A taskforce for national improvement of innovation implementation in radiotherapy

Background and purpose: Previous research among Dutch radiotherapy centres (RTCs) showed that 69% of innovations was simultaneously implemented in 7/19 centres, with a success rate of 51%. However, no structure to share lessons learned about the implementation process existed. Therefore, a national Taskforce Implementation (TTI) was raised to stimulate efficient implementation of innovations. The aim of the current study was to develop and pilot-evaluate a website for facilitating mutual learning on implementation issues. Material and methods: First, we made an inventory in all Dutch RTCs on their 10 most valuable innovations between 2019 and 2022. In-depth interviews, structured according to the Consolidated Framework for Implementation Research, were performed on the four most mentioned topics. A website was built, and pilot evaluated 1 year after the launch, using a qualitative survey amongst the TTI members. Results: In 13/18 centres, 19 interviews were conducted on 1) automation, 2) patient participation, 3) adaptive radiotherapy 4) surface guided radiotherapy and tracking. Most innovations (13/16) were implemented with a delay, with many comparable challenges: e.g. shortage of personnel (7/16) and prioritization of projects (9/16). The website allows users to upload and search for projects, including implementation experiences. After 1 year, 14 projects were uploaded. The qualitative evaluation was largely positive with room for improvement, i.e.75 % would recommend the website to others. Conclusion: This study showed that RTCs experience comparable challenges when implementing innovations, thereby underlining the need for a platform to share implementation-lessons learned. The first concept of this platform was evaluated positively

A Randomized Controlled Trial to Examine the Effect of 2-Year Vitamin B12 and Folic Acid Supplementation on Physical Performance, Strength, and Falling: Additional Findings from the B-PROOF Study

Elevated homocysteine concentrations are associated with a decline in physical function in elderly persons. Homocysteine-lowering therapy may slow down this decline. This study aimed to examine the effect of a 2-year intervention of vitamin B12 and folic acid supplementation on physical performance, handgrip strength, and risk of falling in elderly subjects in a double-blind, randomized placebo-controlled trial. Participants aged ≥65 years with elevated plasma homocysteine concentrations [12–50 µmol/L (n = 2919)] were randomly assigned to daily supplementation of 500 µg vitamin B12, 400 µg folic acid, and 600 I

Negative Concord in Russian. An Overview

In this article I will describe the general properties of Negative Concord in Russian, which is a strict Negative Concord language, where all negative indefinites must co-occur with sentential negation. However, there are several cases where the negation marker can be absent (like in fragment answers) or can appear in a non-standard position (like at the left of an embedded infinitival). I will take into consideration all these specific cases described by the literature on the negation system of Russian and analyse them according to current approaches to Negative Concord

The construction of viewpoint aspect: the imperfective revisited

This paper argues for a constructionist approach to viewpoint Aspect by exploring the idea that it does not exert any altering force on the situation-aspect properties of predicates. The proposal is developed by analyzing the syntax and semantics of the imperfective, which has been attributed a coercer role in the literature as a de-telicizer and de-stativizer in the progressive, and as a de-eventivizer in the so-called ability (or attitudinal) and habitual readings. This paper proposes a unified semantics for the imperfective, preserving the properties of eventualities throughout the derivation. The paper argues that the semantics of viewpoint aspect is encoded in a series of functional heads containing interval-ordering predicates and quantifiers. This richer structure allows us to account for a greater amount of phenomena, such as the perfective nature of the individual instantiations of the event within a habitual construction or the nonculminating reading of perfective accomplishments in Spanish. This paper hypothesizes that nonculminating accomplishments have an underlying structure corresponding to the perfective progressive. As a consequence, the progressive becomes disentangled from imperfectivity and is given a novel analysis. The proposed syntax is argued to have a corresponding explicit morphology in languages such as Spanish and a nondifferentiating one in languages such as English; however, the syntax-semantics underlying both of these languages is argued to be the same

Searches at HERA for Squarks in R-Parity Violating Supersymmetry

A search for squarks in R-parity violating supersymmetry is performed in e^+p collisions at HERA at a centre of mass energy of 300 GeV, using H1 data corresponding to an integrated luminosity of 37 pb^(-1). The direct production of single squarks of any generation in positron-quark fusion via a Yukawa coupling lambda' is considered, taking into account R-parity violating and conserving decays of the squarks. No significant deviation from the Standard Model expectation is found. The results are interpreted in terms of constraints within the Minimal Supersymmetric Standard Model (MSSM), the constrained MSSM and the minimal Supergravity model, and their sensitivity to the model parameters is studied in detail. For a Yukawa coupling of electromagnetic strength, squark masses below 260 GeV are excluded at 95% confidence level in a large part of the parameter space. For a 100 times smaller coupling strength masses up to 182 GeV are excluded.Comment: 32 pages, 14 figures, 3 table

Multiplicity Structure of the Hadronic Final State in Diffractive Deep-Inelastic Scattering at HERA

The multiplicity structure of the hadronic system X produced in deep-inelastic processes at HERA of the type ep -> eXY, where Y is a hadronic system with mass M_Y< 1.6 GeV and where the squared momentum transfer at the pY vertex, t, is limited to |t|<1 GeV^2, is studied as a function of the invariant mass M_X of the system X. Results are presented on multiplicity distributions and multiplicity moments, rapidity spectra and forward-backward correlations in the centre-of-mass system of X. The data are compared to results in e+e- annihilation, fixed-target lepton-nucleon collisions, hadro-produced diffractive final states and to non-diffractive hadron-hadron collisions. The comparison suggests a production mechanism of virtual photon dissociation which involves a mixture of partonic states and a significant gluon content. The data are well described by a model, based on a QCD-Regge analysis of the diffractive structure function, which assumes a large hard gluonic component of the colourless exchange at low Q^2. A model with soft colour interactions is also successful.Comment: 22 pages, 4 figures, submitted to Eur. Phys. J., error in first submission - omitted bibliograph

Differential (2+1) Jet Event Rates and Determination of alpha_s in Deep Inelastic Scattering at HERA

Events with a (2+1) jet topology in deep-inelastic scattering at HERA are studied in the kinematic range 200 < Q^2< 10,000 GeV^2. The rate of (2+1) jet events has been determined with the modified JADE jet algorithm as a function of the jet resolution parameter and is compared with the predictions of Monte Carlo models. In addition, the event rate is corrected for both hadronization and detector effects and is compared with next-to-leading order QCD calculations. A value of the strong coupling constant of alpha_s(M_Z^2)= 0.118+- 0.002 (stat.)^(+0.007)_(-0.008) (syst.)^(+0.007)_(-0.006) (theory) is extracted. The systematic error includes uncertainties in the calorimeter energy calibration, in the description of the data by current Monte Carlo models, and in the knowledge of the parton densities. The theoretical error is dominated by the renormalization scale ambiguity.Comment: 25 pages, 6 figures, 3 tables, submitted to Eur. Phys.

Measurements of Transverse Energy Flow in Deep-Inelastic Scattering at HERA

Measurements of transverse energy flow are presented for neutral current deep-inelastic scattering events produced in positron-proton collisions at HERA. The kinematic range covers squared momentum transfers Q^2 from 3.2 to 2,200 GeV^2, the Bjorken scaling variable x from 8.10^{-5} to 0.11 and the hadronic mass W from 66 to 233 GeV. The transverse energy flow is measured in the hadronic centre of mass frame and is studied as a function of Q^2, x, W and pseudorapidity. A comparison is made with QCD based models. The behaviour of the mean transverse energy in the central pseudorapidity region and an interval corresponding to the photon fragmentation region are analysed as a function of Q^2 and W.Comment: 26 pages, 8 figures, submitted to Eur. Phys.