Monte Carlo modeling of a 4 mm conical collimator for a Novalis Tx Linear Accelerator

The work presented in this poster outlines the steps taken to model a 4 mm conical collimator (BrainLab, Germany) on a Novalis Tx linear accelerator (Varian, Palo Alto, USA) capable of producing a 6MV photon beam for treatment of Stereotactic Radiosurgery (SRS) patients. The verification of this model was performed by measurements in liquid water and in virtual water. The measurements involved scanning depth dose and profiles in a water tank plus measurement of output factors in virtual water using Gafchromic® EBT3 film.

A rate-one full-diversity low-complexity space-time-frequency block code (STFBC) for 4-Tx MIMO-OFDM

It is known that by employing space-time-frequency codes (STFCs) to frequency selective MIMO-OFDM systems, all the three diversity viz spatial, temporal and multipath can be exploited. There exists space-time-frequency block codes (STFBCs) designed using orthogonal designs with constellation precoder to get full diversity (Z.Liu, Y.Xin and G.Giannakis IEEE Trans. Signal Processing, Oct. 2002). Since orthogonal designs of rate one exists only for two transmit antennas, for more than two transmit antennas STFBCs of rate-one and full-diversity cannot be constructed using orthogonal designs. This paper presents a STFBC scheme of rate one for four transmit antennas designed using quasi-orthogonal designs along with co-ordinate interleaved orthogonal designs (Zafar Ali Khan and B. Sundar Rajan Proc: ISIT 2002). Conditions on the signal sets that give full-diversity are identified. Simulation results are presented to show the superiority of our codes over the existing ones.

Dual-hop amplify-and-forward cooperative relaying in the presence of Tx and Rx in-phase and quadrature-phase imbalance

In this study, dual-hop channel state information-assisted amplify-and-forward (AF) cooperative systems in the presence of in-phase and quadrature-phase (I/Q) imbalance, which refers to the mismatch between components in the I and Q branches, are investigated. First, the authors analyse the performance of the considered AF cooperative protocol without compensation for the I/Q imbalance as the benchmark. Then, a compensation algorithm for the I/Q imbalance is proposed, which makes use of the received signals at the destination, from the source and the relay nodes, together with their conjugations to detect the transmitted signal. Moreover, the authors study the considered AF cooperative system implemented with the opportunistic relay selection and the proposed compensation mechanism for the I/Q imbalance. The performance of the AF cooperative system under study is evaluated in terms of average symbol error probability, which is derived by considering transmission in a Rayleigh fading environment. Numerical results are provided and show that the proposed compensation algorithm can efficiently mitigate the effect of the I/Q imbalance. On the other hand, it is observed that the AF cooperative system with opportunistic relay selection acquires a performance gain beyond that without relay selection.

Análise da influência dos solutos Zr e Ti sobre as propriedades mecânica, elétrica e de termorresistência de uma liga Al-Cu-Fe-Si destinada a Tx e a Dx de energia elétrica

O contexto energético mundial apresenta um aumento constante do consumo de energia elétrica no último século, desta forma exigindo a pesquisa de novos materiais para a aplicação em cabos e fios condutores de eletricidade. A partir destas demandas por novos materiais, desenvolveu-se uma análise da influência dos solutos zircônio e titânio na modificação de características importantes de uma liga Al-Cu-Fe-Si, destinada a ser o meio condutor de energia elétrica, almejando obter propriedades termorresistentes. Para a realização deste estudo, as ligas foram obtidas por fundição direta em lingoteira metálica em formato “U”, a partir do Al-EC, fixando-se na liga-base os teores de 0,05% Cu, [0,24 a 0,28]% Fe e 0,7% de Si, e em seguida, inserindo-se os teores de 0,26% Zr e 0,26% Ti. O experimento foi dividido em duas etapas, ETAPA A e ETAPA B, respectivamente, com o intuito de se avaliar as características mecânicas, elétricas e estruturais das ligas. Os corpos de prova após laminação a frio (nos diâmetros 2,7; 3,0; 3,8 e 4,0 mm) foram analisados sem tratamento térmico (STT) e com tratamento térmico (CTT): 230 ºC por uma hora, de acordo com o protocolo COPEL, 310 ºC e 390 ºC por uma hora, visando avaliar a ermorresistência em temperaturas mais elevadas, a estabilidade térmica e analisar as microestruturas desenvolvidas em tais tratamentos térmicos (TT). Verificou-se que o Ti tem maior capacidade de refinar o grão em relação ao Zr, que apresenta grãos menos refinados, porém com melhores propriedades físicas e apresentando-se termorresistente.

Correlação da coalescência de microcavidades com as propriedades mecânicas e elétricas de fios para Tx e Dx de energia elétrica da liga base Al-0,5%Cu-[0,24-0,28]%Fe modificada com teores de silício

Neste trabalho, é feita uma tentativa para estabelecer a influência dos teores [0,5; 0,7 e 0,9]%Si, como agentes modificadores da liga Al-0,05%Cu-[0,24-0,28]%Fe, avaliada através de aspectos que levaram em conta parâmetros operacionais de vazamentos unidirecionais horizontais tais como velocidades (Vs) e taxas de solidificação (Tx). Após operações de corte e usinagem foram obtidos perfis cilíndricos, com diâmetros de 9,5mm e comprimento de 120mm, a partir dos quais, após operações de trabalho à frio, chegou-se a fios com diâmetros de 2,7; 3,0; 3,8 e 4,0mm. Estes perfis foram submetidos à caracterização elétrica, com base na condutividade elétrica, à caracterização mecânica, com base em ensaios tensão/deformação enfatizando o alongamento, e a caracterização estrutural em seções longitudinais, com ênfase na distribuição das partículas de segunda fase e no aspecto da fratura, na qual a metodologia de avaliação das dimensões das microcavidades se utiliza da razão do cumprimento (L) pela largura (W).

Efeito de teores de Zr sobre as propriedades mecânicas e elétricas de ligas Al-Ec-Si aplicadas na elaboração de ligas para Tx e Dx de energia elétrica

Este trabalho objetiva desenvolver uma análise da influência do Zr na modificação de características importantes em ligas de Al-EC-Si para aplicação como condutor de energia elétrica, almejando obter-se propriedades termorresistentes. Para a realização deste estudo, as ligas foram obtidas por fundição direta em lingoteira metálica em formato “U”, a partir do Al-EC, fixando-se na base o teor de 0,7% de Si, e em seguida, variando-se diferentes teores de Zr. Com o intuito de precipitar as partículas de segunda fase chamadas de dispersóides, que tem como principal característica a retenção da microestrutura deformada quando exposta a altas temperaturas, foi necessário submeter as ligas a um tratamento térmico de 310 ºC durante 24 horas afim de provocar o surgimento dos finos dispersóides de Al₃Zr. Foram estabelecidas duas etapas para obtenção dos resultados: A ETAPA I composta da solidificação, usinagem e deformações obtidas com as ligas, gerando os fios que foram utilizados em todos os ensaios. A ETAPA II repete os mesmos procedimentos adotados na ETAPA I, porém é feito um tratamento térmico de 310ºC por 24 horas antes da deformação. A caracterização das amostras dos fios de cada liga quanto à termorresistividade, que obedeceu a exigência da COPEL (Companhia Paranaense de Energia), sendo submetidos à temperatura de 230 ºC por uma hora e foram feitos também tratamentos térmicos na temperatura de 310 e 390ºC, com a finalidade de se avaliar a estabilidade térmica das ligas estudadas. Verificou-se de maneira geral que teores crescentes de Zr provocam um refinamento de grão e aumentam o LRT e a estabilidade térmica da liga, tanto na ETAPA I quanto na ETAPA II. Foi observado ainda que na ETAPA I, a condutividade foi bastante afetada pelos teores de Zr, e que a inserção do tratamento térmico da ETAPA II melhorou a capacidade de conduzir energia elétrica na liga, particularmente para o diâmetro que sofreram maior deformação.

Frameless linac-based (Novalis TX) stereotactic treatment for vestibular schwannoma that extend distally into the iac (Internal Acoustic Canal): an analysis of the dose to the cochlea

Objectives: We compare the dose parameters between 3 different radiosurgery delivery techniques which may have an impact on cochlea function. Methods: Five patients with unilateral vestibular schwannoma (VS) were selected for this study. Planning procedure was carried out using the BrainLAB® iPlan planning system v. 4.5. For each patient three different planning techniques were used: dynamic arc (DA) with 5 arcs per plan, hybrid arc (HA) with 5 arcs per plan and IMRT with 8 fields per plan. For each technique, two plans were generated with different methods: with the first method (PTV coverage) it was the goal to fully cover the PTV with at least 12 Gy (normalization: 12 Gy covered 99% of the PTV) and with the second method (cochlea sparing) it was the goal to spare the cochlea (normalization: 12 Gy covers 50% of the PTV/V4Gy of cochlea lower than 1%). Plan evaluation was done considering target volume and coverage (conformity and homogeneity) and OAR constraints (mean (Dmean) and maximum dose (Dmax) to cochlea, Dmax to brainstem and cochlea). The total number of monitor units (MU) was analyzed. Results: The median tumor volume was 0.95 cm³ (range, 0.86-3 cm³). The median PTV was 1.44 cm³ (range, 1-3.5 cm³). The median distance between the tumor and the cochlea's modiulus was 2.7 mm (range, 1.8-6.3 mm). For the PTV coverage method, when we compared the cochlear dose in VS patients planned with DA, HA and IMRT, there were no significant differences in Dmax (p = 0.872) and in Dmean (p= 0.860). We found a significant correlation (p< 0.05) between the target volume and the cochlear Dmean for all plans with Pearson's coefficient correlation of 0.90, 0.92 and 0.94 for the DA, HA and IMRT techniques, respectively. For the cochlea sparing method, when we compared the cochlear dose in VS patients planned with DA, HA and IMRT, there were no significant differences in Dmax (p = 0.310) and in Dmean (p= 0.275). However, in this group the V4Gy of the ipsilateral cochlea represents less than 1%. When using the HA or IMRT technique, the homogeneity and conformity in the PTV, but also the number of MUs were increased in comparison to the DA technique. Conclusion: VS tumors that extend distally into the IAC had an equivalent sparing of cochlea with DA approach compared with the HA and IMRT techniques. Disclosure: No significant relationships.

Sexual orientation and sexual behavior patterns: Evaluation of agreement and variation in a cohort of male, African American drug users in Houston, TX

Background. Sexual orientation and sexual behavior among men have shown disagreement in past studies. The term "on the down low" has been adopted by many to describe "straight" identifying men who have sex with men but do not inform their primary female partner. Methods. This secondary analysis of data collected from the "DASH Project---A Hepatitis B Vaccine Model for HIV Vaccine Trial in Drug Users," assessed sexual behavior patterns among African American drug-using men over time. Using a screener questionnaire to determine sexual orientation and sexual behavior of the men, the study specifically evaluated "straight" identified men who have sex with women only (MSW) to determine what factors were associated with sexual behavior variation to include men during follow-up. The Fisher's Exact Test was used to evaluate the factors. Results. Variation of sexual behavior was highest among "bisexual" identified men followed by "gay" identified men. Fifteen of the original 593 "straight" and MSW men had sexual behavior variation to include men. In the analysis of "straight" and MSW men with variation in sexual behavior compared to those who did not, living on the streets, greater number of sexual partners, trading sex for drugs, and trading sex for money were associated with sexual behavior variation (all p-values <0.01). Conclusions. The factors were only associated when considering the interview when the variation occurred. The same factors at screening were not predictive of sexual behavior variation in the future. Environmental factors, such as living situation, appear to play a role in sexual behavior variations in "straight" and MSW men. ^ Keywords. sexual behavior, sexual orientation, Fisher's Exact Test^

Retrospective study of prevalence of Community Associated Methicillin Resistant Staphylococcus Aureus (CA-MRSA) seen in Texas MedClinics, San Antonio, TX from April 2006-August 2009

Purpose. To evaluate the presence of Community Associated–Methicillin Resistant Staphylococcus Aureus, CA-MRSA, in abscesses and skin and soft tissue infections presenting at 9 urgent care clinics in San Antonio, TX. ^ Methods. During the 40-month retrospective study (April 2006 to August 2009), wound cultures collected in 9 urgent care centers were evaluated for MRSA growth, antibiotics prescribed, follow up wound care, and antibiotic prescribing habits by physicians for all patients presenting with abscesses and skin/soft tissue infections. ^ Results. Across 9 urgent care centers in San Antonio, TX, 36,797 abscesses and cases of skin and soft tissue infections were treated during 40 months. Of the 36,797 cases, 9290 patients had wound cultures sent with 5,630 cultures sent to Texas MedClinic’s primary lab. Of the 5630 cultures sent to their primary lab, this reflected a prevalence of 4727 (84 %) cultures were positive for MRSA. Of the 9290 patients who had a wound culture sent (April 10th, 2006 to August 31st, 2009), a total of 4,307 antibiotics were prescribed. The top five antibiotics prescribed for CA-MRSA were Bactrim (55.5%), Clindamycin (18.4%), Bactroban (5%), Amoxicillin (3.5%), and Doxycycline (3%) representing 85.4% of the antibiotics prescribed. 8809/9290 (94.8%) of patients required no more than 3 follow up visits. Of the 33 physicians working full time during the entire study period, 29/33 (87.8%) of the physicians were family medicine physicians and represented varied prescribing rates of antibiotics between 11-76% with 26/33 (78.8%) of physicians prescribing antibiotics greater than 40% of the time.^ Conclusions. Abscesses and soft tissue infections are a common presenting complaint to urgent care centers. This study reveals that antibiotic-prescribing practices can be improved with physician education since this high prevalence was not known previously. Also, treating abscesses with limited packing has been shown to be a viable option in this particular circumstance and would be open field for additional clinical research. Due to the high prevalence of CA-MRSA skin and soft tissue infections among patients presenting to urgent care centers presumptive treatment for MRSA is indicated. Increasing levels of resistance to penicillin antibiotics is concerning and warrants alternative antibiotic management strategies.^

A retrospective analysis of patients referred for tuberculosis testing at Parkland Hospital, Dallas, TX

Tuberculosis (TB) is an infectious disease of great public health importance, particularly to institutions that provide health care to large numbers of TB patients such as Parkland Hospital in Dallas, TX. The purpose of this retrospective chart review was to analyze differences in TB positive and TB negative patients to better understand whether or not there were variables that could be utilized to develop a predictive model for use in the emergency department to reduce the overall number of suspected TB patients being sent to respiratory isolation for TB testing. This study included patients who presented to the Parkland Hospital emergency department between November 2006 and December 2007 and were isolated and tested for TB. Outcome of TB was defined as a positive sputum AFB test or a positive M. tuberculosis culture result. Data were collected utilizing the UT Southwestern Medical Center computerized database OACIS and included demographic information, TB risk factors, physical symptoms, and clinical results. Only two variables were significantly (P<0.05) related to TB outcome: dyspnea (shortness of breath) (P<0.001) and abnormal x-ray (P<0.001). Marginally significant variables included hemoptysis (P=0.06), weight loss (P=0.11), night sweats (P=0.20), history of homelessness or incarceration (P=0.15), and history of positive skin PPD (P=0.19). Using a combination of significant and marginally significant variables, a predictive model was designed which demonstrated a specificity of 24% and a sensitivity of 70%. In conclusion, a predictive model for TB outcome based on patients who presented to the Parkland Hospital emergency department between November 2006 and December 2007 was unsuccessful given the limited number of variables that differed significantly between TB positive and TB negative patients. It is suggested that a future prospective cohort study should be implemented to collect data on TB positive and TB negative patients. It may be possible that a more thorough prospective collection of data may lead to clearer comparisons between TB positive and TB negative patients and ultimately to the design of a more sensitive predictive model for TB outcome. ^

Understanding causes of hospitalization and access to care among newly diagnosed HIV patients in Houston, TX

More than a quarter of patients with HIV in the United States are diagnosed in hospital settings most often with advanced HIV related conditions.(1) There has been little research done on the causes of hospitalization when the patients are first diagnosed with HIV. The aim of this study was to determine if the patients are hospitalized due to an HIV related cause or due to some other co-morbidity. Reduced access to care could be one possible reason why patients are diagnosed late in the course of the disease. This study compared the access to care of patients diagnosed with HIV in hospital and outpatient setting. The data used for the study was a part of the ongoing study “Attitudes and Beliefs and Steps of HIV Care”. The participants in the study were newly diagnosed with HIV and recruited from both inpatient and outpatient settings. The primary and the secondary diagnoses from hospital discharge reports were extracted and a primary reason for hospitalization was ascertained. These were classified as HIV-related, other infectious causes, non–infectious causes, other systemic causes, and miscellaneous causes. Access to care was determined by a score based on responses to a set of questions derived from the HIV Cost and Services Utilization Study (HCSUS) on a 6 point scale. The mean score of the hospitalized patients and mean score of the patients diagnosed in an outpatient setting was compared. We used multiple linear regressions to compare mean differences in the two groups after adjusting for age, sex, race, household income educational level and health insurance at the time of diagnosis. There were 185 participants in the study, including 78 who were diagnosed in hospital settings and 107 who were diagnosed in outpatient settings. We found that HIV-related conditions were the leading cause of hospitalization, accounting for 60% of admissions, followed by non-infectious causes (20%) and then other infectious causes (17%). The inpatient diagnosed group did not have greater perceived access-to-care as compared to the outpatient group. Regression analysis demonstrated a statistically significant improvement in access-to-care with advancing education level (p=0.04) and with better health insurance (p=0.004). HIV-related causes account for many hospitalizations when patients are first diagnosed with HIV. Many of these HIV-related hospitalizations could have been prevented if patients were diagnosed early and linked to medical care. Programs to increase HIV awareness need to be an integral part of activities aimed at control of spread of HIV in the community. Routine testing for HIV infection to promote early HIV diagnosis can prevent significant morbidity and mortality.^

Spatial analysis of water body distance and West Nile Virus human cases in Houston, TX

West Nile Virus (WNV) is an arboviral disease that has affected hundreds of residents in Harris County, Texas since its introduction in 2002. Persistent infection, lingering sequelae and other long-term symptoms of patients reaffirm the need for prevention of this important vector-borne disease. This study aimed to determine if living within 400m of a water body increases one’s odds of infection with WNV. Additionally, we wanted to determine if one’s proximity to a particular water type or water body source increased one’s odds of infection with WNV.^ 145 cases’ addresses were abstracted from the initial interview and consent records from a cohort of patients (Epidemiology of Arboviral Encephalitis in Houston study, HSC-SPH-03-039). After applying inclusion criteria, 140 cases were identified for analysis. 140 controls were selected for analysis using a population proportionate to size model and US Census Bureau data. MapMarker USA v14 was used to geocode the cases’ addresses. Both cases’ and controls’ coordinates were uploaded onto a Harris County water shapefile in MapInfo Professional v9.5.1. Distance in meters to the closest water source, closest water source type, and closest water source name were recorded.^ Analysis of Variance (p=0.329, R2 = 0.0034) indicated no association between water body distance and risk of WNV disease. Living near a creek (x2 = 11.79, p < 0.001), or the combined group of creek and gully (x 2 = 14.02, p < 0.001) were found to be strongly associated with infection of WNV. Living near Cypress Creek and its feeders (x2 = 15.2, p < 0.001) was found to be strongly associated with WNV infection. We found that creek and gully habitats, particularly Cypress Creek, were preferential for the local disease transmitting Culex quinquefasciatus and reservoir avian population.^