bluuebunny/crossref_metadata_2025_split huggingface dataset:
Commissioning and initial experience with the first clinical gantry‐mounted proton therapy system
Authors: Zhao Tianyu , Sun Baozhou , Grantham Kevin , Rankine Leith , Cai Bin , Goddu Sreekrishna M. , Santanam Lakshmi , Knutson Nels , Zhang Tiezhi , Reilly Michael , Bottani Beth , Bradley Jeffrey , Mutic Sasa , Klein Eric E. 
Published: February 2017

The purpose of this study is to describe the comprehensive commissioning process and initial clinical experience of the Mevion S250 proton therapy system, a gantry‐mounted, single‐room proton therapy platform clinically implemented in the S. Lee Kling Proton Therapy Center at Barnes‐Jewish Hospital in St. Louis, MO, USA. The Mevion S250 system integrates a compact synchrocyclotron with a C‐inner gantry, an image guidance system and a 6D robotic couch into a beam delivery platform. We present our commissioning process and initial clinical experience, including i) CT calibration; ii) beam data acquisition and machine characteristics; iii) dosimetric commissioning of the treatment planning system; iv) validation through the Imaging and Radiation Oncology Core credentialing process, including irradiations on the spine, prostate, brain, and lung phantoms; v) evaluation of localization accuracy of the image guidance system; and vi) initial clinical experience. Clinically, the system operates well and has provided an excellent platform for the treatment of diseases with protons.PACS number(s): 87.55.ne, 87.56.bd
Evaluation of the ΔV 4D CT ventilation calculation method usingin vivoxenon CT ventilation data and comparison to other methods
Authors: Zhang Geoffrey G. , Latifi Kujtim , Du Kaifang , Reinhardt Joseph M. , Christensen Gary E. , Ding Kai , Feygelman Vladimir , Moros Eduardo G. 
Published: February 2017

Ventilation distribution calculation using 4D CT has shown promising potential in several clinical applications. This study evaluated the direct geometric ventilation calculation method, namely the ΔV method, with xenon‐enhanced CT (XeCT) ventilation data from four sheep, and compared it with two other published methods, the Jacobian and the Hounsfield unit (HU) methods. Spearman correlation coefficient (SCC) and Dice similarity coefficient (DSC) were used for the evaluation and comparison. The average SCC with one standard deviation waswith a range between 0.29 and 0.61 between the XeCT and DLV ventilation distributions. The average DSC value for lower 30% ventilation volumes between the XeCT and ΔV ventilation distributions waswith a range between 0.48 and 0.63. Ventilation difference introduced by deformable image registration errors improved with smoothing. In conclusion, ventilation distributions generated using ΔV‐4D CT and deformable image registration are in reasonably agreement with thein vivoXeCT measured ventilation distribution.PACS number(s): 87.57.N‐,87.57.nj, 87.57.Q‐, 87.85.Pq
Improved setup and positioning accuracy using a three‐point customized cushion/mask/bite‐block immobilization system for stereotactic reirradiation of head and neck cancer
Authors: Wang He , Wang Congjun , Tung Samuel , Dimmitt Andrew Wilson , Wong Pei Fong , Edson Mark A. , Garden Adam S. , Rosenthal David I. , Fuller Clifton D. , Gunn Gary B. , Takiar Vinita , Wang Xin A. , Luo Dershan , Yang James N. , Wong Jennifer , Phan Jack 
Published: February 2017

The purpose of this study was to investigate the setup and positioning uncertainty of a custom cushion/mask/bite‐block (CMB) immobilization system and determine PTV margin for image‐guided head and neck stereotactic ablative radiotherapy (HN‐SABR). We analyzed 105 treatment sessions among 21 patients treated with HN‐SABR for recurrent head and neck cancers using a custom CMB immobilization system. Initial patient setup was performed using the ExacTrac infrared (IR) tracking system and initial setup errors were based on comparison of ExacTrac IR tracking system to corrected online ExacTrac X‐rays images registered to treatment plans. Residual setup errors were determined using repeat verification X‐ray. The online ExacTrac corrections were compared to cone‐beam CT (CBCT) before treatment to assess agreement. Intrafractional positioning errors were determined using prebeam X‐rays. The systematic and random errors were analyzed. The initial translational setup errors were , , and in AP, CC, and LR directions, respectively, with a three‐dimensional (3D) vector of . The initial rotational errors were up to 2.4° if 6D couch is not available. CBCT agreed with ExacTrac X‐ray images to within 2 mm and 2.5°. The intrafractional uncertainties were , , and in AP, CC, and LR directions, respectively, and , , and in yaw, roll, and pitch direction, respectively. The translational vector was . The calculated PTV margins were within 1.6 mm when using image guidance for online setup correction. The use of image guidance for online setup correction, in combination with our customized CMB device, highly restricted target motion during treatments and provided robust immobilization to ensure minimum dose of 95% to target volume with 2.0 mm PTV margin for HN‐SABR.PACS number(s): 87.55.ne
Initial evaluation of automated treatment planning software
Authors: Gintz Dawn , Latifi Kujtim , Caudell Jimmy , Nelms Benjamin , Zhang Geoffrey , Moros Eduardo , Feygelman Vladimir 
Published: February 2017

Even with advanced inverse‐planning techniques, radiation treatment plan optimization remains a very time‐consuming task with great output variability, which prompted the development of more automated approaches. One commercially available technique mimics the actions of experienced human operators to progressively guide the traditional optimization process with automatically created regions of interest and associated dose‐volume objectives. We report on the initial evaluation of this algorithm on 10 challenging cases of locoreginally advanced head and neck cancer. All patients were treated with VMAT to 70 Gy to the gross disease and 56 Gy to the elective bilateral nodes. The results of post‐treatment autoplanning (AP) were compared to the original human‐driven plans (HDP). We used an objective scoring system based on defining a collection of specific dosimetric metrics and corresponding numeric score functions for each. Five AP techniques with different input dose goals were applied to all patients. The best of them averaged the composite score 8% lower than the HDP, across the patient population. The difference in median values was statistically significant at the 95% confidence level (Wilcoxon paired signed‐rank test ). This result reflects the premium the institution places on dose homogeneity, which was consistently higher with the HDPs. The OAR sparing was consistently better with the APs, the differences reaching statistical significance for the mean doses to the parotid glands () and the inferior pharyngeal constrictor (), as well as for the maximum doses to the spinal cord () and brainstem (). If one is prepared to accept less stringent dose homogeneity criteria from the RTOG 1016 protocol, nine APs would comply with the protocol, while providing lower OAR doses than the HDPs. Overall, AP is a promising clinical tool, but it could benefit from a better process for shifting the balance between the target dose coverage/homogeneity and OAR sparing.PACS number(s): 87.55.D
Validation of total skin electron irradiation (TSEI) technique dosimetry data by Monte Carlo simulation
Authors: Nevelsky Alexander , Borzov Egor , Daniel Shahar , Bar‐Deroma Raquel 
Published: February 2017

Total skin electron irradiation (TSEI) is a complex technique which requires many nonstandard measurements and dosimetric procedures. The purpose of this work was to validate measured dosimetry data by Monte Carlo (MC) simulations using EGSnrc‐based codes (BEAMnrc and DOSXYZnrc). Our MC simulations consisted of two major steps. In the first step, the incident electron beam parameters (energy spectrum, FWHM, mean angular spread) were adjusted to match the measured data (PDD and profile) at for an open field. In the second step, these parameters were used to calculate dose distributions at the treatment distance of 400 cm. MC simulations of dose distributions from single and dual fields at the treatment distance were performed in a water phantom. Dose distribution from the full treatment with six dual fields was simulated in a CT‐based anthropomorphic phantom. MC calculations were compared to the available set of measurements used in clinical practice. For one direct field, MC calculated PDDs agreed within 3%/1 mm with the measurements, and lateral profiles agreed within 3% with the measured data. For the OF, the measured and calculated results were within 2% agreement. The optimal angle of 17° was confirmed for the dual field setup. Dose distribution from the full treatment with six dual fields was simulated in a CT‐based anthropomorphic phantom. The MC‐calculated multiplication factor (B12‐factor), which relates the skin dose for the whole treatment to the dose from one calibration field, for setups with and without degrader was 2.9 and 2.8, respectively. The measured B12‐factor was 2.8 for both setups. The difference between calculated and measured values was within 3.5%. It was found that a degrader provides more homogeneous dose distribution. The measured X‐ray contamination for the full treatment was 0.4%; this is compared to the 0.5% X‐ray contamination obtained with the MC calculation. Feasibility of MC simulation in an anthropomorphic phantom for a full TSEI treatment was proved and is reported for the first time in the literature. The results of our MC calculations were found to be in general agreement with the measurements, providing a promising tool for further studies of dose distribution calculations in TSEI.PACS number(s): 87.10. Rt, 87.55.K, 87.55.ne
Dosimetric comparison between cone/Iris‐based and InCise MLC‐based CyberKnife plans for single and multiple brain metastases
Authors: Jang Si Young , Lalonde Ron , Ozhasoglu Cihat , Burton Steven , Heron Dwight , Huq M. Saiful 
Published: February 2017

We performed an evaluation of the CyberKnife InCise MLC by comparing plan qualities for single and multiple brain lesions generated using the first version of InCise MLC, fixed cone, and Iris collimators. We also investigated differences in delivery efficiency among the three collimators. Twenty‐four patients with single or multiple brain mets treated previously in our clinic on a CyberKnife M6 using cone/Iris collimators were selected for this study. Treatment plans were generated for all lesions using the InCise MLC. Number of monitor units, delivery time, target coverage, conformity index, and dose falloff were compared between MLC‐ and clinical cone/Iris‐based plans. Statistical analysis was performed using the nonparametric Wilcoxon‐Mann‐Whitney signed‐rank test. The planning accuracy of the MLC‐based plans was validated using chamber and film measurements. The InCise MLC‐based plans achieved mean dose and target coverage comparable to the cone/Iris‐based plans. Although the conformity indices of the MLC‐based plans were slightly higher than those of the cone/Iris‐based plans, beam delivery time for the MLC‐based plans was shorter by . For smaller targets or cases with OARs located close to or abutting target volumes, MLC‐based plans provided inferior dose conformity compared to cone/Iris‐based plans. The QA results of MLC‐based plans were within 5% absolute dose difference with over 90% gamma passing rate using gamma criteria. The first version of InCise MLC could be a useful delivery modality, especially for clinical situations for which delivery time is a limiting factor or for multitarget cases.PACS number(s): 87.53.Ly, 87.55.D‐
Characterization of a 2.5 MV inline portal imaging beam
Authors: Gräfe James L. , Owen Jennifer , Eduardo Villarreal‐Barajas J. , Khan Rao F.H. 
Published: February 2017

A new megavoltage (MV) energy was recently introduced on Varian TrueBeam linear accelerators for imaging applications. This work describes the experimental characterization of a 2.5 MV inline portal imaging beam for commissioning, routine clinical use, and quality assurance purposes. The beam quality of the 2.5 MV beam was determined by measuring a percent depth dose, PDD, in water phantom for field at source‐to‐surface distance 100 cm with a CC13 ion chamber, plane parallel Markus chamber, and GafChromic EBT3 film. Absolute dosimetric output calibration of the beam was performed using a traceable calibrated ionization chamber, following the AAPM Task Group 51 procedure. EBT3 film measurements were also performed to measure entrance dose. The output stability of the imaging beam was monitored for five months. Coincidence of 2.5 MV imaging beam with 6 MV therapy beam was verified with hidden‐target cubic phantom. Image quality was studied using the Leeds and QC3 phantom. The depth of maximum dose, , and percent dose at 10 cm depth were, respectively, 5.7 mm and 51.7% for CC13, 6.1 mm and 51.9% for Markus chamber, and 5.1 mm and 51.9% for EBT3 film. The 2.5 MV beam quality is slightly inferior to that of a teletherapy beam; however, an estimated of 1.00 was used for output calibration purposes. The beam output was found to be stable to within 1% over a five‐month period. The relative entrance dose as measured with EBT3 films was 63%, compared to 23% for a clinical 6 MV beam for a field. Overall coincidence of the 2.5 MV imaging beam with the 6 MV clinical therapy beam was within 0.2 mm. Image quality results for two commonly used imaging phantoms were superior for the 2.5 MV beam when compared to the conventional 6 MV beam. The results from measurements on two TrueBeam accelerators show that 2.5 MV imaging beam is slightly softer than a therapeutic beam, it provides superior image quality than a 6 MV therapy beam, and has excellent output stability. These 2.5 MV beam characterization results can serve as reference for clinics planning to commission and use this novel energy‐image modality.PACS number(s): 87.57.‐s, 87.59.‐e, 06.20.fb, 87.53.Bn
Factors Influencing Tuberculosis Treatment Outcome in Adult Patients Treated with Thrice-Weekly Regimens in India
Authors: Ramachandran Geetha , Agibothu Kupparam Hemanth Kumar , Vedhachalam Chandrasekaran , Thiruvengadam Kannan , Rajagandhi Vijayalakshmi , Dusthackeer Azger , Karunaianantham Ramesh , Jayapal Lavanya , Swaminathan Soumya 
Published: February 2017

ABSTRACT

The Indian Revised National Tuberculosis (TB) Control Programme uses thrice-weekly treatment with standard drug dosages. The role of plasma drug levels and other factors in determining TB treatment outcomes is not well understood. We aimed to determine the factors influencing the concentrations of rifampin (RMP), isoniazid (INH), and pyrazinamide (PZA) at 2 h postdosing in adult TB patients and to study the factors impacting TB treatment outcome. We recruited 1,912 adult TB patients (newly treated and retreated patients) with pulmonary/extrapulmonary TB receiving antitubercular treatment (ATT) in the RNTCP in Chennai, India. At steady state, the concentrations of RMP, INH, and PZA were determined at 2 h postdosing after supervised drug administration. A total of 1,648 patients had a favorable outcome, while 264 (14%) had an unfavorable outcome. A total of 91%, 16%, and 17% of the patients had suboptimal concentrations of RMP (<8 μg/ml), INH (<3 μg/ml), and PZA (<20 μg/ml), respectively. Factors associated with treatment outcome were low RMP concentrations (adjusted odds ratio [aOR], 0.94; 95% confidence interval [CI], 0.89 to 0.99;
P
= 0.036), category II ATT (aOR, 2.39; 95% CI, 1.56 to 3.65;
P
< 0.001), low body weight (aOR, 0.96; 95% CI, 0.94 to 0.98;
P
< 0.001), alcohol use (aOR, 2.17; 95% CI, 1.42 to 3.31;
P
< 0.001), male gender (aOR, 1.92; 95% CI, 1.02 to 3.62;
P
= 0.043), and baseline INH resistance (aOR, 5.74; 95% CI, 3.12 to 10.59;
P
< 0.001), which significantly increased the likelihood of an unfavorable outcome in multivariate logistic regression analysis. Further studies are needed to optimize anti-TB drug dosages and improve cure rates. Drug susceptibility testing at the baseline and attention to undernutrition and alcohol dependence are other important interventions.
Role of Periostin in Early Brain Injury After Subarachnoid Hemorrhage in Mice
Authors: Liu Lei , Kawakita Fumihiro , Fujimoto Masashi , Nakano Fumi , Imanaka-Yoshida Kyoko , Yoshida Toshimichi , Suzuki Hidenori 
Published: February 2017

Background and Purpose—
A matricellular protein tenascin-C is implicated in early brain injury after experimental subarachnoid hemorrhage (SAH). This study first evaluated the role of another matricellular protein periostin and the relationships with tenascin-C in post-SAH early brain injury.

Methods—
Wild-type (n=226) and tenascin-C knockout (n=9) C57BL/6 male adult mice underwent sham or filament perforation SAH modeling. Vehicle, anti-periostin antibody, or recombinant periostin was randomly administrated by an intracerebroventricular injection at 30 minutes post-modeling. Neuroscores, SAH grading, brain water content, immunostaining, and Western blotting were blindly evaluated at 24 to 48 hours post-SAH.

Results—
Periostin was induced in brain capillary endothelial cells and neurons at 24 hours post-SAH. Anti-periostin antibody improved post-SAH neurobehavior, brain edema, and blood–brain barrier disruption associated with downregulation of tenascin-C, inactivation of p38, extracellular signal-related kinase 1/2 and matrix metalloproteinase-9, and subsequent preservation of zona occludens-1. Recombinant periostin aggravated post-SAH brain edema and tenascin-C induction. Tenascin-C knockout prevented post-SAH neurobehavioral impairments and periostin induction.

Conclusions—
Periostin may cause post-SAH early brain injury through activating downstream signaling pathways and interacting with tenascin-C, providing a novel approach for the treatment of early brain injury.
The Role of NR2B-CREB-miR212/132-CRTC1-CREB Signal Network in Pain Regulation In Vitro and In Vivo
Authors: Xia Tianjiao , Chu Shuaishuai , Cui Yin , Xu Fangxia , Liu Yue , Song Jia , Qian Yue , Shao Xueming , Li Xiuxiu , Gu Xiaoping , Ma Zhengliang 
Published: February 2017

BACKGROUND:
Chronic pain is a debilitating threat to human health, and its molecular mechanism remains undefined. Previous studies have illustrated a key role of cAMP response element-binding protein (CREB) in pain regulation; CREB-regulated transcription coactivator 1 (CRTC1) and microRNA212/132 (miR212/132) are also vital in synaptic plasticity. However, little is known about the interaction among these factors in pain condition. We conducted this experiment mainly to determine the crosstalk between CREB, CRTC1, and miR212/132 in vitro. Moreover, we explored the changes in hyperalgesia on chronic constrictive injury (CCI) mouse in vivo when given CREB-related adenovirus vectors, CRTC1-related adenovirus vectors, and miR212/132-locked nucleic acid (LNA).

METHODS:
We cultured primary neurons in the spinal cord of mouse embryos. Exogenous glutamate was added to cultured neurons to simulate in vivo pain process. Real-time quantitative polymerase chain reaction was used to determine changes of NR2B, CRTC1, CREB, and miR212/132 at the mRNA level; Western blot was used to detect p-NR2B, p-CREB, and CRTC1 at protein level. Von Frey cilia were used to study mechanical hyperalgesia in a murine model of CCI. CREB-miR (adenovirus vector interfering CREB gene), CREB-AD (adenovirus vector overexpressing CREB gene); CRTC1-miR (adenovirus vector interfering CRTC1 gene), CRTC1-AD (adenovirus vector overexpressing CRTC1 gene), and miR212/132-LNA were injected intrathecally.

RESULTS:
In vitro, 100 μmol/L glutamate induced p-CREB and miR212/132-LNA. CRTC1 protein was downregulated by CREB-miR and miR212/132-LNA. CRTC1 mRNA was upregulated by CREB-AD and downregulated by CREB-miR and miR212-LNA. P-CREB was upregulated by CRTC1-AD and downregulated by miR212/132. CREB mRNA was upregulated by CRTC1-AD and downregulated by CRTC1-miR. MiR212/132 was upregulated by CRTC1-AD and CREB-AD; downregulated by CREB-miR. In vivo, CRTC1-miR, CREB-miR, and miR212/132-LNA increased paw withdrawal mechanical threshold in various degrees.

CONCLUSIONS:
The NR2B-CREB-miR212/132-CRTC1-CREB signal network plays an important role in the regulation of pain. Intervening with any molecule in this signal network would reduce pain perception.
Processing and properties of high-purity micro-lamellate (NH4)2RuCl6 particles
Authors: Xin Zena , Zhao Panchao , Chen Jialin , Ma Yaohong , Xu Ying , Cui Hao , Yi Wei 
Published: February 2017

Abstract(NH4)2RuCl6is an important precursor in the synthesis of Ru powder with high-purity requirement. In this study, high-purity (>99.999 wt%) micro-sized (NH4)2RuCl6pieces were synthesized by distillation and precipitation from crude Ru powder. Then, the thermal decomposition behavior of the (NH4)2RuCl6pieces was investigated. The decomposition process included two stages. First, (NH4)2RuCl6was decomposed from 255.0°C to 314.0°C, with the endothermic peak located at 309.4°C. At this stage, HCl and NH3were released, while the dense micro-pieces were transformed to loosened micro-pieces due to the thermal decomposition. Then, the solid phase [(NH3)4Ru3Cl12] kept decomposing from 314.0°C to 352.7°C, HCl and N2were released, and agglomerated Ru particles were achieved. Thermogravimetric analysis-differential thermal analysis-mass spectrum coupling (TG-DTA-MS) was used to monitor the thermal decomposition process and identify the released gaseous phases, respectively. The solid phases in different stages were characterized by high-temperature X-ray diffraction (HTXRD). A good understanding of the processing and thermal decomposition of (NH4)2RuCl6is crucial in the creation of Ru products.
The Influence of “Super-Diversity” on Pre-service Teachers’ Sensitivity to Cultural Issues
Authors: Wyatt Tasha R. 
Published: February 2017

Abstract
While many teachers in American pre-service programs struggle to develop experience and awareness of multicultural issues (Sleeter, 2001, Preparing teachers for culturally diverse schools: Research and the overwhelming presence of Whiteness. Journal of teacher education, 52(2), 94–106. doi:10.1177/0022487101052002002), there is a modicum of evidence to suggest that today’s college students are ahead of their predecessors in preparing for multicultural teaching. This study analyzes how seven pre-service teachers made sense of their students’ cultural struggles as they authored multicultural literature written for children in Hawai‘i. The results indicate teachers used their own experiences to make sense of students’ cultural struggles and when they could not find commonality, they engaged in ethnographic research. The results have implications for preparing millennial teachers and calls for rethinking the standard curriculum in preparing teachers for multicultural teaching.
Superstructure formation in PrNi2Al3 and ErPd2Al3
Authors: Eustermann Fabian , Hoffmann Rolf-Dieter , Janka Oliver 
Published: February 2017

Abstract
The intermetallic phase ErPd2Al3 was obtained by arc-melting of the elements and subsequent annealing for crystal growth. The sample was studied by X-ray diffraction on powders and single crystals. The structure of ErPd2Al3 was refined from X-ray diffraction data and revealed a superstructure of PrNi2Al3 – a CaCu5 derivative (P6/m, a=1414.3(1), c=418.87(3) pm wR=0.0820, 1060 F
2 values, 48 variables. The same superstructure was subsequently found for PrNi2Al3 (P6/m, a=1407.87(4), c=406.19(2) pm, wR=0.0499, 904 F
2 values, 47 variables). In the crystal structure, the aluminium and transition metal atoms form a polyanionic network according to [T
2Al3]
δ−

, while rare earth atoms fill cavities within the networks. They are coordinated by six transition metal and twelve aluminum atoms. In contrast to the PrNi2Al3 type structure reported so far, two crystallographic independent rare-earth sites are found of which one (1b) is shifted by 1/2 z, causing a distortion in the structure along with a recoloring of the T and Al atoms in the network.