bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intraoperative management and early postoperative outcomes of pediatric renal transplants
Authors: Taylor Katherine , Kim Wooheon Thomas , Maharramova Malak , Figueroa Victor , Ramesh Smruthi , Lorenzo Armando 
Published: August 2016

SummaryIntroductionSmaller children are presenting for renal transplantation as the treatment of choice for end‐stage renal disease. Adult donor organs are more successful than pediatric deceased donor organs. An adult kidney may sequester ~75% of the circulating volume of a 5 year‐old child and requires significantly increased cardiac output to maintain renal perfusion. Treatment includes volume, inotropic or vasopressor agents, or central neuroaxial blockade for sympatholysis.We describe the perioperative anesthestic management as a guide to clinical outcomes.MethodsA retrospective chart review of renal transplant patients between 2006 and 2014 was performed. We recorded patient demographics, surgical and anesthetic factors and postoperative outcome.ResultsOne hundred and fifty‐six children underwent renal transplantation, of which 38% were from living donors. There were 99/156 (63.5%) males. Median age was 10 years (range 1–17 years) and the mean weight was 36.2 kg (sd 20.6 kg; range 7.6–109.6 kg). There were 36 children ≤5 years of age and 14 children ≤2 years of age. One hundred and nineteen (77%) were dialysis dependent.Pharmacological support to increase renal perfusion included mannitol in 95%, and dopamine in 83%. Furosemide was used in 82% of cases. Inotropic therapy continued into the postoperative period in 34%. Radiological pulmonary edema was diagnosed in 33% and clinical pulmonary edema in 7%. Intraoperative use of dopamine delayed the time to creatinine nadir in all grafts (9.5 days vs 6.5 days, P = 0.04) and in deceased donor grafts (12.9 vs 7.4 days, P = 0.007). Patients who received dopamine had no significant difference in central venous pressure (CVP) preclamp removal, 14 mmHg vs 11.5 mmHg (P = 0.12) but a higher CVP after clamp removal, 14.3 mmHg vs 11.8 mmHg (P = 0.003).ConclusionDopamine use was common and was an independent risk factor for delayed time to creatinine nadir. Many different agents were used to enhance renal perfusion. The ‘supra‐physiological’ hemodynamics resulted in pulmonary edema in 33% of patients.
The Construction of Hinduism in America
Authors: Altman Michael J. 
Published: August 2016

AbstractYet, there has never been a unified or singular Hinduism in America. Rather, the story of Hinduisms in America provides an important example for the ways a religious tradition is imagined in America. In the 18th and 19th century, Americans described religion in India as ‘heathenism’, ‘Hindoo religion’, ‘Hindu religion’, and ‘Brahmanism’. By the end of the 19th century, figures like Swami Vivekanada brought the idea of ‘Hinduism’, a world religion, to America. In the 20th century, Hindu immigrants from South Asia began to build temples and practice their own forms of Hinduism throughout the United States.
Revisiting the Memory‐Based Processing Approach to Common Ground
Authors: Horton William S. , Gerrig Richard J. 
Published: August 2016

AbstractHorton and Gerrig (2005a) outlined a memory‐based processing model of conversational common ground that provided a description of how speakers could both strategically and automatically gain access to information about others through domain‐general memory processes acting over ordinary memory traces. In this article, we revisit this account, reviewing empirical findings that address aspects of this memory‐based model. In doing so, we also take the opportunity to clarify what we believe this approach implies about the cognitive psychology of common ground, and just as important, what it does not imply. We also highlight related areas of research demonstrating how general cognitive processes can constrain access to relevant knowledge in ways that shape both language production and comprehension.
EU Trade Regulation for Baby Food: Protecting Health or Trade?
Authors: DeMaria Federica , Drogue Sophie 
Published: August 2016

AbstractThis paper explores the effect of European Union (EU) food safety regulations on EU imports of baby food. Pesticides and contaminants contribute to various health problems. Children are more vulnerable to the dangers of pesticides and contaminants because as soon as they start eating solids, they consume a limited number of food items, most of which are fruits and vegetables. To protect the health of the most vulnerable part of the population, the EU regulations stipulate that no more than 0.01 mg/kg of any single pesticide residue is permitted in baby food. In this respect, the EU differs from most of its trading partners, the majority of which do not differentiate food safety regulations according to the age of the consumer. The purpose of this paper is to compare the EU regulations on maximum residue limits of pesticides to those of its major competitors through a severity index. This index is then introduced into a gravity equation to assess the impact on EU imports of baby food. We find that the EU regulation had a negative impact on the volume of trade but a positive one on the probability of setting up new trade relationships.
Caloric restriction selectively reduces the GABAergic phenotype of mouse hypothalamic proopiomelanocortin neurons
Authors: Jarvie Brooke C. , King Connie M. , Hughes Alexander R. , Dicken Matthew S. , Dennison Christina S. , Hentges Shane T. 
Published: August 2016

Key points
Hypothalamic proopiomelanocortin (POMC) neurons release peptide products that potently inhibit food intake and reduce body weight.
These neurons also release the amino acid transmitter GABA, which can inhibit downstream neurons.
Although the release of peptide transmitters from POMC neurons is regulated by energy state, whether similar regulation of GABA release might occur had not been examined.
The present results show that the GABAergic phenotype of POMC neurons is decreased selectively by caloric deficit and not altered by high‐fat diet or stress.
The fact the GABAergic phenotype of POMC neurons is sensitive to energy state suggests a dynamic physiological role for this transmitter and highlights the importance of determining the functional consequence of GABA released from POMC neurons in terms of the regulation of normal energy balance.
AbstractIn addition to peptide transmitters, hypothalamic neurons, including proopiomelanocortin (POMC) and agouti‐related peptide (AgRP) neurons, also release amino acid transmitters that can alter energy balance regulation. While recent studies show that the GABAergic nature of AgRP neurons is increased by caloric restriction, whether the GABAergic phenotype of POMC neurons is also regulated in an energy‐state‐dependent manner has not been previously examined. The present studies used fluorescence in situ hybridization to detect Gad1 and Gad2 mRNA in POMC neurons, as these encode the glutamate decarboxylase enzymes GAD67 and GAD65, respectively. The results show that both short‐term fasting and chronic caloric restriction significantly reduce the percentage of POMC neurons expressing Gad1 mRNA in both male and female mice, with less of an effect on Gad2 expression. Neither acute nor chronic intermittent restraint stress altered Gad1 expression in POMC neurons. Maintenance on a high‐fat diet also did not affect the portion POMC neurons expressing Gad1, suggesting that the GABAergic phenotype of POMC neurons is particularly sensitive to energy deficit. Because changes in Gad1 expression have been previously shown to correlate with altered terminal GABA release, fasting is likely to cause a decrease in GABA release from POMC neurons. Altogether, the present results show that the GABAergic nature of POMC neurons can be dynamically regulated by energy state in a manner opposite to that in AgRP neurons and suggest the importance of considering the functional role of GABA release in addition to the peptide transmitters from POMC neurons.
Sci‐Thur PM – Brachytherapy 05: Surface Collimation Applied to Superficial Flap High Dose‐Rate Brachytherapy
Authors: Liu Derek , Sabondjian Eric , Lawrence Kailin , Sankreacha Raxa 
Published: August 2016

Purpose:To apply surface collimation for superficial flap HDR skin brachytherapy utilizing common clinical resources and to demonstrate the potential for OAR dose reduction within a clinically relevant setting.Methods:Two phantom setups were used. 3 mm lead collimation was applied to a solid slab phantom to determine appropriate geometries relating to collimation and dwell activation. The same collimation was applied to the temple of an anthropomorphic head phantom to demonstrate lens dose reduction. Each setup was simulated and planned to deliver 400 cGy to a 3 cm circular target to 3 mm depth. The control and collimated irradiations were sequentially measured using calibrated radiochromic films.Results:Collimation for the slab phantom attenuated the dose beyond the collimator opening, decreasing the fall‐off distances by half and reducing the area of healthy skin irradiated. Target coverage can be negatively impacted by a tight collimation margin, with the required margin approximated by the primary beam geometric penumbra.Surface collimation applied to the head phantom similarly attenuated the surrounding normal tissue dose while reducing the lens dose from 84 to 68 cGy. To ensure consistent setup between simulation and treatment, additional QA was performed including collimator markup, accounting for collimator placement uncertainties, standoff distance verification, and in vivo dosimetry.Conclusions:Surface collimation was shown to reduce normal tissue dose without compromising target coverage. Lens dose reduction was demonstrated on an anthropomorphic phantom within a clinical setting. Additional QA is proposed to ensure treatment fidelity.
Poster ‐ 16: Time‐resolved diode dosimetry for in vivo proton therapy range verification: calibration through numerical modeling
Authors: Toltz Allison , Hoesl Michaela , Schuemann Jan , Seuntjens Jan , Lu Hsiao‐Ming , Paganetti Harald 
Published: August 2016

Purpose:A method to refine the implementation of an in vivo, adaptive proton therapy range verification methodology was investigated. Simulation experiments and in‐phantom measurements were compared to validate the calibration procedure of a time‐resolved diode dosimetry technique.Methods:A silicon diode array system has been developed and experimentally tested in phantom for passively scattered proton beam range verification by correlating properties of the detector signal to the water equivalent path length (WEPL). The implementation of this system requires a set of calibration measurements to establish a beam‐specific diode response to WEPL fit for the selected ‘scout’ beam in a solid water phantom. This process is both tedious, as it necessitates a separate set of measurements for every ‘scout’ beam that may be appropriate to the clinical case, as well as inconvenient due to limited access to the clinical beamline. The diode response to WEPL relationship for a given ‘scout’ beam may be determined within a simulation environment, facilitating the applicability of this dosimetry technique. Measurements for three ‘scout’ beams were compared against simulated detector response with Monte Carlo methods using the Tool for Particle Simulation (TOPAS).Results:Detector response in water equivalent plastic was successfully validated against simulation for spread out Bragg peaks of range 10 cm, 15 cm, and 21 cm (168 MeV, 177 MeV, and 210 MeV) with adjusted R2 of 0.998.Conclusion:Feasibility has been shown for performing calibration of detector response for a given ‘scout’ beam through simulation for the time resolved diode dosimetry technique.
Poster ‐ 20: Detector selection for commissioning of a Monte Carlo based electron dose calculation algorithm
Authors: Anusionwu Princess , Alpuche Aviles Jorge E. , Pistorius Stephen 
Published: August 2016

Objective:Commissioning of a Monte Carlo based electron dose calculation algorithm requires percentage depth doses (PDDs) and beam profiles which can be measured with multiple detectors. Electron dosimetry is commonly performed with cylindrical chambers but parallel plate chambers and diodes can also be used. The purpose of this study was to determine the most appropriate detector to perform the commissioning measurements.Methods:PDDs and beam profiles were measured for beams with energies ranging from 6 MeV to 15 MeV and field sizes ranging from 6 cm × 6 cm to 40 cm × 40 cm. Detectors used included diodes, cylindrical and parallel plate ionization chambers. Beam profiles were measured in water (100 cm source to surface distance) and in air (95 cm source to detector distance).Results:PDDs for the cylindrical chambers were shallower (1.3 mm averaged over all energies and field sizes) than those measured with the parallel plate chambers and diodes. Surface doses measured with the diode and cylindrical chamber were on average larger by 1.6 % and 3% respectively than those of the parallel plate chamber. Profiles measured with a diode resulted in penumbra values smaller than those measured with the cylindrical chamber by 2 mm.Conclusion:The diode was selected as the most appropriate detector since PDDs agreed with those measured with parallel plate chambers (typically recommended for low energies) and results in sharper profiles. Unlike ion chambers, no corrections are needed to measure PDDs, making it more convenient to use.
Poster ‐ 22: Retrospective analysis of portal dosimetry based QA of Prostate VMAT Plans
Authors: Badu Shyam , Darko Johnson , Fleck Andre , Osei Ernest 
Published: August 2016

Purpose:The purpose of this study is to retrospectively analyze the portal dosimetry based quality assurance of prostate VMAT plans.Methods:Our standard quality assurance of VMAT treatment plans are performed using EPID installed on Varian TrueBeam Linac. In our current study we analyzed 84 prostate pretreatment VMAT plans. All plans consisted of two arcs, 7800cGy in 39 fractions with a 6MV beam. For each of these VMAT plans, the measured fluence for each arc is compared with the reference fluence using gamma index analysis.Results:We have compared the gamma passing rates for three criteria; 3%/3mm, 2%/2mm and 1%/1mm. Out of 168 arcs measured, the number below the gamma passing rate 95% using the area, Field+1cm, are 0, 2, and 124 for 3%/3mm, 2%/2mm and 1%/1mm criteria respectively. Corresponding numbers for MLC CIAO are 0, 2, and 139 respectively. The average gamma passing rate for all arcs measured using Field+1cm are 99.9±0.4, 99.6±1.2, and 90.9±6.5 for 3%/3mm, 2%/2mm and 1%/1mm respectively. Similarly if the MLC CIAO area is analyzed, a passing rate of 99.9±0.2, 99.2±1.2 and 87.2±8.5 respectively was observed. The average of the maximum gamma was also found to increase with tighter criteria.Conclusion:Analysis of prostate VMAT quality assurance plans indicate that the gamma passing rate is sensitive to the criteria and the area analyzed.
Poster ‐ 23: Dosimetric Characterization and Transferability of an Accessory Mounted Mini‐Beam Collimator
Authors: Davis William , Crewson Cody , Alexander Andrew , Cranmer‐Sargison Gavin , Kundapur Vijayananda 
Published: August 2016

Objective:The dosimetric characterization of an accessory‐mounted mini‐beam collimator across three beam matched linear accelerators.Materials and Methods:Percent depth dose and profiles were measured for the open and mini‐beam collimated fields. The average beam quality and peak‐to‐valley dose ratio (PVDR), the ratio of average peak dose to average valley dose, were obtained from these measurements. The open field relative output and the mini‐beam collimator factor, the ratio of the mini‐beam dose to open field dose at the beam center, were measured for square fields of side 2, 3, 4, and 5 cm. Mini‐beam output as a function of collimator inclination angle relative to the central axis was also investigated.Results and Discussion:Beam quality for both the open and mini‐beam collimated fields agreed across all linacs to within ±1.0%. The PVDR was found to vary by up to ±6.6% from the mean. For the 2, 3, and 4 cm fields the average open field relative output with respect to the 5 cm field was 0.874±0.4%, 0.921±0.3%, and 0.962±0.1%. The average collimator factors were 0.450±3.9%, 0.443±3.9%, 0.438±3.9%, and 0.434±3.9%. A decrease in collimator factor greater than 7% was found for an inclination angle change of 0.09°.Conclusion:The mini‐beam collimator has revealed a difference between the three linacs not apparent in the open field data, yet transferability can still be attained through thorough dosimetric characterization.
Poster ‐ 32: Atlas Selection for Automated Segmentation of Pelvic CT for Prostate Radiotherapy
Authors: Mallawi Abrar , Farrell TomTom , Diamond Kevin‐Ross , Wierzbicki Marcin 
Published: August 2016

Atlas based‐segmentation has recently been evaluated for use in prostate radiotherapy. In a typical approach, the essential step is the selection of an atlas from a database that the best matches of the target image. This work proposes an atlas selection strategy and evaluate it impacts on final segmentation accuracy.Several anatomical parameters were measured to indicate the overall prostate and body shape, all of these measurements obtained on CT images. A brute force procedure was first performed for a training dataset of 20 patients using image registration to pair subject with similar contours; each subject was served as a target image to which all reaming 19 images were affinity registered. The overlap between the prostate and femoral heads was quantified for each pair using the Dice Similarity Coefficient (DSC). Finally, an atlas selection procedure was designed; relying on the computation of a similarity score defined as a weighted sum of differences between the target and atlas subject anatomical measurement.The algorithm ability to predict the most similar atlas was excellent, achieving mean DSCs of 0.78 ± 0.07 and 0.90 ± 0.02 for the CTV and either femoral head. The proposed atlas selection yielded 0.72 ± 0.11 and 0.87 ± 0.03 for CTV and either femoral head. The DSC obtained with the proposed selection method were slightly lower than the maximum established using brute force, but this does not include potential improvements expected with deformable registration. The proposed atlas selection method provides reasonable segmentation accuracy.
Poster ‐ 50: The effect of metallic artifacts and their correction on CyberKnife skull and spine tracking
Authors: Sutherland Justin 
Published: August 2016

Purpose:CyberKnife tracking compares DRRs and periodic orthogonal x‐rays for patient localization, couch adjustments, and position adjustment of the linac head. Metallic artifacts in CT scans can potentially create discrepancies between DRRs and x‐rays. Additionally, suboptimal correction of artifacts may lead to inaccurate reconstruction of anatomy. This study investigates the effects that metallic artifacts and their correction have on CyberKnife skull and spine tracking.Methods:Skull tracking was tested with an anthropomorphic head‐neck phantom, using a Philips Brilliance Big Bore 16‐slice CT‐simulator with and without gold placed on the eye to simulate an external eyelid weight. Metallic artifacts in images with gold were corrected with orthopedic metal artifact reduction (O‐MAR). For each scan set, treatment plans were created and corrected couch positions for 10 phantom setups were recorded. To test spine tracking where bony anatomy is distorted due to O‐MAR for spinal screws, a spinous process was over‐ridden with a CT number of 55 HU. DRRs for this spine were compared with anatomically‐correct x‐rays to test for errors in spine matching.Results:Standard deviations in each direction and rotation for the no‐metal, metal, and metal with O‐MAR setups were comparable. Differences in average setup between the uncorrected and O‐MAR corrected plans were less than 0.8 times the no‐metal standard deviations. For the removed spinous process, the skeletal matching mesh indicated minimal error in anatomy: within daily patient variation.Conclusions:CyberKnife skull and spine tracking performed robustly against clinically realistic metallic artifacts and bony anatomy errors possibly introduced by O‐MAR.
Sci‐Fri AM: MRI and Diagnostic Imaging ‐ 01: Estimating the Transverse Relaxation Time of Taurine Protons in Rat Brain at 9.4 T with Optimized PRESS Sequence Timings
Authors: Fisher Marissa , Dobberthien Brennen , Tessier Anthony , Yahya Atiyah 
Published: August 2016

Purpose:To investigate the response of taurine (Tau) protons as a function of PRESS echo times, TE1 and TE2, to determine two TE combinations that can be employed to estimate the T2 (transverse relaxation) value of Tau at 9.4 T. The Tau protons are involved in J‐coupling interactions; therefore, the two timing combinations should result in similar signal losses due to J‐coupling.Methods:Experiments were performed with a 9.4 T animal MRI scanner. Numerical calculations of the response of Tau as a function of PRESS TE1 and TE2 were calculated and two TE combinations that yield a similar area for the 3.42 ppm Tau resonance were selected as optimal. The timings were verified on a 50 mM Tau/10 mM Cr (creatine) phantom. In‐vivo experiments were performed on four rats. Spectra were acquired with the timings from a voxel placed in the rat brain and Tau peak areas were fit to monoexponentially decaying functions to obtain T2 values.Results:The PRESS TE combinations selected for Tau T2 determination are {TE1, TE2} = {17 ms, 10 ms} and {80 ms, 70 ms}; the signal yield for the two timings differs by 5 % theoretically. The average Tau T2 for the four rats was found to be 106 ms with a standard deviation of 12 ms.Conclusions:We have demonstrated that acquiring PRESS spectra with {TE1, TE2} = {17 ms, 10 ms} and {TE1, TE2} = {80 ms, 70 ms} enables T2 corrected measures of Tau to be obtained at 9.4 T.
Sci‐Fri AM: Quality, Safety, and Professional Issues 06: An Evaluation of Incident Reporting and Learning using the Canadian National System for Incident Reporting – Radiation Treatment
Authors: Montgomery Logan , Kildea John 
Published: August 2016

We report on the development and clinical deployment of an in‐house incident reporting and learning system that implements the taxonomy of the Canadian National System for Incident Reporting – Radiation Treatment (NSIR‐RT). In producing our new system, we aimed to:

Analyze actual incidents, as well as potentially dangerous latent conditions.
Produce recommendations on the NSIR‐RT taxonomy.
Incorporate features to divide reporting responsibility among clinical staff and expedite incident categorization within the NSIR‐RT framework.
Share anonymized incident data with the national database.Our multistep incident reporting workflow is focused around an initial report and a detailed follow‐up investigation. An investigator, chosen at the time of reporting, is tasked with performing the investigation. The investigation feature is connected to our electronic medical records database to allow automatic field population and quick reference of patient and treatment information. Additional features include a robust visualization suite, as well as the ability to flag incidents for discussion at monthly Risk Management meetings and task ameliorating actions to staff.Our system was deployed into clinical use in January 2016. Over the first three months of use, 45 valid incidents were reported; 31 of which were reported as actual incidents as opposed to near‐misses or reportable circumstances. However, we suspect there is ambiguity within our centre in determining the appropriate event type, which may be arising from the taxonomy itself.Preliminary trending analysis aided in revealing workflow issues pertaining to storage of treatment accessories and treatment planning delays. Extensive analysis will be undertaken as more data are accrued.