Monitoring daily MLC positional errors using trajectory log files and EPID measurements for IMRT and VMAT deliveries

This work investigated the differences between multileaf collimator (MLC) positioning accuracy determined using either log files or electronic portal imaging devices (EPID) and then assessed the possibility of reducing patient specific quality control (QC) via phantom-less methodologies. In-house software was developed, and validated, to track MLC positional accuracy with the rotational and static gantry picket fence tests using an integrated electronic portal image. This software was used to monitor MLC daily performance over a 1 year period for two Varian TrueBeam linear accelerators, with the results directly compared with MLC positions determined using leaf trajectory log files. This software was validated by introducing known shifts and collimator errors. Skewness of the MLCs was found to be 0.03 ± 0.06° (mean ±1 standard deviation (SD)) and was dependent on whether the collimator was rotated manually or automatically. Trajectory log files, analysed using in-house software, showed average MLC positioning errors with a magnitude of 0.004 ± 0.003 mm (rotational) and 0.004 ± 0.011 mm (static) across two TrueBeam units over 1 year (mean ±1 SD). These ranges, as indicated by the SD, were lower than the related average MLC positioning errors of 0.000 ± 0.025 mm (rotational) and 0.000 ± 0.039 mm (static) that were obtained using the in-house EPID based software. The range of EPID measured MLC positional errors was larger due to the inherent uncertainties of the procedure. Over the duration of the study, multiple MLC positional errors were detected using the EPID based software but these same errors were not detected using the trajectory log files. This work shows the importance of increasing linac specific QC when phantom-less methodologies, such as the use of log files, are used to reduce patient specific QC. Tolerances of 0.25 mm have been created for the MLC positional errors using the EPID-based automated picket fence test. The software allows diagnosis of any specific leaf that needs repair and gives an indication as to the course of action that is required.

Performance Analysis of Randomized Distributed Space-Time Codes over Composite Gamma/Lognormal Fading Channels

This work investigates the end-to-end performance of randomized distributed space-time codes with complex Gaussian distribution, when employed in a wireless relay network. The relaying nodes are assumed to adopt a decode-and-forward strategy and transmissions are affected by small and large scale fading phenomena. Extremely tight, analytical approximations of the end-to-end symbol error probability and of the end-to-end outage probability are derived and successfully validated through Monte-Carlo simulation. For the high signal-to-noise ratio regime, a simple, closed-form expression for the symbol error probability is further provided.

Impact of community based, specialist palliative care teams on hospitalisations and emergency department visits late in life and hospital deaths: a pooled analysis

Objective: To determine the pooled effect of exposure to one of 11 specialist palliative care teams providing services in patients’ homes.Design: Pooled analysis of a retrospective cohort study.Setting: Ontario, Canada.Participants: 3109 patients who received care from specialist palliative care teams in 2009-11 (exposed) matched by propensity score to 3109 patients who received usual care (unexposed).Intervention: The palliative care teams studied served different geographies and varied in team composition and size but had the same core team members and role: a core group of palliative care physicians, nurses, and family physicians who provide integrated palliative care to patients in their homes. The teams’ role was to manage symptoms, provide education and care, coordinate services, and be available without interruption regardless of time or day.Main outcome measures: Patients (a) being in hospital in the last two weeks of life; (b) having an emergency department visit in the last two weeks of life; or (c) dying in hospital.Results: In both exposed and unexposed groups, about 80% had cancer and 78% received end of life homecare services for the same average duration. Across all palliative care teams, 970 (31.2%) of the exposed group were in hospital and 896 (28.9%) had an emergency department visit in the last two weeks of life respectively, compared with 1219 (39.3%) and 1070 (34.5%) of the unexposed group (P<0.001). The pooled relative risks of being in hospital and having an emergency department visit in late life comparing exposed versus unexposed were 0.68 (95% confidence interval 0.61 to 0.76) and 0.77 (0.69 to 0.86) respectively. Fewer exposed than unexposed patients died in hospital (503 (16.2%) v 887 (28.6%), P<0.001), and the pooled relative risk of dying in hospital was 0.46 (0.40 to 0.52).Conclusions: Community based specialist palliative care teams, despite variation in team composition and geographies, were effective at reducing acute care use and hospital deaths at the end of life.

Security Enhancement of Cooperative Single Carrier Systems

In this paper, the impact of multiple active eavesdroppers on cooperative single carrier systems with multiple relays and multiple destinations is examined. To achieve the secrecy diversity gains in the form of opportunistic selection, a two-stage scheme is proposed for joint relay and destination selection, in which, after the selection of the relay with the minimum effective maximum signal-to-noise ratio (SNR) to a cluster of eavesdroppers, the destination that has the maximum SNR from the chosen relay is selected. In order to accurately assess the secrecy performance, the exact and asymptotic expressions are obtained in closed-form for several security metrics including the secrecy outage probability, the probability of non-zero secrecy rate, and the ergodic secrecy rate in frequency selective fading. Based on the asymptotic analysis, key design parameters such as secrecy diversity gain, secrecy array gain, secrecy multiplexing gain, and power cost are characterized, from which new insights are drawn. Moreover, it is concluded that secrecy performance limits occur when the average received power at the eavesdropper is proportional to the counterpart at the destination. Specifically, for the secrecy outage probability, it is confirmed that the secrecy diversity gain collapses to zero with outage floor, whereas for the ergodic secrecy rate, it is confirmed confirm that its slope collapses to zero with capacity ceiling.

Physical Layer Secrecy Performance over Rayleigh/Rician Fading Channels

In this paper, we investigate the physical layer secrecy performance of a single-input single-output system that consists of single antenna devices and operates in the presence of a single antenna passive eavesdropper over dissimilar fading channels. In particular, we consider two scenarios in terms of dissimilar fading channel arrangements: the legal/illegal channels are subject to Rayleigh/Rician fading, respectively; and the legal/illegal channels are subject to Rician/Rayleigh fading, respectively. Specifically, analytical expressions for the probability of the existence of a non-zero secrecy capacity and the secrecy outage probability are derived by using statistical characteristics of the signal-to-noise ratio. Numerical results are provided for selected scenarios to illustrate applications of the developed analytical expressions.

Secured Communication in Cognitive MIMO Schemes under Hardware Impairments

In this paper, the impact of hardware impairments on secrecy performance of cognitive MIMO schemes is investigated. In addition, the relay which helps the source forward the source signal to the destination can operate either half-duplex mode or full-duplex mode. For performance evaluation, we give the expressions of average secrecy rate over Rayleigh fading channel. Monte-Carlo simulations are presented to compare and optimize the performance of the proposed schemes.

A statistical characterization of on–body fading using the shadowed k–µ fading model

In this paper we investigate the received signal characteristics of on-body communications channels at 2.45 GHz. The hypothetical body area network configuration considered a transmitter node situated on the person’s left waist and receiving nodes positioned on the head, knee and wrist of the person’s right side. The on-body channel measurements were performed in both anechoic and reverberant environments while the person was moving. It was found that the recently proposed shadowed κ‒μ fading model provided an excellent fit to the measured data.

Shadowed fading in body–to–body communications channels in an outdoor environment at 2.45 GHz

In this paper a number of outdoor body-to-body communications channels at 2.45 GHz which are deemed to be susceptible to shadowed fading are analyzed. The newlyproposed shadowed K-Il model is used to characterize thesechannels. Its probability density function is shown to provide an improved fit to the distribution of the signal fading compared to established models such as lognormal, Nakagamiand Rice.

Indoor off–body communications at 5.8 GHz with multiple antennas at the base station: a statistical characterization using the Nakagami–m fading model

In this paper we investigate the first and second order characteristics of the received signal at the output ofhypothetical selection, equal gain and maximal ratio combiners which utilize spatially separated antennas at the basestation. Considering a range of human body movements, we model the model the small-scale fading characteristics ofthe signal using diversity specific analytical equations which take into account the number of available signal branchesat the receiver. It is shown that these equations provide an excellent fit to the measured channel data. Furthermore, formany hypothetical diversity receiver configurations, the Nakagami-m parameter was found to be close to 1.

Characteristics of shadowed fading in off–body communications channels at 2.45 GHz

In this paper, a number of off-body channels which are susceptible to shadowing caused by the human body are investigated. In particular, the recently proposed shadowed κ–μ fading model is fitted to data obtained from field trials performed in low multipath conditions at 2.45 GHz. It is shown that this model provides a significantly improved fit to off-body channels which are subject to shadowing when compared to other fading models such as lognormal, Nakagami-m and Rice which are commonly applied to model fading in body centric communications channels.

A Measurements Based Comparison of New and Classical Models Used to Characterize Fading in Body Area Networks

In this paper we compare a number of the classical models used to characterize fading in body area networks (BANs) with the recently proposed shadowed ț–ȝ fading model. In particular, we focus on BAN channels which are considered to be susceptible to shadowing by the human body. The measurements considered in this study were conducted at 2.45 GHz for hypothetical BAN channels operating in both anechoic and highly reverberant environments while the person was moving. Compared to the Rice, Nakagami and lognormal fading models, it was found that the recently proposed shadowed ț௅μ fading model provided an enhanced fit to the measured data.

Human body shadowing in cellular device-to-device communications: channel modeling using the shadowed κ−μ fading model

Using device-to-device communications as an underlay for cellular communications will provide an exciting opportunity to increase network capacity as well as improving spectral efficiency. The unique geometry of device-to-device links, where user equipment is often held or carried at low elevation and in close proximity to the human body, will mean that they are particularly susceptible to shadowing events caused not only by the local environment but also by the user's body. In this paper, the shadowed κ - μ fading model is proposed, which is capable of characterizing shadowed fading in wireless communication channels. In this model, the statistics of the received signal are manifested by the clustering of multipath components. Within each of these clusters, a dominant signal component with arbitrary power may exist. The resultant dominant signal component, which is formed by the phasor addition of these leading contributions, is assumed to follow a Nakagami- m distribution. The probability density function, moments, and the moment-generating function are also derived. The new model is then applied to device-to-device links operating at 868 MHz in an outdoor urban environment. It was found that shadowing of the resultant dominant component can vary significantly depending upon the position of the user equipment relative to the body and the link geometry. Overall, the shadowed κ - μ fading model is shown to provide a good fit to the field data as well as providing a useful insight into the characteristics of the received signal.

Massive MIMO with Optimal Power and Training Duration Allocation

We consider the uplink of massive multicell multiple-input multiple-output systems, where the base stations (BSs), equipped with massive arrays, serve simultaneously several terminals in the same frequency band. We assume that the BS estimates the channel from uplink training, and then uses the maximum ratio combining technique to detect the signals transmitted from all terminals in its own cell. We propose an optimal resource allocation scheme which jointly selects the training duration, training signal power, and data signal power in order to maximize the sum spectral efficiency, for a given total energy budget spent in a coherence interval. Numerical results verify the benefits of the optimal resource allocation scheme. Furthermore, we show that more training signal power should be used at low signal-to-noise ratio (SNRs), and vice versa at high SNRs. Interestingly, for the entire SNR regime, the optimal training duration is equal to the number of terminals.

Performance analysis of switch-and-stay combining in two-way relay systems with analog network coding and time-division broadcast protocols

In this paper, weconsider switch-and-stay combining (SSC) in two-way relay systems with two amplify-and-forward relays, one of which is activated to assist the information exchange between the two sources. The system operates in either analog network coding (ANC) protocol where the communication is only achieved with the help of the active relay or timedivision broadcast (TDBC) protocol where the direct link between two sources can be utilized to exploit more diversity gain. In both cases, we study the outage probability and bit error rate (BER) for Rayleigh fading channels. In particular, we derive closed-form lower bounds for the outage probability and the average BER, which remain tight for different fading conditions. We also present asymptotic analysis for both the outage probability and the average BER at high signalto-noise ratio. It is shown that SSC can achieve the full diversity order in two-way relay systems for both ANC and TDBC protocols with proper switching thresholds. Copyright © 2014 John Wiley & Sons, Ltd.