Motion Management for Radical Radiotherapy in Non-small Cell Lung Cancer

Intrafraction tumour motion is an issue that is of increased interest in the era of image-guided radiotherapy. It is particularly relevant for non-small cell lung cancer, for which a number of recent developments are in use to aid with motion management in the delivery of radical radiotherapy. The ability to deliver hypofractionated ablative doses, such as in stereotactic radiotherapy, has been aided by improvements in the ability to analyse tumour motion and amend treatment delivery. In addition, accounting for tumour motion can enable dose escalation to occur by reducing the normal tissue being irradiated by virtue of a reduction in target volumes. Motion management for lung tumours incorporates five key components: imaging, breath-hold techniques, abdominal compression, respiratory tracking and respiratory gating. These will be described, together with the relevant benefits and associated complexities. Many studies have described improved dosimetric coverage and reduced normal tissue complication probability rates when using motion management techniques. Despite the widespread uptake of many of these techniques, there is a paucity of literature reporting improved outcome in overall survival and local control for patients whenever motion management techniques are used. This overview will review the extent of lung tumour motion, ways in which motion is detected and summarise the key methods used in motion management.

Defining target volumes for stereotactic ablative radiotherapy of early-stage lung tumours: a comparison of three-dimensional 18F-fluorodeoxyglucose positron emission tomography and four-dimensional computed tomography.:PETCT versus 4DCT for SABR in Early Stage NSCLC

AIMS: High local control rates are achieved in stage I lung cancer using
stereotactic ablative radiotherapy. Target delineation is commonly based on
four-dimensional computed tomography (CT) scans. Target volumes defined by
positron emission tomography/computed tomography (PET/CT) are compared with those defined by four-dimensional CT and conventional ('three-dimensional')
(18)F-fluorodeoxyglucose ((18)F-FDG) PET/CT.

MATERIALS AND METHODS: For 16 stage I non-small cell lung cancer tumours, six
approaches for deriving PET target volumes were evaluated: manual contouring,
standardised uptake value (SUV) absolute threshold of 2.5, 35% of maximum SUV
(35%SUV(MAX)), 41% of SUV(MAX) (41%SUV(MAX)) and two different source to
background ratio techniques (SBR-1 and SBR-2). PET-derived target volumes were compared with the internal target volume (ITV) from the modified maximum
intensity projection (MIP(MOD) ITV). Volumetric and positional correlation was
assessed using the Dice similarity coefficient (DSC).

RESULTS: PET-based target volumes did not correspond to four-dimensional CT-based target volumes. The mean DSC relative to MIP(MOD) ITV were: PET manual = 0.64, SUV2.5 = 0.64, 35%SUV(MAX) = 0.63, 41%SUV(MAX) = 0.57. SBR-1 = 0.52, SBR-2 =0.49. PET-based target volumes were smaller than corresponding MIP ITVs.

CONCLUSIONS: Conventional three-dimensional (18)F-FDG PET-derived target volumes for lung stereotactic ablative radiotherapy did not correspond well with those derived from four-dimensional CT, including those in routine clinical use
(MIP(MOD) ITV). Caution is required in using three-dimensional PET for motion
encompassing target volume delineation.

Constitutional Questions

Constitutional Questions
Professor John Morison MRIA School of Law, Queen’s University Belfast
How should we live together? Is there any ethical question more fundamental than this?
Is a constitution only about who does what in government or is it about what is to be done? Does a constitution provide the ground rules for deciding this or is it part of the answer itself? Is it the repository of fundamental values about how to live? What is the good life anyway? Is it about the preservation of life and liberty, and the pursuit of happiness? Or something more? What about preserving (or radically reordering) the distribution of property? Or ensuring that everyone has the same chances? Is it the job of the constitution to simply promise dignity, equality and freedom, or to deliver these values?
If the constitution is the place where the state undertakes “to promote the welfare of the whole people”, what does this actually mean in practical terms? And who pays for it? Should a constitution give us an entitlement to at least a basic minimum by way of a lifestyle? Or is it the job only of the political process to decide issues about the allocation of resources? What do we do if we feel that we cannot trust our politicians? Are there basic rules that should govern the operation of politics and are there fundamental values that should not be overridden? Are these “sacred and undeniable”? Or to be interpreted in line with modern conditions and within a “margin of appreciation”? Who decides on this in individual cases?
Who is entitled to any of this, and on what basis? Is everyone equal? Is the constitution about making it clear that no-one is better than you, and that in turn, you are better than no-one? Is a constitution about ensuring that you will always be an end in yourself and never simply a means to anyone else’s end? Or does it simply reinforce the existing distribution of power and wealth?
Are citizens to be given more than those who are not citizens? Is more to be expected from them, and what might that be? Can the constitution tell us how we should treat those from outside who now live with us?
What is the relationship between a constitution and a nation? Who is in the nation anyway? Should we talk about “we the people” or “we the peoples”? Should a constitution confirm a nationality or facilitate diversity? Is the constitution the place to declare aspirations for a national territory? Or to confirm support for the idea of consent? What about all our neighbours – on the island of Ireland and in Great Britain? Or in Europe? And beyond?
What is the relationship between a constitution and democracy? Is a constitution simply the rules by which the powerful govern the powerless? In what sense does a constitution belong to everyone, across past, present and future generations? Is it the place where we state common values? Are there any? Do they change across time? Should the people be asked about changes they may want? How often should this be done? Should the constitution address the past and its problems? How might this be done? What do we owe future generations?
Finally, if we can agree that the constitution is about respecting human rights, striving for social justice and building a fair and democratic Ireland – North and South – how do we make it happen in practice?

Bird diversity and environmental gradients in Britain:a test of the species-energy hypothesis

1. We tested the species diversity-energy hypothesis using the British bird fauna. This predicts that temperature patterns should match diversity patterns. We also tested the hypothesis that the mechanism operates directly through effects of temperature on thermoregulatory loads; this further predicts that seasonal changes in temperature cause matching changes in patterns of diversity, and that species' body mass is influential.

2. We defined four assemblages using migration status (residents or visitors) and season (summer or winter distribution). Records of species' presence/absence in a total of 2362, 10 x 10-km, quadrats covering most of Britain were used, together with a wide selection of habitat, topographic and seasonal climatic data.

3. We fitted a logistic regression model to each species' distribution using the environmental data. We then combined these individual species models mathematically to form a diversity model. Analysis of this composite model revealed that summer temperature was the factor most strongly associated with diversity.

4. Although the species-energy hypothesis was supported, the direct mechanism, predicting an important role for body mass and matching seasonal patterns of change between diversity and temperature, was not supported.

5. However, summer temperature is the best overall explanation for bird diversity patterns in Britain. It is a better predictor of winter diversity than winter temperature. Winter diversity is predicted more precisely from environmental factors than summer diversity.

6. Climate change is likely to influence the diversity of different areas to different extents; for resident species, low diversity areas may respond more strongly as climate change progresses. For winter visitors, higher diversity areas may respond more strongly, while summer visitors are approximately neutral.

HRM and the employment of older workers: Germany and Britain compared

This study examines Human Resource Management (HRM) policies and practices towards older workers in Britain and Germany. While it is widely suggested that older workers have to be better integrated into the labour market, youth-centric HRM is still prevalent. However, HRM is shaped by multiple and contradictory pressures from the international and national institutional environments. We test this dynamic by analysing two national surveys, the German firm panel (IAB)1 and the British Workplace and Employment Relations Survey (WERS).2 Our findings suggest that the institutional environment shapes HR policies and practices distinctively in both countries. We find that age discrimination at the workplace is more prevalent in Germany than in Britain, which can be explained by divergent institutional patterns. As a result, we argue that although both countries will have to continue fostering an age-neutral HR approach, this has to take country-specific institutional peculiarities into account.

The Marquess of Londonderry: Aristocracy, Power and Politics in Britain and Ireland

The decline and fall of the British aristocracy looked headlong and irreversible in the twentieth century yet many grandees tried to preserve their power, wealth and influence by every means - and with some success. There is no better example than the Seventh Marquess of Londonderry whose life from 1878 to 1949 spanned and mirrored the period. The Londonderrys had enjoyed immense wealth in land and minerals in Britain and Ireland for centuries, played leading roles in Parliament and the state, and in an earlier time the Seventh Marquess would have continued in the family tradition of patrician prominence. Drawing upon original state and family papers, N.C. Fleming places the Londonderrys in the context of the history and the political theory of aristocracy and shows the constant struggle - not without success - against marginalisation. The theme runs through Londonderry's career as Conservative MP, on the Irish Viceroy's Council, as a junior minister in Lloyd Geroge's coalition, at the Air Ministry with Trenchard - the 'father of the RAF' - and in the National Government. Perhaps an element of desperation entered in his private business ventures and with contacts with the far Right - all in sharp contrast to past family achievement.

'Incorrigibly Plural’: New Histories of Ulster and Northern Ireland’

Review article of Carson’s Army: The Ulster Volunteer Force, 1910–22. By Timothy Bowman. Manchester University Press, Manchester, 2007. 256 pp. ISBN 0719073715, £55. A History of the Northern Ireland Labour Party: Democratic Socialism and Sectarianism. By Aaron Edwards. Manchester University Press, Manchester, 2009. xiii + 240 pp. ISBN 0719078741, £60. Catholic Belfast and Nationalist Ireland in the Era of Joe Devlin 1871–1934. By A.C. Hepburn. Oxford University Press, Oxford, 2008. xix +307 pp. ISBN 019929884X, £55. The Big House in the North of Ireland: Land, Power and Social Elites, 1878–1960. By Olwen Purdue. University College Dublin Press, Dublin, 2009. xv + 297 pp. ISBN 978-1-906359-25-6, £24.

Manuscript of James Cummings- August 28, 1860

Transcript (spelling and grammar retained): Chippawa [Chippewa] 28th August 1860 My Dear Sir I duly received your very kind letter of the 24th [June] asking me to communicate such facts of general interest connected with my career during the War with the United States. I have no objection to afford you such information as came under my own observation; nevertheless I do so, with the understanding, I have no desire to be my own trumpeter. With respect to your circular wherein you state you have been for several years collecting materials for a History of the late War between the United States & Great Britain, for which you are now gathering further materials to add to your collection, concerning the Second War for Independence. I am rather at a loss to know, what is meant by the second war; If you allude to the petty Rebellion, it could not be called a War, Those that caused the outbreak were very soon put down, by the Loyal people of the Province without the aid of Regular Troops being satisfied with the Independence they enjoyed. With respect to the several questions names in your circular: To the 1st I would say, this locality is made memorable by the battle of Chippawa [Chippewa] which took place about a mile above the village on the ground I pointed out to you, when I had the pleasure of seeing you a few days ago, with Mr Porter of the Niagara Falls, of which I believe you took sketches at the time. 2nd I have no historical documents of any value; so many years having gone past, the most of my old papers have either been lost or destroyed, I however came across two letters, one dated Queenston 9th July 1812 from Lt. Col. Nicholl Quarter Master General of Militia, the other from Lt. Col Myers Deputy Quarter Master General of the Regular Army date Fort George 23rd same month, directed to me in the hand writing of each of those officers as Deputy Quarter Master General of Militia, which letters I shall be obliged you would return at as early a day possible, as I wish to place them with tome others in the case, I have had made to hold the cocked hat & feather I wore during that eventful period, which I am sorry I did not exhibit when you was at my house; with reference to it I now enclose a letter from Lt. Col. Clark, residing at Port Dalhousie he was Captain & Adjutant of Militia in the War of 1812__ I send the letter in proof of the cock’d hat it is a lengthy one, but you may find time to turn over it, as I shall also place it in the hat case__ 3rd Where are [but] [for] traditionary [sic] witnesses residing in this vicinity – Col Clark above named Mr Merritt of St. Catharines, & Mr Kerby of Brantford are the only ones I now recollect, who could offord [sic] you any statistical information. 4th I have no pictorial sketches of any Military Movements or fortifications. As regards my own career, which you appear [ ? ] of knowing__ I was first a Lieutenant in a volunteer flank company stationed on the river side opposite [Navy] Island not far from the battle ground of Chippawa [Chippewa], I got promotion as Lieutenant of Cavalry before I got my Cavalry dress completed in three days more, I was called by General Brock to Fort George, was appointed Deputy Quarter Master General of Militia with the rank of Captain s the accompanying letters will show. I was at the battle of Stony Creek, several skirmishes at the Cross Roads, when the American army [ ? ] Fort George, at the taking of Col. Boerstler at the Beaver Dam, & had the honor of receiving Colonel Chapens sword at the surrender, who commanded a company of volunteer Horse Men was at the taking of 15 regulars & two officers at Fort Schlosser—was with Col. Bishop at the taking of Black Rock, near him when he fell, three men of the 8th Reg. more killed in the Boat I was in – I was at Chippawa battle, and the last, not the least in Lundy’s lane battle, which the Americans call the battle of Bridge [Waters]. I had forgot; there was another small affair at Corks Mill where I was. I could write a little history of events, but have not the time to do so. If what I have stated will be of any service for the purpose you require I shall feel happy. The history of the late War was published at Toronto in the Anglo American Magazine. Did you ever see it, I have the Books, there were however several errors which came under my notice, which I could have corrected. If my time would permit I could give you a more detailed statement of events. I trust however you may succeed with your publication , and I shall be most happy to hear from you at all times—I related many little occurances verbally to you when here, which I thought not necessary to repeat again as you would have a perfect recollection of them. Be pleased to return the letters for the purpose I require them. I am My Dear Sir Your respectful friend James Cummings

The Columbian Newspaper vol. IV no. 1105- June 12, 1813

The "Columbian" was established by Mr. Holt in 1808 as an "organ of the Clintonians" (Journalism in the United States, from 1690-1872 By Frederic Hudson) and a replacement to the "Citizen". It was a passionate Democratic paper that supported both Jefferson and Madison. Holt later sold the "Columbian" to Alden Spooner, who published the Long Island "Star". The Columbian ceased in 1821. This issue includes the following War of 1812 topics: Page 2: copies of letters from U.S. Gen. H. Dearborn describing the U.S. attack on Ft. George 27 May 1813; letter from Gen. H. Dearborn describing U.S. pursuit of British troops at Beaver Dams and the U.S. capture of Fort Erie; list of U.S. killed and wounded in Commodore Isaac Chauncey's squadron in attack on York 27 April, 1813; list of killed and wounded in Commodore Isaac Chauncey's squadron in attack on Ft. George 27 May 1813; abstract of the cartel for the exchange of prisoners of war between Great Britain and the United States; mention of troop movements through New York on their way to the battle front; list of persons killed or lost on the privateer Saratoga; Page 3: account of the loss of the U.S. war ships the Growler and Eagle to the British; news from Quebec and Kingston of troop movements; U.S. ship Syren unsuccessfully pursues British ship Herald; account of a U.S. cargo ship being captured by a British military ship; account of U.S. ship Siro capturing British ship Loyal Sam; report from Halifax of recent British troop and ship movements; list of recent troop enrollments in various states; report of British troop build up in Kingston;

Boston Patriot Vol. 8 No. 13- October 24, 1812

A semi-weekly paper that began in 1809 and ceased in 1816. Its succeeding title was the Boston Patriot and Morning Advertiser. Publishers included: Everett and Munroe, 1809-Mar. 7, 1810; Isaac Munroe, Mar. 10, 1810-May 1, 1811; Munroe and French, May 4, 1811-1813; D.C. Ballard, 1814-1816. Editor: David Everett, Mar. 10, 1810-Oct. 23, 1811. Topics of interest include: Page 1: announcement of war against Great Britain and the reasons for the war; Page 2: announcement of nomination of war supporter Francis Carr for Congress; Statement of the Senate of Massachusetts in support of the war; 3 accounts of the American attack on Queenston; Page 3: report of the movement of war ships in and out of the port of Boston; news of naval movements by American and British ships; Page 4: advertisement of American and British muskets and swords for sale;

Letter from the Secretary of State to Mr. Monroe, on the subject of the attack on the Chesapeake : the correspondence of Mr. Monroe with the British Government; and also Mr. Madison's correspondence with Mr. Rose on the same subject

March 23, 1808. Printed by order of the House of Representatives.

Proceedings of the Court Martial, held on the officers and crew of His Majesty's late ship, the Java.

Ordered to be printed 10th May 1813.

Commemorative stamps, British, American and Canadian, 1974-1977, 1982-1984, 1996.

The Guernsey post office stamps consist of 2 exhibition series souvenir sheets commemorating Major-General Sir Issac Brock, 1769-1812. The stamp was issued in 1996 to celebrate Guernsey’s attendance at Canada’s international stamp exhibition CAPEX 96. The stamps issued by the United States postal service consist of 1 sheet of stamps commemorating the 50th anniversary of the Peace Bridge, 1927-1977. The stamps issued by Canada Post include 5 commemorative day-of-issue envelopes with stamps featuring William Hamilton Merritt and the Welland Canal. This stamp was issued in 1974 to celebrate the 150th anniversary of the canal. There is also a set of 4 inscription corner blocks of stamps. These items are contained in an envelope addressed to Mr. J.N. Jackson, St. Catharines, ON. There is also a separate sheet of the same stamp. Also issued by Canada Post are 2 full sheets of stamps, one commemorating the 50th anniversary of the Peace Bridge (1927-1977), and one commemorating 25 years of the St. Lawrence Seaway (1959-1984). Lastly, there are 2 full sheets of stamps commemorating the 100th anniversary of the Royal Henley Regatta, issued in 1982.