"Freezing" the Tumor in a Known Position During Radiation Therapy In Regard to Boda-Heggemann et al

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Respatialization and local protest strategy formation: Investigating high-speed rail megaproject development in the UK

Understanding spatial conceptions is critical to the analysis of local protest strategy formation. Spatialities provoke inquiry into the drivers that may prompt local actors to adhere to particular strategies, and the implications this has on forms of contestation and the way protest is organized. It is argued that local protest can ‘respatialize’ when actors are embedded in social movements and translocal assemblages associated with controversy over development, and that this warrants reconsidering the role of ‘place’. A case study of a proposed megaproject framed in the national interest – a high-speed rail network called HS2, in the United Kingdom – is used to investigate local protest respatialization. Fieldwork was conducted in the Chilterns, an area of high scenic beauty which will be adversely impacted by HS2. The results show how the perceived need to respatialize protest away from the local to the national domain reconfigures debate to focus primarily on economic issues. Respatialization also has implications for the dynamics of protest assemblages with unlikely alliances developing around a need to engage with or engender debate in the national polity. It is concluded that local actors may opt to respatialize their protest in response to their interaction with social movements and protest assemblages that disengage from specific place-based interests. The paper recommends that future research on the geographies of social action take forward spatialization as a powerful lens for investigating protest strategy formation

Does encouraging a belief in determinism increase cheating? Reconsidering the value of believing in free will

A key source of support for the view that challenging people’s beliefs about free will may undermine moral behavior is two classic studies by Vohs and Schooler (2008). These authors reported that exposure to certain prompts suggesting that free will is an illusion increased cheating behavior. In the present paper, we report several attempts to replicate this influential and widely cited work. Over a series of five studies (sample sizes of N = 162, N = 283, N = 268, N = 804, N = 982) (four preregistered) we tested the relationship between (1) anti-free-will prompts and free will beliefs and (2) free will beliefs and immoral behavior. Our primary task was to closely replicate the findings from Vohs and Schooler (2008) using the same or highly similar manipulations and measurements as the ones used in their original studies. Our efforts were largely unsuccessful. We suggest that manipulating free will beliefs in a robust way is more difficult than has been implied by prior work, and that the proposed link with immoral behavior may not be as consistent as previous work suggests

Operation, characterisation & physical modelling of unflattened medical linear accelerator beams and their application to radiotherapy treatment planning

The flattening filter is a conical shaped piece of metal sitting within the treatment head of a linear accelerator, used to produce a flat, uniform beam of X-rays from the forward-peaked distribution exiting the target. Despite their routine use since the introduction of the linac in the 1950’s, however, there are still several unresolved issues surrounding their use. The photon scatter and electron contamination introduced by modifying the fluence are difficult to model, as is the variation in energy spectrum caused by differential absorption across the field. Leakage radiation also causes increased whole body doses to the patient, and the filter itself causes acts as an amplifier for beam bending and steering issues. With advances in tumour imaging, dose optimisation and in-room image-guidance it is now possible to locate a tumour accurately in space and to design radiation fields to conform to its shape, avoiding adjacent normal and critical tissues. This active production of non-flat fields means that the prerequisite for flat fields no longer exists, and the filter is potentially no longer a necessary component. This thesis reports on research to produce a filter-free linear accelerator, from basic operation and optimisation, dosimetric characterisation and beam modelling, through to treatment planning and dose delivery. FFF beams have been shown reduce many of the problems seen with the current generation of linear accelerators, producing beams that are inherently more stable, simple to model and with reduced patient leakage (leading to reduced secondary cancers). The increase in dose rate also translates into shorter treatment times for many treatments, aiding patient comfort and reducing problems associated with intra-fraction motion

Population viability of mottled sculpin (cottus bairdi) in Black Partridge Creek

ID: 8936; Final Report issued May 1, 2002INHS Technical Report prepared for Illinois Department of Transportation, Bureau of Design and Environmen

Shortening the preparation time of the single prolonged breath-hold for radiotherapy sessions.

OBJECTIVE Single prolonged breath-holds of >5 min can be obtained in cancer patients. Currently, however, the preparation time in each radiotherapy session is a practical limitation for clinical adoption of this new technique. Here, we show by how much our original preparation time can be shortened without unduly compromising breath-hold duration. METHODS 44 healthy subjects performed single prolonged breath-holds from 60% O and mechanically induced hypocapnia. We tested the effect on breath-hold duration of shortening preparation time (the durations of acclimatization, hyperventilation and hypocapnia) by changing these durations and or ventilator settings. RESULTS Mean original breath-hold duration was 6.5 ± 0.2 (standard error) min. The total original preparation time (from connecting the facemask to the start of the breath-hold) was 26 ± 1 min. After shortening the hypocapnia duration from 16 to 5 min, mean breath-hold duration was still 6.1 ± 0.2 min ( the original). After abolishing the acclimatization and shortening the hypocapnia to 1 min (a total preparation time now of 9 ± 1 min), a mean breath-hold duration of >5 min was still possible (now significantly shortened to 5.2 ± 0.6 min, 5 min (5.3 ± 0.2 min, < 0.05) was still possible. Here, the final total preparation time was 3.5 ± 0.3 min. CONCLUSIONS These improvements may facilitate adoption of the single prolonged breath-hold for a range of thoracic and abdominal radiotherapies especially involving hypofractionation. ADVANCES IN KNOWLEDGE Multiple short breath-holds improve radiotherapy for thoracic and abdominal cancers. Further improvement may occur by adopting the single prolonged breath-hold of >5 min. One limitation to clinical adoption is its long preparation time. We show here how to reduce the mean preparation time from 26 to 3.5 min without compromising breath-hold duration

The feasibility, safety and optimization of multiple prolonged breath-holds for radiotherapy.

BACKGROUND & PURPOSE Multiple, short breath-holds are now used in single radiotherapy treatment sessions. Here we investigated the feasibility and safety of multiple prolonged breath-holds in a single session. We measured how long is a second breath-hold if we prematurely terminate a single, prolonged breath-hold of >5 min either by using a single breath of oxygen (O), or by reintroducing preoxygenation and hypocapnia. We also investigated the feasibility and safety of undertaking 9 prolonged breath-holds in a row. MATERIALS & METHODS 30 healthy volunteers with no previous breath-holding experience were trained to perform single prolonged breath-holds safely. RESULTS Their mean single, prolonged breath-hold duration was 6.1 ± 0.3 se minutes (n = 30). In 18/18 subjects, premature termination (at 5.1 ± 0.2 min) with a single breath of 60% O, enabled a 2nd safe breath-hold lasting 3.3 ± 0.2 min. In 18/18 subjects, premature termination at 5.3 ± 0.2 min) by reintroducing preoxygenation and hypocapnia, enabled a 2nd safe breath-hold lasting 5.8 ± 0.3 min. 17/17 subjects could safely perform 9 successive prolonged breath-holds, each terminated (at 4.3 ± 0.2 min) by reintroducing preoxygenation and hypocapnia for 3.1 ± 0.2 min. The 9th unconstrained breath-hold (mean of 6.0 ± 0.3 min) lasted as long as their single breath-hold. CONCLUSIONS Multiple prolonged breath-holds are possible and safe. In a ∼19 min treatment session, it would therefore be possible to have ∼13 min for radiotherapy treatment (3 breath-holds) and ∼6 min for setup and recovery. In a 65 min session, it would be possible to have 41 min for radiotherapy and 25 min for setup and recovery

Mitigating Respiratory Motion in Radiation Therapy: Rapid, Shallow, Non-invasive Mechanical Ventilation for Internal Thoracic Targets.

PURPOSE Reducing respiratory motion during the delivery of radiation therapy reduces the volume of healthy tissues irradiated and may decrease radiation-induced toxicity. The purpose of this study was to assess the potential for rapid shallow non-invasive mechanical ventilation to reduce internal anatomy motion for radiation therapy purposes. METHODS AND MATERIALS Ten healthy volunteers (mean age, 38 years; range, 22-54 years; 6 female and 4 male) were scanned using magnetic resonance imaging during normal breathing and at 2 ventilator-induced frequencies: 20 and 25 breaths per minute for 3 minutes. Sagittal and coronal cinematic data sets, centered over the right diaphragm, were used to measure internal motions across the lung-diaphragm interface. Repeated scans assessed reproducibility. Physiologic parameters and participant experiences were recorded to quantify tolerability and comfort. RESULTS Physiologic observations and experience questionnaires demonstrated that rapid shallow non-invasive ventilation technique was tolerable and comfortable. Motion analysis of the lung-diaphragm interface demonstrated respiratory amplitudes and variations reduced in all subjects using rapid shallow non-invasive ventilation compared with spontaneous breathing: mean amplitude reductions of 56% and 62% for 20 and 25 breaths per minute, respectively. The largest mean amplitude reductions were found in the posterior of the right lung; 40.0 mm during normal breathing to 15.5 mm (P < .005) and 15.2 mm (P < .005) when ventilated with 20 and 25 breaths per minute, respectively. Motion variations also reduced with ventilation; standard deviations in the posterior lung reduced from 14.8 mm during normal respiration to 4.6 mm and 3.5 mm at 20 and 25 breaths per minute, respectively. CONCLUSIONS To our knowledge, this study is the first to measure internal anatomic motion using rapid shallow mechanical ventilation to regularize and minimize respiratory motion over a period long enough to image and to deliver radiation therapy. Rapid frequency and shallow, non-invasive ventilation both generate large reductions in internal thoracic and abdominal motions, the clinical application of which could be profound-enabling dose escalation (increasing treatment efficacy) or high-dose ablative radiation therapy