bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficient Synthesis of 2‐Substituted Phthalimides from Phthalic Acids in One Step
Authors: Chorell Erik , Chorell Elin
Published: October 2013

Efficient procedures for synthesizing 2‐substituted phthalimide (isoindole‐1,3‐dione) analogues starting from phthalic acids have been developed by using experimental design. The phthalimide central fragment frequently appears in biologically active compounds, materials, catalysts, and fluorescent probes, and therefore the development of general, fast, and convenient synthetic methods to this scaffold under neutral, acidic, and basic conditions would be attractive. After an initial screening, the use of acetonitrile, acetic acid, or pyridine in combination with microwave heating proved most promising. Experimental design was applied to these conditions to optimize the time, temperature, and concentration. This strategy has successfully generated synthetic methods that have been used to synthesize a series of phthalimides from phthalic acids and various amines or anilines in excellent yields. The developed methods have proven to be general, fast, convenient, and economic, and thus are expected to have broad utility to efficiently construct novel compounds for future biological and chemical applications.
Total Synthesis of Mycophenolic Acid by a Palladium‐Catalyzed Decarboxylative Allylation and Biomimetic Aromatization Sequence
Authors: Brookes Paul A. , Cordes Jens , White Andrew J. P. , Barrett Anthony G. M.
Published: October 2013

This paper describes the total synthesis of the fungal natural product mycophenolic acid through palladium‐catalyzed allylation, biomimetic cyclization, and aromatization. Methyl (4E)‐6‐hydroxy‐4‐methylhex‐4‐enoate, which was converted in four steps into the key diketo ester dioxinone via two selective C‐acylation reactions, was transformed into a resorcylate. Subsequent phenol methylation, lactonization, iodo‐ether formation, and halogenation gave a tricyclic intermediate. Palladium‐catalyzed cross‐coupling with DABCO–(AlMe3)2 and saponification gave mycophenolic acid. An alternative approach with early stage arene methyl incorporation unexpectedly resulted in the formation of a γ‐pyrone.
Nitrile Oxide versus Nitrone – Switching Regioselectivity of Intramolecular 1,3‐Dipolar Cycloadditions towards the Preparation of Aminopiperidinecarboxylates
Authors: Würdemann Martina , Christoffers Jens
Published: October 2013

3‐(Allylamino)‐ and 3‐(propargylamino)propanal were converted via the corresponding oximes into nitrile oxides, which readily underwent intramolecular 1,3‐dipolar cycloadditions to furnish a piperidine‐annulated isoxazole or isoxazoline. The annulated isoxazoline was transformed into orthogonally carbamate‐protected cis‐ and trans‐4‐aminopiperidine‐3‐carboxylates, both representing interesting scaffolds for combinatorial chemistry. Through sequences of amidations and deprotections two triply functionalized products were obtained as examples for diversification. After Boc removal, the piperidino‐annulated isoxazole was also subjected to diversifying reactions, such as reductive amination, amidation, and the formation of sulfonamido‐ and ureido‐substituted derivatives.
Synthesis of Functionalized Pyridine‐2,6‐bis(imidazolines) by Ring Transformation of 4‐(Aminomethyl)oxazoline Derivatives
Authors: Schulz Marvin , Christoffers Jens
Published: October 2013

Optically active pyridine‐2,6‐bis(4‐azidomethyloxazoline) was prepared by starting from L‐serine and pyridine 2,6‐dicarboxylic acid. Reduction of the azide moieties gave pyridine‐2,6‐bis(4‐aminomethyloxazoline), which was not a stable compound, but readily underwent a ring‐transforming rearrangement to furnish the pyridine‐2,6‐bis(4‐hydroxymethylimidazoline). After Boc protection of the amidine functionalities, this compound could be further converted into the pyridine‐2,6‐bis(4‐aminomethylimidazoline) via the corresponding bis(azidomethyl) compound. The azide functions of the bis(oxazoline) and the bis(imidazoline) intermediate products could also be further derivatized with an alkyne to give triazoles or through aza‐Wittig reactions with benzaldehyde to give imines.
Catalytic Adsorptive Stripping Chronopotentiometry of Co(II)‐DMG‐Bromate System at an In Situ Plated Lead Film Electrode
Authors: Bobrowski Andrzej , Królicka Agnieszka , Putek Maria , Zarębski Jerzy , Antonatos Nikolas , Economou Anastasios
Published: October 2013

A novel catalytic adsorptive stripping chronopotentiometric (CC‐CAdSCP) procedure for the determination of Co(II) traces was developed using a lead film electrode (PbFE). The PbFE was generated in situ on a glassy carbon support from a 0.1 M ammonia buffer containing 1×10−5 M Pb(II), 6.5×10−5 M DMG and the target metals. An addition of 0.2 M NaBrO3 to the solution yielded an 11‐fold catalytic enhancement of chronopotentiometric response of the Co(II)‐DMG complex. The CC‐CAdSCP curves were well‐developed, sharp and reproducible (RSD 5.0 % for 5×10−9 M Co(II)). The limit of detection for Co(II) for 210 s of accumulation time was 4×10−10 M (0.024 µg L−1). In addition, the elaborated method allowed the simultaneous quantification of Co(II) and Ni(II) simultaneously.
Fast evaluation of enantioselective drug metabolism by electrophoretically mediated microanalysis: Application to fluoxetine metabolism by CYP2D6
Authors: Asensi‐Bernardi Lucía , Martín‐Biosca Yolanda , Escuder‐Gilabert Laura , Sagrado Salvador , Medina‐Hernández María José
Published: October 2013

In this work, a capillary electrophoretic methodology for the enantioselective in vitro evaluation of drugs metabolism is applied to the evaluation of fluoxetine (FLX) metabolism by cytochrome 2D6 (CYP2D6). This methodology comprises the in‐capillary enzymatic reaction and the chiral separation of FLX and its major metabolite, norfluoxetine enantiomers employing highly sulfated β‐CD and the partial filling technique. The methodology employed in this work is a fast way to obtain a first approach of the enantioselective in vitro metabolism of racemic drugs, with the additional advantage of an extremely low consumption of enzymes, CDs and all the reagents involved in the process. Michaelis–Menten kinetic parameters (Km and Vmax) for the metabolism of FLX enantiomers by CYP2D6 have been estimated by nonlinear fitting of experimental data to the Michaelis–Menten equation. Km values have been found to be 30 ± 3 μM for S‐FLX and 39 ± 5 μM for R‐FLX. Vmax estimations were 28.6 ± 1.2 and 34 ± 2 pmol·min−1·(pmol CYP)−1 for S‐ and R‐FLX, respectively. Similar results were obtained using a single enantiomer (R‐FLX), indicating that the use of the racemate is a good option for obtaining enantioselective estimations. The results obtained show a slight enantioselectivity in favor of R‐FLX.
Sieving polymer synthesis by reversible addition fragmentation chain transfer polymerization
Authors: Nai Yi Heng , Jones Roderick C. , Breadmore Michael C.
Published: October 2013

Replaceable sieving polymers are the fundamental component for high‐resolution nucleic acids separation in CE. The choice of polymer and its physical properties play significant roles in influencing separation performance. Recently, reversible addition fragmentation chain transfer (RAFT) polymerization has been shown to be a versatile polymerization technique capable of yielding well‐defined polymers previously unattainable by conventional free‐radical polymerization. In this study, a high molecular weight poly‐(N,N‐dimethylacrylamide) (PDMA) at 765 000 gmol−1 with a polydispersity index of 1.55 was successfully synthesized with the use of chain transfer agent—2‐propionic acidyl butyl trithiocarbonate in a multistep sequential RAFT polymerization approach. This study represents the first demonstration of RAFT polymerization for synthesizing polymers with the molecular weight range suitable for high‐resolution DNA separation in sieving electrophoresis. Adjustment of pH in the reaction was found to be crucial for the successful RAFT polymerization of high molecular weight polymer as the buffered condition minimizes the effect of hydrolysis and aminolysis commonly associated with trithiocarbonate chain transfer agents. The separation efficiency of 2‐propionic acidyl butyl trithiocarbonate PDMA was found to have marginally superior separation performance compared to a commercial PDMA formulation, POP™‐CAP, of similar molecular weight range.
Emerging therapies for the treatment of hepatitis C
Authors: Lange Christian M , Jacobson Ira M , Rice Charles M , Zeuzem Stefan
Published: October 2013

Opportunities to treat infection with hepatitis C virus (HCV) are evolving rapidly. From the introduction of interferon‐α monotherapy in 1992 to the approval of telaprevir‐ and boceprevir‐based triple therapies with pegylated interferon‐α and ribavirin in 2011, the chances of curing patients infected with HCV genotype 1 have improved from <10% to approximately 70%. Significant further improvements are on the horizon, which may well cure virtually all hepatitis C patients with an all‐oral, interferon‐free regimen in the very near future. These exciting developments are reviewed in the present article.
Toxicity of pesticides associated with potato production, including soil fumigants, to snapping turtle eggs (C
helydra Serpentina)
Authors: de Solla Shane Raymond , Palonen Kimberley Elizabeth , Martin Pamela Anne
Published: October 2013

Turtles frequently oviposit in soils associated with agriculture and, thus, may be exposed to pesticides or fertilizers. The toxicity of a pesticide regime that is used for potato production in Ontario on the survivorship of snapping turtle (Chelydra serpentina) eggs was evaluated. The following treatments were applied to clean soil: 1) a mixture of the pesticides chlorothalonil, S-metolachlor, metribuzin, and chlorpyrifos, and 2) the soil fumigant metam sodium. Turtle eggs were incubated in soil in outdoor plots in which these mixtures were applied at typical and higher field application rates, where the eggs were subject to ambient temperature and weather conditions. The pesticide mixture consisting of chlorothalonil, S-metolachlor, metribuzin, and chlorpyrifos did not affect survivorship, deformities, or body size at applications up to 10 times the typical field application rates. Hatching success ranged between 87% and 100% for these treatments. Metam sodium was applied at 0.1¯ times, 0.3¯ times, 1 times, and 3 times field application rates. Eggs exposed to any application of metam sodium had 100% mortality. At typical field application rates, the chemical regime associated with potato production does not appear to have any detrimental impacts on turtle egg development, except for the use of the soil fumigant metam sodium, which is highly toxic to turtle eggs at the lowest recommended application rate. Environ Toxicol Chem 2014;33:102–106. © 2013 SETAC
Designing high‐yielding wheat ideotypes for a changing climate
Authors: Semenov Mikhail A. , Stratonovitch Pierre
Published: October 2013

Global warming is characterized by shifts in weather patterns and increases in climatic variability and extreme events. New wheat cultivars will be required for a rapidly changing environment, putting severe pressure on breeders who must select for climate conditions which can only be predicted with a great degree of uncertainty. To assist breeders to identify key wheat traits for improvements under climate change, wheat ideotypes can be designed and tested in silico using a wheat simulation model for a wide range of future climate scenarios predicted by global climate models. A wheat ideotype is represented by a set of cultivar parameters in a model, which could be optimized for best wheat performance under projected climate change. As an example, high‐yielding wheat ideotypes were designed at two contrasting European sites for the 2050 (A1B) climate scenario. Simulations showed that wheat yield potential can be substantially increased for new ideotypes compared with current wheat varieties under climate change. The main factors contributing to yield increase were improvement in light conversion efficiency, extended duration of grain filling resulting in a higher harvest index, and optimal phenology.
Development of a Self‐Adaptive Direct Methanol Fuel Cell Fed with 20 M Methanol
Authors: Guo J. , Zhang H. , Jiang J. , Huang Q. , Yuan T. , Yang H.
Published: October 2013

A passive and self‐adaptive direct methanol fuel cell (DMFC) directly fed with 20 M of methanol is developed for a high energy density of the cell. By using a polypropylene based pervaporation film, methanol is supplied into the DMFC's anode in vapor form. The mass transport of methanol from the cartridge to the anodic catalyst layer can be controlled by varying the open ratio of the anodic bipolar plate and by tuning the hydrophobicity of anodic diffusion layer. An effective back diffusion of water from the cathode to the anode through Nafion film is carried out by using an additive microporous layer in the cathode that consists of 50 wt.% Teflon and KB‐600 carbon. Accordingly, the water back diffusion not only ensures the water requirement for the methanol oxidation reaction but also reduces water accumulation in the cathode and then avoids serious water flooding, thus improving the adaptability of the passive DMFC. Based on the optimized DMFC structure, a passive DMFC fed with 20 M methanol exhibits a peak power density of 42 mW cm–2 at 25 °C, and no obvious performance degradation after over 90 h continuous operation at a constant current density of 40 mA cm–2.
Building protection for the inner city tunnel excavation for the Metro in Rome / Bauwerksschutz für den innerstädtischen Tunnelbau am Beispiel der Metro in Rom
Authors: Kummerer Clemens
Published: October 2013

For the construction of the Metro B1 line in Rome, special settlement reduction measures were implemented for settlement‐sensitive structures beside deep excavations with depths of up to 45 m. These measures were necessary due to the excavation of tunnels with 6.8 and 9.8 m diameter under challenging soil and groundwater conditions. The originally designed jet grouting bodies were replaced by compensation grouting. This enabled all works to be performed from eight shafts (maximum 24 m depth), limiting the public space requirement. The efficiency of compensation grouting was demonstrated in two full‐scale field trials and the advantages of active settlement compensation were proved during tunnel excavation.

Für den Bau der Metro B1 in Rom wurden neben bis zu 45 m tiefen Baugruben auch Sondermaßnahmen zur Setzungsreduktion für verformungsempfindliche Bauwerke realisiert. Diese Maßnahmen waren aufgrund des Vortriebs von Tunneln mit einem Durchmesser von 6,8 bzw. 9,8 m unter anspruchsvollen Boden‐ und Grundwasserverhältnissen erforderlich. Die im Amtsentwurf geplanten DSV‐Arbeiten wurden durch Kompensationsinjektionen ersetzt. Dadurch konnten die Arbeiten aus acht Schächten (max. 24 m Tiefe) ausgeführt werden, wodurch sich ein geringer Bedarf an öffentlichen Flächen ergab. Die Effizienz der Injektionen konnte anhand von zwei großmaßstäblichen Feldversuchen gezeigt und die Vorteile eines aktiven Setzungsausgleichs während der eigentlichen Tunneldurchfahrt bestätigt werden.
Overcoming congestion below ground with a D‐shaped pile / Beherrschung von begrenzten Platzverhältnissen durch Ausführung eines D‐förmigen Pfahls
Authors: Nikolic Alex , Cook Jim
Published: October 2013

The paper describes some of the challenging geotechnical issues related to the redevelopment of a central London site in Tottenham Court Road. The London Underground station is being upgraded, and proposed tunnels of the Crossrail project and the Denmark Place project also have to be accommodated, which led to significant difficulties due to spatial restraints underground. Innovative solutions have been adopted for the design and installation of some of the piles together with an unprecedented low clearance between piles and a running tunnel of the Northern Line and the proposed Crossrail tunnel respectively. For one pile, a D‐shaped section had to be chosen due to space limitations in the ground.

Dieser Beitrag beschreibt einige der geotechnischen Herausforderungen bei der Neugestaltung eines zentralen Stadtteils von London, der Tottenham Court Road. Aufgrund der Tatsache, dass neben dem Ausbau der bestehenden U‐Bahnstation ein geplanter Crossrail‐Tunnel sowie das Projekt Denmark Place in diesem Areal errichtet werden, entstehen erhebliche Schwierigkeiten durch die sehr beengten Platzverhältnissen im Untergrund. Innovative Lösungen in Planung und Herstellung der Pfähle waren erforderlich, wobei ein noch nie dagewesener geringer Abstand zwischen Pfahl und Northern Line Tunnel bzw. dem geplanten Crossrail Tunnel genehmigt wurde. Für einen Pfahl musste aus Platzgründen ein D‐förmiger Querschnitt gewählt werden.
Design and construction of the Second Avenue subway project in New York / Entwurf und Bau der Second Avenue Subway in New York
Authors: Nasri Verya
Published: October 2013

The Second Avenue Subway Project is a major capital expansion project of the New York City subway that will provide a dedicated line for the east side of Manhattan. The project is approximately 13.7 km long including 16 stations, and its estimated cost is about 17 billion US‐$. Under the current design of the whole subway route, ten stations will be cut‐and‐cover and six mined caverns. The excavated diameter of the bored tunnels is 6.6 m and the caverns span ranges from 12 to 21 m. As the geology of Manhattan varies along its length, the subway will pass through both hard rock and soft ground and there will be multiple rock/soil interfaces along the alignment. This paper presents details of planning, design and construction of the first phase of Second Avenue Subway in the very dense urban environment of Manhattan.

Der Bau der Second Avenue Subway ist ein wichtiges Erweiterungsprojekt der New York City Subway und wird eine Linie für die östliche Seite Manhattans bereitstellen. Das Projekt ist ungefähr 13,7 km lang und beinhaltet 16 Haltestellen. Die geschätzten Kosten liegen bei etwa 17 Mrd. US‐$. Nach aktuellem Entwurf der Gesamtstrecke der Erweiterung sind zehn Haltestellen in offener Bauweise und sechs bergmännisch ausgebrochene Kavernen herzustellen. Der Ausbruchdurchmesser der maschinell aufgefahrenen Tunnel beträgt 6,6 m und die Spannweiten der Kavernen zwischen 12 m und 21 m. Da die Geologie Manhattans sich entlang der Trasse ändert, durchquert die Subway sowohl Hartgestein als auch weichen Untergrund. Außerdem gibt es zahlreiche Fels/Boden‐Übergangsstellen entlang der Trassierung. Dieser Beitrag stellt Einzelheiten der Planung, des Entwurfs und des Baus der ersten Phase der Second Avenue Subway in der sehr dichten städtischen Umgebung Manhattans dar.
As Good as Being There
Authors: Weinzierl Stefan
Published: October 2013

From the concert hall to virtual performances, creating a spatially authentic listening experience requires a great deal of technology and even more measurements and simulations. By building a large database of spatial acoustic data, researchers hope to create the perfect signal chain – and thus optimise the quality of audio transmissions.
Land use change and nitrogen feedbacks constrain the trajectory of the land carbon sink
Authors: Gerber Stefan , Hedin Lars O. , Keel Sonja G. , Pacala Stephen W. , Shevliakova Elena
Published: October 2013

Our understanding of Earth's carbon climate system depends critically upon interactions between rising atmospheric CO2, changing land use, and nitrogen limitation on vegetation growth. Using a global land model, we show how these factors interact locally to generate the global land carbon sink over the past 200 years. Nitrogen constraints were alleviated by N2 fixation in the tropics and by atmospheric nitrogen deposition in extratropical regions. Nonlinear interactions between land use change and land carbon and nitrogen cycling originated from three major mechanisms: (i) a sink foregone that would have occurred without land use conversion; (ii) an accelerated response of secondary vegetation to CO2 and nitrogen, and (iii) a compounded clearance loss from deforestation. Over time, these nonlinear effects have become increasingly important and reduce the present‐day net carbon sink by ~40% or 0.4 PgC yr−1.
A slower fault may produce a smaller preseismic moment rate: Non‐1/tf acceleration of moment rate during nucleation and dependency on the background slip rate
Authors: Noda Hiroyuki , Nakatani Masao , Hori Takane
Published: October 2013

A recent global study has revealed that seismicity near the hypocenter prior to large earthquakes, which could be a proxy for preseismic moment rate, accelerates before interplate earthquakes, while it rarely does before intraplate earthquakes. Understanding the amplitude of preseismic deformation is important in assessing the possibility of its detection. For a class of rate‐state friction laws without a characteristic speed‐related parameter (e.g., aging law and slip law), a dimensional analysis has shown that if the moment rate increases more mildly than 1/tf where tf is the time‐to‐failure, then the amplitude of preseismic moment rate is smaller for a smaller quasistatic slip rate. Three‐dimensional numerical simulations have revealed that the aging law yields 1/tf acceleration, while the slip law causes milder acceleration. If the latter is the case, faults with very low long‐term slip rates (e.g., intraplate faults) may have very small preseismic moment rates.
A new wave scheme for trajectory simulations of stratospheric water vapor
Authors: Kim Ji‐Eun , Joan Alexander M.
Published: October 2013

We have developed a new wave scheme particularly aiming to provide better temperature fields with realistic variability for trajectory modeling of dehydration processes in the tropical tropopause layer (TTL). The new scheme includes amplitude‐phase interpolation and amplification of waves in reanalysis data. Amplification factors are based on statistical variability differences between reanalysis data and radiosonde observations at 24 tropical locations during 1997–2013 boreal winters. We show that conventional linear interpolation of temperatures in the vertical coordinate degrades wave amplitudes and variability. Amplitude‐phase interpolation in Fourier space greatly mitigates the problem found in linear interpolation. Furthermore, amplitudes of existing waves in reanalyses were amplified to generate realistic variability. In addition to improvements in variability, the scheme lowers cold point temperatures and raises cold point tropopause heights. Having realistic variability with the new approach will reduce uncertainties in simulations of TTL cirrus clouds and stratospheric water vapor.
Interictal networks in Magnetoencephalography
Authors: Malinowska Urszula , Badier Jean‐Michel , Gavaret Martine , Bartolomei Fabrice , Chauvel Patrick , Bénar Christian‐George
Published: October 2013

Epileptic networks involve complex relationships across several brain areas. Such networks have been shown on intracerebral EEG (stereotaxic EEG, SEEG), an invasive technique. Magnetoencephalography (MEG) is a noninvasive tool, which was recently proven to be efficient for localizing the generators of epileptiform discharges. However, despite the importance of characterizing non‐invasively network aspects in partial epilepsies, only few studies have attempted to retrieve fine spatiotemporal dynamics of interictal discharges with MEG. Our goal was to assess the relevance of magnetoencephalography for detecting and characterizing the brain networks involved in interictal epileptic discharges. We propose here a semi‐automatic method based on independent component analysis (ICA) and on co‐occurrence of events across components. The method was evaluated in a series of seven patients by comparing its results with networks identified in SEEG. On both MEG and SEEG, we found that interictal discharges can involve remote regions which are acting in synchrony. More regions were identified in SEEG (38 in total) than in MEG (20). All MEG regions were confirmed by SEEG when an electrode was present in the vicinity. In all patients, at least one region could be identified as leading according to our criteria. A majority (71%) of MEG leaders were confirmed by SEEG. We have therefore shown that MEG measurements can extract a significant proportion of the networks visible in SEEG. This suggests that MEG can be a useful tool for defining noninvasively interictal epileptic networks, in terms of regions and patterns of connectivity, in search for a “primary irritative zone.” Hum Brain Mapp 35:2789–2805, 2014. © 2013 Wiley Periodicals, Inc.
The Redevelopment of the New South Wales Remote X‐ray Operators Licensing Course
Authors: Smith Tony , McKiernan Sharmaine
Published: October 2013

The NSW Remote X‐ray Operators Licensing Course is for rural and remote general practitioners (GPs) and registered nurses (RNs) to obtain a limited x‐ray licence to operate diagnostic x‐ray equipment in communities where there is no radiographer available. Between 1994 and 2001 it was a five‐day, intensive, face‐to‐face, non‐award short‐course conducted by the Discipline of Medical Radiation Science (MRS) from the university of Newcastle. The participants were taught basic radiographic technique and radiation protection through a logical sequence of lectures, tutorials and practical sessions. It included basic radiation physics and radiographic instrumentation, basic radiobiology and radiation protection, and routine radiographic positioning for some anatomical regions.

Problems with access and with the intensity of the educational experience for participants encouraged the MRS staff to secure funding from RHSET and NSW Health to redevelop the course into a more flexible mixed mode of delivery. The course content has not been changed appreciably. However, the new course structure integrates a six‐week distance learning component with practical exercises and a two‐day workshop, followed by completion of a short answer question final assignment. Participants are required to establish a working relationship with a nominated local radiographer and senior rural radiographers run the workshop, thus encouraging the development of a rural radiography support network. The course has been piloted successfully with participants performing at least as well as those in the old course. The course evaluation was very positive and it will continue to be offered in the new format.
Root Cause Analysis — A Mock Case Study
Authors: Miller Julie
Published: October 2013

A percentage of Radiation Therapy treatments will result in an error, be it a treatment or planning error. These errors, or incidents, will range from the very insignificant to the very significant. Although some incidents may be able to be corrected in future treatments, in general it is not possible to completely correct an incorrect treatment. The one positive that can be taken from every incident is to learn from it, identifying the processes which failed and replacing these with more robust processes.

A root cause analysis (RCA) is a tool which focuses investigation of an incident onto processes and away from people. Incident analysis will only ever be successful if personal blame is removed.

This paper uses a mock case study to take the reader through the process of an RCA with the purpose of raising the appreciation of the value and benefits of such an analysis.
Measurement of Anatomy Contouring in EPI Review: A Practical Method for use in Radiation Therapy Departments
Authors: Rybovic Michala , Halkett Georgia K.B. , Williams Marie T.
Published: October 2013

Radiation therapy treatment verification can be performed using hard copy portal films or digital Electronic Portal Images (EPI) of the treatment field, acquired at the time of treatment. This paper describes a practical method of assessing the accuracy of reference anatomy outlining, for treatment sites involving the pelvis, breast and lumbar spine. Seven original bone anatomy outlines contoured onto verification images of five patients, were printed on transparency sheets and reference points were marked at equal distances along the anatomy curves. Two sample anatomy contour sets were created by two independent radiation therapists who outlined visible bone anatomy on the same seven digitally reconstructed radiographs (DRR) and hard copy outlines were obtained. Three independent observers with differing levels of experience, assessed the discrepancies between the original anatomy contours and the sample sets on two occasions one week apart, by measuring the distances between the original and sample set contours (absolute values in mm). The degree of agreement between the same assessor on two occasions (intra‐rater reliability) and between assessors (inter‐rater reliability) was analysed using parametric analysis for levels of relationship and significant differences. This simple method of reference anatomy outline measurement was shown to be highly reliable within assessors and between assessors (r > 0.87 and r2 > 0.75 for both intra‐ and inter‐rater comparisons). This measurement process may be a suitable method, for undertaking quality assurance activities in image verification within radiation therapy departments.
Cranial Immobilisation — Is There A Better Way?
Authors: Chelvarajah Radhini , Leighton Brigid , Martin Linda , Smith Wayne , Beldham‐Collins Rachael
Published: October 2013

Westmead Radiation Oncology Department like many radiation therapy department's has high demands on staffing and equipment resources within the mould room, while continuing to combat a dramatically increasing waiting list. The radiation oncologist at Westmead specialising in cranial irradiation instigated the formation of a research group to explore the most resource effective and accurate way of stabilising cranial patients and to confirm whether the cranial immobilisation protocols already in practice within the department are suitable.

Westmead Radiation Oncology employs four methods of cranial immobilisation; fixed and removable head frames that are used for stereotactic radiosurgery (SRS) and rigid plastic (uvex) and thermoplastic (orfit) casts. The latter two are used for brain lesions and head and neck treatments. With the advent of Intensity Modulated Radiation Therapy — IMRT, and modern day treatment, the field parameters employed are becoming smaller and the shielding more complex as the avoidance of critical organs which may be in the beams pathways is crucial. The necessity for rigid immobilisation and reproducibility on a daily basis is apparent.
Spreadsheet Based Application of The ‘Standard Model’ In Variable Part Thickness Radiography
Authors: Garbett Ian Thomas
Published: October 2013

The ‘standard model’ of radiographic exposure technique allows for generation of exposure technique variables in various forms. A Microsoft Excel spreadsheet application and additional dedicated ‘Add‐In’ functions are described that implement the standard model.

The Visual Basic for Applications (VBA) coded application (named ‘StandardXp’) is a menu driven system and allows for traditional fixed kVp and variable kVp method solutions as well as the variable source to image distance (SID) method and also ‘combination method’ (simultaneous variation of tube voltage and tube charge) types of solution. The associated set of ‘Add‐In’ functions also enable the same solutions (using any of the methods just mentioned), to be obtained. Aspects of implementation of the standard model in the coded calculations are described, and some limitations of the StandardXp application and functions in generating usable exposure charts are also discussed. Such limitations are suggested to be mainly due to limitations of the standard model itself.
Student perceptions of a quality clinical experience: findings from the literature and their application to radiation therapy
Authors: Fenton Paul
Published: October 2013

This paper seeks to provide a review of research findings into the clinical experience from the perception of students, with the aim of improving the clinical placements of radiation therapy students. Drawing on evidence from other allied health professions, the attributes of the ideal supervisor perceived by students is presented. The effect of clinical environment, departmental culture and communication with universities on student perception is also discussed. The lack of literature on radiation therapy education in the clinical setting has been highlighted and may be remedied in the future with the appointment of research radiation therapists. There is an ongoing need for the universities to assist radiation therapists in maintaining their skills in the supervision of students, perhaps through the provision of workshops and seminars. The list of attributes of the ideal supervisor extracted from the literature is extensive. It is an unrealistic expectation for a person to possess all of the characteristics, however the challenge is for supervisors to develop and exhibit as many as possible.
Radiographers at risk of assault
Authors: Caruana E
Published: October 2013

Purpose To identify the types and causes of violence towards radiographers by the patient and or relatives/friends. To determine actions to minimise these incidents.

Methods Questionnaires were distributed to radiographers in New South Wales, Australia. The sample group was originally obtained from the Australia Institute of Radiography then the University of Sydney's NSW clinical database. The questions asked related to violence towards radiographers – experienced or observed, triggers for the violence and responses to the events.

Results The survey responses allowed the identification of violence into various categories. To determine the cause of violence (these responses were placed into two groups: patient related and employer related); to establish how the radiographer/management handle these incidents. The most frequent type of violence by the patient and or relatives/friends towards radiographers was verbal abuse, followed by threats of physical aggression.

Conclusions The best way for the radiographer to deal with violence is to remain calm yet assertive, by taking control and reasoning with the patient.
The use of whole body magnetic resonance imaging in detecting bone marrow disorders – a valid alternative to imaging modalities that utilise ionising radiation
Authors: Hansen Susanne S
Published: October 2013

Imaging modalities for investigation of bone marrow abnormalities have traditionally involved the use of ionising radiation. Now magnetic resonance imaging (MRI) offers an alternative to x‐rays, computer tomography (CT), nuclear medicine bone scans and bone mineral densitometry.

This study attempts to evaluate the sensitivity and specificity of whole body MRI in detecting bone marrow abnormalities, using T1 and short tau inversion recovery (STIR) weighted sequences. This was achieved by reviewing already acquired scan data to discover whether this method is more sensitive to marrow changes than conventional radiographic skeletal surveys and other imaging tests, involving ionising radiation.

The study involved 10 adult participants all of whom suffered from heamatological malignancies, including multiple myeloma, plasma cell dyscrasia, non‐Hodgkin's lymphoma and acute lymphocytic leukaemia. Most of the study group presented with multiple myeloma. Abnormal skeletal MRI findings were reported in nine out of the 10 participants, i.e., a positive detection rate of 90%, using whole body MRI. All participants in the study who suffered from multiple myeloma or plasma cell dyscrasia showed positive MRI findings regardless of the stage of their disease. Four already had a confirmed diagnosis prior to the MRI scan, which was either visible on x‐ray or bone scintigraphy. Three participants had positive serum/urine tests, but negative radiographic findings. The study therefore established that, when investigating possible marrow disorders, MRI was more sensitive to changes in the bone‐marrow producing part of the skeleton and that MRI therefore must be considered a more suitable imaging tool.
Uncovering the causes of unnecessary repeated medical imaging examinations, or part of, in two hospital departments
Authors: Nol James , Isouard Godfrey , Mirecki Jerzy
Published: October 2013

A study was undertaken to identify the causes of unnecessary repeated medical imaging examinations. The repeat analysis study investigated repeated medical imaging examinations at two medium sized hospitals in Sydney, Australia. The analytical part of the study was conducted jointly by a radiologist and a radiographer. Overall there were 9.3% and 7.2% of total films repeated respectively at the two hospital sites. Unnecessary repeats were found to have been caused by numerous factors including: poor technical judgement, the adoption of unconventional techniques, non availability of radiologist for advice, patient movement or motion, equipment mishandling, disorganised practice and poor supervision of students. At both of the sites, senior radiographers were associated with 70.2% and 84.5% respectively of dark and light film errors, and 59.7% and 85.5% respectively of the repeated cases had students' involvement. On the other hand, junior radiographers were involved with 70.3% and 86.1 % respectively of positioning errors.

It was recommended that major changes be introduced to radiographer practice including, quality control, radiological techniques, training, supervision and continuing professional development. It was also recommended that the radiologist takes a more active role in future guidance and training of radiographers.
Minimising the risk: reducing breast tissue dose in an adolescent female
Authors: Thompson Ann L , Teo Aimee , Ungureanu Elena , Wolf M , Wirth Andrew
Published: October 2013

Breast cancer is amongst the leading radiation‐associated, second malignancies that develop in patients after treatment for Hodgkin's disease. This risk is affected by two main factors:

The age of the patient at the time of radiotherapy; and

The dose received by the breast tissue

The adolescent female thus faces an exceptionally high risk, as breast tissue at this age is undergoing rapid developmental growth and small doses of radiation exposure could be carcinogenic. This case report of a fifteen‐year‐old girl who received radiotherapy for Hodgkin's disease demonstrates how radiation therapists worked together with the radiation oncologists and medical physicists to provide an optimal treatment plan for a high‐risk patient.
Diagnostic value of non‐invasive imaging techniques in the detection of carotid artery stenosis: a systematic review
Authors: Al Shuhaimy A , Ababtain K , Sun Z
Published: October 2013

The purpose of the study was to evaluate the diagnostic performance of non‐invasive imaging methods of detecting carotid artery stenosis in comparison to digital subtraction angiography (DSA) by undertaking a systematic review of the literature. The non‐invasive methods reviewed include multi‐slice computed tomography (MSCT) angiography, duplex ultrasound (US) and magnetic resonance (MR) angiography.

A search of medical databases (PubMed, Medline, ScienceDirect, ProQuest) of the English literature was performed and 22 studies with 68 comparisons were found to meet the selection criteria and included in our study. Five studies were performed with MSCT angiography, 11 with duplex US and 13 with MR angiography. Both duplex US and MR angiography were studied in seven out of 24 US and MR studies. The diagnostic value of each imaging modality was reviewed in terms of the sensitivity and specificity compared to DSA, which is regarded as the standard method.

The mean sensitivity and specificity for MSCT angiography, duplex US and MR angiography were 88% (95% CI; 83%–92%) and 90% (95% CI; 85%–94%), 88% (95% CI; 81%–94%) and 89% (95% CI; 85%–94%), 94% (95% CI; 90%–97%) and 89% (95% CI; 85%–92%), respectively based on overall assessment. The evaluation showed that contrast‐enhanced MR angiography has high diagnostic value for detection of more than 50% stenosis of carotid artery stenosis with mean sensitivity and specificity being 95% (95% CI; 92%–98%) and 91% (95% CI; 86%–95%). When assessment was based on a combination of MR angiography and duplex US, the sensitivity reached the highest value of 98% (95% CI; 96%–100%). This analysis indicates that MR angiography, especially contrast‐enhanced MR angiography could be used as a reliable alternative modality to DSA in the detection of carotid artery stenosis.
Avenues for role expansion in image guided radiation therapy: discussion and recommendations for kilovoltage and megavoltage imaging
Authors: Burow R , Cavenagh J , Simpson C , West M , Cox J , Szymura K
Published: October 2013

Recent advances in imaging modalities within radiation therapy departments have the capability to initiate differing roles for radiation therapists. This has the potential to considerably improve the knowledge base and clinical skills of radiation therapists, while also enhancing the relationship between the allied health and medical professions. In addition, the quality of patient care may be improved while reducing the workload of oncologists. This article aims to discuss possible links between role expansion and image guided radiation therapy (IGRT) and avenues where this may be possible in modern radiotherapy departments. The work focuses on kilovoltage (kV) and megavoltage (MV) imaging modalities and their use in IGRT processes – primarily at treatment delivery. A literature review was conducted and knowledge gathered based on clinical experience at a number of departments across New South Wales and Queensland, Australia with the literature discussed framed by the authors' clinical learning and experiences. It was found that information is available supporting role expansion and IGRT separately; however, there is no direct correlation of information between these two subject areas across the current Australian or international spectra. Role expansion for radiation therapists must be accompanied by a clear definition of redeveloped roles and responsibilities in order to avoid confusion between oncologists and therapists. The authors recommend funding as vital to ensure adequate education and standardised training intra and inter departments. Ultimately, the development of radiation therapists into IGRT specialists may involve exclusively in imaging planning and treatment aspects.
Continuing Professional Development: the perceptions of radiographers in New South Wales
Authors: Lee SHE , Reed W , Poulos A
Published: October 2013

Purpose: The Australian Institute of Radiography's (AIR) Continuing Professional Development (CPD) programme provides activities for radiographers, radiation therapists and sonographers. This article aims to investigate the perceptions of radiographers in New South Wales (NSW) of the current AIR CPD programme. Methods: 400 questionnaires were distributed within NSW. The questionnaire was designed to investigate the perceptions of radiographers concerning CPD using five themes: motivation for CPD participation; appropriateness of activities; constraints experienced; effectiveness of programme; and mandatory CPD. Results: One hundred and eight‐eight questionnaires (47%) were returned. A total of 68% (n = 127) of the participants were participating in CPD activities. The participants were most motivated by gaining knowledge through CPD. A total of 80% (n = 151) of the participants considered the activities listed in the Credit Recognition Framework to be adequate. The main constraint experienced by the radiographers in the rural setting was the lack of access to CPD activities, while in the metropolitan area, it was lack of time. A total of 59% (n = 111) of the participants commented that the current AIR CPD programme is an effective programme and 66% (n = 125) of the participants stated that CPD should be voluntary for all radiographers. Conclusion: Overall, radiographers identified the strengths and weaknesses of the AIR CPD programme. They were motivated to engage in CPD. This study also highlighted the constraints experienced, which need to be addressed to encourage more participation in the CPD programme.
Uniformity in the analysis of head and neck image guided radiotherapy across multiple departments
Authors: Devereux B , Sisson T , Fenton P , Bradford C , Ambler A , Plank A , Middleton M
Published: October 2013

Purpose: Head and Neck Image Guided Radiation Therapy (IGRT) is of vital importance particularly with the advent of Intensity Modulated Radiation Therapy (IMRT). The responsibility of IGRT rests with the treating radiation therapy team, therefore it is essential that they undertake IGRT in a uniform manner. This study represents an assessment of head and neck IGRT analysis across multiple radiation oncology departments, inclusive of radiation therapist seniority, image modality and anatomical variation within the treatment volume. Methods: Site visits were undertaken at three radiation oncology departments. At each site kV and MV image datasets were analysed by one senior radiation therapist and one junior radiation therapist. The influence of differing sites, radiation therapist seniority, image modality and cervical vertebra position on head and neck IGRT was then assessed. Results: Statistical analysis of the diagnosed field placement errors indicated that head and neck IGRT was undertaken consistently regardless of site, radiation therapist seniority, image modality and the position of the cervical vertebra. Conclusion: In the era of sophisticated treatment planning it is vital that the treatment delivery mechanism (IGRT) is performed consistently. Head and neck IGRT is the responsibility of the treating radiation therapist regardless of site, seniority, image modality and positioning challenges.
Stereotactic body radiation therapy: an emerging technique for prostate cancer treatment
Authors: Davenport S L A , King S , Giles E , Potter A
Published: October 2013

Purpose: Stereotactic Body Radiation Therapy (SBRT) is treatment using stereotactic techniques outside of the brain. SBRT involves accurate delivery of an extremely hypofractionated treatment which should be beneficial for tumours with a low α/β ratio. The focus of the review is on low risk localised prostate cancer due to the low α/β ratio and lack of research into the region. This will help to determine if further research into SBRT for prostate cancer is warranted. Methods: A review of the literature was performed to discover the history and current use of SBRT for various body sites. Results: SBRT has been investigated for lung and liver cancers with studies finding toxicity and survival outcomes equivalent to conventional radiation therapy. Research into the use of SBRT in other body sites has also been conducted. However, short follow up times, small patient populations and lack of randomised trials mean the results are not of the highest reliability. The same limitations are true of studies examining SBRT for prostate cancer. Despite these limitations, positive acute toxicity and survival outcomes were observed across five studies into SBRT for prostate cancer. Conclusion: There has been no published study into the use of SBRT for prostate cancer within Australia. Theoretical modelling suggests prostate cancer will respond well to the hypofractionated treatment provided by SBRT. Good clinical outcomes with reduced treatment times are possible with SBRT making it a more convenient treatment option for the patient. SBRT also allows greater patient throughput in radiation oncology departments.