437 resultados para Conformity.
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Materials/Methods: Four patients who underwent whole-brain radiotherapy (WBRT) and simultaneous integrated boost (SIB) between August 2010 and February 2011 were included to this study. Their age were 60, 61, 65, and 70 years. Primary diagnosis was infiltrative ductal breast cancer in two patients, sigmoid adenocarcinoma in one, and transitional bladder cancer in the other patient. All patients underwent cranial surgery but not all of the metastases were operated in 2 patients. All but one (five metastases) patient presented with single brain metastasis. In 2 of the 4 patients, hippocampus was spared contralaterally due to vicinity of the lesions to unilateral hippocampus. Planning irradiation dose was 30 Gy in 10 fractions for WBRT and 40 Gy in 10 fractions for SIB over two weeks in three patients. In one patient, WBRT and boost doses were 36Gy and 50.4 Gy in 18 fractions. Our maximum dose constraints for hippocampus and eyes were 10 and 20 Gy, respectively. All organs were contoured manually. Hippocampi were contoured according to published guidelines, and 5-mm margin expansion was used for hippocampal avoidance volume. All plans utilized a field width of 2.5 cm. Modulation factors ranged between 2 and 3.5. A pitch of 0,287 was used for all patients. All plans were evaluated according to conformity index (CI), homogeneity index (HI), target coverage (TC), and mean normalized total dose (NTDmean). An alpha/beta ratio of 2 was assumed for the hippocampus.Results: Median planning target volume (PTV) for metastases was 17.47 cc.Median hippocampal avoidance volume was 14.73 cc (range, 9.25-16.18 cc). Median average hippocampaldose was 11.84 Gy (range, 10.14-21.01 Gy). PTVs were fully covered with more than 95% of the prescribed dose for all patients. With a median follow-up time of 6 months (range, 3-9 months), all patients were alive without recurrent intracranial disease. To date, no neurocognitive decline reported in any of the patients.Conclusions: Preclinical evidence suggests that hippocampal sparing during cranial irradiation may mitigate neurocognitive decline. Using HT, we significantly reduced the mean dose to the hippocampus without jeopardizing coverage of metastases and whole brain.
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BACKGROUND: Peer pressure is regarded as an important determinant of substance use, sexual behavior and juvenile delinquency. However, few peer pressure scales are validated, especially in French or German. Little is known about the factor structure of such scales or the kind of scale needed: some scales takes into account both peer pressure to do and peer pressure not to do, while others consider only peer pressure to do. The aim of the present study was to adapt French and German versions of the Peer Pressure Inventory, which is one of the most widely used scales in this field. We considered its factor structure and concurrent validity. METHODS: Five thousand eight hundred and sixty-seven young Swiss men filled in a questionnaire on peer pressure, substance use, and other variables (conformity, involvement) in a cohort study. RESULTS: We identified a four-factor structure, with the three factors of the initial Peer Pressure Inventory (involvement, conformity, misconduct) and adding a new one (relationship with girls). A non-valued scale (from no peer pressure to peer pressure to do only) showed stronger psychometric qualities than a valued scale (from peer pressure not to do to peer pressure to do). Concurrent validity was also good. Each behavior or attitude was significantly associated with peer pressure. CONCLUSION: Peer pressure seems to be a multidimensional concept. In this study, peer pressure to do showed the strongest influence on participants. Indeed, peer pressure not to do did not add anything useful. Only peer pressure to do affected young Swiss men's behaviors and attitudes and was reliable.
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Many experiments have shown that human subjects do not necessarily behave in line with game theoretic assumptions and solution concepts. The reasons for this non-conformity are multiple. In this paper we study the argument whether a deviation from game theory is because subjects are rational, but doubt that others are rational as well, compared to the argument that subjects, in general, are boundedly rational themselves. To distinguish these two hypotheses, we study behavior in repeated 2-person and many-person Beauty-Contest-Games which are strategically different from one another. We analyze four different treatments and observe that convergence toward equilibrium is driven by learning through the information about the other player s choice and adaptation rather than self-initiated rational reasoning.
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Neuroblastoma (NB) is the most common extracranial malignant tumor in young children and arises at any site of the sympathetic nervous system. The disease exhibits a remarkable phenotypic diversity ranging from spontaneous regression to fatal disease. Poor outcome results from a rapidly progressive, metastatic and drug-resistant disease. Recent studies have suggested that solid tumors may arise from a minor population of cancer stem cells (CSCs) with stem cell markers and typical properties such as self-renewal ability, asymmetric division and drug resistance. In this model, CSCs possess the exclusive ability to initiate and maintain the tumor, and to produce distant metastases. Tumor cell subpopulations with stem-like phenotypes have indeed been identified in several cancer including leukemia, breast, brain and colon cancers. CSC hypothesis still needs to be validated in the other cancers including NB.NB originates from neural crest-derived malignant sympatho-adrenal cells. We have identified rare cells that express markers in conformity with neural crest stem cells and their derived lineages within primary NB tissue and cell lines, leading us to postulate the existence of CSCs in NB tumors.In the absence of specific markers to isolate CSCs, we adapted to NB tumor cells the sphere functional assay, based on the ability of stem cells to grow as spheres in non-adherent conditions. By serial passages of spheres from bone marrow NB metastases, a subset of cells was gradually selected and its specific gene expression profile identified by micro-array time-course analysis. The differentially expressed genes in spheres are enriched in genes implicated in development including CD133, ABC-transporters, WNT and NOTCH genes, identified in others solid cancers as CSCs markers, and other new markers, all referred by us as the Neurosphere Expression Profile (NEP). We confirmed the presence of a cell subpopulation expressing a combination of the NEP markers within a few primary NB samples.The tumorigenic potential of NB spheres was assayed by in vivo tumor growth analyses using orthotopic (adrenal glands) implantations of tumor cells into immune-compromised mice. Tumors derived from the sphere cells were significantly more frequent and were detected earlier compared to whole tumor cells. However, NB cells expressing the neurosphere-associated genes and isolated from the bulk tumors did not recapitulate the CSC-like phenotype in the orthotopic model. In addition, the NB sphere cells lost their higher tumorigenic potential when implanted in a subcutaneous heterotopic in vivo model.These results highlighted the complex behavior of CSC functions and led us to consider the stem-like NB cells as a dynamic and heterogeneous cell population influenced by microenvironment signals.Our approach identified for the first time candidate genes that may be associated with NB self-renewal and tumorigenicity and therefore would establish specific functional targets for more effective therapies in aggressive NB.
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PURPOSE: We investigated the influence of beam modulation on treatment planning by comparing four available stereotactic radiosurgery (SRS) modalities: Gamma-Knife-Perfexion, Novalis-Tx Dynamic-Conformal-Arc (DCA) and Dynamic-Multileaf-Collimation-Intensity-Modulated-radiotherapy (DMLC-IMRT), and Cyberknife. MATERIAL AND METHODS: Patients with arteriovenous malformation (n = 10) or acoustic neuromas (n = 5) were planned with different treatment modalities. Paddick conformity index (CI), dose heterogeneity (DH), gradient index (GI) and beam-on time were used as dosimetric indices. RESULTS: Gamma-Knife-Perfexion can achieve high degree of conformity (CI = 0.77 ± 0.04) with limited low-doses (GI = 2.59 ± 0.10) surrounding the inhomogeneous dose distribution (D(H) = 0.84 ± 0.05) at the cost of treatment time (68.1 min ± 27.5). Novalis-Tx-DCA improved this inhomogeneity (D(H) = 0.30 ± 0.03) and treatment time (16.8 min ± 2.2) at the cost of conformity (CI = 0.66 ± 0.04) and Novalis-TX-DMLC-IMRT improved the DCA CI (CI = 0.68 ± 0.04) and inhomogeneity (D(H) = 0.18 ± 0.05) at the cost of low-doses (GI = 3.94 ± 0.92) and treatment time (21.7 min ± 3.4) (p<0.01). Cyberknife achieved comparable conformity (CI = 0.77 ± 0.06) at the cost of low-doses (GI = 3.48 ± 0.47) surrounding the homogeneous (D(H) = 0.22 ± 0.02) dose distribution and treatment time (28.4min±8.1) (p<0.01). CONCLUSIONS: Gamma-Knife-Perfexion will comply with all SRS constraints (high conformity while minimizing low-dose spread). Multiple focal entries (Gamma-Knife-Perfexion and Cyberknife) will achieve better conformity than High-Definition-MLC of Novalis-Tx at the cost of treatment time. Non-isocentric beams (Cyberknife) or IMRT-beams (Novalis-Tx-DMLC-IMRT) will spread more low-dose than multiple isocenters (Gamma-Knife-Perfexion) or dynamic arcs (Novalis-Tx-DCA). Inverse planning and modulated fluences (Novalis-Tx-DMLC-IMRT and CyberKnife) will deliver the most homogeneous treatment. Furthermore, Linac-based systems (Novalis and Cyberknife) can perform image verification at the time of treatment delivery.
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The objectives of the project were to develop methodologies for (i) prediction and measurement of the magnitude of pressure which develops within pores of saturated porous materials upon freezing, (ii) determination of pore structure (pore size distribution) of porous materials; (iii) prediction and measurement of the rate with which pore ice grows; and (iv) prediction of frost susceptibility of porous materials with varying pore structures. As with all research endeavors solution of one problem leads to another one and this project was no exception. Emergence of new problems and the measures taken as the work progressed were discussed in progress reports submitted to the board. This final report will discuss only the conclusive finds and suggest measures to be taken for future investigations. The theory discussed in the proposal is not repeated in this report for the sake of brevity. However, the paper published as part of this project containing the theory is attached as Appendix I for the reader interested in the theory. In conformity with the objectives, this report consists of four parts. In accordance with the project contract two ice porosimeters were built and one will be delivered to the Iowa DOT after training of a DOT technician under the supervision of Mr. Wendell Dubberke with assistance from ISU researchers. During the training period debugging and further improvements in software will continue.
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In May 1950 a proposal for a research project was submitted to the newly formed Iowa Highway Research Board for consideration and action. This project, designated RPSl by the Board, encompassed the study, development, preparation of preliminary plans and specifications for the construction of a wheel track to be used in the accelerated testing of highway pavements. The device envisioned in the proposal was a circular track about seventy-five feet in diameter equipped with a suitable automobile-tired device to test pavements about five feet in width laid into the track under regular construction practices by small scale construction equipment. The Board, upon review, revised and expanded the basic concepts of the project. The project as revised by the Board included a study of the feasibility of developing, constructing and operating an accelerated testing track in which pavements, bases and subgrades may be laid one full lane, or at least ten feet, in width by full size construction equipment in conformity with usual construction practices. The pavements so laid are to be subjected, during test, to conditions as nearly simulating actual traffic as possible.
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Objective: To report a single-center experience treating patients with squamous- cell carcinoma of the anal canal using helical Tomotherapy (HT) and concurrent chemotherapy (CT).Materials/Methods: From October 2007 to February 2011, 55 patients were treated with HT and concurrent CT (5-fluorouracil/capecitabin and mitomycin) for anal squamous-cell carcinoma. All patients underwent computed- tomography-based treatment planning, with pelvic and inguinal nodes receiving 36 Gy in 1.8 Gy/fraction. Following a planned 1-week break, primary tumor site and involved nodes were boosted to a total dose 59.4 Gy in 1.8 Gy/fraction. Dose-volume histograms of several organs at risk (OAR; bladder, small intestine, rectum, femoral heads, penile bulb, external genitalia) were assessed in terms of conformal avoidance. All toxicity was scored according to the CTCAE, v.3.0. HT plans and treatment were implemented using the Tomotherapy, Inc. software and hardware. For dosimetric comparisons, 3D RT and/or IMRT plans were also computed for some of the patients using the CMS planning system, for treatment with 6-18 MV photons and/or electrons with suitable energies from a Siemens Primus linear accelerator equipped with a multileaf collimator.Locoregional control and survival curves were compared with the log-rank test, and multivariate analysis by the Cox model.Results: With 360-degree-of-freedom beam projection, HT has an advantage over other RT techniques (3D or 5-field step-and-shot IMRT). There is significant improvement over 3D or 5-field IMRT plans in terms of dose conformity around the PTV, and dose gradients are steeper outside the target volume, resulting in reduced doses to OARs. Using HT, acute toxicity was acceptable, and seemed to be better than historical standards.Conclusions: Our results suggest that HT combined with concurrent CT for anal cancer is effective and tolerable. Compared to 3D RT or 5-field step-andshot IMRT, there is better conformity around the PTV, and better OAR sparing.
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Iowa law allows taxpayers to deduct federal income taxes from income prior to calculating state income tax liability. Due to the federal tax deduction, changes to federal income taxes enacted by Congress directly and automatically impact Iowa's revenue stream. While this issue is present every year, the impact on the budget process has been more pronounced over the past three years as federal tax reductions enacted during the early 2000s were set to expire, were extended, and are now set to expire again. This issue review examines federal deductability and the related issue of federal conformity.
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Perinteisten kaarihitsausmenetelmien suhteellisen suuri lämmöntuonti aiheuttaa huomattavia muodonmuutoksia laivan rungon valmistusprosessin alkuvaiheessa. Muodonmuutosten seurauksena rakenteiden mitta- ja muototarkkuus heikkenee, mikä lisää oikaisu- ja sovitustyötä myöhemmissä työvaiheissa. Hitsausmuodonmuutoksia voidaan vähentää siirtymällä käyttämään laser-MAG-hybridihitsausta, jossa lämmöntuonti on merkittävästi pienempi kuin kaarihitsauksessa. Näin kyetään oleellisesti leikkaamaan oikaisu- ja sovitustyöstä syntyviä kustannuksia. Tämän diplomityön tavoitteena oli kehittää tuotantovalmiiksi kuitulaser- ja MAG-hitsauksen yhdistelmäprosessi Aker Yards Oy:n Turun telakalla loppuvuoden 2006 aikana. Hitsauslaitteiston asennus oli valmistunut kesäkuussa 2006, minkä jälkeen aloitettiin luokituslaitoksen hyväksymän koeohjelman hitsaukset. Käyttöönotto suunnitelmaan sisältyvä koehitsausohjelma oli laadittu Det Norske Veritaksen julkaisemaa ohjetta (Guidelines no. 19) mukaillen. Ensimmäiseksi määritettiin hitsauskokeiden avulla prosessille laadun ja tehokkuuden suhteen optimaalinen railogeometria. Seuraavaksi optimoitiin prosessin hitsausparametrit 6 mm:n aineenpaksuudelle hyödyntäen Taguchi-koesuunnittelumenetelmää. Tämän jälkeen optimiparametreilla hitsattiin koekappale väsytyskokeisiin, jotka suoritettiin Teknillisen korkeakoulun laivalaboratoriossa. Väsytyskoetulokset täyttivät luokituslaitoksen vaatimukset. Myös hitsauksen menetelmäkoe suoritettiin hyväksytetysti. Viimeinen koeohjelman mukainen hitsauskoesarja tehtiin prosessiparametrien sallittujen vaihtelurajojen määrittämiseksi. Diplomityön tavoite täyttyi joulukuussa 2006, jolloin 'laivan kansipaneeli hitsattiin ensimmäistä kertaa uudella hitsausprosessilla. Hitsauksen laatu korreloi hyvin menetelmäkokeen tulosten kanssa ¿ hitsit olivat tasalaatuisia ja ne täyttivät B-luokan vaatimukset.
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Tämä diplomityö on tehty ohjeeksi väyläsuunnittelijoille, tiehankkeiden suunnittelussa tehtävään ympäristön tilan selvittämiseen sekä ympäristövaikutusten arviointiin.Työn toimeksiantajana on Tieliikelaitoksen Konsultoinnin Suunnittelupalvelut. Tutkimusongelmaa lähestyttiin selvittämällä aikaisemmin suunnittelussa käytettyjätyöskentelytapoja ja -menetelmiä sekä tarkastelemalla aiemmin tehtyjä tiensuunnittelun asiakirjoja. Selvitys keskittyi Tieliikelaitoksen ja sitä edeltäneen Tielaitoksen toimintaan, mutta työssä tarkasteltiin myös muiden asiantuntijoiden laatimia suunnitelmia. Työn lähtökohtana oli laatia ohje, jonkaavulla suunnittelijat voivat tehdä suunnitelmaan kuuluvan ympäristötiedon käsittelyn itsenäisesti. Hankkeissa, joissa näin toimitaan, oletetaan ympäristövaikutusten jäävän melko vähäisiksi eikä niissä vaadita YVA-lain mukaista menettelyä. Laaditun ohjeen myötä eri suunnittelijoiden laatimat tiehankkeiden suunnitelmat yhtenäistyvät ympäristötiedon käsittelyn osalta, sillä aiemmin yhtenäistä käytäntöä ei ole ollut. Suunnitelmien laatu paranee ja ympäristövaikutusten arviointi helpottuu samaan ohjeeseen kootun tiedon avulla. Ohjeen aikaansaaman suunnittelutoiminnan kehittyminen näkyy vasta, kun ohjetta on sovellettukäytännössä hankkeiden suunnitteluun.
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Tutkielman tavoitteena oli selvittää case-organisaatio Stora Enson Anjalan paperitehtaan uudistumiskyky, toiminnan strategianmukaisuus sekä vahvuudet ja kehitettävät osa-alueetuudistumiskyvyssä. Tutkielmassa käytettiin kvantitatiivista tutkimusotetta. Aineisto kerättiin kahdella eri mittarilla: KM-Factor¿ ¿ uudistumiskyvyn mittarilla ja organisaation muutoskyvyn mittarilla. KM-Factor¿ ¿mittarin avulla kerättiin tietoa organisaation suhteiden, tiedonkulun, osaamisen ja johtamisen nyky- ja tavoitetilasta erilaisissa tietoympäristöissä. Muutoskyvyn mittarin avulla kerättiin tietoa organisaation uudistumiskyvystä kuuden sitä kuvaavan ominaisuuden, strategisen kyvykkyyden, johtajuuden, ajan hyödyntämisen, verkostoituneisuuden, tiedon johtamisen ja oppimissuuntautuneisuuden perusteella. Mittaukset suoritettiin helmikuussa 2006 ja niiden kohteena oli Stora Enson Anjalan paperitehtaan koko henkilöstö. Kahden uudistumiskyvyn mittarin tulokset analysoitiin ja niitä vertailtiin keskenään. Tällä tavalla pyrittiinmyös lisäämään tutkimuksen validiteettia. Mittaustulokset purettiin sanalliseenmuotoon ja niistä raportoitiin case-organisaatiolle. Mittausten mukaan case-organisaation uudistumiskyky oli hieman keskitasoa heikompi. Toiminnan vahvuuksia olivat yksimielisyys muutostarpeista ja tilanneherkkyys. Merkittävimmät toiminnan heikkoudet löytyivät nykyisestä toimintatavasta, joka ei ollut strategian mukainen, ja innovaatiopotentiaalista, joka oli hyvin alhainen. Kehittämisen tarpeita löytyi sekä johdon että henkilöstön suhteiden ja yhteistyön osalta. Koko organisaation tulisi lisätä yhteistyötä ulkopuolisten tahojen ja sidosryhmien kanssa. Organisaatiossa tulisi miettiä, miten strategia saataisiin selkeästi viestittyä myös johtoa alemmille tasoille. Johto painotti liikaa autoritääristä johtamista, kun taas henkilöstöltä odotettaisiin enemmän vastuunottoa toiminnastaan. Organisaatiossa tulisi saada nykyistä avoimemmin ja itsenäisemmin ilmaista omia näkemyksiään, toimia aloitteellisesti ja luoda uusia ideoita toiminnan kehittämiseksi. Innovatiivisuudesta ja parannusehdotuksista tulisi myös palkita paremmin.
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CONTEXT: Increased altruism, self-transcendence, and quests for meaning in life (MiL) have been found in palliative care (PC) patients and their families who experience the finiteness of life. Similar changes were observed in healthy subjects who were experimentally confronted with their mortality. OBJECTIVES: The study investigated how daily experiences of the transitoriness of life influence PC health care professionals' (HCPs) values, MiL, and religiousness. METHODS: In a cross-sectional study, the Schwartz Value Survey, the Schedule for Meaning in Life Evaluation, and the Idler Index of Religiosity were used to investigate personal values, MiL, and private religiousness. HCPs working in PC (confronted with death) were compared with a control group of HCPs working at maternity wards (MWs) using multivariate models. Differences were considered to be statistically significant at P < 0.05. RESULTS: Seventy PC- and 70 MW-HCPs took part in the study (response rate 74.0%). No differences between the groups were found in overall MiL satisfaction scores. PC-HCPs were significantly more religious than MW-HCPs; they listed spirituality and nature experience more often as areas in which they experience MiL. Furthermore, hedonism was more important for PC-HCPs, and they had higher scores in openness-to-change values (stimulation and self-direction). MW-HCPs were more likely to list family as a MiL area. They assigned more importance to health and scored higher in conservation values (conformity and security). Duration of professional experience did not influence these results. CONCLUSION: Basic differences in values, MiL, and religiousness between PC-HCPs and MW-HCPs might have influenced the choice of working environment because no effect of job duration was observed. Longitudinal research is needed to confirm this hypothesis.
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Työssä tarkasteltiin paikallisen teleyhtiön muutos- ja sopeuttamisprosessia vanhanaikaisesta puhelinyhtiöstänykyajan moderniksi teletoimijaksi. Selvitettiin, miten kaikki on saanut alkunsa ja minkälainen yritys on tänä päivänä. Yrityksen kehitykseen vaikuttaa väkisinkin organisaatiokulttuuri ja sen muuttuminen yrityksen toiminnan laajentuessa jamuuttuessa. Käytiin läpi orgäanisaatioteoriaa sekä siihen olennaisena osana liittyvää yrityksen arvomaailmaa ja yrityskuvaa. Tutkimus suoritettiin aikasarjana.Tutkimuksessa suoritettiin lyhyt historiakuvaus, jonka avulla selvitettiin tämän päivän kehitykseen vaikuttavat tekijät. Niitä olivat pääsääntöisesti yleinen teleliikennetoimialan kehittyminen ja viranomaisvalvonta. Asiaa tutkittiin kulttuurin kasvu- ja kehitysvaiheet menetelmää avuksi käyttäen. Empiirisenä aineistonakäytettiin paikallisen teleyhtiön vuosikertomuksia, otoksia julkisista lehti- ja internetartikkeleista sekä paikallisesta teleyhtiöstä ja yleisesti telealasta kertovaa kirjallisuutta. Lisäksi käytettiin hyväksi tutkijan omaa kokemusta pitkään telealalla työskennelleenä. Tutkimuksessa päädyttiin siihen tulokseen, että paikallisen teleyhtiön pitäisi näkyä enemmän valtakunnallisesti. Henkilöstön sopeuttaminen uuteen tilanteeseen tulee olemaan yritysjohdolle tärkein tehtävä. Tässä asiassa edesauttaa se, että yritysjohdolta löytyisi hyvät muutos-johtamisen ja vuorovaikuttamisen taidot. Viestinnän merkitys nousee myös erittäin tärkeäksi.Sen pitää toimia kumpaankin suuntaan, henkilöstön ja yritysjohdon välillä pitääolla kahdensuuntaista viestintää. Lisäksi todettiin, että todennäköisesti tapahtuu fuusioitumista joko niin, että isommat paikalliset teleyhtiöt ostavat pieniäyhtiöitä, ja markkinoille jää vain muutama iso paikallinen teleyhtiö, tai sitten kaikki paikalliset teleyhtiöt fuusioituvat yhteen isoon yhtiöön. Tulevaisuudessa kilpailun kiristyminen tulee luomaan tämänkaltaisia paineita. Tuote- ja palvelukehitykseen pitää tulevaisuudessa panostaa huomattavasti enemmän. Telealalla saadaan myös tottua siihen, että EU:n alueella tullaan vaatimaan kilpailun täyttävapautumista. Lisäksi viranomaiset tulevat seuraamaan telealaa jatkossakin erittäin tarkasti.
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Commercially available PCM RT 20, RT 27, SP 22, A17 and SP 25 A8. Were analyzed using dynamic and step method of heat flux DSC. The results of the dinamic and step method were compared with commercial valures. It was found that RT 20 & RT 27 showed good conforming of results with commercial values while SP 22 A17 & SP 25 A8 did not show conformity.