Approximately two years after promulgation of the Energy Employees Occupational Illness Compensation Program Act, the National Institute for Occupational Safety and Health Office of Compensation and Analysis Support selected a contractor team to perform many aspects of the radiation dose reconstruction process. The project scope and schedule necessitated the development of an organization involving a comparatively large number of health physicists. From the initial stages, there were many technical and managerial challenges that required continuous planning, integration, and conflict resolution. This paper identifies those challenges and describes the resolutions and lessons learned. These insights are hopefully useful to managers of similar scientific projects, especially those requiring significant data, technical methods, and calculations. The most complex challenge has been to complete defensible, individualized dose reconstructions that support timely compensation decisions at an acceptable production level. Adherence to applying claimant-favorable and transparent science consistent with the requirements of the Act has been the key to establishing credibility, which is essential to this large and complex project involving tens of thousands of individual stakeholders. The initial challenges included garnering sufficient and capable scientific staff, developing an effective infrastructure, establishing necessary methods and procedures, and integrating activities to ensure consistent, quality products. The continuing challenges include maintaining the project focus on recommending a compensation determination (rather than generating an accurate dose reconstruction), managing the associated very large data and information management challenges, and ensuring quality control and assurance in the presence of an evolving infrastructure. The lessons learned concern project credibility, claimant favorability, project priorities, quality and consistency, and critical path project activities.
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http://dx.doi.org/10.1097/01.HP.0000312371.64013.52 | DOI Listing |
Pharmacol Res
January 2025
Department of Anesthesiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Key Laboratory of Anesthesiology (Shanghai Jiao Tong University), Ministry of Education, Shanghai, China. Electronic address:
Biased µ-opioid receptor (MOR) agonists enhance pain relief by selectively activating G protein-coupled receptor signaling and minimizing β-arrestin-2 activation, resulting in fewer side effects. This multicenter Phase II/III trial evaluated the optimal dosage, efficacy, and safety of SHR8554, a biased MOR agonist, for postoperative pain management following orthopedic surgery. In Phase II, 121 patients were divided into four groups to receive varying patient-controlled analgesia (PCA) doses of SHR8554 or morphine.
View Article and Find Full Text PDFPhys Med
January 2025
Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.
Background And Purpose: Free-breathing computed tomography (FBCT) used in treatment planning for lower thoracic (Th8-Th12) spine stereotactic body radiotherapy (SBRT) can cause deviations between planned and irradiated doses due to diaphragm movement (DM). This study analyzed the dosimetric impact of DM on lower thoracic spine SBRT.
Materials And Methods: Data were collected from 19 patients who underwent FBCT and four-dimensional CT (4DCT) during the same session.
Phys Med
January 2025
Department of Radiation Oncology, The Third Affiliated Hospital, Sun Yan-Sen University, Guangzhou 510630, China. Electronic address:
A preliminary study was conducted using electronic portal imaging device (EPID) based dose verification in pre-treatment and in vivo dose reconstruction modes for breast cancer intensity-modulated radiation therapy (IMRT) technique with known repositioning set-up errors. For 43 IMRT plans, the set-up errors were determined from 43 sets of EPID images and 258 sets of cone beam computed tomography images. In-house developed Edose software was used to reconstruct the dose distribution using the pre-treatment and on-treatment (in vivo) EPID acquired fluence maps.
View Article and Find Full Text PDFArch Orthop Trauma Surg
January 2025
Medical University of Graz, Graz, Austria.
Background: The role of local infiltration anesthesia (LIA) in knee surgery is significant. LIA can be more potent than a nerve block, but without the downsides. A wide range of agents are used for LIA, including some off-label medications such as dexmedetomidine and ropivacaine.
View Article and Find Full Text PDFPhys Med Biol
January 2025
Department of Radiation Oncology, University of Texas Southwestern Medical Center, 2280 Inwood Road, Dallas, 75390, UNITED STATES.
Real-time cone-beam computed tomography (CBCT) provides instantaneous visualization of patient anatomy for image guidance, motion tracking, and online treatment adaptation in radiotherapy. While many real-time imaging and motion tracking methods leveraged patient-specific prior information to alleviate under-sampling challenges and meet the temporal constraint (< 500 ms), the prior information can be outdated and introduce biases, thus compromising the imaging and motion tracking accuracy. To address this challenge, we developed a framework (DREME) for real-time CBCT imaging and motion estimation, without relying on patient-specific prior knowledge.
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