Assessment of organs-at-risk contouring practices in radiosurgery institutions around the world – The first initiative of the OAR Standardization Working Group

2016 ◽  
Vol 121 (2) ◽  
pp. 180-186 ◽  
Author(s):  
Helena Sandström ◽  
Caroline Chung ◽  
Hidefumi Jokura ◽  
Michael Torrens ◽  
David Jaffray ◽  
...  
Keyword(s):  
At Risk ◽  
Working Group ◽  
Organs At Risk ◽  
The World

“Utopia First!” A Machiavellian Conception of Solidarity in More's Utopia

Moreana ◽  
2018 ◽  
Vol 55 (Number 209) (1) ◽  
pp. 79-93
Author(s):  
Marie-Claire Phélippeau
Keyword(s):  
At Risk ◽  
Human Beings ◽  
Farm Work ◽  
The World ◽  
Social Difficulties ◽  
The Republic ◽  
The Individual ◽  
Democratic Elections ◽  
Communal Organization

This paper shows how solidarity is one of the founding principles in Thomas More's Utopia (1516). In the fictional republic of Utopia described in Book II, solidarity has a political and a moral function. The principle is at the center of the communal organization of Utopian society, exemplified in a number of practices such as the sharing of farm work, the management of surplus crops, or the democratic elections of the governor and the priests. Not only does solidarity benefit the individual Utopian, but it is a prerequisite to ensure the prosperity of the island of Utopia and its moral preeminence over its neighboring countries. However, a limit to this principle is drawn when the republic of Utopia faces specific social difficulties, and also deals with the rest of the world. In order for the principle of solidarity to function perfectly, it is necessary to apply it exclusively within the island or the republic would be at risk. War is not out of the question then, and compassion does not apply to all human beings. This conception of solidarity, summed up as “Utopia first!,” could be dubbed a Machiavellian strategy, devised to ensure the durability of the republic. We will show how some of the recommendations of Realpolitik made by Machiavelli in The Prince (1532) correspond to the Utopian policy enforced to protect their commonwealth.

Un Kilo de Ayuda

2018 ◽  
Author(s):  
Mary Kay Gugerty ◽  
Dean Karlan
Keyword(s):  
At Risk ◽  
Impact Evaluation ◽  
Health Problems ◽  
Health Data ◽  
Outcome Data ◽  
Monitoring Data ◽  
Program Monitoring ◽  
At Risk Children ◽  
The World ◽  
The Right

This case explores two common challenges facing organizations around the world: how to collect the right amount of data, and how to credibly use outcome data collected during program monitoring. Health promoters at Un Kilo de Ayuda (UKA) in Mexico use regularly collected health data on more than 50,000 children to structure their work, track their progress, and identify at-risk children in time to treat health problems. In this case, readers will assess the tradeoffs between actionability and responsibility that UKA faces in determining how much data to collect. They will also examine the challenges of monitoring data on a program’s outcomes instead of outputs, particularly when it comes to asserting a program’s impact on those outcomes. Finally, readers will propose ways to generate credible data on one of the organization’s programs when plans for an impact evaluation fall through.

scholarly journals Use of a Head-Tilting Baseplate During Tomotherapy to Shorten the Irradiation Time and Protect the Hippocampus and Lens in Hippocampal Sparing-Whole Brain Radiotherapy

2021 ◽  
Vol 20 ◽  
pp. 153303382098682
Author(s):  
Kosei Miura ◽  
Hiromasa Kurosaki ◽  
Nobuko Utsumi ◽  
Hideyuki Sakurai
Keyword(s):  
At Risk ◽  
Planning Target Volume ◽  
Irradiation Time ◽  
Organs At Risk ◽  
Absorbed Dose ◽  
Whole Brain Radiotherapy ◽  
Target Volume ◽  
Whole Brain ◽  
Brain Radiotherapy ◽  
Hippocampal Sparing

Purpose: The aim of this study is to comparatively examine the possibility of reducing the exposure dose to organs at risk, such as the hippocampus and lens, and improving the dose distribution of the planned target volume with and without the use of a head-tilting base plate in hippocampal-sparing whole-brain radiotherapy using tomotherapy. Methods: Five paired images of planned head computed tomography without and with tilt were analyzed. The hippocampus and planning target volume were contoured according to the RTOG 0933 contouring atlas protocol. The hippocampal zone to be avoided was delineated using a 5-mm margin. The prescribed radiation dose was 30 Gy in 10 fractions. The absorbed dose to planning target volume dose, absorbed dose to the organ at risk, and irradiation time were evaluated. The paired t-test was used to analyze the differences between hippocampal-sparing whole-brain radiotherapy with head tilts and without head tilts. Results: Hippocampal-sparing whole-brain radiotherapy with tilt was not superior in planning target volume doses using the homogeneity index than that without tilt; however, it showed better values, and for Dmean and D2%, the values were closer to 30 Gy. Regarding the hippocampus, dose reduction with tilt was significantly greater at Dmax, Dmean, and Dmin, whereas regarding the lens, it was significantly greater at Dmax and Dmin. The irradiation time was also predominantly shorter. Conclusion: In our study, a tilted hippocampal-sparing whole-brain radiotherapy reduced the irradiation time by >10%. Therefore, our study indicated that hippocampal-sparing whole-brain radiotherapy with tomotherapy should be performed with a tilt. The head-tilting technique might be useful during hippocampal-sparing whole-brain radiotherapy. This method could decrease the radiation exposure time, while sparing healthy organs, including the hippocampus and lens.

scholarly journals High-Tech Training for Birds of Prey

Animals ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 530
Author(s):  
Giovanni Granati ◽  
Francesca Cichella ◽  
Pia Lucidi
Keyword(s):  
At Risk ◽  
Wild Bird ◽  
Muscular Strength ◽  
Risk Groups ◽  
Birds Of Prey ◽  
High Tech ◽  
Training Method ◽  
Top Predators ◽  
The World ◽  
Modern Technologies

Raptors are some of the most at-risk groups of birds in the world and saving these top predators is essential for maintaining the health of many ecosystems. After hospitalization, raptors are often released when muscular recovery is still unfitting when they are unable to hunt efficiently and are at risk of dying from starvation within a few days. On the other hand, if a convalescent bird is trained with the only use of classic falconry techniques, it is likely to remain dependent on the caretaker/falconer even long after the release, so unable to hunt independently. To overcome these problems, a new training method was conceived, which could improve raptors’ muscular strength while limiting habituation to humans. This has been possible due to the combination of classic falconry techniques and modern technologies, such as the introduction of specific workouts with drones. Three falconry raptors and one wild Eurasian hobby were trained through high-tech falconry to develop the ability to catch, grasp, and airlift their prey at a different speed, altitude, and resistance. The main findings of this study were: (i) The rapid increase of the raptors’ speed; (ii) the muscular growth and endurance, and (iii) successful reintroduction of a wild bird.

scholarly journals Effects of deep inspiration breath hold on prone photon or proton irradiation of breast and regional lymph nodes

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Bruno Speleers ◽  
Max Schoepen ◽  
Francesca Belosi ◽  
Vincent Vakaet ◽  
Wilfried De Neve ◽  
...  
Keyword(s):  
Lung Cancer ◽  
At Risk ◽  
Lymph Node ◽  
Organs At Risk ◽  
Lymph Node Status ◽  
Breath Hold ◽  
Deep Inspiration ◽  
Proton Radiotherapy ◽  
Regional Lymph Nodes ◽  
Deep Inspiration Breath Hold

AbstractWe report on a comparative dosimetrical study between deep inspiration breath hold (DIBH) and shallow breathing (SB) in prone crawl position for photon and proton radiotherapy of whole breast (WB) and locoregional lymph node regions, including the internal mammary chain (LN_MI). We investigate the dosimetrical effects of DIBH in prone crawl position on organs-at-risk for both photon and proton plans. For each modality, we further estimate the effects of lung and heart doses on the mortality risks of different risk profiles of patients. Thirty-one patients with invasive carcinoma of the left breast and pathologically confirmed positive lymph node status were included in this study. DIBH significantly decreased dose to heart for photon and proton radiotherapy. DIBH also decreased lung doses for photons, while increased lung doses were observed using protons because the retracting heart is displaced by low-density lung tissue. For other organs-at-risk, DIBH resulted in significant dose reductions using photons while minor differences in dose deposition between DIBH and SB were observed using protons. In patients with high risks for cardiac and lung cancer mortality, average thirty-year mortality rates from radiotherapy-related cardiac injury and lung cancer were estimated at 3.12% (photon DIBH), 4.03% (photon SB), 1.80% (proton DIBH) and 1.66% (proton SB). The radiation-related mortality risk could not outweigh the ~ 8% disease-specific survival benefit of WB + LN_MI radiotherapy in any of the assessed treatments.

Deep Learning-Based Delineation of Head and Neck Organs at Risk: Geometric and Dosimetric Evaluation

2019 ◽  
Vol 104 (3) ◽  
pp. 677-684 ◽  
Author(s):  
Ward van Rooij ◽  
Max Dahele ◽  
Hugo Ribeiro Brandao ◽  
Alexander R. Delaney ◽  
Berend J. Slotman ◽  
...  
Keyword(s):  
At Risk ◽  
Deep Learning ◽  
Head And Neck ◽  
Organs At Risk
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