Optimizing geometric accuracy of four dimensional CT scans acquired using the wall and couch mounted Varian Real-Time Position Management camera systems

Objective:

The aim of this study was to identify sources of anatomical misrepresentation due to the location of camera mounting, tumour motion velocity and image processing artefacts in order to optimise the 4DCT scan protocol and improve geometrical-temporal accuracy.

A phantom with an imaging insert was driven with a sinusoidal superior-inferior motion of varying amplitude and period for 4DCT scanning. The length of a high density cube within the insert was measured using treatment planning software to determine the accuracy of its spatial representation. Scan parameters were varied including the tube rotation period and the cine time between reconstructed images. A CT image quality phantom was used to measure various image quality signatures under the scan parameters tested.

No significant difference in spatial accuracy was found for 4DCT scans carried out using the wall mounted or couch mounted camera for sinusoidal target motion. Greater spatial accuracy was found for 4DCT scans carried out using a tube rotation speed of 0.5s rather than 1.0s. The reduction in image quality when using a faster rotation speed was not enough to require an increase in patient dose.

4DCT accuracy may be increased by optimising scan parameters, including choosing faster tube rotation speeds. Peak misidentification in the recorded breathing trace leads to spatial artefacts and this risk can be reduced by using a couch mounted infrared camera.

This study explicitly shows that 4DCT scan accuracy is improved by scanning with a faster CT tube rotation speed.

Research Protocol: A Randomized Controlled Trial of Functional Family Therapy: An Early Intervention Foundation (EIF) Partnership between Croydon Council and Queen's University Belfast

The paper presents a protocol for ‘A Randomized Controlled Trial of Functional Family Therapy (FFT): An Early Intervention Foundation (EIF) Partnership between Croydon Council and Queen's University Belfast’. The protocol describes a trial that uses FFT as an alternative intervention to current use of the youth justice system and local authority care with the aim of reducing crime/recidivism in young people referred to Croydon Council. The trial will take place over a period of 36 months and will involve up to 154 families. Croydon Council will employ a team of five Functional Family Therapists who will work with families to promote effective outcomes. The Centre for Effective Education at Queen’s University Belfast will act as independent evaluators of outcomes for families and young people. The work is supported from the United Kingdom Economic & Social Research Council/Early Intervention Foundation Grant Number ES/M006921/1.

Balls to the wall: How acoustic information from a ball in motion guides interceptive movement in people with Parkinson’s disease

Previous research has shown that Parkinson's disease (PD) patients can increase the speed of their movement when catching a moving ball compared to when reaching for a static ball (Majsak et al., 1998). A recent model proposed by Redgrave et al. (2010) explains this phenomenon with regard to the dichotomic organization of motor loops in the basal ganglia circuitry and the role of sensory micro-circuitries in the control of goal-directed actions. According to this model, external visual information that is relevant to the required movement can induce a switch from a habitual control of movement toward an externally-paced, goal-directed form of guidance, resulting in augmented motor performance (Bienkiewicz et al., 2013). In the current study, we investigated whether continuous acoustic information generated by an object in motion can enhance motor performance in an arm reaching task in a similar way to that observed in the studies of Majsak et al. (1998, 2008). In addition, we explored whether the kinematic aspects of the movement are regulated in accordance with time to arrival information generated by the ball's motion as it reaches the catching zone. A group of 7 idiopathic PD (6 male, 1 female) patients performed a ball-catching task where the acceleration (and hence ball velocity) was manipulated by adjusting the angle of the ramp. The type of sensory information (visual and/or auditory) specifying the ball's arrival at the catching zone was also manipulated. Our results showed that patients with PD demonstrate improved motor performance when reaching for a ball in motion, compared to when stationary. We observed how PD patients can adjust their movement kinematics in accordance with the speed of a moving target, even if vision of the target is occluded and patients have to rely solely on auditory information. We demonstrate that the availability of dynamic temporal information is crucial for eliciting motor improvements in PD. Furthermore, these effects appear independent from the sensory modality through-which the information is conveyed. 

Space-Constrained Massive MIMO: Hitting the Wall of Favorable Propagation

The recent development of the massive multiple-input multiple-output (MIMO) paradigm, has been extensively based on the pursuit of favorable propagation: in the asymptotic limit, the channel vectors become nearly orthogonal and interuser interference tends to zero [1]. In this context, previous studies
have considered fixed inter-antenna distance, which implies an increasing array aperture as the number of elements increases. Here, we focus on a practical, space-constrained topology, where an increase in the number of antenna elements in a fixed total space imposes an inversely proportional decrease in the inter-antenna distance. Our analysis shows that, contrary to existing studies, inter-user interference does not vanish in the massive MIMO regime, thereby creating a saturation effect on the achievable rate.

Book Review - An Architecture of Parts: Architects, Building Workers and Industrialisation in Britain 1940–1970 by Christine Wall and Architecture and the Welfare State, edited by Mark Swenarton, Tom Avermaete and Dirk van den Heuvel.

Progress at JET in integrating ITER-relevant core and edge plasmas within the constraints of an ITER-like wall

This paper reports the progress made at JET-ILW on integrating the requirements of the reference ITER baseline scenario with normalized confinement factor of 1, at a normalized pressure of 1.8 together with partially detached divertor whilst maintaining these conditions over many energy confinement times. The 2.5 MA high triangularity ELMy H-modes are studied with two different divertor configurations with D-gas injection and nitrogen seeding. The power load reduction with N seeding is reported. The relationship between an increase in energy confinement and pedestal pressure with triangularity is investigated. The operational space of both plasma configurations is studied together with the ELM energy losses and stability of the pedestal of unseeded and seeded plasmas. The achievement of stationary plasma conditions over many energy confinement times is also reported.

A diode for ferroelectric domain-wall motion

For over a decade, controlling domain wall injection, motion and annihilation along nanowires has been the preserve of the nanomagnetics research community. Revolutionary technologies have resulted, like race-track memory and domain wall logic. Until recently, equivalent research in analogous ferroic materials did not seem important. However, with the discovery of sheet conduction, the control of domain walls in ferroelectrics has become vital for the future of what has been termed “domain wall electronics”. Here we report the creation of a ferroelectric domain wall diode, which allows a single direction of motion for all domain walls, irrespective of their polarity, under a series of alternating electric field pulses. The diode’s saw-tooth morphology is central to its function. Domain walls can move readily in the direction in which thickness increases gradually, but are prevented from moving in the other direction by the sudden thickness increase at the saw-tooth edge.

Cystic Fibrosis Foundation and European Cystic Fibrosis Society Survey of cystic fibrosis mental health care delivery

Background: Psychological morbidity in individuals with cystic fibrosis (CF) and their caregivers is common. The Cystic Fibrosis Foundation (CFF) and European Cystic Fibrosis Society (ECFS) Guidelines Committee on Mental Health sought the views of CF health care professionals concerning mental health care delivery. Methods: An online survey which focused on the current provision and barriers to mental health care was distributed to CF health care professionals. Results: Of the 1454 respondents, many did not have a colleague trained in mental health issues and 20% had no one on their team whose primary role was focused on assessing or treating these issues. Insufficient resources and a lack of competency were reported in relation to mental health referrals. Seventy-three percent of respondents had no experience with mental health screening. Of those who did, they utilized 48 different, validated scales. Conclusions: These data have informed the decision-making, dissemination and implementation strategies of the Mental Health Guidelines Committee sponsored by the CFF and ECFS.

FRENKEL-KONTOROVA DOMAIN-WALL PHASE-TRANSITIONS IN AN ADSORBED LAYER - POTASSIUM ON CO(10(1)OVER-BAR-0)

As the potassium fractional coverage of a cobalt {1010BAR} surface is increased over the range 0.2 to 0.6 monolayer the adlayer passes through a series of phase transitions. A commensurate phase is formed at exactly 0.5 monolayer, and corresponds to adatoms bonded in high-symmetry hollow sites on the unreconstructed cobalt surface, with an effective adatom radius lying between the ionic and covalent radii of potassium. A detailed structural study shows that the structural transitions can be characterised within a one-dimensional Frenkel-Kontorova model, with small lateral displacements of adatoms away from hollow sites in the low and high coverage phases. The low coverage phases progress from a distributed vacancy structure to a low density domain-wall structure; while the high coverage phase formed above half a monolayer is a high density asymmetric domain-wall structure.

Predictors of Chest Wall Toxicity after Lung Stereotactic Ablative Radiotherapy

AIMS: To determine the incidence and predictive factors of rib fracture and chest wall pain after lung stereotactic ablative radiotherapy (SABR).

MATERIALS AND METHODS: Patients were treated with lung SABR of 48-60 Gy in four to five fractions. The treatment plan and follow-up computed tomography scans of 289 tumours in 239 patients were reviewed. Dose-volume histogram (DVH) metrics and clinical factors were evaluated as potential predictors of chest wall toxicity.

RESULTS: The median follow-up was 21.0 months (range 6.2-52.1). Seventeen per cent (50/289) developed a rib fracture, 44% (22/50) were symptomatic; the median time to fracture was 16.4 months. On univariate analysis, female gender, osteoporosis, tumours adjacent (within 5 mm) to the chest wall and all of the chest wall DVH metrics predicted for rib fracture, but only tumour location adjacent to the chest wall remained significant on the multivariate model (P < 0.01). The 2 year fracture-free probability for those adjacent to the chest wall was 65.6%. Among those tumours adjacent to the chest wall, only osteoporosis (P = 0.02) predicted for fracture, whereas none of the chest wall DVH metrics were predictive. Eight per cent (24/289) experienced chest wall pain without fracture.

CONCLUSIONS: None of the chest wall DVH metrics independently predicted for SABR-induced rib fracture when tumour location is taken into account. Patients with tumours adjacent (within 5 mm) to the chest wall are at greater risk of rib fracture after lung SABR, and among these, an additional risk was observed in osteoporotic patients.