Validation of the usefulness of dose calculation algorithms in radiotherapy planning system

One of the main goals of radiotherapy is to achieve tumor control and minimize probability of normal-tissue complications. For this reason radiation oncology requires high accuracy, which implies no more than 2-3% uncertainty levels in the treatment planning calculations. That is challenging, when heterogeneous tissues such as lungs and bones are involved. To verify the accuracy of the dose calculation algorithms numerous approaches might be performed. The most common are point dose, one-dimensional profile and two-dimensional isodose line comparison with experimental measurements. In presented study, results of transport modeling and the deposited spatial distribution of the dose, obtained by anisotropic analytical algorithm and pencil beam convolution algorithm, were compared to measurements recorded during the experiment. To achieve meaningful conclusions, three parameters: dose difference, distance to agreement and gamma parameter (γ) were taken into consideration and examined. The irradiation was performed using CIRS anthropomorphic phantom. For dose detection gafchromic EBT films were used and scanned after exposure using Epson Scanner. Measured and planned dose distributions were analyzed via FilmQA software. Preliminary results showed that the anisotropic analytical algorithm, with its complex accounting of heterogeneities, provides more accurate dose calculation within an area of a high density gradient, than pencil beam convolution does. The level of the data accuracy derived from the experiment was: dose difference (5%) - 83.4% and 68% pixels passing, distance to agreement (3 mm) - 99.0% and 96.7%, gamma parameter (for dose difference (3%), distance to agreement (3 mm)) - 90% and 75.5%, respectively, for anisotropic analytical algorithm and pencil beam convolution algorithms. The comparison between studied parameters dose difference, distance to agreement and γ for both algorithms implicated anisotropic analytical algorithm as an appropriate approach in radiotherapy treatment planning

Challenges in radiotherapy planning : dose verification in the vicinity of the border of tissue-prosthesis medium

The success or failure of radiotherapy largely depends on the accuracy with which the dose will be delivered to a specific volume in the patient’s body. One of the problems associated with radiotherapy planning for patients with endoprostheses is the inaccuracy of the algorithm calculating the dose distribution in the treatment planning system for the area in the vicinity of the border of tissue–prosthesis medium. The aim of this study is verification of a planned dose on the border of hip prosthesis–acetabulum surface. At the examined energy — 6 MV — a dose results in decrease at the border of the medium, to achieve up to 10%. To verify this hypothesis, a water-filled phantom (soft tissue equivalent) was used with bone fragments (imitating hip joint) and metallic elements (hip joint endoprostheses) placed in a working stand. On acetabulum surface, thermoluminescent microdosimeters (TLD) based on lithium fluoride (LiF) was placed. The irradiation by medical linear accelerator was performed. The planned dose is higher compared with measured dose by approx. 9.8% (1.112 vs. 1.003 Gy for 2 Gy of fraction dose). It was confirmed that the treatment planning system overestimates the dose on the surface of acetabulum

Urban nitrogen budgets: Evaluating and comparing the path of nitrogen through cities for improved management

Reactive nitrogen (Nr) released to the environment is a cause of multiple environmental threats. While Nr flows are often only analyzed in an agricultural context, consumption and emission takes place in the urban environment, and opportunities for Nr recycling and effective policy implementation for mitigation often appear in cities. Since little information is available on the bigger picture of Nr flows through the urban environment, these opportunities often remain unexploited. Here we developed a framework to model Nr pathways through urban and surrounding areas, which we applied to four test areas (Beijing and Shijiazhuang (China), Vienna (Austria), and Zielona Góra (Poland)). Using indicators such as recycling rates and Nr surplus, we estimated environmental risks and recycling potentials based on Nr flows and their entry and exit points. Our findings show marked differences between the core and surrounding areas of each city, with the former being a site of Nr consumption with largest flows associated with households, and the latter a site of (agricultural) production with largest flows associated with industry (fertilizers) and urban plants. As a result, Nr transgresses the core areas in a rather linear manner with only 0-5 % being re-used, with inputs from Nr contained in food and fuels and outputs most commonly as non-reactive N2 emissions to the atmosphere from wastewater treatment and combustion processes. While the peri-urban areas show a higher Nr recycling rate (6-14 %), Nr accumulation and emissions from cultivated land pose significant environmental challenges, indicating the need for mitigation measures. We found potential to increase nitrogen use efficiency through improved Nr management on cultivated areas and to increase Nr recycling using urine and sewage sludge as synthetic fertilizer substitutes. Hence our framework for urban nitrogen budgets not only allows for consistent budgeting but helps identify common patterns, potentially harmful flows and Nr recycling potential

Emissions from mechanically-biologically treated waste landfills at field scale

Modern waste management tends towards greater sustainability in landfilling, with the implementation of strategies such as the pretreatment of solid waste. This work assesses the behaviour of rejects from a refining stage of mechanically-biologically treated municipal solid waste at the landfill. The main results of 18 months' monitoring of an experimental pilot cell with waste from a full-scale plant are presented. This first stages are expected to be the most problematic period for this type of waste. The evolution of the temperature and the composition of leachate and gas at various points within the cell are included. During the first weeks, pollutant concentrations in the leachate exceeded the reference ranges in the literature, coinciding with a rapid onset of methanogenic conditions. However, there was a quick wash, reducing concentrations to below one third of the initial values before the first year. pH values influenced concentrations of some pollutants such as copper. These results indicate that, right from the beginning of disposal, such facilities should be prepared to treat a high pollution load in the leachate and install the gas emissions control elements due to the rapid onset of methanogenesis.This work is funded by the Spanish Ministry of Economics and Competitiveness through the CTM2012-35055 project. The project is financed jointly by the European Regional Development Fund, FEDER (operational period 2007-2013). The authors wish to thank the Government of Cantabria, through the public company MARE, and TirCantabria, the landfill operator company, for their collaboration

Urban nitrogen budgets: flows and stock changes of potentially polluting nitrogen compounds in cities and their surroundings – a review

Concepts of material flow and mass consistency of nitrogen compounds have been used to elucidate nitrogen’s fate in an urban environment. While reactive nitrogen commonly is associated to agriculture and hence to large areas, here we have compiled scientific literature on nitrogen budget approaches in cities, following the central role cities have in anthropogenic activities generally. This included studies that specifically dealt with individual sectors as well as budgets covering all inputs and outputs to and from a city across all sectors and media. In the available data set, a clear focus on Asian cities was noted, making full use of limited information and thus enable to quantitatively describe a local pollution situation. Time series comparisons helped to identify trends, but comparison between cities was hampered by a lack of harmonized methodologies. Some standardization, or at least improved reference to relevant standardized data collection along international norms was considered helpful. Analysis of results available pointed to the following aspects that would reveal additional benchmarks for urban nitrogen budgets: analysing the share of nitrogen that is recycled or reused, separating largely independent sets of nitrogen flows specifically between food nitrogen streams and fossil fuel combustion-related flows, and estimating the stock changes for the whole domain or within individual pools

Continuous selections of multivalued mappings

This survey covers in our opinion the most important results in the theory of continuous selections of multivalued mappings (approximately) from 2002 through 2012. It extends and continues our previous such survey which appeared in Recent Progress in General Topology, II, which was published in 2002. In comparison, our present survey considers more restricted and specific areas of mathematics. Note that we do not consider the theory of selectors (i.e. continuous choices of elements from subsets of topological spaces) since this topics is covered by another survey in this volume

Effect of clinical signs, endocrinopathies, timing of surgery, hyperlipidemia, and hyperbilirubinemia on outcome in dogs with gallbladder mucocele

Gallbladder mucocele (GBM) is a common extra-hepatic biliary syndrome in dogs with death rates ranging from 7 to 45%. Therefore, the aim of this study was to identify the association of survival with variables that could be utilized to improve clinical decisions. A total of 1194 dogs with a gross and histopathological diagnosis of GBM were included from 41 veterinary referral hospitals in this retrospective study. Dogs with GBM that demonstrated abnormal clinical signs had significantly greater odds of death than subclinical dogs in a univariable analysis (OR, 4.2; 95% CI, 2.14–8.23; P < 0.001). The multivariable model indicated that categorical variables including owner recognition of jaundice (OR, 2.12; 95% CI, 1.19–3.77; P = 0.011), concurrent hyperadrenocorticism (OR 1.94; 95% CI, 1.08–3.47; P = 0.026), and Pomeranian breed (OR, 2.46; 95% CI 1.10–5.50; P = 0.029) were associated with increased odds of death, and vomiting was associated with decreased odds of death (OR, 0.48; 95% CI, 0.30–0.72; P=0.001). Continuous variables in the multivariable model, total serum/plasma bilirubin concentration (OR, 1.03; 95% CI, 1.01– 1.04; P < 0.001) and age (OR, 1.17; 95% CI, 1.08–1.26; P < 0.001), were associated with increased odds of death. The clinical utility of total serum/plasma bilirubin concentration as a biomarker to predict death was poor with a sensitivity of 0.61 (95% CI, 0.54–0.69) and a specificity of 0.63 (95% CI, 0.59–0.66). This study identified several prognostic variables in dogs with GBM including total serum/plasma bilirubin concentration, age, clinical signs, concurrent hyperadrenocorticism, and the Pomeranian breed. The presence of hypothyroidism or diabetes mellitus did not impact outcome in this study

DRhigh+CD45RA−-Tregs Potentially Affect the Suppressive Activity of the Total Treg Pool in Renal Transplant Patients

Recent studies show that regulatory T cells (Tregs) play an essential role in tolerance induction after organ transplantation. In order to examine whether there are differences in the composition of the total CD4+CD127low+/−FoxP3+- Treg cell pool between stable transplant patients and patients with biopsy proven rejection (BPR), we compared the percentages and the functional activity of the different Treg cell subsets (DRhigh+CD45RA−-Tregs, DRlow+CD45RA−-Tregs, DR−CD45RA−-Tregs, DR−CD45RA+-Tregs). All parameters were determined during the three different periods of time after transplantation (0–30 days, 31–1,000 days, >1,000 days). Among 156 transplant patients, 37 patients suffered from BPR. The most prominent differences between rejecting and non-rejecting patients were observed regarding the DRhigh+CD45RA−-Treg cell subset. Our data demonstrate that the suppressive activity of the total Treg pool strongly depends on the presence of these Treg cells. Their percentage within the total Treg pool strongly decreased after transplantation and remained relatively low during the first year after transplantation in all patients. Subsequently, the proportion of this Treg subset increased again in patients who accepted the transplant and reached a value of healthy non-transplanted subjects. By contrast, in patients with acute kidney rejection, the DRhigh+CD45RA−-Treg subset disappeared excessively, causing a reduction in the suppressive activity of the total Treg pool. Therefore, both the monitoring of its percentage within the total Treg pool and the monitoring of the HLA-DR MFI of the DR+CD45RA−-Treg subset may be useful tools for the prediction of graft rejection