The impact of advancing the standard of care in radiotherapy on operational treatment resources.

Purpose: To demonstrate the impact of implementing hypofractionated prescription regimens and advanced treatment techniques on institutional operational hours and radiotherapy personnel resources in a multi-institutional setting. The study may be used to describe the impact of advancing the standard of care with modern radiotherapy techniques on patient and staff resources.

Methods: This study uses radiation therapy data extracted from the radiotherapy information system from two tertiary care, university-affiliated cancer centers from 2012 to 2021.

Characterization of real-time cine MR imaging distortion on 0.35 T MRgRT with concentric cine imaging QA phantom.

. Real-time MRgRT uses 2D-cine imaging for target tracking and motion evaluation. Rotation of gantry inducedoff-resonance, resulting in image artifacts and imaging isocenter-shift precluding MR-guided arc therapy.

Sediment discharge from Greenland's marine-terminating glaciers is linked with surface melt.

Sediment discharged from the Greenland Ice Sheet delivers nutrients to marine ecosystems around Greenland and shapes seafloor habitats. Current estimates of the total sediment flux are constrained by observations from land-terminating glaciers only. Addressing this gap, our study presents a budget derived from observations at 30 marine-margin locations.

Global mosquito observations dashboard (GMOD): creating a user-friendly web interface fueled by citizen science to monitor invasive and vector mosquitoes.

Background: Mosquitoes and the diseases they transmit pose a significant public health threat worldwide, causing more fatalities than any other animal. To effectively combat this issue, there is a need for increased public awareness and mosquito control. However, traditional surveillance programs are time-consuming, expensive, and lack scalability.

Advanced automated treatment planning for total body irradiation: Implementation and effects on standardization.

Purpose: This work describes the automation of our volumetric modulated arc therapy (VMAT) total body irradiation (TBI) treatment planning. It also aims to determine if plan standardization is impacted by automation.

Methods: We introduced automated beam placement for TBI in March 2021.

Comprehensive MR imaging QA of 0.35 T MR-Linac using a multi-purpose large FOV phantom: A single-institution experience.

Purpose: Magnetic resonance-guided radiotherapy (MRgRT) is desired for the treatment of diseases in the abdominothoracic region, which has a broad imaging area and continuous motion. To ensure accurate treatment delivery, an effective image quality assurance (QA) program, with a phantom that covers the field of view (FOV) similar to a human torso, is required. However, routine image QA for a large FOV is not readily available at many MRgRT centers.

Cost-Effectiveness of Motivational Interviewing to Reduce Alcohol and Cannabis Use Among Patients With Depression.

Objective: Motivational interviewing (MI) is a promising intervention for helping patients with mental health problems reduce their substance use. Examining the cost-effectiveness of MI and associations between MI and the use of health services can inform appropriate intervention strategies for these patients.

Method: Kaiser Permanente adult patients with depression symptoms (Patient Health Questionnaire [PHQ-9] score > 5) seen in outpatient psychiatry ( = 302) who reported unhealthy alcohol use or other substance use (primarily cannabis) were randomized to three sessions of MI (intervention) or printed literature (control) with telephone follow-up interviews at 6 and 12 months.

An updated approach for deriving PTV margins using image guidance and deformable dose accumulation.

To demonstrate an updated approach for deriving planning target volume (PTV) margins for a patient population treated with volumetric image-guided radiotherapy.The approach uses a semi-automated workflow within commercial radiotherapy applications that combines dose accumulation with the bidirectional local distance (BLD) metric. The patient cohort is divided into derivation and validation datasets.

Increasing Demand on Human Capital and Resource Utilization in Radiation Therapy: The Past Decade.

Purpose: To quantify the change resource utilization in radiation therapy in the context of advancing technologies and techniques over the last decade.

Methods And Materials: Prospectively, the time to complete radiation therapy workflow tasks was captured between January 1, 2020, and December 31, 2020. The institutional task workflows are specific to each technique and broadly organized into 4 categories: 3-dimenstional conformal radiation therapy, intensity modulated radiation therapy, volumetric modulated arc therapy simple, and volumetric modulated arc therapy complex.

Determining Clinical Patient Selection Guidelines for Head and Neck Adaptive Radiation Therapy Using Random Forest Modelling and a Novel Simplification Heuristic.

Purpose: To determine which head and neck adaptive radiotherapy (ART) correction objectives are feasible and to derive efficient ART patient selection guidelines.

Methods: We considered various head and neck ART objectives including independent consideration of dose-sparing of the brainstem/spinal cord, parotid glands, and pharyngeal constrictor, as well as prediction of patient weight loss. Two-hundred head and neck cancer patients were used for model development and an additional 50 for model validation.

Technical Note: A standardized automation framework for monitoring institutional radiotherapy protocol compliance.

Purpose: To establish a framework for the standardization of monitoring radiotherapy protocol compliance.

Methods: An automated protocol compliance tool was developed using best practice in software design and a flexible framework to easily adapt to changing institutional standards. The Eclipse scripting environment was used to develop the application with the scripting application programing interface (API) and direct data extraction from ARIA.

Association of Anxiety With High-Cost Health Care Use Among Individuals With Type 2 Diabetes.

Objective: People with type 2 diabetes vary greatly in their use of high-cost health care resources. We examined the association of anxiety with high-cost use after accounting for depression and medical comorbidity.

Research Design And Methods: Using electronic health record data, we assessed past anxiety diagnosis, health care use and costs, demographics, comorbidities, and diabetes control status and complications during 2008-2012 for 143,573 adult members of an integrated health care system with type 2 diabetes.

Rapidly Progressing Sporadic Creutzfeldt-Jakob Disease Presenting as a Stroke.

Sporadic Creutzfeldt-Jakob disease (sCJD) is a rare, fatal human prion disease that is characterized by progressive dementia and neurologic degeneration. It can mimic multiple other neurological disorders, and a high index of clinical suspicion is necessary to make a diagnosis. A 74-year-old woman with a 3-month history of a stroke and progressive neurologic deterioration was found to have sCJD.

Exceptional 20 century glaciological regime of a major SE Greenland outlet glacier.

The early 2000s accelerated ice-mass loss from large outlet glaciers in W and SE Greenland has been linked to warming of the subpolar North Atlantic. To investigate the uniqueness of this event, we extend the record of glacier and ocean changes back 1700 years by analyzing a sediment core from Sermilik Fjord near Helheim Glacier in SE Greenland. We show that multidecadal to centennial increases in alkenone-inferred Atlantic Water SSTs on the shelf occurred at times of reduced solar activity during the Little Ice Age, when the subpolar gyre weakened and shifted westward promoted by atmospheric blocking events.

Minimal Holocene retreat of large tidewater glaciers in Køge Bugt, southeast Greenland.

Køge Bugt, in southeast Greenland, hosts three of the largest glaciers of the Greenland Ice Sheet; these have been major contributors to ice loss in the last two decades. Despite its importance, the Holocene history of this area has not been investigated. We present a 9100 year sediment core record of glaciological and oceanographic changes from analysis of foraminiferal assemblages, the abundance of ice-rafted debris, and sortable silt grain size data.

Magnetic Resonance Angiography: Principles and Applications.

Magnetic Resonance Angiography: Principles and Applications. Carr J. C.

Is high titre ANA specific for connective tissue disease?

Objective: A positive antinuclear antibody (ANA), while sensitive, is not specific for systemic lupus erythematosus or connective tissue diseases (CTD). The purpose of the present study was to review those sera with a high titre (> or = dilutions above screening) ANA and determine from a review of the charts if these higher titres offered a satisfactory specificity for CTD.

Methods: All FANA testing in this region is carried out in one of two related laboratories.

Hemodynamic and hormonal changes during pneumoperitoneum and trendelenburg positioning for operative gynecologic laparoscopy surgery.

Objective: The number and types of surgical procedures being preformed using laparoscopic technique is increasing due to technological advances. Recent studies suggest the carbon dioxide pneumoperitoneum and patient positioning causes hemodynamic alterations, respiratory acidosis, and a release of stress hormones. However, to date, no studies have investigated the physiological effect of laparoscopic procedures lasting more than 60 minutes on the stress response and the effect of Trendelenburg positioning.

Designing attenuators for total-body irradiation using virtual simulation.

In total-body photon irradiation, the lungs are the most commonly shielded organ. Lung compensators are often designed by using high-energy portal films. Other organs, such as the kidneys and liver, are poorly visualized in portal films due to their unit-density composition.

Assessment of health locus of control in the use of nonconventional remedies by patients with rheumatic diseases.

Objective: To assess the prevalence and characteristics of the use of nonconventional remedies (NCR) and to determine the type of health locus of control that the users of NCR may have.

Methods: We conducted a cross sectional survey of 200 patients with rheumatic diseases at 3 outpatient rheumatic clinics in Edmonton, Canada. A face-to-face structured interview was administered by a trained assistant to evaluate the prevalence of use, and patient beliefs, perceptions, and expectations in relation to NCR.

Objective assessment of "cardioprotective" efficacy as a prognostic guide to management of mildly symptomatic revascularizable coronary artery disease.

Objectives: The concept of "cardioprotection" based on ejection fraction was tested to see whether patients with coronary artery disease in whom medical treatment fails to be cardioprotective can be distinguished from those in whom it is safe to continue such treatment.

Background: Ejection fraction is of fundamental prognostic importance. Its modification by anti-ischemic medication may allow assessment of cardioprotection from adverse outcome.

Exercise testing without interruption of medication for refining the selection of mildly symptomatic patients for prognostic coronary angiography.

Objective: To examine how exercise testing on background medical treatment affects the ability of the test to predict prognostically important patterns of coronary anatomy in patients with a high clinical probability of coronary artery disease but who are well controlled on medication.

Design: Prospective study.

Setting: Regional cardiothoracic centre and referring district general hospital.

Suppression of inducible painless myocardial ischemia by conventional medical therapy: effect on short-term outcome and left ventricular systolic function.

To test the hypothesis that abolition of exercise-induced painless myocardial ischemia by anti-ischemic medication improves prognosis in patients with medically treated coronary artery disease, we studied such patients with painless ischemia during exercise radionuclide ventriculography performed after temporary discontinuation of medication. The test was repeated while patients received conventional medical therapy that rendered angina no worse than New York Heart Association class I. The relative risk of adverse cardiac events was reduced by > 5-fold when painless ischemia was abolished by symptom-dictated therapy.