Planning Research Articles

Prospective In Silico Evaluation of Cone-Beam Computed Tomography-Guided StereoTactic Adaptive Radiation Therapy (CT-STAR) for the Ablative Treatment of Ultracentral Thoracic Disease

PurposeWe conducted a prospective, in silico study to evaluate the feasibility of cone-beam computed tomography (CBCT)-guided stereotactic adaptive radiation therapy (CT-STAR) for the treatment of ultracentral thoracic cancers (NCT04008537). We hypothesized that CT-STAR would reduce dose to organs at risk (OARs) compared with nonadaptive stereotactic body radiation therapy (SBRT) while maintaining adequate tumor coverage. Methods and MaterialsPatients who were already receiving radiation therapy for ultracentral thoracic malignancies underwent 5 additional daily CBCTs on the ETHOS system as part of a prospective imaging study. These were used to simulate CT-STAR, in silico. Initial, nonadaptive plans (PI) were created based on simulation images and simulated adaptive plans (PA) were based on study CBCTs. 55 Gy/5 fractions was prescribed, with OAR constraint prioritization over PTV coverage under a strict isotoxicity approach. PI were applied to patients’ anatomy of the day and compared with daily PA using dose-volume histogram metrics, with selection of superior plans for simulated delivery. Feasibility was defined as completion of the end-to-end adaptive workflow while meeting strict OAR constraints in ≥80% of fractions. CT-STAR was performed under time pressures to mimic clinical adaptive processes. ResultsSeven patients were accrued, 6 with intraparenchymal tumors and 1 with a subcarinal lymph node. CT-STAR was feasible in 34 of 35 simulated fractions. In total, 32 dose constraint violations occurred when the PI was applied to anatomy-of-the-day across 22 of 35 fractions. These violations were resolved by the PA in all but one fraction, in which the proximal bronchial tree dose was still numerically improved through adaptation. The mean difference between the planning target volume and gross total volume V100% in the PI and the PA was –0.24% (–10.40 to 9.90) and –0.62% (–11.00 to 8.00), respectively. Mean end-to-end workflow time was 28.21 minutes (18.02-50.97). ConclusionsCT-STAR widened the dosimetric therapeutic index of ultracentral thorax SBRT compared with nonadaptive SBRT. A phase 1 protocol is underway to evaluate the safety of this paradigm for patients with ultracentral early-stage NSCLC.

NORTH CAROLINA NURSING HOME AND PUBLIC HEALTH RESILIENCE DURING 2021 OF THE COVID-19 PANDEMIC

Abstract Since the onset of the COVID-19 pandemic many healthcare organizations have operated in a climate of uncertainty. Building resilience is one method used to survive and thrive during periods of uncertainty. Measuring an organization’s resilience (ability to prepare for, respond and adapt during time of change) allows the organization to identify its vulnerabilities and set priorities to avert negative outcomes during an untoward event. Through collaboration with four long-term care professional associations, the Benchmark Resilience Tool (BRT-13) resilience survey was disseminated to North Carolina long-term care leaders in April 2021. The BRT-13 survey was also sent to North Carolina public health officials via email during the same timeframe. The BRT-13 contains 13 resilience (RES) items divided into two factors of adaptive capacity (AC) and planning (PL) on a five-point Likert scale of strongly disagree (1) to strongly agree (5). Organizational factors surveyed included type of facility, rural-urban classification area designation, ownership type, level of debt, level of profitability, and employee satisfaction. A total of 142 completed surveys were received, 101 (71%) from long-term care leaders and 41 (28.9%) from Public Health officials. Overall average resilience scores ranged from 3.96 for public health respondents to 4.46 for continuing care retirement communities (CCRC) respondents. Analysis of Variance (ANOVA) was employed to compare the three factors (AC, PL, and RES) to the organizational factors. Resilience was significantly associated with one factor, employee satisfaction. Our findings indicate that organizations can build resilience through processes that contribute to staff satisfaction.

Factors Affecting User Satisfaction Entrepreneurial Financial Planning for Sustainability Creative Economy SMEs in the Tourism Sector during Covid 19 pandemic

One of the causes of the decline in creative economy SMEs in the tourism sector during the pandemic is the limited financial resources owned by SME entrepreneurs. Financial planning user satisfaction is one of the important things for business co ntinuity. This study uses quantitative research methods with primary data obtained through the interview process. The research data obtained will be processed using validation and reliability tests. The sample data involves 100 entrepreneurial respondents who are creative economy SME entrepreneurs in the tourism sector originating from the Medan UKM Center and IPEMI Medan. The results of the study found that quality and knowing variables had an effect on user satisfaction with entrepreneurial financial plan ning for the sustainability of the creative economy of SMEs in the tourism sector during the COVID-19 pandemic, while understanding, knowledge and information had no effect on user satisfaction with entrepreneurial financial planning for the sustainability of the creative economy of SMEs in the tourism sector during covid 19.

Greenhouse Gas Emission Intensity Assessment for Power Plants in Peninsular Malaysia

The power sector has been playing a vital role in the industrialization, societal and economic development of a nation. In Malaysia, the total power generation for 2014 is 147,480GWh and eventually accounts for 54% of total carbon emissions for that year alone. A study was conducted to quantify the greenhouse gas emission from stationary combustion from several power plants in Peninsular Malaysia, followed by proposal for the emission reduction strategies. For the GHG emissions assessment, the Greenhouse Gas Protocol: A Corporate Accounting and Reporting Standard and Intergovernmental Panel on Climate Change (IPCC) methodologies was adopted. Based on this study, the highest GHG emission intensity were from coal power plants which ranged from 0.67 – 0.85 tCO2/ MWh. The GHG emission intensity for natural gas power plants ranged from 0.38 – 0.78 tCO2/ MWh. The overall GHG emission intensity for all power plants studied was estimated to be 0.54 tCO2/ MWh. The large variations in CO2 emissions per MWh of electricity generated in fossil fuel power plants were due to differences in generation efficiency, fuel selection, technology, and plant age. In supporting Malaysia’s conditional commitment of 45% GHG emissions intensity reduction target against the country’s GDP, the emission reduction strategies up to 2025 were assessed using three key scenarios namely Business-As-Usual (BAU), Planning (PLAN) and Ambitious (AMB). Based on the analysis, the projection indicates that the emissions intensity for the power sector is about 0.79 tCO2/ MWh, 0.49 tCO2/ MWh, and 0.44 tCO2/ MWh under the BAU, PLN AMB scenarios respectively. Finally, GHG emission reduction potentials were also outlined in this paper.

Planned Versus Bailout Rotational Atherectomy: A Systematic Review and Meta-Analysis

Background/purposeRotational atherectomy (RA) plays a central role in the treatment of heavily calcified coronary artery lesions. Our aim was to compare periprocedural characteristics and outcomes of planned (PA) vs. bailout (BA) rotational atherectomy. MethodsWe conducted a systematic review and performed a meta-analysis on studies which compared PA vs. BA strategy. ResultsFive studies fulfilled the inclusion criteria, pooling a total of 2120 patients. There was no difference in procedural success, PA vs. BA risk ratio (RR) 1.03 and 95% confidence interval (95% CI) 0.99–1.07. Compared to BA, PA was associated with a shorter procedural time [mean difference (MD) -25.88 min, 95% CI -35.55 to −16.22], less contrast volume (MD -43.71 ml, 95% CI -69.17 to −18.25), less coronary dissections (RR 0.50, 95% CI 0.26–0.99), fewer stents (MD -0.20, 95% CI -0.29 to −0.11), and a trend favouring less periprocedural myocardial infarctions (MI) (RR 0.77, 95% CI 0.54–1.11). There was no difference in major adverse cardiovascular events on follow-up (RR 1.04, 95% CI 0.62–1.74), death (RR 0.98, 95% CI 0.59–1.64), MI (RR 1.16, 95% CI 0.62–2.18), target vessel revascularization (RR 1.40, 95% CI 0.83 to 2.36), stroke (RR 1.50, 95% CI 0.46–4.86) or stent thrombosis (RR 0.82, 95% CI 0.06–10.74); all PA vs. BA comparisons. ConclusionsCompared to bailout RA, planned RA resulted in significantly shorter procedural times, less contrast use, lesser dissection rates and fewer stents used. The bailout RA approach appears to enhance periprocedural risk, but there is no difference on mid-term outcomes.

Levantamento e representatividade das Unidades de Conservação instituídas no estado de Mato Grosso do Sul

<p>O sistema de Unidades de Conservação (UCs) constitui-se em uma das mais importantes políticas públicas de proteção da biodiversidade, mesmo considerando a falta de gestão e manejo que atinge algumas UCs do Brasil. A despeito dessa situação, torna-se importante registrar e conhecer as UCs (municipais, estaduais e federais) criadas no âmbito do estado de Mato Grosso do Sul. Para isso, por meio de bibliografias disponíveis, foram realizadas consultas à legislação e levantamento. As análises dos dados obtidos até março de 2020 indicaram um total de 136 UCs, distribuídas entre as de Uso Sustentável (72,06%) e de Proteção Integral (27,94%), que representam 16,5% do território do estado. Em todas as esferas, a maior proporção de UCs criadas é referente às UCs de uso sustentável. A situação das UCs, em Mato Grosso do Sul, aponta para a urgente necessidade de uma política pública concreta, que possibilite atender os objetivos das diferentes categorias, de modo a contribuir com a conservação da natureza no tocante à manutenção da diversidade biológica e de ecossistema existentes no estado. Sendo necessário, para tanto, a elaboração dos planos de manejo, a consolidação de conselhos, a viabilização da visitação pública, do ecoturismo, pesquisa e da educação ambiental.</p>

Una película de Robert Flaherty, en la pampa, filmada por Sergei Eisenstein, para Victoria Ocampo, a espaldas de Waldo Frank

Victoria Ocampo meets Sergei Eisenstein in New York, in 1930. He is on his way to Hollywood where he plans to make a film and she is there to meet Waldo Frank and discuss the project of the journal Sur. Ocampo invites the filmmaker to come to Argentina make a film about the pampas. The aim of this article is to reconstruct the relationship between the writer and the filmmaker in order to support the hypothesis that we might identify some traces of that project in the film Eisenstein engages with when his trip to Argentina fails: ¡Que viva México!.

Marshall, T.: The Politics and Ideology of Planning

Marshall, T.: The Politics and Ideology of Planning

Of Blobs and Buzzes: Does SISCOM Imaging Actually Help SEEG Planning?

Of Blobs and Buzzes: Does SISCOM Imaging Actually Help SEEG Planning?

Response to Commentaries: Applying the Theory of Planned Behavior to Female Genital Cutting and Deinfibulation.

Response to Commentaries: Applying the Theory of Planned Behavior to Female Genital Cutting and Deinfibulation.

Outsourcing Marketing Plans for Small and Medium Enterprises using Knowledge Sharing Process Case study: Tehran Wood and Furniture Companies

Outsourcing Marketing Plans for Small and Medium Enterprises using Knowledge Sharing Process Case study: Tehran Wood and Furniture Companies

An Operational Planning Approach Distribution Automation Considering the Contribution of Demand Response Programs in Service Restoration Process

An Operational Planning Approach Distribution Automation Considering the Contribution of Demand Response Programs in Service Restoration Process

On Planning for an Unimaginable Future.

On Planning for an Unimaginable Future.

Impact of family planning on maternal and infant mortality in Cameroon: Protocol for a clustered non-randomized controlled trial

The study aimed to assess the impact of family planning on maternal and infant mortality in Tiko CDC plantation camp. This is a clustered non-randomized controlled trial with a predetermined intervention site (Tiko CDC plantation camp) and a control site (Pena Mboko camp). Four clusters were randomly selected in each group using simple ballot and the intervention administered in all clusters in the intervention site. Households/participants were then systematically sampled (250 in each site) for data collection and analysis. The intervention comprises a triad of health education, facilities strengthening and distribution of contraceptives in the intervention cohort. After baseline study, re-evaluation visits are scheduled for 3rd, 6th and 9th month of intervention and a post-intervention data collection at 12th months of intervention. The pre-intervention phase was conducted from December 2019 to February 2020; data was partially analysed and intervention was designed. Primary outcomes to be measured are contraceptive knowledge, perception and practice while secondary outcomes are maternal and infant morbi-mortality. Ethical clearance was obtained from the institutional ethics committee for research on human health at University of Douala. While the study adds to existing literature, its strengths and limits could be useful in informing similar interventions in the study area and beyond. Key words: Non-randomized clustered, Family planning, Health education, Maternal, Infant, mortality, Cameroon.

How a Focused Legacy Campaign Resulted in 110 New $100,000‐Plus Planned Gifts

How a Focused Legacy Campaign Resulted in 110 New $100,000‐Plus Planned Gifts

Choice Neighborhoods Planning Grants (HUD)

Choice Neighborhoods Planning Grants (HUD)

Interdisciplinarity, Ethics and Territorial Planning

Representing a phenomenon of social aggregation, the settlements of the rock civilization of Fasano and Monopoli in Brindisi, Italy and their recovery, is one of the objectives pursued by the technical-scientific committee of the San Domenico Foundation, which involves experts at national and international level. This paper, presented at the 8th International Conference, intends to highlight how art, as a testimony of these settlements in the area of this rock civilization, is not attributable only to beauty, but also to ethics, and as such, is synonymous with identity. This leads to concepts and meanings deriving from interdisciplinarity, sustainability, planning, territorial development, as well as the need to train a specialized and multi-faceted professional figure who is qualified to operate in the field of the protection and valorisation of the past, in order to be able to competently pass it on through to the future

From Site Survey to HBIM Model for the Documentation of Historic Buildings: the Case Study of Hexinwu Village in China

Architectural heritage surveying plays a fundamental role in the preservation of historic buildings for scientific research, education and tourism. The use of Unmanned Aerial Vehicles and Terrestrial Laser Scanning techniques are essential for architectural heritage surveying and mapping. In recent years, the combination of Building Information Modelling (BIM) with heritage studies has been presented as Historic BIM (HBIM) which, integrated with UVA and TLS, is a technique that is able to deal more efficiently with the management and protection of historic buildings. This paper focuses on the integration of UVA images and point clouds from laser scanning to build a 3D architectural model for the documentation of Chinese historic buildings. In particular, the method, tested in the case study of the traditional village, Hexinwu, China, can contribute further to the analysis, evaluation and heritage planning of this remarkable architectural structure, thus increasing its historical significance for the future.

The Undercommons: Fugitive Planning and Black Study. By Sterano Harney and Fred Moten: (New York: Minor Compositions, 2013).

The Undercommons: Fugitive Planning and Black Study. By Sterano Harney and Fred Moten: (New York: Minor Compositions, 2013).

Broadening participation, creating community, and learning that it never goes as planned

Broadening participation, creating community, and learning that it never goes as planned