Clinical implications of the anisotropic analytical algorithm for IMRT treatment planning and verification

PURPOSE: To determine the implications of the use of the Anisotropic Analytical Algorithm(AAA) for the production and dosimetric verification of IMRT plans for treatments of the prostate, parotid, nasopharynx and lung. METHODS: 72 IMRT treatment plans produced using the Pencil Beam Convolution (PBC)algorithm were recalculated using the AAA and the dose distributions compared. 24 of the plans were delivered to inhomogeneous phantoms and verification measurements made using a pinpoint ionisation chamber. The agreement between the AAA and measurement was determined. RESULTS: Small differences were seen in the prostate plans, with the AAA predicting slightly lower minimum PTV doses. In the parotid plans, there were small increases in the lens and contralateral parotid doses while the nasopharyngeal plans revealed a reduction in the volume of the PTV covered by the 95% isodose (the V95%) when the AAA was used. Large changes were seen in the lung plans, the AAA predicting reductions in the minimum PTV dose and large reductions in the V95%. The AAA also predicted small increases in the mean dose to the normal lung and the V20. In the verification measurements, all AAA calculations were within 3% or 3.5mm distance to agreement of the measured doses. Conclusions: The AAA should be used in preference to the PBC algorithm for treatments involving low density tissue but this may necessitate re-evaluation of plan acceptability criteria. Improvements to the Multi-Resolution Dose Calculation algorithm used in the inverse planning are required to reduce the convergence error in the presence of lung tissue. There was excellent agreement between the AAA and verification measurements for all sites

Serendipitous Data Following a Severe Windstorm in an Old-Growth Pine Stand

Reliable dimensional data for old-growth pine-dominated forests in the Gulf Coastal Plain of Arkansas are hard to find, but sometimes unfortunate circumstances provide good opportunities to acquire this information. On July 11, 2013, a severe thunderstorm with high winds struck the Levi Wilcoxon Demonstration Forest (LWDF) near Hamburg, Arkansas. This storm uprooted or snapped dozens of large pines and hardwoods and provided an opportunity to more closely inspect these rare specimens. For instance, the largest tree killed in this event, a loblolly pine (Pinus taeda), was 105 cm in diameter at breast height, 39.3 m tall, and if the tree had been sound would have yielded 3,803 board feet (Doyle log rule) of lumber. Gross board foot volume yield was also estimated from two other recently toppled large pines, an 85-cm-DBH loblolly and an 86-cm-DBH shortleaf pine (Pinus echinata), which tallied 2,430 and 2,312 board feet Doyle, respectively. A number of the other wind thrown pines on the LWDF were sound enough to count their rings for a reasonable (± 2-5 years) estimate of their ages. The stump of the fallen national champion shortleaf pine had 168 rings, and counts from other pines toppled by this storm had from 68 to 198 rings. We also searched for a new champion shortleaf pine using a LiDAR canopy height model of the LWDF to narrow our search. This preliminary assessment produced a number of targets that exceeded 40 m in height; further field checking of the tallest of these trees found that these were loblolly pines up to about 44 m. We eventually found shortleaf pines between 37 and 41 m tall, with diameters of up to 85 cm, indicating that the LWDF could still contain the Arkansas state champion

Autophagia in a Patient with Dementia and Hemineglect: A Case Report

Introduction: Patients living with dementia as well as patients with neurological deficits are at significant risk for injury from multiple sources. Injuries may include falls, neglect, and, in some cases, self-injury. These patients require significant observation and closely monitored care.  Case Report: A 90-year-old man presented to a suburban emergency department (ED) by his family, who cared for him at home. The following case report describes a patient with dementia, hemineglect, and bruxism from a previous stroke who suffered a self-induced, partial amputation of his own thumb on the neglected side of his body.    Conclusion: Patients with dementia and neurologic deficits present frequently in the ED. These patients are at considerable risk of self-injury. The emergency physician should maintain vigilance in both screening for injuries and being aware of these risks when planning living arrangements after disposition from the ED

EMU Ag-Zn battery wet-life extension test

The Extravehicular Mobility Unit (EMU) silver/zinc (Ag/Zn) battery is an 11 cell battery of approximately 30 AH. The Ag/Zn battery is comprised of two 4-cell monoblocks and one 3-cell monoblock. A discussion of a wet-life extension test performed on the battery is given in viewgraph form

Simulation of iced wing aerodynamics

The sectional and total aerodynamic load characteristics of moderate aspect ratio wings with and without simulated glaze leading edge ice were studied both computationally, using a three dimensional, compressible Navier-Stokes solver, and experimentally. The wing has an untwisted, untapered planform shape with NACA 0012 airfoil section. The wing has an unswept and swept configuration with aspect ratios of 4.06 and 5.0. Comparisons of computed surface pressures and sectional loads with experimental data for identical configurations are given. The abrupt decrease in stall angle of attack for the wing, as a result of the leading edge ice formation, was demonstrated numerically and experimentally