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[Quality control of equipment used for radiotherapy].

Due to the modifications of components, to unexpected breakage of elements or to electronic dysfunctions, the performance of radiotherapy machines may decrease with age. Quality Assurance procedures and maintenance program are necessary to guarantee the performances. For linear accelerators, modus operandi of control tests and their frequency are based on regulations and recommendations widely published, that are presented here. Concerning accessories, especially those recently developed (multileaf collimators, dynamic wedges, ...), recommendations remains to be defined. Simple tests are proposed. Concerning numerical imaging systems, widely used for three dimensional dosimetry, image quality and geometry controls must be performed with phantom tests. For portal imaging, a quality assurance program is proposed. A strict and complete Quality Assurance program is essential to guarantee quality and safety of the treatment. A regular control of linear accelerator is one of the important component of this program. It suppose the implementation of permanent tests procedures, periodically modified following technological progresses and treatment techniques. Measurements must be sensible to variations below the tolerance level defined during the installation process. The analysis of the variations of measurements with time are an objective criterion of quality.

Equipment Safety↗

Simultaneous quantitation of opioids in blood by GC-EI-MS analysis following deproteination, detautomerization of keto analytes, solid-phase extraction, and trimethylsilyl derivatization.

Seven opioid analytes including codeine, morphine, 6-acetylmorphine, hydrocodone, hydromorphone, oxycodone, and oxymorphone were detected in postmortem blood (n > 1000). Two milliliters of specimen was deproteinated with approximately 2.5 mL of methanol and derivatized with hydroxylamine before solid-phase extraction and derivatization with BSTFA + 1% TMCS. Extracts were assayed by gas chromatography-electron impact-mass spectrometry utilizing selected ion mode. One-microliter aliquots were injected onto an HP-1MS capillary column (30 m x 0.25-mm i.d., 0.25 microm) with a helium linear velocity of 62 cm/s. Temperature programming began at 160 degrees C (hold 0 min), then increased at rates of 35 degrees C/min to 195 degrees C, 5 degrees C/min to 240 degrees C, and 30 degrees C/min to 300 degrees C (hold 2 min) resulting in a total run time of 14-min. Quantitative determinations were based on the ratios of the analyte peak areas to the corresponding deuterated analogues. Calibration curves were linear for the following concentrations: 10-500 ng/mL (6-AM), 100-2000 ng/mL (oxycodone), and 50-1000 ng/mL (all other opioids). LOQs ranged from 5 ng/mL (6-AM) to 20 ng/mL (oxycodone). Between-run precision yielded CVs ranging from 2.79% to 5.34% (n = 12). These data suggest that methanolic deproteination and dual derivatization improve separation and simultaneous quantitation of seven opioid analytes in difficult matrices.

Forensic Medicine↗

Evaluation of a structure-driven retention model for temperature-programmed gas chromatography.

The solvation parameter model is suitable for describing the retention properties of compounds of varied structure in temperature-programmed gas chromatography. An empirical second-order model provides a good account of the change in system constants as a function of program rate. These relationships codify the reduction in retention time at higher program rates and changes in elution order (selectivity) with program rate. The prediction of retention times from structure, while quite good, is probably adversely affected by descriptor quality and the possibility of a mixed retention mechanism on polar stationary phases. Plots of experimental against predicted temperature-programmed retention times for varied compounds are linear but generally contain a small bias from an ideal model (slope of one and an intercept of zero). The average absolute deviation in temperature-programmed retention times on three columns (DB-210, DB-1701 and EC-Wax) varied from 0.15 to 0.89 min with the best results obtained at higher program rates on the columns of lower polarity.

Chromatography, Gas↗

Computer programs for the analysis of cellular survival data.

Four programs have been written to enable radiobiologists to build a computer data base of cellular dose-survival data, calculate cell survival with a correction for cell multiplicity at the time of irradiation, fit various survival models to the data by iteratively weighted least squares, and calculate the ratio of survival levels corresponding to specified doses or the ratio of doses that produce specified survival levels (e.g., oxygen enhancement ratio or relative biological effectiveness). The programs make plots of survival curves and data, and they calculate standard errors and confidence intervals of the fitted survival curve parameters and ratios. The programs calculate survival curves for the linear-quadratic, repair-saturation, single-hit multitarget, linear-multitarget, and repair-misrepair models of cell survival and have been designed to accommodate the addition of other survival models in the future. The programs can be used to compare the accuracy with which different models fit the data, determine if a difference in fit is statistically significant, and show how the estimated value of a survival curve parameter, such as the extrapolation number or the final slope, varies with the survival model. The repair of radiation-induced damage is analyzed in a novel way using these programs.

Cell Survival↗

Improvement in accuracy of multiple sequence alignment using novel group-to-group sequence alignment algorithm with piecewise linear gap cost.

BACKGROUND: Multiple sequence alignment (MSA) is a useful tool in bioinformatics. Although many MSA algorithms have been developed, there is still room for improvement in accuracy and speed. In the alignment of a family of protein sequences, global MSA algorithms perform better than local ones in many cases, while local ones perform better than global ones when some sequences have long insertions or deletions (indels) relative to others. Many recent leading MSA algorithms have incorporated pairwise alignment information obtained from a mixture of sources into their scoring system to improve accuracy of alignment containing long indels. RESULTS: We propose a novel group-to-group sequence alignment algorithm that uses a piecewise linear gap cost. We developed a program called PRIME, which employs our proposed algorithm to optimize the well-defined sum-of-pairs score. PRIME stands for Profile-based Randomized Iteration MEthod. We evaluated PRIME and some recent MSA programs using BAliBASE version 3.0 and PREFAB version 4.0 benchmarks. The results of benchmark tests showed that PRIME can construct accurate alignments comparable to the most accurate programs currently available, including L-INS-i of MAFFT, ProbCons, and T-Coffee. CONCLUSION: PRIME enables users to construct accurate alignments without having to employ pairwise alignment information. PRIME is available at http://prime.cbrc.jp/.

Algorithms↗

A FORTRAN technique for correlating a circular environmental variable with a linear physiological variable in the sugar maple.

This paper deals with a computer program adapted to a statistical method for analyzing an unlimited quantity of binary recorded data of an independent circular variable (e.g. wind direction), and a linear variable (e.g. maple sap flow volume). Circular variables cannot be statistically analyzed with linear methods, unless they have been transformed. The program calculates a critical quantity, the acrophase angle (PHI, phi o). The technique is adapted from original mathematics [1] and is written in Fortran 77 for easier conversion between computer networks. Correlation analysis can be performed following the program or regression which, because of the circular nature of the independent variable, becomes periodic regression. The technique was tested on a file of approximately 4050 data pairs.

Air Movements↗

Declining prevalence of chlamydial infection among adolescent girls.

BACKGROUND AND OBJECTIVES: Chlamydial control programs that identify and treat infected persons have been used as a means of reducing prevalence and morbidity. The overall objective of the current study was to examine the prevalence of chlamydial infection during the course of such a program. GOALS: To determine whether a reduction in isolation rates was evident among adolescent girls during the 8.75 years that the control program has been in place. STUDY DESIGN: The study population consisted of all 4,329 sexually active girls between the ages of 13 and 19 attending the four adolescent health clinics in Indianapolis, Indiana, during the period beginning October 1, 1985, and ending June 30, 1994. All girls were cultured for Chlamydia trachomatis, and behavioral data were collected for those attending the clinics before 1989. The trend in quarterly isolation rates was examined using linear regression analysis. RESULTS: Results showed that there was a significant decrease (P = 0.0001), from 25.9% to 9.7%, in the first-visit chlamydial isolation rate over the study period. Behavioral data showed decreases in the frequency of sexual intercourse and in lifetime years of sexual activity, as well as an increase in condom use. CONCLUSIONS: The quarterly isolation rates showed that there has been a 63% decline in chlamydial infection among adolescent girls attending the clinics for the first time.

Adolescent↗

Effectiveness of a training program in reducing infections in toddlers attending day care centers.

The objective of this study was to assess the effectiveness of a hygiene program in reducing the incidence of respiratory and diarrheal diseases in toddlers attending day care centers. A randomized field trial was conducted in 52 day care centers in Quebec, Canada, between September 1, 1996 and November 30, 1997. Absences for any reasons and the daily occurrence of colds and/or diarrhea in toddlers were recorded on calendars by the educators. The number of fecal coliforms on children's hands and on educators' hands was measured during three unannounced visits. Overall, 1,729 children were followed in 47 day care centers for a total of 153,643 child-days. The incidence rate of diarrhea was considerably reduced by the effect of monitoring (IRR = 0.73, 95% CI = 0.54,0.97), and the intervention reduced the incidence rate of upper respiratory tract infections (IRR = 0.80, 95% CI = 0.68,0.93). Monitoring alone also had an important effect in reducing the level of bacterial contamination on children's and educators' hands. The results indicate that both an intervention program and monitoring alone play a role in reducing infections in children attending day care centers.

Child Day Care Centers↗

[Monte Carlo simulation of a dynamic multileaf collimator:implementation and applications].

A model for the simulation of the accelerator heads of two identical linear accelerators was designed at the University Hospital of Tübingen, using the BEAM program developed at the National Research Council of Canada. Both linear accelerators are equipped with multileaf collimators (MLCs) and backup jaws (y-direction) with curved leaf-ends. The accelerator models were divided into two parts. The first part consisted of target, primary collimator, flattening filter, monitor chamber, and mirror. After the Monte Carlo simulation of these parts, the phase-space characteristics below the mirror were stored in a file and used as source for the second part of the accelerator head (jaw, MLC). The electron source was assumed to deliver a gaussian energy spectrum, with parallel direction to the beam axis. With this electron source, there was good agreement between the measured and simulated depth dose curves in water, with difference < 2%. A new module was created for the BEAM program to simulate backup jaws, while the standard MLCQ module from BEAM was used to simulate a MLC with curved leaf-ends. As a result, MLCs and backup jaws with curved leaf-ends make the shoulder of the y-profile higher than the straight-end MLCs.

Computer Simulation↗

Trait-based analysis in dairy cattle using blood group polymorphisms.

The potential of trait-based analysis to detect quantitative trait loci was investigated using blood group polymorphisms as the marker systems and milk and type traits in Holstein cattle as the quantitative traits. Within large half-sib families, animals were ranked on their predicted transmitted abilities or phenotypes, and blood group allele frequencies were compared between the upper and lower 5% tails of the distributions. Genotype frequencies within large families were also examined for evidence of selection. All of the major effects that had previously been detected using linear model analyses were identified by the trait-based analyses of a C blood group effect on rump angle, an L effect on milk yield and composition traits, an S effect on milk fat yield, and a direct effect of the M locus on milk and protein yields. These results provide additional support for the biological validity of these associations and also demonstrate the utility of trait-based analysis for the detection of quantitative trait loci within existing dairy breeding programs. However, just as in the linear model analyses, an analytical strategy should be utilized that allows the identification of the effects that are consistent across environments and genetic backgrounds.

Alleles↗

A randomized double-blind, cross-over study of the linear and nonlinear algorithms for the QT sensing rate adaptive pacemaker.

We have compared the pacing rate responses during cardiopulmonary exercise testing in 11 patients (mean 59 years, six female) with implanted QT sensing rate adaptive pacemakers who were randomly programmed to 1-month periods in the linear and nonlinear algorithms using a double-blind, cross-over design. Exercise testing was performed at the end of each month block and symptoms were scored with the MacMaster questionnaire. With exercise, the time to a 10 beats/min increment in rate was significantly less with the nonlinear compared to the linear algorithm (126 sec vs 255 sec, P = 0.02) but there were no significant differences in exercise duration, the peak pacing rate, the peak VO2, the VO2 at the anaerobic threshold or the mean correlation coefficients of the pacing rate VO2 relationship. Rate oscillation occurred in seven patients in the linear algorithm and in two patients in the nonlinear setting. Initial deceleration of the pacing rate at the onset of exercise occurred in seven patients in the linear algorithm and in four patients in the nonlinear setting. The nonlinear algorithm is associated with a faster response time during exercise and fewer instances of rate instability. However, it has not overcome the problem of a dip in the pacing rate at the beginning of exercise. The major difference in the function of the two algorithms is faster initial acceleration with the nonlinear algorithm. This is explained by the significantly higher values of the slope setting at the lower rate limit for the nonlinear versus the linear algorithm (6.3 ms/ms vs 5.1 ms/ms).

Adult↗

[Isodose computations of linear and circular interstitial radiation sources].

A new program for computation and representation of isodoses around interstitial radiation sources is presented. The sources can be arranged in a line or circularly. The choice for the location of the isodose plane is restricted by a sole condition: It has to be positioned parallel to a given axis. The program comprises different possibilities for an optimal description of the isodoses.

Electronic Data Processing↗

A simple method of obtaining equivalent doses for use in HDR brachytherapy.

PURPOSE: To develop a simple program that can be easily used by clinicians to calculate the tumor and late tissue equivalent doses (as if given in 2 Gy/day fractions) for different high-dose-rate (HDR) brachytherapy regimens. The program should take into account the normal tissue sparing effect of brachytherapy. METHODS AND MATERIALS: Using Microsoft Excel, a program was developed incorporating the linear-quadratic (LQ) formula to calculate the biologically equivalent dose (BED). To express the BED in terms more familiar to all clinicians, it was reconverted to equivalent doses as if given as fractionated irradiation at 2 Gy/fraction. Since doses given to normal tissues in HDR brachytherapy treatments are different from those given to tumor, a normal tissue dose modifying factor (DMF) was applied in this spreadsheet (depending on the anticipated dose to normal tissue) to obtain more realistic equivalent normal tissue effects. RESULTS: The spreadsheet program created requires the clinician to enter only the external beam total dose and dose/fraction, HDR dose, and the number of HDR fractions. It automatically calculates the equivalent doses for tumor and normal tissue effects, respectively. Generally, the DMF applied is < 1 since the doses to normal tissues are less than the doses to the tumor. However, in certain circumstances, a DMF of > 1 may need to be applied if the dose to critical normal tissues is higher than the dose to tumor. Additionally, the alpha/beta ratios for tumor and normal tissues can be changed from their default values of 10 Gy and 3 Gy, respectively. This program has been used to determine HDR doses needed for treatment of cancers of the cervix, prostate, and other organs. It can also been used to predict the late normal tissue effects, alerting the clinician to the possibility of undue morbidity of a new HDR regimen. CONCLUSION: A simple Excel spreadsheet program has been developed to assist clinicians to easily calculate equivalent doses to be used in HDR brachytherapy regimens. The novelty of this program is that the equivalent doses are expressed as if given at 2 Gy per fraction rather than as BED values and a more realistic equivalent normal tissue effect is obtained by applying a DMF. Its ease of use should promote the use of LQ radiobiological modeling to determine doses to be used for HDR brachytherapy. The program is to be used judiciously as a guide only and should be correlated with clinical outcome.

Algorithms↗

Composition of mixed octadecadienoates via ozonolysis, chromatography and computer solution of linear equations.

An approach to the analysis of 55 possible nonconjugated positional isomers of octadecadienoic acid is described and tested with mixtures of individual synthetic methyl esters. In the first example, by ozonolysis a seven-component mixture consisting of cis,cis 5,12-, 6,10-, 6,11-, 6,12-, 7,12-, 8,12-, and 9,12-octadecadienoates was converted to aldehydes, aldehyde-esters and dialdehydes. These fragments were separated on a 50 m X 0.2 mm free fatty acid phase (FFAP) vitreous silica capillary column. Equations for an arbitrarily restricted 12 X 15 matrix of linear simultaneous equations and a computer solution of the matrix provided the composition of the initial methyl octadecadienoate mixture. The power and significance of this method became apparent with the observation that only two of the seven isomers in the known mixture were resolved as single peaks by state-of-the-art capillary gas chromatography, but all seven were identified and estimated with acceptable error by the ozonolysis-capillary gas chromatography-computer procedure. In a generalized approach to the analysis of the 55 possible nonconjugated isomers, a computer program selects the appropriate matrix of linear simultaneous equations based on the aldehyde data supplied by the analyst. Twenty of 21 combinations of seven isomeric esters taken five at a time have been analyzed to assess the efficiency of the method. To illustrate applicability at this stage of development, the method has been used to analyze the diene products of the hydrazine reduction of gamma-linolenic acid and the diene products from the biological desaturation of isomeric monoenes.(ABSTRACT TRUNCATED AT 250 WORDS)

Chromatography, Gas↗

A curve analyzer for micro-computers.

A computer program is described that emulates a curve analyzer and fits a sum of up to 30 Gaussian components plus a straight background to any set of equi-spaced data points. The program allows interactive, real time curve fitting by the operator and/or objective curve fitting using a non-linear least squares fitting routine, or a combination of the two. The program is more robust in a micro-computer environment than subtractive or generalized non-linear least squares methods and faster than pattern searching methods. The program has been used over the last 4 years in my laboratory by a number of personnel without any previous experience of computers. It is written in BASIC and runs on a Hewlett-Packard series 200 model 16S (9816) computer or on a Hewlett-Packard model 9845S computer. The program is structured to allow use of any underlying curve shape with 3 parameters per component.

Computers↗

[Evaluation of control measures for visceral leishmaniasis (kala azar) in an endemic area in Bahia, Brazil (1995-2000)].

This study evaluated the Control Program for Visceral Leishmaniasis in the city of Feira de Santana, Bahia, Brazil. Information was collected on control measures from 1995 to June 2000, and focused on periodicity, coverage, and incidence trends in the target areas. The dependent variable was the incidence rate for human cases, and independent variables were: percentage of buildings visited in the canine survey and buildings sprayed, number of cycles in the canine survey and spraying, and canine prevalence rate. To evaluate the correlation between control measures and the human visceral leishmaniasis incidence rate, we calculated the Pearson s correlations coefficients and performed linear regression analysis. No association was observed between the prevalence of dogs with positive serology and the incidence rate of human cases. The variables that remained in the final model and that proved most effective in controlling the disease were: percentage of buildings visited during the survey and spraying and number of cycles in the canine survey, capable of explaining 40% of the incidence of human cases. The findings constitute relevant material for the discussion of effectiveness in control measures for visceral leishmaniasis.

Animals↗

A comparison of measured and calculated output for highly blocked photon fields.

The present work measured the accuracy of VAX monitor unit calculations currently used for highly blocked photon fields at The University of Texas M. D. Anderson Cancer Center. The VAX program is an in-house computer program that calculates the setting for linear accelerator photons that is needed to deliver a prescribed dose to a muscle miniphantom located on the beam's central axis at a prescribed depth beneath the surface in water. Monitor unit settings were computed for the Varian 2100 with multileaf collimation using 6 MV and 18 MV photons at a depth of 10 cm with different blocking ratios. Concentric and lateral blocking methods were used. Measurements were taken with an ion chamber and then compared with the VAX calculations with off-axis factors and peak scatter factors added in that are not available in the program. The results showed less than 2% difference for the concentric fields containing no more than 80% blocking and an equivalent square of at least 3.5 cm for 6 MV and 5 cm for 18 MV X-rays. For the lateral fields with the central axis blocked, less than 2% difference was found when blocking was 80% or less and the equivalent square was no less than 3.5 cm for 6 MV X-rays. For 18 MV X-rays, the maximum blocking and minimum equivalent square were 60% and 5 cm for 2% accuracy. This confirmed that the VAX system currently in use is accurate unless a very large amount of blocking is present or the central axis is blocked in very small fields. Previous research done at dmax with similar blocking ratios produced similar results.

Humans↗

Predicting posttreatment cocaine abstinence for first-time admissions and treatment repeaters.

OBJECTIVES: This study examined client and program characteristics that predict posttreatment cocaine abstinence among cocaine abusers with different treatment histories. METHODS: Cocaine abusers (n = 507) treated in 18 residential programs were interviewed at intake and 1-year follow-up as part of the nationwide Drug Abuse Treatment Outcome Study (DATOS). Program directors provided the program-level data in a mail survey. We applied the hierarchical linear modeling approach for the analysis. RESULTS: No prior treatment and longer retention in DATOS programs were positive predictors of posttreatment abstinence. The interactive effect of these 2 variables was also significantly positive. Program that offered legal services and included recovering staff increased their clients' likelihood of cocaine abstinence. Crack use at both the client and program level predicted negative impact. None of the program variables assessed differentially affected the outcomes of first-timers and repeaters. CONCLUSIONS: Although treatment repeaters were relatively difficult to treat, their likelihood of achieving abstinence was similar to that of first-timers if they were retained in treatment for a sufficient time. First-timers and repeaters responded similarly to the treatment program characteristics examined. The treatment and policy implications of these findings are discussed.

Adult↗