgery, a dedicated institute in Mexico City, on average 19.3 computed tomography (CT) examinations are performed daily on hospitalized patients for neurological disease diagnosis, control scans and follow-up imaging. The purpose of this work was to estimate the effective dose received by hospitalized patients who underwent a diagnostic CT scan using typical effective dose values for all CT types and to obtain the estimated effective dose distributions received by surgical and non-surgical patients. Effective patient doses were estimated from values per study type reported in the applications guide provided by the scanner manufacturer. This retrospective study included all hospitalized patients who underwent a diagnostic CT scan between 1 January 2011 and 31 December 2012. A total of 8777 CT scans were performed in this two-year period. Simple brain scan was the CT type performed the most (74.3%) followed by contrasted brain scan (6.1%) and head angiotomography (5.7%). The average number of CT scans per patient was 2.83; the average effective dose per patient was 7.9 mSv; the mean estimated radiation dose was significantly higher for surgical (9.1 mSv) than non-surgical patients (6.0 mSv). Three percent of the patients had 10 or more brain CT scans and exceeded the organ radiation dose threshold set by the International Commission on Radiological Protection for deterministic effects of the eye-lens. Although radiation patient doses from CT scans were in general relatively low, 187 patients received a high effective dose (>20 mSv) and 3% might develop cataract from cumulative doses to the eye lens.

  15. Dermatofibrosarcoma Protuberans: Long-term Outcomes of 53 Patients Treated With Conservative Surgery and Radiation Therapy

    SciTech Connect (OSTI)

    Castle, Katherine O. [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States)] [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Guadagnolo, B. Ashleigh, E-mail: aguadagn@mdanderson.org [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Tsai, C. Jillian [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States)] [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Feig, Barry W. [Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States)] [Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Zagars, Gunar K. [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States)] [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2013-07-01

    Purpose: To evaluate outcomes of conservative surgery and radiation therapy (RT) treatment in patients with dermatofibrosarcoma protuberans. Methods and Materials: We retrospectively reviewed the medical records of 53 consecutive dermatofibrosarcoma protuberans patients treated with surgery and preoperative or postoperative radiation therapy between 1972 and 2010. Median tumor size was 4 cm (range, 1-25 cm). Seven patients (13%) were treated with preoperative RT (50-50.4 Gy) and 46 patients (87%) with postoperative RT (60-66 Gy). Of the 46 patients receiving postoperative radiation, 3 (7%) had gross disease, 14 (30%) positive margins, 26 (57%) negative margins, and 3 (7%) uncertain margin status. Radiation dose ranged from 50 to 66 Gy (median dose, 60 Gy). Results: At a median follow-up time of 6.5 years (range, 0.5 months-23.5 years), 2 patients (4%) had disease recurrence, and 3 patients (6%) had died. Actuarial overall survival was 98% at both 5 and 10 years. Local control was 98% and 93% at 5 and 10 years, respectively. Disease-free survival was 98% and 93% at 5 and 10 years, respectively. The presence of fibrosarcomatous change was not associated with increased risk of local or distant relapse (P=.43). One of the patients with a local recurrence had gross residual disease at the time of RT and despite RT to 65 Gy developed both an in-field recurrence and a nodal and distant recurrence 3 months after RT. The other patient with local recurrence was found to have in-field recurrence 10 years after initial treatment. Thirteen percent of patients had an RT complication at 5 and 10 years, and 9% had a moderate or severe complication at 5 and 10 years. Conclusions: Dermatofibrosarcoma protuberans is a radioresponsive disease with excellent local control after conservative surgery and radiation therapy. Adjuvant RT should be considered for patients with large or recurrent tumors or when attempts at wide surgical margins would result in significant morbidity.

  16. Application of Virtual Mobile Networking to Real-Time Patient Monitoring

    E-Print Network [OSTI]

    Bhatti, Saleem N.

    Application of Virtual Mobile Networking to Real-Time Patient Monitoring Devan Rehunathan of such technology in mobile Wireless Body Area Networks (WBANs) for medical purposes allow for inexpensive the vital signs of these patients remotely despite them being mobile. Applications of this approach can

  17. Simultaneous Segmentation and Grading of Hippocampus for Patient Classification with Alzheimer's

    E-Print Network [OSTI]

    Paris-Sud XI, Université de

    Simultaneous Segmentation and Grading of Hippocampus for Patient Classification with Alzheimer library used during our experiments was composed by 2 populations, 50 Cognitively Normal subjects (CN of the HC at the same time resulted in an efficient patient classification with a success rate of 90

  18. oligoclonal IgG in patients with multiple sclerosis is probably not directed against myelin antigens.

    E-Print Network [OSTI]

    Squire, Larry R.

    oligoclonal IgG in patients with multiple sclerosis is probably not directed against myelin antigens. The pursuit of the intrathecal B-cell response in multiple sclerosis has been ongoing for decades to the need for an individualised approach to treat patients with multiple sclerosis. Trygve Holmøy, Anne Lise

  19. CTSHIV: A KnowledgeBased System For the Management of HIVinfected Patients

    E-Print Network [OSTI]

    Pazzani, Michael J.

    See Ranjit Iyer Edison Schroeder Jeremiah Tilles Department of Information & Computer Science) that recommends an in­ dividualized treatment strategy for HIV patients is de­ scribed. Since the HIV virus has developed. By monitoring the HIV virus of the patient, the treatment strategy can be switched

  20. RESEARCH ARTICLE Open Access Causes of death in patients with extranodal

    E-Print Network [OSTI]

    Hemminki, Akseli

    RESEARCH ARTICLE Open Access Causes of death in patients with extranodal cancer of unknown primary that the organ which is designated as the cause of death may give clues about the primary site. Methods: A total of 20,570 patients with CUP were identified from the Swedish Family-Cancer Database. Causes of death

  1. HIPAA: Patient Rights This document is designed to give you concrete information about how HIPAA may

    E-Print Network [OSTI]

    Chapman, Michael S.

    HIPAA: Patient Rights This document is designed to give you concrete information about how HIPAA information about and more control over their own health information. The patient rights are: 1. The Right to Receive a Notice of Privacy Practices (NPP) 2. The Right to Access Protected Health Information (PHI); 3

  2. Novel Serum Biomarker Candidates for Liver Fibrosis in Hepatitis C Patients

    E-Print Network [OSTI]

    Novel Serum Biomarker Candidates for Liver Fibrosis in Hepatitis C Patients Bevin Gangadharan samples from patients with varying degrees of hepatic scarring induced by infection with the hepatitis C. In general, 2 macroglobulin (a2M) and immunoglobulin components increased with hepatic fibrosis, whereas

  3. PATIENT REGISTRATION ONTO A CLINICAL TRIAL AND PROCEDURE FOR CHARGING PIC SERVICES (EXCLUDES CRC)

    E-Print Network [OSTI]

    Oliver, Douglas L.

    PATIENT REGISTRATION ONTO A CLINICAL TRIAL AND PROCEDURE FOR CHARGING PIC SERVICES (EXCLUDES CRC to OCTR Patient visit that produces Protocol Induced Costs PIC 1. Coordinator will complete voucher, including research label "" and case number, documenting PIC associated with the visit 2. Voucher containing

  4. Duke Health Briefs: Positive Outlook Linked to Longer Life in Heart Patients

    E-Print Network [OSTI]

    Hunter, David

    Duke Health Briefs: Positive Outlook Linked to Longer Life in Heart Patients keywords : CardiologyMinute. Here's some health advice to take to heart: if you want to live longer, stay happy. A recent Duke study of more than 800 heart patients found that those who reported experiencing more positive emotions

  5. Gastrostomy Tube Placement Without Nasogastric Tube: A Retrospective Evaluation in 85 Patients

    SciTech Connect (OSTI)

    Heberlein, Wolf E., E-mail: weheberlein@uams.edu; Goodwin, Whitney J.; Wood, Clint E.; Yousaf, Muhammad; Culp, William C. [University of Arkansas for Medical Sciences, Department of Radiology (United States)

    2012-12-15

    Purpose: Our study evaluated techniques for percutaneous gastrostomy (G)-tube placement without the use of a nasogastric (NG) tube. Instead, direct puncture of a physiologic air bubble or effervescent-enhanced gastric bubble distention was performed in patients with upper digestive tract obstruction (UDTO) or psychological objections to NG tubes. Materials and Methods: A total of 886 patients underwent G-tube placement in our department during a period of 7 years. We present our series of 85 (9.6%) consecutive patients who underwent percutaneous G-tube placement without use of an NG tube. Results: Of these 85 patients, fluoroscopic guided access was attempted by direct puncture of a physiologically present gastric air bubble in 24 (28%) cases. Puncture of an effervescent-induced large gastric air bubble was performed in 61 (72%) patients. Altogether, 82 (97%) of 85 G tubes were successfully placed in this fashion. The three failures comprised refusal of effervescent, vomiting of effervescent, and one initial tube misplacement when a deviation from our standard technique occurred. Conclusion: The described techniques compare favorably with published large series on G-tube placement with an NG tube in place. The techniques are especially suited for patients with UDTO due to head, neck, or esophageal malignancies, but they should be considered as an alternative in all patients. Direct puncture of effervescent-enhanced gastric bubble distention is a safe, patient-friendly and effective technique.

  6. Prediction of Patient's Response to an Acute Inflammation Treatment by Mixture of Experts

    E-Print Network [OSTI]

    Obradovic, Zoran

    is the leading cause of death in non-coronary intensive care units in the United States. In practice, clin pattern (area C) - anti- inflammatory response restoring patient state, any therapy likely harmful. United on mixture of ex- perts. The proposed model identifies stages (regimes) of patient state and builds

  7. Temporal Features and Kernel Methods for Predicting Sepsis in Postoperative Patients

    E-Print Network [OSTI]

    Scott, Clayton

    ]. In the United States, 0.8 to 2 million patients become septic every year, 30% of which are surgical patients, and are based on four physiological variables: body temperature, heart rate, breathing rate, and white blood positive rate), which diminishes their utility in clinical settings. This paper presents new features

  8. Lung Cancer (2004) 46, 333--340 High serum YKL-40 level in patients with small

    E-Print Network [OSTI]

    Price, Paul A.

    2004-01-01

    Lung Cancer (2004) 46, 333--340 High serum YKL-40 level in patients with small cell lung cancer May 2004; accepted 6 May 2004 KEYWORDS Small cell lung carcinoma; Tumor invasiveness; YKL-40; HC gp-39 evaluated serum YKL-40 in 131 patients with small cell lung cancer (SCLC). Twenty-two percent

  9. TP53 gene mutations of lung cancer patients in upper northern Thailand and environmental risk factors

    E-Print Network [OSTI]

    TP53 gene mutations of lung cancer patients in upper northern Thailand and environmental risk mutations are observed in about 40e70% of lung cancer tissues, and the hot spot codon mu- tations factors that influence TP53 gene mutation in lung cancer patients residing areas with high lung cancer

  10. Automatic Drug Side Effect Discovery from Online Patient-Submitted Reviews: Focus on Statin Drugs

    E-Print Network [OSTI]

    Automatic Drug Side Effect Discovery from Online Patient-Submitted Reviews: Focus on Statin Drugs become empowered to share personal experiences regarding prescription drugs via Web page discussion from patient-provided drug reviews on health-related web sites. We focus on the statin class

  11. A Biomedical Patient Data Driven Approach for the Prediction of Tumor Motion

    E-Print Network [OSTI]

    Wu, Yuqing Melanie

    1 A Biomedical Patient Data Driven Approach for the Prediction of Tumor Motion Jonanthan of the patient biomedical data and the tumor motion data for accurate tumor motion characterization and prediction. Method and Materials: For the analysis of biomedical data, we worked through the main steps

  12. AN ARTIFICIAL NEURAL NETWORK EVALUATION OF TUBERCULOSIS USING GENETIC AND PHYSIOLOGICAL PATIENT DATA

    SciTech Connect (OSTI)

    Griffin, William O.; Darsey, Jerry A. [Department of Chemistry of Arkansas at Little Rock, Little Rock, AR (United States); Hanna, Josh [Department of Bioinformatics of Arkansas at Little Rock, Little Rock, AR (United States); Razorilova, Svetlana; Kitaev, Mikhael; Alisherov, Avtandiil [National Center of Tuberculosis, Bishkek (Kyrgyzstan); Tarasenko, Olga [Department of Biology University of Arkansas at Little Rock, Little Rock, AR (United States)

    2010-04-12

    When doctors see more cases of patients with tell-tale symptoms of a disease, it is hoped that they will be able to recognize an infection administer treatment appropriately, thereby speeding up recovery for sick patients. We hope that our studies can aid in the detection of tuberculosis by using a computer model called an artificial neural network. Our model looks at patients with and without tuberculosis (TB). The data that the neural network examined came from the following: patient' age, gender, place, of birth, blood type, Rhesus (Rh) factor, and genes of the human Leukocyte Antigens (HLA) system (9q34.1) present in the Major Histocompatibility Complex. With availability in genetic data and good research, we hope to give them an advantage in the detection of tuberculosis. We try to mimic the doctor's experience with a computer test, which will learn from patient data the factors that contribute to TB.

  13. Incidence of Second Malignancies Among Patients Treated With Proton Versus Photon Radiation

    SciTech Connect (OSTI)

    Chung, Christine S., E-mail: chungc1@sutterhealth.org [Department of Radiation Oncology, Alta Bates Summit Medical Center, Berkeley, California (United States); Yock, Torunn I. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Nelson, Kerrie [Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts (United States); Xu, Yang [Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts (United States); Keating, Nancy L. [Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts (United States); Department of General Internal Medicine, Brigham and Women's Hospital, Boston, Massachusetts (United States); Tarbell, Nancy J. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Office of the Executive Dean, Harvard Medical School, Boston, Massachusetts (United States)

    2013-09-01

    Purpose: Proton radiation, when compared with photon radiation, allows delivery of increased radiation dose to the tumor while decreasing dose to adjacent critical structures. Given the recent expansion of proton facilities in the United States, the long-term sequelae of proton therapy should be carefully assessed. The objective of this study was to compare the incidence of second cancers in patients treated with proton radiation with a population-based cohort of matched patients treated with photon radiation. Methods and Materials: We performed a retrospective cohort study of 558 patients treated with proton radiation from 1973 to 2001 at the Harvard Cyclotron in Cambridge, MA and 558 matched patients treated with photon therapy in the Surveillance, Epidemiology, and End Results (SEER) Program cancer registry. Patients were matched by age at radiation treatment, sex, year of treatment, cancer histology, and site. The main outcome measure was the incidence of second malignancies after radiation. Results: We matched 558 proton patients with 558 photon patients from the Surveillance, Epidemiology, and End Results registry. The median duration of follow-up was 6.7 years (interquartile range, 7.4) and 6.0 years (interquartile range, 9.3) in the proton and photon cohorts, respectively. The median age at treatment was 59 years in each cohort. Second malignancies occurred in 29 proton patients (5.2%) and 42 photon patients (7.5%). After we adjusted for sex, age at treatment, primary site, and year of diagnosis, proton therapy was not associated with an increased risk of second malignancy (adjusted hazard ratio, 0.52 [95% confidence interval, 0.32-0.85]; P=.009). Conclusions: The use of proton radiation therapy was not associated with a significantly increased risk of secondary malignancies compared with photon therapy. Longer follow-up of these patients is needed to determine if there is a significant decrease in second malignancies. Given the limitations of the study, these results should be viewed as hypothesis generating.

  14. SU-E-I-95: Personalized Radiography Technical Parameters for Each Patient and Exam

    SciTech Connect (OSTI)

    Soares, F; Camozzato, T; Kahl, G; Soares, A; Zottis, A [Instituto Federal de Santa Catarina, Florianopolis (Brazil)

    2014-06-01

    Purpose: To determine exact electrical parameters (kV, mAs) a radiological technologist shall use taking account the exam and patient's structure, with guarantee of minimum dose and adequate quality image. Methods: A patient's absorbed dose equation was developed by means of Entrance Skin Dose (ESD), irradiated area and patient width for specific anatomy. ESD is calculated from a developed equation, where entrance surface air-KERMA and backscatter factor are included, with air-to-skin coefficient conversion. We developed specific Lambert-Beer attenuation equations derived from mass energy-absorption coefficients data for skin, fat, and muscle and bone as one tissue. Anatomy tissue thickness distribution at central X-ray location in anteroposterior incidence for hand and chest, was estimate by discounting constant skin and bone thickness from patient measured width, assuming the result as muscle and fat. A clinical research at a big hospital were executed when real parameters (kV, mAs, filtration, ripple) used by technologists were combined with the image quality and patient's data: anatomy width, height and weight. A correlation among the best images acquired and electrical parameters used were confronted with patient's data and dose estimation. The best combinations were used as gold standards. Results: For each anatomy, two equations were developed to calculate voltage (kV) and exposure (mAs) to reproduce and interpolate the gold standards. Patient is measured and data are input into equations, giving radiological technologists the right set of electrical parameters for that specific exam. Conclusion: This work indicates that radiological technologist can personalize the exact electrical parameters for each patient exam, instead of using standard values. It also guarantee that patients under or over-sized measures will receive the right dose for the best image. It will stop wrong empiric adjusts technologists do when examining a non-standard patient and reduce probability of radiography retaken because of over or under exposition.

  15. Pretreatment Staging Positron Emission Tomography/Computed Tomography in Patients With Inflammatory Breast Cancer Influences Radiation Treatment Field Designs

    SciTech Connect (OSTI)

    Walker, Gary V.; Niikura, Naoki; Yang Wei; Rohren, Eric; Valero, Vicente; Woodward, Wendy A.; Alvarez, Ricardo H.; Lucci, Anthony; Ueno, Naoto T.; Buchholz, Thomas A.

    2012-08-01

    Purpose: Positron emission tomography/computed tomography (PET/CT) is increasingly being utilized for staging of inflammatory breast cancer (IBC). The purpose of this study was to define how pretreatment PET/CT studies affected postmastectomy radiation treatment (PMRT) planning decisions for IBC. Methods and Materials: We performed a retrospective analysis of 62 patients diagnosed with IBC between 2004 and 2009, who were treated with PMRT in our institution and who had a staging PET/CT within 3 months of diagnosis. Patients received a baseline physical examination, staging mammography, ultrasonographic examination of breast and draining lymphatics, and chest radiography; most patients also had a bone scan (55 patients), liver imaging (52 patients), breast MRI (46 patients), and chest CT (25 patients). We compared how PET/CT findings affected PMRT, assuming that standard PMRT would target the chest wall, level III axilla, supraclavicular fossa, and internal mammary chain (IMC). Any modification of target volumes, field borders, or dose prescriptions was considered a change. Results: PET/CT detected new areas of disease in 27 of the 62 patients (44%). The areas of additional disease included the breast (1 patient), ipsilateral axilla (1 patient), ipsilateral supraclavicular (4 patients), ipsilateral infraclavicular (1 patient), ipsilateral IMC (5 patients), ipsilateral subpectoral (3 patients), mediastinal (8 patients), other distant/contralateral lymph nodes (15 patients), or bone (6 patients). One patient was found to have a non-breast second primary tumor. The findings of the PET/CT led to changes in PMRT in 11 of 62 patients (17.7%). These changes included additional fields in 5 patients, adjustment of fields in 2 patients, and higher doses to the supraclavicular fossa (2 patients) and IMC (5 patients). Conclusions: For patients with newly diagnosed IBC, pretreatment PET/CT provides important information concerning involvement of locoregional lymph nodes, mediastinal lymph nodes, and unsuspected sites of distant metastasis. This information is important in the design of radiotherapy treatment fields and, therefore, we recommend that PET/CT be a component of initial staging for IBC.

  16. Does administering iodine in radiological procedures increase patient doses?

    SciTech Connect (OSTI)

    He, Wenjun; Yao, Hai, E-mail: haiyao@clemson.edu [Clemson-MUSC Bioengineering Program, Department of Bioengineering, Clemson University, Charleston, South Carolina 29425 (United States); Huda, Walter; Mah, Eugene [Department of Radiology and Radiological Science, Medical University of South Carolina (MUSC), Charleston, South Carolina 29425 (United States)

    2014-11-01

    Purpose: The authors investigated the changes in the pattern of energy deposition in tissue equivalent phantoms following the introduction of iodinated contrast media. Methods: The phantom consisted of a small “contrast sphere,” filled with water or iodinated contrast, located at the center of a 28 cm diameter water sphere. Monte Carlo simulations were performed using MCNP5 codes, validated by simulating irradiations with analytical solutions. Monoenergetic x-rays ranging from 35 to 150 keV were used to simulate exposures to spheres containing contrast agent with iodine concentrations ranging from 1 to 100 mg/ml. Relative values of energy imparted to the contrast sphere, as well as to the whole phantom, were calculated. Changes in patterns of energy deposition around the contrast sphere were also investigated. Results: Small contrast spheres can increase local absorbed dose by a factor of 13, but the corresponding increase in total energy absorbed was negligible (<1%). The highest localized dose increases were found to occur at incident photon energies of about 60 keV. For a concentration of about 10 mg/ml, typical of clinical practice, localized absorbed doses were generally increased by about a factor of two. At this concentration of 10 mg/ml, the maximum increase in total energy deposition in the phantom was only 6%. These simulations demonstrated that increases in contrast sphere doses were offset by corresponding dose reductions at distal and posterior locations. Conclusions: Adding iodine can result in values of localized absorbed dose increasing by more than an order of magnitude, but the total energy deposition is generally very modest (i.e., <10%). Their data show that adding iodine primarily changes the pattern of energy deposition in the irradiated region, rather than increasing patient doses per se.

  17. New Breast Cancer Recursive Partitioning Analysis Prognostic Index in Patients With Newly Diagnosed Brain Metastases

    SciTech Connect (OSTI)

    Niwinska, Anna; Murawska, Magdalena

    2012-04-01

    Purpose: The aim of the study was to present a new breast cancer recursive partitioning analysis (RPA) prognostic index for patients with newly diagnosed brain metastases as a guide in clinical decision making. Methods and Materials: A prospectively collected group of 441 consecutive patients with breast cancer and brain metastases treated between the years 2003 and 2009 was assessed. Prognostic factors significant for univariate analysis were included into RPA. Results: Three prognostic classes of a new breast cancer RPA prognostic index were selected. The median survival of patients within prognostic Classes I, II, and III was 29, 9, and 2.4 months, respectively (p < 0.0001). Class I included patients with one or two brain metastases, without extracranial disease or with controlled extracranial disease, and with Karnofsky performance status (KPS) of 100. Class III included patients with multiple brain metastases with KPS of {<=}60. Class II included all other cases. Conclusions: The breast cancer RPA prognostic index is an easy and valuable tool for use in clinical practice. It can select patients who require aggressive treatment and those in whom whole-brain radiotherapy or symptomatic therapy is the most reasonable option. An individual approach is required for patients from prognostic Class II.

  18. Percutaneous Treatment of Central Venous Stenosis in Hemodialysis Patients: Long-Term Outcomes

    SciTech Connect (OSTI)

    Kim, Young Chul; Won, Jong Yun Choi, Sun Young; Ko, Heung-kyu; Lee, Kwang-Hun; Lee, Do Yun; Kang, Byung-Chul; Kim, Seung-Jung

    2009-03-15

    The purpose of this study was to evaluate the long-term outcomes of endovascular treatment of central venous stenosis in patients with arteriovenous fistulas (AVFs) for hemodialysis. Five hundred sixty-three patients with AVFs who were referred for a fistulogram were enrolled in this study. Among them, 44 patients showed stenosis (n = 35) or occlusions (n = 9) in the central vein. For the initial treatment, 26 patients underwent percutaneous transluminal angioplasty (PTA) and 15 patients underwent stent placements. Periods between AVF formation and first intervention ranged from 3 to 144 months. Each patient was followed for 14 to 60 months. Procedures were successful in 41 of 44 patients (93.2%). Primary patency rates for PTA at 12 and 36 months were 52.1% and 20.0%, and assisted primary patency rates were 77.8% and 33.3%, respectively. Primary patency rates for stent at 12 and 36 months were 46.7% and 6.7%, and assisted primary patency rates were 60.0% and 20.0%, respectively. Fifteen of 26 patients with PTAs underwent repeated interventions because of restenosis. Fourteen of 15 patients with a stent underwent repeated interventions because of restenosis and combined migration (n = 1) and shortening (n = 6) of the first stent. There was no significant difference in patency between PTAs and stent placement (p > 0.05). Average AVF patency duration was 61.8 months and average number of endovascular treatments was 2.12. In conclusion, endovascular treatments of central venous stenosis could lengthen the available period of AVFs. There was no significant difference in patency between PTAs and stent placement.

  19. Transjugular Endovascular Recanalization of Splenic Vein in Patients with Regional Portal Hypertension Complicated by Gastrointestinal Bleeding

    SciTech Connect (OSTI)

    Luo, Xuefeng; Nie, Ling; Wang, Zhu; Tsauo, Jiaywei; Tang, Chengwei; Li, Xiao

    2013-05-02

    PurposeRegional portal hypertension (RPH) is an uncommon clinical syndrome resulting from splenic vein stenosis/occlusion, which may cause gastrointestinal (GI) bleeding from the esophagogastric varices. The present study evaluated the safety and efficacy of transjugular endovascular recanalization of splenic vein in patients with GI bleeding secondary to RPH.MethodsFrom December 2008 to May 2011, 11 patients who were diagnosed with RPH complicated by GI bleeding and had undergone transjugular endovascular recanalization of splenic vein were reviewed retrospectively. Contrast-enhanced computed tomography revealed splenic vein stenosis in six cases and splenic vein occlusion in five. Etiology of RPH was chronic pancreatitis (n = 7), acute pancreatitis with pancreatic pseudocyst (n = 2), pancreatic injury (n = 1), and isolated pancreatic tuberculosis (n = 1).ResultsTechnical success was achieved in 8 of 11 patients via the transjugular approach, including six patients with splenic vein stenosis and two patients with splenic vein occlusion. Two patients underwent splenic vein venoplasty only, whereas four patients underwent bare stents deployment and two covered stents. Splenic vein pressure gradient (SPG) was reduced from 21.5 ± 7.3 to 2.9 ± 1.4 mmHg after the procedure (P < 0.01). For the remaining three patients who had technical failures, splenic artery embolization and subsequent splenectomy was performed. During a median follow-up time of 17.5 (range, 3–34) months, no recurrence of GI bleeding was observed.ConclusionsTransjugular endovascular recanalization of splenic vein is a safe and effective therapeutic option in patients with RPH complicated by GI bleeding and is not associated with an increased risk of procedure-related complications.

  20. Intrahepatic Left to Right Portoportal Venous Collateral Vascular Formation in Patients Undergoing Right Portal Vein Ligation

    SciTech Connect (OSTI)

    Lienden, K. P. van; Hoekstra, L. T.; Bennink, R. J.; Gulik, T. M. van

    2013-12-15

    Purpose: We investigated intrahepatic vascular changes in patients undergoing right portal vein ligation (PVL) or portal vein embolization (PVE) in conjunction with the ensuing hypertrophic response and function of the left liver lobe. Methods: Between December 2008 and October 2011, 7 patients underwent right PVL and 14 patients PVE. Computed tomographic (CT) volumetry to assess future remnant liver (FRL) and functional hepatobiliary scintigraphy were performed in all patients before and 3 weeks after portal vein occlusion. In 18 patients an intraoperative portography was performed to assess perfusion through the occluded portal branches. Results: In all patients after initially successful PVL, reperfused portal veins were observed on CT scan 3 weeks after portal occlusion. This was confirmed in all cases during intraoperative portography. Intrahepatic portoportal collaterals were identified in all patients in the PVL group and in one patient in the PVE group. In all other PVE patients, complete occlusion of the embolized portal branches was observed on CT scan and on intraoperative portography. The median increase of FRL volume after PVE was 41.6 % (range 10-305 %), and after PVL was only 8.1 % (range 0-102 %) (p = 0.179). There were no differences in FRL function between both groups. Conclusion: Preoperative PVE and PVL are both methods to induce hypertrophy of the FRL in anticipation of major liver resection. Compared to PVE, PVL seems less efficient in inducing hypertrophy of the nonoccluded left lobe. This could be caused by the formation of intrahepatic portoportal neocollateral vessels, through which the ligated portal branches are reperfused within 3 weeks.

  1. Survival Benefit for Pediatric Patients With Recurrent Ependymoma Treated With Reirradiation

    SciTech Connect (OSTI)

    Bouffet, Eric; Ballourah, Walid; Bartels, Ute K.; Tsangaris, Elena; Huang, Annie; Mabbot, Donald J.; Laperriere, Normand; Tabori, Uri

    2012-08-01

    Purpose: The outcome of recurrent ependymoma in children is dismal. Reirradiation has been proposed as an effective modality for ependymoma at relapse. However, the toxicity and outcome benefits of this approach have not been well established. Methods and Materials: We conducted a retrospective population-based study of all patients with recurrent ependymoma treated between 1986 and 2010 in our institution. Demographic, treatment, and outcome data were analyzed for the entire cohort. Results: Of 113 patients with intracranial ependymoma, 47 patients relapsed. At the time of relapse, 29 patients were treated with surgical resection and/or chemotherapy, and 18 patients received full-dose ({>=}54 Gy focal and/or craniospinal) reirradiation with or without surgery at recurrence. Reirradiation was tolerated well with no severe acute complications noticed. Three-year overall survival was 7% {+-} 6% and 81% {+-} 12% for nonreirradiated and reirradiated patients, respectively (p < 0.0001). Time to second progression after reirradiation was significantly longer than time to first progression. This surprising phenomenon was associated with improved progression-free survival for tumors with evidence of DNA damage (n = 15; p = 0.002). At a mean follow-up of 3.73 years, only 2/18 patients had endocrine dysfunction, and 1 patient required special education support. However, a decline in intellectual function from pre- to postreirradiation assessment was observed. Conclusions: Reirradiation is an effective treatment that may change the natural history of recurrent ependymoma in children. However, this change may be associated with increased neurocognitive toxicity. Additional follow-up is needed to determine the risk of late recurrence, secondary radiation-induced tumors, and long-term functional outcome of these patients.

  2. A Comparison of Three Music Therapy Introduction Dialogues on Acceptance of Music Therapy Services by Cancer Patients

    E-Print Network [OSTI]

    Barck, Leanne Kathleen

    2014-12-31

    ABSTRACT The purpose of this study was to compare the effectiveness of 3 different music therapy introduction dialogues with cancer patients. Relationships between patient-reported anxiety levels, sex, and age and the acceptance rate of music...

  3. 19Bulletin Infirmier du Cancer Vol.6-n1-janvier-fvrier-mars 2006 SOR savoir patient

    E-Print Network [OSTI]

    Paris-Sud XI, Université de

    19Bulletin Infirmier du Cancer Vol.6-n°1-janvier-février-mars 2006 SOR savoir patient A fin de;20Bulletin Infirmier du Cancer Vol.6-n°1-janvier-février-mars 2006 SOR savoir patient mandations pour la

  4. Use of Nitinol Stents Following Recanalization of Central Venous Occlusions in Hemodialysis Patients

    SciTech Connect (OSTI)

    Rajan, Dheeraj K., E-mail: dheeraj.rajan@uhn.on.ca; Saluja, Jasdeep S. [Toronto General Hospital, University Health Network University of Toronto, Division of Vascular and Interventional Radiology, Department of Medical Imaging (Canada)

    2007-07-15

    Purpose. To retrospectively review the patency of endovascular interventions with nitinol stent placement for symptomatic central venous occlusions in hemodialysis patients. Methods. A retrospective review of all patients who underwent endovascular interventions for dysfunctional hemodialysis grafts and fistulas was performed from April 2004 to August 2006. A total of 6 patients presented with arm and/or neck and facial swelling and left brachiocephalic vein occlusion. The study group consisted of 3 men and 3 women with a mean age of 79.5 years (SD 11.2 years). Of these 6 patients, 1 had a graft and 5 had fistulas in the left arm. The primary indication for nitinol stent placement was technical failure of angioplasty following successful traversal of occluded central venous segments. Patency was assessed from repeat fistulograms and central venograms performed when patients redeveloped symptoms or were referred for access dysfunction determined by the ultrasound dilution technique. No patients were lost to follow-up. Results. Nitinol stent placement to obtain technically successful recanalization of occluded venous segments was initially successful in 5 of 6 patients (83%). In 1 patient, incorrect stent positioning resulted in partial migration to the superior vena cava requiring restenting to prevent further migration. Clinical success was observed in all patients (100%). Over the follow-up period, 2 patients underwent repeat intervention with angioplasty alone. Primary patency was 83.3% (95% CI 0.5-1.2) at 3 months, and 66.7% at 6 and 12 months (0.2-1.1, 0.1-1.2). Secondary patency was 100% at 12 months with 3 patients censored over that time period. Mean primary patency was 10.4 months with a mean follow-up of 12.4 months. No complications related to recanalization of the occluded central venous segments were observed. Conclusion. Our initial experience has demonstrated that use of nitinol stents for central venous occlusion in hemodialysis patients is associated with good mid-term patency and may exceed historical observations with prior use of Wallstents.

  5. J U N E 2 0 1 0 One does not discover new lands without consenting to lose sight

    E-Print Network [OSTI]

    Selmic, Sandra

    Available for Gulf of Mexico Oil Spill Research May 27, 2010 In light of the recent oil spill in the Gulf to the oil spill. RAPID is a special grant mechanism developed specifically to respond to unusual the New Croton Aqueduct, Warren Environ., Inc. 6,800 Patrick O'Neal Medical-Device-Industry Experience

  6. Acquisition, tracking, pointing, and line-of-sight control laboratory experiments for a space-based bifocal relay mirror

    E-Print Network [OSTI]

    as well as the development of a test bed for a bifocal relay mirror spacecraft. Figure 1. Bifocal Relay-based bifocal relay mirror M. G. Spencer*, B. N. Agrawal, M. Romano Spacecraft Research and Design Center Naval ABSTRACT Space based bifocal relay mirrors are potentially an enabling/enhancing piece of any architecture

  7. A Priori vision : the transcendence of pre-ontological sight : the disparity of externalizing the internal architecture of creation

    E-Print Network [OSTI]

    Lawson, Matthew Everett

    2012-01-01

    The completion of any visual work is not an arrival, but furthered from the origin, the inner plane of perspective, which is so readily lent from the context of communicating the seemingly coded space from which I am ...

  8. One-arcsecond line-of-sight pointing control on exoplanetsat, a three-unit CubeSat

    E-Print Network [OSTI]

    Pong, Christopher Masaru

    2011-01-01

    ExoplanetSat is a proposed 10×10×34-cm space telescope designed to detect down to Earth-sized exoplanets in an orbit out to the habitable zone of bright, Sun-like stars via the transit method. Achieving this science objective ...

  9. DOE-STD-1040-93 CN-1; Guide to Good Practices for Control of On-Sight Training

    Office of Energy Efficiency and Renewable Energy (EERE) Indexed Site

    AFDC Printable Version Share this resource Send a link to EERE: Alternative Fuels Data Center Home Page to someone by E-mail Share EERE: Alternative Fuels Data Center Home Page on Facebook Tweet about EERE: Alternative Fuels Data Center Home Page on Twitter Bookmark EERE: Alternative Fuels Data Center Home Page on Google Bookmark EERE: Alternative Fuels Data Center Home Page on Delicious Rank EERE:FinancingPetroleum Based| Department8, 2015 GATEWAY6.1viiiDepartment of4-93 March 19937-930-93 June

  10. Blind Geothermal System Exploration in Active Volcanic Environments...

    Open Energy Info (EERE)

    within the Haleakala Southwest Rift Zone (HSWRZ); the faults of which are the main drilling targets - Demonstrate viability, usefulness and cost-effectiveness of merged...

  11. Man made global warming explained - closing the blinds

    E-Print Network [OSTI]

    Sloan, T

    2010-01-01

    One of the big problems of the age concerns 'Global Warming', and whether it is 'man-made' or 'natural'. Most climatologists believe that it is very likely to be the former but some scientists (mostly non-climatologists) subscribe to the latter. Unsurprisingly, the population at large is often confused and and is not convinced either way. Here we try to explain the principles of man-made global warming in a simple way. Our purpose is to try to understand the story which the climatologists are telling us through their rather complicated general circulation models. Although the effects in detail are best left to the climatologists' models, we show that for the Globe as a whole the effects of man-made global warming can be demonstrated in a simple way. The simple model of only the direct heating from the absorption of infrared radiation, illustrates the main principles of the science involved. The predicted temperature increase due to the increase of greenhouse gases in the atmosphere over the last century descr...

  12. A Blind Approach to Identification of Hammerstein Systems

    E-Print Network [OSTI]

    Wang, Jiandong

    of faulty control valves in feed- back control systems. The nonlinearity of control valves has a variety. [2] did so by passing output measurements through an inverse of the iden- tified linear system

  13. Manuscript NC 2079 Blind Source Separation by Sparse

    E-Print Network [OSTI]

    Pearlmutter, Barak

    Zibulevsky Dept. of Computer Science University of New Mexico Albuquerque, NM 87131 Barak A. Pearlmutter Dept. of Computer Science Dept. of Neurosciences University of New Mexico Albuquerque, NM 87131 July 9, 2000 (Final A, and possibly corrupted by additive noise #24;(t) x(t) = As(t) + #24;(t) (1) We wish to estimate

  14. Blind Source Separation by Sparse Decomposition in a Signal Dictionary

    E-Print Network [OSTI]

    Zibulevsky, Michael

    @cs.unm.edu Barak A. Pearlmutter bap@cs.unm.edu Dept. of Computer Science University of New Mexico Albuquerque, NM corrupted by additive noise #24;(t) x(t) = As(t) + #24;(t) (1) We wish to estimate the mixing matrix

  15. Blind Source Separation by Sparse Decomposition in a Signal Dictionary

    E-Print Network [OSTI]

    Pearlmutter, Barak

    .A. Pearlmutter, University of New Mexico P. Bo#12;ll, Universitat Polit#18;ecnica de Catalunya P. Kisilev #2; M matrix A, and possibly corrupted by additive noise #24;(t) x(t) = As(t) + #24;(t) (1.1) We wish

  16. Identification of a New Blind Geothermal System with Hyperspectral...

    Open Energy Info (EERE)

    with Hyperspectral Remote Sensing and Shallow Temperature Measurements at Columbus Salt Marsh, Esmeralda County, Nevada Jump to: navigation, search OpenEI Reference LibraryAdd...

  17. BLINDED BY ASSUMPTIONS bridges vol. 17, April 2008 / Pielke's Perspective

    E-Print Network [OSTI]

    Colorado at Boulder, University of

    either the increase in the global use of energy or the growth in the size of the global economy, and in China in particular. Some scholars believe that the rapid pace of growth will continue for decades. Our for this resistance is undoubtedly that political commitments are built upon the justifications in policy analyses

  18. Overview of First CAPRI Blind Protein Docking Experiment

    E-Print Network [OSTI]

    Ritchie, Dave

    et al. Rey 3 Hemagglutinin HC63 U/B Barbey-Martin et al. Knossow 4 -Amylase AMD10 U/B Desmyter et al. Cambillau 5 -Amylase AMB7 U/B Desmyter et al. Cambillau 6 -Amylase AMD9 U/B Desmyter et al. Cambillau 7 Spe

  19. 3 Blind Men, an Elephant and Materials Characterization | GE...

    Broader source: All U.S. Department of Energy (DOE) Office Webpages (Extended Search)

    an Elephant and Materials Characterization Swarna Addepalli 2012.06.04 As a child in India, I grew up listening to and reading a lot of stories, which, in essence, teach how one...

  20. The Path of the Blind Watchmaker: A Model of Evolution

    E-Print Network [OSTI]

    Poggio, Andrew Anthony

    2011-01-01

    Patrinos. (2003). The Human Genome Project: Lessons fromScience, 300, 286-90. Human Genome Project. Functional andinitiation of the Human Genome Project, the cost to sequence

  1. SOLAR-BLIND PYROMETRIC TEMPERATURE MEASUREMENT UNDER CONCENTRATED SOLAR

    E-Print Network [OSTI]

    solar thermal applications. As contact thermometry is often not appropriate in the presence of high;Introduction In high temperature solar thermal applications, where key components are driven near reflections1,2 . The distinction between the emitted thermal and the reflected solar radiation becomes

  2. A Reliable method for Blind Channel Identification using Burst Data

    E-Print Network [OSTI]

    Raphaeli, Dan

    methods can be partitioned to those based on Second Order Statis- tics(SOS) relative to others based on Higher Order Statis- tics(HOS). SOS methods are applicable when we have time or antenna diversity

  3. Fusion of Live Audio Recordings for Blind Noise Reduction

    E-Print Network [OSTI]

    Kuzmanovic, Aleksandar

    , this assumption is inappropriate in the context of a quiet auditorium, where one cough may appear on every

  4. Robust wavelet estimation and blind deconvolution of noisy surface seismics

    E-Print Network [OSTI]

    van der Baan, Mirko

    these days because it is judged to be less reliable. With the advent of the microelectromechanical system MEMS sensors, bandwidth is much less of a problem now than it was 20 years ago; and this supports

  5. SPARSE REPRESENTATION AND BLIND DECONVOLUTION OF DYNAMICAL SYSTEMS

    E-Print Network [OSTI]

    Vialatte, François

    Cichocki Lab. for Advanced Brain Signal Processing RIKEN Brain Science Institute Wako shi, Saitama, 351, speech recognition, image enhancement and biomedical signal pro- cessing [1, 2, 3, 4, 5, 6, 7, 8, 9, 10 sources. The seismic data, the cocktail problem and biomedical data such as EEG signals are typical exam

  6. THE BLIND PATTERN MATCHING ATTACK ON WATERMARK SYSTEMS

    E-Print Network [OSTI]

    Petitcolas, Fabien A.P.

    complex- ity to reverse the permutations as a preprocessing step for watermark detection. In this paper, we describe the logistics of the attack and a recipe for its implementation against an audio be shown that any WM detector is facing a task of exponential complexity to reverse the permutations

  7. Photochemical restoration of visual responses in blind mice

    E-Print Network [OSTI]

    Polosukhina, Aleksandra

    2013-01-01

    retinal cells allows for direct stimulation of surviving neurons, potentially shaping a clearer neu- ral/processing

  8. Novel Coupled Thermochronometric and Geochemical Investigation of Blind

    Office of Energy Efficiency and Renewable Energy (EERE) Indexed Site

    AFDC Printable Version Share this resource Send a link to EERE: Alternative Fuels Data Center Home Page to someone by E-mail Share EERE: Alternative Fuels Data Center Home Page on Facebook Tweet about EERE: Alternative Fuels Data Center Home Page on Twitter Bookmark EERE: Alternative Fuels Data Center Home Page on Google Bookmark EERE: Alternative Fuels Data Center Home Page on Delicious RankADVANCED MANUFACTURINGEnergy Bills and Reduce CarbonEnergyDepartment13 FederalJuly 28,1

  9. Blind Geothermal System Exploration in Active Volcanic Environments;

    Office of Energy Efficiency and Renewable Energy (EERE) Indexed Site

    AFDC Printable Version Share this resource Send a link to EERE: Alternative Fuels Data Center Home Page to someone by E-mail Share EERE: Alternative Fuels Data Center Home Page on Facebook Tweet about EERE: Alternative Fuels Data Center Home Page on Twitter Bookmark EERE: Alternative Fuels Data Center Home Page on Google Bookmark EERE: Alternative Fuels Data Center Home Page on Delicious Rank EERE:FinancingPetroleum Based Fuels Researchof Energy|Make6, 2015Multi-phase Geophysical and

  10. Blind Geothermal System Exploration in Active Volcanic Environments;

    Open Energy Info (EERE)

    AFDC Printable Version Share this resource Send a link to EERE: Alternative Fuels Data Center Home Page to someone by E-mail Share EERE: Alternative Fuels Data Center Home Page on Facebook Tweet about EERE: Alternative Fuels Data Center Home Page on Twitter Bookmark EERE: Alternative Fuels Data Center Home Page on Google Bookmark EERE: Alternative Fuels Data Center Home Page on QA:QA J-E-1 SECTION JEnvironmental JumpInformationBio-Gas Technologies,BlackhawkBlauvelt, NewMulti-phase

  11. Identification of a New Blind Geothermal System with Hyperspectral Remote

    Open Energy Info (EERE)

    AFDC Printable Version Share this resource Send a link to EERE: Alternative Fuels Data Center Home Page to someone by E-mail Share EERE: Alternative Fuels Data Center Home Page on Facebook Tweet about EERE: Alternative Fuels Data Center Home Page on Twitter Bookmark EERE: Alternative Fuels Data Center Home Page on Google Bookmark EERE: Alternative Fuels Data Center Home Page on QA:QA J-E-1 SECTION J APPENDIXsource History View NewGuam:on Openei | Opensource History View New PagesLog Data

  12. Alabama Institute for Deaf and Blind to Launch Lighting Project |

    Broader source: Energy.gov (indexed) [DOE]

    AFDC Printable Version Share this resource Send a link to EERE: Alternative Fuels Data Center Home Page to someone by E-mail Share EERE: Alternative Fuels Data Center Home Page on Facebook Tweet about EERE: Alternative Fuels Data Center Home Page on Twitter Bookmark EERE: Alternative Fuels Data Center Homesum_a_epg0_fpd_mmcf_m.xls" ,"Available from WebQuantity of Natural GasAdjustmentsShirleyEnergyTher i n c i p a l De p u t y A sCOLONYDepartment of EnergyDepartmentDepartment

  13. Patients with Life-Threatening Arterial Renal Hemorrhage: CT Angiography and Catheter Angiography with Subsequent Superselective Embolization

    SciTech Connect (OSTI)

    Sommer, C. M., E-mail: christof.sommer@med.uni-heidelberg.de; Stampfl, U.; Bellemann, N.; Ramsauer, S. [University Hospital Heidelberg, Department of Diagnostic and Interventional Radiology (Germany); Loenard, B. M. [University Hospital Heidelberg, Department of Urology (Germany); Haferkamp, A. [University Hospital Heidelberg, Department of Anesthesiology (Germany); Hallscheidt, P.; Richter, G. M.; Kauczor, H. U.; Radeleff, B. A. [University Hospital Heidelberg, Department of Diagnostic and Interventional Radiology (Germany)

    2010-06-15

    The purpose of this study was to evaluate the technical and clinical success of superselective embolization in patients with life-threatening arterial renal hemorrhage undergoing preinterventional CT angiography. Forty-three patients with clinical signs of life-threatening arterial renal hemorrhage underwent CT angiography and catheter angiography. Superselective embolization was indicated in the case of a positive catheter angiography. Primary study goals were technical and clinical success of superselective embolization. Secondary study goals were CT angiographic and catheter angiographic image findings and clinical follow-up. The mean time interval between CT angiography and catheter angiography was 8.3 {+-} 10.3 h (range, 0.2-34.1 h). Arterial renal hemorrhage was identified with CT angiography in 42 of 43 patients (98%) and catheter angiography in 39 of 43 patients (91%) (overview angiography in 4 of 43 patients [9%], selective angiography in 16 of 43 patients [37%], and superselective angiography in 39 of 43 patients [91%]). Superselective embolization was performed in 39 of 43 patients (91%) and technically successful in 37 of 39 patients (95%). Therefore, coil embolization was performed in 13 of 37 patients (35%), liquid embolization in 9 of 37 patients (24%), particulate embolization in 1 of 37 patients (3%), and a combination in 14 of 37 patients (38%). Clinical failure occurred in 8 of 39 patients (21%) and procedure-related complications in 2 of 39 patients (5%). The 30-day mortality rate was 3%. Hemoglobin decreased significantly prior to intervention (P < 0.001) and increased significantly after intervention (P < 0.005). In conclusion, superselective embolization is effective, reliable, and safe in patients with life-threatening arterial renal hemorrhage. In contrast to overview and selective angiography, only superselective angiography allows reliable detection of arterial renal hemorrhage. Preinterventional CT angiography is excellent for detection and localization of arterial renal hemorrhage and appropriate for guidance of the embolization procedure.

  14. Percutaneous Transsplenic Access to the Portal Vein for Management of Vascular Complication in Patients with Chronic Liver Disease

    SciTech Connect (OSTI)

    Chu, Hee Ho; Kim, Hyo-Cheol Jae, Hwan Jun; Yi, Nam-Joon; Lee, Kwang-Woong; Suh, Kyung-Suk; Chung, Jin Wook; Park, Jae Hyung

    2012-12-15

    Purpose: To evaluate the safety and feasibility of percutaneous transsplenic access to the portal vein for management of vascular complication in patients with chronic liver diseases. Methods: Between Sept 2009 and April 2011, percutaneous transsplenic access to the portal vein was attempted in nine patients with chronic liver disease. Splenic vein puncture was performed under ultrasonographic guidance with a Chiba needle, followed by introduction of a 4 to 9F sheath. Four patients with hematemesis or hematochezia underwent variceal embolization. Another two patients underwent portosystemic shunt embolization in order to improve portal venous blood flow. Portal vein recanalization was attempted in three patients with a transplanted liver. The percutaneous transsplenic access site was closed using coils and glue. Results: Percutaneous transsplenic splenic vein catheterization was performed successfully in all patients. Gastric or jejunal varix embolization with glue and lipiodol mixture was performed successfully in four patients. In two patients with a massive portosystemic shunt, embolization of the shunting vessel with a vascular plug, microcoils, glue, and lipiodol mixture was achieved successfully. Portal vein recanalization was attempted in three patients with a transplanted liver; however, only one patient was treated successfully. Complete closure of the percutaneous transsplenic tract was achieved using coils and glue without bleeding complication in all patients. Conclusion: Percutaneous transsplenic access to the portal vein can be an alternative route for portography and further endovascular management in patients for whom conventional approaches are difficult or impossible.

  15. HC: 810 (6/12) Patient Rights & Responsibilities Health Education University of California, Santa Cruz Student Health Services

    E-Print Network [OSTI]

    California at Santa Cruz, University of

    HC: 810 (6/12) Patient Rights & Responsibilities Health Education University of California, Santa Cruz Student Health Services PATIENT RIGHTS AND RESPONSIBILITIES Every patient has certain rights be submitted by: Filling out a Quick Comment slip found in all Student Health Services lobbies Contacting

  16. Master Trainer Agreement and Certification Form October 2014 ~ 1 ~ STANFORD Stanford Patient Education Research Center

    E-Print Network [OSTI]

    Kay, Mark A.

    Master Trainer Agreement and Certification Form October 2014 ~ 1 ~ STANFORD Stanford Patient Education Research Center SCHOOL OF MEDICINE http://patienteducation.stanford.edu Master Trainer Agreement the express written consent of Stanford University. #12;Master Trainer Agreement and Certification Form

  17. Using prediction to facilitate patient flow in a health care delivery chain

    E-Print Network [OSTI]

    Peck, Jordan S. (Jordan Shefer)

    2013-01-01

    A health care delivery chain is a series of treatment steps through which patients flow. The Emergency Department (ED)/Inpatient Unit (IU) chain is an example chain, common to many hospitals. Recent literature has suggested ...

  18. The effect of pet ownership/attachment on the stress level of multiple sclerosis patients 

    E-Print Network [OSTI]

    Loven, Ashley Marie

    2005-11-01

    Multiple Sclerosis (MS) is the most common demyelinating disease affecting the central nervous system. Over 80% of MS patients are in the relapsing remitting stage. Symptoms range from fever, fatigue, emotional distress, tingling, numbness, optic...

  19. Reduction of CD8(+) T lymphocytes in multiple sclerosis patients treated with dimethyl fumarate.

    E-Print Network [OSTI]

    Spencer, CM; Crabtree-Hartman, EC; Lehmann-Horn, K; Cree, BA; Zamvil, SS

    2015-01-01

    1 T lymphocytes in multiple sclerosis patients treated withTecfidera) treatment of multiple sclerosis (MS) on leukocyte1) and US National Multiple Sclerosis Society (FG 2067-A-1).

  20. Understanding how primary care physicians work with personality disorder patients: a qualitative approach 

    E-Print Network [OSTI]

    Deegear, James Otis

    2004-11-15

    The purpose of the present study was to begin to develop an understanding of how primary care resident physicians work with patients with personality disorder-type characteristics and processes. Participants include fifteen primary care resident...

  1. Vitamin K Antagonists Predispose to Calciphylaxis in Patients with End-Stage Renal Disease

    E-Print Network [OSTI]

    Galloway, P. A. G.; El-Damanawi, R.; Bardsley, V.; Pritchard, N. R; Fry, A. C.; Ojha, S. K.; Hiemstra, T. F

    2015-02-26

    Background/Aims: Calciphylaxis is associated with a poor prognosis in dialysis patients, and its pathogenesis remains incompletely understood. Although the use of vitamin K antagonists (VKA) has been implicated, previous reports are conflicting...

  2. Experiences of specialist inpatient treatment for anorexia nervosa: a qualitative study from adult patients’ perspectives 

    E-Print Network [OSTI]

    Smith, Vivien

    2012-06-26

    Background: Response to treatment in anorexia nervosa entails various challenges, including an increased risk of relapse and re-admission in those treated as inpatients. A better understanding of patients’ experiences ...

  3. Efficacy of DVD Technology in Chronic Obstructive Pulmonary Disease Self- Management Education of Rural Patients 

    E-Print Network [OSTI]

    Stellefson, Michael L.

    2010-01-14

    Despite the efficacy of pulmonary rehabilitation programs which assist patients in managing chronic obstructive pulmonary disease (COPD), the high costs and lack of availability of such programs pose considerable barriers ...

  4. Monitoring Motor Fluctuations in Patients With Parkinson's Disease Using Wearable Sensors

    E-Print Network [OSTI]

    Patel, Shyamal

    This paper presents the results of a pilot study to assess the feasibility of using accelerometer data to estimate the severity of symptoms and motor complications in patients with Parkinson's disease. A support vector ...

  5. Detecting Hazardous Intensive Care Patient Episodes Using Real-time Mortality Models

    E-Print Network [OSTI]

    Hug, Caleb

    2009-08-26

    The modern intensive care unit (ICU) has become a complex, expensive, data-intensive environment. Caregivers maintain an overall assessment of their patients based on important observations and trends. If an advanced ...

  6. Detecting hazardous intensive care patient episodes using real-time mortality models

    E-Print Network [OSTI]

    Hug, Caleb W. (Caleb Wayne)

    2009-01-01

    The modern intensive care unit (ICU) has become a complex, expensive, data-intensive environment. Caregivers maintain an overall assessment of their patients based on important observations and trends. If an advanced ...

  7. THE IMPACT OF WORK UNIT AND ORGANIZATION SUPPORT ON HOSPITAL PATIENT SAFETY

    E-Print Network [OSTI]

    Kemper, Carol Ann

    2009-01-27

    Based on the construct of a culture of safety, the study purpose was to discern the relationships between Organization Support (OS) and Work Unit Support (WS) on Hospital Patient Safety. OS and WS were operationalized ...

  8. Controlled guidance of handwriting in Parkinson's Disease patients. Can a sonic aid improve tau guidance measures 

    E-Print Network [OSTI]

    Baxter, Holly

    2006-01-01

    Aim: To identify, using “tau theory” (Lee, 1998), i) if there are significant differences in tau guidance of handwriting between PD patients and normal healthy controls, and if so, ii) whether tau guidance for these ...

  9. Front desk talk: A study of interaction between receptionists and patients in general practice surgeries 

    E-Print Network [OSTI]

    Hewitt, Heather Mary

    Receptionists who work in general practice surgeries in Great Britain are part of a large, state-funded organisation, the National Health Service. Their duties include registering patients with practices, arranging ...

  10. Critical processes and performance measures for patient safety systems in healthcare institutions: a Delphi study 

    E-Print Network [OSTI]

    Akins, Ralitsa B.

    2004-11-15

    This dissertation study presents a conceptual framework for implementing and assessing patient safety systems in healthcare institutions. The conceptual framework consists of critical processes and performance measures identified in the context...

  11. The Relationship between the Nurses' Work Environment and Patient and Nurse Outcomes

    E-Print Network [OSTI]

    Blake, Nancy

    2012-01-01

    in other countries and nurses in adult intensive care units.countries and among nurses in adult intensive care units, noadult ICUs that these three variables have an impact on patient and nurse

  12. Pilomatrical carcinoma: A case in a patient with HIV and hepatitis C

    E-Print Network [OSTI]

    Scheinfeld, Noah

    2008-01-01

    in a patient with HIV and hepatitis C Dermatology Onlinea 51-year-old man with HIV, hepatitis C, and pilomatricalCD4 count of 84, and hepatitis C with hepatic cirrhosis,

  13. Neuroimaging abnormalities, neurocognitive function, and fatigue in patients with hepatitis C.

    E-Print Network [OSTI]

    2015-01-01

    fatigue in patients with hepatitis C April D. Thames, PhDamong a sample of adults with hepatitis C virus (HCV). WeControl and Prevention: Hepatitis C Information for Health

  14. Parkinson's Disease Patient-Derived Induced Pluripotent Stem Cells Free of Viral Reprogramming Factors

    E-Print Network [OSTI]

    Soldner, Frank

    Induced pluripotent stem cells (iPSCs) derived from somatic cells of patients represent a powerful tool for biomedical research and may provide a source for replacement therapies. However, the use of viruses encoding the ...

  15. Detection of early basal cell carcinoma with dermoscopy in a patient with psoriasis

    E-Print Network [OSTI]

    Liebman, Tracey N; Wang, Steven Q

    2011-01-01

    distinction between sBCC and psoriasis can be established,intraepidermal carcinoma, and psoriasis. J Am Acad Dermatol,dermoscopy in a patient with psoriasis Tracey N Liebman BA,

  16. Reducing intraday patient wait times through just-in-time bed assignment

    E-Print Network [OSTI]

    McNichols, Sean T

    2015-01-01

    Massachusetts General Hospital (MGH) is the oldest and largest hospital in New England as well as the original and largest teaching hospital of the Harvard Medical School. The neuroscience units experience patient flow ...

  17. Cancer survivors and survivorship care: Provider expectations, post-treatment health services, and patient reported outcomes

    E-Print Network [OSTI]

    Hahn, Erin Elizabeth

    2013-01-01

    2011) Long Term Effects and Cancer Survivorship in the OlderGanz (Eds. ), Management of Cancer for the Older Patient (the Quality of Care for Cancer Survivors. Psycho-Oncology (

  18. IGF1 as a Potential Treatment for Rett Syndrome: Safety Assessment in Six Rett Patients

    E-Print Network [OSTI]

    Pini, Giorgio

    2012-01-01

    Rett syndrome (RTT) is a devastating neurodevelopmental disorder that affects one in ten thousand girls and has no cure. The majority of RTT patients display mutations in the gene that codes for the methyl-CpG-binding ...

  19. Problems of tort litigation as a means of patient and consumer protection in health care systems

    E-Print Network [OSTI]

    Moore, Michael David

    2009-01-01

    The U.S. health care system relies on tort litigation as a means of protecting patients and consumers from medical malpractice. The system of tort litigation has contributed to the U.S. having the highest health care ...

  20. Healthcare technology, patient engagement and adherence : systems and business opportunity analysis

    E-Print Network [OSTI]

    Jog, Chetan R. (Chetan Ravindra)

    2012-01-01

    In the current shift in the US healthcare system, lower cost, higher quality of care, access and safety are the main drivers that are effecting changes. Patient compliance with medication and technology enabled wellness ...

  1. Again: An account of demoralisation in patients and families experiencing recurrence of cancer 

    E-Print Network [OSTI]

    Vivar, Cristina G

    2007-01-01

    AIMS The aims of this thesis are to provide understanding of the psychosocial impact of recurrent cancer on patients and family members and to develop a substantive theory that explains the phenomenon of recurrence from ...

  2. Grade 1 spondylolisthesis and interspinous device placement: removal in six patients and analysis of current data

    E-Print Network [OSTI]

    Bohm, Parker E.; Anderson, Karen K.; Friis, Elizabeth A.; Arnold, Paul M.

    2015-04-02

    In the treatment of patients with Grade 1 spondylolisthesis, the use of interspinous devices has been controversial for nearly a decade. Several authors have suggested that Grade 1 spondylolisthesis be considered a ...

  3. Enhancement of a fluorescent sensor for monitoring glucose concentration in diabetic patients 

    E-Print Network [OSTI]

    Ibey, Bennett Luke

    2007-04-25

    The need for overnight and continuous monitoring of glucose levels in diabetic patients is profound, especially among juveniles. Implantation of a chemical assay which responds optically to changes in glucose concentration shows promise as a...

  4. Texas Dental Hygienists' Use of Behavioral Management Techniques for Patients with Dental Anxiety 

    E-Print Network [OSTI]

    Utt, Laurie Gene

    2015-03-06

    Purpose: Dental anxiety is a prevalent condition negatively affecting both the dental patient and the dental team. Behavioral management techniques have shown to help increase relaxation, reduce anxiety and decrease the amount of pharmaceutical...

  5. Wearable Doppler radar with integrated antenna for patient vital sign monitoring

    E-Print Network [OSTI]

    Fletcher, Richard Ribon

    A 2.45 GHz wearable Doppler radar unit with radio data link is presented for use in portable patient monitoring and emergency response. Unlike portable Electrocardiograms (ECG) or Photoplethysmography (PPG), the near-field ...

  6. Malfunctions of Implantable Cardiac Devices in Patients Receiving Proton Beam Therapy: Incidence and Predictors

    SciTech Connect (OSTI)

    Gomez, Daniel R., E-mail: dgomez@mdanderson.org [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Poenisch, Falk [Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Pinnix, Chelsea C. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Sheu, Tommy [Department of Experimental Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Chang, Joe Y. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Memon, Nada [Department of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Mohan, Radhe [Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Rozner, Marc A. [Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Dougherty, Anne H. [Department of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2013-11-01

    Purpose: Photon therapy has been reported to induce resets of implanted cardiac devices, but the clinical sequelae of treating patients with such devices with proton beam therapy (PBT) are not well known. We reviewed the incidence of device malfunctions among patients undergoing PBT. Methods and Materials: From March 2009 through July 2012, 42 patients with implanted cardiac implantable electronic devices (CIED; 28 pacemakers and 14 cardioverter-defibrillators) underwent 42 courses of PBT for thoracic (23, 55%), prostate (15, 36%), liver (3, 7%), or base of skull (1, 2%) tumors at a single institution. The median prescribed dose was 74 Gy (relative biological effectiveness; range 46.8-87.5 Gy), and the median distance from the treatment field to the CIED was 10 cm (range 0.8-40 cm). Maximum proton and neutron doses were estimated for each treatment course. All CIEDs were checked before radiation delivery and monitored throughout treatment. Results: Median estimated peak proton and neutron doses to the CIED in all patients were 0.8 Gy (range 0.13-21 Gy) and 346 Sv (range 11-1100 mSv). Six CIED malfunctions occurred in 5 patients (2 pacemakers and 3 defibrillators). Five of these malfunctions were CIED resets, and 1 patient with a defibrillator (in a patient with a liver tumor) had an elective replacement indicator after therapy that was not influenced by radiation. The mean distance from the proton beam to the CIED among devices that reset was 7.0 cm (range 0.9-8 cm), and the mean maximum neutron dose was 655 mSv (range 330-1100 mSv). All resets occurred in patients receiving thoracic PBT and were corrected without clinical incident. The generator for the defibrillator with the elective replacement indicator message was replaced uneventfully after treatment. Conclusions: The incidence of CIED resets was about 20% among patients receiving PBT to the thorax. We recommend that PBT be avoided in pacing-dependent patients and that patients with any type of CIED receiving thoracic PBT be followed closely.

  7. An Integrated Model of Patient and Staff Satisfaction Using Queuing Theory

    E-Print Network [OSTI]

    Komashie, Alexander; Mousavi, Ali; Clarkson, P. John; Young, Terry

    2015-02-06

    development are discussed in the following section. A. DATA COLLECTION AND MODEL DEVELOPMENT At the time of this research, a major evaluation project around Accident and Emergency involving a satisfaction survey was already underway, using a questionnaire... and patient satisfaction,’’ Med. Care, vol. 42, no. 2, pp. II57–II66, Feb. 2004. [17] E. S. Williams et al., ‘‘The effect of workplace health care worker stress and burnout on patient outcomes,’’ in Handbook of Human Factors and Ergonomics in Health Care...

  8. Self-Reported Cognitive Outcomes in Patients With Brain Metastases Before and After Radiation Therapy

    SciTech Connect (OSTI)

    Cole, Ansa Maer; Scherwath, Angela; Ernst, Gundula; Lanfermann, Heinrich; Bremer, Michael; Steinmann, Diana

    2013-11-15

    Purpose: Patients with brain metastases may experience treatment-related cognitive deficits. In this study, we prospectively assessed the self-reported cognitive abilities of patients with brain metastases from any solid primary cancer before and after irradiation of the brain. Methods and Materials: The treatment group (TG) consisted of adult patients (n=50) with brain metastases who received whole or partial irradiation of the brain without having received prior radiation therapy (RT). The control group (CG) consisted of breast cancer patients (n=27) without cranial involvement who were treated with adjuvant RT. Patients were recruited between May 2008 and December 2010. Self-reported cognitive abilities were acquired before RT and 6 weeks, 3 months, and 6 months after irradiation. The information regarding the neurocognitive status was collected by use of the German questionnaires for self-perceived deficits in attention (FEDA) and subjectively experienced everyday memory performance (FEAG). Results: The baseline data showed a high proportion of self-perceived neurocognitive deficits in both groups. A comparison between the TG and the CG regarding the course of self-reported outcomes after RT showed significant between-group differences for the FEDA scales 2 and 3: fatigue and retardation of daily living activities (P=.002) and decrease in motivation (P=.032) with an increase of attention deficits in the TG, but not in the CG. There was a trend towards significance in FEDA scale 1: distractibility and retardation of mental processes (P=.059) between the TG and the CG. The FEAG assessment presented no significant differences. An additional subgroup analysis within the TG was carried out. FEDA scale 3 showed significant differences in the time-related progress between patients with whole-brain RT and those receiving hypofractionated stereotactic RT (P=.025), with less decrease in motivation in the latter group. Conclusion: Self-reported attention declined in patients with brain metastases after RT to the brain, whereas it remained relatively stable in breast cancer patients.

  9. Double-Layered PTFE-Covered Nitinol Stents: Experience in 32 Patients with Malignant Esophageal Strictures

    SciTech Connect (OSTI)

    Park, Jung Gu; Jung, Gyoo-Sik Oh, Kyung Seung; Park, Seon-Ja

    2010-08-15

    We evaluated the effectiveness of a double-layered polytetrafluoroethylene (PTFE)-covered nitinol stent in the palliative treatment of malignant esophageal strictures. A double-layered PTFE-covered nitinol stent was designed to reduce the propensity to migration of conventional covered stent. The stent consists of an inner PTFE-covered stent and an outer uncovered nitinol stent tube. With fluoroscopic guidance, the stent was placed in 32 consecutive patients with malignant esophageal strictures. During the follow-up period, the technical and clinical success rates, complications, and cumulative patient survival and stent patency were evaluated. Stent placement was technically successful in all patients, and no procedural complications occurred. After stent placement, the symptoms of 30 patients (94%) showed improvement. During the mean follow-up of 103 days (range, 9-348 days), 11 (34%) of 32 patients developed recurrent symptoms due to tumor overgrowth in five patients (16%), tumor ingrowth owing to detachment of the covering material (PTFE) apart from the stent wire in 3 (9%), mucosal hyperplasia in 2 (6%), and stent migration in 1 (3%). Ten of these 11 patients were treated by means of placing a second covered stent. Thirty patients died, 29 as a result of disease progression and 1 from aspiration pneumonia. The median survival period was 92 days. The median period of primary stent patency was 190 days. The double-layered PTFE-covered nitinol stent seems to be effective for the palliative treatment of malignant esophageal strictures. We believe that the double-layer configuration of this stent can contribute to decreasing the stent's migration rate.

  10. Prevalence and Measurement of Anxiety in Samples of Patients With Heart Failure: Meta-analysis

    E-Print Network [OSTI]

    Easton, Katherine; Coventry, Peter; Lovell, Karina; Carter, Lesley-Anne; Deaton, Christi

    2015-05-07

    or community-based patients & Q18 y & HF as the primary diagnosis & Patients with HF who received an ICD, CRT, CABG, or PCI will be included if anxiety symptoms/ disorder measurement is not immediate preintervention/postintervention (must be at least 3 mo... graft; PCI, percutaneous coronary intervention; DSM, Diagnostic Statistical Manual. Prevalence of Anxiety in Heart Failure Samples 3 distinguish between anxiety and depression, as deter- mined through evaluation of available psychometric and empirical...

  11. Shorter-Course Whole-Brain Radiotherapy for Brain Metastases in Elderly Patients

    SciTech Connect (OSTI)

    Rades, Dirk; Evers, Jasmin N.; Veninga, Theo; Stalpers, Lukas J.A.; Lohynska, Radka; Schild, Steven E.

    2011-11-15

    Purpose: Many patients with brain metastases receive whole-brain radiotherapy (WBRT) alone. Using 10 Multiplication-Sign 3 Gy in 2 weeks is the standard regimen in most centers. Regarding the extraordinarily poor survival prognosis of elderly patients with multiple brain metastases, a shorter WBRT regimen would be preferable. This study compared 10 Multiplication-Sign 3 Gy with 5 Multiplication-Sign 4 Gy in elderly patients ({>=}65 years). Methods and Materials: Data from 455 elderly patients who received WBRT alone for brain metastases were retrospectively analyzed. Survival and local (= intracerebral) control of 293 patients receiving 10 Multiplication-Sign 3 Gy were compared with 162 patients receiving 5 Multiplication-Sign 4 Gy. Eight additional potential prognostic factors were investigated including age, gender, Karnofsky performance score (KPS), primary tumor, number of brain metastases, interval from tumor diagnosis to WBRT, extracerebral metastases, and recursive partitioning analysis (RPA) class. Results: The 6-month overall survival rates were 29% after 5 Multiplication-Sign 4 Gy and 21% after 10 Multiplication-Sign 3 Gy (p = 0.020). The 6-month local control rates were 12% and 10%, respectively (p = 0.32). On multivariate analysis, improved overall survival was associated with KPS {>=} 70 (p < 0.001), only one to three brain metastases (p = 0.029), no extracerebral metastasis (p = 0.012), and lower RPA class (p < 0.001). Improved local control was associated with KPS {>=} 70 (p < 0.001), breast cancer (p = 0.029), and lower RPA class (p < 0.001). Conclusions: Shorter-course WBRT with 5 Multiplication-Sign 4 Gy was not inferior to 10 Multiplication-Sign 3 Gy with respect to overall survival or local control in elderly patients. 5 Multiplication-Sign 4 Gy appears preferable for the majority of these patients.

  12. Potential immunological consequences of pharmacological suppression of gastric acid production in patients with multiple sclerosis

    E-Print Network [OSTI]

    Biswas, Sangita; Benedict, Stephen H.; Lynch, Sharon G.; LeVine, Steven M.

    2012-06-07

    lesions in a patient with systemic lupus erythematosus associated with cimetidine [82], lymphocytic infiltration in patients with breast cancer associated with famotidine [83], and exacerbation of psoriasis associated with H2R antagonists [84]. Proton pump...: Exacerbation of psoriasis during treatment with H2 antagonists. Ugeskr Laeger 1991, 153:132. 85. Shin JM, Sachs G: Pharmacology of proton pump inhibitors. Curr Gastroenterol Rep 2008, 10:528-534. 86. Ohara T, Arakawa T: Lansoprazole decreases peripheral blood...

  13. Osteoradionecrosis and Radiation Dose to the Mandible in Patients With Oropharyngeal Cancer

    SciTech Connect (OSTI)

    Tsai, Chiaojung Jillian; Hofstede, Theresa M.; Sturgis, Erich M.; Garden, Adam S.; Lindberg, Mary E.; Wei Qingyi; Tucker, Susan L.; Dong Lei

    2013-02-01

    Purpose: To determine the association between radiation doses delivered to the mandible and the occurrence of osteoradionecrosis (ORN). Methods and Materials: We reviewed the records of 402 oropharyngeal cancer patients with stage T1 or T2 disease treated with definitive radiation between January 2000 and October 2008 for the occurrence of ORN. Demographic and treatment variables were compared between patients with ORN and those without. To examine the dosimetric relationship further, a nested case-control comparison was performed. One to 2 ORN-free patients were selected to match each ORN patient by age, sex, radiation type, treatment year, and cancer subsite. Detailed radiation treatment plans for the ORN cases and matched controls were reviewed. Mann-Whitney test and conditional logistic regression were used to compare relative volumes of the mandible exposed to doses ranging from 10 Gy-60 Gy in 10-Gy increments. Results: In 30 patients (7.5%), ORN developed during a median follow-up time of 31 months, including 6 patients with grade 4 ORN that required major surgery. The median time to develop ORN was 8 months (range, 0-71 months). Detailed radiation treatment plans were available for 25 of the 30 ORN patients and 40 matched ORN-free patients. In the matched case-control analysis, there was a statistically significant difference between the volumes of mandible in the 2 groups receiving doses between 50 Gy (V50) and 60 Gy (V60). The most notable difference was seen at V50, with a P value of .02 in the multivariate model after adjustment for the matching variables and dental status (dentate or with extraction). Conclusions: V50 and V60 saw the most significant differences between the ORN group and the comparison group. Minimizing the percent mandibular volume exposed to 50 Gy may reduce ORN risk.

  14. Efficacy and Safety of Transarterial Radioembolization Versus Chemoembolization in Patients With Hepatocellular Carcinoma

    SciTech Connect (OSTI)

    Moreno-Luna, Laura E., E-mail: morenoluna.laura@gmail.com; Yang, Ju Dong; Sanchez, William [College of Medicine, Mayo Clinic, Division of Gastroenterology and Hepatology (United States); Paz-Fumagalli, Ricardo [College of Medicine, Mayo Clinic, Department of Radiology (United States); Harnois, Denise M.; Mettler, Teresa A. [College of Medicine, Mayo Clinic, Division of Gastroenterology and Hepatology (United States); Gansen, Denise N. [College of Medicine, Mayo Clinic, Department of Radiology (United States); Groen, Piet C. de; Lazaridis, Konstantinos N.; Narayanan Menon, K. V.; LaRusso, Nicholas F. [College of Medicine, Mayo Clinic, Division of Gastroenterology and Hepatology (United States); Alberts, Steven R. [College of Medicine, Mayo Clinic and Mayo Clinic Cancer Center, Department of Oncology (United States); Gores, Gregory J. [College of Medicine, Mayo Clinic, Division of Gastroenterology and Hepatology (United States); Fleming, Chad J. [College of Medicine, Mayo Clinic, Department of Radiology (United States); Slettedahl, Seth W.; Harmsen, William S.; Therneau, Terry M. [College of Medicine, Mayo Clinic, Department of Health Sciences Research (United States); Wiseman, Gregory A.; Andrews, James C. [College of Medicine, Mayo Clinic, Department of Radiology (United States); Roberts, Lewis R., E-mail: roberts.lewis@mayo.edu [College of Medicine, Mayo Clinic, Division of Gastroenterology and Hepatology (United States)

    2013-06-15

    Purpose. Intermediate-stage hepatocellular carcinoma (HCC) is usually treated with locoregional therapy using transarterial chemoembolization (TACE). Transarterial radioembolization (TARE) using {beta}-emitting yttrium-90 integral to the glass matrix of the microspheres is an alternative to TACE. This retrospective case-control study compared the outcomes and safety of TARE versus TACE in patients with unresectable HCC. Materials and Methods. Patients with unresectable HCC without portal vein thrombosis treated with TARE between 2005 and 2008 (n = 61) were retrospectively frequency-matched by age, sex, and liver dysfunction with TACE-treated patients (n = 55) in the Mayo Clinic Hepatobiliary Neoplasia Registry. Imaging studies were reviewed, and clinical and safety outcomes were abstracted from the medical records. Results. Complete tumor response was more common after TARE (12 %) than after TACE (4 %) (p = 0.17). When complete response was combined with partial response and stable disease, there was no difference between TARE and TACE. Median survival did not differ between the two groups (15.0 months for TARE and 14.4 months for TACE; p = 0.47). Two-year survival rates were 30 % for TARE and 24 % for TACE. TARE patients received fewer treatments (p < 0.001). Fifty-nine (97 %) TARE patients received outpatient treatment. In contrast, 53 (98 %) TACE patients were hospitalized for {>=}1 day (p < 0.001). Compared with TACE, TARE was more likely to induce fatigue (p = 0.003) but less likely to cause fever (p = 0.02). Conclusion. There was no significant difference in efficacy between TARE and TACE. TARE patients reported more fatigue but had less fever than TACE patients. Treatment with TARE required less hospitalization than treatment with TACE. These findings require confirmation in randomized trials.

  15. Replanning During Intensity Modulated Radiation Therapy Improved Quality of Life in Patients With Nasopharyngeal Carcinoma

    SciTech Connect (OSTI)

    Yang Haihua; Hu Wei; Wang Wei; Chen Peifang; Ding Weijun; Luo Wei

    2013-01-01

    Purpose: Anatomic and dosimetric changes have been reported during intensity modulated radiation therapy (IMRT) in patients with nasopharyngeal carcinoma (NPC). The purpose of this study was to evaluate the effects of replanning on quality of life (QoL) and clinical outcomes during the course of IMRT for NPC patients. Methods and Materials: Between June 2007 and August 2011, 129 patients with NPC were enrolled. Forty-three patients received IMRT without replanning, while 86 patients received IMRT replanning after computed tomography (CT) images were retaken part way through therapy. Chinese versions of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 and Head and Neck Quality of Life Questionnaire 35 were completed before treatment began and at the end of treatment and at 1, 3, 6, and 12 months after the completion of treatment. Overall survival (OS) data were compared using the Kaplan-Meier method. Results: IMRT replanning had a profound impact on the QoL of NPC patients, as determined by statistically significant changes in global QoL and other QoL scales. Additionally, the clinical outcome comparison indicates that replanning during IMRT for NPC significantly improved 2-year local regional control (97.2% vs 92.4%, respectively, P=.040) but did not improve 2-year OS (89.8% vs 82.2%, respectively, P=.475). Conclusions: IMRT replanning improves QoL as well as local regional control in patients with NPC. Future research is needed to determine the criteria for replanning for NPC patients undergoing IMRT.

  16. Cytogenetic damage in lymphocytes of patients undergoing therapy for small cell lung cancer and ovarian carcinoma

    SciTech Connect (OSTI)

    Padjas, Anna; Lesisz, Dominika; Lankoff, Anna; Banasik, Anna; Lisowska, Halina; Bakalarz, Robert; Gozdz, Stanislaw; Wojcik, Andrzej . E-mail: awojcik@pu.kielce.pl

    2005-12-01

    The level of cytogenetic damage in peripheral blood lymphocytes of patients undergoing chemotherapy has been analyzed incisively 20 years ago. The results showed that the highest level of cytogenetic damage was observed at the end of therapy. In recent years, the doses of anticancer drugs were intensified thanks to the discovery of colony stimulating factors. Therefore, it was interesting to analyze the kinetics of micronuclei formation in lymphocytes of patients undergoing modern chemotherapy. The frequencies of micronuclei were measured in lymphocytes of 6 patients with small cell lung cancer treated with a combination of cisplatin and etoposide and 7 patients with ovarian carcinoma treated with a combination of taxol and cisplatin. 3 patients with lung cancer received radiotherapy in addition to chemotherapy. Micronuclei were analyzed in lymphocytes collected before the start of therapy and 1 day before each following cycle of chemotherapy. The micronucleus frequencies were compared with the kinetics of leukocyte counts. The micronucleus frequencies showed an interindividual variability. On average, the frequencies of micronuclei increased during the first half of therapy and declined thereafter, reaching, in some patients with ovarian carcinoma, values below the pre-treatment level. Leukocyte counts decreased strongly at the beginning of therapy with an upward trend at the end. We suggest that the decline of micronuclei was due to repopulation of lymphocytes and acquired drug resistance.

  17. Rhabdomyosarcoma Arising in a Previously Irradiated Field: An Analysis of 43 Patients

    SciTech Connect (OSTI)

    Dang, Nguyen D.; Teh, Bin S.; Paulino, Arnold C.

    2013-03-01

    Patients with soft tissue sarcomas that arise from previously irradiated fields have traditionally been reported to have a poor prognosis. In this report, we examined the characteristics and outcomes of patients who developed a rhabdomyosarcoma in a previously irradiated field (RMS-RIF); we hypothesize that these patients should have a better outcome compared to other postradiation soft tissue sarcomas as these tumors are chemosensitive and radiosensitive. A PubMed search of the literature from 1961-2010 yielded 33 studies with data for patients with RMS-RIF. The study included 43 patients with a median age of 6.5 years at the time of radiation therapy (RT) for the initial tumor. The median RT dose was 48 Gy. The median latency period, the time from RT to development of RMS-RIF, was 8 years. The 3-year overall survival for RMS-RIF was 42%. The 3-year overall survival was 66% for patients receiving chemotherapy and local treatment (surgery and/or RT) compared to 29% for those who had systemic treatment only or local treatment only (P=.049). Other factors associated with increased 3-year overall survival included retinoblastoma initial diagnosis (P<.001), age ?18 years at diagnosis of RMS-RIF (P=.003), favorable site (P=.008), and stage 1 disease (P=.002). Age at time of RMS-RIF, retinoblastoma initial tumor, favorable site, stage 1 disease, and use of both systemic and local treatment were found to be favorable prognostic factors for 3-year overall survival.

  18. Is radiography justified for the evaluation of patients presenting with cervical spine trauma?

    SciTech Connect (OSTI)

    Theocharopoulos, Nicholas; Chatzakis, Georgios; Damilakis, John [Department of Medical Physics, Faculty of Medicine, University of Crete, P.O. Box 2208, Iraklion, 71003 Crete (Greece) and Department of Natural Sciences, Technological Education Institute of Crete, P.O. Box 140, Iraklion 71004 Crete (Greece); Department of Radiology, Faculty of Medicine, University of Crete, P.O. Box 2208, Iraklion, 71003 Crete (Greece); Department of Medical Physics, Faculty of Medicine, University of Crete, P.O. Box 2208, Iraklion, 71003 Crete (Greece)

    2009-10-15

    Conventional radiography has been for decades the standard method of evaluation for cervical spine trauma patients. However, currently available helical multidetector CT scanners allow multiplanar reconstruction of images, leading to increased diagnostic accuracy. The purpose of this study was to determine the relative benefit/risk ratio between cervical spine CT and cervical spine radiography and between cervical spine CT and cervical spine radiography, followed by CT as an adjunct for positive findings. A decision analysis model for the determination of the optimum imaging technique was developed. The sensitivity and specificity of CT and radiography were obtained by dedicated meta-analysis. Lifetime attributable risk of mortal cancer from CT and radiography was calculated using updated organ-specific risk coefficients and organ-absorbed doses. Patient organ doses from radiography were calculated using Monte Carlo techniques, simulated exposures performed on an anthropomorphic phantom, and thermoluminescence dosimetry. A prospective patient study was performed regarding helical CT scans of the cervical spine. Patient doses were calculated based on the dose-length-product values and Monte Carlo-based CT dosimetry software program. Three groups of patient risk for cervical spine fracture were incorporated in the decision model on the basis of hypothetical trauma mechanism and clinical findings. Radiation effects were assessed separately for males and females for four age groups (20, 40, 60, and 80 yr old). Effective dose from radiography amounts to 0.050 mSv and from a typical CT scan to 3.8 mSv. The use of CT in a hypothetical cohort of 10{sup 6} patients prevents approximately 130 incidents of paralysis in the low risk group (a priori fracture probability of 0.5%), 500 in the moderate risk group (a priori fracture probability of 2%), and 5100 in the high risk group (a priori fracture probability of 20%). The expense of this CT-based prevention is 15-32 additional radiogenic lethal cancer incidents. According to the decision model calculations, the use of CT is more favorable over the use of radiography alone or radiography with CT by a factor of 13, for low risk 20 yr old patients, to a factor of 23, for high risk patients younger than 80 yr old. The radiography/CT imaging strategy slightly outperforms plain radiography for high and moderate risk patients. Regardless of the patient age, sex, and fracture risk, the higher diagnostic accuracy obtained by the CT examination counterbalances the increase in dose compared to plain radiography or radiography followed by CT only for positive radiographs and renders CT utilization justified and the radiographic screening redundant.

  19. Pain Analysis in Patients with Hepatocellular Carcinoma: Irreversible Electroporation versus Radiofrequency Ablation-Initial Observations

    SciTech Connect (OSTI)

    Narayanan, Govindarajan, E-mail: gnarayanan@med.miami.edu; Froud, Tatiana, E-mail: tfroud@med.miami.edu [Miller School of Medicine, University of Miami, Department of Vascular and Interventional Radiology (United States)] [Miller School of Medicine, University of Miami, Department of Vascular and Interventional Radiology (United States); Lo, Kaming, E-mail: KLo@biostat.med.miami.edu [Miller School of Medicine, University of Miami, Department of Epidemiology and Public Health (United States)] [Miller School of Medicine, University of Miami, Department of Epidemiology and Public Health (United States); Barbery, Katuska J., E-mail: kbarbery@med.miami.edu; Perez-Rojas, Evelyn, E-mail: eprojas@med.miami.edu; Yrizarry, Jose, E-mail: jyrizarr@med.miami.edu [Miller School of Medicine, University of Miami, Department of Vascular and Interventional Radiology (United States)] [Miller School of Medicine, University of Miami, Department of Vascular and Interventional Radiology (United States)

    2013-02-15

    To retrospectively compare the postprocedure pain of hepatocellular carcinoma treated with irreversible electroporation (IRE) with radiofrequency ablation (RFA). This Health Insurance Portability and Accountability Act-compliant, institutional review board-approved study compared postprocedure pain in 21 patients (15 men, six women; mean age 61.5 years) who underwent IRE of 29 intrahepatic lesions (mean size 2.20 cm) in 28 IRE sessions with 22 patients (16 men, six women; mean age 60.2 years) who underwent RFA of 27 lesions (mean size 3.38 cm) in 25 RFA sessions. Pain was determined by patient-disclosed scores with an 11-point numerical rating scale and 24 h cumulative hydromorphone use from patient-controlled analgesia pump. Complications were noted. Statistical significance was evaluated by Fisher's exact test, the Chi-square test, and Student's t test. There was no significant difference in the cumulative hydromorphone dose (1.54 mg (IRE) vs. 1.24 mg (RFA); P = 0.52) and in the mean pain score (1.96 (IRE) vs. 2.25 (RFA); P = 0.70). In nine (32.14 %) of 28 IRE sessions and 11 (44.0 %) of 25 RFA sessions, patients reported no pain. Complications occurred in three (10.7 %) of 28 IRE treatments and included pneumothorax (n = 1), pleural effusion (n = 1), and bleeding in the form of hemothorax (n = 1); one (4 %) of 25 RFA treatments included burn. IRE is comparable to RFA in the amount of pain that patients experience and the amount of pain medication self-administered. Both modalities were well tolerated by patients. Prospective, randomized trials are necessary to further evaluate these findings.

  20. Percutaneous Vertebroplasty for Pain Management in Patients with Multiple Myeloma: Is Radiofrequency Ablation Necessary?

    SciTech Connect (OSTI)

    Orgera, Gianluigi [Sapienza Rome University, Department of Radiology, S. Andrea Hospital (Italy); Krokidis, Miltiadis, E-mail: mkrokidis@hotmail.com [Cambridge University Hospitals NHS Trust, Department of Radiology (United Kingdom); Matteoli, Marco; Varano, Gianluca Maria [Sapienza Rome University, Department of Radiology, S. Andrea Hospital (Italy); La Verde, Giacinto [Sapienza Rome University, Department of Medical Oncology, S. Andrea Hospital (Italy); David, Vincenzo; Rossi, Michele [Sapienza Rome University, Department of Radiology, S. Andrea Hospital (Italy)

    2013-05-08

    PurposeThis study was designed to investigate the added role of radiofrequency ablation (RFA) to vertebroplasty on the pain management of patients with multiple myeloma (MM).MethodsThirty-six patients (51–82 years) with vertebral localization of MM were randomly divided into two groups: 18 patients (group A) who underwent RFA and then vertebroplasty, and 18 patients (group B) who underwent only vertebroplasty. Primary endpoints were technical success and pain relief score rate measured by the visual analogue pain scores (VAS) and Roland–Morris Questionnaire (RMQ); secondary endpoint was the amount of administered analgesia. Survival and complications were compared.ResultsTechnical success was 100 % in both groups. The VAS score (at 24 h and 6 weeks postprocedure) decreased in equal manner for both groups from a mean of 9.1–3.4 and 2.0 for group A and from a mean of 9.3–3.0 and 2.3 for group B; RMQ mean score was 19.8 for group A and 19.9 for group B and decreased to a mean of 9.6 and 8.2 for group A and 9.5 and 8.7 for group B. The amount of medication was equally decreased in the two groups. No statistically significant difference was noted. No major complication occurred and two patients died from other causes.ConclusionsThe use of percutaneous vertebroplasty alone appears to be effective for the pain management of the patients with vertebral involvement of multiple myeloma. The use of RFA that includes cost and time does not offer any clear added benefit on the midterm pain management of such patients.

  1. Disparities in the Use of Radiation Therapy in Patients With Local-Regionally Advanced Breast Cancer

    SciTech Connect (OSTI)

    Martinez, Steve R., E-mail: steve.martinez@ucdmc.ucdavis.ed [Department of Surgery, Division of Surgical Oncology, University of California Davis, Sacramento, CA (United States); Beal, Shannon H.; Chen, Steven L.; Canter, Robert J.; Khatri, Vijay P. [Department of Surgery, Division of Surgical Oncology, University of California Davis, Sacramento, CA (United States); Chen, Allen [Department of Radiation Oncology, University of California Davis, Sacramento, CA (United States); Bold, Richard J. [Department of Surgery, Division of Surgical Oncology, University of California Davis, Sacramento, CA (United States)

    2010-11-01

    Background: Radiation therapy (RT) is indicated for the treatment of local-regionally advanced breast cancer (BCa). Hypothesis: We hypothesized that black and Hispanic patients with local-regionally advanced BCa would receive lower rates of RT than their white counterparts. Methods: The Surveillance Epidemiology and End Results database was used to identify white, black, Hispanic, and Asian patients with invasive BCa and {>=}10 metastatic lymph nodes diagnosed between 1988 and 2005. Univariate and multivariate logistic regression evaluated the relationship of race/ethnicity with use of RT. Multivariate models stratified for those undergoing mastectomy or lumpectomy. Results: Entry criteria were met by 12,653 patients. Approximately half of the patients did not receive RT. Most patients were white (72%); the remainder were Hispanic (10.4%), black (10.3%), and Asian (7.3%). On univariate analysis, Hispanics (odd ratio [OR] 0.89; 95% confidence interval [CI], 0.79-1.00) and blacks (OR 0.79; 95% CI, 0.70-0.89) were less likely to receive RT than whites. On multivariate analysis, blacks (OR 0.76; 95% CI, 0.67-0.86) and Hispanics (OR 0.80; 95% CI, 0.70-0.90) were less likely than whites to receive RT. Disparities persisted for blacks (OR 0.74; 95% CI, 0.64-0.85) and Hispanics (OR 0.77; 95% CI, 0.67-0.89) who received mastectomy, but not for those who received lumpectomy. Conclusions: Many patients with local-regionally advanced BCa do not receive RT. Blacks and Hispanics were less likely than whites to receive RT. This disparity was noted predominately in patients who received mastectomy. Future efforts at improving rates of RT are warranted. Efforts at eliminating racial/ethnic disparities should focus on black and Hispanic candidates for postmastectomy RT.

  2. Serum Amyloid A as a Predictive Marker for Radiation Pneumonitis in Lung Cancer Patients

    SciTech Connect (OSTI)

    Wang, Yu-Shan [Department of Radiation Therapy and Oncology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan (China) [Department of Radiation Therapy and Oncology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan (China); Department of Animal Science, National Ilan University, Ilan, Taiwan (China); Chang, Heng-Jui [Department of Radiation Therapy and Oncology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan (China)] [Department of Radiation Therapy and Oncology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan (China); Chang, Yue-Cune [Department of Mathematics, Tamkang University, Taipei, Taiwan (China)] [Department of Mathematics, Tamkang University, Taipei, Taiwan (China); Huang, Su-Chen; Ko, Hui-Ling; Chang, Chih-Chia [Department of Radiation Therapy and Oncology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan (China)] [Department of Radiation Therapy and Oncology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan (China); Yeh, Yu-Wung; Jiang, Jiunn-Song [Department of Chest Medicine, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan (China)] [Department of Chest Medicine, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan (China); Lee, Cheng-Yen; Chi, Mau-Shin [Department of Radiation Therapy and Oncology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan (China)] [Department of Radiation Therapy and Oncology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan (China); Chi, Kwan-Hwa, E-mail: M006565@ms.skh.org.tw [Department of Radiation Therapy and Oncology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan (China) [Department of Radiation Therapy and Oncology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan (China); Institute of Radiation Science and School of Medicine, National Yang-Ming University, Taipei, Taiwan (China)

    2013-03-01

    Purpose: To investigate serum markers associated with radiation pneumonitis (RP) grade ?3 in patients with lung cancer who were treated with radiation therapy. Methods and Materials: Pretreatment serum samples from patients with stage Ib-IV lung cancer who developed RP within 1 year after radiation therapy were analyzed to identify a proteome marker able to stratify patients prone to develop severe RP by surface-enhanced laser desorption/ionization time-of-flight mass spectrometry (SELDI-TOF-MS). Dosimetric parameters and 3 biological factors were compared. Results: Serum samples from 16 patients (28%) with severe RP (grade 3-4) and 42 patients (72%) with no or mild RP (grade 0-2) were collected for analysis. All patients received a median of 54 Gy (range, 42-70 Gy) of three-dimensional conformal radiation therapy with a mean lung dose (MLD) of 1502 cGy (range, 700-2794 cGy). An m/z peak of 11,480 Da was identified by SELDI-TOF-MS, and serum amyloid A (SAA) was the primary splitter serum marker. The receiver operating characteristic area under the curve of SAA (0.94; 95% confidence interval [CI], 0.87-1.00) was higher than those of C-reactive protein (0.83; 95% CI, 0.72-0.94), interleukin-6 (0.79; 95% CI, 0.65-0.94), and MLD (0.57; 95% CI, 0.37-0.77). The best sensitivity and specificity of combined SAA and MLD for predicting RP were 88.9% and 96.0%, respectively. Conclusions: Baseline SAA could be used as an auxiliary marker for predicting severe RP. Extreme care should be taken to limit the lung irradiation dose in patients with high SAA.

  3. Pregnancy Following Uterine Artery Embolization with Polyvinyl Alcohol Particles for Patients with Uterine Fibroid or Adenomyosis

    SciTech Connect (OSTI)

    Kim, Man Deuk Kim, Nahk Keun; Kim, Hee Jin; Lee, Mee Hwa

    2005-06-15

    Purpose:To determine whether uterine fibroid embolization (UFE) with polyvinyl alcohol (PVA) particles affects fertility in women desiring future pregnancy.Methods:Of 288 patients managed with UFE with PVA particles for uterine myoma or adenomyosis between 1998 and 2001, 94 patients were enrolled in this study. The age range of participants was 20-40 years. The data were collected through review of medical records and telephone interviews. Mean duration of follow-up duration was 35 months (range 22-60 months). Patients using contraception and single women were excluded, and the chance of infertility caused by possible spousal infertility or other factors was disregarded. Contrast-enhanced magnetic resonance imaging was performed in all patients before and after UFE, and the size of PVA particles used was 255-700 {mu}m.Results:Among 94 patients who underwent UFE with PVA, 74 were on contraceptives, 6 had been single until the point of interview, and 8 were lost to follow-up. Of the remaining 6 patients who desired future pregnancy, 5 (83%) succeeded in becoming pregnant (1 patient became pregnant twice). Of a total of 8 pregnancies, 6 were planned pregnancies and 2 occurred after contraception failed. Five deliveries were vaginal, and 2 were by elective cesarean. Artificial abortion was performed in 1 case of unplanned pregnancy. There was 1 case of premature rupture of membrane (PROM) followed by preterm labor and delivery of an infant who was small-for-gestational-age. After UFE, mean volume reduction rates of the uterus and fibroid were 36.6% (range 0 to 62.6%) and 69.3% (range 36.3% to 93.3%), respectively.Conclusion:Although the absolute number of cases was small, UFE with PVA particles ultimately did not affect fertility in the women who underwent the procedure.

  4. Insertion of Balloon Retained Gastrostomy Buttons: A 5-Year Retrospective Review of 260 Patients

    SciTech Connect (OSTI)

    Power, Sarah Kavanagh, Liam N.; Shields, Mary C.; Given, Mark F.; Keeling, Aoife N.; McGrath, Frank P.; Lee, Michael J.

    2013-04-15

    Radiologically inserted gastrostomy (RIG) is an established way of maintaining enteral nutrition in patients who cannot maintain nutrition orally. The purpose of this study was to evaluate the safety and efficacy of primary placement of a wide bore button gastrostomy in a large, varied patient population through retrospective review. All patients who underwent gastrostomy placement from January 1, 2004 to January 1, 2009 were identified. 18-Fr gastrostomy buttons (MIC-Key G) were inserted in the majority. Follow-up ranged from 6 months to 4.5 years. A total of 260 patients (M:F 140:120, average age 59.2 years) underwent gastrostomy during the study period. Overall success rate for RIG placement was 99.6 %, with success rate of 95.3 % for primary button insertion. Indications included neurological disorders (70 %), esophageal/head and neck malignancy (21 %), and other indications (9 %). Major and minor complication rates were 1.2 and 12.8 %, respectively. Thirty-day mortality rate was 6.8 %. One third of patients underwent gastrostomy reinsertion during the study period, the main indication for which was inadvertent catheter removal. Patency rate was high at 99.5 %. The maximum number of procedures in any patient was 8 (n = 2), and the average tube dwell time was 125 days. Primary radiological insertion of a wide bore button gastrostomy is a safe technique, with high success rate, high patency rate, and low major complication rate. We believe that it is feasible to attempt button gastrostomy placement in all patients, once tract length is within limits of tube length. If difficulty is encountered, then a standard tube may simply be placed instead.

  5. Initial Clinical Experience Performing Patient Treatment Verification With an Electronic Portal Imaging Device Transit Dosimeter

    SciTech Connect (OSTI)

    Berry, Sean L.; Polvorosa, Cynthia; Cheng, Simon; Deutsch, Israel; Chao, K. S. Clifford; Wuu, Cheng-Shie

    2014-01-01

    Purpose: To prospectively evaluate a 2-dimensional transit dosimetry algorithm's performance on a patient population and to analyze the issues that would arise in a widespread clinical adoption of transit electronic portal imaging device (EPID) dosimetry. Methods and Materials: Eleven patients were enrolled on the protocol; 9 completed and were analyzed. Pretreatment intensity modulated radiation therapy (IMRT) patient-specific quality assurance was performed using a stringent local 3%, 3-mm ? criterion to verify that the planned fluence had been appropriately transferred to and delivered by the linear accelerator. Transit dosimetric EPID images were then acquired during treatment and compared offline with predicted transit images using a global 5%, 3-mm ? criterion. Results: There were 288 transit images analyzed. The overall ? pass rate was 89.1% ± 9.8% (average ± 1 SD). For the subset of images for which the linear accelerator couch did not interfere with the measurement, the ? pass rate was 95.7% ± 2.4%. A case study is presented in which the transit dosimetry algorithm was able to identify that a lung patient's bilateral pleural effusion had resolved in the time between the planning CT scan and the treatment. Conclusions: The EPID transit dosimetry algorithm under consideration, previously described and verified in a phantom study, is feasible for use in treatment delivery verification for real patients. Two-dimensional EPID transit dosimetry can play an important role in indicating when a treatment delivery is inconsistent with the original plan.

  6. The cough response to ultrasonically nebulized distilled water in heart-lung transplantation patients

    SciTech Connect (OSTI)

    Higenbottam, T.; Jackson, M.; Woolman, P.; Lowry, R.; Wallwork, J.

    1989-07-01

    As a result of clinical heart-lung transplantation, the lungs are denervated below the level of the tracheal anastomosis. It has been questioned whether afferent vagal reinnervation occurs after surgery. Here we report the cough frequency, during inhalation of ultrasonically nebulized distilled water, of 15 heart-lung transplant patients studied 6 wk to 36 months after surgery. They were compared with 15 normal subjects of a similar age and sex. The distribution of the aerosol was studied in five normal subjects using /sup 99m/technetium diethylene triamine pentaacetate (/sup 99m/Tc-DTPA) in saline. In seven patients, the sensitivity of the laryngeal mucosa to instilled distilled water (0.2 ml) was tested at the time of fiberoptic bronchoscopy by recording the cough response. Ten percent of the aerosol was deposited onto the larynx and trachea, 56% on the central airways, and 34% in the periphery of the lung. The cough response to the aerosol was strikingly diminished in the patients compared with normal subjects (p less than 0.001), but all seven patients coughed when distilled water was instilled onto the larynx. As expected, the laryngeal mucosa of heart-lung transplant patients remains sensitive to distilled water. However, the diminished coughing when the distilled water is distributed by aerosol to the central airways supports the view that vagal afferent nerves do not reinnervate the lungs after heart-lung transplantation, up to 36 months after surgery.

  7. Receipt of Guideline-Concordant Treatment in Elderly Prostate Cancer Patients

    SciTech Connect (OSTI)

    Chen, Ronald C., E-mail: Ronald_chen@med.unc.edu [Department of Radiation Oncology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States); Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States); Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States); Carpenter, William R. [Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States); Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States); Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States); Hendrix, Laura H. [Department of Radiation Oncology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States); Bainbridge, John [Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States); Wang, Andrew Z. [Department of Radiation Oncology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States); Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States); Nielsen, Matthew E. [Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States); Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States); Department of Urology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States); and others

    2014-02-01

    Purpose: To examine the proportion of elderly prostate cancer patients receiving guideline-concordant treatment, using the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database. Methods and Materials: A total of 29,001 men diagnosed in 2004-2007 with localized prostate cancer, aged 66 to 79 years, were included. We characterized the proportion of men who received treatment concordant with the National Comprehensive Cancer Network guidelines, stratified by risk group and age. Logistic regression was used to examine covariates associated with receipt of guideline-concordant management. Results: Guideline concordance was 79%-89% for patients with low- or intermediate-risk disease. Among high-risk patients, 66.6% of those aged 66-69 years received guideline-concordant management, compared with 51.9% of those aged 75-79 years. Discordance was mainly due to conservative management—no treatment or hormone therapy alone. Among the subgroup of patients aged ?76 years with no measured comorbidity, findings were similar. On multivariable analysis, older age (75-79 vs 66-69 years, odds ratio 0.51, 95% confidence interval 0.50-0.57) was associated with a lower likelihood of guideline concordance for high-risk prostate cancer, but comorbidity was not. Conclusions: There is undertreatment of elderly but healthy patients with high-risk prostate cancer, the most aggressive form of this disease.

  8. Is Androgen Deprivation Therapy Necessary in All Intermediate-Risk Prostate Cancer Patients Treated in the Dose Escalation Era?

    SciTech Connect (OSTI)

    Castle, Katherine O.; Hoffman, Karen E.; Levy, Lawrence B.; Lee, Andrew K.; Choi, Seungtaek; Nguyen, Quynh N.; Frank, Steven J.; Pugh, Thomas J.; McGuire, Sean E.; Kuban, Deborah A.

    2013-03-01

    Purpose: The benefit of adding androgen deprivation therapy (ADT) to dose-escalated radiation therapy (RT) for men with intermediate-risk prostate cancer is unclear; therefore, we assessed the impact of adding ADT to dose-escalated RT on freedom from failure (FFF). Methods: Three groups of men treated with intensity modulated RT or 3-dimensional conformal RT (75.6-78 Gy) from 1993-2008 for prostate cancer were categorized as (1) 326 intermediate-risk patients treated with RT alone, (2) 218 intermediate-risk patients treated with RT and ?6 months of ADT, and (3) 274 low-risk patients treated with definitive RT. Median follow-up was 58 months. Recursive partitioning analysis based on FFF using Gleason score (GS), T stage, and pretreatment PSA concentration was applied to the intermediate-risk patients treated with RT alone. The Kaplan-Meier method was used to estimate 5-year FFF. Results: Based on recursive partitioning analysis, intermediate-risk patients treated with RT alone were divided into 3 prognostic groups: (1) 188 favorable patients: GS 6, ?T2b or GS 3+4, ?T1c; (2) 71 marginal patients: GS 3+4, T2a-b; and (3) 68 unfavorable patients: GS 4+3 or T2c disease. Hazard ratios (HR) for recurrence in each group were 1.0, 2.1, and 4.6, respectively. When intermediate-risk patients treated with RT alone were compared to intermediate-risk patients treated with RT and ADT, the greatest benefit from ADT was seen for the unfavorable intermediate-risk patients (FFF, 74% vs 94%, respectively; P=.005). Favorable intermediate-risk patients had no significant benefit from the addition of ADT to RT (FFF, 94% vs 95%, respectively; P=.85), and FFF for favorable intermediate-risk patients treated with RT alone approached that of low-risk patients treated with RT alone (98%). Conclusions: Patients with favorable intermediate-risk prostate cancer did not benefit from the addition of ADT to dose-escalated RT, and their FFF was nearly as good as patients with low-risk disease. In patients with GS 4+3 or T2c disease, the addition of ADT to dose-escalated RT did improve FFF.

  9. Technical Note: Spatial resolution of proton tomography: Impact of air gap between patient and detector

    SciTech Connect (OSTI)

    Schneider, Uwe; Besserer, Juergen; Hartmann, Matthias [Vetsuisse Faculty, University of Zuerich, Winterthurerstrasse 260, 8057 Zuerich (Switzerland) and Radiotherapy Hirslanden AG, Rain 34, 5000 Aarau (Switzerland); Radiotherapy Hirslanden AG, Rain 34, 5000 Aarau (Switzerland)

    2012-02-15

    Purpose: Proton radiography and tomography were investigated since the early 1970s because of its low radiation dose, high density resolution, and ability to image directly proton stopping power. However, spatial resolution is still a limiting factor. In this note, preliminary results of the impact of an air gap between detector system and patient on spatial resolution are presented. Methods: Spatial resolution of proton radiography and tomography is governed by multiple Coulomb scattering (MCS) of the protons in the patient. In this note, the authors employ Monte Carlo simulations of protons traversing a 20 cm thick water box. Entrance and exit proton coordinate measurements were simulated for improved spatial resolution. The simulations were performed with and without a 5 cm air gap in front of and behind the patient. Loss of spatial resolution due to the air gap was studied for protons with different initial angular confusion. Results: It was found that spatial resolution is significantly deteriorated when a 5 cm air gap between the position sensitive detector and the patient is included. For a perfect parallel beam spatial resolution worsens by about 40%. Spatial resolution is getting worse with increasing angular confusion and can reach 80%. Conclusions: When proton radiographies are produced by measuring the entrance and exit coordinates of the protons in front of and behind the patient the air gap between the detector and the patient can significantly deteriorate the spatial resolution of the system by up to 80%. An alternative would be to measure in addition to the coordinates also the exit and entrance angles of each proton. In principle, using the air gap size and proton angle, images can be reconstructed with the same spatial resolution than without air gap.

  10. Ethical Considerations in the Termination of Patient Care The ACOFP Ethics Committee is offering this column to provide a forum for discussion of medical ethical questions.

    E-Print Network [OSTI]

    Solka, Jeff

    communication relationship with the physician. Good for Practice, Patient and Society Ethical decisions should be based not only on what is good for the practice but the patient and society as well. The issues" and terminate care of the patient. Legally it is possible to discharge a patient from your practice as long

  11. Predicting objective function weights from patient anatomy in prostate IMRT treatment planning

    SciTech Connect (OSTI)

    Lee, Taewoo Hammad, Muhannad; Chan, Timothy C. Y.; Techna Institute for the Advancement of Technology for Health, 124-100 College Street, Toronto, Ontario M5G 1P5 ; Craig, Tim; Department of Radiation Oncology, University of Toronto, 148-150 College Street, Toronto, Ontario M5S 3S2 ; Sharpe, Michael B.; Department of Radiation Oncology, University of Toronto, 148-150 College Street, Toronto, Ontario M5S 3S2; Techna Institute for the Advancement of Technology for Health, 124-100 College Street Toronto, Ontario M5G 1P5

    2013-12-15

    Purpose: Intensity-modulated radiation therapy (IMRT) treatment planning typically combines multiple criteria into a single objective function by taking a weighted sum. The authors propose a statistical model that predicts objective function weights from patient anatomy for prostate IMRT treatment planning. This study provides a proof of concept for geometry-driven weight determination. Methods: A previously developed inverse optimization method (IOM) was used to generate optimal objective function weights for 24 patients using their historical treatment plans (i.e., dose distributions). These IOM weights were around 1% for each of the femoral heads, while bladder and rectum weights varied greatly between patients. A regression model was developed to predict a patient's rectum weight using the ratio of the overlap volume of the rectum and bladder with the planning target volume at a 1 cm expansion as the independent variable. The femoral head weights were fixed to 1% each and the bladder weight was calculated as one minus the rectum and femoral head weights. The model was validated using leave-one-out cross validation. Objective values and dose distributions generated through inverse planning using the predicted weights were compared to those generated using the original IOM weights, as well as an average of the IOM weights across all patients. Results: The IOM weight vectors were on average six times closer to the predicted weight vectors than to the average weight vector, usingl{sub 2} distance. Likewise, the bladder and rectum objective values achieved by the predicted weights were more similar to the objective values achieved by the IOM weights. The difference in objective value performance between the predicted and average weights was statistically significant according to a one-sided sign test. For all patients, the difference in rectum V54.3 Gy, rectum V70.0 Gy, bladder V54.3 Gy, and bladder V70.0 Gy values between the dose distributions generated by the predicted weights and IOM weights was less than 5 percentage points. Similarly, the difference in femoral head V54.3 Gy values between the two dose distributions was less than 5 percentage points for all but one patient. Conclusions: This study demonstrates a proof of concept that patient anatomy can be used to predict appropriate objective function weights for treatment planning. In the long term, such geometry-driven weights may serve as a starting point for iterative treatment plan design or may provide information about the most clinically relevant region of the Pareto surface to explore.

  12. Measured dose rate constant from oncology patients administered 18F for positron emission tomography

    SciTech Connect (OSTI)

    Quinn, Brian; Holahan, Brian; Aime, Jean; Humm, John; St Germain, Jean; Dauer, Lawrence T.

    2012-10-15

    Purpose: Patient exposure rate measurements verify published patient dose rate data and characterize dose rates near 2-18-fluorodeoxyglucose ({sup 18}F-FDG) patients. A specific dose rate constant based on patient exposure rate measurements is a convenient quantity that can be applied to the desired distance, injection activity, and time postinjection to obtain an accurate calculation of cumulative external radiation dose. This study reports exposure rates measured at various locations near positron emission tomography (PET) {sup 18}F-FDG patients prior to PET scanning. These measurements are normalized for the amount of administered activity, measurement distance, and time postinjection and are compared with other published data. Methods: Exposure rates were measured using a calibrated ionization chamber at various body locations from 152 adult oncology patients postvoid after a mean uptake time of 76 min following injection with a mean activity of 490 MBq {sup 18}F-FDG. Data were obtained at nine measurement locations for each patient: three near the head, four near the chest, and two near the feet. Results: On contact with, 30 cm superior to and 30 cm lateral to the head, the mean (75th percentile) dose rates per unit injected activity at 60 min postinjection were 0.482 (0.511), 0.135 (0.155), and 0.193 (0.223) {mu}Sv/MBq h, respectively. On contact with, 30 cm anterior to, 30 cm lateral to and 1 m anterior to the chest, the mean (75th percentile) dose rates per unit injected activity at 60 min postinjection were 0.623 (0.709), 0.254 (0.283), 0.190 (0.218), and 0.067 (0.081) {mu}Sv/MBq h respectively. 30 cm inferior and 30 cm lateral to the feet, the mean (75th percentile) dose rates per unit injected activity at 60 min postinjection were 0.024 (0.022) and 0.039 (0.044) {mu}Sv/MBq h, respectively. Conclusions: The measurements for this study support the use of 0.092 {mu}Sv m{sup 2}/MBq h as a reasonable representation of the dose rate anterior from the chest of patients immediately following injection. This value can then be reliably scaled to the desired time and distance for planning and staff dose evaluation purposes. At distances closer than 1 m, a distance-specific dose rate constant of 0.367 {mu}Sv/MBq h at 30 cm is recommended for accurate calculations. An accurate patient-specific dose rate constant that accounts for patient-specific variables (e.g., distribution and attenuation) will allow an accurate evaluation of the dose rate from a patient injected with an isotope rather than simply utilizing a physical constant.

  13. Smaller cornu ammonis 2-3/dentate gyrus volumes and elevated cortisol in multiple sclerosis patients with depressive symptoms.

    E-Print Network [OSTI]

    2010-01-01

    and elevated cortisol in multiple sclerosis patients withNancy L Sicotte 1,2 Multiple Sclerosis Program, Departmentwords: relapsing-remitting multiple sclerosis – depression –

  14. Lymphedema in Breast Cancer Survivors : : Risk Factors, Distress and Quality of Life, and Patient Compliance with a Physician Referral

    E-Print Network [OSTI]

    Dominick, Sally Ann

    therapy PH, physical health PSM, prospective surveillancesurveillance model (PSM), in which patients receivean integral part of a PSM [7,9]. Occupational therapists (

  15. The safety of immunosuppressants in the treatment of psoriasis patients: Is there concern regarding those with familial lymphoproliferative disease?

    E-Print Network [OSTI]

    Shutty, Brandon G; Hogan, Daniel J

    2013-01-01

    immunosuppressant therapy for psoriasis and a positiveweekly in patients with psoriasis. Arch Dermatol 2007; 143:of malignancy associated with psoriasis. Arch Dermatol 2001

  16. Diffuse large B-cell lymphoma with lung involvement in a psoriatic arthritis patient treated with methotrexate

    E-Print Network [OSTI]

    2010-01-01

    lymphoma in patients with psoriasis. J Invest Dermatol 2006;cyclosporine for recalcitrant psoriasis. Br J Dermatol 1999;methotrexate therapy for psoriasis. Arch Dermatol. 1997;

  17. PULMONARY FUNCTION TESTING REQUISITION ALL TESTS MUST BE SCHEDULED BY THE REFERRRING PHYSICIAN'S OFFICE, NOT BY THE PATIENT

    E-Print Network [OSTI]

    Goldman, Steven A.

    PATIENT INSRUCTION SHEET ***** Asthma Unexplained cough Bronchial allergy Please check all applicable of gases _________ COPD Guillain-Barre syndrome (specify) Cough Muscular dystrophy Toxic effect

  18. Decreased expression of RNA interference machinery, Dicer and Drosha, is associated with poor outcome in ovarian cancer patients

    E-Print Network [OSTI]

    Merritt, William M.

    2009-01-01

    Molecular determinants of ovarian cancer plasticity. Am Jsmall interfering RNA on ovarian cancer cell growth. Journalwith Poor Outcome in Ovarian Cancer Patients William M.

  19. Localized customized mortality prediction modeling for patients with acute kidney injury admitted to the intensive care unit

    E-Print Network [OSTI]

    Celi, Leo Anthony G

    2009-01-01

    Introduction. Models for mortality prediction are traditionally developed from prospective multi-center observational studies involving a heterogeneous group of patients to optimize external validity. We hypothesize that ...

  20. Upper Digestive Disorders Approved by the UHS Patient Education Committee 02/2012

    E-Print Network [OSTI]

    Maroncelli, Mark

    Upper Digestive Disorders Approved by the UHS Patient Education Committee 02/2012 Revised 02/08/12 Page 1 of 2 Upper Digestive Tract Anatomy Esophagus: A long muscular tube in the chest area occurs in the duodenum. Upper Digestive Disorders Reflux with Esophagitis: The flowing back (or reflux

  1. On the Design of an Interactive, Patient-Specific Surgical Simulator for Mitral Valve Repair

    E-Print Network [OSTI]

    On the Design of an Interactive, Patient-Specific Surgical Simulator for Mitral Valve Repair Neil A repair of the mitral valve is a difficult procedure that is often avoided in favor of less effective valve replacement because of the associated technical challenges facing non-expert surgeons

  2. Gene expression profile in multiple sclerosis patients and healthy controls: identifying

    E-Print Network [OSTI]

    Ringnér, Markus

    Gene expression profile in multiple sclerosis patients and healthy controls: identifying pathways June 12, 2003; Accepted June 26, 2003 Multiple sclerosis (MS) and other T cell-mediated autoimmune cells aimed at characterizing disease phenotypes. INTRODUCTION Multiple sclerosis (MS) is a chronic

  3. Human Transaldolase and Cross-Reactive Viral Epitopes Identified by Autoantibodies of Multiple Sclerosis Patients1

    E-Print Network [OSTI]

    Vajda, Sandor

    Banki,* and Andras Perl2 * Multiple sclerosis is mediated by an autoimmune process causing selectiveHuman Transaldolase and Cross-Reactive Viral Epitopes Identified by Autoantibodies of Multiple Sclerosis Patients1 Maria Esposito,* Vijay Venkatesh,* Laszlo Otvos, Zhiping Weng,§ Sandor Vajda,§ Katalin

  4. CTSHIV: A Knowledge-Based System For the Management of HIV-infected Patients

    E-Print Network [OSTI]

    Pazzani, Michael J.

    See Ranjit Iyer Edison Schroeder Jeremiah Tilles Department of Information & Computer Science has developed. By monitoringthe HIV virus of the patient, the treatment strategy can be switched in response to mutations of the virus. CTSHIV contains a knowledge base that encodes information from

  5. Int. J. Security and Networks, Vol. ESPAC: Enabling Security and Patient-centric Access

    E-Print Network [OSTI]

    Shen, Xuemin "Sherman"

    sensitive Personal Health Information (PHI), where PHI is expected to be securely stored in cloud storageHealth in cloud computing', Int. J. Security and Networks, Vol. Biographical notes: Mrinmoy Barua is now pursuingInt. J. Security and Networks, Vol. ESPAC: Enabling Security and Patient-centric Access Control

  6. Intelligent Agents for Rehabilitation and Care of Disabled and Chronic Patients Sarit Kraus

    E-Print Network [OSTI]

    Kraus, Sarit

    Intelligent Agents for Rehabilitation and Care of Disabled and Chronic Patients Sarit Kraus- ities with the rehabilitation and care necessary to al- low them good quality of life creates overwhelming de- mands for health and rehabilitation services. We sug- gest that advancements in intelligent

  7. Elevated levels of carbon monoxide in the patient compartment of ambulances

    SciTech Connect (OSTI)

    Iglewicz, R.; Rosenman, K.D.; Iglewicz, B.; O'Leary, K.; Hockemeier, R.

    1984-05-01

    Six hundred and ninety New Jersey ambulances were monitored for carbon monoxide (CO); 27 per cent had CO levels of 10 ppm or more greater than ambient air in the breathing zone of the patient. Twenty-nine of these ambulances had levels of at least 35 ppm greater than ambient air. Results indicate that a CO exposure problem exists in ambulances.

  8. Preoperative irradiation, lymphadenectomy, and 125iodine implantation for patients with localized carcinoma of the prostate

    SciTech Connect (OSTI)

    DeLaney, T.F.; Shipley, W.U.; O'Leary, M.P.; Biggs, P.J.; Prout, G.R. Jr.

    1986-10-01

    Fifty-four patients with clinically and surgically localized prostatic carcinoma were treated with low-dose preoperative irradiation (1050 cGy), pelvic lymphadenectomy, and interstitial /sup 125/Iodine implantation. The follow-up range is 2 to 9 years with a median follow-up of 5 years. Overall local tumor control is 92%. Actuarial 5-year survival is 86% and the actuarial disease-free survival at 5 years is 73%. Patients with poorly differentiated tumors have a significantly worse actuarial survival (62%) at 5 years than patients with well (95%) or moderately well differentiated tumors (93%), p = 0.04. Disease-free survival at 5 years was influenced by grade: well (100%), moderate (60%), and poor (48%), p = 0.03. Multivariate regression analysis indicates that only the degree of differentiation (p = 0.05) significantly impacts on survival. Both degree of differentiation (p = 0.04) and nodal status (p = 0.03) significantly influence disease-free survival. Potency has been maintained in 71% of patients potent at the time of implantation. Late reactions have been acceptable to date: bladder outlet obstruction (13%), mild proctitis (13%), cystourethritis (6%), incontinence (2%), and prostatic calculi (2%).

  9. "Infusion Management in Paediatric Patients": a New Course in Touch with Paediatric Life Support Courses

    E-Print Network [OSTI]

    Manstein, Dietmar J.

    "Infusion Management in Paediatric Patients": a New Course in Touch with Paediatric Life Support School Hannover - Paediatric Cardiology & Intensive Care 1.Introduction: infusion management become more and more complex in PICU. New strategies and approaches are needed. A well designed infusion management

  10. AUTHORIZATION TO USE OR DISCLOSE HEALTH INFORMATION Patient/Employee Name: ___________________________ Date of Birth: ___________Medical Record #: __________________

    E-Print Network [OSTI]

    New Mexico, University of

    information _____ initial 4. I understand that I have a right to revoke this Authorization at any time. I, I have the right to examine and copy the information to be disclosed. A copy of this signedAUTHORIZATION TO USE OR DISCLOSE HEALTH INFORMATION Patient/Employee Name

  11. AUTHORIZATION TO REQUEST HEALTH INFORMATION Patient Name: __________________________ Date of Birth: ___________Medical Record #: __________________

    E-Print Network [OSTI]

    New Mexico, University of

    , I have the right to examine and copy the information to be disclosed. A copy of this signedAUTHORIZATION TO REQUEST HEALTH INFORMATION Patient Name: __________________________ Date of Birth of the UNM Center for Occupational and Environmental Health Promotion to receive information from my health

  12. CRC -PATIENT REGISTRATION ONTO A CLINICAL TRIAL AND PROCEDURE FOR CHARGING PIC SERVICES

    E-Print Network [OSTI]

    Oliver, Douglas L.

    CRC - PATIENT REGISTRATION ONTO A CLINICAL TRIAL AND PROCEDURE FOR CHARGING PIC SERVICES Study that produces Protocol Induced Costs PIC 1. Coordinator will complete voucher, including research label "" and case number, documenting PIC associated with the visit 2. Voucher containing research label

  13. Increased muscle activity to stabilise mobile bearing knees in patients with rheumatoid arthritis

    E-Print Network [OSTI]

    van Vliet, Lucas J.

    Increased muscle activity to stabilise mobile bearing knees in patients with rheumatoid arthritis) between a posterior stabilised (PS) total knee design and a mobile bearing (MB) posterior cruciate of the EMG activity of the main flexor and extensor muscles showed that the activity of both extensor

  14. Recursive Partitioning Analysis for New Classification of Patients With Esophageal Cancer Treated by Chemoradiotherapy

    SciTech Connect (OSTI)

    Nomura, Motoo; Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya; Department of Radiation Oncology, Aichi Cancer Center Hospital, Nagoya ; Shitara, Kohei; Kodaira, Takeshi; Kondoh, Chihiro; Takahari, Daisuke; Ura, Takashi; Kojima, Hiroyuki; Kamata, Minoru; Muro, Kei; Sawada, Satoshi

    2012-11-01

    Background: The 7th edition of the American Joint Committee on Cancer staging system does not include lymph node size in the guidelines for staging patients with esophageal cancer. The objectives of this study were to determine the prognostic impact of the maximum metastatic lymph node diameter (ND) on survival and to develop and validate a new staging system for patients with esophageal squamous cell cancer who were treated with definitive chemoradiotherapy (CRT). Methods: Information on 402 patients with esophageal cancer undergoing CRT at two institutions was reviewed. Univariate and multivariate analyses of data from one institution were used to assess the impact of clinical factors on survival, and recursive partitioning analysis was performed to develop the new staging classification. To assess its clinical utility, the new classification was validated using data from the second institution. Results: By multivariate analysis, gender, T, N, and ND stages were independently and significantly associated with survival (p < 0.05). The resulting new staging classification was based on the T and ND. The four new stages led to good separation of survival curves in both the developmental and validation datasets (p < 0.05). Conclusions: Our results showed that lymph node size is a strong independent prognostic factor and that the new staging system, which incorporated lymph node size, provided good prognostic power, and discriminated effectively for patients with esophageal cancer undergoing CRT.

  15. SU-E-T-208: Incidence Cancer Risk From the Radiation Treatment for Acoustic Neuroma Patient

    SciTech Connect (OSTI)

    Kim, D; Chung, W; Shin, D; Yoon, M

    2014-06-01

    Purpose: The present study aimed to compare the incidence risk of a secondary cancer from therapeutic doses in patients receiving intensitymodulated radiotherapy (IMRT), volumetric modulated arc therapy (VMAT), and stereotactic radiosurgery (SRS). Methods: Four acoustic neuroma patients were treated with IMRT, VMAT, or SRS. Their incidnece excess relative risk (ERR), excess absolute risk (EAR), and lifetime attributable risk (LAR) were estimated using the corresponding therapeutic doses measured at various organs by radio-photoluminescence glass dosimeters (RPLGD) placed inside a humanoid phantom. Results: When a prescription dose was delivered in the planning target volume of the 4 patients, the average organ equivalent doses (OED) at the thyroid, lung, normal liver, colon, bladder, prostate (or ovary), and rectum were measured. The OED decreased as the distance from the primary beam increased. The thyroid received the highest OED compared to other organs. A LAR were estimated that more than 0.03% of AN patients would get radiation-induced cancer. Conclusion: The tyroid was highest radiation-induced cancer risk after radiation treatment for AN. We found that LAR can be increased by the transmitted dose from the primary beam. No modality-specific difference in radiation-induced cancer risk was observed in our study.

  16. Supporting medical decision in telecardiology: a patient-centered ontology-based approach

    E-Print Network [OSTI]

    Zweigenbaum, Pierre

    , France Abstract and Objective The objective of the AKENATON project is to improve alert management, and is expected to decrease mortality and hospitali- zation rates [1]. In this context, ICDs send many remote-up to perspectives centered on individualized patient care, in order to improve alert management. To achieve

  17. A Model-Based Approach to Synthesizing Insulin Infusion Pump Usage Parameters for Diabetic Patients

    E-Print Network [OSTI]

    Sankaranarayanan, Sriram

    A Model-Based Approach to Synthesizing Insulin Infusion Pump Usage Parameters for Diabetic Patients Fainekos Abstract-- We present a model-based approach to synthesiz- ing insulin infusion pump usage parameters against varying meal scenarios and physiological conditions. Insulin infusion pumps are commonly

  18. Isolated Spontaneous Dissection of the Common Iliac Artery: Percutaneous Stent Placement in Two Patients

    SciTech Connect (OSTI)

    Kwak, Hyo-Sung; Han, Young-Min Chung, Gyung-Ho; Yu, Hee Chul; Jeong, Yeon-Jun

    2006-10-15

    Isolated spontaneous dissection of the common iliac artery (CIA) is a rare entity. Two patients with this condition were successfully treated by percutaneous stent placement. We emphasize the feasibility of nonsurgical management by percutaneous stent placement for isolated spontaneous dissection of the CIA.

  19. AUTOMATED ANALYSIS OF VITAL SIGNS TO IDENTIFY PATIENTS WITH SUBSTANTIAL BLEEDING BEFORE HOSPITAL ARRIVAL

    E-Print Network [OSTI]

    AUTOMATED ANALYSIS OF VITAL SIGNS TO IDENTIFY PATIENTS WITH SUBSTANTIAL BLEEDING BEFORE HOSPITAL at a hospital. Previous analysis suggested that prehospital vital signs contained patterns indicating, a computational platform for real-time analysis of vital signs, for identification of substantial bleeding

  20. HEALTH SCIENCE CENTER HANDBOOK OF OPERATING PROCEDURES Chapter 11 Patient Privacy Policies Effective: April 2003

    E-Print Network [OSTI]

    Nicholson, Bruce J.

    HEALTH SCIENCE CENTER HANDBOOK OF OPERATING PROCEDURES Chapter 11 Patient Privacy Policies Effective: April 2003 Section 11.2 Uses and Disclosures of Protected Health Information Revised: March 2013 OR ADMINISTRATIVE PROCEEDINGS Policy The Health Science Center may disclose protected health information without

  1. Iliac Artery Stent Placement Relieves Claudication in Patients with Iliac and Superficial Femoral Artery Lesions

    SciTech Connect (OSTI)

    Ichihashi, Shigeo Higashiura, Wataru; Itoh, Hirofumi; Sakaguchi, Shoji; Kichikawa, Kimihiko

    2013-06-15

    Purpose. To evaluate the efficacy of iliac artery stent placement for relief of claudication in patients with both iliac and superficial femoral artery (SFA) lesions. Methods. Stent placement for only iliac artery occlusive disease was performed in 94 limbs (74 patients) with both iliac and SFA occlusive disease on the same limb. All procedures were performed because intermittent claudication did not improve after continuation of antiplatelet medication therapy and home-based exercise for 3 months. Rutherford classification was 2 in 20 limbs and 3 in 74 limbs. Patients with critical limb ischemia were excluded. Median duration of follow-up was 40 months. Primary patency rates of the iliac stent, clinical improvement rates, and risk factors for requiring additional SFA procedures were evaluated. Results. Primary patency rates of the iliac stent at 1, 3, 5, and 7 years were 97, 93, 79, and 79 %, respectively. The initial clinical improvement rate was 87 %. Continued clinical improvement rates at 1, 3, 5, and 7 years were 87, 81, 69, and 66 %, respectively. SFA Trans-Atlantic Inter-Society Consensus (TASC) II C/D lesion was a significant risk factor for requiring additional SFA procedures. Conclusion. Intermittent claudication was relieved by iliac stent placement in most patients with both iliac and SFA lesions. Thus, the indications for treatment of the SFA intended for claudicants should be evaluated after treatment of the iliac lesion.

  2. Delayed Complications in Patients Surviving at Least 3 Years After Stereotactic Radiosurgery for Brain Metastases

    SciTech Connect (OSTI)

    Yamamoto, Masaaki; Department of Neurosurgery, Tokyo Women's Medical University Medical Center East, Tokyo ; Kawabe, Takuya; Department of Neurosurgery, Kyoto Prefectural University of Medicine Graduate School of Medical Sciences, Kyoto ; Higuchi, Yoshinori; Sato, Yasunori; Nariai, Tadashi; Barfod, Bierta E.; Kasuya, Hidetoshi; Urakawa, Yoichi

    2013-01-01

    Purpose: Little is known about delayed complications after stereotactic radiosurgery in long-surviving patients with brain metastases. We studied the actual incidence and predictors of delayed complications. Patients and Methods: This was an institutional review board-approved, retrospective cohort study that used our database. Among our consecutive series of 2000 patients with brain metastases who underwent Gamma Knife radiosurgery (GKRS) from 1991-2008, 167 patients (8.4%, 89 women, 78 men, mean age 62 years [range, 19-88 years]) who survived at least 3 years after GKRS were studied. Results: Among the 167 patients, 17 (10.2%, 18 lesions) experienced delayed complications (mass lesions with or without cyst in 8, cyst alone in 8, edema in 2) occurring 24.0-121.0 months (median, 57.5 months) after GKRS. The actuarial incidences of delayed complications estimated by competing risk analysis were 4.2% and 21.2% at the 60th month and 120th month, respectively, after GKRS. Among various pre-GKRS clinical factors, univariate analysis demonstrated tumor volume-related factors: largest tumor volume (hazard ratio [HR], 1.091; 95% confidence interval [CI], 1.018-1.154; P=.0174) and tumor volume {<=}10 cc vs >10 cc (HR, 4.343; 95% CI, 1.444-12.14; P=.0108) to be the only significant predictors of delayed complications. Univariate analysis revealed no correlations between delayed complications and radiosurgical parameters (ie, radiosurgical doses, conformity and gradient indexes, and brain volumes receiving >5 Gy and >12 Gy). After GKRS, an area of prolonged enhancement at the irradiated lesion was shown to be a possible risk factor for the development of delayed complications (HR, 8.751; 95% CI, 1.785-157.9; P=.0037). Neurosurgical interventions were performed in 13 patients (14 lesions) and mass removal for 6 lesions and Ommaya reservoir placement for the other 8. The results were favorable. Conclusions: Long-term follow-up is crucial for patients with brain metastases treated with GKRS because the risk of complications long after treatment is not insignificant. However, even when delayed complications occur, favorable outcomes can be expected with timely neurosurgical intervention.

  3. Salvage Radiosurgery for Brain Metastases: Prognostic Factors to Consider in Patient Selection

    SciTech Connect (OSTI)

    Kurtz, Goldie; Zadeh, Gelareh; Gingras-Hill, Geneviève; Millar, Barbara-Ann; Laperriere, Normand J.; Bernstein, Mark; Jiang, Haiyan; Ménard, Cynthia; Chung, Caroline

    2014-01-01

    Purpose: Stereotactic radiosurgery (SRS) is offered to patients for recurrent brain metastases after prior brain radiation therapy (RT), but few studies have evaluated the efficacy of salvage SRS or factors to consider in selecting patients for this treatment. This study reports overall survival (OS), intracranial progression-free survival (PFS), and local control (LC) after salvage SRS, and factors associated with outcomes. Methods and Materials: This is a retrospective review of patients treated from 2009 to 2011 with salvage SRS after prior brain RT for brain metastases. Survival from salvage SRS and from initial brain metastases diagnosis (IBMD) was calculated. Univariate and multivariable (MVA) analyses included age, performance status, recursive partitioning analysis (RPA) class, extracranial disease control, and time from initial RT to salvage SRS. Results: There were 106 patients included in the analysis with a median age of 56.9 years (range 32.5-82 years). A median of 2 metastases were treated per patient (range, 1-12) with a median dose of 21 Gy (range, 12-24) prescribed to the 50% isodose. With a median follow-up of 10.5 months (range, 0.1-68.2), LC was 82.8%, 60.1%, and 46.8% at 6 months, 1 year, and 3 years, respectively. Median PFS was 6.2 months (95% confidence interval [CI] = 4.9-7.6). Median OS was 11.7 months (95% CI = 8.1-13) from salvage SRS, and 22.1 months from IBMD (95% CI = 18.4-26.8). On MVA, age (P=.01; hazard ratio [HR] = 1.04; 95% CI = 1.01-1.07), extracranial disease control (P=.004; HR = 0.46; 95% CI = 0.27-0.78), and interval from initial RT to salvage SRS of at least 265 days (P=.001; HR = 2.46; 95% CI = 1.47-4.09) were predictive of OS. Conclusions: This study demonstrates that patients can have durable local control and survival after salvage SRS for recurrent brain metastases. In particular, younger patients with controlled extracranial disease and a durable response to initial brain RT are likely to benefit from salvage SRS.

  4. Internet-Based Survey Evaluating Use of Pain Medications and Attitudes of Radiation Oncology Patients Toward Pain Intervention

    SciTech Connect (OSTI)

    Simone, Charles B. Vapiwala, Neha; Hampshire, Margaret K.; Metz, James M.

    2008-09-01

    Purpose: Pain is a common symptom among cancer patients, yet many patients do not receive adequate pain management. Few data exist quantifying analgesic use by radiation oncology patients. This study evaluated the causes of pain in cancer patients and investigated the reasons patients fail to receive optimal analgesic therapy. Methods and Materials: An institutional review board-approved, Internet-based questionnaire assessing analgesic use and pain control was posted on the OncoLink (available at (www.oncolink.org)) Website. Between November 2005 and April 2006, 243 patients responded. They were predominantly women (73%), white (71%), and educated beyond high school (67%) and had breast (38%), lung (6%), or ovarian (6%) cancer. This analysis evaluated the 106 patients (44%) who underwent radiotherapy. Results: Of the 106 patients, 58% reported pain from their cancer treatment, and 46% reported pain directly from their cancer. The pain was chronic in 51% and intermittent in 33%. Most (80%) did not use medication to manage their pain. Analgesic use was significantly less in patients with greater education levels (11% vs. 36%, p = 0.002), with a trend toward lower use by whites (16% vs. 32%, p 0.082) and women (17% vs. 29%, p = 0.178). The reasons for not taking analgesics included healthcare provider not recommending medication (87%), fear of addiction or dependence (79%), and inability to pay (79%). Participants experiencing pain, but not taking analgesics, pursued alternative therapies for relief. Conclusions: Many radiation oncology patients experience pain from their disease and cancer treatment. Most study participants did not use analgesics because of concerns of addiction, cost, or failure of the radiation oncologist to recommend medication. Healthcare providers should have open discussions with their patients regarding pain symptoms and treatment.

  5. Prospective Assessment of Optimal Individual Position (Prone Versus Supine) for Breast Radiotherapy: Volumetric and Dosimetric Correlations in 100 Patients

    SciTech Connect (OSTI)

    Lymberis, Stella C.; Wyngaert, John Keith de; Parhar, Preeti; Chhabra, Arpit M.; Fenton-Kerimian, Maria; Chang Jengwha; Hochman, Tsivia; Department of Environmental Medicine, New York University School of Medicine and Langone Medical Center, New York, New York ; Guth, Amber; Roses, Daniel; Goldberg, Judith D.; Department of Environmental Medicine, New York University School of Medicine and Langone Medical Center, New York, New York ; Formenti, Silvia C.

    2012-11-15

    Purpose: Damage to heart and lung from breast radiotherapy is associated with increased cardiovascular mortality and lung cancer development. We conducted a prospective study to evaluate which position is best to spare lung and heart from radiotherapy exposure. Methods and Materials: One hundred consecutive Stage 0-IIA breast cancer patients consented to participate in a research trial that required two computed tomography simulation scans for planning both supine and prone positions. The optimal position was defined as that which best covered the contoured breast and tumor bed while it minimized critical organ irradiation, as quantified by the in-field heart and lung volume. The trial was designed to plan the first 100 patients in each position to study correlations between in-field volumes of organs at risk and dose. Results: Fifty-three left and 47 right breast cancer patients were consecutively accrued to the trial. In all patients, the prone position was optimal for sparing lung volume compared to the supine setup (mean lung volume reduction was 93.5 cc for right and 103.6 cc for left breast cancer patients). In 46/53 (87%) left breast cancer patients best treated prone, in-field heart volume was reduced by a mean of 12 cc and by 1.8 cc for the other 7/53 (13%) patients best treated supine. As predicted, supine-prone differences in in-field volume and mean dose of heart and lung were highly correlated (Spearman's correlation coefficient for left breast cancer patients was 0.90 for heart and 0.94 for lung and 0.92 for right breast cancer patients for lung). Conclusions: Prone setup reduced the amount of irradiated lung in all patients and reduced the amount of heart volume irradiated in 87% of left breast cancer patients. In-field organ volume is a valid surrogate for predicting dose; the trial continued to the planned target of 400.

  6. Locoregional Recurrence of Breast Cancer in Patients Treated With Breast Conservation Surgery and Radiotherapy Following Neoadjuvant Chemotherapy

    SciTech Connect (OSTI)

    Min, Sun Young; Lee, Seung Ju; Shin, Kyung Hwan; Park, In Hae; Jung, So-Youn; Lee, Keun Seok; Ro, Jungsil; Lee, Seeyoun; Kim, Seok Won; Kim, Tae Hyun; Kang, Han-Sung; Cho, Kwan Ho

    2011-12-01

    Purpose: Breast conservation surgery (BCS) and radiotherapy (RT) following neoadjuvant chemotherapy (NCT) have been linked with high locoregional recurrence (LRR) rates and ipsilateral breast tumor recurrence (IBTR) rates. The purpose of this study was to analyze clinical outcomes in patients who exhibited LRR and IBTR after being treated by BCS and RT following NCT. Methods and Materials: In total, 251 breast cancer patients treated with BCS and RT following NCT between 2001 and 2006 were included. All patients had been shown to be clinically node-positive. Clinical stage at diagnosis (2003 AJCC) was II in 68% of patients and III in 32% of patients. Of those, 50%, 35%, and 15% of patients received anthracycline-based, taxane-based, and combined anthracycline-taxane NCT, respectively. All patients received RT. Results: During follow-up (median, 55 months), 26 (10%) patients had LRR, 19 of these patients had IBTR. Five-year actuarial rates of IBTR-free and LRR-free survival were 91% and 89%, respectively. In multivariate analyses, lack of hormone suppression therapy was found to increase both LRR and IBTR rates. Hazard ratios were 7.99 (p < 0.0001) and 4.22 (p = 0.004), respectively. Additionally, pathology stage N2 to N3 increased LRR rate (hazard ratio, 4.22; p = 0.004), and clinical AJCC stage III IBTR rate (hazard ratio, 9.05; p = 0.034). Achievement of pathological complete response and presence of multifocal tumors did not affect LRR or IBTR. Conclusions: In patients with locally advanced disease, who were clinically node-positive at presentation, BCS after NCT resulted in acceptably low rates of IBTR and LRR. Mastectomy should be considered as an option in patients who present with clinical stage III tumors or who are not treated with adjuvant hormone suppression therapy, because they exhibit high IBTR rates after NCT and BCS.

  7. Title: Gender differences in presentation, management and in-hospital outcome in patients with ST-elevation myocardial infarction. Data from 5,000 patients included in the ORBI

    E-Print Network [OSTI]

    1 Title: Gender differences in presentation, management and in-hospital outcome in patients with ST. Titre: Différences liées au genre dans la présentation, la gestion et le devenir intra hospitalier des: Background: Gender differences in presentation, management and outcome in patients with ST

  8. Correction for FDG PET dose extravasations: Monte Carlo validation and quantitative evaluation of patient studies

    SciTech Connect (OSTI)

    Silva-Rodríguez, Jesús Aguiar, Pablo; Servicio de Medicina Nuclear, Complexo Hospitalario Universidade de Santiago de Compostela , 15782, Galicia; Grupo de Imaxe Molecular, Instituto de Investigación Sanitarias , Santiago de Compostela, 15706, Galicia ; Sánchez, Manuel; Mosquera, Javier; Luna-Vega, Víctor; Cortés, Julia; Garrido, Miguel; Pombar, Miguel; Ruibal, Álvaro; Grupo de Imaxe Molecular, Instituto de Investigación Sanitarias , Santiago de Compostela, 15706, Galicia; Fundación Tejerina, 28003, Madrid

    2014-05-15

    Purpose: Current procedure guidelines for whole body [18F]fluoro-2-deoxy-D-glucose (FDG)-positron emission tomography (PET) state that studies with visible dose extravasations should be rejected for quantification protocols. Our work is focused on the development and validation of methods for estimating extravasated doses in order to correct standard uptake value (SUV) values for this effect in clinical routine. Methods: One thousand three hundred sixty-seven consecutive whole body FDG-PET studies were visually inspected looking for extravasation cases. Two methods for estimating the extravasated dose were proposed and validated in different scenarios using Monte Carlo simulations. All visible extravasations were retrospectively evaluated using a manual ROI based method. In addition, the 50 patients with higher extravasated doses were also evaluated using a threshold-based method. Results: Simulation studies showed that the proposed methods for estimating extravasated doses allow us to compensate the impact of extravasations on SUV values with an error below 5%. The quantitative evaluation of patient studies revealed that paravenous injection is a relatively frequent effect (18%) with a small fraction of patients presenting considerable extravasations ranging from 1% to a maximum of 22% of the injected dose. A criterion based on the extravasated volume and maximum concentration was established in order to identify this fraction of patients that might be corrected for paravenous injection effect. Conclusions: The authors propose the use of a manual ROI based method for estimating the effectively administered FDG dose and then correct SUV quantification in those patients fulfilling the proposed criterion.

  9. Prognostic Factors and Outcome in Askin-Rosai Tumor: A Review of 104 Patients

    SciTech Connect (OSTI)

    Laskar, Siddhartha; Nair, Chandrika; Mallik, Suman; Bahl, Gaurav; Pai, Suresh; Shet, Tanuja; Gupta, Tejpal; Arora, Brijesh; Bakshi, Ashish; Pramesh, C.S.; Mistry, Rajesh; Qureshi, Sajid; Medhi, Seema; Jambhekar, Nirmala; Kurkure, Purna; Banavali, Shripad; Muckaden, Mary Ann

    2011-01-01

    Purpose: To evaluate the prognostic factors and treatment outcome of patients with Askin-Rosai tumor of the chest wall treated at a single institution. Methods and Materials: Treatment comprised multiagent chemotherapy and local therapy, which was either in the form of surgery alone, radical external-beam radiotherapy (EBRT) alone, or a combination of surgery and EBRT. Thirty-two patients (40%) were treated with all three modalities, 21 (27%) received chemotherapy and radical EBRT, and 19 (24%) underwent chemotherapy followed by surgery only. Results: One hundred four consecutive patients aged 3-60 years were treated at the Tata Memorial Hospital from January 1995 to October 2003. Most (70%) were male (male/female ratio, 2.3:1). Asymptomatic swelling (43%) was the most common presenting symptom, and 25% of patients presented with distant metastasis. After a median follow-up of 28 months, local control, disease-free survival, and overall survival rates were 67%, 36%, and 45%, respectively. Median time to relapse was 25 months, and the median survival was 76 months. Multivariate analysis revealed age {>=}18 years, poor response to induction chemotherapy, and presence of pleural effusion as indicators of inferior survival. Fifty-six percent of patients with metastatic disease at presentation died within 1 month of diagnosis, with 6-month and 5-year actuarial survival of 14% and 4%, respectively. Conclusion: Primary tumor size, pleural effusion, response to chemotherapy, and optimal radiotherapy were important prognostic factors influencing outcome. The combination of neoadjuvant chemotherapy, surgery, and radiotherapy resulted in optimal outcome.

  10. Survival after Radiofrequency Ablation in 122 Patients with Inoperable Colorectal Lung Metastases

    SciTech Connect (OSTI)

    Gillams, Alice, E-mail: alliesorting@gmail.com [The London Clinic, Radiology Department (United Kingdom); Khan, Zahid [Countess of Chester Hospital (United Kingdom); Osborn, Peter [Queen Alexandra Hospital (United Kingdom); Lees, William [University College London Medical School (United Kingdom)

    2013-06-15

    Purpose. To analyze the factors associated with favorable survival in patients with inoperable colorectal lung metastases treated with percutaneous image-guided radiofrequency ablation. Methods. Between 2002 and 2011, a total of 398 metastases were ablated in 122 patients (87 male, median age 68 years, range 29-90 years) at 256 procedures. Percutaneous CT-guided cool-tip radiofrequency ablation was performed under sedation/general anesthesia. Maximum tumor size, number of tumors ablated, number of procedures, concurrent/prior liver ablation, previous liver or lung resection, systemic chemotherapy, disease-free interval from primary resection to lung metastasis, and survival from first ablation were recorded prospectively. Kaplan-Meier analysis was performed, and factors were compared by log rank test. Results. The initial number of metastases ablated was 2.3 (range 1-8); the total number was 3.3 (range 1-15). The maximum tumor diameter was 1.7 (range 0.5-4) cm, and the number of procedures was 2 (range 1-10). The major complication rate was 3.9 %. Overall median and 3-year survival rate were 41 months and 57 %. Survival was better in patients with smaller tumors-a median of 51 months, with 3-year survival of 64 % for tumors 2 cm or smaller versus 31 months and 44 % for tumors 2.1-4 cm (p = 0.08). The number of metastases ablated and whether the tumors were unilateral or bilateral did not affect survival. The presence of treated liver metastases, systemic chemotherapy, or prior lung resection did not affect survival. Conclusion. Three-year survival of 57 % in patients with inoperable colorectal lung metastases is better than would be expected with chemotherapy alone. Patients with inoperable but small-volume colorectal lung metastases should be referred for ablation.

  11. SU-E-J-191: Automated Detection of Anatomic Changes in H'N Patients

    SciTech Connect (OSTI)

    Usynin, A; Ramsey, C [Thompson Cancer Survival Center Knoxville, TN (United States)

    2014-06-01

    Purpose: To develop a novel statistics-based method for automated detection of anatomical changes using cone-beam CT data. A method was developed that can provide a reliable and automated early warning system that enables a “just-in-time” adaptation of the treatment plan. Methods: Anatomical changes were evaluated by comparing the original treatment planning CT with daily CBCT images taken prior treatment delivery. The external body contour was computed on a given CT slice and compared against the corresponding contour on the daily CBCT. In contrast to threshold-based techniques, a statistical approach was employed to evaluate the difference between the contours using a given confidence level. The detection tool used the two-sample Kolmogorov-Smirnov test, which is a non-parametric technique that compares two samples drawn from arbitrary probability distributions. 11 H'N patients were retrospectively selected from a clinical imaging database with a total of 186 CBCT images. Six patients in the database were confirmed to have anatomic changes during the course of radiotherapy. Five of the H'N patients did not have significant changes. The KS test was applied to the contour data using a sliding window analysis. The confidence level of 0.99 was used to moderate false detection. Results: The algorithm was able to correctly detect anatomical changes in 6 out of 6 patients with an excellent spatial accuracy as early as at the 14th elapsed day. The algorithm provided a consistent and accurate delineation of the detected changes. The output of the anatomical change tool is easy interpretable, and can be shown overlaid on a 3D rendering of the patient's anatomy. Conclusion: The detection method provides the basis for one of the key components of Adaptive Radiation Therapy. The method uses tools that are readily available in the clinic, including daily CBCT imaging, and image co-registration facilities.

  12. Timing of Radiotherapy and Outcome in Patients Receiving Adjuvant Endocrine Therapy

    SciTech Connect (OSTI)

    Karlsson, Per, E-mail: per.karlsson@oncology.gu.s [Department of Oncology, Sahlgrenska University Hospital, Gothenburg (Sweden); Cole, Bernard F. [Department of Mathematics and Statistics, University of Vermont College of Engineering and Mathematical Sciences, Burlington, VT (United States); International Breast Cancer Study Group Statistical Center, Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, MA (United States); Colleoni, Marco [Department of Medicine, Research Unit in Medical Senology, European Institute of Oncology, Milan (Italy); Roncadin, Mario [Department of Radiotherapy, Centro di Riferimento Oncologico, Aviano (Italy); Chua, Boon H. [Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne (Australia); Murray, Elizabeth [Department of Radiation Oncology, Groote Shuur Hospital and University of Cape Town, Cape Town (South Africa); Price, Karen N. [International Breast Cancer Study Group Statistical Center, Frontier Science and Technology Research Foundation, Boston, MA (United States); Castiglione-Gertsch, Monica [International Breast Cancer Study Group Coordinating Center, Bern (Switzerland); Goldhirsch, Aron [European Institute of Oncology, Milan (Italy); Oncology Institute of Southern Switzerland, Bellinzona (Switzerland); Gruber, Guenther [Institut fuer Radiotherapie, Klinik Hirslanden, Zuerich (Switzerland)

    2011-06-01

    Purpose: To evaluate the association between the interval from breast-conserving surgery (BCS) to radiotherapy (RT) and the clinical outcome among patients treated with adjuvant endocrine therapy. Patients and Methods: Patient information was obtained from three International Breast Cancer Study Group trials. The analysis was restricted to 964 patients treated with BCS and adjuvant endocrine therapy. The patients were divided into two groups according to the median number of days between BCS and RT and into four groups according to the quartile of time between BCS and RT. The endpoints were the interval to local recurrence, disease-free survival, and overall survival. Proportional hazards regression analysis was used to perform comparisons after adjustment for baseline factors. Results: The median interval between BCS and RT was 77 days. RT timing was significantly associated with age, menopausal status, and estrogen receptor status. After adjustment for these factors, no significant effect of a RT delay {<=}20 weeks was found. The adjusted hazard ratio for RT within 77 days vs. after 77 days was 0.94 (95% confidence interval [CI], 0.47-1.87) for the interval to local recurrence, 1.05 (95% CI, 0.82-1.34) for disease-free survival, and 1.07 (95% CI, 0.77-1.49) for overall survival. For the interval to local recurrence the adjusted hazard ratio for {<=}48, 49-77, and 78-112 days was 0.90 (95% CI, 0.34-2.37), 0.86 (95% CI, 0.33-2.25), and 0.89 (95% CI, 0.33-2.41), respectively, relative to {>=}113 days. Conclusion: A RT delay of {<=}20 weeks was significantly associated with baseline factors such as age, menopausal status, and estrogen-receptor status. After adjustment for these factors, the timing of RT was not significantly associated with the interval to local recurrence, disease-free survival, or overall survival.

  13. DOMINO-AD protocol: donepezil and memantine in moderate to severe Alzheimer's disease - a multicentre RCT

    E-Print Network [OSTI]

    Jones, Rob; Sheehan, Bart; Phillips, Patrick; Juszczak, Ed; Adams, Jessica; Baldwin, Ashley; Ballard, Clive; Banerjee, Sube; Barber, Bob; Bentham, Peter; Brown, Richard; Burns, Alistair; Dening, Tom; Findlay, David; Gray, Richard; Griffin, Mary; Holmes, Clive; Hughes, Alan; Jacoby, Robin; Johnson, Tony; Jones, Roy; Knapp, Martin; Lindesay, James; McKeith, Ian; McShane, Rupert; Macharouthu, Ajay; O'Brien, John; Onions, Caroline; Passmore, Peter; Raftery, James; Ritchie, Craig; Howard, Rob; Domino-ad Team

    2009-07-24

    . Method DOMINO-AD is a pragmatic, 15 centre, double-blind, randomized, placebo controlled trial. Patients with AD, currently living at home, receiving donepezil 10 mg daily, and with Standardized Mini-Mental State Examination (SMMSE) scores between 5...

  14. Abstract--We describe an inexpensive in-home monitoring system designed to assist patients with traumatic

    E-Print Network [OSTI]

    Minnesota, University of

    Abstract-- We describe an inexpensive in-home monitoring system designed to assist patients wireless sensors, including motion, pressure, door, flow, accelerometer, magnetometer, temperature, light daily activities in a home setting. In particular, the system is intended to help such patients plan

  15. BiDil for Heart Failure in Black Patients: The U.S. Food and Drug Administration Perspective

    E-Print Network [OSTI]

    Noble, William Stafford

    BiDil for Heart Failure in Black Patients: The U.S. Food and Drug Administration Perspective Robert Temple, MD, and Norman L. Stockbridge, MD, PhD Critics of the U.S. Food and Drug Administration (FDA patient-reported functional status" (1). Approval followed the unanimous recommen- dation of the FDA

  16. A method for evaluating the effectiveness of medications prescribed for Intention Tremor in Patients with Multiple Sclerosis

    E-Print Network [OSTI]

    Lübeck, Universität zu

    in Patients with Multiple Sclerosis Suha, Abuarqub1,5 , Giampaolo Brichetto 3 , Claudio Solaro 2,3,4 , Ulrich in the upper limb in patients with Multiple Sclerosis, based on kinematic analysis of visually guided reaching of the movement [1][2][3]. Intention Tremor has been described in Multiple Sclerosis (MS) and observed to appear

  17. Knowledge-based Patient Data Generation Zhisheng Huang, Frank van Harmelen, Annette ten Teije, and Kathrin Dentler

    E-Print Network [OSTI]

    van Harmelen, Frank

    Knowledge-based Patient Data Generation Zhisheng Huang, Frank van Harmelen, Annette ten Teije and the quality of the data. By defining the required format, data can easily be generated based on realistic,Frank.van.Harmelen,annette,k.dentler}@cs.vu.nl Abstract. The development and investigation of medical applications require patient data from various

  18. PRIVACY AND CONFIDENTIALITY OF PATIENT INFORMATION The University of Connecticut School of Medicine (UConn SOM) and affiliated sites establish

    E-Print Network [OSTI]

    Page 148 ` PRIVACY AND CONFIDENTIALITY OF PATIENT INFORMATION The University of Connecticut School patient information that is protected from disclosure by both Connecticut and federal laws in all respects with both Connecticut and federal laws, such as HIPAA. For the UConn Health's full policy

  19. Abstract. Background: There is a strong need for prognostic biomarkers in ovarian cancer patients due to the

    E-Print Network [OSTI]

    Abstract. Background: There is a strong need for prognostic biomarkers in ovarian cancer patients ionization-time of flight mass spectrometry (SELDI-TOF MS) in ovarian cancer tissue to obtain protein analysed on SELDI-TOF MS. Applying these protocols on tissue of 9 ovarian cancer patients showed different

  20. A New Prognostic Index and Comparison to Three Other Indices for Patients With Brain Metastases: An Analysis of 1,960 Patients in the RTOG Database

    SciTech Connect (OSTI)

    Sperduto, Paul W. Berkey, Brian M.S.; Gaspar, Laurie E.; Mehta, Minesh; Curran, Walter

    2008-02-01

    Purpose: The purpose of this study is to introduce a new prognostic index for patients with brain metastases and compare it with three published indices. Treatment for brain metastases varies widely. A sound prognostic index is thus important to guide both clinical decision making and outcomes research. Methods and Materials: A new index was developed because of limitations in the three existing indices and new data (Radiation Therapy Oncology Group 9508) are available since the others were developed. All four indices were compared using the Radiation Therapy Oncology Group database of 1,960 patients with brain metastases from five randomized trials. The ability of the four indices to distinguish its separate classes was determined statistically. Advantages and disadvantages of each index are discussed. Results: Recursive partitioning analysis (RPA) and the new Graded Prognostic Assessment (GPA) had the most statistically significant differences between classes (p < 0.001 for all classes). Conclusions: The new index, the GPA, is as prognostic as the RPA and more prognostic than the other indices. The GPA is the least subjective, most quantitative and easiest to use of the four indices. Future clinical trials should compare the GPA with the RPA to prospectively validate these findings.

  1. Patient 231

    E-Print Network [OSTI]

    Reed, Michelle

    2007-09-01

    , holding both arms behind her back. They didn't hear us coming. I took Red and Sally took Black, and we washed Ella's white dress in their b lood. 13. A Visit with My Father Daddy arrives at n o o n . Sharp, because he's always exactly on time. It... clogs my nose. N o breath, no air. He spins in gray in front of me, white lights dance behind. I have no feet. T h e n he spits himself into the back of my throat and I 'm empty again, washing the sidewalk with his poison and my blood. Eat it, he...

  2. RTOG 0211: A Phase 1/2 Study of Radiation Therapy With Concurrent Gefitinib for Newly Diagnosed Glioblastoma Patients

    SciTech Connect (OSTI)

    Chakravarti, Arnab; Wang, Meihua; Robins, H. Ian; Lautenschlaeger, Tim; Curran, Walter J.; Brachman, David G.; Schultz, Christopher J.; Choucair, Ali; Dolled-Filhart, Marisa; Christiansen, Jason; Gustavson, Mark; Molinaro, Annette; Ludwig Institute for Cancer Research, University of California–San Diego, La Jolla, California ; Mischel, Paul; Dicker, Adam P.; and others

    2013-04-01

    Purpose: To determine the safety and efficacy of gefitinib, an epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor, in combination with radiation for newly diagnosed glioblastoma (GBM) patients. Methods and Materials: Between March 21, 2002, and May 3, 2004, Radiation Therapy Oncology Group (RTOG) 0211 enrolled 31 and 147 GBM patients in the phase 1 and 2 arms, respectively. Treatment consisted of daily oral gefinitnib started at the time of conventional cranial radiation therapy (RT) and continued post RT for 18 months or until progression. Tissue microarrays from 68 cases were analyzed for EGFR expression. Results: The maximum tolerated dose (MTD) of gefitinib was determined to be 500 mg in patients on non-enzyme-inducing anticonvulsant drugs (non-EIAEDs). All patients in the phase 2 component were treated at a gefitinib dose of 500 mg; patients receiving EIADSs could be escalated to 750 mg. The most common side effects of gefitinib in combination with radiation were dermatologic and gastrointestinal. Median survival was 11.5 months for patients treated per protocol. There was no overall survival benefit for patients treated with gefitinib + RT when compared with a historical cohort of patients treated with RT alone, matched by RTOG recursive partitioning analysis (RPA) class distribution. Younger age was significantly associated with better outcome. Per protocol stratification, EGFR expression was not found to be of prognostic value for gefitinib + RT-treated patients. Conclusions: The addition of gefitinib to RT is well tolerated. Median survival of RTOG 0211 patients treated with RT with concurrent and adjuvant gefitinib was similar to that in a historical control cohort treated with radiation alone.

  3. Prone Accelerated Partial Breast Irradiation After Breast-Conserving Surgery: Five-year Results of 100 Patients

    SciTech Connect (OSTI)

    Formenti, Silvia C.; Hsu, Howard; Fenton-Kerimian, Maria; Roses, Daniel; Guth, Amber; Jozsef, Gabor; Goldberg, Judith D.; DeWyngaert, J. Keith

    2012-11-01

    Purpose: To report the 5-year results of a prospective trial of three-dimensional conformal external beam radiotherapy (3D-CRT) to deliver accelerated partial breast irradiation in the prone position. Methods and Materials: Postmenopausal patients with Stage I breast cancer with nonpalpable tumors <2 cm, negative margins and negative nodes, positive hormone receptors, and no extensive intraductal component were eligible. The trial was offered only after eligible patients had refused to undergo standard whole-breast radiotherapy. Patients were simulated and treated on a dedicated table for prone setup. 3D-CRT was delivered at a dose of 30 Gy in five 6-Gy/day fractions over 10 days with port film verification at each treatment. Rates of ipsilateral breast failure, ipsilateral nodal failure, contralateral breast failure, and distant failure were estimated using the cumulative incidence method. Rates of disease-free, overall, and cancer-specific survival were recorded. Results: One hundred patients were enrolled in this institutional review board-approved prospective trial, one with bilateral breast cancer. One patient withdrew consent after simulation, and another patient elected to interrupt radiotherapy after receiving two treatments. Ninety-eight patients were evaluable for toxicity, and, in 1 case, both breasts were treated with partial breast irradiation. Median patient age was 68 years (range, 53-88 years); in 55% of patients the tumor size was <1 cm. All patients had hormone receptor-positive cancers: 87% of patients underwent adjuvant antihormone therapy. At a median follow-up of 64 months (range, 2-125 months), there was one local recurrence (1% ipsilateral breast failure) and one contralateral breast cancer (1% contralateral breast failure). There were no deaths due to breast cancer by 5 years. Grade 3 late toxicities occurred in 2 patients (one breast edema, one transient breast pain). Cosmesis was rated good/excellent in 89% of patients with at least 36 months follow-up. Conclusions: Five-year efficacy and toxicity of 3D-CRT delivered in prone partial breast irradiation are comparable to other experiences with similar follow-up.

  4. Electromagnetic Tracking of Intrafraction Prostate Displacement in Patients Externally Immobilized in the Prone Position

    SciTech Connect (OSTI)

    Bittner, Nathan [Tacoma/Valley Radiation Oncology Centers, Tacoma, WA (United States); Butler, Wayne M.; Reed, Joshua L.; Murray, Brian C.; Kurko, Brian S. [Schiffler Cancer Center and Wheeling Jesuit University, Wheeling, WV (United States); Wallner, Kent E. [Puget Sound Health Care System, Department of Veterans Affairs, Seattle, WA (United States); Merrick, Gregory S., E-mail: gmerrick@urologicresearchinstitute.or [Schiffler Cancer Center and Wheeling Jesuit University, Wheeling, WV (United States)

    2010-06-01

    Purpose: To evaluate intrafraction prostate displacement among patients immobilized in the prone position using real-time monitoring of implanted radiofrequency transponders. Methods and Materials: The Calypso localization system was used to track prostate motion in patients receiving external beam radiation therapy (XRT) for prostate cancer. All patients were treated in the prone position and immobilized with a thermoplastic immobilization device. Real-time measurement of prostate displacement was recorded for each treatment fraction. These measurements were used to determine the duration and magnitude of displacement along the three directional axes. Results: The calculated centroid of the implanted transponders was offset from the treatment isocenter by >=2 mm, >=3 mm, and >=4 mm for 38.0%, 13.9%, and 4.5% of the time. In the lateral dimension, the centroid was offset from the treatment isocenter by >=2 mm, >=3 mm, and >=4 mm for 2.7%, 0.4%, and 0.06% of the time. In the superior-inferior dimension, the centroid was offset from the treatment isocenter by >=2 mm, >=3 mm, and >=4 mm for 16.1%, 4.7%, and 1.5% of the time, respectively. In the anterior-posterior dimension, the centroid was offset from the treatment isocenter by >=2 mm, >=3 mm, and >=4 mm for 13.4%, 3.0%, and 0.5% of the time. Conclusions: Intrafraction prostate displacement in the prone position is comparable to that in the supine position. For patients with large girth, in whom the supine position may preclude accurate detection of implanted radiofrequency transponders, treatment in the prone position is a suitable alternative.

  5. SU-E-J-29: Audiovisual Biofeedback Improves Tumor Motion Consistency for Lung Cancer Patients

    SciTech Connect (OSTI)

    Lee, D; Pollock, S; Makhija, K; Keall, P [The University of Sydney, Camperdown, NSW (Australia); Greer, P [The University of Newcastle, Newcastle, NSW (Australia); Calvary Mater Newcastle Hospital, Newcastle, NSW (Australia); Arm, J; Hunter, P [Calvary Mater Newcastle Hospital, Newcastle, NSW (Australia); Kim, T [The University of Sydney, Camperdown, NSW (Australia); University of Virginia Health System, Charlottesville, VA (United States)

    2014-06-01

    Purpose: To investigate whether the breathing-guidance system: audiovisual (AV) biofeedback improves tumor motion consistency for lung cancer patients. This will minimize respiratory-induced tumor motion variations across cancer imaging and radiotherapy procedues. This is the first study to investigate the impact of respiratory guidance on tumor motion. Methods: Tumor motion consistency was investigated with five lung cancer patients (age: 55 to 64), who underwent a training session to get familiarized with AV biofeedback, followed by two MRI sessions across different dates (pre and mid treatment). During the training session in a CT room, two patient specific breathing patterns were obtained before (Breathing-Pattern-1) and after (Breathing-Pattern-2) training with AV biofeedback. In each MRI session, four MRI scans were performed to obtain 2D coronal and sagittal image datasets in free breathing (FB), and with AV biofeedback utilizing Breathing-Pattern-2. Image pixel values of 2D images after the normalization of 2D images per dataset and Gaussian filter per image were used to extract tumor motion using image pixel values. The tumor motion consistency of the superior-inferior (SI) direction was evaluated in terms of an average tumor motion range and period. Results: Audiovisual biofeedback improved tumor motion consistency by 60% (p value = 0.019) from 1.0±0.6 mm (FB) to 0.4±0.4 mm (AV) in SI motion range, and by 86% (p value < 0.001) from 0.7±0.6 s (FB) to 0.1±0.2 s (AV) in period. Conclusion: This study demonstrated that audiovisual biofeedback improves both breathing pattern and tumor motion consistency for lung cancer patients. These results suggest that AV biofeedback has the potential for facilitating reproducible tumor motion towards achieving more accurate medical imaging and radiation therapy procedures.

  6. Vertebral Augmentation with Nitinol Endoprosthesis: Clinical Experience in 40 Patients with 1-Year Follow-up

    SciTech Connect (OSTI)

    Anselmetti, Giovanni Carlo, E-mail: gc.anselmetti@fastwebnet.it [Villa Maria Hospital, Interventional Radiology Unit (Italy); Manca, Antonio, E-mail: anto.manca@gmail.com [Institute for Cancer Research and Treatment (IRCC), Interventional Radiology Unit (Italy); Marcia, Stefano, E-mail: stemarcia@gmail.com [Institute of Radiology, University of Cagliari (Italy); Chiara, Gabriele, E-mail: gabriele.chiara@ircc.it [Institute for Cancer Research and Treatment (IRCC), Interventional Radiology Unit (Italy); Marini, Stefano, E-mail: stemarini@gmail.com [Institute of Radiology, University of Cagliari (Italy); Baroud, Gamal, E-mail: gamalbaroud@gmail.com [University of Sherbrooke, Departement de Genie Mecanique (Canada); Regge, Daniele, E-mail: daniele.regge@ircc.it [Institute for Cancer Research and Treatment (IRCC), Radiology Unit (Italy); Montemurro, Filippo, E-mail: filippo.montemurro@ircc.it [Institute for Cancer Research and Treatment (IRCC), Internal Medicine Unit (Italy)

    2013-05-08

    PurposeThis study was designed to assess the clinical outcomes of patients treated by vertebral augmentation with nitinol endoprosthesis (VNE) to treat painful vertebral compression fractures.MethodsForty patients with one or more painful osteoporotic VCF, confirmed by MRI and accompanied by back-pain unresponsive to a minimum 2 months of conservative medical treatment, underwent VNE at 42 levels. Preoperative and postoperative pain measured with Visual Analog Scale (VAS), disability measured by Oswestry Disability Index (ODI), and vertebral height restoration (measured with 2-dimensional reconstruction CT) were compared at last follow-up (average follow-up 15 months). Cement extravasation, subsequent fractures, and implant migration were recorded.ResultsLong-term follow-up was obtained in 38 of 40 patients. Both VAS and ODI significantly improved from a median of 8.0 (range 5–10) and 66 % (range 44–88 %) to 0.5 (range 0–8) and 6 % (range 6–66 %), respectively, at 1 year (p < 0.0001). Vertebral height measurements comparing time points increased in a statistically significant manner (ANOVA, p < 0.001). Overall cement extravasation rate was 9.5 %. Discal and venous leakage rates were 7.1 and 0 % respectively. No symptomatic extravasations occurred. Five of 38 (13.1 %) patients experienced new spontaneous, osteoporotic fractures. No device change or migration was observed.ConclusionsVNE is a safe and effective procedure that is able to provide long-lasting pain relief and durable vertebral height gain with a low rate of new fractures and cement leakages.

  7. Antioxidant-Essential Oil Gel as a Treatment for Gingivitis in Orthodontic Patients 

    E-Print Network [OSTI]

    Martin, Benjamin John

    2014-04-22

    to receive orthodontic treatment; control group 6 subjects did not receive orthodontic treatment (n=30 for both groups). Patients in the experimental group were evaluated prior to appliance placement and 3 months following appliance placement... looked specifically at several polyphenolic compounds, including gallic acid, tannic acid, quercetin and salicylic acid.14 Each of these compounds was tested for antimicrobial capability against Streptococcus mutans and also for their antioxidant...

  8. Redox Protein Expression Predicts Radiotherapeutic Response in Early-Stage Invasive Breast Cancer Patients

    SciTech Connect (OSTI)

    Woolston, Caroline M.; Al-Attar, Ahmad; Storr, Sarah J.; Ellis, Ian O.; Morgan, David A.L.; Martin, Stewart G.

    2011-04-01

    Purpose: Early-stage invasive breast cancer patients have commonly undergone breast-conserving surgery and radiotherapy. In a large majority of these patients, the treatment is effective; however, a proportion will develop local recurrence. Deregulated redox systems provide cancer cells protection from increased oxidative stress, such as that induced by ionizing radiation. Therefore, the expression of redox proteins was examined in tumor specimens from this defined cohort to determine whether such expression could predict response. Methods and Materials: The nuclear and cytoplasmic expression of nine redox proteins (glutathione, glutathione reductase, glutaredoxin, glutathione peroxidase 1, 3, and 4, and glutathione S-transferase-{theta}, -{pi}, and -{alpha}) was assessed using conventional immunohistochemistry on a tissue microarray of 224 tumors. Results: A high cytoplasmic expression of glutathione S-transferase-{theta} significantly correlated with a greater risk of local recurrence (p = .008) and, when combined with a low nuclear expression (p = .009), became an independent predictive factor (p = .002) for local recurrence. High cytoplasmic expression of glutathione S-transferase-{theta} also correlated with a worse overall survival (p = .009). Low nuclear and cytoplasmic expression of glutathione peroxidase 3 (p = .002) correlated with a greater risk of local recurrence and was an independent predictive factor (p = .005). These proteins did not correlate with tumor grade, suggesting their function might be specific to the regulation of oxidative stress rather than alterations of tumor phenotype. Only nuclear (p = .005) and cytoplasmic (p = .001) expression of glutathione peroxidase 4 correlated with the tumor grade. Conclusions: Our results support the use of redox protein expression, namely glutathione S-transferase-{theta} and glutathione peroxidase 3, to predict the response to radiotherapy in early-stage breast cancer patients. If incorporated into routine diagnostic tests, they have the potential to aid clinicians in their stratification of patients into more tailored treatment regimens. Future targeted therapies to these systems might improve the efficacy of reactive oxygen species-inducing therapies, such as radiotherapy.

  9. Cosmetic Outcomes and Complications Reported by Patients Having Undergone Breast-Conserving Treatment

    SciTech Connect (OSTI)

    Hill-Kayser, Christine E.; Vachani, Carolyn; Hampshire, Margaret K.; Di Lullo, Gloria A.; Metz, James M.

    2012-07-01

    Purpose: Over the past 30 years, much work in treatment of breast cancer has contributed to improvement of cosmetic and functional outcomes. The goal of breast-conservation treatment (BCT) is avoidance of mastectomy through use of lumpectomy and adjuvant radiation. Modern data demonstrate 'excellent' or 'good' cosmesis in >90% of patients treated with BCT. Methods and Materials: Patient-reported data were gathered via a convenience sample frame from breast cancer survivors using a publically available, free, Internet-based tool for creation of survivorship care plans. During use of the tool, breast cancer survivors are queried as to the cosmetic appearance of the treated breast, as well as perceived late effects. All data have been maintained anonymously with internal review board approval. Results: Three hundred fifty-four breast cancer survivors having undergone BCT and voluntarily using this tool were queried with regard to breast cosmesis and perceived late effects. Median diagnosis age was 48 years, and median current age 52 years. 'Excellent' cosmesis was reported by 27% (n = 88), 'Good' by 44% (n = 144), 'Fair' by 24% (n = 81), and 'Poor' by 5% (n = 18). Of the queries posted to survivors after BCT, late effects most commonly reported were cognitive changes (62%); sexual concerns (52%); changes in texture and color of irradiated skin (48%); chronic pain, numbness, or tingling (35%); and loss of flexibility in the irradiated area (30%). Survivors also described osteopenia/osteoporosis (35%), cardiopulmonary problems (12%), and lymphedema (19%). Conclusions: This anonymous tool uses a convenience sample frame to gather patient reported assessments of cosmesis and complications after breast cancer. Among the BCT population, cosmetic assessment by survivors appears less likely to be 'excellent' or 'good' than would be expected, with 30% of BCT survivors reporting 'fair' or 'poor' cosmesis. Patient reported incidence of chronic pain, as well as cognitive and sexual changes, also appears higher than expected.

  10. Evaluation of atlas-based auto-segmentation software in prostate cancer patients

    SciTech Connect (OSTI)

    Greenham, Stuart; Dean, Jenna; Fu, Cheuk Kuen Kenneth; Goman, Joanne; Mulligan, Jeremy; Tune, Deanna; Sampson, David; Westhuyzen, Justin; McKay, Michael

    2014-09-15

    The performance and limitations of an atlas-based auto-segmentation software package (ABAS; Elekta Inc.) was evaluated using male pelvic anatomy as the area of interest. Contours from 10 prostate patients were selected to create atlases in ABAS. The contoured regions of interest were created manually to align with published guidelines and included the prostate, bladder, rectum, femoral heads and external patient contour. Twenty-four clinically treated prostate patients were auto-contoured using a randomised selection of two, four, six, eight or ten atlases. The concordance between the manually drawn and computer-generated contours were evaluated statistically using Pearson's product–moment correlation coefficient (r) and clinically in a validated qualitative evaluation. In the latter evaluation, six radiation therapists classified the degree of agreement for each structure using seven clinically appropriate categories. The ABAS software generated clinically acceptable contours for the bladder, rectum, femoral heads and external patient contour. For these structures, ABAS-generated volumes were highly correlated with ‘as treated’ volumes, manually drawn; for four atlases, for example, bladder r = 0.988 (P < 0.001), rectum r = 0.739 (P < 0.001) and left femoral head r = 0.560 (P < 0.001). Poorest results were seen for the prostate (r = 0.401, P < 0.05) (four atlases); however this was attributed to the comparison prostate volume being contoured on magnetic resonance imaging (MRI) rather than computed tomography (CT) data. For all structures, increasing the number of atlases did not consistently improve accuracy. ABAS-generated contours are clinically useful for a range of structures in the male pelvis. Clinically appropriate volumes were created, but editing of some contours was inevitably required. The ideal number of atlases to improve generated automatic contours is yet to be determined.

  11. CT-Guided Radiofrequency Ablation in Patients with Hepatic Metastases from Breast Cancer

    SciTech Connect (OSTI)

    Jakobs, Tobias F., E-mail: tobias.jakobs@med.uni-muenchen.de; Hoffmann, Ralf-Thorsten; Schrader, Angelika [Ludwig-Maximilians-University of Munich, Department of Radiology (Germany); Stemmler, Hans Joachim [Ludwig-Maximilians-University of Munich, Department of Internal Medicine III (Germany); Trumm, Christoph [Ludwig-Maximilians-University of Munich, Department of Radiology (Germany); Lubienski, Andreas [University of Schleswig-Holstein, Department of Radiology (Germany); Murthy, Ravi [The University of Texas M. D. Anderson Cancer Center, Division of Diagnostic Imaging (United States); Helmberger, Thomas K. [Klinikum Bogenhausen, Department of Radiology (Germany); Reiser, Maximilian F. [Ludwig-Maximilians-University of Munich, Department of Radiology (Germany)

    2009-01-15

    The purpose of this study was to evaluate technical success, technique effectiveness, and survival following radiofrequency ablation for breast cancer liver metastases and to determine prognostic factors. Forty-three patients with 111 breast cancer liver metastases underwent CT-guided percutaneous radiofrequency (RF) ablation. Technical success and technique effectiveness was evaluated by performing serial CT scans. We assessed the prognostic value of hormone receptor status, overexpression of human epidermal growth factor receptor 2 (HER2), and presence of extrahepatic tumor spread. Survival rates were calculated using the Kaplan-Meier method. Technical success was achieved in 107 metastases (96%). Primary technique effectiveness was 96%. During follow-up local tumor progression was observed in 15 metastases, representing a secondary technique effectiveness of 86.5%. The overall time to progression to the liver was 10.5 months. The estimated overall median survival was 58.6 months. There was no significant difference in terms of survival probability with respect to hormone receptor status, HER2 overexpression, and presence of isolated bone metastases. Survival was significantly lower among patients with extrahepatic disease, with the exception of skeletal metastases. We conclude that CT-guided RF ablation of liver metastases from breast cancer can be performed with a high degree of technical success and technique effectiveness, providing promising survival rates in patients with no visceral extrahepatic disease. Solitary bone metastases did not negatively affect survival probability after RF ablation.

  12. Radiation-induced complications in prostate cancer patients treated with radiotherapy

    SciTech Connect (OSTI)

    Azuddin, A. Yusof; Rahman, I. Abdul; Mohamed, F.; Siah, N. J.; Saadc, M.; Ismail, F.

    2014-09-03

    The purpose of the study is to determine the relationship between radiation-induced complications with dosimetric and radiobiological parameters for prostate cancer patients that underwent the conformal radiotherapy treatment. 17 prostate cancer patients that have been treated with conformal radiotherapy were retrospectively analysed. The dosimetric data was retrieved in the form of dose-volume histogram (DVH) from Radiotherapy Treatment Planning System. The DVH was utilised to derived Normal Tissue Complication Probability (NTCP) in radiobiological data. Follow-up data from medical records were used to grade the occurrence of acute gastrointestinal (GI) and genitourinary (GU) complications using Radiation Therapy Oncology Group (RTOG) scoring system. The chi-square test was used to determine the relationship between radiation-induced complication with dosimetric and radiobiological parameters. 8 (47%) and 7 (41%) patients were having acute GI and GU complications respectively. The acute GI complication can be associated with V60{sub rectum}, rectal mean dose and NTCP{sub rectum} with p-value of 0.016, 0.038 and 0.049 respectively. There are no significant relationships of acute GU complication with dosimetric and radiobiological variables. Further study can be done by increase the sample size and follow up duration for deeper understanding of the factors that effecting the GU and GI complication in prostate cancer radiotherapy.

  13. Survival analysis of colorectal cancer patients with tumor recurrence using global score test methodology

    SciTech Connect (OSTI)

    Zain, Zakiyah Ahmad, Yuhaniz; Azwan, Zairul E-mail: farhanaraduan@gmail.com Raduan, Farhana E-mail: farhanaraduan@gmail.com Sagap, Ismail E-mail: farhanaraduan@gmail.com; Aziz, Nazrina

    2014-12-04

    Colorectal cancer is the third and the second most common cancer worldwide in men and women respectively, and the second in Malaysia for both genders. Surgery, chemotherapy and radiotherapy are among the options available for treatment of patients with colorectal cancer. In clinical trials, the main purpose is often to compare efficacy between experimental and control treatments. Treatment comparisons often involve several responses or endpoints, and this situation complicates the analysis. In the case of colorectal cancer, sets of responses concerned with survival times include: times from tumor removal until the first, the second and the third tumor recurrences, and time to death. For a patient, the time to recurrence is correlated to the overall survival. In this study, global score test methodology is used in combining the univariate score statistics for comparing treatments with respect to each survival endpoint into a single statistic. The data of tumor recurrence and overall survival of colorectal cancer patients are taken from a Malaysian hospital. The results are found to be similar to those computed using the established Wei, Lin and Weissfeld method. Key factors such as ethnic, gender, age and stage at diagnose are also reported.

  14. Impact of Radiotherapy on Fertility, Pregnancy, and Neonatal Outcomes in Female Cancer Patients

    SciTech Connect (OSTI)

    Wo, Jennifer Y.; Viswanathan, Akila N.

    2009-04-01

    Purpose: Radiation has many potential long-term effects on cancer survivors. Female cancer patients may experience decreased fertility depending on the site irradiated. Oncologists should be aware of these consequences and discuss options for fertility preservation before initiating therapy. Methods and Materials: A comprehensive review of the existing literature was conducted. Studies reporting the outcomes for female patients treated with cranio-spinal, abdominal, or pelvic radiation reporting fertility, pregnancy, or neonatal-related outcomes were reviewed. Results: Cranio-spinal irradiation elicited significant hormonal changes in women that affected their ability to become pregnant later in life. Women treated with abdomino-pelvic radiation have an increased rate of uterine dysfunction leading to miscarriage, preterm labor, low birth weight, and placental abnormalities. Early menopause results from low-dose ovarian radiation. Ovarian transposition may decrease the rates of ovarian dysfunction. Conclusions: There is a dose-dependent relationship between ovarian radiation therapy (RT) and premature menopause. Patients treated with RT must be aware of the impact of treatment on fertility and explore appropriate options.

  15. SU-E-J-128: 3D Surface Reconstruction of a Patient Using Epipolar Geometry

    SciTech Connect (OSTI)

    Kotoku, J; Nakabayashi, S; Kumagai, S; Ishibashi, T; Kobayashi, T; Haga, A; Saotome, N; Arai, N

    2014-06-01

    Purpose: To obtain a 3D surface data of a patient in a non-invasive way can substantially reduce the effort for the registration of patient in radiation therapy. To achieve this goal, we introduced the multiple view stereo technique, which is known to be used in a 'photo tourism' on the internet. Methods: 70 Images were taken with a digital single-lens reflex camera from different angles and positions. The camera positions and angles were inferred later in the reconstruction step. A sparse 3D reconstruction model was locating by SIFT features, which is robust for rotation and shift variance, in each image. We then found a set of correspondences between pairs of images by computing the fundamental matrix using the eight-point algorithm with RANSAC. After the pair matching, we optimized the parameter including camera positions to minimize the reprojection error by use of bundle adjustment technique (non-linear optimization). As a final step, we performed dense reconstruction and associate a color with each point using the library of PMVS. Results: Surface data were reconstructed well by visual inspection. The human skin is reconstructed well, althogh the reconstruction was time-consuming for direct use in daily clinical practice. Conclusion: 3D reconstruction using multi view stereo geometry is a promising tool for reducing the effort of patient setup. This work was supported by JSPS KAKENHI(25861128)

  16. SU-E-J-90: MRI-Based Treatment Simulation and Patient Setup for Radiation Therapy of Brain Cancer

    SciTech Connect (OSTI)

    Yang, Y; Cao, M; Han, F; Santhanam, A; Neylon, J; Gomez, C; Kaprealian, T; Sheng, K; Agazaryan, N; Low, D; Hu, P

    2014-06-01

    Purpose: Traditional radiation therapy of cancer is heavily dependent on CT. CT provides excellent depiction of the bones but lacks good soft tissue contrast, which makes contouring difficult. Often, MRIs are fused with CT to take advantage of its superior soft tissue contrast. Such an approach has drawbacks. It is desirable to perform treatment simulation entirely based on MRI. To achieve MR-based simulation for radiation therapy, bone imaging is an important challenge because of the low MR signal intensity from bone due to its ultra-short T2 and T1, which presents difficulty for both dose calculation and patient setup in terms of digitally reconstructed radiograph (DRR) generation. Current solutions will either require manual bone contouring or multiple MR scans. We present a technique to generate DRR using MRI with an Ultra Short Echo Time (UTE) sequence which is applicable to both OBI and ExacTrac 2D patient setup. Methods: Seven brain cancer patients were scanned at 1.5 Tesla using a radial UTE sequence. The sequence acquires two images at two different echo times. The two images were processed using in-house software. The resultant bone images were subsequently loaded into commercial systems to generate DRRs. Simulation and patient clinical on-board images were used to evaluate 2D patient setup with MRI-DRRs. Results: The majority bones are well visualized in all patients. The fused image of patient CT with the MR bone image demonstrates the accuracy of automatic bone identification using our technique. The generated DRR is of good quality. Accuracy of 2D patient setup by using MRI-DRR is comparable to CT-based 2D patient setup. Conclusion: This study shows the potential of DRR generation with single MR sequence. Further work will be needed on MR sequence development and post-processing procedure to achieve robust MR bone imaging for other human sites in addition to brain.

  17. Preliminary Results of Whole Brain Radiotherapy With Concurrent Trastuzumab for Treatment of Brain Metastases in Breast Cancer Patients

    SciTech Connect (OSTI)

    Chargari, Cyrus; Idrissi, Hind Riahi; Pierga, Jean-Yves; Bollet, Marc A.; Dieras, Veronique; Campana, Francois; Cottu, Paul; Fourquet, Alain; Kirova, Youlia M.

    2011-11-01

    Purpose: To assess the use of trastuzumab concurrently with whole brain radiotherapy (WBRT) for patients with brain metastases from human epidermal growth factor receptor-2-positive breast cancer. Methods and Materials: Between April 2001 and April 2007, 31 patients with brain metastases from human epidermal growth factor receptor-2-positive breast cancer were referred for WBRT with concurrent trastuzumab. At brain progression, the median age was 55 years (range, 38-73), and all patients had a performance status of 0-2. The patients received trastuzumab 2 mg/kg weekly (n = 17) or 6 mg/kg repeated every 21 days (n = 14). In 26 patients, concurrent WBRT delivered 30 Gy in 10 daily fractions. In 6 patients, other fractionations were chosen because of either poor performance status or patient convenience. Results: After WBRT, radiologic responses were observed in 23 patients (74.2%), including 6 (19.4%) with a complete radiologic response and 17 (54.8%) with a partial radiologic response. Clinical responses were observed in 27 patients (87.1%). The median survival time from the start of WBRT was 18 months (range, 2-65). The median interval to brain progression was 10.5 months (range, 2-27). No Grade 2 or greater acute toxicity was observed. Conclusion: The low toxicity of trastuzumab concurrently with WBRT should probably not justify delays. Although promising, these preliminary data warrant additional validation of trastuzumab as a potential radiosensitizer for WBRT in brain metastases from breast cancer in the setting of a clinical trial.

  18. Endovascular Aortic Aneurysm Repair with the Talent Stent-Graft: Outcomes in Patients with Large Iliac Arteries

    SciTech Connect (OSTI)

    England, Andrew; Butterfield, John S.; McCollum, Charles N.; Ashleigh, Raymond J.

    2008-07-15

    The purpose of this study is to report outcomes following endovascular aneurysm repair (EVAR) of abdominal aortic aneurysm (AAA) in patients with ectatic common iliac arteries (CIAs). Of 117 AAA patients treated by EVAR between 1998 and 2005, 87 (74%) had CIAs diameters <18 mm and 30 (26%) patients had one or more CIA diameters >18 but <25 mm. All patients were treated with Talent stent-grafts, 114 bifurcated and 3 AUI devices. Departmental databases and patient records were reviewed to assess outcomes. Technical success, iliac-related outcome, and iliac-related reintervention (IRSI) were analyzed. Patients with EVAR extending into the external iliac artery were excluded. Median (range) follow-up for the study group was 24 (1-84) months. Initial technical success was 98% for CIAs <18 mm and 100% for CIAs {>=}18 mm (p = 0.551). There were three distal type I endoleaks (two in the ectatic group) and six iliac limb occlusions (one in an ectatic patient); there were no statistically significant differences between groups (p = 0.4). There were nine IRSIs (three stent-graft extensions, six femorofemoral crossover grafts); three of these patients had one or both CIAs {>=}18 mm (p = 0.232). One-year freedom from IRSI was 92% {+-} 3% and 84% {+-} 9% for the <18-mm and {>=}18-mm CIA groups, respectively (p = 0.232). We conclude that the treatment of AAA by EVAR in patients with CIAs 18-24 mm appears to be safe and effective, however, it may be associated with more frequent reinterventions.

  19. SU-E-T-215: Interactive Dose Shaping: Proof of Concept Study for Six Prostate Patients

    SciTech Connect (OSTI)

    Kamerling, CP [The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London (United Kingdom); German Cancer Research Center (DKFZ), Heidelberg (Germany); Ziegenhein, P; Oelfke, U [The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London (United Kingdom); Sterzing, F [German Cancer Research Center (DKFZ), Heidelberg (Germany)

    2014-06-01

    Purpose: To provide a proof of concept study for IMRT treatment planning through interactive dose shaping (IDS) by utilising the respective tools to create IMRT treatment plans for six prostate patients. Methods: The IDS planning paradigm aims to perform interactive local dose adaptations of an IMRT plan without compromising already established valuable dose features in real-time. Various IDS tools are available in our in-house treatment planning software Dynaplan and were utilised to create IMRT treatment plans for six patients with an adeno-carcinoma of the prostate. The sequenced IDS treatment plans were compared to conventionally optimised clinically approved plans (9 beams, co-planar). The starting point consisted of open fields. The IDS tools were utilised to sculpt dose out of the rectum and bladder. For each patient, several IDS plans were created, with different trade-offs between organ sparing and target coverage. The reference dose distributions were imported into Dynaplan. For each patient, the IDS treatment plan with a similar or better trade-off between target coverage and OAR sparing was selected for plan evaluation, guided by a physician. Pencil beam dose calculation was performed on a grid with a voxel size of 1.95×1.95×2.0 mm{sup 3}. D98%, D2%, mean dose and dose-volume indicators as specified by Quantec were calculated for plan evaluation. Results: It was possible to utilise the software prototype to generate treatment plans for prostate patient geometries in 15–45 minutes. Individual local dose adaptations could be performed in less than one second. The average differences compared to the reference plans were for the mean dose: 0.0 Gy (boost) and 1.2 Gy (CTV), for D98%: ?1.1 Gy and for D2%: 1.1 Gy (both target volumes). The dose-volume quality indicators were well below the Quantec constraints. Conclusion: Real-time treatment planning utilising IDS is feasible and has the potential to be implemented clinically. Research at The Institute of Cancer Research is supported by Cancer Research UK under Programme C46/A10588.

  20. Predicting Risk of End-Stage Liver Disease in Antiretroviral-Treated Human Immunodeficiency Virus/Hepatitis C Virus-Coinfected Patients.

    E-Print Network [OSTI]

    2015-01-01

    immunode?ciency virus-hepatitis C virus-coinfected patientsslower viral clearance in hepatitis C, genotype-1 patientsImmunode?ciency Virus/Hepatitis C Virus-Coinfected Patients

  1. The Demographic Characteristics of Patients Seeking Health Care for Infant and Childhood Illnesses at Nepal Medical College and Teaching Hospital

    E-Print Network [OSTI]

    Pandey, Kishore Raj; Kafle, Phanindra Prasad; Karki, Debendra

    2003-01-01

    and another 36 patients stated that they belonged to a Terai Tribal Group. The most overlooked group consisted of Authors nrc Associal~d with Nepal Medical ColI~go. Allarkhe1. Kathmandu. K. R. Pandey/ The Demographic Characleristics ... 219 the Dalit Group... stating that they live with their family members or have other living arrangements. Of the 424 patients, 411 stated that they live with their immediate family members. only 13 patients stated that they have other living arrangements. 2 2 2 O c c a s i a n...

  2. Verbal De-escalation of the Agitated Patient: Consensus Statement of the American Association for Emergency Psychiatry Project BETA De-escalation Workgroup

    E-Print Network [OSTI]

    2012-01-01

    Agree or Agree to Disagree Fogging is an empathic behaviorfor the patient to be heard. Fogging and the broken record

  3. Frequently Asked Questions about Patient Care Costs Background from NIH Grants Policy Statement: The following definition should be kept in mind when

    E-Print Network [OSTI]

    Minnesota, University of

    Frequently Asked Questions about Patient Care Costs Background from NIH Grants Policy Statement: The following definition should be kept in mind when answering questions regarding research patient care costs. Research patient care costs are the costs of routine and ancillary services provided by hospitals

  4. Comparative Effectiveness of Analgesic Sedation as Primary Sedation in Medical ICU Patients vs. Conventional Sedation and Analgesia Regimens

    E-Print Network [OSTI]

    Taylor, Scott M.

    2014-05-31

    ventilation (MV). Pharmacotherapy including analgesics, sedatives, and antipsychotics are considered the standard of care to optimize patient safety and comfort during MV. Although the use of analgesics, sedatives, and antipsychotic therapies in the ICU...

  5. Do Emergency Physicians and Medical Students Find It Unethical to ‘Look up’ Their Patients on Facebook or Google?

    E-Print Network [OSTI]

    Ben-Yakov, Maxim; Kayssi, Ahmed; Di Bernardo, Jennifer; Hicks, Christopher; Devon, Karen

    2015-01-01

    Research ( with a Focus on Web Surveys). Am J Prev Med.know about February, 2011. “Web 2.0”. Med Teach. 2008;30(2):prevalence of OSM and web-searching for patient information

  6. Method and system for the diagnosis of disease using retinal image content and an archive of diagnosed human patient data

    DOE Patents [OSTI]

    Tobin, Kenneth W; Karnowski, Thomas P; Chaum, Edward

    2013-08-06

    A method for diagnosing diseases having retinal manifestations including retinal pathologies includes the steps of providing a CBIR system including an archive of stored digital retinal photography images and diagnosed patient data corresponding to the retinal photography images, the stored images each indexed in a CBIR database using a plurality of feature vectors, the feature vectors corresponding to distinct descriptive characteristics of the stored images. A query image of the retina of a patient is obtained. Using image processing, regions or structures in the query image are identified. The regions or structures are then described using the plurality of feature vectors. At least one relevant stored image from the archive based on similarity to the regions or structures is retrieved, and an eye disease or a disease having retinal manifestations in the patient is diagnosed based on the diagnosed patient data associated with the relevant stored image(s).

  7. Microvolt T-wave alternans testing should be used to guide arrhythmic therapy in heart failure patients

    E-Print Network [OSTI]

    Cohen, Richard J.

    Jackson et al. reported on a cohort of heart failure patients and concluded that microvolt T-wave alternans (MTWA) testing has limited utility in this population. Of note, this assessment was made in the complete absence ...

  8. Transference effects on student physicians' affective interactions and clinical inferences in interviews with standardized patients: an experimental study 

    E-Print Network [OSTI]

    van Walsum, Kimberly Lynn

    2005-11-01

    and related PAFS-QVC variables onto positive affect, negative affect, clinical inferences (patient as partner) and clinical inferences (likelihood of treatment success) revealed statistically significant effects of intergenerational family relationship...

  9. Comparison of doses to normal brain in patients treated with boron neuron capture therapy at Brookhaven National Laboratory and MIT

    E-Print Network [OSTI]

    Turcotte, Julie Catherine

    2004-01-01

    A number of boron neutron capture therapy (BNCT) clinical trials are currently underway around the world. Due to the small number of patients at each of the individual centers, it is desirable to pool the clinical data ...

  10. Genetic Databases: Assessing the Benefits and the Impact on Human and Patient Rights – A World Health Organisation Report 

    E-Print Network [OSTI]

    Laurie, Graeme

    2004-01-01

    This article summarises the underlying rational and provisions of a report on genetic databases prepared for the European Partnership on Patients’ Rights and Citizens’ Empowerment, a network of the World Health Organisation ...

  11. Patient characteristics associated with clustering of RFLP patterns in isolates of Mycobacterium tuberculosis callected from a non-outbreak setting 

    E-Print Network [OSTI]

    Williams, Michelle Russell

    1995-01-01

    an eighteen month period from patients at the VA Hospital in Houston, Texas. A total of 61 isolates were collected and fingerprinted using IS6110 as, the target for RFLP analysis. The resulting fingerprint patterns were compared visually and categorized...

  12. Giving patients online access to their electronic primary care record: experiences and perceptions of practice staff and service users 

    E-Print Network [OSTI]

    Shand, Tim; Pagliari, Claudia; Fisher, Brian

    The Record Access Collaborative is a voluntary network of clinicians, academics, industry representatives and policymakers interested in emerging Personal Health Record technologies and their impacts on patients and health ...

  13. The effects of maintenance schedules following pulmonary rehabilitation in patients with chronic obstructive pulmonary disease: a randomised controlled trial

    E-Print Network [OSTI]

    Wilson, Andrew M.; Browne, Paula; Olive, Sandra; Clark, Allan; Galey, Penny; Dix, Emma; Woodhouse, Helene; Robinson, Sue; Wilson, Edward C. F.; Staunton, Lindi

    2015-03-11

    %. Patients were excluded if they had significant cardiac or pulmonary disease other than COPD, a myocardial infarction within the previous 6 months or unstable angina, respiratory infection (defined as cough, anti- biotic use or purulent sputum within 4 weeks...

  14. Modlisation et prvision des flux quotidiens des patients aux urgences hospitalires en utilisant l'analyse de sries

    E-Print Network [OSTI]

    Paris-Sud XI, Université de

    chronologiques, Modèle ARIMA, Prévision. Abstract: Effective management of patient flow in emergency departments Systèmes Hospitaliers (GISEH), Liège : Belgique (2014)" #12;2 d'urgences a été réduit de 9% [1]. En France

  15. ‘Facing choices’: a mixed-methods approach to patients’ experience of care and discharge in an inpatient mental health unit. 

    E-Print Network [OSTI]

    Strachan, Jennifer Claire

    2012-06-26

    Objectives: This thesis addresses patients’ conceptualising of the experience of admission to and discharge from an inpatient mental health unit, and the role of measurable psychosocial constructs in this conceptualisa ...

  16. Lymphedema in Breast Cancer Survivors : : Risk Factors, Distress and Quality of Life, and Patient Compliance with a Physician Referral

    E-Print Network [OSTI]

    Dominick, Sally Ann

    11 to 20 nodes ? 21 nodes Breast Cancer Surgery Lumpectomy/Mastectomies Time since Breast Cancer Surgery, yearsKahn KL. Arm edema in breast cancer patients. J Natl Cancer

  17. Percutaneous Transhepatic Biliary Drainage in the Management of Postsurgical Biliary Leaks in Patients with Nondilated Intrahepatic Bile Ducts

    SciTech Connect (OSTI)

    Cozzi, Guido, E-mail: guido.cozzi@istitutotumori.mi.it; Severini, Aldo; Civelli, Enrico; Milella, Marco [National Cancer Institute (Istituto Nazionale Tumori), Department of Radiology, Radiologia 3 Unit (Italy); Pulvirenti, Andrea [National Cancer Institute (Istituto Nazionale Tumori), Department of Surgery, Gastrointestinal Surgery and Liver Transplantation Unit (Italy); Salvetti, Monica [National Cancer Institute (Istituto Nazionale Tumori), Department of Radiology, Radiologia 3 Unit (Italy); Romito, Raffaele [National Cancer Institute (Istituto Nazionale Tumori), Department of Surgery, Gastrointestinal Surgery and Liver Transplantation Unit (Italy); Suman, Laura; Chiaraviglio, Francesca [National Cancer Institute (Istituto Nazionale Tumori), Department of Radiology, Radiologia 3 Unit (Italy); Mazzaferro, Vincenzo [National Cancer Institute (Istituto Nazionale Tumori), Department of Surgery, Gastrointestinal Surgery and Liver Transplantation Unit (Italy)

    2006-06-15

    Purpose. To assess the feasibility of percutaneous transhepatic biliary drainage (PTBD) for the treatment of postsurgical biliary leaks in patients with nondilated intrahepatic bile ducts, its efficacy in restoring the integrity of bile ducts, and technical procedures to reduce morbidity. Methods. Seventeen patients out of 936 undergoing PTBD over a 20-year period had a noncholestatic liver and were retrospectively reviewed. All patients underwent surgery for cancer and suffered a postsurgical biliary leak of 345 ml/day on average; 71% were in poor condition and required permanent nutritional support. An endoscopic approach failed or was excluded due to inaccessibility of the bile ducts. Results. Established biliary leaks and site of origin were diagnosed an average of 21 days (range 1-90 days) after surgery. In all cases percutaneous access to the biliary tree was achieved. An external (preleakage) drain was applied in 7 cases, 9 patients had an external-internal fistula bridging catheter, and 1 patient had a percutaneous hepatogastrostomy. Fistulas healed in an average of 31 days (range 3-118 days ) in 15 of 17 patients (88%) following PTBD. No major complications occurred after drainage. Post-PTBD cholangitis was observed in 6 of 17 patients (35%) and was related to biliary sludge formation occurring mostly when drainage lasted >30 days and was of the external-internal type. Median patient survival was 17.7 months and in all cases the repaired biliary leaks remained healed. Conclusions. PTBD is a feasible, effective, and safe procedure for the treatment of postsurgical biliary leaks. It is therefore a reliable alternative to surgical repair, which entails longer hospitalization and higher costs.

  18. Predictive Factors for Acute and Late Urinary Toxicity After Permanent Prostate Brachytherapy: Long-Term Outcome in 712 Consecutive Patients

    SciTech Connect (OSTI)

    Keyes, Mira Miller, Stacy; Moravan, Veronika; Pickles, Tom; McKenzie, Michael; Pai, Howard; Liu, Mitchell; Kwan, Winkle; Agranovich, Alexander; Spadinger, Ingrid; Lapointe, Vincent; Halperin, Ross; Morris, W. James

    2009-03-15

    Purpose: To describe the frequency of acute and late Radiation Therapy Oncology Group (RTOG) urinary toxicity, associated predictive factors, and resolution of International Prostate Symptom Score (IPSS) in 712 consecutive prostate brachytherapy patients. Methods and Materials: Patients underwent implantation between 1998 and 2003 (median follow-up, 57 months). The IPSS and RTOG toxicity data were prospectively collected. The patient, treatment, and implant factors were examined for an association with urinary toxicity. The time to IPSS resolution was examined using Kaplan-Meier curves, and multivariate modeling of IPSS resolution was done using Cox proportional hazards regression analysis. Logistic regression analysis was used to examine the factors associated with urinary toxicity. Results: The IPSS returned to baseline at a median of 12.6 months. On multivariate analysis, patients with a high baseline IPSS had a quicker resolution of their IPSS. Higher prostate D90 (dose covering 90% of the prostate), maximal postimplant IPSS, and urinary retention slowed the IPSS resolution time. The rate of the actuarial 5-year late urinary (>12 months) RTOG Grade 0, 1, 2, 3, and 4 was 32%, 36%, 24%, 6.2%, and 0.1%, respectively. At 7 years, the prevalence of RTOG Grade 0-1 was 92.5%. Patients with a larger prostate volume, greater number of needles, greater baseline IPSS, and use of hormonal therapy had more acute toxicity. On multivariate analysis, the significant predictors for late greater than or equal to RTOG toxicity 2 were a greater baseline IPSS, maximal postimplant IPSS, presence of acute toxicity, and higher prostate V150 (volume of the prostate covered by 150% of the dose). More recently implanted patients had less acute urinary toxicity and patients given hormonal therapy had less late urinary toxicity (all p < 0.02). Conclusion: Most urinary symptoms resolved within 12 months after prostate brachytherapy, and significant long-term urinary toxicity was very low. Refined patient selection and greater technical experience in prostate brachytherapy were associated with less urinary toxicity.

  19. A Phase II trial of subcutaneous amifostine and radiation therapy in patients with head-and-neck cancer

    SciTech Connect (OSTI)

    Anne, Pramila Rani . E-mail: rani.anne@mail.tju.edu; Machtay, Mitchell; Rosenthal, David I.; Brizel, David M.; Morrison, William H.; Irwin, David H.; Chougule, Prakash B.; Estopinal, Noel C.; Berson, Anthony; Curran, Walter J.

    2007-02-01

    Purpose: Intravenous amifostine 200 mg/m{sup 2} reduces xerostomia in head-and-neck cancer patients. This Phase II study evaluated subcutaneous (s.c.) amifostine in a similar patient population. Patients and Methods: Patients received amifostine 500 mg, administered as two 250-mg s.c. injections 60 min before once-daily radiation for head-and-neck cancer (50-70 Gy in 5-7 weeks). The primary endpoint was the incidence of {>=}Grade 2 acute xerostomia. Results: Fifty-four patients received s.c. amifostine and radiotherapy. The incidence of {>=}Grade 2 acute xerostomia was 56% (95% CI, 43-69%) and the incidence of {>=}Grade 2 late xerostomia at 1 year was 45% (95% CI, 29-61%). The incidence of acute xerostomia was lower than reported previously with no amifostine in a controlled study; rates of acute xerostomia were similar between s.c. and i.v. amifostine in the two studies. The rate of late xerostomia with s.c. amifostine was intermediate between rates for i.v. amifostine and no amifostine, and not statistically significantly different from either historical control. Grades 1-2 nausea and emesis were the most common amifostine-related adverse events. Grade 3 amifostine-related adverse events reported by >1 patient included: dehydration (11%); rash (6%); and weight decrease, mucositis, dyspnea, and allergic reaction (each 4%). Seven patients (13%) had serious cutaneous adverse events outside the injection site. One-year rates of locoregional control, progression-free survival, and overall survival were 78%, 75%, and 85%, respectively. Conclusions: Subcutaneous amifostine provides a well-tolerated yet simpler alternative to i.v. amifostine for reducing acute xerostomia in head-and-neck cancer patients.

  20. Respiration-Correlated Image Guidance Is the Most Important Radiotherapy Motion Management Strategy for Most Lung Cancer Patients

    SciTech Connect (OSTI)

    Korreman, Stine, E-mail: korreman@ruc.dk [Department of Science, Systems and Models, Roskilde University, Roskilde (Denmark); Department of Radiation Oncology, The Finsen Centre, Rigshospitalet, Copenhagen (Denmark); Niels Bohr Institute, University of Copenhagen, Copenhagen (Denmark); Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison (United States); Persson, Gitte; Nygaard, Ditte [Department of Radiation Oncology, The Finsen Centre, Rigshospitalet, Copenhagen (Denmark); Brink, Carsten [Laboratory of Radiation Physics, Odense University Hospital, Odense (Denmark); Faculty of Health Sciences, University of Southern Denmark, Odense (Denmark); Juhler-Nottrup, Trine [Department of Oncology, Herlev Hospital, Copenhagen (Denmark)

    2012-07-15

    Purpose: The purpose of this study was to quantify the effects of four-dimensional computed tomography (4DCT), 4D image guidance (4D-IG), and beam gating on calculated treatment field margins in a lung cancer patient population. Materials and Methods: Images were acquired from 46 lung cancer patients participating in four separate protocols at three institutions in Europe and the United States. Seven patients were imaged using fluoroscopy, and 39 patients were imaged using 4DCT. The magnitude of respiratory tumor motion was measured. The required treatment field margins were calculated using a statistical recipe (van Herk M, et al. Int J Radiat Oncol Biol Phys 2000;474:1121-1135), with magnitudes of all uncertainties, except respiratory peak-to-peak displacement, the same for all patients, taken from literature. Required margins for respiratory motion management were calculated using the residual respiratory tumor motion for each patient for various motion management strategies. Margin reductions for respiration management were calculated using 4DCT, 4D-IG, and gated beam delivery. Results: The median tumor motion magnitude was 4.4 mm for the 46 patients (range 0-29.3 mm). This value corresponded to required treatment field margins of 13.7 to 36.3 mm (median 14.4 mm). The use of 4DCT, 4D-IG, and beam gating required margins that were reduced by 0 to 13.9 mm (median 0.5 mm), 3 to 5.2 mm (median 5.1 mm), and 0 to 7 mm (median 0.2 mm), respectively, to a total of 8.5 to 12.4 mm (median 8.6 mm). Conclusion: A respiratory management strategy for lung cancer radiotherapy including planning on 4DCT scans and daily image guidance provides a potential reduction of 37% to 47% in treatment field margins. The 4D image guidance strategy was the most effective strategy for >85% of the patients.

  1. Acute Toxicity in High-Risk Prostate Cancer Patients Treated With Androgen Suppression and Hypofractionated Intensity-Modulated Radiotherapy

    SciTech Connect (OSTI)

    Pervez, Nadeem, E-mail: nadeempe@cancerboard.ab.c [Division of Radiation Oncology, Cross Cancer Institute, Edmonton, Alberta (Canada); Small, Cormac [Division of Radiation Oncology, Cross Cancer Institute, Edmonton, Alberta (Canada); MacKenzie, Marc [Division of Medical Physics, Cross Cancer Institute, Edmonton, Alberta (Canada); Yee, Don; Parliament, Matthew [Division of Radiation Oncology, Cross Cancer Institute, Edmonton, Alberta (Canada); Ghosh, Sunita [Division of Experimental Oncology, Cross Cancer Institute, Edmonton, Alberta (Canada); Mihai, Alina; Amanie, John; Murtha, Albert [Division of Radiation Oncology, Cross Cancer Institute, Edmonton, Alberta (Canada); Field, Colin [Division of Medical Physics, Cross Cancer Institute, Edmonton, Alberta (Canada); Murray, David [Division of Experimental Oncology, Cross Cancer Institute, Edmonton, Alberta (Canada); Fallone, Gino [Division of Medical Physics, Cross Cancer Institute, Edmonton, Alberta (Canada); Pearcey, Robert, E-mail: robertpe@cancerboard.ab.c [Division of Radiation Oncology, Cross Cancer Institute, Edmonton, Alberta (Canada)

    2010-01-15

    Purpose: To report acute toxicity resulting from radiotherapy (RT) dose escalation and hypofractionation using intensity-modulated RT (IMRT) treatment combined with androgen suppression in high-risk prostate cancer patients. Methods and Materials: Sixty patients with a histological diagnosis of high-risk prostatic adenocarcinoma (having either a clinical Stage of >=T3a or an initial prostate-specific antigen [PSA] level of >=20 ng/ml or a Gleason score of 8 to 10 or a combination of a PSA concentration of >15 ng/ml and a Gleason score of 7) were enrolled. RT prescription was 68 Gy in 25 fractions (2.72 Gy/fraction) over 5 weeks to the prostate and proximal seminal vesicles. The pelvic lymph nodes and distal seminal vesicles concurrently received 45 Gy in 25 fractions. The patients were treated with helical TomoTherapy-based IMRT and underwent daily megavoltage CT image-guided verification prior to each treatment. Acute toxicity scores were recorded weekly during RT and at 3 months post-RT, using Radiation Therapy Oncology Group acute toxicity scales. Results: All patients completed RT and follow up for 3 months. The maximum acute toxicity scores were as follows: 21 (35%) patients had Grade 2 gastrointestinal (GI) toxicity; 4 (6.67%) patients had Grade 3 genitourinary (GU) toxicity; and 30 (33.33%) patients had Grade 2 GU toxicity. These toxicity scores were reduced after RT; there were only 8 (13.6%) patients with Grade 1 GI toxicity, 11 (18.97%) with Grade 1 GU toxicity, and 5 (8.62%) with Grade 2 GU toxicity at 3 months follow up. Only the V60 to the rectum correlated with the GI toxicity. Conclusion: Dose escalation using a hypofractionated schedule to the prostate with concurrent pelvic lymph node RT and long-term androgen suppression therapy is well tolerated acutely. Longer follow up for outcome and late toxicity is required.

  2. Pain Levels Within 24 Hours After UFE: A Comparison of Morphine and Fentanyl Patient-Controlled Analgesia

    SciTech Connect (OSTI)

    Kim, Hyun S. Czuczman, Gregory J.; Nicholson, Wanda K.; Pham, Luu D.; Richman, Jeffrey M.

    2008-11-15

    The purpose of this study was to assess the presence and severity of pain levels during 24 h after uterine fibroid embolization (UFE) for symptomatic leiomyomata and compare the effectiveness and adverse effects of morphine patient-controlled analgesia (PCA) versus fentanyl PCA. We carried out a prospective, nonrandomized study of 200 consecutive women who received UFE and morphine or fentanyl PCA after UFE. Pain perception levels were obtained on a 0-10 scale for the 24-h period after UFE. Linear regression methods were used to determine pain trends and differences in pain trends between two groups and the association between pain scores and patient covariates. One hundred eighty-five patients (92.5%) reported greater-than-baseline pain after UFE, and 198 patients (99%) required IV opioid PCA. One hundred thirty-six patients (68.0%) developed nausea during the 24-h period. Seventy-two patients (36%) received morphine PCA and 128 (64%) received fentanyl PCA, without demographic differences. The mean dose of morphine used was 33.8 {+-} 26.7 mg, while the mean dose of fentanyl was 698.7 {+-} 537.4 {mu}g. Using this regimen, patients who received morphine PCA had significantly lower pain levels than those who received fentanyl PCA (p < 0.0001). We conclude that patients develop pain requiring IV opioid PCA within 24 h after UFE. Morphine PCA is more effective in reducing post-uterine artery embolization pain than fentanyl PCA. Nausea is a significant adverse effect from opioid PCA.

  3. Intra-arterial Autologous Bone Marrow Cell Transplantation in a Patient with Upper-extremity Critical Limb Ischemia

    SciTech Connect (OSTI)

    Madaric, Juraj; Klepanec, Andrej; Mistrik, Martin; Altaner, Cestmir; Vulev, Ivan

    2013-04-15

    Induction of therapeutic angiogenesis by autologous bone marrow mononuclear cell transplantation has been identified as a potential new option in patients with advanced lower-limb ischemia. There is little evidence of the benefit of intra-arterial cell application in upper-limb critical ischemia. We describe a patient with upper-extremity critical limb ischemia with digital gangrene resulting from hypothenar hammer syndrome successfully treated by intra-arterial autologous bone marrow mononuclear cell transplantation.

  4. SU-E-T-159: Evaluation of a Patient Specific QA Tool Based On TG119

    SciTech Connect (OSTI)

    Ashmeg, S; Zhang, Y; O'Daniel, J; Yin, F; Ren, L

    2014-06-01

    Purpose: To evaluate the accuracy of a 3D patient specific QA tool by analysis of the results produced from associated software in homogenous phantom and heterogonous patient CT. Methods: IMRT and VMAT plans of five test suites introduced by TG119 were created in ECLIPSE on a solid water phantom. The ten plans -of increasing complexity- were delivered to Delta4 to give a 3D measurement. The Delta4's “Anatomy” software uses the measured dose to back-calculate the energy fluence of the delivered beams, which is used for dose calculation in a patient CT using a pencilbeam algorithm. The effect of the modulated beams' complexity on the accuracy of the “Anatomy” calculation was evaluated. Both measured and Anatomy doses were compared to ECLIPSE calculation using 3% - 3mm gamma criteria.We also tested the effect of heterogeneity by analyzing the results of “Anatomy” calculation on a Brain VMAT and a 3D conformal lung cases. Results: In homogenous phantom, the gamma passing rates were found to be as low as 74.75% for a complex plan with high modulation. The mean passing rates were 91.47% ± 6.35% for “Anatomy” calculation and 99.46% ± 0.62% for Delta4 measurements.As for the heterogeneous cases, the rates were 96.54%±3.67% and 83.87%±9.42% for Brain VMAT and 3D lung respectively. This increased error in the lung case could be due to the use of the pencil beam algorithm as opposed to the AAA used by ECLIPSE.Also, gamma analysis showed high discrepancy along the beam edge in the “Anatomy” calculated results. This suggests a poor beam modeling in the penumbra region. Conclusion: The results show various sources of errors in “Anatomy” calculations. These include beam modeling in the penumbra region, complexity of a modulated beam (shown in homogenous phantom and brain cases) and dose calculation algorithms (3D conformal lung case)

  5. The sensitivity of patient specific IMRT QC to systematic MLC leaf bank offset errors

    SciTech Connect (OSTI)

    Rangel, Alejandra; Palte, Gesa; Dunscombe, Peter [Department of Medical Physics, Tom Baker Cancer Centre, 1331-29 Street NW, Calgary, Alberta T2N 4N2, Canada and Department of Physics and Astronomy, University of Calgary, 2500 University Drive North West, Calgary, Alberta T2N 1N4 (Canada); Department of Medical Physics, Tom Baker Cancer Centre, 1331-29 Street NW, Calgary, Alberta T2N 4N2 (Canada); Department of Medical Physics, Tom Baker Cancer Centre, 1331-29 Street NW, Calgary, Alberta T2N 4N2 (Canada); Department of Physics and Astronomy, University of Calgary, 2500 University Drive NW, Calgary, Alberta T2N 1N4 (Canada) and Department of Oncology, Tom Baker Cancer Centre, 1331-29 Street NW, Calgary, Alberta T2N 4N2 (Canada)

    2010-07-15

    Purpose: Patient specific IMRT QC is performed routinely in many clinics as a safeguard against errors and inaccuracies which may be introduced during the complex planning, data transfer, and delivery phases of this type of treatment. The purpose of this work is to evaluate the feasibility of detecting systematic errors in MLC leaf bank position with patient specific checks. Methods: 9 head and neck (H and N) and 14 prostate IMRT beams were delivered using MLC files containing systematic offsets ({+-}1 mm in two banks, {+-}0.5 mm in two banks, and 1 mm in one bank of leaves). The beams were measured using both MAPCHECK (Sun Nuclear Corp., Melbourne, FL) and the aS1000 electronic portal imaging device (Varian Medical Systems, Palo Alto, CA). Comparisons with calculated fields, without offsets, were made using commonly adopted criteria including absolute dose (AD) difference, relative dose difference, distance to agreement (DTA), and the gamma index. Results: The criteria most sensitive to systematic leaf bank offsets were the 3% AD, 3 mm DTA for MAPCHECK and the gamma index with 2% AD and 2 mm DTA for the EPID. The criterion based on the relative dose measurements was the least sensitive to MLC offsets. More highly modulated fields, i.e., H and N, showed greater changes in the percentage of passing points due to systematic MLC inaccuracy than prostate fields. Conclusions: None of the techniques or criteria tested is sufficiently sensitive, with the population of IMRT fields, to detect a systematic MLC offset at a clinically significant level on an individual field. Patient specific QC cannot, therefore, substitute for routine QC of the MLC itself.

  6. A Halotyrosine Antibody that Detects Increased Protein Modifications in Asthma Patients

    SciTech Connect (OSTI)

    Jin, Hongjun; Hallstrand, Teal S.; Daly, Don S.; Matzke, Melissa M.; Nair, Parameswaran; Bigelow, Diana J.; Pounds, Joel G.; Zangar, Richard C.

    2014-01-31

    Background-Airway inflammation plays an important pathophysiological role in asthma. Eosinophils produce hypobromite and bromotyrosine while neutrophils produce hypochlorite and chlorotyrosine. Objective-To evaluate halotyrosine modifications of individual airway proteins as a marker of inflammation in asthma using an antibody-based assay. Methods-We developed a novel monoclonal antibody (BTK-94C) that binds halogenated tyrosine residues, and used this antibody in a custom enzyme-linked immunosorbent assay (ELISA) microarray platform to examine halotyrosine levels in 23 proteins in three independent sets of sputum samples (52 samples total). Results-In 15 subjects with either no asthma, or with asthma characterized by high or low sputum eosinophil counts, we found associations between increased halotyrosine levels of at least three proteins and severity of airway hyperresponsiveness (AHR). Treatment with mepolizumab in 17 patients with sputum eosinophilia markedly reduced the sputum eosinophilia and significantly reduced halotyrosine levels in one sputum protein. Further analysis of 10 subjects with neutrophilic asthma and 10 health controls demonstrated a broad increase in halotyrosine in the patients with airway neutrophilia. Conclusions-Significantly higher levels of halotyrosine are associated with asthma in the asthma phenotypes we examined. The halotyrosine levels correlated with indirect AHR in the form of exercise-induced bronchoconstriction. Clinical Implication-An antibody-based assay for tyrosine halogenation in specific proteins may prove useful for assessing airway inflammation in asthma. Capsule Summary-An antibody to measure protein monobrominated tyrosine and other halotyrosine modifications was developed and used to evaluate halogenation in specific proteins in the airways for the first time. Associations were found between levels of halotyrosine and exercise-induced bronchoconstriction, and eosinophil and neutrophil inflammation in sputum from asthma patients. The ELISA developed here can be easily translated into a clinical test.

  7. Pancreas imaging by computed tomography after endoscopic retrograde pancreatography. [Dogs; patients

    SciTech Connect (OSTI)

    Frick, M.P.; O'Leary, J.F.; Salomonowitz, E.; Stoltenberg, E.; Hutton, S.; Gedgaudas, E.

    1984-01-01

    A method using CT after endoscopic retrograde pancreatography (CT-ERP) is described for pancreatic imaging. When using an ERP technique in the canine model comparable to that used in humans, small amounts of contrast material in peripheral pancreatic radicles resulted in enhancement of the pancreas on CT scans. Nine patients were also studied by CT-ERP images. The main pancreatic duct was seen on delayed images. In cases of chronic pancreatitis (n = 2), pancreatic opacification was patchy and heterogeneous. There was no contrast-material enhancement in areas of pancreatic carcimomas (n = 2). CT-ERP showed the true extent of carcinoma better than ERP alone.

  8. Constitutive STAT5 Activation Correlates With Better Survival in Cervical Cancer Patients Treated With Radiation Therapy

    SciTech Connect (OSTI)

    Chen, Helen H.W. [Department of Radiation Oncology, National Cheng Kung University, Medical College and Hospital, Tainan, Taiwan (China); Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan (China); Chou, Cheng-Yang [Department of Obstetrics and Gynecology, National Cheng Kung University, Medical College and Hospital, Tainan, Taiwan (China); Wu, Yuan-Hua; Hsueh, Wei-Ting; Hsu, Chiung-Hui [Department of Radiation Oncology, National Cheng Kung University, Medical College and Hospital, Tainan, Taiwan (China); Guo, How-Ran [Department of Environmental and Occupational Health, National Cheng Kung University, Medical College and Hospital, Tainan, Taiwan (China); Lee, Wen-Ying, E-mail: 7707@so-net.net.tw [Department of Pathology, Chi Mei Medical Center, Tainan, Taiwan (China) and Department of Pathology, College of Medicine, Taipei Medical University, Taipei, Taiwan (China); Su, Wu-Chou, E-mail: sunnysu@mail.ncku.edu.tw [Department of Internal Medicine, National Cheng Kung University, Medical College and Hospital, Tainan, Taiwan (China)

    2012-02-01

    Purpose: Constitutively activated signal transducers and activators of transcription (STAT) factors, in particular STAT1, STAT3, and STAT5, have been detected in a wide variety of human primary tumors and have been demonstrated to directly contribute to oncogenesis. However, the expression pattern of these STATs in cervical carcinoma is still unknown, as is whether or not they have prognostic significance. This study investigated the expression patterns of STAT1, STAT3, and STAT5 in cervical cancer and their associations with clinical outcomes in patients treated with radical radiation therapy. Methods and Materials: A total of 165 consecutive patients with International Federation of Gynecology and Obstetrics (FIGO) Stages IB to IVA cervical cancer underwent radical radiation therapy, including external beam and/or high-dose-rate brachytherapy between 1989 and 2002. Immunohistochemical studies of their formalin-fixed, paraffin-embedded tissues were performed. Univariate and multivariate analyses were performed to identify and to evaluate the effects of these factors affecting patient survival. Results: Constitutive activations of STAT1, STAT3, and STAT5 were observed in 11%, 22%, and 61% of the participants, respectively. While STAT5 activation was associated with significantly better metastasis-free survival (p < 0.01) and overall survival (p = 0.04), STAT1 and STAT3 activation were not. Multivariate analyses showed that STAT5 activation, bulky tumor ({>=}4 cm), advanced stage (FIGO Stages III and IV), and brachytherapy (yes vs. no) were independent prognostic factors for cause-specific overall survival. None of the STATs was associated with local relapse. STAT5 activation (odds ratio = 0.29, 95% confidence interval = 0.13-0.63) and advanced stage (odds ratio = 2.54; 95% confidence interval = 1.03-6.26) were independent predictors of distant metastasis. Conclusions: This is the first report to provide the overall expression patterns and prognostic significance of specific STATs in cervical carcinoma. Our results indicate that constitutive STAT5 activation correlates with better metastasis-free survival and overall survival in cervical cancer patients who have received radiation therapy.

  9. SeizAlert could give patients 4.5 hour warning of seizure

    ScienceCinema (OSTI)

    Dr. Lee Hively and Kara Kruse

    2010-01-08

    One percent of Americans, 3 million people, suffer from epilepsy. And their lives are about to be dramatically changed by scientists at Oak Ridge National Laboratory. For 15 years, Dr. Lee Hively has been working on "SeizAlert", a seizure-detecting device that resembles a common PDA. "It allows us to analyze scalp brain waves and give us up to 4.5 hours' forewarning of that event," he said. With the help of partner Kara Kruse, he's now able to help patients predict the previously unpredictable.

  10. The Use of Color-Coded Duplex Scanning in the Selection of Patients with Lower Extremity Arterial Disease for Percutaneous Transluminal Angioplasty: A Prospective Study

    SciTech Connect (OSTI)

    Elsman, Bernard H.P. [Department of Vascular Surgery, Utrecht University Hospital, Heidelberglaan 100, NL-3584 CX Utrecht (Netherlands); Legemate, Dink A. [Department of Surgery, Academic Medical Center, Meibergdreef 9, NL-1105 AZ Amsterdam (Netherlands); Heyden, Frank W.H.M. van der [Department of Vascular Surgery, Utrecht University Hospital, Heidelberglaan 100, NL-3584 CX Utrecht (Netherlands); Vos, Henk de [Vascular Laboratory, Utrecht University Hospital, Heidelberglaan 100, NL-3584 CX Utrecht (Netherlands); Mali, Willem P.T.M. [Department of Radiology, Utrecht University Hospital, Heidelberglaan 100, NL-3584 CX Utrecht (Netherlands); Eikelboom, Bert C. [Department of Vascular Surgery, Utrecht University Hospital, Heidelberglaan 100, NL-3584 CX Utrecht (Netherlands)

    1996-09-15

    Purpose: To exploit the potential benefits of percutaneous transluminal angioplasty (PTA) in patients with short obstructive lesions in the lower extremity, it is preferable to select patients suitable for PTA before proceeding to hospital admission and angiography. The aim of this prospective study was to evaluate the role of color-coded duplex scanning in the correct selection of patients for PTA and its influence on planning the approach to the lesion. Methods: On the basis of clinical history, physical examination, pressure indices, and ultrasound duplex scanning, 109 patients were scheduled for PTA. Results: The indication for PTA was correct in 103 patients (94%), while the procedure was performed successfully in 98 patients (90%). The approach to the lesion was planned successfully in the majority of patients. Conclusion: This study shows that it is justifiable to plan PTA on the basis of information obtained by duplex scanning. Results of the duplex scan may guide the catheterization route.

  11. Treatment Outcomes in Non-Metastatic Prostate Cancer Patients With Ultra-High Prostate-Specific Antigen

    SciTech Connect (OSTI)

    Tai, Patricia, E-mail: ptai2@yahoo.com [Saskatchewan Cancer Agency, Regina, SK (Canada); Tonita, Jon; Woitas, Carla; Zhu Tong [Saskatchewan Cancer Agency, Regina, SK (Canada); Joseph, Kurian [Department of Oncology, Cross Cancer Institute, University of Alberta, Calgary, AB (Canada); Skarsgard, David [Department of Oncology, Tom Baker Cancer Center, University of Alberta, Calgary, AB (Canada)

    2012-07-15

    Purpose: It is commonly believed that prostate cancer patients with very high prostate-specific antigen (PSA) levels are unlikely to benefit from definitive local treatment, and patients with very high PSA are often underrepresented in, or excluded from, randomized clinical trials. Consequently, little is known about their optimal treatment or prognosis. We performed a registry-based analysis of management and outcome in this population of patients. Methods and Materials: Our provincial Cancer Registry was used to identify all men who were diagnosed with prostate cancer from 1990 to 2001. A retrospective chart review provided information on stage, Gleason score, PSA at diagnosis, and treatment. In this study, ultra-high PSA was defined as PSA of {>=}50 ng/ml. For a more complete perspective, treatment outcomes of patients with PSA of 20 to 49.9 ng/ml were also studied. Results: Of the 8378 men diagnosed with prostate cancer during this period, 6,449 had no known nodal or distant metastatic disease. The median follow-up of this group was 67.2 months (range, 0-192 months). A total of 1534 patients had PSA of {>=}20 ng/ml. Among the 995 patients with PSA 20 to 49.9 ng/ml, 85 had radical prostatectomy (RP), and their 5- and 10-year cause-specific survivals (CSS) were 95% and 84%, respectively. The 497 patients treated with radiotherapy (RT) had 5- and 10-year CSS of 92% and 71%. For the 332 patients with PSA 50-99.9 ng/ml, RT was associated with 5- and 10-year CSS of 81% and 55%. For the 207 patients with PSA of {>=}100 ng/ml, RT was associated with 5- and 10-year CSS of 80% and 54%. Conclusions: This is the largest series in the world on non metastatic cancer patients with ultra-high PSA at diagnosis. Even in the setting of a very high presenting PSA level, prostatectomy and radiotherapy are often associated with prolonged survival.

  12. Interventional Radiological Treatment of Perihepatic Vascular Stenosis or Occlusion in Pediatric Patients After Liver Transplantation

    SciTech Connect (OSTI)

    Uller, Wibke; Knoppke, Birgit; Schreyer, Andreas G.; Heiss, Peter; Schlitt, Hans J.; Melter, Michael; Stroszczynski, Christian; Zorger, Niels; Wohlgemuth, Walter A.

    2013-12-15

    Purpose: Evaluation of the efficacy and safety of percutaneous treatment of vascular stenoses and occlusions in pediatric liver transplant recipients. Methods: Fifteen children (mean age 8.3 years) underwent interventional procedures for 18 vascular complications after liver transplantation. Patients had stenoses or occlusions of portal veins (n = 8), hepatic veins (n = 3), inferior vena cava (IVC; n = 2) or hepatic arteries (n = 5). Technical and clinical success rates were evaluated. Results: Stent angioplasty was performed in seven cases (portal vein, hepatic artery and IVC), and sole balloon angioplasty was performed in eight cases. One child underwent thrombolysis (hepatic artery). Clinical and technical success was achieved in 14 of 18 cases of vascular stenoses or occlusions (mean follow-up 710 days). Conclusion: Pediatric interventional radiology allows effective and safe treatment of vascular stenoses after pediatric liver transplantation (PLT). Individualized treatment with special concepts for each pediatric patient is necessary. The variety, the characteristics, and the individuality of interventional management of all kinds of possible vascular stenoses or occlusions after PLT are shown.

  13. A patient-specific respiratory model of anatomical motion for radiation treatment planning

    E-Print Network [OSTI]

    Zhang, Qinghui; Hertanto, Agung; Hu, Yu-Chi; Rosenzweig, Kenneth E; Ling, C Clifton; Mageras, Gig S

    2007-01-01

    Modeling of respiratory motion is important for a more accurate understanding and accounting of its effect on dose to cancers in the thorax and abdomen by radiotherapy. We have developed a model of respiration-induced organ motion in the thorax, without the commonly adopted assumption of repeatable breath cycles. The model describes the motion of a volume of interest within the patient, based on a reference 3-dimensional image (at end-expiration), and the diaphragm positions at different time points. The input data are respiration-correlated CT images of patients treated for nonsmall cell lung cancer, consisting of 3D images, including the diaphragm positions, at 10 phases of the respiratory cycle. A deformable image registration algorithm calculates the deformation field that maps each 3D image to the reference 3D image. A principle component analysis is performed to parameterize the 3D deformation field in terms of the diaphragm motion. We show that the first two principal components are adequate to accurat...

  14. Poster — Thur Eve — 16: 4DCT simulation with synchronized contrast injection of liver SBRT patients

    SciTech Connect (OSTI)

    Karotki, A.; Korol, R.; Milot, L.; Chu, W.; Chung, H. T.; Erler, D.

    2014-08-15

    Stereotactic body radiation therapy (SBRT) has recently emerged as a valid option for treating liver metastases. SBRT delivers highly conformai dose over a small number of fractions. As such it is particularly sensitive to the accuracy of target volume delineation by the radiation oncologist. However, contouring liver metastases remains challenging for the following reasons. First, the liver usually undergoes significant motion due to respiration. Second, liver metastases are often nearly indistinguishable from the surrounding tissue when using computed tomography (CT) for imaging making it difficult to identify and delineate them. Both problems can be overcome by using four dimensional CT (4DCT) synchronized with intravenous contrast injection. We describe a novel CT simulation process which involves two 4DCT scans. The first scan captures the tumor and immediately surrounding tissue which in turn reduces the 4DCT scan time so that it can be optimally timed with intravenous contrast injection. The second 4DCT scan covers a larger volume and is used as the primary CT dataset for dose calculation, as well as patient setup verification on the treatment unit. The combination of two 4DCT scans, short and long, allows visualization of the liver metastases over all phases of breathing cycle while simultaneously acquiring long enough 4DCT dataset suitable for planning and patient setup verification.

  15. Alternative Techniques for Treatment of Complex Below-the Knee Arterial Occlusions in Diabetic Patients With Critical Limb Ischemia

    SciTech Connect (OSTI)

    Gandini, Roberto; Uccioli, Luigi; Spinelli, Alessio; Del Giudice, Costantino Ros, Valerio Da; Volpi, Tommaso; Meloni, Marco; Simonetti, Giovanni

    2013-02-15

    The purpose of this study was to describe alternative endovascular (EV) techniques and assess their feasibility and efficacy in minimizing failure rates in limb salvage for the treatment of complex below-the knee (BTK) occlusions that could not be crossed with a conventional antegrade access. Between December 2007 and November 2010, 1,035 patients (557 male) underwent EV treatment for critical limb ischemia in our institution. In 124 (12% [83 male], mean age 68.2 {+-} 0.5 years) patients, transfemoral antegrade revascularization attempt failed, and an alternative approach was used. Follow-up was performed at 1 and 6 months. Results were compared with 56 patients treated between November 2002 and November 2007, in whom conventional technique was unsuccessful and unconventional techniques were not adopted. Technical success was achieved in 119 (96%) patients. The limb-salvage rates were 96.8% and 83% at 1- and 6-month follow-up, respectively. Sixteen (12.9%) and 33 (26.6%) patients underwent reintervention at 1- and 6-month follow-up, respectively. Transcutaneous oxygen tension increased at 1 month (44.7 {+-} 1.1 vs. 15.7 {+-} 0.8 mmHg; p < 0.001) and remained stable at follow-up. Twenty (16.1%) patients required major amputation. Thirteen (10.4%) patients died during follow-up. In our previous experience, percutaneous transluminal angioplasty failure, amputation, and death rates were 10.9, 39.2, and 23.2%, respectively. Alternative techniques allowed a significant decrease of major amputation and death rates (p = 0.0001 and p = 0.02, respectively). The use of alternative techniques seems feasible in case of a failed antegrade BTK revascularization attempt and could minimize failure rates in the treatment of complex occlusions while providing satisfying clinical success rates at 6 months.

  16. Vector Analysis of Prostate Patient Setup With Image-Guided Radiation Therapy via kV Cone Beam Computed Tomography

    SciTech Connect (OSTI)

    Perks, Julian, E-mail: julian.perks@ucdmc.ucdavis.ed [Department of Radiation Oncology, University of California, Davis, Sacramento, California (United States); Turnbull, Helen; Liu Tianxiao; Purdy, James; Valicenti, Richard [Department of Radiation Oncology, University of California, Davis, Sacramento, California (United States)

    2011-03-01

    Purpose: To analyze the daily setup variations in a cohort of intensity-modulated radiation therapy (IMRT) prostate cancer patients who had received daily image-guided RT without the use of fiducial markers to determine if daily image guidance is necessary. Methods and Materials: 2134 Kilovoltage (kV) cone beam computed tomography (CBCT) images were analyzed, with three shifts recorded for each image. The number of times that the vector of the combined shifts would have exceeded the planning tumor volume (PTV) margin was tallied. Then, the average scalar shift of the first five images was removed from all subsequent images for a given patient, and the number of days for which the shift vector was greater than the three-dimensional clinical tumor volume-PTV (3D CTV-PTV) margin (8 mm, created with rolling ball technique) was recorded. Additionally, the scalar shifts from every other fraction were studied to determine if the individual patient's shift vector would be adequately sampled if CBCT was not performed daily, thus reducing patient imaging dose without compromising treatment quality. Results: There were 297 cases where the vector shift was initially greater than the PTV margin. By correcting each patient's data set by the average shift of their first five images the total was 248 cases. By considering only every other image of each patient data set (after correction for the first 5 days), only 137 days in which the CTV was outside the PTV would have been seen. Conclusions: Daily imaging is recommended for prostate cancer IMRT patients in order to know the 3D (vector) position of the CTV and to ensure that it is always within the PTV margin. Correcting the data set by the average shift from the first 5 days reduces the overall number of outlier days but does not eliminate them completely.

  17. The Impact of Post-Mastectomy Radiation Therapy on Male Breast Cancer Patients-A Case Series

    SciTech Connect (OSTI)

    Yu, Edward; Suzuki, Hiromichi; Younus, Jawaid; Elfiki, Tarek; Stitt, Larry; Yau, Gary; Vujovic, Olga; Perera, Francisco; Lock, Michael; Tai, Patricia

    2012-02-01

    Objective: To assess the impact of radiation management on male breast cancer (MBC) at London Regional Cancer Program (LRCP). Methods and Materials: Men with a diagnosis of breast cancer referred to LRCP were reviewed. The seventh American Joint Committee on Cancer staging system was used. Patients treated with and without post-mastectomy radiation therapy (PMRT) were analyzed. Disease-free survival (DFS) was defined as time duration from diagnosis to first recurrence. Overall survival (OS) was defined as time duration from pathologic diagnosis to death or last follow-up with any death defined as an event. Survival estimates were obtained using Kaplan-Meier methodology. Results: From January 1977 to December 2006, 81 men had invasive ductal carcinoma. The median age was 65 (range, 35-87 years). There were 15 Stage I, 40 Stage II, 20 Stage III, and 6 Stage IV patients. Median follow-up time was 46 months (range, 1-225 months). Of the 75 patients treated with curative intent, 29 did not receive PMRT and 46 completed PMRT. Patients who received PMRT demonstrated no benefit in overall survival (p = 0.872) but significantly better local recurrence free survival (p < 0.001) compared with those who did not receive RT. There was trend toward improving locoregional recurrence with PMRT in patients with high-risk features (node-positive, advanced stage, and {<=}2 mm or unknown surgical margin). The median, 5-year, and 10-year disease-free survival and overall survival for the 75 patients were 77.7 months, 66.3%, 32.7%, and 91.2 months, 73.9%, and 36.6%, respectively. Conclusion: The experience at LRCP suggests that high-risk MBC patients should consider PMRT to improve their chance of local recurrence-free survival.

  18. A Phase 2 Trial of Once-Weekly Hypofractionated Breast Irradiation: First Report of Acute Toxicity, Feasibility, and Patient Satisfaction

    SciTech Connect (OSTI)

    Dragun, Anthony E.; Quillo, Amy R.; Riley, Elizabeth C.; Roberts, Teresa L.; Hunter, Allison M.; Rai, Shesh N.; Callender, Glenda G.; Jain, Dharamvir; McMasters, Kelly M.; Spanos, William J.

    2013-03-01

    Purpose: To report on early results of a single-institution phase 2 trial of a 5-fraction, once-weekly radiation therapy regimen for patients undergoing breast-conserving surgery (BCS). Methods and Materials: Patients who underwent BCS for American Joint Committee on Cancer stage 0, I, or II breast cancer with negative surgical margins were eligible to receive whole breast radiation therapy to a dose of 30 Gy in 5 weekly fractions of 6 Gy with or without an additional boost. Elective nodal irradiation was not permitted. There were no restrictions on breast size or the use of cytotoxic chemotherapy for otherwise eligible patients. Patients were assessed at baseline, treatment completion, and at first posttreatment follow-up to assess acute toxicity (Common Terminology Criteria for Adverse Events, version 3.0) and quality of life (European Organization for Research and Treatment of Cancer QLQ-BR23). Results: Between January and September 2011, 42 eligible patients underwent weekly hypofractionated breast irradiation immediately following BCS (69.0%) or at the conclusion of cytotoxic chemotherapy (31.0%). The rates of grade ?2 radiation-induced dermatitis, pain, fatigue, and breast edema were 19.0%, 11.9%, 9.5%, and 2.4%, respectively. Only 1 grade 3 toxicity—pain requiring a course of narcotic analgesics—was observed. One patient developed a superficial cellulitis (grade 2), which resolved with the use of oral antibiotics. Patient-reported moderate-to-major breast symptoms (pain, swelling, and skin problems), all decreased from baseline through 1 month, whereas breast sensitivity remained stable over the study period. Conclusions: The tolerance of weekly hypofractionated breast irradiation compares well with recent reports of daily hypofractionated whole-breast irradiation schedules. The regimen appears feasible and cost-effective. Additional follow-up with continued accrual is needed to assess late toxicity, cosmesis, and disease-specific outcomes.

  19. Development of Patients' Decision Aid for Older Women With Stage I Breast Cancer Considering Radiotherapy After Lumpectomy

    SciTech Connect (OSTI)

    Wong, Jennifer; D'Alimonte, Laura; Angus, Jan; Paszat, Larry; Metcalfe, Kelly; Whelan, Tim; Llewellyn-Thomas, Hilary; Warner, Eiran; Franssen, Edmee; Szumacher, Ewa

    2012-09-01

    Purpose: To develop a patient decision aid (PtDA) for older women with Stage I, pathologically node negative, estrogen receptor-positive progesterone receptor-positive breast cancer who are considering adjuvant radiotherapy after lumpectomy and to examine its impact on patients' decision making. Methods and Materials: A PtDA was developed and evaluated in three steps according to the Ottawa Decision Support Framework: (1) needs assessment (n = 16); (2) Pilot I to examine PtDA acceptability (n = 12); and (3) Pilot II, a pretest posttest (n = 38) with older women with estrogen receptor-positive progesterone receptor-positive breast cancer after lumpectomy who were receiving adjuvant radiation therapy. Measures included patients' satisfaction with the PtDA, self-reported decisional conflict, level of distress, treatment-related knowledge, and choice predisposition. Results: The PtDA is a booklet that details each adjuvant treatment option's benefits, risks, and side effects tailored to the patient's clinical profile; includes a values clarification exercise; and includes steps to guide patients towards their decision. On the basis of qualitative comments and satisfaction ratings, all women thought that the PtDA was helpful and informative. In comparison with their baseline scores, patients had a statistically significant (p < 0.05) reduction in decisional conflict (adjusted mean difference [AMD], -7.18; 95% confidence interval [CI], -13.50 to 12.59); increased clarity of the benefits and risks (AMD, -10.86; CI, -20.33 to 21.49); and improved general treatment knowledge (AMD, 8.99; CI, 2.88-10.28) after using the PtDA. General trends were also reported in the patients' choice predisposition scores that suggested potential differences in treatment decision after PtDA use. Conclusions: This study provides evidence that this PtDA may be a helpful educational tool for this group of women. The quality of care for older breast cancer patients may be enhanced by the use of a tailored PtDA to help patients be better informed about their treatment options.

  20. Role of Salvage Radiation Therapy for Patients With Relapsed or Refractory Hodgkin Lymphoma Who Failed Autologous Stem Cell Transplant

    SciTech Connect (OSTI)

    Goda, Jayant S.; Massey, Christine; Kuruvilla, John; Gospodarowicz, Mary K.; Wells, Woodrow; Hodgson, David C.; Sun, Alexander; Keating, Armand; Crump, Michael; Tsang, Richard W.

    2012-11-01

    Purpose: To analyze, through chart review, the efficacy of salvage radiation therapy (sRT) for relapsed or progressive Hodgkin lymphoma (HL) patients who failed autologous stem cell transplant (ASCT). Patients and Methods: Among 347 patients with recurrent/refractory HL who received ASCT from 1986-2006, 163 had post-ASCT progression or relapse. Of these, 56 received sRT and form the basis of this report. Median age at sRT was 30 years (range, 17-59 years). Disease was confined to lymph nodes in 27 patients, whereas 24 had both nodal and extranodal disease. Salvage radiation therapy alone was given in 34 patients (61%), and sRT plus chemotherapy was given in 22 (39%). Median interval from ASCT to sRT was 0.8 years (range, 0.1-5.6 years). The median dose was 35 Gy (range, 8-40.3 Gy). The sRT technique was extended-field in 14 patients (25%) and involved-field in 42 (75%). Results: The median follow-up from sRT was 31.3 months (range, 0.2-205.5 months). Overall response rate was 84% (complete response: 36%; partial response: 48%). The median overall survival was 40.8 months (95% confidence interval, 34.2-56.3 months). The 5-year overall survival was 29% (95% confidence interval, 14%-44%). The 2-year progression-free survival (PFS) was 16%; the 2-year local PFS was 65%, whereas the 2-year systemic PFS was 17%. The 1-year PFS was higher in patients in whom all diseased sites were irradiated (49%) compared with those in whom only the symptomatic site was treated (22%, P=.07). Among 20 alive patients, 5 were disease free (at 6.4, 6.8, 7.4, 7.9, and 17.1 years). Conclusion: For patients with HL who fail ASCT, a selective use of RT provides a durable local control rate of 65% at 2 years and should be considered as part of the standard management plan for the palliation of incurable HL. Occasionally irradiation of truly localized disease can lead to long-term survival.