Rigid Application Research Articles

Ductility and Toughness Improvement of Injection-Molded Compostable Pieces of Polylactide by Melt Blending with Poly(ε-caprolactone) and Thermoplastic Starch.

The present study describes the preparation and characterization of binary and ternary blends based on polylactide (PLA) with poly(ε-caprolactone) (PCL) and thermoplastic starch (TPS) to develop fully compostable plastics with improved ductility and toughness. To this end, PLA was first melt-mixed in a co-rotating twin-screw extruder with up to 40 wt % of different PCL and TPS combinations and then shaped into pieces by injection molding. The mechanical, thermal, and thermomechanical properties of the resultant binary and ternary blend pieces were analyzed and related to their composition. Although the biopolymer blends were immiscible, the addition of both PCL and TPS remarkably increased the flexibility and impact strength of PLA while it slightly reduced its mechanical strength. The most balanced mechanical performance was achieved for the ternary blend pieces that combined high PCL contents with low amounts of TPS, suggesting a main phase change from PLA/TPS (comparatively rigid) to PLA/PCL (comparatively flexible). The PLA-based blends presented an “island-and-sea” morphology in which the TPS phase contributed to the fine dispersion of PCL as micro-sized spherical domains that acted as a rubber-like phase with the capacity to improve toughness. In addition, the here-prepared ternary blend pieces presented slightly higher thermal stability and lower thermomechanical stiffness than the neat PLA pieces. Finally, all biopolymer pieces fully disintegrated in a controlled compost soil after 28 days. Therefore, the inherently low ductility and toughness of PLA can be successfully improved by melt blending with PCL and TPS, resulting in compostable plastic materials with a great potential in, for instance, rigid packaging applications.

Intrapatient Dosimetric Variability Between Two Adjustable Brachytherapy Applicators for Cervical Cancer: Tandem/Ovoid vs. Tandem/Split-Ring

The choice of intracavitary applicator for high-dose rate brachytherapy for cervical cancer has dosimetric implications for target coverage as well as toxicity. Prior analyses have compared rigid (tandem/ring) and adjustable applicators, however there is a deficiency of data clarifying the differences and indications among tandem/ovoid (TO) and the increasingly-used tandem/split-ring (TSR) applicator. To our knowledge, our institution is the first to analyze intrapatient spatial and dosimetric variability between adjustable TO and TSR applicators. Between 2010 and 2017, 108 patients with cervical cancer were treated with a brachytherapy boost (median 28 Gy in 4 fractions) with two insertions under general anesthesia one week apart, after pelvic external beam radiotherapy to 45-50.4 Gy. Sixteen of these patients were treated with both TO and TSR applicators. CT-based high-risk CTVs were delineated according to GEC-ESTRO guidelines. Doses to ICRU points A, B, P, organs at risk (OAR) including bladder, rectum, vagina, and D2cc of OAR were compared. Spatial characteristics of the 100% isodose distribution and physical geometry of the applicators were analyzed as well (craniocaudal, anterior-posterior, and horizontal left-right dimensions). Target coverage was evaluated by comparing the CTV volume, D90 (Gy) and V100 (%) between insertions. Paired two-tailed T-tests were used, and significance was assessed at p<0.05. Across the 32 insertions studied, there were no statistically significant differences in CTV volume, D90, V100, or dose to points A, B, P, rectum and bladder between the two applicators. TO applicators had a significantly lower dose delivered to the left and right vaginal mucosae than TSR applicators (left mean 8.1 vs. 13.3 Gy, p<0.01; right mean 7.67 vs. 12.5 Gy, p<0.01). TO applicators also yielded a larger maximum craniocaudal dimension of the 100% isodose distribution (mean 8.2 vs. 6.8cm, p<0.01). TSR applicators, however, yielded a wider horizontal max dimension of the 100% isodose distribution (mean 7.8 vs. 6.7cm, p<0.01) and a correspondingly wider horizontal colpostat separation (mean 5.4 vs. 3.7 cm, p<0.01). Because this analysis evaluates both TO and TSR applicators in the same patients, it provides the unique advantage of contrasting dosimetry and target coverage while controlling for tumor and pelvic anatomy. Our study demonstrates that TO applicators consistently yield lower vaginal mucosal doses compared to TSR, likely reflective of the generally larger ovoid caps, without significantly different dose to the rectum or bladder. Although tumor coverage was equivalent, differences in dose distribution persist, such as greater horizontal width with TSR and improved craniocaudal coverage with TO, which may guide selection between the two devices.

P185] Comparison of two inverse planing algorithms HIPO and IPSA in terms of their suitability for breast brachytherapy planning

Purpose The aim of the study was to compare two algorithms of inverse brachytherapy planning Hybrid Inverse Planning Optimization (HIPO) and Inverse Planning Simulated Annealing (IPSA) in terms of their suitability for breast brachytherapy planning. The values of dose distribution parameters was evaluated for target volumes and critical organs. Methods The analysis included 40 treatment plans prepared for 20 breast cancer patients treated with brachytherapy boost using rigid interstitial applicators. For each patient CTV and organs at risk were contoured. Next two treatment plans were performed using HIPO and IPSA algorithms, with individual constrains selected to be fully comparable. The source step was set at 3 mm and dwell time gradient restriction (DTGR) at 0.5 level. Obtained treatment plans were not supposed to fulfill clinical criteria, but only to show differences between the analyzed algorithms. The collected data were analyzed statistically using the Wilcoxon test for non-parametric variables. Results For CTV the following average values were obtained: V100 71.26% and 82.35%, V150 13.85% and 19.11% and V200 6.31% and 8.39% for the IPSA and HIPO algorithms respectively. Similarly, COIN and DNR values were higher using the HIPO algorithm and were 0.65 and 0.93 and 0.2 and 0.22. In case of organs at risk, the following values were obtained: for chestwall D1cc 49.60% and 53.80% and D0.1 cc 55.62% and 60.56%, for skin D1cc 41.91% and 54.72% and D0,2 cc 55.66% and 62.1% respectively for IPSA and HIPO algorithms. The mean dose in the lung was also higher for the HIPO algorithm and reached 15.19% and 21.48% respectively. All differences were statistically significant at p Conclusions Presented results indicate the predominance of the IPSA algorithm, especially in the area of lowering doses for critical organs. However the coverage parameter COIN clearly indicates the advantage of the HIPO algorithm. This is directly due to much more uniform dwell times generated by HIPO algorithm. The presented comparison may be used as a valuable hint for choosing the initial optimization method in planning the BT boost for breast cancer patients.

The politics of Estonia’s offshore wind energy programme: Discourse, power and marine spatial planning

There is growing recognition that marine spatial planning is an inherently political process marked by a clash of discourses, power and conflicts of interest. Yet, there are very few attempts to make sense of and explain the political practices of marine spatial planning protests in different contexts, especially the way that planners and developers create the conditions for the articulation of objections, and then develop new strategies to negotiate and mediate community resistance. Using poststructuralist discourse theory, the article analyses the politics of a proposed offshore wind energy project in Estonia within the context of the country’s marine spatial planning processes. First, through the lens of politicization, it explores the strategies of political mobilization and the rival discourses of expertise and sustainability through which residents and municipal actors have contested the offshore wind energy project. Secondly, through the lens of depoliticization, it explains the discursive and legalistic strategies employed by developers, planners and an Administrative Court to displace – spatially and temporally – the core issues of contestation, thus legitimizing the offshore wind energy plan. We argue that the spaces created by the pre-planning conjuncture offered the most conducive conditions for residents to voice concerns about the proposed project in a dialogical fashion, whereas the marine spatial planning and post-planning phases became mired in a therapeutic-style consultation, set alongside rigid and unreflexive interpretations and applications of legality. We conclude by setting out the limits of the Estonian marine spatial planning as a process for resolving conflicts, while offering an alternative model of handling such public controversies, which we call pragmatic adversarialism.

Using normalisation process theory to understand barriers and facilitators to implementing mindfulness-based stress reduction for people with multiple sclerosis.

Objectives To study barriers and facilitators to implementation of mindfulness-based stress reduction for people with multiple sclerosis. Methods Qualitative interviews were used to explore barriers and facilitators to implementation of mindfulness-based stress reduction, including 33 people with multiple sclerosis, 6 multiple sclerosis clinicians and 2 course instructors. Normalisation process theory provided the underpinning conceptual framework. Data were analysed deductively using normalisation process theory constructs (coherence, cognitive participation, collective action and reflexive monitoring). Results Key barriers included mismatched stakeholder expectations, lack of knowledge about mindfulness-based stress reduction, high levels of comorbidity and disability and skepticism about embedding mindfulness-based stress reduction in routine multiple sclerosis care. Facilitators to implementation included introducing a pre-course orientation session; adaptations to mindfulness-based stress reduction to accommodate comorbidity and disability and participants suggested smaller, shorter classes, shortened practices, exclusion of mindful-walking and more time with peers. Post-mindfulness-based stress reduction booster sessions may be required, and objective and subjective reports of benefit would increase clinician confidence in mindfulness-based stress reduction. Discussion Multiple sclerosis patients and clinicians know little about mindfulness-based stress reduction. Mismatched expectations are a barrier to participation, as is rigid application of mindfulness-based stress reduction in the context of disability. Course adaptations in response to patient needs would facilitate uptake and utilisation. Rendering access to mindfulness-based stress reduction rapid and flexible could facilitate implementation. Embedded outcome assessment is desirable.

Fiscal Rules and Structural Reforms

Implementation of fiscal surveillance rules relies heavily on the proper interpretation of legal terms, creating a need to infuse economic insight into legal analysis. Rigid legal application of fiscal deficit rules may curtail structural reforms, as reforms can go against fiscal consolidation in the short run. However, if reforms are expected to improve public finances in the long run, they should not be viewed as incompatible with the legal framework. Focussing on the case of EU fiscal surveillance, this paper identifies the circumstances under which the positive budgetary long-term effect of structural reforms materialize in such a way that the legal rules should be applied with a degree of leniency, allowing for a short-term deterioration of the fiscal position. To that end, we quantify the short-run fiscal costs and long-run fiscal benefits of reforms, and investigate how the design of reforms can affect this trade-off. Results suggest that as short run output losses of reforms are alleviated by fiscal stimulus, long run output gains from the reforms imply that fiscal viability can be reached within a reasonable period of time. Product market reforms are generally preferable over labour market reforms, as they have a larger impact on fiscal revenues. These insights inform the legal analysis in several regards. First, the economic analysis is in line with teleological interpretation of legal rules aimed at ensuring long-term fiscal stability, while allowing short-term fiscal leniency. Second, the economic analysis can give contours to vague legal terms, such as prompt positive budgetary effects and the legal requirement of major structural reforms, showing that the type of reform matters as much as the size of the reform, and that while larger reforms have larger long run budgetary effects, they also require greater leniency in the short run. More generally, our analysis calls for the design and interpretation of legal fiscal regimes with reference to the interdependency between fiscal policy and structural economic policies.

In situ immobilization of commercial lipase in rigid polyurethane foam and application in the esterification of geraniol and oleic acid

The aim of this work was to evaluate the immobilization of Candida antarcticalipase B (CalB) using polyurethane (PU) foam. The stability of the enzymatic derivative against temperature (40, 60 and 80 °C) together with the recycle capacity and storage stability (4 and 25°C) were evaluated. The application of the enzymatic derivative of CalB in esterification reactions was accomplished. Results indicated that the molar ratio between polyol and isocyanate monomers of 5:3 (v/v) was the best one for the immobilization. The immobilization process resulted in a 1363% increase in activity for the enzymatic derivative. The enzymatic derivative obtained kept its initial activity even after 21 h of exposure to high temperatures. The enzymatic activity of the complex was maintained during 30 days at low temperatures, and showed stability during 4 consecutive reuse cycles. The synthesis of geranyl oleate catalyzed by the immobilized derivative presented conversion of 87%. Taking into account the promising results obtained, the low cost of the immobilization support employed and the whole technique developed, this work comprise an innovative contribution.

Survey on Vertical Agreements in 2017 – Is the Rigid Application of Competition Law to Distribution Agreements Going to Kill the Buyer–Reseller Model?*

Distribution agreements constitute one of the principal areas of application of competition law.1 As vertical agreements between businesses, they may be subject to the law on restrictive agreements where their object or effect is to restrict competition or the rules on abuse of dominant position – if the supplier is in such a position and its conduct is abusive.2 The competition authorities can even sanction the same conduct under both the law on restrictive agreements and abuse of dominant position.3 Exceptionally, a distribution agreement can also fall within the scope of merger control.4 In addition to those three basic precepts which are common to EU competition law and the laws of the Member States – referred to in France as ‘grand’ droit de la concurrence – exist a profusion of exclusively domestic competition law rules in the broader sense which apply to distribution agreements, specifically national laws pertaining to abuses of dependence and restrictive practices (‘petit’ droit de la concurrence).5

Spatial and Dosimetric Comparison of Tandem/Ring Applicator Against Adjustable Tandem/Ovoid and Tandem/Split-Ring for Intracavitary Brachytherapy Treatment of Cervical Cancer

There is limited clinical guidance for the selection of a tandem and ring (TR) applicator versus the tandem and ovoid (TO), and tandem and split-ring (TSR) applicators during intracavitary brachytherapy treatment of cervical cancer. We evaluated the geometric configuration and dosimetric coverage for cases treated with tandem and ring, a rigid applicator system, as compared with TSR and TO, which utilize adjustable colpostats. 12 patients with FIGO stage IB-IIIB cervical cancer between 2010 and 2016 received external beam therapy to pelvis of 45 Gy followed by two intraoperative insertions, totaling 4 fractions of 7 Gy each. All patients received an HDR brachytherapy boost using the TR for one insertion and either the TSR or TO for the second insertion. All patient data was de-identified in accordance with institutional IRB requirements to evaluate the geometric and dosimetric impact of applicator type. Geometric analysis of the applicator included measurement of the horizontal max dimension in the transverse plane (X) and colpostat build-up cap dimension (c). Dosimetric analysis of ICRU points A, bladder, rectum and vagina and coverage of the CTV were evaluated for both applicator insertions. Standard two-tailed T-Test was used to assess the relationship between applicator types regarding geometric parameters and dosimetric values. Significance was assessed at p<0.05. We included 12 patients with 24 insertions in our analysis, 9 had TR and TSR insertions and 3 received TR and TO insertions. The fixed applicator (TR) had significantly smaller measured X and c dimensions than the adjustable applicators (TO and TSR) (p<0.001). The absolute dose per fraction to the left and right vagina was significantly greater in plans utilizing the fixed applicators versus the adjustable applicators (p<0.01). There were no other statistically significant differences in ICRU reference points or dosimetric volumes between plans utilizing fixed versus adjustable applicators (p=NS).Abstract 2743; Table 1Mean metrics (N=12)ApplicatorX (cm)c (mm)CTV Vol (cm3)CTV V95 (%)ICRUA point R (Gy)A point L (Gy)Bladder (Gy)Rectum (Gy)Vagina R (Gy)Vagina L (Gy)TR (N=12)3.24.946.792.86.36.35.84.217.317.7TSR (N=9)5.06.751.893.46.56.76.34.511.912.6TO (N=3)3.514.037.297.35.95.97.14.66.56.9TR (Fixed) vs TSR and TO Combined (Adjustable)Paired T-test (P value)0.00010.0050.570.850.830.630.320.480.0030.001 Open table in a new tab Geometric design of the TSR and TO applicator allow for greater transverse displacement of the colpostasts as compared to the fixed TR applicator, however, this did not translate into differences in the dosimetric coverage of the CTV or organs at risk. However the TR applicator is limited to a small buildup cap size which is associated with increased vaginal doses as compared to TSR and TO applicator systems.

Challenges faced by franchise entrepreneurs operating in a volatile business environment: a case of the fast food industry in Harare, Zimbabwe

Franchising plays a pivotal role in sustainable economic development through employment creation, improving the standards of living and increasing the growth of entrepreneurship worldwide. However, the volatile business environment in Zimbabwe has a negative impact on the growth of franchising in the fast food industry. The aim of the study was to uncover the challenges of franchising in a volatile business environment in Zimbabwe. The study focused on an under studied area of franchising in the fast food industry of Zimbabwe. The study is important, as franchising can be used as a tool for economic growth and the study breaks a new ground, as no similar studies have been conducted to identify the challenges faced by franchise entrepreneurs in a volatile business environment. Ten qualitative interviews were successfully conducted with franchise entrepreneurs using face to face semi structured interviews as data collection method and thematic coding was used to analyze the collected data. The findings of the study indicate that franchise entrepreneurs face difficulties in obtaining operating licences from the Harare’s City Municipal Authorities and registering their businesses. Electricity power cuts severely affect the operations of fast food businesses. The majority of the entrepreneurs do not have adequate capital to expand and grow their businesses and they fail to meet lending requirements from the financial institutions, top-most among them being the provision of collateral security accompanied by rigid application procedures for funding. Recommendations made include that the government must play an active role in promoting franchising by setting up a vibrant franchise board and speeding up the business registration process.

How should we (not) judge the ‘quality’ of qualitative research? A re-assessment of current evaluative criteria in International Business

In this paper, we initiate a debate about evaluative criteria (such as validity) which are – or should be – in use to assess the quality of qualitative manuscripts in International Business (IB). We identify three generations of evaluative criteria, each derived from different philosophical orientations. Based on an analysis of published articles in two IB journals, expert interviews and sample reviews, we show how these generations shape what the scholarly community considers to be “good” qualitative research. As an alternative to rigid application of a single set of quality procedures, we advocate a pluralist, contextual approach, reflecting the inherent characteristics of IB as a field.

BLASKI I CIENIE BADAŃ POSTKOLONIALNYCH NAD POLSKĄ LITERATURĄ ROMANTYCZNĄ

This paper aims at a synthetic presentation of four representative research practices in the first stage of postcolonial studies concerned with Polish literature of the Romantic period. This is currently one of the key tools utilised in the studies of Polish Romanticism, which proved to offer a considerable scope for revisions, especially with regard to the myth of the Borderlands and Messianism, thus enabling major Romantic ideologies and myths to be redefined in terms of identity. An analysis of research discourses reveals the shortcomings and benefits of the postcolonial method when employed in the studies of Polish Romanticism. On the one hand, an all too rigid application of the tools has led to certain interpretive simplifications of Romantic texts, while on the other the authors of the discussed works were able to conceptualize the identities of Polish Romantic literature anew.

Toric chordality

We study the geometric change of Chow cohomology classes in projective toric varieties under the Weil–McMullen dual of the intersection product with a Lefschetz element. Based on this, we introduce toric chordality, a generalization of graph chordality to higher skeleta of simplicial complexes with a coordinatization over characteristic 0, leading us to a far-reaching generalization of Kalai's work on applications of rigidity of frameworks to polytope theory. In contrast to “homological” chordality, the notion that is usually studied as a higher-dimensional analogue of graph chordality, we will show that toric chordality has several advantageous properties and applications.∘Most strikingly, we will see that toric chordality allows us to introduce a higher version of Dirac's propagation principle.∘Aside from the propagation theorem, we also study the interplay with the geometric properties of the simplicial chain complex of the underlying simplicial complex, culminating in a quantified version of the Stanley–Murai–Nevo generalized lower bound theorem.∘Finally, we apply our technique to give a simple proof of the generalized lower bound theorem in polytope theory and∘prove the balanced generalized lower bound conjecture of Klee and Novik.

Treatment of traumatic sternal fractures with titanium plate internal fixation: a retrospective study

BackgroundThis study aim to evaluate surgical procedures for titanium plate internal fixation of sternal fractures with displacement or nonunion.MethodsFrom January 2010 to December 2014, 64 patients with sternal fractures were treated with titanium plate internal fixation in the thoracic surgery department of the Shanghai Sixth People’s Hospital. Pain severity scale scores were analyzed preoperatively and postoperatively. All the patients had a 2-month follow-up for treatment evaluation.ResultsThe mean hospital length of stay was 16.89 days. Forty-five patients underwent surgery for combined injuries. A statistically significant difference (P < 0.05) was found between preoperative and postoperative pain severity scores (7.74 ± 0.89 vs. 3.80 ± 0.79, respectively). At follow-up, healing of the nonunion or fracture was confirmed in all the cases.ConclusionThe rigid titanium plate application ensured a safe and easy management of traumatic sternal fractures and nonunion with a good prognosis as compared with other methods.

Glycidyl methacrylate-compatibilized poly(lactic acid)/hemp hurd biocomposites: Processing, crystallization, and thermo-mechanical response

Poly(lactic acid)-based biocomposites were developed with hemp hurd (Cannabis sativa L.) with grafting-based interfacial compatibilization. Poly(lactic acid) was extruded with hemp hurd and glycidyl methacrylate as the polymer/hurd interfacial compatibilizer, and injection molded. Interfacial compatibility between poly(lactic acid) and hemp hurd increased with grafted glycidyl methacrylate in comparison to the non-compatibilized control, as corroborated by scanning electron microscopy fractography and mechanical analysis, which showed increases in the glycidyl methacrylate-grafted 20% (w/w) hemp hurd/poly(lactic acid) biocomposite, retaining 94% of the neat polymer strength, with increases in crystallinity, and showing a range of thermo-mechanical properties desirable for rigid biocomposite applications.

Under Pressure: The Utility of Spacers in Univalved Fiberglass Casts.

Univalving fiberglass casts after fracture manipulation or extremity surgery reduces the risk of developing compartment syndrome (CS). Previous experiments have demonstrated that univalving decreases intracompartmental pressures (ICPs), but increases the risk for loss of fracture reduction due to altering the mechanical properties of the cast. The purpose of this study was to correlate cast valve width within a univalved cast model to decreasing ICP. Saline bags (1 L) were covered with stockinette, Webril, and fiberglass tape then connected to an arterial pressure line monitor. Resting pressure was recorded. A water column was added to simulate 2 groups (n=5 each) of clinical CS: low pressure CS (LPCS range, 28 to 31 mm Hg) and high pressure CS (HPCS, range, 64 to 68 mm Hg). After the designated pressure was reached, the fiberglass was cut (stockinette and Webril remained intact). Cast spacers were inserted into each univalve and secured with varying widths: position #1 (3 mm wide), #2 (6 mm), #3 (9 mm), and #4 (12 mm). Pressure was recorded after cutting the fiberglass and following each spacer placement. In LPCS and HPCS groups, after univalve and placement of spacer position #1, pressure dropped by a mean of 52% and 58%, respectively. Spacer #2, decreased the pressure by a mean of 78% and 80%, respectively. Both spacer sizes significantly decreased the underlying pressure in both groups. Spacer #3 and #4 progressively reduced pressure within the cast, but not statistically significantly more than the previous spacer widths. This experimental model replicates the iatrogenic elevation in interstitial compartment pressure due to rigid cast application, not necessarily a self-sustained true CS. Increasing the univalved cast spread by ≥9 mm of the initial cast diameter will reduce pressure to a pre-CS level; however, a spread of only 6 mm can effectively reduce the pressure to <30 mm Hg depending on the initial elevated ICP. Cutting the Webril and stockinette in our model yielded a pressure decrease of 91% and 94% from the starting experimental pressure in the LPCS and the HPCS groups, respectively. Although the utility of splitting fiberglass casts has been previously demonstrated, we present evidence highlighting the benefit of spacing the split by at least 6 to 9 mm.

Effects of the Non-linear Stress-Strain Behavior of RAP Concrete on Structural Responses for Rigid Pavement Application

Effects of the Non-linear Stress-Strain Behavior of RAP Concrete on Structural Responses for Rigid Pavement Application

Materials for next-generation molecularly selective synthetic membranes.

Materials research is key to enable synthetic membranes for large-scale, energy-efficient molecular separations. Materials with rigid, engineered pore structures add an additional degree of freedom to create advanced membranes by providing entropically moderated selectivities. Scalability - the capability to efficiently and economically pack membranes into practical modules - is a critical yet often neglected factor to take into account for membrane materials screening. In this Progress Article, we highlight continuing developments and identify future opportunities in scalable membrane materials based on these rigid features, for both gas and liquid phase applications. These advanced materials open the door to a new generation of membrane processes beyond existing materials and approaches.

Toward mindfulness in quality-of-life research: perspectives on how to avoid rigor becoming rigidity

BackgroundThe field of quality-of-life (QOL) research has matured into a discipline with scientific rigor, sophisticated methods, and guidelines. While this maturation is laudable and needed, it can result in a limiting rigidity. We aim to highlight examples of practices that are based on shared research values and principles that, when dogmatically applied, may limit the potential impact of QOL research.MethodsBy juxtaposing rigorous standards with their rigid application for different stages of the research cycle, we suggest more balanced approaches.ResultsRigidity in cultivating a research question relates to constraining our thinking, leading to ‘safe’ research focusing on small variations of similar studies. Rigidity in operationalizing key constructs focuses on problems with validation practices that hinder further innovations, the use of static questionnaires when a more flexible approach is needed, dismissing rarely endorsed items that are clinically relevant, use of insensitive generic measures when specific measures are required, and a rigid emphasis on short questionnaires. Rigidity in data analysis relates to an undue emphasis on delineating primary and secondary outcomes and an unquestioned insistence on reducing Type 1 errors regardless of the research context. Rigidity in research infrastructure focuses on the unquestioned validity of patient input on scientific matters, and increasingly rigid guidelines and checklists that end up driving grant applications.DiscussionIt is hoped that this overview will lead to a reconsideration of a more flexible application of research principles while retaining scientific rigor.

A method to incorporate interstitial components into the TPS gynecologic rigid applicator library.

PurposeT2 magnetic resonance imaging (MRI) is recommended as the imaging modality for image-guided brachytherapy. In locally advanced cervical carcinoma, combined endocavitary and interstitial applicators are appropriate (Vienna or Utrecht). To cover extensive disease, Template Benidorm (TB) was developed. Treatment planning system applicator libraries are currently unavailable for the Utrecht applicator or the TB. The purpose of this work is to develop an applicator library for both applicators.Material and methodsThe library developed in this work has been used in the Oncentra Brachytherapy TPS, version 4.3.0, which has a brachytherapy module that includes a library of rigid applicators. To add the needles of the Utrecht applicator and to model the TB, we used FreeCAD and MeshLab. The reconstruction process was based on the points that the rigid section and the interstitial part have in common. This, together with the free length, allowed us to ascertain the position of the tip.ResultsIn case of the Utrecht applicator, one of the sources of uncertainty in the reconstruction was determining the distance of the tip of needle from the ovoid. In case of the TB, the large number of needles involved made their identification time consuming. The developed library resolved both issues.ConclusionsThe developed library for the Utrecht and TB is feasible and efficient improving accuracy. It allows all the required treatment planning to proceed using just a T2 MRI sequence. The additional use of specific free available software applications makes it possible to add this information to the already existing library of the Oncentra Brachytherapy TPS. Specific details not included on this manuscript will be available under request. This library is also currently being implemented also into the Sagiplan v 2.0 TPS.