Software Options Research Articles

Alveolar bone density and its clinical implication in the placement of dental implants and orthodontic mini-implants.

Objectives:To assess the bone density in maxilla and mandible in dentate and edentulous patients in Saudi population.Methods:This study involved a retrospective analysis of cone beam CT images of 100 patients (50 male and 50 female) who have come to College of Dentistry, University of Dammam, Dammam, Kingdom of Saudi Arabia between January 2014 and 2015. Using the bone density option in the Simplant software, the Hounsfield unit (HU) was calculated at the edentulous sites. While for dentate sites, a region of interest was selected coronally at 3-5 mm to the root apex using I-CAT vision software. The densities of the buccal bone and cancellous bone were measured at interradicular areas of a specific teeth.Results:The highest bone density at the edentulous sites was at the mandibular anterior region (776.5 ± 65.7 HU), followed by the mandibular posterior region (502.2 ± 224.2 HU). Regarding the dentate sites, the highest bone density was at the buccal cortical plate of the lower incisor teeth (937.56 ± 176.92 HU) and the lowest bone density was at the cancellous bone around the posterior maxillary teeth (247.12 ± 46.75 HU).Conclusion:The alveolar bone density at dentate and edentulous sites in our population is generally lower than the norm reference density of other populations, which dictates the need for quantitative assessment of bone density before implants and mini-implants placement.

Подготовка данных для многофакторного анализа в медицине и биологии с помощью алгебраической модели конструктивной логики

An algebraic model of constructive logic is intended to build multivariate non-linear logical mathematical model and is widely used in analytical studies in medicine and biology. An important stage of its construction is the data preparation in accordance with the following requirements:
 ▪ The optimal choice of the analyzed factors with the following features: the pursuit of the researcher to involve the largest possible number of factors is a common mistake; factors must be independent; it is advisable to select only those factors that meet the research objectives; the ability of the algorithm to exclude certain fac-tors from the resulting mathematical model, it is observed, when the array of data input is sufficiently complete; the ability to use both continuous variables and discrete; the mathematical model is a more compact, if less factors are used, this model is easier to analyze and identify the characteristics of the test process.
 ▪ Verification of the data is the identification and correction of errors at the stage of entering the informa-tion into the database; using the built-in intelligent tools that facilitate the process of correct coding of medical information; additional data verification by using special techniques, such as the analytical testing method in the database records.
 ▪ Selecting of objective study with the following features: the goal can be represented not only two dis-crete (the goal is achieved or not achieved), but also a large number of them; the more discrete, the amount of base should be larger; possibility to use calculated target value by using various criteria.
 ▪ Presence of the necessary number of entries for a full analysis, it is necessary to ensure compliance with each of the target case (corresponding to the goal) at least two cases of non-target (not corresponding to the goal).
 ▪ Choice of software options is adequate available data.
 These requirements will allow to performing the analytical studies in accordance with the required relia-bility.

Radiation Dose to the Vaginal Vault During Brachytherapy-Early Experience and an Audit

Radiation Dose to the Vaginal Vault During Brachytherapy-Early Experience and an Audit

Solution of integration tasks in enterprise management information systems

Valerij Yu. Vahrushev - Dean, Faculty of Automation and Computing Machines, Vyatka State University Address: 36, Moskovskaya Street, Kirov, 610000, Russian FederationE-mail: vahrushev@vyatsu.ruElena V. Bogomolova - Leading Programming Engineer, LEPSE Company; Post-graduate, Department of Automatics and Telemechanics, Vyatka State University Address: 36, Moskovskaya Street, Kirov, 610000, Russian FederationE-mail: elenaoops@mail.ruAnna M. Lanskih - Associate Professor, Department of Automatics and Telemechanics, Vyatka State University Address: 36, Moskovskaya Street, Kirov, 610000, Russian FederationE-mail: usr00221@vyatsu.ruYurij V. Lanskih - Associate Professor, Department of Automatics and Telemechanics, Vyatka State University Address: 36, Moskovskaya Street, Kirov, 610000, Russian FederationE-mail: lyuv@inbox.ruAndrej V. Luppov - Associate Professor, Department of Automatics and Telemechanics, Vyatka State University Address: 36, Moskovskaya Street, Kirov, 610000, Russian FederationE-mail: dei123@mail.ruAnna V. Malysheva - Lecturer, Department of Automatics and Telemechanics, Vyatka State University Address: 36, Moskovskaya Street, Kirov, 610000, Russian FederationE-mail: annyml@mail.ruNatalya A. Shmakova - Senior Lecturer, Department of Automatics and Telemechanics, Vyatka State University Address: 36, Moskovskaya Street, Kirov, 610000, Russian FederationE-mail: shmakova.natalya@mail.ru The authors consider the problems of constructing systems of accounting, management and analysis of a company. One of the most cost-effective ways to build such systems is the integration of legacy, acquired and developed components on a middleware base, which can be characterized as a technological platform for integration. Consideration is given to the formalization of principles for creation of such platform software. These principles are formed similarly to the principles of forming a microprogram processor control unit. We are shown how to develop a software platform that makes it possible to organize the launch of procedures for processing, visualization, data exchange by a schedule or by user request, using the microprogram processor control unit as a formal model. The totality of the information and software that acts as a platform is decomposed into instructions memory, metacommand memory, the instruction memory controller and metacommand memory controller. A document management system is considered as one of the options of platform software. The electronic document management system for the exchange of information is protected by digital signature. It facilitates integration between information subsystems of reference, accounting and other purposes. This practice is called EDMS-bus. Within the theoretical formulation of the problem the authors considered the informational domain model as a set of business processes performed in it. The automation of activity in the subject field amounts to forming a set of automated business processes, whose power is determined by the functionality of the implemented information system, and which cover to the maximum extent a set of business processes of the subject area. Examination is made of cases of overlapping sets of legacy information systems business processes and of implemented information systems business processes.

Next generation sequencing for whole genome analysis and surveillance of influenza A viruses

BackgroundThe Wadsworth Center, New York State Department of Health (NYSDOH), conducts routine diagnosis and surveillance of influenza viruses. Whole genome sequencing (WGS) with next generation sequencing (NGS) was initiated to provide more rapid, detailed, thorough, and accurate analysis. ObjectivesTo optimize and implement a method for routine WGS of influenza A viruses. To use WGS to monitor influenza A viruses for reassortment, mutations associated with antiviral resistance and antigenicity changes, as well as those potentially affecting virulence and tropism. Study designMultiple extraction and amplification methods were investigated and optimized for the production of template to be used for NGS. Additionally, software options were considered for data analysis. Initial WGS influenza projects have included the comparison of mixed population sequence data obtained with NGS, Sanger dideoxy sequencing, and pyrosequencing, the comparison of sequences obtained from paired primary/cultured samples, the analysis of sequence changes over several influenza seasons, and phylogenetic analysis. ResultsProcedures were optimized for extraction and amplification such that WGS could be successfully performed on both cultured isolates and primary specimens. Data is presented on 15 A/H1pdm09 and 44 A/H3N2 samples. Analysis of influenza A viruses identified and confirmed variant and mixed populations affecting antigenicity and antiviral susceptibility in both primary specimens and cultured isolates. ConclusionsAn influenza A whole genome PCR method has been optimized for the reliable production of template for NGS. The WGS method has been successfully implemented for enhanced comprehensive surveillance and the generation of detailed clinical data on drug resistance and virulence. Data obtained with this method will also aid in future vaccine selection.

Energy conscious deterministic self-healing new generation wireless sensor network: smart WSN using the Aatral framework

It is expected that in the next year, over a billion wireless sensor network (WSN) nodes will be deployed throughout the world, constituting a wide variety of sensor applications. In such a domain, management of the randomly distributed sensor networks is complicated by issues such as knowledge of energy consumption and coverage, extended lifetimes and demands for improved quality of service parameters. Several researchers have addressed these issues through their own innovations and discoveries of different schemes, methods, techniques or mathematical models and architectures or applications, using a variety of node designs. This in turn, has lead to multiple different choices of hardware and software options. However, this has not simplified the process of setting up application testbeds considering energy consumption. There is no readily available solution for setting up a WSN with user selected profiles and parameters. Multiple communication protocols, routing protocols, signal calibration and propagation methods, data aggregation schemes, clustering formations with multiple variations have been proposed for different research objectives. This paper proposes a method for consolidating all the initiatives and integrating these in a service panel framework that helps manage the desired WSN with options to set up an individual WSN profile and supporting the energy engineering processes involved in the WSN.

Bending Process Simulation of a Flat Workpiece with Various Cross-Sectional Mechanical Properties with PAM-STAMP 2G

We have simulated an aluminum workpiece tool bending process with and without consideration of the heat affected zone after laser cutting with PAM-STAMP 2G. To describe the heat affected zone we have used a customized software option for calculating welded materials and dissimilar ones. We have also provided an analysis of the stress-strain state with a different scale of mechanical properties of the material on its “edge” and in the center of the workpiece.

Polymorphic variants in the vitamin D pathway genes and the risk of ovarian cancer among non-carriers of BRCA1/BRCA2 mutations.

Previous studies have produced inconsistent results regarding the contribution of single-nucleotide polymorphisms (SNPs) in the vitamin D receptor (VDR) gene to ovarian cancer (OC) in various ethnicities. Additionally, little has been established with regard to the role of SNPs located in the retinoid X receptor α (RXRA), vitamin D-binding protein [also know as group-specific component (GC)] and VDR genes in non-carriers of the breast cancer 1/2 early onset (BRCA1/BRCA2) gene mutations. All participating individuals in the present study were evaluated for BRCA1 mutations (5382incC, C61G and 4153delA) with HybProbe assays, and for BRCA2 mutation (5946delT) using high-resolution melting (HRM) analysis. The associations of 8 SNPs located in RXRA, GC and VDR were investigated in OC patients without the BRCA1/BRCA2 mutations (n=245) and healthy controls (n=465). Genotyping of RXRA rs10881578 and rs10776909, and GC rs1155563 and rs2298849 SNPs was conducted by HRM analysis, while RXRA rs749759, GC rs7041, VDR BsmI rs1544410 and FokI rs2228570 genotyping was performed by polymerase chain reaction-restriction fragment length polymorphism analysis. In addition, the gene-gene interactions among all tested SNPs were studied using the epistasis option in PLINK software. The lowest P-values of the trend test were identified for VDR rs1544410 and GC rs2298849 as Ptrend=0.012 and Ptrend=0.029, respectively. It was also found that, in the dominant inheritance model, VDR BsmI contributed to an increased risk of OC [odds ratio (OR), 1.570; 95% confidence interval (CI), 1.136-2.171; P=0.006; Pcorr=0.048]. The gene-gene interaction analysis indicated a significant interaction between RXRA rs749759 and VDR FokI rs2228570 (OR for interaction, 1.687; χ2=8.278; asymptotic P-value=0.004; Pcorr=0.032). In conclusion, this study demonstrated that certain VDR and RXRA SNPs may be risk factors for OC in non-carriers of BRCA1/BRCA2 mutations in the Polish population.

Implementing a generic method for bias correction in statistical models using random effects, with spatial and population dynamics examples

Statistical models play an important role in fisheries science when reconciling ecological theory with available data for wild populations or experimental studies. Ecological models increasingly include both fixed and random effects, and are often estimated using maximum likelihood techniques. Quantities of biological or management interest (“derived quantities”) are then often calculated as nonlinear functions of fixed and random effect estimates. However, the conventional “plug-in” estimator for a derived quantity in a maximum likelihood mixed-effects model will be biased whenever the estimator is calculated as a nonlinear function of random effects. We therefore describe and evaluate a new “epsilon” estimator as a generic bias-correction estimator for derived quantities. We use simulated data to compare the epsilon-method with an existing bias-correction algorithm for estimating recruitment in four configurations of an age-structured population dynamics model. This simulation experiment shows that the epsilon-method and the existing bias-correction method perform equally well in data-rich contexts, but the epsilon-method is slightly less biased in data-poor contexts. We then apply the epsilon-method to a spatial regression model when estimating an index of population abundance, and compare results with an alternative bias-correction algorithm that involves Markov-chain Monte Carlo sampling. This example shows that the epsilon-method leads to a biologically significant difference in estimates of average abundance relative to the conventional plug-in estimator, and also gives essentially identical estimates to a sample-based bias-correction estimator. The epsilon-method has been implemented by us as a generic option in the open-source Template Model Builder software, and could be adapted within other mixed-effects modeling tools such as Automatic Differentiation Model Builder for random effects. It therefore has potential to improve estimation performance for mixed-effects models throughout fisheries science.

Software for spatial analysis and visualisation of cluster randomised trials - a review of available tools

In this context we define spatial analysis to mean Statistical Inference which takes into account spatial data, including but not limited to spatial exploratory data analysis. Groups in a Cluster randomised trial (CRT) are often defined geographically, giving spatial structure to the data. Taking account of the spatial aspects in the design and analysis of such a trial is important as it may influence results. In addition, the hierarchical structure imposed by the design should be adjusted for in the analysis. Therefore selecting software for spatial analysis of CRTs necessitates the capacity to accommodate for both spatial and clustering effects. The range of spatial software available is broad in focus and capabilities, with a plethora of options to choose from determining what tool to use is not necessarily straight forward. In the last decade due to rapid development of spatial methods in Statistical packages and the expansion of Statistical toolboxes in Geographical Information Systems there is substantial overlap in abilities. This review provides a comparison of current software options offering spatial analytical and visualisation techniques. First giving a brief account of the numerous cartographic visualisation tools, then focusing on what differentiates the capabilities of the analytical software. In regards to the latter we'll give special attention to multi-level modelling in both a Frequentist and Bayesian framework. Therefore demonstrating the flexibility of the options now available for the Analysis of CRTs taking into account spatial aspects.

Measuring Abdominal Circumference and Skeletal Muscle From a Single Cross-Sectional Computed Tomography Image: A Step-by-Step Guide for Clinicians Using National Institutes of Health ImageJ.

Diagnostic computed tomography (CT) scans provide numerous opportunities for body composition analysis, including quantification of abdominal circumference, abdominal adipose tissues (subcutaneous, visceral, and intermuscular), and skeletal muscle (SM). CT scans are commonly performed for diagnostic purposes in clinical settings, and methods for estimating abdominal circumference and whole-body SM mass from them have been reported. A supine abdominal circumference is a valid measure of waist circumference (WC). The valid correlation between a single cross-sectional CT image (slice) at third lumbar (L3) for abdominal SM and whole-body SM is also well established. Sarcopenia refers to the age-associated decreased in muscle mass and function. A single dimensional definition of sarcopenia using CT images that includes only assessment of low whole-body SM has been validated in clinical populations and significantly associated with negative outcomes. However, despite the availability and precision of SM data from CT scans and the relationship between these measurements and clinical outcomes, they have not become a routine component of clinical nutrition assessment. Lack of time, training, and expense are potential barriers that prevent clinicians from fully embracing this technique. This tutorial presents a systematic, step-by-step guide to quickly quantify abdominal circumference as a proxy for WC and SM using a cross-sectional CT image from a regional diagnostic CT scan for clinical identification of sarcopenia. Multiple software options are available, but this tutorial uses ImageJ, a free public-domain software developed by the National Institutes of Health.

Accommodating taste heterogeneity and desired substitution pattern in exit choices of pedestrian crowd evacuees using a mixed nested logit model

Mixed logit has been recognised and widely practised by researchers as a highly flexible modelling tool that can address the main shortcomings of the standard logit. Despite the potential to be generalised, the random-coefficient modelling has rarely been integrated with more advanced GEV-type models, possibly due to the unavailability of such estimation options in most econometric software. This particular generalisation has been recommended by a number of econometricians for analysing choice problems in which capturing taste variation and specific non-IIA patterns of substitution are both of modeller's concern. This way, the analyst will be able to limit the number of explanatory variables to the ones whose distributions of coefficients offer behavioural interpretations about taste variation, and leave the imposition of the desired substitution pattern to the GEV core.In this paper, we report on a mixed nested logit application aimed at understanding evacuation behaviour of human crowd, particularly the choice of exit. Evacuees' trade-off between contributing factors are elicited through a data set of stated exit choices. We attempt to improve the realism of the choice experiments by conducting face-to-face interviews with pedestrians (respondents) as they exit a building; and designing scenarios that refer to their recent actual choice of exit. The primary analysis strongly suggests the presence of taste heterogeneity as well as the violation of the IIA assumption (i.e. the presence of a particular pattern of correlation between exit utilities). We propose and estimate a mixed nested logit model through which we accommodate these two econometric aspects of the problem in a unified model. Compared to the counterpart mixed multinomial logit model in which the desired substitution pattern is embodied through specification of the explanatory variables, the proposed model reduces the dimension of simulation in the likelihood maximisation procedure, and also yields a slightly better statistical fit.

Linear quantile regression models for longitudinal experiments: an overview

We provide an overview of linear quantile regression models for continuous responses repeatedly measured over time. We distinguish between marginal approaches, that explicitly model the data association structure, and conditional approaches, that consider individual-specific parameters to describe dependence among data and overdispersion. General estimation schemes are discussed and available software options are listed. We also mention methods to deal with non-ignorable missing values, with spatially dependent observations and nonparametric and semiparametric models. The paper is concluded by an overview of open issues in longitudinal quantile regression.

Podcasting and its Apps: Software, Sound, and the Interfaces of Digital Audio

Mobile applications for downloading podcasts to smartphones and tablets, or podcatcher apps, are some of the most plentiful in various digital software application stores (app stores). The software features, interfaces, and options podcatchers make available give digital soundworks new functionality, materiality, visuality, and aurality. By collecting and analyzing some of the most popular podcasting applications, this article surveys the affordances and restrictions promoted by podcatching app interfaces. Our research explores how podcast apps promote new instances of listening, arguing that podcatchers reconfigure relationships between listeners and producers, and are also ultimately people-catchers that attempt to aggregate listeners in a fragmented media environment by increasing sonic interactivity, encouraging ubiquitous listening, curating and packaging podcasts as visual media, and emphasizing social features that allow users to share podcasts with each other.

Medical Virtual Instrumentation for Ambient Assisted Living: Part 1 Concepts

Ambient Assisted Living has become a cost-effective option for coping with the rapid aging of society. Personalized health monitoring is an important aspect of Ambient Assisted Living, and it depends on the availability and use of appropriate medical devices. Medical virtual instruments provide a viable option for such devices. They refer to a hardware/software co-design of medical instruments that provides the dependability of hardware as well as the flexibility of software. In this paper, we discuss the concept of medical virtual instruments and their use as an effective option for Ambient Assisted Living. The discussion covers the enablers of this technology, the main challenges, and the hardware, software and connectivity options for such instruments.

WE-D-204-06: An Open Source ImageJ CatPhan Analysis Tool

Purpose: The CatPhan is a popular QA device for assessing CT image quality. There are a number of software options which perform analysis of the CatPhan. However, there is often little ability for the user to adjust the analysis if it isn't running properly, and these are all expensive options. An open source tool is an effective solution. Methods: To use the software, the user imports the CT as an image sequence in ImageJ. The user then scrolls to the slice with the lateral dots. The user then runs the plugin. If tolerance constraints are not already created, the user is prompted to enter them or to use generic tolerances. Upon completion of the analysis, the plugin calls pdfLaTex to compile the pdf report. There is a csv version of the report as well. A log of the results from all CatPhan scans is kept as a csv file. The user can use this to baseline the machine. Results: The tool is capable of detecting the orientation of the phantom. If the CatPhan was scanned backwards, one can simply flip the stack of images horizontally and proceed with the analysis. The analysis includes Sensitometry (estimating the effective beam energy), HU values and linearity, Low Contrast Visibility (using LDPE & Polystyrene), Contrast Scale, Geometric Accuracy, Slice Thickness Accuracy, Spatial resolution (giving the MTF using the line pairs as well as the point spread function), CNR, Low Contrast Detectability (including the raw data), Uniformity (including the Cupping Effect). Conclusion: This is a robust tool that analyzes more components of the CatPhan than other software options (with the exception of ImageOwl). It produces an elegant pdf and keeps a log of analyses for long-term tracking of the system. Because it is open source, users are able to customize any component of it.

TU-E-BRB-00: Deformable Image Registration: Is It Right for Your Clinic

Deformable image registration (DIR) is developing rapidly and is poised to substantially improve dose fusion accuracy for adaptive and retreatment planning and motion management and PET fusion to enhance contour delineation for treatment planning. However, DIR dose warping accuracy is difficult to quantify, in general, and particularly difficult to do so on a patient-specific basis. As clinical DIR options become more widely available, there is an increased need to understand the implications of incorporating DIR into clinical workflow. Several groups have assessed DIR accuracy in clinically relevant scenarios, but no comprehensive review material is yet available. This session will also discuss aspects of the AAPM Task Group 132 on the Use of Image Registration and Data Fusion Algorithms and Techniques in Radiotherapy Treatment Planning official report, which provides recommendations for DIR clinical use. We will summarize and compare various commercial DIR software options, outline successful clinical techniques, show specific examples with discussion of appropriate and inappropriate applications of DIR, discuss the clinical implications of DIR, provide an overview of current DIR error analysis research, review QA options and research phantom development and present TG-132 recommendations. Learning Objectives: 1. Compare/contrast commercial DIR software and QA options 2. Overview clinical DIR workflow for retreatment 3. To understand uncertainties introduced by DIR 4. Review TG-132 proposed recommendations

TU-E-BRB-01: Overview of DIR Advantages/Challenges and Workflow

Deformable image registration (DIR) is developing rapidly and is poised to substantially improve dose fusion accuracy for adaptive and retreatment planning and motion management and PET fusion to enhance contour delineation for treatment planning. However, DIR dose warping accuracy is difficult to quantify, in general, and particularly difficult to do so on a patient-specific basis. As clinical DIR options become more widely available, there is an increased need to understand the implications of incorporating DIR into clinical workflow. Several groups have assessed DIR accuracy in clinically relevant scenarios, but no comprehensive review material is yet available. This session will also discuss aspects of the AAPM Task Group 132 on the Use of Image Registration and Data Fusion Algorithms and Techniques in Radiotherapy Treatment Planning official report, which provides recommendations for DIR clinical use. We will summarize and compare various commercial DIR software options, outline successful clinical techniques, show specific examples with discussion of appropriate and inappropriate applications of DIR, discuss the clinical implications of DIR, provide an overview of current DIR error analysis research, review QA options and research phantom development and present TG-132 recommendations. Learning Objectives: 1. Compare/contrast commercial DIR software and QA options 2. Overview clinical DIR workflow for retreatment 3. To understand uncertainties introduced by DIR 4. Review TG-132 proposed recommendations

TU-E-BRB-02: DIR QA Options and Research Development

Deformable image registration (DIR) is developing rapidly and is poised to substantially improve dose fusion accuracy for adaptive and retreatment planning and motion management and PET fusion to enhance contour delineation for treatment planning. However, DIR dose warping accuracy is difficult to quantify, in general, and particularly difficult to do so on a patient-specific basis. As clinical DIR options become more widely available, there is an increased need to understand the implications of incorporating DIR into clinical workflow. Several groups have assessed DIR accuracy in clinically relevant scenarios, but no comprehensive review material is yet available. This session will also discuss aspects of the AAPM Task Group 132 on the Use of Image Registration and Data Fusion Algorithms and Techniques in Radiotherapy Treatment Planning official report, which provides recommendations for DIR clinical use. We will summarize and compare various commercial DIR software options, outline successful clinical techniques, show specific examples with discussion of appropriate and inappropriate applications of DIR, discuss the clinical implications of DIR, provide an overview of current DIR error analysis research, review QA options and research phantom development and present TG-132 recommendations. Learning Objectives: 1. Compare/contrast commercial DIR software and QA options 2. Overview clinical DIR workflow for retreatment 3. To understand uncertainties introduced by DIR 4. Review TG-132 proposed recommendations

TU-E-BRB-03: Overview of Proposed TG-132 Recommendations

Deformable image registration (DIR) is developing rapidly and is poised to substantially improve dose fusion accuracy for adaptive and retreatment planning and motion management and PET fusion to enhance contour delineation for treatment planning. However, DIR dose warping accuracy is difficult to quantify, in general, and particularly difficult to do so on a patient-specific basis. As clinical DIR options become more widely available, there is an increased need to understand the implications of incorporating DIR into clinical workflow. Several groups have assessed DIR accuracy in clinically relevant scenarios, but no comprehensive review material is yet available. This session will also discuss aspects of the AAPM Task Group 132 on the Use of Image Registration and Data Fusion Algorithms and Techniques in Radiotherapy Treatment Planning official report, which provides recommendations for DIR clinical use. We will summarize and compare various commercial DIR software options, outline successful clinical techniques, show specific examples with discussion of appropriate and inappropriate applications of DIR, discuss the clinical implications of DIR, provide an overview of current DIR error analysis research, review QA options and research phantom development and present TG-132 recommendations. Learning Objectives: 1.Compare/contrast commercial DIR software and QA options 2.Overview clinical DIR workflow for retreatment 3.To understand uncertainties introduced by DIR 4.Review TG-132 proposed recommendations