donkeychance542

For every treatment fraction, the agreement between the CBCT images and Calypso® guidance was optimal, with EMTs always within the defined tolerance (i.e., CT-Calypso or CBCT-Calypso measured differences in inter-EMT distances within 0.3 cm). Electromagnetic transponders to isocenter distances measured by Calypso® reproduced CT data and were confirmed on CBCTs. During RT, the EMTs centroid exceeded the threshold 24 times (20% of all fractions) 5 times in the left-right, 15 times in the anterior-posterior (AP), and 4 times in the superior-inferior directions. The largest motions recorded were in the AP axis 0.6 cm anteriorly and 0.5 cm posteriorly in patients with unilateral and bilateral MHP, respectively. CONCLUSIONS Our study represents the first clinical experience assessing the localization and tracking accuracy of Calypso® EMTs during curative RT of PCa patients with of unilateral or bilateral MHP. INTRODUCTION Incident learning is a critical part of the quality improvement process for all radiotherapy clinics. Failure mode and effects analysis (FMEA) has also been adopted as a hazard analysis method within the field of radiation oncology based on the recommendations of AAPM Task Group 100. In this work, we demonstrate a fusion of these techniques that is efficient and transferrable to all types of clinics, and allows data-driven targeting of the highest risk error types. METHODS Four clinical physicists recorded safety events detected during physics treatment plan quality assurance over a 27-month period. Events were sorted into the broad categories of either a documentation or plan construction error. Events were further stratified into subcategories until sufficiently discriminated against for analysis. Event risks were quantified using reduced-resolution TG-100 severity scores combined with observed occurrence rates. The highest risk categories were examined for intervention strategies. RESULTS A total of 871 events were identified over the study period. Of these, 652 (74.9%) were classified as low severity, 178 (20.4%) as medium severity, and 41 (4.7%) as high severity. Four of the top five ranked categories could be targeted by a pre-planning chart rounds. Several of the categories could be targeted by additional automation in the planning and QA processes. CONCLUSIONS The retrospective classification and risk analysis of safety events allows clinics to design targeted workflow and quality assurance changes aimed at reducing the occurrence of high risk events. The method presented here leverages incident learning efforts that many clinics are already performing, allows the severity of events to be efficiently assigned, and generates actionable results without requiring a complete FMEA. https://www.selleckchem.com/products/Vandetanib.html AIMS To demonstrate the use of novel planning techniques in producing high quality stereotactic radiosurgery (SRS) plans using standard 5mm multileaf collimator (MLC) delivered clinically at local institution using multiple isocenters. METHODS Novel planning techniques consisted of offset isocentre, variable asymmetric jaws and dicom edits to reduce leaf tip transmission, all with the aim of maximising dose conformity. A local institution clinical cohort was planned (1-4 targets) and plan conformity metrics common to SRS were compared against conformity metrics from selected previous publications comparing gamma knife (GK) to Linac SRS using HD-MLC (2.5mm). Additionally, local institution plan conformity metrics for two benchmark SRS planning cases (3 and 7 targets) are compared to metrics from other centres treating SRS clinically in England. Finally, pre-treatment QA results, both point dose measurement and film analysis, are presented to demonstrate plan deliverability. RESULTS Clinical conformity metrics are shown to be comparable to previously published results using either GK or Linac with HD-MLC. Metrics from benchmark planning cases are shown to be comparable and have better prescription dose conformity than average nationally in England. Pre-treatment QA results demonstrate suitable plan deliverability. CONCLUSIONS SRS planning using standard 5 mm MLC and multiple isocentres produces high quality treatment plans for a limited number of targets with a high degree of dose conformity and dose fall off when employing novel planning techniques to compensate for MLC leaf size and multiple isocentres. OBJECTIVE Parenting behaviors have largely been studied in isolation with regard to child development in cross-national contexts. We examine and compare the relative strength of association between physical discipline and deprivation with risk for children's socio-emotional and cognitive developmental delay in a cross-national sample. METHOD The sample was drawn from the UNICEF Multiple Indicator Cluster Survey. Analyses used observations with data on parental physical discipline, parenting behaviors associated with deprivation, and child developmental outcomes. The present analysis included 29,792 children aged 36-59 months across 17 countries. Using the Early Child Development Index, risk for cognitive or socio-emotional developmental delay was indicated if a child could not accomplish 2 or more items within that specific sub-domain. Overall risk for delay was indicated if a child was at risk in either sub-domain. Associations between discipline, deprivation and delay were assessed using multivariable logistic regression. RESULTS Five of the seven exposures were associated with risk for overall developmental delay. Physical discipline (OR=1·49 [95% CI 1·39-1·59]; p less then 0·001) had the largest association with risk for socio-emotional delay. Not having books (OR=1·62 [95% CI 1·42-1·84]; p less then 0·001) and not counting with the child (OR=1·47 [95% CI 1·32-1·64]; p less then 0·001) had the largest associations with risk for cognitive delay. CONCLUSION The exposures of physical discipline and deprivation measured here have distinct associations with risk for socio-emotional and cognitive delay cross-nationally. Programmatic and clinical interventions should seek to act on adversities that are relevant to the targeted delay.