Towards the production of radiotherapy treatment shells on 3D printers using data derived from DICOM CT and MRI: preclinical feasibility studies

Background: Immobilisation for patients undergoing brain or head and neck radiotherapy is achieved using perspex or thermoplastic devices that require direct moulding to patient anatomy. The mould room visit can be distressing for patients and the shells do not always fit perfectly. In addition the mould room process can be time consuming. With recent developments in three-dimensional (3D) printing technologies comes the potential to generate a treatment shell directly from a computer model of a patient. Typically, a patient requiring radiotherapy treatment will have had a computed tomography (CT) scan and if a computer model of a shell could be obtained directly from the CT data it would reduce patient distress, reduce visits, obtain a close fitting shell and possibly enable the patient to start their radiotherapy treatment more quickly. Purpose: This paper focuses on the first stage of generating the front part of the shell and investigates the dosimetric properties of the materials to show the feasibility of 3D printer materials for the production of a radiotherapy treatment shell. Materials and methods: Computer algorithms are used to segment the surface of the patient’s head from CT and MRI datasets. After segmentation approaches are used to construct a 3D model suitable for printing on a 3D printer. To ensure that 3D printing is feasible the properties of a set of 3D printing materials are tested. Conclusions: The majority of the possible candidate 3D printing materials tested result in very similar attenuation of a therapeutic radiotherapy beam as the Orfit soft-drape masks currently in use in many UK radiotherapy centres. The costs involved in 3D printing are reducing and the applications to medicine are becoming more widely adopted. In this paper we show that 3D printing of bespoke radiotherapy masks is feasible and warrants further investigation

Negotiating sacred roles:a sociological exploration of priests who are mothers

In 1992, in a historic move, the Church of England voted to allow women's ordination to priesthood and in 1994 the first women priests started to be ordained. Despite much research interest, the experiences of priests who are mothers to dependent children have been minimally investigated. Based on in-depth interviews with seventeen mothers ordained in the Church, this paper will focus on how the sacred-profane boundary is managed. Priests who are mothers have a particular insight into the Church hierarchy as they symbolically straddle the competing discourses of sacred and profane. However, instead of reifying these binaries, the experiences of these women show how such dualisms are challenged and managed in everyday life. Indeed, in terms of experience, ritual, ministry and preaching, priests who are mothers are resisting, recasting and renegotiating sacred terrain in subtle and nuanced ways. Mothers thus not only negotiate the practical and sacramental demands placed on priests, but also illuminate how the sacred domain is regulated and constructed

A tunable amorphous p-type ternary oxide system:the highly mismatched alloy of copper tin oxide

The approach of combining two mismatched materials to form an amorphous alloy was used to synthesise ternary oxides of CuO and SnO2. These materials were analysed across a range of compositions, and the electronic structure was modelled using density functional theory. In contrast to the gradual reduction in optical band gap, the films show a sharp reduction in both transparency and electrical resistivity with copper contents greater than 50%. Simulations indicate that this change is caused by a transition from a dominant Sn 5s to Cu 3d contribution to the upper valence band. A corresponding decrease in energetic disorder results in increased charge percolation pathways: a “compositional mobility edge.” Contributions from Cu(II) sub band-gap states are responsible for the reduction in optical transparency

Tulžies latakų akmenligė: ligos įtarimas, diagnozė, gydymas

Bile duct stones are a quite common (10–18%) complication of gallstone disease or an autonomous condition. New noninvasive diagnostic methods established in the last decades allow to confirm suspected choledocholithiasis with minimal risk of iatrogenic complications.In this literature review we discuss various scores for choledocholithiasis risk degree, different diagnostic investigations and management approaches including timing for invasive procedures.Tulžies latakų akmenys – gana dažna (10–18 %) tulžies pūslės akmenligės komplikacija ar savarankiška patologija. Pastaraisiais dešimtmečiais atsiradę nauji neinvaziniai diagnostikos metodai leidžia patikslinti įtariamą tulžies latakų akmenligės diagnozę minimalizavus jatrogeninių komplikacijų riziką.Šioje literatūros apžvalgoje aptariamos rizikos vertinimo sistemos, leidžiančios apsispręsti dėl papildomų tyrimų tikslingumo, pristatomi įvairūs diagnostiniai metodai, skirtingos gydymo ir tyrimo taktikos, aptariamas gydymo laiko pasirinkimas

Voicing passion: The emotional economy of songwriting

This article examines articulations of the role of passion in accounts of the life and work of the songwriter. It draws upon a range of interviews with successful artists captured in the Sodajerker On Songwriting podcast. It is suggested that these interviews capture the ‘voicing’ of the conventions of creativity in popular music, exploring a context in which passionate motivation, expression and understanding of the (potentially) affective responses to songs are paramount to the labour of the songwriter. The article explores how the core of this labour deals in emotion, attempting to articulate feelings in recognisable, tradable form. This is a process that is both instrumentally rationalised but often felt to be a deeply authentic process, understood (and believed) to spring from the individual’s emotional experience, so conferring identity in a generic field. In light of current debates about the nature of creative work and emotional labour, the accounts drawn upon here can be seen to epitomise many of the qualities of what constitutes ‘good work’ through a mode of self-actualisation

Developing a community based psychosocial intervention with older people and third sector workers for anxiety and depression: a qualitative study

Background: One-in-five people in the UK experience anxiety and/or depression in later life. However, anxiety and depression remain poorly detected in older people, particularly in those with chronic physical ill health. In the UK, a stepped care approach, to manage common mental health problems, is advocated which includes service provision from non-statutory organisations (including third/voluntary sector). However, evidence to support such provision, including the most effective interventions, is limited. The qualitative study reported here constitutes the first phase of a feasibility study which aims to assess whether third sector workers can deliver a psychosocial intervention to older people with anxiety and/or depression. The aim of this qualitative study is to explore the views of older people and third sector workers about anxiety and depression among older people in order to refine an intervention to be delivered by third sector workers. Methods: Semi-structured interviews with participants recruited through purposive sampling from third sector groups in North Staffordshire. Interviews were digitally recorded with consent, transcribed and analysed using principles of constant comparison. Results: Nineteen older people and 9 third sector workers were interviewed. Key themes included: multiple forms of loss, mental health as a personal burden to bear, having courage and providing/receiving encouragement, self- worth and the value of group activities, and tensions in existing service provision, including barriers and gaps. Conclusions: The experience of loss was seen as central to feelings of anxiety and depression among community- dwelling older people. This study contributes to the evidence pointing to the scale and severity of mental health needs for some older people which can arise from multiple forms of loss, and which present a significant challenge to health, social care and third sector services. The findings informed development of a psychosocial intervention and training for third sector workers to deliver the intervention

The Effect of Auditory Distraction on the Useful Field of View in Hearing Impaired Individuals and its implications for driving

This study assessed whether the increased demand of listening in hearing impaired individuals exacerbates the detrimental impact of auditory distraction on a visual task (useful field of view test), relative to normally hearing listeners. Auditory distraction negatively affects this visual task, which is linked with various driving performance outcomes. Hearing impaired and normally hearing participants performed useful field of view testing with and without a simultaneous listening task. They also undertook a cognitive test battery. For all participants, performing the visual and auditory tasks together reduced performance on each respective test. For a number of subtests, hearing impaired participants showed poorer visual task performance, though not to a statistically significant extent. Hearing impaired participants were significantly poorer at a reading span task than normally hearing participants and tended to score lower on the most visually complex subtest of the visual task in the absence of auditory task engagement. Useful field of view performance is negatively affected by auditory distraction, and hearing loss may present further problems, given the reductions in visual and cognitive task performance suggested in this study. Suggestions are made for future work to extend this study, given the practical importance of the findings