Restraint Characteristics Research Articles

Modern Electromagnetic Field Theory and Its Application in Future Wireless Communication

With the advent of the 5G era, more and more technologies in life are applied to the technological development and theory of antennas. Waveform constraints. These basic applications are obtained due to the natural seismic source and the continuous arrangement and combination of arrays. In this article, we first discuss the spherically symmetric electric field distribution of antenna elements in space, and then discuss the influence of a circular array on the electromagnetic intensity of the space radiated field. At the same time, the basic characteristics of waveform restraint, array radar and array telescope are discussed. Afterwards, from a theoretical point of view, the physical properties and radiation characteristics of the near-field induction field and radiation field of the factory around the vibrator were analyzed quantitatively and qualitatively. Later, I discussed the relationship between an annular array and the eddy current. Through theoretical derivation and excitation factors, we used the original radiation equation to derive the Bessel function, and used a computer to make a simulation to explore the factors that can affect the array radiation.

Fault current suppression for MMC-MTDC with the resistive type superconducting fault current limiter

With effective properties, a resistive-type superconducting fault current limit (R-SFCL) has become an effective device to restrain DC-side bipolar short fault currents in multilevel modular converter multiterminal DC systems (MMC-MTDCs). However, due to the resistance-energy accumulation-dependent characteristics of the R-SFCL device, the fault durations and different fault current values will produce various output resistances at each fault stage, and the related coordinated protection and control strategy needs to be adjusted accordingly. Therefore, in the first part of this paper, we analysed the DC side short circuit current mechanism and the fault current restraint characteristics of R-SFCLs. Subsequently, to verify the above analysis, the R-SFCL-based four-terminal MMC-MTDC with DC bipolar short fault modelling and simulation are presented in the next section. Finally, based on the above analysis and research, the advanced DC bipolar fault control and protection strategies of the R-SFCL-based MMC-MTDC system are discussed to promote further study of coordinated and protection control and the application of R-SFCLs in subsequent engineering applications.

Pediatric Safety Restraint Use in Motor Vehicle Crashes at a Level I Safety-Net Trauma Center

BackgroundAdherence to child passenger safety recommendations is essential to prevent death and injury in children involved in motor vehicle crashes. Parents may not undertake the proper safety measures, which can lead to increase injury. MethodsA safety net, level I trauma center's database was used to identify admitted children (age<15 y/o) involved in motor vehicle crashes over a 2-y period to investigate safety restraint device use and compliance with state recommendations. Variables evaluated were crash characteristics, presence and method of passenger restraint, demographics, Glasgow Coma Scale, and Injury Severity Score. Excluded were patients where restraint characteristics could not be identified and those discharged from the trauma center. ResultsEighty patients met inclusion criteria. Thirty-two (40%) children were unrestrained. Safety restraint device was noted in 48 (60%) children with 13 (27.1%) patients improperly restrained. The most common method of improper restraint (6, 46.2%) was traveling in the front seat before the age state law recommends. With respect to proper, improper, and no restraint, age (7.31 ± 14.26, 5.76 ± 3.24, P = 0.36), female sex (17, 8, 13, P = 0.32), low-income status (14, 5, 24, P = 0.28), and race (P = 0.08) did not differ between the groups. The unrestrained children had statistically lower initial Glasgow Coma Scale and higher Injury Severity Score and were more often involved in high-risk mechanism of Injury motor vehicle crashes. ConclusionsDespite recommendations and regulations regarding child passenger safety measures, there are a significant number of children that remain suboptimally restrained who are admitted to a safety-net trauma center. Further research is needed to understand the barriers to increase the compliance with recommendations along with targeted educational campaigns in low-compliance populations.

A Study on the Constraint of the Resource Environment to the Development of the Urban Economy in ChinaNatural resources environment; Innovation driving force; Urban environmental protection; Sustainable economic development

With the rapid development of urbanization and urban economy in China, in the face of the sustainable development of urban economy restricted by environmental resources and on the basis of analyzing the influence and restraint characteristics of environmental resources on the space of economic development, the development of low-carbon energy and utilization of renewable energy are studied. The scientific and technological progress plays an important role in solving the constraint problem. This paper puts forward a concept of sustainable development of a new type of city based on the optimal allocation of social resources, and makes a beneficial discussion on the realization of sustainable development and the promotion of core competitiveness.

Analysis of Vehicle Front Impact Pulse Severity in US NCAP

&lt;div class="section abstract"&gt;&lt;div class="htmlview paragraph"&gt;There have been multiple studies on the effect of vehicle impact pulses on occupant responses, and studies on the previous and current US NCAP (New Car Assessment Program) vehicle pulses. This paper analyzes 35 mph (56.3 kph) front impact vehicle pulses and occupant responses in US NCAP tests conducted by the NHTSA from 2011 to 2019. Based on the occupant response analysis, a simple generic occupant restraint force-relative displacement model has been created. This generic model captures the fundamental restraint characteristics of the vehicles in the recent years, and together with the vehicle pulse, they provide several occupant response predictors. Furthermore, this paper proposes a new pulse severity metric PSD (Pulse Severity by Displacement) based on the vehicle impact data statistics, and uses the pulse severity to compare with other pulse severity definitions. It explains the shortcomings of using the vehicle dynamic crush and TTZV (Time-To-Zero Velocity) as pulse severity metrics, and shows how improvements can be made with simple modifications. Data regression methods are used to assess relationships among different metrics and variables. The paper also provides statistics of the vehicle pulses, the trend of pulse severity and characteristics over the years.&lt;/div&gt;&lt;/div&gt;

Impact of child restraint policies on child occupant fatalities and injuries in Chile and its regions: An interrupted time-series study

ObjectivesWe assessed the effectiveness of the child restraint legislation (CRL) introduced in Chile in December 2005 and the National Decree enacted in February 2007, which regulated the technical characteristics of child restraint devices with the goal of reducing child occupant fatalities and severe injuries nationally and within Chile’s regions. MethodsAn interrupted time–series design was used to measure the effect of CRL and the National Decree on two dependent variables—number of child occupant deaths in traffic collisions and number of child occupants severely injured in traffic collisions per vehicle fleet from 2002 to 2014 (police data). Our analyses compared the incidence of these outcomes in the post-intervention period (2006 to 2014) with the period prior to these interventions (2002–2005) nationally and by region, controlling for several confounders. ResultsNationally, the child restraint policies were associated with a 39.3% (95% CI: 4.7; 73.9) reduction in child occupant fatalities, but no significant decrease was observed in child severe injuries. These interventions were associated with a 75.3% (95% CI: 15.6; 135.1) reduction in the rate of child occupant fatalities in the southern regions, and a 32.9% (95% CI: 1.1; 67.0) reduction in the rate of children severely injured in the northern regions. ConclusionIn the short term, the CRL and the National Decree were associated with fewer child occupant fatalities, at the national level and in the southern regions, and severely injured child occupants in traffic collisions in Chile’s northern regions. These results demonstrate a limited temporal and territorial impact. This suggests that to effectively protect vulnerable populations across all territories, efforts should be expanded more consistently and sustained over time.

Partial operating current characteristics to discriminate internal and external faults of differential protection zones during CT saturation

To protect transformers, transmission lines and busbar systems, low impedance current differential protection schemes based on percentage restraint characteristics are widely used in power systems. The main application issue of these schemes is mis-operation due to current transformer (CT) saturation during close-in external faults. A comprehensive fault discrimination algorithm is highly required for current differential protection schemes to overcome the CT saturation issue. The purpose of this study is to introduce a methodology based on partial operating current (POC) characteristics which discriminate internal and external faults of differential protection zones. The study includes the mathematical model of POC characteristics, a fault discriminating algorithm using POC features, and bus differential protection zone results. The results documented encompasses various possible short-circuit (fault) scenarios and indicate the capability of the proposed algorithm in discriminating internal and external faults under CT saturation conditions.

Reducing restraint with clozapine in involuntarily admitted patients with schizophrenia

IntroductionIn the entire world, restraint and seclusion are common interventions in psychiatric in-patient settings due to aggressive behavior.ObjectivesOur objective was to test for the immediate anti-aggressive property of clozapine compared to other antipsychotic treatments in an enriched cohort with high rates of restraint during early hospitalization.MethodsWe present a retrospective chart review in all involuntary admissions with schizophrenia during 2011–2014 in Psychiatry and Neurology Hospital, Brasov, Romania. Timing and number of restraints in addition to clinical, demographic and treatment characteristics were extracted. Based on our earlier observation of clinical efficacy of early, fast titration of clozapine, we tested the hypothesis that clozapine treatment was associated with reduced use of restraint, and with longer restraint-free periods.ResultsIn 115 patients with schizophrenia (age = 39.7 ± 11.1 years; male = 59%) involuntarily admitted due to externalized (74.78%) or self-directed violence (25.22%), restraint was used in 89.6%; with a median duration of 3 hours until restraint past admission. Antipsychotics used immediately after hospitalization included haloperidol (70.4%), clozapine (11.3%), olanzapine (10.4%) and other second-generation antipsychotics (7.9%). Comparison of restraint characteristics favored immediate clozapine use with highly reduced rates of restraint (38.5% vs.95.6%. P &lt; 0.001) and significantly extended hours until restraint ([118 h,24 h, 426 h] vs.[3 h,0.25 h, 48 h]; median; 25th, 75th percentile; P &lt; 0.001) relative to the remaining cohort. These effects remained highly significant after controlling for potential moderators of restraint use in multivariate models.ConclusionsThese retrospective data suggest an early anti-aggressive effect of clozapine during the immediate use of clozapine in highly problematic patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Reducing Restraint With Clozapine in Involuntarily Admitted Patients With Schizophrenia.

In the entire world, restraint and seclusion are common interventions in psychiatric inpatient settings because of aggressive behavior. Our objective was to test for the immediate antiaggressive property of clozapine compared with other antipsychotic treatments in an enriched cohort with high rates of restraint during early hospitalization. We present a retrospective chart review in all involuntary admissions with schizophrenia during 2011-2014 in Psychiatry and Neurology Hospital, Brasov, Romania. Timing and number of restraints in addition to clinical, demographic, and treatment characteristics were extracted. Based on our earlier observation of clinical efficacy of early, fast titration of clozapine, we tested the hypothesis that clozapine treatment was associated with reduced use of restraint and with longer restraint-free periods. In 115 consecutive patients with schizophrenia (age = 39.7 ± 11.1 years; male = 59%) involuntarily admitted because of externalized (74.7%) or self-directed violence (25.2%), restraint was used in 89.6%; with a median duration of 3 hours until restraint past admission. Antipsychotics used immediately after hospitalization included haloperidol (70.4%), clozapine (11.3%), olanzapine (10.4%), and other second-generation antipsychotics (7.9%). Comparison of restraint characteristics favored immediate clozapine use with highly reduced rates of restraint (23% vs. 95.6%; P < 0.001) and significantly extended hours until restraint [(118, 24, 426 hours) vs. (3, 0.25, 48 hours); median; 25th, 75th percentile; P < 0.001] relative to the remaining cohort. These effects remained highly significant after controlling for potential moderators of restraint use in multivariate models. These retrospective data suggest an early antiaggressive effect of clozapine during the immediate use of clozapine in highly problematic patients.

An Improved Differential Protection of Large Power Transformer using Fuzzy based Protective Relay for Inrush Current and Harmonic Components

This paper deals with the analysis of various operating conditions of power transformer such as energization, inrush current, over excitation and CT saturation. In this work a new relaying algorithm is used to enhance the fault detection sensitivities of conventional techniques by using a fuzzy logic approach. An improved differential protection scheme is proposed which uses voltages and current to detect the abnormalities in the different zone of protection. The magnetizing inrush current during transformer energization is taken with a simplified excitation curve. Discrete fourier transform is used for extraction of fundamental and higher harmonic components of the differential current. The fuzzy based protective relaying algorithm will analyze inrush current, residual flux, saturation flux, harmonics restraint and percentage differential characteristics curve. This method of fuzzy based protective relaying algorithm is tested with MATLAB simulink model and a performance comparison of conventional scheme and fuzzy logic based protection scheme is provided.

Composite multi-functional over layer: A novel design to improve the photovoltaic performance of DSSC

Light scattering in dye-sensitized solar cell (DSSC) plays a vital role in extending the traveling distance by confining light propagation within the photoanode and also promotes interaction of incident photons with the dye molecules. A novel strategy was adopted to improve the performance of DSSC with better absorption of solar spectrum both in the visible as well as near IR regions. A double layer photoanode structure with TiO2 nanoparticles (P25) as main layer and composite of titanium nanotubes (TNTs) and P25 as over-layer was introduced. Three different compositions of TNT/P25 were investigated, and finally an optimized composition with excellent performance was prepared. Performance of cells having composite over-layer was compared with the cells having TNT and conventional bigger particles (G2) over-layers. Composite over-layer structure of 75/25-TNT/P25 showed best photovoltaic performance of 8.52% with Jsc of 16.49mA/cm2, which is 7.30% higher than the cells having G2 over-layer and 4.9% higher than the cells having pure TNT over-layer. Different characterization analysis proved that DSSC with optimized composite over-layer structure has significant advantages of better dye adsorption, large surface area, better photo-electron generation, superior electron recombination restraint characteristics, better conductive behavior, better light scattering, and long electron lifetime. Composite over-layer structure is a promising and innovative approach for further improving the efficiency of DSSC and this will be a concrete fundamental background toward the development of the applications of the next generation dye-sensitized solar cells.

Motor Vehicle Crash–Related Injury Causation Scenarios for Spinal Injuries in Restrained Children and Adolescents

Objective: Motor vehicle crash (MVC)-related spinal injuries result in significant morbidity and mortality in children. The objective was to identify MVC-related injury causation scenarios for spinal injuries in restrained children.Methods: This was a case series of occupants in MVCs from the Crash Injury Research and Engineering Network (CIREN) data set. Occupants aged 0–17 years old with at least one Abbreviated Injury Scale (AIS) 2+ severity spinal injury in vehicles model year 1990+ that did not experience a rollover were included. Unrestrained occupants, those not using the shoulder portion of the belt restraint, and those with child restraint gross misuse were excluded. Occupants with preexisting comorbidities contributing to spinal injury and occupants with limited injury information were also excluded. A multidisciplinary team retrospectively reviewed each case to determine injury causation scenarios (ICSs). Crash conditions, occupant and restraint characteristics, and injuries were qualitatively summarized.Results: Fifty-nine cases met the study inclusion criteria and 17 were excluded. The 42 occupants included sustained 97 distinct AIS 2+ spinal injuries (27 cervical, 22 thoracic, and 48 lumbar; 80 AIS-2, 15 AIS-3, 1 AIS-5, and 1 AIS-6), with fracture as the most common injury type (80%). Spinal-injured occupants were most frequently in passenger cars (64%), and crash direction was most often frontal (62%). Mean delta-V was 51.3 km/h ± 19.4 km/h. The average occupant age was 12.4 ± 5.3 years old, and 48% were 16- to 17-year-olds. Thirty-six percent were right front passengers and 26% were drivers. Most occupants were lap and shoulder belt restrained (88%). Non-spinal AIS 2+ injuries included those of the lower extremity and pelvis (n = 56), head (n = 43), abdomen (n = 39), and thorax (n = 36). Spinal injury causation was typically due to flexion or lateral bending over the lap and or shoulder belt or child restraint harness, compression by occupant's own seat back, or axial loading through the seat pan. Nearly all injuries in children <12 years occurred by flexion over a restraint, whereas teenage passengers had flexion, direct contact, and other ICS mechanisms. All of the occupants with frontal flexion mechanism had injuries to the lumbar spine, and most (78%) had associated hollow or solid organ abdominal injuries.Conclusions: Restrained children in nonrollover MVCs with spinal injuries in the CIREN database are most frequently in high-speed frontal crashes, of teenage age, and have vertebral fractures. There are age-specific mechanism patterns that should be further explored. Because even moderate spinal trauma can result in measurable morbidity, future efforts should focus on mitigating these injuries.

Double-Layer Structure Photoanode with TiO2 Nanotubes and Nanoparticles for Dye-Sensitized Solar Cells

Here, we report a novel double-layer structure photoanode with TiO2 nanotube (TNT) layer and TiO2 nanoparticle (TP) layer via a two-step method of electrochemical anodization and screen printing for dye-sensitized solar cells (DSSCs). The results indicate that DSSCs with this double-layer structure have significant advantages of large surface area, long electron lifetime, superior electron recombination restraint characteristics, and high light scattering. The layer thickness of nanotubes and nanoparticles is also investigated and finally an optimized double-layer structure with excellent performance is prepared. With such a double-layer structure photoanode, DSSC with a relative high conversion efficiency of 6.43% and a short-circuit photocurrent density of 16.40 mA·cm−2 is obtained.

From food to fuel

Objective: An investigation of the discussion surrounding the relationship between food and exercise in one community of photography-based food blogs that past research has identified as exhibiting characteristics of dietary restraint. Design: Forty-five blogs written by young adult women belonging to a food-blogging community were selected for study. All selected blogs had been publicly posted online. Method: Using a qualitative approach of constant comparative analysis, two months of entries from food blogs created by young women were analyzed and coded for entries discussing food before, during and after exercise. Results: Analysis revealed that bloggers discussed three themes, mainly prior to and following exercise: food as fuel, food restricted and worked off through exercise, and food intake as justified by exercise. Conclusion: These findings provide insight into how a community of food bloggers views the relationship between food and exercise, suggest ways that women practising dietary restraint perceive food and exercise, and encourage further research on food blogging.

Weekend Prescribing Practices and Subsequent Seclusion and Restraint in a Psychiatric Inpatient Setting

Weekend Prescribing Practices and Subsequent Seclusion and Restraint in a Psychiatric Inpatient Setting

Fuel Consumption Test Method for 4WD HEVs – On a Necessity of Double Axis Chassis Dynamometer Test –

Concerns regarding global climate change have caused the transportation sector to look for alternatives to petroleum as a fuel for vehicles of all types. Hybrid electric vehicles (HEVs) have been recognized as being particularly efficient for urban traffic use. In the last few years, Four wheel drive (4WD) transmissions have been developed for heavy passenger vehicles. As these vehicles become more popular, there is a need for accurate fuel consumptions test methods. Clearly the most accurate fuel consumption measurements would be obtained by using dual axis dynamometers, but these systems are not always available. Single axis dynamometers are commonly used for evaluating fuel consumption, but these are inadequate for 4WD vehicles without adjustments to account for the uncertainty that will result from disabling one of the drive axles.This paper describes a method for extrapolating fuel consumption results from single axle chassis dynamometer testing to estimate the fuel consumption of 4WD vehicles. A simple method is proposed that will allow reasonable estimates of fuel consumption for 4WD vehicles to be made from single axle dynamometer testing.This paper also describes methods to reduce the uncertainty in 4WD chassis dynamometer testing by paying particular attention to road load, tire conditions and restraint characteristics.

The Effects of External Ankle Support on Dynamic Restraint Characteristics of the Ankle in Volleyball Players

To examine any changes in electromechanical delay and reaction time as a result of the use of external ankle supports over an entire season (3-5 months) in college volleyball players. A 2 x 3 pre-post factorial design. Biomechanics laboratory, Human Performance Research Center. Thirty healthy, active male and female intercollegiate volleyball players were recruited for this study (age, 20.4 +/- 2.3 years; height, 183.1 +/- 8.6 cm; weight, 74.0 +/- 9.5 kg). External supports consisted of the subjects wearing either tape or braces for practices and games for the duration of the volleyball season. Subjects in the control group wore nothing on their ankles for practices and games for the duration of the volleyball season. The electromechanical delay (EMD) of the peroneus longus was determined by the onset of force contribution after artificial activation, as measured by electromyographic (EMG) and forceplate data. Reaction time was measured after an inversion perturbation during walking. No significant (F2,27 = 0.141, P = 0.869) interaction was observed for reaction time between the groups over time. No significant (F2,27 = 0.236, P = 0.791) interaction was observed for EMD between groups over time. Use of an external ankle support over an entire season does not induce neuromuscular changes in the onset timing of the peroneus longus.

Categorical strategies based on subject characteristics of dietary restraint and physical activity, for weight maintenance

The aim of this study was to investigate the effect of categorical strategies based on subject-specific characteristics of dietary restraint and physical activity, on weight maintenance (WM) in overweight and obese subjects, after a very low calorie diet (VLCD). Furthermore, find predictors of WM that can be important in the context of obesity treatment. In all, 120 subjects (age: 49.0+/-9.8 y, BMI 31.0+/-3.8 kg/m(2)) followed a VLCD (2.1 MJ/day) for 6 weeks in a free-living situation, followed by a period of 1 y WM. Body weight (BW), body composition, leptin concentration, dietary restraint and physical activity were determined right before (t0) and after (t1) the VLCD, after 3 months (t2) and after 1 y (t3). During WM, subjects were divided into four categories of WM guidelines (dietary, activity, diet+activity, placebo), taking their capability measured during weight loss and their preference for particular guidelines into account. BW loss during VLCD was 7.0+/-3.1 kg. After 1 y follow-up, BW regain was 56.3+/-55.0%, without significant differences between the four groups. With respect to measured capability during weight loss, subjects with an increased dietary restraint (F1 of the Three Factor Eating Questionnaire) had less BW regain than subjects with an increased physical activity (Baecke questionnaire) (35.5+/-53.2 vs 68.5+/-46.4%, P<0.05). Moreover, activity guidelines promoted WM in dietary disciplined subjects compared to activity-related disciplined subjects (% regain: 25.2 vs 74.3%, P<0.05). Subjects receiving guidelines that were opposite to their preference showed a better WM than subjects receiving preferred guidelines. After 1 y WM, 21 subjects were successful (<10% BW regain) and 99 unsuccessful (> or =10% BW regain). At baseline, these groups were significantly different in BMI (resp. 32.7+/-4.9 vs 30.7+/-3.5 kg/m(2), P<0.05), waist circumference (106.5+/-14.0 vs 100.6+/-11.2 cm, P<0.05) and fat mass (FM) (35.2+/-10.6 vs 32.1+/-6.6%, P=0.06). Finally, successful subjects appeared to spare fat-free mass (FFM) to a greater extent than unsuccessful subjects. After weight loss, type of guidelines (dietary, activity, placebo) is not related to the magnitude of WM, whereas guidelines opposite to the subject's capability and preference are related. These only reach successful WM (>90%) in originally dietary disciplined subjects who are supported by characteristics such as a relatively high baseline BMI, waist circumference and FM, together with the ability to spare FFM.

Rear Impact Responses of Different Sized Adult Hybrid III Dummies

Rear impact sled tests were conducted using 5th, 50th, and 95th percentile Hybrid III dummies to evaluate proposed injury criteria. Different head restraint height (750, 800 mm) and backset (0, 50, 100 mm) positions were used to determine axial and shear forces, bending moments, and injury criteria (NIC, N ij , and N km ). The time sequence to attain each parameter was also determined. Three events were identified in the response. Event I was coincident with the maximum rearward motion of the torso, Event II occurred at the time of the peak upper neck flexion moment, and Event III occurred at the time of maximum rearward motion of the head. Parameters such as backset, head restraint height, seat-head restraint interaction, and anthropometry affected impact responses. Head rotations increased with increasing backset and increasing head restraint height. However, N ij and N km did not exhibit such clear trends. The 50th percentile dummy responded with consistent injury criteria values (e.g., the magnitude of the injury criteria increased with backset increase or head restraint height decrease). However, the 5th and 95th percentile dummies did not demonstrate such trends. These findings underscore the need to include subject anthropometry in addition to seat and head restraint characteristics for better assessment of rear impact responses.

The evolution of quality assurance for intensity- modulated radiation therapy (IMRT): sequential tomotherapy

Purpose To identify the pertinent issues to be addressed in successfully implementing IMRT using sequential tomotherapy into clinical reality and presenting the maturation of quality assurance (QA) programs for both the delivery system and patient treatments that allow routine clinical use of the system. Methods and materials Initially, a cubic phantom containing silver halide film was exposed to the entire treatment before patient treatment. The processed films were digitized with a laser densitometer and the dose distributions were compared with that generated by the planning system. Later, software that calculates the dose delivered to any phantom employing the intensity patterns developed in the inverse planning system for an individual patient was implemented for point checks of dose. A measurement phantom for use with this software was developed and evaluated on a large number of patients. Invasive fixation was used for all cranial patients initially. To use sequential tomotherapy for other sites and larger targets, noninvasive immobilization systems using two types of thermoplastic masks for cranial targets and reusable, evacuated body cradles were evaluated for positional accuracy and suitability for use with port films for patient QA. Results The program for equipment validation is divided into daily, weekly, and monthly programs that add only small amounts of time to routine QA programs. For the first 15 patients treated with this modality, the maximum dose measured on the film was within 5% of that predicted by the planning computer. The prescription isodose line was measured in the anteroposterior and lateral dimensions and the average discrepancy between measured and predicted was less than 2 mm. For an isodose line between 50% and 70% of the prescribed dose, the agreement was better than 3 mm. Success with the volume QA program was followed by a point check QA program that reduced the time required for individual patient QA from days to hours. Phantom measurements compared with computer predictions for 588 data points resulted in only 8% being outside a ±5% criterion. These cases were identified and allow a further reduction in the frequency of tests. Thermoplastic mask materials have adequate restraint characteristics for use with the system and port films on 21 patients resulted in one standard deviation = 1.3 mm. Body cradles are less accurate and require more frequent port films. A QA system that reduces the frequency of port films was developed. Conclusion The evolution of sequential tomotherapy in our department has been from a maximum of 3 cranial patients per day with invasive fixation to 60 patients per day for treatment of cranial, head-and-neck, and prostate tumors using different immobilization techniques. With proper preparation and refinement of tools used in commissioning and validation, sequential tomotherapy IMRT can become a routine clinical treatment modality.