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Dose Error Reduction System

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https://www.readbyqxmd.com/read/28179741/innovations-in-medication-preparation-safety-and-wastage-reduction-use-of-a-workflow-management-system-in-a-pediatric-hospital
#1
Stephen Jerome Davis, Josephine Hurtado, Rosemary Nguyen, Tran Huynh, Ivan Lindon, Cedric Hudnall, Sara Bork
Background: USP <797> regulatory requirements have mandated that pharmacies improve aseptic techniques and cleanliness of the medication preparation areas. In addition, the Institute for Safe Medication Practices (ISMP) recommends that technology and automation be used as much as possible for preparing and verifying compounded sterile products. Objective: To determine the benefits associated with the implementation of the workflow management system, such as reducing medication preparation and delivery errors, reducing quantity and frequency of medication errors, avoiding costs, and enhancing the organization's decision to move toward positive patient identification (PPID)...
January 2017: Hospital Pharmacy
https://www.readbyqxmd.com/read/28130918/anifrolumab-an-anti-interferon-%C3%AE-receptor-monoclonal-antibody-in-moderate-to-severe-systemic-lupus-erythematosus
#2
Richard Furie, Munther Khamashta, Joan T Merrill, Victoria P Werth, Kenneth Kalunian, Philip Brohawn, Gabor G Illei, Jorn Drappa, Liangwei Wang, Stephen Yoo
OBJECTIVE: To assess the efficacy and safety of anifrolumab, a type I interferon (IFN) receptor antagonist, in a phase IIb, randomized, double-blind, placebo-controlled study of adults with moderate-to-severe systemic lupus erythematosus (SLE). METHODS: Patients (n = 305) were randomized to receive intravenous anifrolumab (300 mg or 1,000 mg) or placebo, in addition to standard therapy, every 4 weeks for 48 weeks. Randomization was stratified by SLE Disease Activity Index 2000 score (<10 or ≥10), oral corticosteroid dosage (<10 or ≥10 mg/day), and type I IFN gene signature test status (high or low) based on a 4-gene expression assay...
February 2017: Arthritis & Rheumatology
https://www.readbyqxmd.com/read/28126192/using-vitamin-e-to-prevent-the-impairment-in-behavioral-test-cell-loss-and-dendrite-changes-in-medial-prefrontal-cortex-induced-by-tartrazine-in-rats
#3
Ali Rafati, Nasrin Nourzei, Saied Karbalay-Doust, Ali Noorafshan
Tartrazine is a food color that may adversely affect the nervous system. Vitamin E is a neuro-protective agent. This study aimed to evaluate the effects of tartrazine and vitamin E on the performance of rats in memory and learning tests as well as the structure of medial Prefrontal Cortex (mPFC). The rats were first divided into seven groups which received the followings for a period of seven weeks: distilled water, corn oil, vitamin E (100mg/kg/day), a low dose (50mg/kg/day) and a high dose (50mg/kg/day) of tartrazine with and without vitamin E...
March 2017: Acta Histochemica
https://www.readbyqxmd.com/read/28099320/closed-loop-delivery-systems-versus-manually-controlled-administration-of-total-iv-anesthesia-a-meta-analysis-of-randomized-clinical-trials
#4
Laura Pasin, Pasquale Nardelli, Margherita Pintaudi, Massimiliano Greco, Massimo Zambon, Luca Cabrini, Alberto Zangrillo
Bispectral Index Scale (BIS)-guided closed-loop delivery of anesthetics has been extensively studied. We performed a meta-analysis of all the randomized clinical trials comparing efficacy and performance between BIS-guided closed-loop delivery and manually controlled administration of total IV anesthesia. Scopus, PubMed, EMBASE, and the Cochrane Central Register of clinical trials were searched for pertinent studies. Inclusion criteria were random allocation to treatment and closed-loop delivery systems versus manually controlled administration of total IV anesthesia in any surgical setting...
February 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28048403/th-ab-201-12-using-machine-log-files-for-treatment-planning-and-delivery-qa
#5
C Stanhope, J Liang, D Drake, D Yan
PURPOSE: To determine the segment reduction and dose resolution necessary for machine log-files to effectively replace current phantom-based patient-specific quality assurance, while minimizing computational cost. METHODS: Elekta's Log File Convertor R3.2 records linac delivery parameters (dose rate, gantry angle, leaf position) every 40ms. Five VMAT plans [4 H&N, 1 Pulsed Brain] comprised of 2 arcs each were delivered on the ArcCHECK phantom. Log-files were reconstructed in Pinnacle on the phantom geometry using 1/2/3/4° control point spacing and 2/3/4mm dose grid resolution...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047871/su-f-t-471-simulated-external-beam-delivery-errors-detection-with-a-large-area-ion-chamber-transmission-detector
#6
D Hoffman, B Dyer, C Kumaran Nair, R Stern, S Benedict, U C Davis
PURPOSE: The Integral Quality Monitor (IQM), developed by iRT Systems GmbH (Koblenz, Germany) is a large-area, linac-mounted ion chamber used to monitor photon fluence during patient treatment. Our previous work evaluated the change of the ion chamber's response to deviations from static 1×1 cm2 and 10×10 cm2 photon beams and other characteristics integral to use in external beam detection. The aim of this work is to simulate two external beam radiation delivery errors, quantify the detection of simulated errors and evaluate the reduction in patient harm resulting from detection...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047845/we-ab-207a-01-best-in-physics-imaging-high-resolution-cone-beam-ct-of-the-extremities-and-cancellous-bone-architecture-with-a-cmos-detector
#7
Q Cao, M Brehler, A Sisniega, E Marinetto, A Zyazin, I Peters, J Stayman, J Yorkston, J Siewerdsen, W Zbijewski
PURPOSE: Extremity cone-beam CT (CBCT) with an amorphous silicon (aSi) flat-panel detector (FPD) provides low-dose volumetric imaging with high spatial resolution. We investigate the performance of the newer complementary metal-oxide semiconductor (CMOS) detectors to enhance resolution of extremities CBCT to ∼0.1 mm, enabling morphological analysis of trabecular bone. Quantitative in-vivo imaging of bone microarchitecture could present an important advance for osteoporosis and osteoarthritis diagnosis and therapy assessment...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047286/su-f-t-241-reduction-in-planning-errors-via-a-process-control-developed-using-the-eclipse-scripting-api
#8
D Barbee, A McCarthy, P Galavis, A Xu
PURPOSE: Errors found during initial physics plan checks frequently require replanning and reprinting, resulting decreased departmental efficiency. Additionally, errors may be missed during physics checks, resulting in potential treatment errors or interruption. This work presents a process control created using the Eclipse Scripting API (ESAPI) enabling dosimetrists and physicists to detect potential errors in the Eclipse treatment planning system prior to performing any plan approvals or printing...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047113/su-g-tep2-13-patient-specific-reduction-of-range-uncertainties-in-proton-therapy-by-proton-radiography-with-a-multi-layer-ionization-chamber
#9
S Deffet, P Farace, R Righetto, B Macq, F Vander Stappen
PURPOSE: The conversion from Hounsfield units (HU) to stopping powers is a major source of range uncertainty in proton therapy (PT). Our contribution shows how proton radiographs (PR) acquired with a multi-layer ionization chamber in a PT center can be used for accurate patient positioning and subsequently for patient-specific optimization of the conversion from HU to stopping powers. METHODS: A multi-layer ionization chamber was used to measure the integral depth-dose (IDD) of 220 MeV pencil beam spots passing through several anthropomorphic phantoms...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047030/su-g-iep3-05-effects-of-image-receptor-technology-and-dose-reduction-software-on-radiation-dose-estimates-for-fluoroscopically-guided-interventional-fgi-procedures
#10
Z Merritt, J Dave, D Eschelman, C Gonsalves
PURPOSE: To investigate the effects of image receptor technology and dose reduction software on radiation dose estimates for most frequently performed fluoroscopically-guided interventional (FGI) procedures at a tertiary health care center. METHODS: IRB approval was obtained for retrospective analysis of FGI procedures performed in the interventional radiology suites between January-2011 and December-2015. This included procedures performed using image-intensifier (II) based systems which were subsequently replaced, flat-panel-detector (FPD) based systems which were later upgraded with ClarityIQ dose reduction software (Philips Healthcare) and relatively new FPD system already equipped with ClarityIQ...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046935/su-d-206-07-cbct-scatter-correction-based-on-rotating-collimator
#11
G Yu, Y Yin, L Qiang, B Li, Z Feng, P Huang, D Li
PURPOSE: Scatter correction in cone-beam computed tomography (CBCT) has obvious effect on the removal of image noise, the cup artifact and the increase of image contrast. Several methods using a beam blocker for the estimation and subtraction of scatter have been proposed. However, the inconvenience of mechanics and propensity to residual artifacts limited the further evolution of basic and clinical research. Here, we propose a rotating collimator-based approach, in conjunction with reconstruction based on a discrete Radon transform and Tchebichef moments algorithm, to correct scatter-induced artifacts...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046922/we-fg-207b-08-dual-energy-ct-iodine-accuracy-across-vendors-and-platforms
#12
M Jacobsen, C Wood, D Cody
PURPOSE: Although a major benefit of dual-energy CT is its quantitative capabilities, it is critical to understand how results vary by scanner manufacturer and/or model before making clinical patient management decisions. Each manufacturer utilizes a specific dual-energy CT approach; cross-calibration may be required for facilities with more than one dual-energy CT scanner type. METHODS: A solid dual-energy quality control phantom (Gammex, Inc.; Appleton, WI) representing a large body cross-section containing three Iodine inserts (2mg/ml, 5mg/ml, 15 mg/ml) was scanned on these CT systems: GE HD-750 (80/140kVp), prototype GE Revolution CT with GSI (80/140kVp), Siemens Flash (80/140kVp and 100/140kVp), and Philips IQon (120kVp and 140kVp)...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046892/su-g-brc-17-using-generalized-mean-for-equivalent-square-estimation
#13
S Zhou, Q Wu, Q Fan, Y Lei, S Li, X Li, R Ma, S Wang, X Wang, D Zheng, X Zhu, C Enke
PURPOSE: Equivalent Square (ES) is a widely used concept in radiotherapy. It enables us to determine many important quantities for a rectangular treatment field, without measurement, based on the corresponding values from its ES field. In this study, we propose a Generalized Mean (GM) type ES formula and compare it with other established formulae using benchmark datasets. METHODS: Our GM approach is expressed as ES=(w•fx^α+(1-w)•fy^α)^(1/α), where fx, fy, α, and w represent field sizes, power index, and a weighting factor, respectively...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046678/su-f-t-147-an-alternative-parameterization-of-scatter-behavior-allows-significant-reduction-of-beam-characterization-for-pencil-beam-proton-therapy
#14
F Van den Heuvel, F Fiorini, B George
PURPOSE: 1) To describe the characteristics of pencil beam proton dose deposition kernels in a homogenous medium using a novel parameterization. 2) To propose a method utilizing this novel parametrization to reduce the measurements and pre-computation required in commissioning a pencil beam proton therapy system. METHODS: Using beam data from a clinical, pencil beam proton therapy center, Monte Carlo simulations were performed to characterize the dose depositions at a range of energies from 100...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046549/tu-fg-brb-10-a-new-approach-to-proton-radiography-using-the-beamline-x-ray-flat-panel
#15
R Zhang, K Jee, G Sharp, J Flanz, H Lu
PURPOSE: Proton radiography, which images the patients with the same type of particles that they are to be treated with, is a promising approach for image guidance and range uncertainties reduction. This study aimed to realize quality proton radiography by measuring dose rate functions (DRF) in time domain using a single flat panel and retrieve water equivalent path length (WEPL) from them. METHODS: An amorphous silicon flat panel (PaxScan™ 4030CB, Varian Medical Systems, Inc...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/27925849/development-and-prospective-federal-state-wide-evaluation-of-a-device-for-height-based-dose-recommendations-in-prehospital-pediatric-emergencies-a-simple-tool-to-prevent-most-severe-drug-errors
#16
Jost Kaufmann, Bernhard Roth, Thomas Engelhardt, Alex Lechleuthner, Michael Laschat, Christoph Hadamitzky, Frank Wappler, Martin Hellmich
OBJECTIVE: Drug dosing errors pose a particular threat to children in prehospital emergency care. With the Pediatric emergency ruler (PaedER), we developed a simple height-based dose recommendation system and evaluated its effectiveness in a pre-post interventional trial as the Ethics Committee disapproved randomization due to the expected positive effect of the PaedER on outcome. METHODS: Pre-interventional data were retrospectively retrieved from the electronic records and medical protocols of the Cologne Emergency Medical Service over a two-year period prior to the introduction of the PaedER...
December 7, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27908164/comparison-of-low-contrast-detectability-between-two-ct-reconstruction-algorithms-using-voxel-based-3d-printed-textured-phantoms
#17
Justin Solomon, Alexandre Ba, François Bochud, Ehsan Samei
PURPOSE: To use novel voxel-based 3D printed textured phantoms in order to compare low-contrast detectability between two reconstruction algorithms, FBP (filtered-backprojection) and SAFIRE (sinogram affirmed iterative reconstruction) and determine what impact background texture (i.e., anatomical noise) has on estimating the dose reduction potential of SAFIRE. METHODS: Liver volumes were segmented from 23 abdominal CT cases. The volumes were characterized in terms of texture features from gray-level co-occurrence and run-length matrices...
December 2016: Medical Physics
https://www.readbyqxmd.com/read/27888168/estimating-the-duration-of-public-concern-after-the-fukushima-dai-ichi-nuclear-power-station-accident-from-the-occurrence-of-radiation-exposure-related-terms-on-twitter-a-retrospective-data-analysis
#18
Naoki Nishimoto, Mizuki Ota, Ayako Yagahara, Katsuhiko Ogasawara
BACKGROUND: After the Fukushima Dai-ichi Nuclear Power Station accident in Japan on March 11, 2011, a large number of comments, both positive and negative, were posted on social media. OBJECTIVE: The objective of this study was to clarify the characteristics of the trend in the number of tweets posted on Twitter, and to estimate how long public concern regarding the accident continued. We surveyed the attenuation period of the first term occurrence related to radiation exposure as a surrogate endpoint for the duration of concern...
November 25, 2016: JMIR Public Health and Surveillance
https://www.readbyqxmd.com/read/27867176/impact-of-pelvic-rotational-setup-error-on-lymph-nodal-dose-in-whole-pelvic-imrt-using-fiducial-markers
#19
Hiroki Katayama, Masaomi Ookubo, Masato Tsuzuki, Yasuhiro Sasakawa, Shigeo Takahashi, Toru Shibata
PURPOSE: The aim of this study was to investigate the impact of pelvic rotational setup error on lymph nodal dose in the whole pelvic intensity-modulated radiation therapy using the fiducial marker. METHODS: The dose differences of clinical target volume for pelvic lymph node (CTVLN) due to isocenter (IC) shift and pelvic rotation were evaluated using the radiation treatment planning system. The rotated computed tomography (CT) images were created for the simulation of the pelvic rotation...
2016: Nihon Hoshasen Gijutsu Gakkai Zasshi
https://www.readbyqxmd.com/read/27819251/reconstruction-of-high-resolution-mlc-leaf-positions-using-a-low-resolution-detector-for-accurate-3d-dose-reconstruction-in-imrt
#20
R Visser, J Godart, D J L Wauben, J A Langendijk, A A Van't Veld, E W Korevaar
In pre-treatment dose verification, low resolution detector systems are unable to identify shifts of individual leafs of high resolution multi leaf collimator (MLC) systems from detected changes in the dose deposition. The goal of this study was to introduce an alternative approach (the shutter technique) combined with a previous described iterative reconstruction method to accurately reconstruct high resolution MLC leaf positions based on low resolution measurements. For the shutter technique, two additional radiotherapy treatment plans (RT-plans) were generated in addition to the original RT-plan; one with even MLC leafs closed for reconstructing uneven leaf positions and one with uneven MLC leafs closed for reconstructing even leaf positions...
December 7, 2016: Physics in Medicine and Biology
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