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Dose Error Reduction System

Lai-Lei Ting, Ho-Chiao Chuang, Ai-Ho Liao, Chia-Chun Kuo, Hsiao-Wei Yu, Yi-Liang Zhou, Der-Chi Tien, Shiu-Chen Jeng, Jeng-Fong Chiou
This study proposed respiratory motion compensation system (RMCS) combined with an ultrasound image tracking algorithm (UITA) to compensate for respiration-induced tumor motion during radiotherapy, and to address the problem of inaccurate radiation dose delivery caused by respiratory movement. This study used an ultrasound imaging system to monitor respiratory movements combined with the proposed UITA and RMCS for tracking and compensation of the respiratory motion. Respiratory motion compensation was performed using prerecorded human respiratory motion signals and also sinusoidal signals...
May 2018: Physica Medica: PM
Patrik Brynolfsson, Jan Axelsson, August Holmberg, Joakim H Jonsson, David Goldhaber, Yiqiang Jian, Fredrik Illerstam, Mathias Engström, Björn Zackrisson, Tufve Nyholm
PURPOSE: Simultaneous collection of PET and MR data for radiotherapy purposes are useful for e.g. target definition and dose escalations. However, a prerequisite for using PET/MR in the radiotherapy workflow is the ability to image the patient in treatment position. The aim of this work was to adapt a GE SIGNA PET/MR scanner to image patients for radiotherapy treatment planning and evaluate the impact on signal-to-noise (SNR) of the MR images, and the accuracy of the PET attenuation correction...
June 3, 2018: Medical Physics
Katherine M Shea, Athena Lv Hobbs, Jason D Shumake, Derek J Templet, Eimeira Padilla-Tolentino, Kristin E Mondy
PURPOSE: The impact of an antiretroviral stewardship strategy on medication error rates was evaluated. METHODS: This single-center, retrospective, comparative cohort study included patients at least 18 years of age infected with human immunodeficiency virus (HIV) who were receiving antiretrovirals and admitted to the hospital. A multicomponent approach was developed and implemented and included modifications to the order-entry and verification system, pharmacist education, and a pharmacist-led antiretroviral therapy checklist...
June 15, 2018: American Journal of Health-system Pharmacy: AJHP
Sven Achenbach, Garth Wells, Chen Shen
In deep X-ray lithography (DXRL), synchrotron radiation is applied to pattern polymer microstructures. At the Synchrotron Laboratory for Micro and Nano Devices (SyLMAND), Canadian Light Source, a chromium-coated grazing-incidence X-ray double-mirror system is applied as a tunable low-pass filter. In a systematic study, the surface conditions of the two mirrors are analyzed to determine the mirror reflectivity for DXRL process optimization, without the need for spectral analysis or surface probing: PMMA resist foils were homogeneously exposed and developed to determine development rates for mirror angles between 6 mrad and 12 mrad as well as for white light in the absence of the mirrors...
May 1, 2018: Journal of Synchrotron Radiation
Christian Ziemann, Maik Stille, Florian Cremers, Thorsten M Buzug, Dirk Rades
BACKGROUND: Metal artifacts caused by high-density implants lead to incorrectly reconstructed Hounsfield units in computed tomography images. This can result in a loss of accuracy in dose calculation in radiation therapy. This study investigates the potential of the metal artifact reduction algorithms, Augmented Likelihood Image Reconstruction and linear interpolation, in improving dose calculation in the presence of metal artifacts. MATERIALS AND METHODS: In order to simulate a pelvis with a double-sided total endoprosthesis, a polymethylmethacrylate phantom was equipped with two steel bars...
May 2018: Journal of Applied Clinical Medical Physics
Brian J Anderson
PURPOSE OF REVIEW: Medication errors in paediatric anaesthesia and the perioperative setting continue to occur despite widespread recognition of the problem and published advice for reduction of this predicament at international, national, local and individual levels. Current literature was reviewed to ascertain drug error rates and to appraise causes and proposed solutions to reduce these errors. RECENT FINDINGS: The medication error incidence remains high. There is documentation of reduction through identification of causes with consequent education and application of safety analytics and quality improvement programs in anaesthesia departments...
June 2018: Current Opinion in Anaesthesiology
Sarah K Pontefract, James Hodson, Ann Slee, Sonal Shah, Alan J Girling, Robin Williams, Aziz Sheikh, Jamie J Coleman
BACKGROUND: In this UK study, we investigated the impact of computerised physician order entry (CPOE) and clinical decision support (CDS) implementation on the rate of 78 high-risk prescribing errors amenable to CDS. METHODS: We conducted a preintervention/postintervention study in three acute hospitals in England. A predefined list of prescribing errors was incorporated into an audit tool. At each site, approximately 4000 prescriptions were reviewed both pre-CPOE and 6 months post-CPOE implementation...
March 23, 2018: BMJ Quality & Safety
Esben S Worm, Morten Høyer, Rune Hansen, Lars P Larsen, Britta Weber, Cai Grau, Per R Poulsen
PURPOSE: Intrafraction motion can compromise the treatment accuracy in liver stereotactic body radiation therapy (SBRT). Respiratory gating can improve treatment delivery; however, gating based on external motion surrogates is inaccurate. The present study reports the use of Calypso-based internal electromagnetic motion monitoring for gated liver SBRT. METHODS AND MATERIALS: Fifteen patients were included in a study of 3-fraction respiratory gated liver SBRT guided by 3 implanted electromagnetic transponders...
June 1, 2018: International Journal of Radiation Oncology, Biology, Physics
Scott Pardo, Rimma M Shaginian, David A Simmons
BACKGROUND: Diabetes treatment is intended to maintain near-normal glycemic levels. Self-monitoring of blood glucose (SMBG) allows patients to track their BG levels compared with glycemic targets and is associated with improved health outcomes. Because of the importance of SMBG, it is essential that results are accurate to prevent errors in nutritional intake and drug dosing. This study presents a new methodology to evaluate the accuracy of BG monitoring systems (BGMSs). METHODS: Sensitivity analyses were performed using real and simulated BGMS data to compute probabilities that, for any BG value, the BGMS result would be within prescribed error bounds and confidence limits compared with laboratory reference values...
May 2018: Journal of Diabetes Science and Technology
Farheen Khan, Rizwan Wahab, Mohamed Essam Hagar, Rua Alnoman, Mohd Rashid
The present work describes the synthesis of copper oxide nanoparticles (CuONPs) via a solution process with the aim of applying the nano-adsorbent for the reduction of methylene blue (MB) dye in alkaline media. These NPs were characterized via Field emission scanning electron microscopy (FE-SEM), X-ray diffraction, high-resolution Transmission electron microscopy (TEM), and ultra violet UV-visible spectroscopy to confirm their morphology and crystalline and optical properties in order to design an adsorption-degradation process...
February 27, 2018: Nanomaterials
Biplab Sarkar, Jyotirmoy Ray, Tharmarnadar Ganesh, Arjunan Manikandan, Anusheel Munshi, Sasikumar Rathinamuthu, Harpreet Kaur, Satheeshkumar Anbazhagan, Upendra K Giri, Soumya Roy, Kanan Jassal, Bidhu Kalyan Mohanti
The aim of this article is to derive and verify a mathematical formulation for the reduction of the six-dimensional (6D) positional inaccuracies of patients (lateral, longitudinal, vertical, pitch, roll and yaw) to three-dimensional (3D) linear shifts. The formulation was mathematically and experimentally tested and verified for 169 stereotactic radiotherapy patients. The mathematical verification involves the comparison of any (one) of the calculated rotational coordinates with the corresponding value from the 6D shifts obtained by cone beam computed tomography (CBCT)...
March 22, 2018: Physics in Medicine and Biology
Elizabeth do Espirito Santo Cestário, Letícia Aparecida Barufi Fernandes, Luiz Tadeu Giollo-Júnior, Jéssica Rodrigues Roma Uyemura, Camila Suemi Sato Matarucco, Manoel Idelfonso Paz Landim, Luciana Neves Cosenso-Martin, Lúcia Helena Bonalume Tácito, Heitor Moreno, José Fernando Vilela-Martin, Juan Carlos Yugar-Toledo
BACKGROUND: Resistant hypertension is characterized when the blood pressure (BP) remains above the recommended goal after taking three antihypertensive drugs with synergistic actions at their maximum recommended tolerated doses, preferably including a diuretic. Identifying the contribution of intravascular volume and serum renin in maintaining BP levels could help tailor more effective hypertension treatment, whether acting on the control of intravascular volume or sodium balance, or acting on the effects of the renin-angiotensin-aldosterone system (RAAS) on the kidney...
February 12, 2018: Trials
Kirsty Symons, Colm Morrison, Jason Parry, Simon Woodings, Yvonne Zissiadis
A study was undertaken to explore the use of volumetric modulated arc therapy (VMAT) for total body irradiation (TBI). Five patient plans were created in Pinnacle3 using nine 6 MV photon dynamic arcs. A dose of 12 Gy in six fractions was prescribed. The planning target volume (PTV) was split into four subsections for the head, chest, abdomen, and pelvis. The head and chest beams were optimized together, followed by the abdomen and pelvis beams. The last stage of the planning process involved turning all beams on and performing a final optimization to achieve a clinically acceptable plan...
January 24, 2018: Journal of Applied Clinical Medical Physics
T B Y Liem, E M A Slob, J U M Termote, T F W Wolfs, A C G Egberts, C M A Rademaker
Background Incorrect dosing is the most frequent prescribing error in neonatology, with antibiotics being the most frequently prescribed medicines. Computer physician order entry and clinical decision support systems can create consistency contributing to a reduction of medication errors. Although evidence-based dosing recommendations should be included in such systems, the evidence is not always available and subsequently, dosing recommendations mentioned in guidelines and textbooks are often based on expert opinion...
April 2018: International Journal of Clinical Pharmacy
Lien Desteghe, Johan Vijgen, Pieter Koopman, Dagmara Dilling-Boer, Joris Schurmans, Paul Dendale, Hein Heidbuchel
Aims: To evaluate the effect of telemonitoring on adherence to non-vitamin K antagonist oral anticoagulants (NOACs) in atrial fibrillation (AF) patients. Methods and results: A randomized, single-blind, crossover, controlled trial in 48 AF patients on once or twice daily (OD or BID) NOAC. The Medication Event Monitoring System tracked NOAC intake during three phases of 3 months each: daily telemonitoring, telemonitoring with immediate telephone feedback in case of intake errors, and an observation phase without daily transmissions...
April 21, 2018: European Heart Journal
Claire Miller, Daniel Kendrick, Andrew Shevitz, Ann Kim, Henry Baele, David Jordan, Vikram S Kashyap
OBJECTIVE: High-resolution fixed C-arm fluoroscopic systems allow high-quality endovascular imaging but come at a cost of greater scatter radiation generation and increased occupational exposure for surgeons. The purpose of this study was to evaluate the efficacy of two methods in reducing scattered radiation exposure. METHODS: There were 164 endovascular cases analyzed in three phases. In phase 1 (P1), baseline radiation exposure was calculated. In phase 2 (P2), staff used real-time radiation dose monitoring (dosimetry badges [RaySafe; Unfors, Hopkinton, Mass])...
April 2018: Journal of Vascular Surgery
Xiaoning Ding, Wei Liu, Jiajian Shen, Aman Anand, Joshua B Stoker, Yanle Hu, Martin Bues
Monte Carlo (MC) simulation has been used to generate commissioning data for the beam modeling of treatment planning system (TPS). We have developed a method called radial projection (RP) for postprocessing of MC-simulation-generated data. We used the RP method to reduce the statistical uncertainty of the lateral profile of proton pencil beams with axial symmetry. The RP method takes advantage of the axial symmetry of dose distribution to use the mean value of multiple independent scores as the representative score...
November 2017: Journal of Applied Clinical Medical Physics
C Connolly, S Tierney, P Grace
BACKGROUND: Nitric oxide (NO) has diverse roles as a biological messenger. [1] Topically applied nitrate donors cause relaxation of the internal anal sphincter (IAS) and facilitate healing of anal fissures [2,3]. Systemic nitrates are commonly used for the treatment of ischaemic heart disease, yet the effects of systemically administered nitrates on the smooth muscle of the IAS are unknown. AIM: Our aim was to test the hypothesis that systemically administered nitrates at a normal dose, cause inhibition of anal sphincter activity...
May 2018: Irish Journal of Medical Science
Hideo Nose, Junji Shiraishi
The use of digital radiographic systems has decreased the frequency of image retakes due to over/underexposure in general radiography. However, image retakes owing to patient positioning errors are likely to increase because of the convenience of a real-time image check on a console table. The purpose of the present study is to propose a novel radiographic examination procedure with an ultra-low-dose pre-test exposure that may be utilized to check patient positioning prior to taking an actual image, thereby reducing unnecessary patient exposure owing to image retakes...
December 2017: Radiological Physics and Technology
Kheirollah Mohammadi, Mohsen Hassani, Mahdi Ghorbani, Bagher Farhood, Courtney Knaup
PURPOSE: High atomic number elements are commonly used in a hip prosthesis which can cause uncertainty in accurate dose calculations in radiation therapy. The aim of this study is to assess the accuracy of the three various algorithms of ISOgray treatment planning system in the presence of hip prosthesis by Monte Carlo (MC). MATERIALS AND METHODS: A MC model of Siemens PRIMUS linear accelerator has been built and verified by the measured data of the different algorithms of ISOgray treatment planning systems (TPS) in 6 and 15 MV photon beam energies...
July 2017: Journal of Cancer Research and Therapeutics
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