Evaluation of soft-tissue match methods for utilization in CBCT guided adaptive radiotherapy of lung cancer patients – clinical benefits, limitations and margin determination

Purpose: The aim of this study is to a) study the benefits and limitations with soft-tissue match for lung cancer patients, b) evaluate five different soft-tissue match methods, c) compare soft-tissue with bony match, d) find the stable surrogates to match on for obscured malignant lymph nodes, e) calculate CTV to PTV and OAR margins and volume of PTV for the corresponding margins, and d) study the anatomical changes associated with radiotherapy for lung cancer. Material and methods: 23 lung cancer patients (16 NSCLC, 7 SCLC) treated with radiotherapy, with 135 weekly CBCT set-up images were retrospectively matched to the planning CTs by five different match methods using the registration software Offline Review, version 10.0 (Varian Medical Systems). Four match methods utilized the volume of interest (VOI) of the CT defined GTV, including the internal motion (GTV-T/IM), plus a 2, 5, 10 or 20 mm symmetrical margin, respectively. The fifth match method used a square VOI enclosing the GTV-T with a 10 mm symmetrical margin. An intensity range of [-150;150] HU was used for automatic soft-tissue matches. Bony match was retrospectively performed and compared to soft-tissue match. Residual GTV-T/IM set-up deviations in all directions were studied for each match and PTV-T margins were calculated. Additionally, stable surrogates close to GTV-N was used for the residual GTV-N set-up deviation measurements and PTVN margin calculations. Total PTV, based on the margins calculated, was measured, by adding CTV to PTV margins to the delineated CTV for bony and GTV-T/IM + 10 mm soft-tissue matches. Additional 5 patients were included and anatomical changes were observed. Results: All soft-tissue match methods gave similar residual GTV-T/IM set-up deviations, ranging between [-3;3] mm, resulting in [5.2;5.8] mm PTV-T margins compared to bony match with deviations between [-8:10] mm and PTV-T margins [7.4;8.6] mm. Match methods utilizing larger VOIs were more stable compared to match methods using smaller VOIs. Auto match on small targets (< 3 cm3) was problematic, and not possible for match method 5. For 77% of the patients with lymph nodes, the main bronchi area was a suitable stable surrogate. For the remaining lateral GVT-Ns the aortic arch and the main pulmonary artery were suitable as surrogates. Soft-tissue and bony residual GTV-N set-up deviations ranged between [-8;10] and [-20;9] mm respectively resulting in PTV-N margins between [6;9.8] and [7.1;8.1] mm respectively. Mean total PTV spare with soft-tissue match was 54 cm3. Anatomical changes, atelectasis (21%) and pneumonitis (4%) occurred randomly during the course of treatment. For the 8 patients with large anatomical changes, which required adaptive strategy, atelectasis and tumor change were the dominant reasons for adaptation. Conclusion: Using soft-tissue match reduces the required PTV-T margins. For semi-automatic softtissue match on the primary tumor, match within GTV-T/IM with a 10 or 20 mm margin extension used as match VOIs were most appropriate. For small tumors (< 3 cm3), match manually on GTVT/ IM itself is advisable. The main bronchi area is a suitable surrogate primarily for centrally positioned mediastinal GTV-N. Atelectasis was the dominant anatomical change observed. Daily CBCT prevent missing significant anatomical changes and shorten the time between the observation and the adaptive strategy implementation.Bildstyrd strålterapi är en process bestående av att ta 2D eller 3D bilder under strålbehandlingens gång och används för att försäkra sig om att patienten är positionerad på samma sätt som referensbilden för att få samma dos som planerades (beräknat på referens bilden). I det här arbetet har en 3D scanning av patientens positionering jämförs med en CT referensbild för patienten. Efter matchen, som utförs precis innan varje behandling,korrigerasavvikelsen mellan bilderna. Avvikelserna i ryggraden (benmatch) eller i tumören (target match) korrigeras genom att automatiskt flytta patienten på plats gnom att flytta britsen i alla nödvändiga riktningar. 3D scanningen ger information om mjukvävnad och tumörens position. Lungtumören rör sig som följd av andningen och andra organens rörelse därför är matchningen på tumören att föredra istället för att matcha på ryggraden. För en säkrare och noggrannare match används därför 3D scanningen för lungcancer patienter. Det har gjordes en jämförelse mellan att matcha på tumören med en marginal runt om och att matcha på ryggmärgen. Veckovisa 3D scanningar har använts för den studien och matchningarna har utförts retrospektivt. Tumörens uppställningsavvikelse beräknades för både benmatch och target match. Baserat på de avvikelserna har marginalen som behövs runt tumören beräknats. Marginalens uppgift är att försäkra sig om att tumören kommer att få den planerade dosen. Anatomiska förändringar och deras uppkomsttid har observerats under behandlingstiden. Resultaten visade att alla target match med en lite större marginal är stabilare att använda jämfört med target match med mindre marginaler. Resultaten visade också att det behövs en mindre marginal runt tumören när matchningen har gjorts på tumören jämförts med matchningen på ryggraden. Mindre marginal innebär att man sparar friskvävnad ifrån onödig strålning. Observeringen av anatomiska förändringar visade att förändringarna skedde slumpmässigt och sammanfallen lungblåsa (då en del av lungan inte har fyllts med luft när man andas in) var den dominerande förändringen. Dagliga 3D scanningar skulle förebygga miss av anatomiska förändringar av betydelse

PELATIHAN IMPLEMENTASI LITERASI DAN NUMERASI DALAM PROSES PEMBELAJARAN UNTUK GURU MTsS

Abstrak: Guru merupakan salah satu komponen yang sangat berpengaruh dalam meningkatkan kualitas pembelajaran di abad 21 ini. Oleh karena itu, sangat diperlukan adanya kegiatan mengenai pengembangan kualitas guru dalam menghadapi proses pembelajaran abad 21 khususnya pada kemampuan literasi. Literasi merupakan kemampuan dan keterampilan individu dalam membaca, menulis, berbicara, menghitung dan memecahkan masalah pada tingkat keahlian tertentu yang diperlukan dalam kehidupan sehari-hari. Tujuan dari kegiatan pengabdian ini adalah memberikan manfaat kepada kepada guru-guru dalam mengimplentasikan literasi dalam proses pembelajaran sehingga dapat meningkatkan hasil belajar siswa khusunya pada kemampuan literasi. Adapun pengabdian ini dilaksanakan dengan menggunakan metode pelatihan dengan tahapan-tahapannya yaitu: persiapan, sosialisasi, pengenalan jenis-jenis literasi, pelatihan dan evaluasi. Kegiatan pengabdian berlangsung di MTsS Tanjong Beuridi yang bertindak sebagai mitra. Kegiatan di ikuti oleh 11 orang guru di sekolah tersebut. Evaluasi dilakukan untuk melihat ketercapaian kegiatan yang telah dilakukan, hasilnya diperoleh rata-rata 91,44% artinya pelaksanaan pengabdian sesuai dengan perencanaan serta mendapat apresiasi yang baik dari peserta yaitu guru MTsS Tanjong Beuridi. Abstract: Teachers are one of the most influential components in improving the quality of learning in the 21st century. Therefore, it is very necessary to have activities regarding the development of teacher quality in facing the 21st century learning process, especially in literacy skills. Literacy is an individual's ability and skill in reading, writing, speaking, calculating and solving problems at a certain level of expertise needed in everyday life. The purpose of this service activity was to provide benefits to teachers in implementing literacy in the learning process so that the teachers can improve student learning outcomes, especially in literacy skills. This service activity was carried out by using a training method with the stages, namely: preparation, socialization, introduction to the types of literacy, training and evaluation. The service activity took place at MTsS Tanjong Beuridi as school partnership. The activity was attended by 11 teachers of the school. The evaluation was carried out to see the achievement of the activities. The results of this service activity obtained an average of 91.44% which meant that the implementation of the service activity run as planned and received a good appreciation from the teacher of MTsS Tanjong Beuridi as participants

ANALISIS KEMAMPUAN LITERASI NUMERASI DALAM MENYELESAIKAN SOAL PROGRAMME FOR INTERNATIONAL STUDENT ASSESSMENT (PISA)

This study aims to reveal deeper numeracy literacy skills in solving the Program for International Student Assessment (PISA) questions. This research was conducted at SMAS Cerdas Murni Tembung in the odd semester of the 2022/2023 academic year. The research subjects consisted of 28 students of class X MIPA-1. The research uses qualitative methods with a descriptive approach. The research instruments used were PISA test questions and interviews. The results showed that 44% of student were able to fulfill the ability indicators in using syimbols, numbers, and calculate mathematical operations contained in questions at levels 1, 4, and 5. In the indicator of the ability to analyze information from tables, graphs, diagrams, schematics, etc., it was obtained that 57,1% of students were able to solve PISA level 3. As well as indicators of skills in applying concepts as well as making decisions contained in level 2 and level 6 questions, 42,3% of students were able to meet these indicators. So that, the overall numeracy literacy ability of class X MIPA-1 students can be categorized as lacking in solving the Program For International Student Assessment (PISA) questions

UPAYA MENINGKATKAN HASIL BELAJAR SISWA MELALUI MODEL PEMBELAJARAN ARIAS (ASSURANCE, RELEVANCE, INTEREST, ASSESSMENT, SATISFACTION

ABSTRAK Penelitian ini bertujuan untuk mengetahui bagaimanakah peningkatan hasil belajar siswa melalui model pembelajaran ARIAS (Assurance, Relevance, Interest, Assessment, Satisfaction) pokok bahasan fluida kelas XI IPA semester II SMA Islamic Centre Sultan Fattah Demak. Metode yang digunakan adalah metode penelitian tindakan kelas yang dilaksanakan dalam dua siklus. Masing-masing siklus merupakan rangkaian tahapan perencanaan, pelaksanaan, observasi dan refleksi. Aktivitas siswa menunjukkan peningkatan sebesar 21% yaitu 61% pada siklus I menjadi 82% pada siklus II. Hasil belajar pada siklus I mencapai ketuntasan klasikal 56,52% dengan 13 tuntas belajar, sedangkan pada siklus II sebesar 86,96% dengan 20 anak tuntas belajar. Hasil pengamatan kinerja guru dalam menerapkan model pembelajaran ARIAS menunjukkan prosentase 73% pada siklus I dan 93% pada siklus II. Berdasarkan hasil analisis dan pembahasan tersebut dapat disimpulkan bahwa model pembelajaran ARIASdapat meningkatkan hasil belajar siswa pokok bahasan fluida kelas XI IPA semester II SMA Islamic Centre Sultan Fattah Demak tahun pelajaran 2011/2012. ?é?á Kata kunci: model pembelajaran ARIAS (Assurance,Relevance, Interest, Assessment, Satisfaction),hasil belajar

Analisis kemampuan literasi numerasi dalam menyelesaikan soal Programme for International Student Assessment (PISA) di SMAS Cerdas Murni Tembung T.A 2022/2023

This study aims to reveal deeper numeracy literacy skills in solving the Program for International Student Assessment (PISA) questions. This research was conducted at SMAS Cerdas Murni Tembung in the odd semester of the 2022/2023 academic year. The research subjects consisted of 28 students of class X MIPA1. The research uses qualitative methods with a descriptive approach. The research instruments used were PISA test questions and interviews. The results of this study indicate that based on indicators of numeracy literacy skills for indicators of the ability to use symbols, numbers, and calculate mathematical operations contained in levels 1,4, and 5 questions 44% of students were able to fulfill these indicators. In the indicator of the ability to analyze information from tables, graphs, diagrams, schematics, etc., it was obtained that 57,1% of students were able to solve PISA level 3 questions correctly according to the indicators of numeracy literacy ability. As well as indicators of skills in applying concepts as well as making decisions contained in level 2 and level 6 questions, 42,3% of students were able to meet these indicators. Thus, the overall numeracy literacy ability of class X MIPA-1 students can be categorized as lacking in solving the Program For International Student Assessment (PISA) question

DAMPAK PANDEMI COVID 19 TERHADAP PENDAPATAN MASYARAKAT KAWASAN WISATA PANTAI SELATAN KABUPATEN BANTUL

Pandemi Covid 19 memberikan dampak pada berbagai kegiatan masyarakat khususnya sektor pariwisata. Mayoritas masyarakat Kabupaten Bantul di daerah pesisir pantai menggantungkan penghidupannya pada sektor parwisata dengan berdagang. Pandemi berdampak pada sumber mata pencaharian dari sektor pariwisata menurun, sehingga penurunkan pendapatan rumah tangga dan menyebabkan ketimpangan distribusi pendapatan masyarakat. Penelitian ini bertujuan untuk mengetahui perubahan pendapatan masyarakat, serta menganalisis ketimpangan distribusi pendapatan masyarakat di Kawasan Wisata Pesisir Pantai Kabupaten Bantul sebelum dan setelah Pandemi Covid 19. Metode dasar yang digunakan adalah deskriptif analitis. Pengambilan lokasi penelitian dilaksanakan menggunakan metode purposive sampling yaitu Pantai Goa Cemara (Kecamatan Sanden) dan Pantai Baru (Kecamatan Srandakan). Metode analisis data yang digunakan untuk mengetahui perubahan pendapatan masyarakat sebelum dan setelah Pandemi Covid 19 adalah uji Analysis of Variance (ANOVA) One-Way yang dilanjutkan dengan uji lanjut (Post Hoc Test), ketimpangan distribusi pendapatan masyarakat dianalisis menggunakan Indeks Gini dan Kurva Lorenz. Hasil penelitian diperoleh perubahan pendapatan masyarakat sebelum dan setelah pandemi covid 19 sangat signifikan perbedaannya antara sebelum (tahun 2019) dan saat tahun pertama pandemi (tahun 2020) serta tahun pertama pandemi (2020) dengan pasca pandemi mereda (tahun 2022). Ketimpangan distribusi pendapatan masyarakat sebelum dan setelah Pandemi Covid 19 mengalami ketimpangan yang tinggi saat pandemi Covid 19 di tahun 2020 dan 2021, berbeda dengan saat sebelum pandemi (tahun 2019) dan pasca pandemi tahun 2022 yang termasuk dalam ketimpangan sedang

Rural Household Livelihood Strategies in the South Coast Tourism Area of Bantul Regency Facing the Covid-19 Pandemic

Rural communities are known to have a tough life survival strategy in the face of all kinds of shocks problem, both natural and economic shocks. They are also easy to adapt. The Covid-19 pandemic affects the economic activities of rural communities in tourist areas, causing the community have a difficulty to earn a living in tourist areas from an economic perspective. This study aims to determine the household strategies of rural communities in achieving sustainable livelihoods in the Coastal Tourism Area of Bantul Regency in Facing the Covid-19 Pandemic. The basic method used is descriptive analytical. The research location was taken on a new beach in Bantul Regency which was crowded with visitors in the last 5 years, namely Goa Cemara Beach (Sanden District) and Baru Beach (Srandakan District). The data analysis method used is descriptive analysis method. The livelihood strategies chosen by rural households are divided into three criteria, namely survival strategies, consolidation, or accumulation. The classification of strategies is carried out based on the household income of the community. The result of the research is that the rural household strategy used to support the achievement of sustainable livelihoods is dominated by the consolidation strategy. Consolidation strategies are mostly carried out by the community both before, during and after the Covid 19 Pandemic. Consolidated community households develop themselves in the use of assets for medium-term goals and have sufficient assets to support daily household livelihoods

Analisis Pemahaman Mahasiswa Fakultas Teknik UNSIKA Terkait Sustainable Development dalam Eco Travel pada Tempat Wisata

Peningkatan pariwisata yang tidak terkendali dapat memberikan dampak negatif bagi keberlanjutan tempat wisata, budaya lokal, dan lingkungan. Sehinnga, kebutuhan akan pengembangan pariwisata berkelanjutan (Eco Travel) pun semakin meningkat. Eco Travel sendiri bertujuan untuk mengurangi dampak negatif terhadap lingkungan dan budaya setempat, sambil memberikan manfaat ekonomi yang berkelanjutan bagi masyarakat lokal. Melihat hal tersebut, sangat penting bagi seluruh masyarakat terutama terutama generasi muda seperti mahasiswa untuk mendapatkan pengetahuan dan pemahaman terhadap konsep Eco Travel. Dalam penelitian ini dilakukan analisis pengetahuan mahasiswa terkait Eco Travel pada tempat wisata. Sehingga dapat diidentifikasi sejauh mana mahasiswa memahami konsep Eco Travel dan ketersediaan mereka mengubah perilaku wisata untuk mendukung pariwisata berkelanjutan. Pemahaman mahasiswa diukur menggunakan indikator pemahaman yang terbagi menjadi 6 indikator, yaitu menafsirkan, mencontohkan, mengklasifikasikan, menyimpulkan, membandingkan, dan menjelaskan. Data yang telah dikumpulkan berdasarkan kuesioner selanjutnya dianalisis lebih lanjut dengan menggunakan uji statistik (Cronbach Alpha) dan bantuan program SPSS untuk mendapatkan hasil penelitian yang sesuai. Hasil penelitian menyebutkan bahwa rata-rata sebesar 70% atau 70 mahasiswa sudah memahami Eco Travel pada tempat wisata dengan nilai yang paling tinggi yaitu pada kemampuan menyimpulkan

Predicting the Halal Food Consumption of Indonesian Moslem Students: an Application of Theory of Planned Behaviour

The study aimed to predict halal food consumption behavior among Moslem students in three different universities in Yogyakarta City. Determinants to explain the halal food consumption was developed based on theory of planned behavior. The research applied cross-sectional design with total respondents of 168 Moslems students from State University, Islamic University, and Catholic University in Yogyakarta. The score of attitude, knowledge, subjective norm, perceived behavioral control and halal food consumption behavior were collected through a questionnaire. The data was analysed using Kruskall-Wallis and Multiple Linear Regression test. The study found that the score of knowledge in Islamic State and State University were higher than in Catholic University (7.43 vs 7.29 vs 7.09). The highest score of attitude was 51.52 in State University compared to Islamic State University and Catholic University (49.8 vs 47.61). The highest score of subjective norm was also in State University with the score of 3.59 while the score of halal food consumption behaviour was higher in State and Islamic State University compared to Catholic University (9.18 vs 9.18 vs 7.89). From those categories, the score of all variables except for the knowledge was statistically different between the three universities (p&lt;0.05). It was concluded that the behavior of halal food consumption among Moslem students in Yogyakarta City may be predicted from the knowledge, attitude, subjective norm, and perceived behavioral control. These findings help to explain why the Moslem students in Yogyakarta eat halal food. Further research is needed to determine whether there are factors affecting halal food consumption behavior and how to improve it