Correlation of phantom-based and log file patient-specific QA with complexity scores for VMAT

The motivation for this study was to reduce physics workload relating to patient- specific quality assurance (QA). VMAT plan delivery accuracy was determined from analysis of pre- and on-treatment trajectory log files and phantom-based ionization chamber array measurements. The correlation in this combination of measurements for patient-specific QA was investigated. The relationship between delivery errors and plan complexity was investigated as a potential method to further reduce patient-specific QA workload. Thirty VMAT plans from three treatment sites - prostate only, prostate and pelvic node (PPN), and head and neck (H&N) - were retrospectively analyzed in this work. The 2D fluence delivery reconstructed from pretreatment and on-treatment trajectory log files was compared with the planned fluence using gamma analysis. Pretreatment dose delivery verification was also car- ried out using gamma analysis of ionization chamber array measurements compared with calculated doses. Pearson correlations were used to explore any relationship between trajectory log file (pretreatment and on-treatment) and ionization chamber array gamma results (pretreatment). Plan complexity was assessed using the MU/ arc and the modulation complexity score (MCS), with Pearson correlations used to examine any relationships between complexity metrics and plan delivery accu- racy. Trajectory log files were also used to further explore the accuracy of MLC and gantry positions. Pretreatment 1%/1 mm gamma passing rates for trajectory log file analysis were 99.1% (98.7%-99.2%), 99.3% (99.1%-99.5%), and 98.4% (97.3%-98.8%) (median (IQR)) for prostate, PPN, and H&N, respectively, and were significantly correlated to on-treatment trajectory log file gamma results (R = 0.989, p < 0.001). Pretreatment ionization chamber array (2%/2 mm) gamma results were also significantly correlated with on-treatment trajectory log file gamma results (R = 0.623, p < 0.001). Furthermore, all gamma results displayed a significant correlation with MCS (R > 0.57, p < 0.001), but not with MU/arc. Average MLC position and gantry angle errors were 0.001 ± 0.002 mm and 0.025° ± 0.008° over all treatment sites and were not found to affect delivery accuracy. However, vari- ability in MLC speed was found to be directly related to MLC position accuracy. The accuracy of VMAT plan delivery assessed using pretreatment trajectory log file fluence delivery and ionization chamber array measurements were strongly correlated with on-treatment trajectory log file fluence delivery. The strong corre- lation between trajectory log file and phantom-based gamma results demonstrates potential to reduce our current patient-specific QA. Additionally, insight into MLC and gantry position accuracy through trajectory log file analysis and the strong cor- relation between gamma analysis results and the MCS could also provide further methodologies to both optimize the VMAT planning and QA process. 

Tensor products of subspace lattices and rank one density

We show that, if M is a subspace lattice with the property that the rank one subspace of its operator algebra is weak* dense, L is a commutative subspace lattice and P is the lattice of all projections on a separable Hilbert space, then L⊗M⊗P is reflexive. If M is moreover an atomic Boolean subspace lattice while L is any subspace lattice, we provide a concrete lattice theoretic description of L⊗M in terms of projection valued functions defined on the set of atoms of M . As a consequence, we show that the Lattice Tensor Product Formula holds for AlgM and any other reflexive operator algebra and give several further corollaries of these results.

The First Government of Northern Ireland, Education Reform, and the Failure of Anti-populist Unionism, 1921–1925

This article examines education reform under the first government of Northern Ireland (1921–5). This embryonic period offered the Ulster Unionist leadership a chance to construct a more inclusive society, one that might diminish sectarian animosities, and thereby secure the fledgling state through cooperation rather than coercion. Such aspirations were severely tested by the ruling party’s need to secure the state against insurgency, and, more lastingly, to assuage the concerns of its historic constituency. The former led to a draconian security policy, the latter to a dependency on populist strategies and rhetoric. It is argued here, however, that this dependency was not absolute until July 1925. Before that, the Belfast government withstood growing pressure from populist agitators to reverse controversial aspects of its education reforms, only relenting when Protestant disaffection threatened the unity of the governing party and the existence of the state.

Characterization and application of two RANK-specific antibodies with different biological activities.

Antibodies play an important role in therapy and investigative biomedical research. The TNF-family member Receptor Activator of NF-κB (RANK) is known for its role in bone homeostasis and is increasingly recognized as a central player in immune regulation and epithelial cell activation. However, the study of RANK biology has been hampered by missing or insufficient characterization of high affinity tools that recognize RANK. Here, we present a careful description and comparison of two antibodies, RANK-02 obtained by phage display (Newa, 2014 [1]) and R12-31 generated by immunization (Kamijo, 2006 [2]). We found that both antibodies recognized mouse RANK with high affinity, while RANK-02 and R12-31 recognized human RANK with high and lower affinities, respectively. Using a cell apoptosis assay based on stimulation of a RANK:Fas fusion protein, and a cellular NF-κB signaling assay, we showed that R12-31 was agonist for both species. R12-31 interfered little or not at all with the binding of RANKL to RANK, in contrast to RANK-02 that efficiently prevented this interaction. Depending on the assay and species, RANK-02 was either a weak agonist or a partial antagonist of RANK. Both antibodies recognized human Langerhans cells, previously shown to express RANK, while dermal dendritic cells were poorly labeled. In vivo R12-31 agonist activity was demonstrated by its ability to induce the formation of intestinal villous microfold cells in mice. This characterization of two monoclonal antibodies should now allow better evaluation of their application as therapeutic reagents and investigative tools.

Rank Regressions, Wage Distributions and the Gender Gap.

In this paper, we model the interactions between the distribution of male and female wages under the assumption that any change in the wage distribution of women must be offset by an opposite change in the wage distribution of men.

Rank Regressions, Wage Distributions and the Gender Gap.

In this paper, we model the interactions between the distribution of male and female wages under the assumption that any change in the wage distribution of women must be offset by an opposite change in the wage distribution of men.

Changing times, 1066-1500. Teaching and learning file.

Es una serie que presenta la historia de una manera que compromete y motiva, al tiempo que hace el aprendizaje activo y divertido. Añade reto y emoción a cada lección. Le proporciona al profesor: los planes, los recursos y la inspiración que necesita para incorporar nuevas estrategias en la enseñanza; objetivos claros para preparar Las actividades: guía para hacer cualquier preparación: ideas alternativas para empezar las sesiones y para el seguimiento de la tarea.

Modern times, 1750-1990 : teaching and learning file.

Material didáctico formado por unas notas detalladas que contienen orientación y asesoramiento para que el profesor utilice las hojas de trabajo que les siguen. Estas hojas de trabajo establecen cuáles son los objetivos y los resultados del aprendizaje que han de cumplir los alumnos, y para ello, se incluyen de varios tipos. Unas, pueden utilizarse para tareas de apoyo referidas al libro del alumno y, otras, son para actividades autónomas ó genéricas. Este recurso contiene también las hojas de trabajo para los libros del alumno editados en dos versiones: básica (foundation) y principal (core).

Revolutionary times, 1500-1750 : teaching and learning file.

Material didáctico formado por unas notas detalladas que contienen orientación y asesoramiento para que el profesor utilice las hojas de trabajo que les siguen. Estas hojas de trabajo establecen cuáles son los objetivos y los resultados del aprendizaje que han de cumplir los alumnos, y para ello, se incluyen de varios tipos. Unas, pueden utilizarse para tareas de apoyo referidas al libro del alumno y, otras, son para actividades autónomas ó genéricas. Este recurso contiene también las hojas de trabajo para los libros del alumno editados en dos versiones: básica (foundation) y principal (core).

Your life KS4 co-ordinator's file : the whole-school solution for citizenship and PSHE.

Libro dirigido a profesores que tengan que impartir la asignatura de 'Educación para la ciudadanía' en relación con 'Educación personal, social y de la salud' en el nivel KS4 (Key Stage 4), enseñanza secundaria. Presenta sugerencias de planificación y materiales adicionales para acompañar a los libros del alumno 'Your life 4' y 'Your life 5'. Cubre los siguientes temas: desarrollo como ciudadano, bienestar personal (comprenderse a si mismo y saber relacionarse), bienestar personal (mantener la salud), bienestar económico y capacidad financiera.