ESTRO-HERO survey: Guidelines for equipment and staffing of radiotherapy facilities in the European countries: Final results of the ESTRO-HERO survey

Background and purpose: In planning to meet evidence based needs for radiotherapy, guidelines for the provision of capital and human resources are central if access, quality and safety are not to be compromised. A component of the ESTRO-HERO (Health Economics in Radiation Oncology) project is to document the current availability and content of guidelines for radiotherapy in Europe. Materials and methods: An 84 part questionnaire was distributed to the European countries through their national scientific and professional radiotherapy societies with 30 items relating to the availability of guidelines for equipment and staffing and selected operational issues. Twenty-nine countries provided full or partial evaluable responses. Results: The availability of guidelines across Europe is far from uniform. The metrics used for capital and human resources are variable. There seem to have been no major changes in the availability or specifics of guidelines over the ten-year period since the QUARTS study with the exception of the recent expansion of RTT staffing models. Where comparison is possible it appears that staffing for radiation oncologists, medical physicists and particularly RTTs tend to exceed guidelines suggesting developments in clinical radiotherapy are moving faster than guideline updating. Conclusion: The efficient provision of safe, high quality radiotherapy services would benefit from the availability of well-structured guidelines for capital and human resources, based on agreed upon metrics, which could be linked to detailed estimates of need

ESTRO-HERO survey: Radiotherapy equipment and departments in the European countries: Final results from the ESTRO-HERO survey

Background: Documenting the distribution of radiotherapy departments and the availability of radiotherapy equipment in the European countries is an important part of HERO the ESTRO Health Economics in Radiation Oncology project. HERO has the overall aim to develop a knowledge base of the provision of radiotherapy in Europe and build a model for health economic evaluation of radiation treatments at the European level. The aim of the current report is to describe the distribution of radiotherapy equipment in European countries. Methods: An 84-item questionnaire was sent out to European countries, principally through their national societies. The current report includes a detailed analysis of radiotherapy departments and equipment (questionnaire items 2629), analyzed in relation to the annual number of treatment courses and the socio-economic status of the countries. The analysis is based on validated responses from 28 of the 40 European countries defined by the European Cancer Observatory (ECO). Results: A large variation between countries was found for most parameters studied. There were 2192 linear accelerators, 96 dedicated stereotactic machines, and 77 cobalt machines reported in the 27 countries where this information was available. A total of 12 countries had at least one cobalt machine in use. There was a median of 0.5 simulator per MV unit (range 0.31.5) and 1.4 (range 0.44.4) simulators per department. Of the 874 simulators, a total of 654 (75%) were capable of 3D imaging (CT-scanner or CBCToption). The number of MV machines (cobalt, linear accelerators, and dedicated stereotactic machines) per million inhabitants ranged from 1.4 to 9.5 (median 5.3) and the average number of MV machines per department from 0.9 to 8.2 (median 2.6). The average number of treatment courses per year per MV machine varied from 262 to 1061 (median 419). While 69% of MV units were capable of IMRT only 49% were equipped for image guidance (IGRT). There was a clear relation between socio-economic status, as measured by GNI per capita, and availability of radiotherapy equipment in the countries. In many low income countries in Southern and Central-Eastern Europe there was very limited access to radiotherapy and especially to equipment for IMRT or IGRT. Conclusions: The European average number of MV machines per million inhabitants and per department is now better in line with QUARTS recommendations from 2005, but the survey also showed a significant heterogeneity in the access to modern radiotherapy equipment in Europe. High income countries especially in Northern-Western Europe are well-served with radiotherapy resources, other countries are facing important shortages of both equipment in general and especially machines capable of delivering high precision conformal treatments (IMRT, IGRT)

ESTRO-HERO survey: Radiotherapy staffing in the European countries: Final results from the ESTRO-HERO survey

Background: The ESTRO Health Economics in Radiation Oncology (HERO) project has the overall aim to develop a knowledge base of the provision of radiotherapy in Europe and build a model for health economic evaluation of radiation treatments at the European level. The first milestone was to assess the availability of radiotherapy resources within Europe. This paper presents the personnel data collected in the ESTRO HERO database. Materials and methods: An 84-item questionnaire was sent out to European countries, through their national scientific and professional radiotherapy societies. The current report includes a detailed analysis of radiotherapy staffing (questionnaire items 4760), analysed in relation to the annual number of treatment courses and the socio-economic status of the countries. The analysis was conducted between February and July 2014, and is based on validated responses from 24 of the 40 European countries defined by the European Cancer Observatory (ECO). Results: A large variation between countries was found for most parameters studied. Averages and ranges for personnel numbers per million inhabitants are 12.8 (2.530.9) for radiation oncologists, 7.6 (019.7) for medical physicists, 3.5 (012.6) for dosimetrists, 26.6 (1.978) for RTTs and 14.8 (0.461.0) for radiotherapy nurses. The combined average for physicists and dosimetrists is 9.8 per million inhabitants and 36.9 for RTT and nurses. Radiation oncologists on average treat 208.9 courses per year (range: 99.9348.8), physicists and dosimetrists conjointly treat 303.3 courses (range: 85757.7) and RTT and nurses 76.8 (range: 25.7156.8). In countries with higher GNI per capita, all personnel categories treat fewer courses per annum than in less affluent countries. This relationship is most evident for RTTs and nurses. Different clusters of countries can be distinguished on the basis of available personnel resources and socio-economic status. Conclusions: The average personnel figures in Europe are now consistent with, or even more favourable than the QUARTS recommendations, probably reflecting a combination of better availability as such, in parallel with the current use of more complex treatments than a decade ago. A considerable variation in available personnel and delivered courses per year however persists among the highest and lowest staffing levels. This not only reflects the variation in cancer incidence and socio-economic determinants, but also the stage in technology adoption along with treatment complexity and the different professional roles and responsibilities within each country. Our data underpin the need for accurate prediction models and long-term education and training programmes

Gerenciamento de resíduos laboratoriais: recuperação de elementos e preparo para descarte final

This work shows some laboratory waste management developed in order to recover some elements or to prepare the waste for a correct final disposal. The 25 elements chosen cover basically all chemical behaviors found for the metals in the Periodic Table. The treatments adopted were based on the classical behavior in aqueous solution (wet chemistry) but an important condition for a full success was the previous knowledge of the qualitative composition of the wastes treated. Some general trends were found: the final liquid waste was always saline and normally presented a higher volume than the original waste; most original wastes were acid in nature; steps such as solid-liquid separation, washing, evaporating and calcining were currently performed. This work was also a very good experience in chemistry in solution for students and showed them the need of treating wastes for a better environment.

Knapsack sets for cryptography

The basic goal of this study is to extend old and propose new ways to generate knapsack sets suitable for use in public key cryptography. The knapsack problem and its cryptographic use are reviewed in the introductory chapter. Terminology is based on common cryptographic vocabulary. For example, solving the knapsack problem (which is here a subset sum problem) is termed decipherment. Chapter 1 also reviews the most famous knapsack cryptosystem, the Merkle Hellman system. It is based on a superincreasing knapsack and uses modular multiplication as a trapdoor transformation. The insecurity caused by these two properties exemplifies the two general categories of attacks against knapsack systems. These categories provide the motivation for Chapters 2 and 4. Chapter 2 discusses the density of a knapsack and the dangers of having a low density. Chapter 3 interrupts for a while the more abstract treatment by showing examples of small injective knapsacks and extrapolating conjectures on some characteristics of knapsacks of larger size, especially their density and number. The most common trapdoor technique, modular multiplication, is likely to cause insecurity, but as argued in Chapter 4, it is difficult to find any other simple trapdoor techniques. This discussion also provides a basis for the introduction of various categories of non injectivity in Chapter 5. Besides general ideas of non injectivity of knapsack systems, Chapter 5 introduces and evaluates several ways to construct such systems, most notably the "exceptional blocks" in superincreasing knapsacks and the usage of "too small" a modulus in the modular multiplication as a trapdoor technique. The author believes that non injectivity is the most promising direction for development of knapsack cryptosystema. Chapter 6 modifies two well known knapsack schemes, the Merkle Hellman multiplicative trapdoor knapsack and the Graham Shamir knapsack. The main interest is in aspects other than non injectivity, although that is also exploited. In the end of the chapter, constructions proposed by Desmedt et. al. are presented to serve as a comparison for the developments of the subsequent three chapters. Chapter 7 provides a general framework for the iterative construction of injective knapsacks from smaller knapsacks, together with a simple example, the "three elements" system. In Chapters 8 and 9 the general framework is put into practice in two different ways. Modularly injective small knapsacks are used in Chapter 9 to construct a large knapsack, which is called the congruential knapsack. The addends of a subset sum can be found by decrementing the sum iteratively by using each of the small knapsacks and their moduli in turn. The construction is also generalized to the non injective case, which can lead to especially good results in the density, without complicating the deciphering process too much. Chapter 9 presents three related ways to realize the general framework of Chapter 7. The main idea is to join iteratively small knapsacks, each element of which would satisfy the superincreasing condition. As a whole, none of these systems need become superincreasing, though the development of density is not better than that. The new knapsack systems are injective but they can be deciphered with the same searching method as the non injective knapsacks with the "exceptional blocks" in Chapter 5. The final Chapter 10 first reviews the Chor Rivest knapsack system, which has withstood all cryptanalytic attacks. A couple of modifications to the use of this system are presented in order to further increase the security or make the construction easier. The latter goal is attempted by reducing the size of the Chor Rivest knapsack embedded in the modified system. '

Aplicación de algunos modelos de series temporales al mercado de la electricidad en España

Hoy día, todo el mundo tiene un ojo puesto en el Mercado Eléctrico en nuestro país. No existe duda alguna sobre la importancia que tiene el comportamiento de la demanda eléctrica. Una de las peculiaridades de la electricidad que producimos, es que hoy por hoy, no existen aún métodos lo suficientemente efectivos para almacenarla, al menos en grandes cantidades. Por consiguiente, la cantidad demandada y la ofertada/producida deben casar de manera casi perfecta. Debido a estas razones, es bastante interesante tratar de predecir el comportamiento futuro de la demanda, estudiando una posible tendencia y/o estacionalidad. Profundizando más en los datos históricos de las demandas; es relativamente sencillo descubrir la gran influencia que la temperatura ambiente, laboralidad o la actividad económica tienen sobre la respuesta de la demanda. Una vez teniendo todo esto claro, podemos decidir cuál es el mejor método para aplicarlo en este tipo de series temporales. Para este fin, los métodos de análisis más comunes han sido presentados y explicados, poniendo de relieve sus principales características, así como sus aplicaciones. Los métodos en los que se ha centrado este proyecto son en los modelos de alisado y medias móviles. Por último, se ha buscado una relación entre la demanda eléctrica peninsular y el precio final que pagamos por la luz.

Incorporação de CuSO4 residual em argamassa, como método de disposição final

Residual CuSO4 was incorporated into the mass utilized for cement preparation. To a cement mass with 1:0.5:5 of cement, lime and sand to 0.25, 0.50, 0.75 and 1.00% of residual CuSO4 were added. The sulfate was mixed separately with lime and water to induce metal precipitation. The hardened test bodies were submerged in Milli-Q water for three months. No Cu was detected in the water by Atomic Absorption Spectrometry. The best proportion for mechanical resistance and porosity is 0.50%. The cement is adequate for non-structural objects.

Water circulations for effective bleaching of high-brightness mechanical pulps

The amount of water available is usually restricted, which leads to a situation where a complete understanding of the process, including water circulations and the influence of water components, is essential. The main aim of this thesis was to clarify the possibilities for the efficient use of residual peroxide by means of water circulation rearrangements. Rearranging water circulations and the reduction of water usage may cause new problems, such as metal induced peroxide decomposition that needs to be addressed. This thesis introduces theoretical methods of water circulations to combine two variables; effective utilization of residual peroxide and avoiding manganese in the alkaline peroxide bleaching stage. Results are mainly based on laboratory and mill site experiments concerning the utilization of residual peroxide. A simulation model (BALAS) was used to evaluate the manganese contents and residual peroxide doses. It was shown that with optimum recirculation of residual peroxide the brightness can be improved or chemical costs can be decreased. From the scientific perspective, it was also very important to discover that recycled peroxide was more effective pre-bleaching agent compared to fresh peroxide. This can be due to the organic acids i.e. per acetic acid in wash press filtrate that have been formed in alkaline bleaching stage. Even short retention time was adequate and the activation of residual peroxide using sodium hydroxide was not necessary. There are several possibilities for using residual peroxide in practice regarding bleaching. A typical modern mechanical pulping process line consist of defibering, screening, a disc filter, a bleach press, high consistency (HC) peroxide bleaching and a wash press. Furthermore there usually is not a particular medium consistency (MC) pre-bleaching stage that includes additional thickening equipment. The most advisable way to utilize residual peroxide in this kind of process is to recycle the wash press filtrate to the dilution of disc filter pulp (low MC pre-bleaching stage). An arrangement such as this would be beneficial in terms of the reduced convection of manganese to the alkaline bleaching stage. Manganese originates from wood material and will be removed to the water phase already in the early stages of the process. Recycling residual peroxide prior to the disc filter is not recommended because of low consistencies. Regarding water circulations, the novel point of view is that, it would be beneficial to divide water circulations into two sections and the critical location for the division is the disc filter. Both of these two sections have their own priority. Section one before the disc filter: manganese removal. Section two after the disc filter: brightening of pulp. This division can be carried out if the disc filter pulp is diluted only by wash press filtrate before the MC storage tower. The situation is even better if there is an additional press after the disc filter, which will improve the consistency of the pulp. This has a significant effect on the peroxide concentration in the MC pre-bleaching stage. In terms of manganese content, it is essential to avoid the use of disc filter filtrate in the bleach press and wash press showers. An additional cut-off press would also be beneficial for manganese removal. As a combination of higher initial brightness and lower manganese content, the typical brightness increase varies between approximately 0.5 and 1% ISO units after the alkaline peroxide bleaching stage. This improvement does not seem to be remarkable, but as it is generally known, the final brightness unit is the most expensive and difficult to achieve. The estimation of cost savings is not unambiguous. For example in GW/TMP mill case 0.6% ISO units higher final brightness gave 10% savings in the costs of bleaching chemicals. With an hypothetical 200 000 ton annual production, this means that the mill could save in the costs of bleaching chemicals more than 400 000 euros per year. In general, it can be said that there were no differences between the behavior of different types of processes (GW, PGW, TMP and BCTMP). The enhancement of recycling gave a similar response in all cases. However, we have to remember that the utilization of residual peroxide in older mills depends a great deal on the process equipment, the amount of water available and existing pipeline connections. In summary, it can be said that processes are individual and the same solutions cannot be applied to all cases.

Treball final de màster

Desenvolupament d’una unitat didàctica dissenyada per al centre d’educació secundària IES Ramon Turró i Darder de Malgrat de Mar que està basada principalment en corrents i teories psicopedagògiques com els processos de la piràmide o taxonomia de Bloom i la teoria de l’aprenentatge significatiu de David Ausubel. Per portar a terme les activitats de la unitat didàctica, des de les inicials fins a les de síntesi, s’han seguit els processos de la piràmide o taxonomia de Bloom en la qual es van superant i es va augmentant el nivell de dificultat de les activitats de l’alumnat fins a aconseguir arribar a nivells de reflexió i de creació per part dels alumnes. Per una altra banda, es destacaria la teoria de l’aprenentatge significatiu de David Ausubel en la qual els nous coneixements es van incorporant en l’alumne a partir d’una sèrie de passos i d’aspectes que s’han de tenir en compte. En relació amb la piràmide de Bloom, l’alumnat rep una informació que desconeixia fins aquell moment i que ha relacionat amb els coneixements que ja portava incorporats. Perquè els diferents passos es puguin desenvolupar cal que per part del docent es produeixi un guiatge i unes explicacions a partir d’uns materials que han d’adequar-se a les capacitats dels alumnes

Construcció d'un refugi situat al terme municipal de Vallfogona de Ripollès, pensat com a final d'etapa per a rutes a cavall

Els negocis relacionats amb les activitats de lleure i els esports d’aventura actualment es troben en expansió, buscant majoritàriament el contacte amb la natura. Les rutes a cavall formen part del gran ventall d’opcions, per aquesta qüestió s’ha pensat en construir un refugi utilitzat com a final d’etapa per a rutes a cavall. En la major part del territori, la presència de població humana es manifesta en pobles, viles i ciutats, les quals disposes d’aigua sanitària, corrent elèctric i sistema de clavegueram. Per altra banda en les urbanitzacions o cases aïllades poder gaudir d’aquests serveis suposa una inversió econòmica elevada, que implica la utilització de sistemes alternatius. En el present projecte s’ha triat un emplaçament on portar a terme el final d’etapa amb una sèrie de requisits a complir : bosc a les proximitats, disposar d’un o varis accessos per a vehicles (transport del material d’intendència), tranquil•litat, bones vistes, i cobertura de telèfon mòbil. S’han acceptat les següents limitacions : no disposar de xarxa pública d’electricitat ni d’aigua. I s’han dimensionat les instal•lacions per a un màxim de dotze persones i els seus respectius cavalls. El principal objectiu del projecte és el dimensionament de les necessitats elèctriques, d’aigua i d’aiguacalenta sanitària en condicions autònomes, i utilitzant energies renovables. La valoració de les possibles solucions per condicionar les instal•lacions, i oferir una resposta eficient per la demanda. No és un objectiu específic del treball la potabilització de l’aigua ni el tractament dels residus produïts. S’han aprofitat els diferents desnivells que presenta l’emplaçament triat a l’hora de distribuir les instal•lacions, i s’ha utilitzat un antic cobert de dos pisos ja existent. Com a residència s’ha triat un model de casa prefabricada de muntanya. Com a sistema de subministrament elèctric, s’instal•laran plaques solars fotovoltaiques i un generador de corrent com a sistema auxiliar. La captació d’aigua s’efectuarà a partir d’un pou que es troba en el terreny i de la recollida d el’aigua pluvial, instal•lant dipòsits d’emmagatzemament d’aigua segons les necessitats. S’utilitzarà un equip de cloració per potabilitzar l’aigua de consum utilitzada a la residència. En la producció d’aigua calenta sanitària s’utilitzaran plaques solars tèrmiques i una caldera instantània de gas propà com a suport. Per cuinar s’ha triat una cuina de gas propà i una barbacoa que s’instal•larà a l’exterior. S’instal•larà una llar de foc amb recuperador d’aire a la residència i una fosa sèptica amb un sistema d’infiltració per poder abocar les aigües provinents de la residència. Els fems dels cavalls podran ser utilitzats com adob pel terreny.

El vibrato en el violín

Este trabajo constituye una aproximación al vibrato en el violín desde diversos puntos de vista. En primer lugar, abordaremos la cuestión histórica: cuándo aparece el vibrato, cómo evoluciona a lo largo de la historia y por qué se ha convertido en un recurso tan explotado hoy en día. A continuación, trataremos el vibrato como un fenómeno acústico y describiremos sus principales parámetros de estudio. Por último, plantearemos el aspecto puramente técnico del vibrato, aportando ejercicios para su correcto desarrollo. El objetivo final no es sólo conocer con mayor profundidad la historia y las características de este recurso, sino también entender su funcionamiento técnico y qué método de estudio se ha de seguir para sacar el máximo partido de él. La metodología del trabajo se basa en la lectura y puesta en práctica del legado de diversos violinistas y pedagogos que han tratado el tema a lo largo de la historia.

La voz del violín en la Rusia de la últimos zares : contraste de sentimientos musicales

El objetivo general de este trabajo es intentar conseguir la particular visión del mundo del violín en la última etapa de la Rusia zarista, sometida a importantes cambios históricos que repercuten en la vida de la sociedad rusa y consecuentemente en su arte; descubriré las figuras de sus intérpretes y su relación con su época y su música. La metodología que he utilizado en el trabajo se trata de un tipo de investigación cualitativa, basada en las figuras de la época y una documentación bibliográfica seleccionada, un estilo historiográfico que nos acerque al sentimiento y el entendimiento de este periodo histórico. La parte final de mi trabajo se compondrá de una serie de conclusiones que avalen mi experiencia y trayectoria en la investigación del proyecto.

Segmental Durations of Speech

This dissertation considers the segmental durations of speech from the viewpoint of speech technology, especially speech synthesis. The idea is that better models of segmental durations lead to higher naturalness and better intelligibility. These features are the key factors for better usability and generality of synthesized speech technology. Even though the studies are based on a Finnish corpus the approaches apply to all other languages as well. This is possibly due to the fact that most of the studies included in this dissertation are about universal effects taking place on utterance boundaries. Also the methods invented and used here are suitable for any other study of another language. This study is based on two corpora of news reading speech and sentences read aloud. The other corpus is read aloud by a 39-year-old male, whilst the other consists of several speakers in various situations. The use of two corpora is twofold: it involves a comparison of the corpora and a broader view on the matters of interest. The dissertation begins with an overview to the phonemes and the quantity system in the Finnish language. Especially, we are covering the intrinsic durations of phonemes and phoneme categories, as well as the difference of duration between short and long phonemes. The phoneme categories are presented to facilitate the problem of variability of speech segments. In this dissertation we cover the boundary-adjacent effects on segmental durations. In initial positions of utterances we find that there seems to be initial shortening in Finnish, but the result depends on the level of detail and on the individual phoneme. On the phoneme level we find that the shortening or lengthening only affects the very first ones at the beginning of an utterance. However, on average, the effect seems to shorten the whole first word on the word level. We establish the effect of final lengthening in Finnish. The effect in Finnish has been an open question for a long time, whilst Finnish has been the last missing piece for it to be a universal phenomenon. Final lengthening is studied from various angles and it is also shown that it is not a mere effect of prominence or an effect of speech corpus with high inter- and intra-speaker variation. The effect of final lengthening seems to extend from the final to the penultimate word. On a phoneme level it reaches a much wider area than the initial effect. We also present a normalization method suitable for corpus studies on segmental durations. The method uses an utterance-level normalization approach to capture the pattern of segmental durations within each utterance. This prevents the impact of various problematic variations within the corpora. The normalization is used in a study on final lengthening to show that the results on the effect are not caused by variation in the material. The dissertation shows an implementation and prowess of speech synthesis on a mobile platform. We find that the rule-based method of speech synthesis is a real-time software solution, but the signal generation process slows down the system beyond real time. Future aspects of speech synthesis on limited platforms are discussed. The dissertation considers ethical issues on the development of speech technology. The main focus is on the development of speech synthesis with high naturalness, but the problems and solutions are applicable to any other speech technology approaches.

Processo UV/H2O2 como pós-tratamento para remoção de cor e polimento final em efluentes têxteis

Several problems are involved the treatment plants of textile effluents, mainly the low efficiency of color removal. This paper presents an alternative of post-treatment by UV/H2O2 process, for color removal in biologically treated textile effluents. The tests were performed in a photochemical reactor and samples were taken at different times to perform analyses. Using 250 mgH2O2.L-1, 96% removal of color was verified, indicating the dyes degradation. A reduction of 84% of aromatics compounds, 90% of TSS removal, and a further reduction of the organic fraction were observed, demonstrating that the process is effective as a post-treatment of effluents from textile industries.