Variational Approach to Hard Sphere Segregation Under Gravity

It is demonstrated that the minimization of the free energy functional for hard spheres and hard disks yields the result that excited granular materials under gravity segregate not only in the widely known "Brazil nut" fashion, i.e. with the larger particles rising to the top, but also in reverse "Brazil nut" fashion. Specifically, the local density approximation is used to investigate the crossover between the two types of segregation occurring in the liquid state, and the results are found to agree qualitatively with previously published results of simulation and of a simple model based on condensation.Comment: 10 pages, 3 figure

Environmental sustainability and gynaecological surgery:Which factors influence behaviour? An interview study

OBJECTIVE: To assess the various factors that influence environmentally sustainable behaviour in gynaecological surgery and examine the differences between gynaecologists and residents.DESIGN: An interview study.SETTING: Academic and non-academic hospitals in the Netherlands.POPULATION: Gynaecologists (n = 10) and residents (n = 6).METHODS: Thematic analysis of semi-structured interviews to determine the various factors that influence environmentally sustainable behaviour in gynaecological surgery and to examine the differences between gynaecologists and residents. By using the Desmond framework and the COM-B BCW, both organisational and individual factors related to behaviour were considered.MAIN OUTCOME MEASURES: Factors that influence environmentally sustainable behaviour.RESULTS: Awareness is increasing but practical knowledge is insufficient. It is crucial to integrate education on the environmental impact of everyday decisions for residents and gynaecologists. Gynaecologists make their own choices but residents' autonomy is limited. There is the necessity to provide environmentally sustainable surgical equipment without compromising other standards. There is a need for a societal change that encourages safe and open communication about environmental sustainability. To transition to environmentally sustainable practices, leadership, time, collaboration with the industry and supportive regulatory changes are essential.CONCLUSION: This study lays the groundwork for promoting more environmentally sustainable behaviour in gynaecological surgery. The key recommendations, addressing hospital regulations, leadership, policy revisions, collaboration with the industry, guideline development and education, offer practical steps towards a more sustainable healthcare system. Encouraging environmentally sustainable practices should be embraced to enhance the well-being of both our planet and our population, driving us closer to a more environmentally sustainable future in healthcare.</p

Wave: A New Family of Trapdoor One-Way Preimage Sampleable Functions Based on Codes

We present here a new family of trapdoor one-way Preimage Sampleable Functions (PSF) based on codes, the Wave-PSF family. The trapdoor function is one-way under two computational assumptions: the hardness of generic decoding for high weights and the indistinguishability of generalized $(U,U+V)$-codes. Our proof follows the GPV strategy [GPV08]. By including rejection sampling, we ensure the proper distribution for the trapdoor inverse output. The domain sampling property of our family is ensured by using and proving a variant of the left-over hash lemma. We instantiate the new Wave-PSF family with ternary generalized $(U,U+V)$-codes to design a "hash-and-sign" signature scheme which achieves existential unforgeability under adaptive chosen message attacks (EUF-CMA) in the random oracle model. For 128 bits of classical security, signature sizes are in the order of 15 thousand bits, the public key size in the order of 4 megabytes, and the rejection rate is limited to one rejection every 10 to 12 signatures.Comment: arXiv admin note: text overlap with arXiv:1706.0806

Platform for automatic patient quality assurance via Monte Carlo simulations in proton therapy

For radiation therapy, it is crucial to ensure that the delivered dose matches the planned dose. Errors in the dose calculations done in the treatment planning system (TPS), treatment delivery errors, other software bugs or data corruption during transfer might lead to significant differences between predicted and delivered doses. As such, patient specific quality assurance (QA) of dose distributions, through experimental validation of individual fields, is necessary. These measurement based approaches, however, are performed with 2D detectors, with limited resolution and in a water phantom. Moreover, they are work intensive and often impose a bottleneck to treatment efficiency. In this work, we investigated the potential to replace measurement-based approach with a simulation-based patient specific QA using a Monte Carlo (MC) code as independent dose calculation engine in combination with treatment log files. Our developed QA platform is composed of a web interface, servers and computation scripts, and is capable to autonomously launch simulations, identify and report dosimetric inconsistencies. To validate the beam model of independent MC engine, in-water simulations of mono-energetic layers and 30 SOBP-type dose distributions were performed. Average Gamma passing ratio 99 ± 0.5% for criteria 2%/2 mm was observed. To demonstrate feasibility of the proposed approach, 10 clinical cases such as head and neck, intracranial indications and craniospinal axis, were retrospectively evaluated via the QA platform. The results obtained via QA platform were compared to QA results obtained by measurement-based approach. This comparison demonstrated consistency between the methods, while the proposed approach significantly reduced in-room time required for QA procedures

Evaluation of robustly optimised intensity modulated proton therapy for nasopharyngeal carcinoma

BACKGROUND AND PURPOSE: To evaluate the dosimetric changes occurring over the treatment course for nasopharyngeal carcinoma (NPC) patients treated with robustly optimised intensity modulated proton therapy (IMPT). MATERIALS AND METHODS: 25 NPC patients were treated to two dose levels (CTV1: 70Gy, CTV2: 54.25Gy) with robustly optimised IMPT plans. Robustness evaluation was performed over 28 error scenarios using voxel-wise minimum distributions to assess target coverage and voxel-wise maximum distributions to assess possible hotspots and critical organ doses. Daily CBCT was used for positioning and weekly repeat CTs (rCT) were taken, on which the plan dose was recalculated and robustly evaluated. Deformable image registration was used to warp and accumulate the nominal, voxel-wise minimum and maximum rCT dose distributions. Changes to target coverage, critical organ and normal tissue dose between the accumulated and planned doses were investigated. RESULTS: 2 patients required a plan adaptation due to reduced target coverage. The D98% in the accumulated voxel-wise minimum distribution was higher than planned for CTV1 in 24/25 patients and for CTV2 in 20/25 patients. Maximum doses to the critical organs remained acceptable in all patients. Other normal tissue doses showed some variation as a result of soft tissue deformations and weight change. Normal tissue complication probabilities for grade ≥2 dysphagia and grade ≥2 xerostomia remained similar to planned values. CONCLUSION: Robustly optimised IMPT plans, in combination with volumetric verification imaging and adaptive planning, provided robust target coverage and acceptable OAR dose variation in our NPC cohort when accumulated over longitudinal data

Guidelines for measuring and reporting environmental parameters for experiments in greenhouses

Background: The importance of appropriate, accurate measurement and reporting of environmental parameters in plant sciences is a significant aspect of quality assurance for all researchers and their research. There is a clear need for ensuring research across the world can be compared, understood and where necessary replicated by fellow researchers. A common set of guidelines to educate, assist and encourage comparativeness is of great importance. On the other hand, the level of effort and attention to detail by an individual researcher should be commensurate with the particular research being conducted. For example, a researcher focusing on interactions of light and temperature should measure all relevant parameters and report a measurement summary that includes sufficient detail allowing for replication. Such detail may be less relevant when the impact of environmental parameters on plant growth and development is not the main research focus. However, it should be noted that the environmental experience of a plant during production can have significant impact when subsequent experiments investigate plants at a molecular, biochemical or genetic level or where species interactions are considered. Thus, researchers are encouraged to make a critical assessment of what parameters are of primary importance in their research and these parameters should be measured and reported. Content: This paper brings together a collection of parameters that the authors, as members of International Committee on Controlled Environment Guidelines (ICCEG) in consultation with members of our three parent organizations, believe constitute those which should be recorded and reported when publishing scientific data from experiments in greenhouses. It provides recommendations to end users on when, how and where these parameters should be measured along with the appropriate internationally standardized units that should be used

Inter- and intrafractional 4D dose accumulation for evaluating ΔNTCP robustness in lung cancer.

BACKGROUND AND PURPOSE Model-based selection of proton therapy patients relies on a predefined reduction in normal tissue complication probability (NTCP) with respect to photon therapy. The decision is necessarily made based on the treatment plan, but NTCP can be affected when the delivered treatment deviates from the plan due to delivery inaccuracies. Especially for proton therapy of lung cancer, this can be important because of tissue density changes and, with pencil beam scanning, the interplay effect between the proton beam and breathing motion. MATERIALS AND METHODS In this work, we verified whether the expected benefit of proton therapy is retained despite delivery inaccuracies by reconstructing the delivered treatment using log-file based dose reconstruction and inter- and intrafractional accumulation. Additionally, the importance of two uncertain parameters for treatment reconstruction, namely deformable image registration (DIR) algorithm and α/β ratio, was assessed. RESULTS The expected benefit or proton therapy was confirmed in 97% of all studied cases, despite regular differences up to 2 percent point (p.p.) NTCP between the delivered and planned treatments. The choice of DIR algorithm affected NTCP up to 1.6 p.p., an order of magnitude higher than the effect of α/β ratio. CONCLUSION For the patient population and treatment technique employed, the predicted clinical benefit for patients selected for proton therapy was confirmed for 97.0 % percent of all cases, although the NTCP based proton selection was subject to 2 p.p. variations due to delivery inaccuracies

Timing manipulations reveal the lack of a causal link across timing of annual-cycle stages in a long-distance migrant

Organisms need to time their annual-cycle stages, like breeding and migration, to occur at the right time of the year. Climate change has shifted the timing of annual-cycle stages at different rates, thereby tightening or lifting time constraints of these annual-cycle stages, a rarely studied consequence of climate change. The degree to which these constraints are affected by climate change depends on whether consecutive stages are causally linked (scenario I) or whether the timing of each stage is independent of other stages (scenario II). Under scenario I, a change in timing in one stage has knock-on timing effects on subsequent stages, whereas under scenario II, a shift in the timing of one stage affects the degree of overlap with previous and subsequent stages. To test this, we combined field manipulations, captivity measurements and geolocation data. We advanced and delayed hatching dates in pied flycatchers (Ficedula hypoleuca) and measured how the timing of subsequent stages (male moult and migration) were affected. There was no causal effect of manipulated hatching dates on the onset of moult and departure to Africa. Thus, advancing hatching dates reduced the male moult–breeding overlap with no effect on the moult–migration interval. Interestingly, the wintering location of delayed males was more westwards, suggesting that delaying the termination of breeding carries over to winter location. Because we found no causal linkage of the timing of annual-cycle stages, climate change could shift these stages at different rates, with the risk that the time available for some becomes so short that this will have major fitness consequences

Feasibility and Coverage of Implementing Intermittent Preventive Treatment of Malaria in Pregnant women Contacting Private or Public Clinics in Tanzania: Experience-based Viewpoints of Health Managers in Mkuranga and Mufindi districts.

Evidence on healthcare managers' experience on operational feasibility of malaria intermittent preventive treatment for malaria during pregnancy (IPTp) using sulphadoxine-pyrimethamine (SP) in Africa is systematically inadequate. This paper elucidates the perspectives of District Council Health Management Team (CHMT)s regarding the feasibility of IPTp with SP strategy, including its acceptability and ability of district health care systems to cope with the contemporary and potential challenges. The study was conducted in Mkuranga and Mufindi districts. Data were collected between November 2005 and December 2007, involving focus group discussion (FGD) with Mufindi CHMT and in-depth interviews were conducted with few CHMT members in Mkuranga where it was difficult to summon all members for FGD. Participants in both districts acknowledged the IPTp strategy, considering the seriousness of malaria in pregnancy problem; government allocation of funds to support healthcare staff training programmes in focused antenatal care (fANC) issues, procuring essential drugs distributed to districts, staff remuneration, distribution of fANC guidelines, and administrative activities performed by CHMTs. The identified weaknesses include late arrival of funds from central level weakening CHMT's performance in health supervision, organising outreach clinics, distributing essential supplies, and delivery of IPTp services. Participants anticipated the public losing confidence in SP for IPTp after government announced artemither-lumefantrine (ALu) as the new first-line drug for uncomplicated malaria replacing SP. Role of private healthcare staff in IPTp services was acknowledged cautiously because CHMTs rarely supplied private clinics with SP for free delivery in fear that clients would be required to pay for the SP contrary to government policy. In Mufindi, the District Council showed a strong political support by supplementing ANC clinics with bottled water; in Mkuranga such support was not experienced. A combination of health facility understaffing, water scarcity and staff non-adherence to directly observed therapy instructions forced healthcare staff to allow clients to take SP at home. Need for investigating in improving adherence to IPTp administration was emphasised. High acceptability of the IPTp strategy at district level is meaningless unless necessary support is assured in terms of number, skills and motivation of caregivers and availability of essential supplies

Comparison of CBCT based synthetic CT methods suitable for proton dose calculations in adaptive proton therapy

In-room imaging is a prerequisite for adaptive proton therapy. The use of onboard cone-beam computed tomography (CBCT) imaging, which is routinely acquired for patient position verification, can enable daily dose reconstructions and plan adaptation decisions. Image quality deficiencies though, hamper dose calculation accuracy and make corrections of CBCTs a necessity. This study compared three methods to correct CBCTs and create synthetic CTs that are suitable for proton dose calculations. CBCTs, planning CTs and repeated CTs (rCT) from 33 H&N cancer patients were used to compare a deep convolutional neural network (DCNN), deformable image registration (DIR) and an analytical image-based correction method (AIC) for synthetic CT (sCT) generation. Image quality of sCTs was evaluated by comparison with a same-day rCT, using mean absolute error (MAE), mean error (ME), Dice similarity coefficient (DSC), structural non-uniformity (SNU) and signal/contrast-to-noise ratios (SNR/CNR) as metrics. Dosimetric accuracy was investigated in an intracranial setting by performing gamma analysis and calculating range shifts. Neural network-based sCTs resulted in the lowest MAE and ME (37/2 HU) and the highest DSC (0.96). While DIR and AIC generated images with a MAE of 44/77 HU, a ME of -8/1 HU and a DSC of 0.94/0.90. Gamma and range shift analysis showed almost no dosimetric difference between DCNN and DIR based sCTs. The lower image quality of AIC based sCTs affected dosimetric accuracy and resulted in lower pass ratios and higher range shifts. Patient-specific differences highlighted the advantages and disadvantages of each method. For the set of patients, the DCNN created synthetic CTs with the highest image quality. Accurate proton dose calculations were achieved by both DCNN and DIR based sCTs. The AIC method resulted in lower image quality and dose calculation accuracy was reduced compared to the other methods