bluuebunny/crossref_metadata_2025_split huggingface dataset:
Poster ‐ 35: Monitoring patient positioning during deep inspiration breath hold with a distance measuring laser
Authors: Weston Mark , Juhasz Janos 
Published: August 2016

Purpose:The accuracy of treatment delivery for left breast/chest wall patients using deep inspiration breath hold (DIBH) is being monitored using a distance measuring laser (DML)Methods:A commercially available DML (DLS‐C15, Dimetix) was mounted behind a Varian TrilogyTM linac. Relative to the machine isocenter, the laser from the beam was offset by 8 cm to the left and by 1 cm in the superior direction. This position was selected because this point is situated on the sternum for the majority of the left breast/chest‐wall patients treated at our institution.The Varian Real‐Time Positioning Management™ (RPM) guided DIBH treatments at our institution is delivered by placing the system's tracking block on the patient's abdomen. The treatment beam is enabled only when the block is in between a predefined abdomen motion range as determined during the CT simulation process. A LabVIEW program was developed to record both beam status (i.e. on/off) and distance measurements. In this study the DML was only used to monitor the position of a single point on the chest and no clinical decisions/adjustments were made based on these measurements.Results and Conclusions:Thus far, 34 fractions have been recorded for 4 patients. As such, the performance of our DIBH treatment technique cannot be fairly evaluated at this point. However, deviations between expected and measured distances have been observed and if these are found to be reproducible, then modifications in our treatment procedures and policies will have to take place.
Poster – 39: Using Optical Scanner and 3D Printer Technology to Create Lead Shielding for Radiotherapy of Facial Skin Cancer with Low Energy Photons
Authors: Rickey Daniel , Leylek Ahmet , Dubey Arbind , Sasaki David , Harris Chad , Butler Jim , Sharma Ankur , McCurdy Boyd , Alpuche Aviles Jorge E. 
Published: August 2016

Purpose:Treatment of skin cancers of the face using orthovoltage radiotherapy often requires lead shielding. However, creating a lead shield can be difficult because the face has complex and intricate contours. The traditional process involved creating a plaster mould of the patient's face can be difficult for patients. Our goal was to develop an improved process by using an optical scanner and 3D printer technology.Methods:The oncologist defined the treatment field by drawing on each patient's skin. Three‐dimensional images were acquired using a consumer‐grade optical scanner. A 3D model of each patient's face was processed with mesh editing software before being printed on a 3D printer. Using a hammer, a 3 mm thick layer of lead was formed to closely fit the contours of the model. A hole was then cut out to define the field.Results:The lead shields created were remarkably accurate and fit the contours of the patients. The hole defining the field exposed only a minimally sized site to be exposed to radiation, while the rest of the face was protected. It was easy to obtain perfect symmetry for the definition of parallel opposed beams.Conclusion:We are routinely using this technique to build lead shielding that wraps around the patient as an alternative to cut‐outs. We also use it for treatment of the tip of the nose using a parallel opposed pair beams with a wax nose block. We found this technique allows more accurate delineation of the cut‐out and a more reproducible set‐up.
Poster ‐ 42: TB ‐ ARC: A Total Body photon ARC technique using a commercially available linac
Authors: Evans Michael D. C. , Ruo Russell , Patrocinio Horacio J. , Poon Emily , Freeman Carolyn , Hijal Tarek , Parker William 
Published: August 2016

We have developed a total body photon irradiation technique using multiple overlapping open field arcs (TB‐ARC). This simple technique uses predetermined arc‐weights, with MUs calculated as a function of prescription depth only. Patients lie on a stretcher, in the prone/supine treatment position with AP/PA arcs. This treatment position has many advantages including ease of delivery (especially for tall, pediatric or compromised patients), dose uniformity, simplicity for organ shielding, and imaging capabilities.Using a Varian TrueBeam linac, 14 arcs using 40×40 cm2 6 MV open photon beams, sweeping across 10 degrees each, complete a 140 degree arc. The nominal SSD at zero degrees is 200 cm. Arcs at the sweep limits (+/− 70 degrees) are differentially weighted and deliver a dose within 10% of the prescription on central axis, at a depth of 10 cm over a superior‐inferior length of 275 cm.CT planning using Varian Eclipse enables dose evaluation. A custom made beam spoiler, consisting of a 2.5 m sheet of polycarbonate (6 mm thick) increases the surface dose from 45% to 90%. This beam spoiler also serves as a support in the event that differential attenuation is required for organs such as lung, heart, liver, kidneys. The geometry of the sweeping beam technique limits organ dose (using varying thicknesses of melting alloy) to about 20% and 40% of prescription at dmax and midplane respectively. Digital imaging with a portable DR cassette enables proper attenuator location prior to treatment.
Sci‐Fri AM: MRI and Diagnostic Imaging ‐ 03: The influence of sampling percentage in deformable registration on kinetic model analysis results in DCE‐MRI of the breast
Authors: Mouawad Matthew , Biernaski Heather , Brackstone Muriel , Klassen Martyn , Lock Michael , Prato Frank S. , Thompson R. Terry , Gaede Stewart , Gelman Neil 
Published: August 2016

Purpose:Dynamic contrast enhanced (DCE) MRI is applied extensively for diagnosis and treatment monitoring of breast cancer. However, patient motion can introduce artificial variation in the signal enhancement curves. Non‐rigid registration can improve the curves but computation time can be long. Reducing the percentage of the image sampled (PS) can reduce time at the theoretical cost of registration accuracy. This work investigates the influence of PS on kinetic model analysis results and goodness‐of‐fit.Methods:DCE images were acquired using a 3T Siemens Biograph mMR. Deformable registration was performed on one patient dataset with 3Dslicer using PS values of 5, 20, and 100%. For three regions of interest within the tumor, tissue contrast agent concentration values versus time were generated and analyzed using the TOFTS pharmacokinetic model. Model parameters, their 95% confidence intervals and the coefficients of variation (CV), which served as a measure of goodness of fit, were recorded.Results:Computation time was approximately 16, 8, and 4 minutes/image for 100, 20, and 5 PS. The CV decreased following registration and there was a trend of decreasing CV with increasing PS. However, no differences in parameter values obtained with 100% PS and parameters values obtained with lower PS were observed. Substantial differences were found between parameter values obtained with versus without registrationConclusions:Increasing PS led to improved goodness‐of‐fit for the kinetic model analysis, at the expense of substantially increased computation time. However, this improved fit did not appear to influence parameter values for this patient.
Sci‐Fri PM: Radiation Therapy, Planning, Imaging, and Special Techniques ‐ 04: Assessment of intra‐fraction motion during lung SABR VMAT using a custom abdominal compression device
Authors: Hyde Derek , Robinson Mark , Araujo Cynthia , Teke Tony , Halperin Ross , Petrik David , Mou Benjamin , Mohamed Islam 
Published: August 2016

Purpose:Lung SABR patients are treated using Volumetrically Modulated Arc Therapy (VMAT), utilizing 2 arcs with Conebeam CT (CBCT) image‐guidance prior to each arc. Intra‐fraction imaging can prolong treatment time (up to 20%), and the aim of this study is to determine if it is necessary.Methods:We utilize an in‐house abdominal compression device to minimize respiratory motion, 4DCT to define the ITV, a 5 mm PTV margin and a 2–3 mm PRV margin. We treated 23 patients with VMAT, fifteen were treated to 48 Gy in 4 fractions, while eight were treated with up to 60 Gy in 8 fractions. Intrafraction motion was assessed by the translational errors recorded for the second CBCT.Results:There was no significant difference (t‐test, p=0.93) in the intra‐fraction motion between the patients treated with 4 and 8 fractions, or between the absolute translations in each direction (ANOVA, p=0.17). All 124 intra‐fraction CBCT images were analysed and 95% remained localized within the 5 mm PTV margin The mean magnitude of the vector displacement was 1.8 mm.Conclusions:For patients localized with an abdominal compression device, the intrafraction CBCT image may not be necessary, if it is only the tumor coverage that is of concern, as the patients are typically well within the 5 mm PTV margin. On the other hand, if there is a structure with a smaller PRV margin, an intrafraction CBCT is recommended to ensure that the dose limit for the organ at risk is not exceeded.
Detection of Anti-Hepatitis B Virus Drug Resistance Mutations Based on Multicolor Melting Curve Analysis
Authors: Mou Yi , Athar Muhammad Ammar , Wu Yuzhen , Xu Ye , Wu Jianhua , Xu Zhenxing , Hayder Zulfiqar , Khan Saeed , Idrees Muhammad , Nasir Muhammad Israr , Liao Yiqun , Li Qingge 
Published: August 2016

ABSTRACTDetection of anti-hepatitis B virus (HBV) drug resistance mutations is critical for therapeutic decisions for chronic hepatitis B virus infection. We describe a real-time PCR-based assay using multicolor melting curve analysis (MMCA) that could accurately detect 24 HBV nucleotide mutations at 10 amino acid positions in the reverse transcriptase region of the HBV polymerase gene. The two-reaction assay had a limit of detection of 5 copies per reaction and could detect a minor mutant population (5% of the total population) with the reverse transcriptase M204V amino acid mutation in the presence of the major wild-type population when the overall concentration was 104copies/μl. The assay could be finished within 3 h, and the cost of materials for each sample was less than $10. Clinical validation studies using three groups of samples from both nucleos(t)ide analog-treated and -untreated patients showed that the results for 99.3% (840/846) of the samples and 99.9% (8,454/8,460) of the amino acids were concordant with those of Sanger sequencing of the PCR amplicon from the HBV reverse transcriptase region (PCR Sanger sequencing). HBV DNA in six samples with mixed infections consisting of minor mutant subpopulations was undetected by the PCR Sanger sequencing method but was detected by MMCA, and the results were confirmed by coamplification at a lower denaturation temperature-PCR Sanger sequencing. Among the treated patients, 48.6% (103/212) harbored viruses that displayed lamivudine monoresistance, adefovir monoresistance, entecavir resistance, or lamivudine and adefovir resistance. Among the untreated patients, the Chinese group had more mutation-containing samples than did the Pakistani group (3.3% versus 0.56%). Because of its accuracy, rapidness, wide-range coverage, and cost-effectiveness, the real-time PCR assay could be a robust tool for the detection if anti-HBV drug resistance mutations in resource-limited countries.
Identification and Antifungal Susceptibility Profiles of Candida haemulonii Species Complex Clinical Isolates from a Multicenter Study in China
Authors: Hou Xin , Xiao Meng , Chen Sharon C.-A. , Wang He , Cheng Jing-Wei , Chen Xin-Xin , Xu Zhi-Peng , Fan Xin , Kong Fanrong , Xu Ying-Chun 
Published: August 2016

ABSTRACT

Candida haemulonii
complex (
Candida haemulonii
,
Candida haemulonii
var.
vulnera
, and
Candida duobushaemulonii
) consists of emerging pathogens. Thirty-one isolates from 14 hospitals in China were studied for their species classification and antifungal susceptibilities. Performances of molecular (i.e., ribosomal DNA [rDNA] internal transcribed spacer [ITS] sequencing, D1/D2 sequencing, and ITS sequencer-based capillary gel electrophoresis [SCGE]) and phenotypic identification methods in species identification were compared. Twenty-six (83.9%) of 31 isolates were identified as
C. haemulonii
and 5 isolates were identified as
C. duobushaemulonii
by ITS sequencing as the reference method; results obtained by D1/D2 sequencing and ITS SCGE were concordant with those obtained by ITS sequencing for all (100%) of the isolates. All 31 isolates were identified as
C. haemulonii
by the Vitek matrix-assisted laser desorption ionization–time of flight mass spectrometry (MALDI-TOF MS) system (bioMérieux, France), whereas the Bruker MS system (Bruker Daltoniks, Germany) correctly provided species identification for 77.4% and 100% of isolates using cutoff scores for species of ≥2.0 and ≥1.70, respectively. The Vitek 2 compact (bioMérieux) only identified 9 (29%) of 31 isolates. All isolates showed high MICs for amphotericin B (range, 2 to >8 μg/ml) and fluconazole (≥128 μg/ml) but low MICs (≤0.5 μg/ml) for the echinocandins. Our results reinforce the need for MALDI-TOF MS and/or molecular differentiation of species within the
C. haemulonii
complex. The multiresistant antifungal susceptibility profile of these isolates represents a challenge to therapy.
Near-Atomic Resolution Structure of a Highly Neutralizing Fab Bound to Canine Parvovirus
Authors: Organtini Lindsey J. , Lee Hyunwook , Iketani Sho , Huang Kai , Ashley Robert E. , Makhov Alexander M. , Conway James F. , Parrish Colin R. , Hafenstein Susan 
Published: August 2016

ABSTRACT

Canine parvovirus (CPV) is a highly contagious pathogen that causes severe disease in dogs and wildlife. Previously, a panel of neutralizing monoclonal antibodies (MAb) raised against CPV was characterized. An antibody fragment (Fab) of MAb E was found to neutralize the virus at low molar ratios. Using recent advances in cryo-electron microscopy (cryo-EM), we determined the structure of CPV in complex with Fab E to 4.1 Å resolution, which allowed
de novo
building of the Fab structure. The footprint identified was significantly different from the footprint obtained previously from models fitted into lower-resolution maps. Using single-chain variable fragments, we tested antibody residues that control capsid binding. The near-atomic structure also revealed that Fab binding had caused capsid destabilization in regions containing key residues conferring receptor binding and tropism, which suggests a mechanism for efficient virus neutralization by antibody. Furthermore, a general technical approach to solving the structures of small molecules is demonstrated, as binding the Fab to the capsid allowed us to determine the 50-kDa Fab structure by cryo-EM.

IMPORTANCE
Using cryo-electron microscopy and new direct electron detector technology, we have solved the 4 Å resolution structure of a Fab molecule bound to a picornavirus capsid. The Fab induced conformational changes in regions of the virus capsid that control receptor binding. The antibody footprint is markedly different from the previous one identified by using a 12 Å structure. This work emphasizes the need for a high-resolution structure to guide mutational analysis and cautions against relying on older low-resolution structures even though they were interpreted with the best methodology available at the time.
Widespread dispersal and aging of organic carbon in shallow marginal seas
Authors: Bao Rui , McIntyre Cameron , Zhao Meixun , Zhu Chun , Kao Shuh-Ji , Eglinton Timothy I. 
Published: August 2016

Abstract
The occurrence of pre-aged organic carbon (OC) in continental margin surface sediments is a commonly observed phenomenon, yet the nature, sources, and causes of this aged OC remain largely undetermined for many continental shelf settings. Here we present the results of an extensive survey of the abundance and radiocarbon content of OC in surface sediments from the northern Chinese marginal seas. Pre-aged OC is associated with both coarser (&gt;63 µm) and finer (&lt;63 µm) sedimentary components; measurements on specific grain-size fractions reveal that it is especially prevalent within the 20–63 µm fraction of inner shelf sediments. We suggest that organic matter associated with this sortable silt fraction is subject to protracted entrainment in resuspension-deposition loops during which it ages, is modified, and is laterally dispersed, most likely via entrainment within benthic nepheloid layers. This finding highlights the complex dynamics and predepositional history of organic matter accumulating in continental shelf sediments, with implications for our understanding of carbon cycling on continental shelves, development of regional carbon budgets, and interpretation of sedimentary records.
Kimberlites and the start of plate tectonics
Authors: Stern R.J. , Leybourne M.I. , Tsujimori Tatsuki 
Published: August 2016

Abstract
We want to know when plate tectonics began and will consider any important Earth feature that shows significant temporal evolution. Kimberlites, the primary source of diamonds, are rare igneous features. We analyze their distribution throughout Earth history; most are young (∼95% are younger than 0.75 Ga), but rare examples are found as far back as the Archean (older than 2.5 Ga). Although there are differing explanations for this age asymmetry (lack of preservation, lack of exposure, fewer mantle plumes, or lack of old thick lithosphere in the Archean and Proterozoic), we suggest that kimberlite eruptions are a consequence of modern-style plate tectonics, in particular subduction of hydrated oceanic crust and sediments deep into the mantle. This recycling since the onset of modern-style plate tectonics ca. 1 Ga has massively increased mantle CO2 and H2O contents, leading to the rapid and explosive ascent of diamond-bearing kimberlite magmas. The age distribution of kimberlites, combined with other large-scale tectonic indicators that are prevalent only in the past ∼1 Ga (blueschists, glaucophane-bearing eclogites; coesite- or diamond-bearing ultrahigh-pressure metamorphic rocks; lawsonite-bearing metamorphic rocks; and jadeitites), indicates that plate tectonics, as observed today, has only operated for &lt;25% of Earth history.
PATIENT/CARERS' RECOLLECTION OF MEDICINES RELATED INFORMATION FROM AN OUT-PATIENT CLINIC APPOINTMENT
Authors: Aston Jeff , Patel Natasha , Smuels Justin , Aujla Teena , Malesi Georgia , Huynh Chi , Wilson Keith , Terry David 
Published: August 2016

AimTo identify what medicines related information children/young people or their parents/carers are able to recall following an out-patient clinic appointment.MethodA convenience sample of patients' prescribed at least one new long-term (>6 weeks) medicine were recruited from a single UK paediatric hospital out-patient pharmacy.A face-to-face semi-structured questionnaire was administered to participants when they presented with their prescription. The questionnaire included the following themes: names of the medicines, therapeutic indication, dose regimen, duration of treatment and adverse effects.The results were analysed using Microsoft Excel 2013.ResultsOne hundred participants consented and were included in the study. One hundred and forty-five medicines were prescribed in total. Participants were able to recall the names of 96 (66%) medicines and were aware of the therapeutic indication for 142 (97.9%) medicines. The dose regimen was accurately described for 120 (82.8%) medicines with the duration of treatment known for 132 (91%). Participants mentioned that they had been advised about side effects for 44 (30.3%) medicines. Specific counselling points recommended by the BNFc1, were either omitted or not recalled by participants for the following systemic treatments: cetirizine (1), chlorphenamine (1), desmopressin (2), hydroxyzine (2), itraconazole (1), piroxicam (2), methotrexate (1), stiripentol (1) and topiramate (1).ConclusionFollowing an out-patient consultation, where a new medicine is prescribed, children and their parents/carers are usually able to recall the indication, dose regimen and duration of treatment. Few were able to recall, or were told about, possible adverse effects. This may include some important drug specific effects that require vigilance during treatment.Patients, along with families and carers, should be involved in the decision to prescribe a medicine.2 This includes a discussion about the benefits of the medicine on the patient's condition and possible adverse effects.2 Treatment side effects have been shown to be a factor in treatment non-adherence in paediatric long-term medical conditions.3 Practitioners should explain to patients, and their family members or carers where appropriate, how to identify and report medicines-related patient safety incidents.4 However, this study suggests that medical staff may not be comfortable discussing the adverse effects of medicines with patients or their parents/carers.Further research in to the shared decision making process in the paediatric out-patient clinic when a new long-term medicine is prescribed is required to further support medicines adherence and the patient safety agenda.
10 steps to facilitating patient death at home
Authors: Kerwat Doa’a , Sayma Meelad , Saleh Dina , Oyewole Folashade , Wahid Samad , Jamshaid Shiraz , Ahmed Aaniya 
Published: August 2016

IntroductionEvidence suggests that most patients want to die at home, however most die in hospital.AimTo identify specific action points to facilitate more patients to achieve home death, should they wish to do so.MethodsA two-step study design was adopted. A systematic literature review (SLR) and primary qualitative data collection. In the SLR 3241 papers were retrieved. 72 articles remained after screening and filtering processes. Qualitative articles were analysed using meta-ethnography and quantitative articles were analysed using a descriptive approach. 33 in-depth interviews were conducted with experts in end-of-life care delivery, with approval from Imperial College Research Ethics Committee. Thematic Analysis of interview transcripts was conducted. The results from both the SLR and primary data collection were then amalgamated to produce a set of overarching barriers and facilitators. Subsequently, action points were produced to overcome the barriers and facilitators identified.ResultsTen action points were identified to enable patients to achieve home death. These action points include: ‘coordinate services’ and ‘evaluate the efficiency of current resource allocation to enhance quality’.ConclusionsBy implementing these ten action points, the barriers to achieving home death would be dissolved, allowing patients to die in their preferred location. However, it is important to acknowledge that these action points are both time-consuming and potentially financially straining to achieve. Consequently, further research is required to identify how susceptible these action points are to implementation, prioritising those with the greatest impact.