Workflow Specification Research Articles

Impact d’un test de diagnostic du coronavirus positif sur le parcours du patient en radiothérapie à l’institut Gustave-Roussy

PurposeThe coronavirus disease 2019 (COVID-19) epidemic continues to spread exponentially around the world. Cancer patients have a higher risk of commorbidity than the rest of the population. Radiotherapy departments are actively involved in the management of these patients, whether they have COVID or not, and it is recognized that the time taken to take charge and the continuity of treatment have a prognostic impact. The main objective was to assess the impact of the coronavirus on the treatment times of patients undergoing radiotherapy. Material and methodsThis retrospective study was conducted in the radiotherapy department of Gustave-Roussy institute (France) during the period from March 3, 2020 to January 12, 2021. Organizational changes, patient care times between the day of the scan and the last radiotherapy session as well as the time taken to take charge of patients between the first session and the last radiotherapy session has been studied. ResultsA total of 1183 patients were included, among which 60 had COVID-19. Patients were divided into four categories. Treatment times of patients who did not have COVID-19 and those of patients who did were not statistically significantly different. ConclusionThe organization of the radiotherapy department at the Gustave-Roussy institute is based on several points: carrying out preventive screening tests, protecting staff and patients and reorganizing the patient circuit. Thanks to the performance of diagnostic tests and the implementation of a specific workflow for patients with COVID, we ensure the continuity of patient treatment in complete safety without impacting treatment times.

Influence of wet compression on aerodynamic performance and stability boundary of transonic compressor

The gas–liquid two-phase flow in a transonic compressor stage, Stage 35, under wet compression was numerically simulated by Computational Fluid Dynamics (CFD) technique along with Euler–Lagrange approach. The evaporation and cooling effect of water droplets on compressor performance and stable flow range was investigated by changing the inlet spraying conditions (droplet sizes and injected water flow rates). Further, the influencing mechanism was explained by the changes of rotor velocity triangle, rotor specific work, blade loading, and tip leakage flow before and after spraying. The results indicate that wet compression can improve the pressure ratio and efficiency of the compressor, but, under different comparison conditions before and after spraying, the influence on compressor power consumption has different trends. Wet compression improves the compressor specific power consumption under constant flow rate conditions, while it reduces compressor specific power consumption under equal pressure ratio conditions. Additionally, the stalling flow rate of compressor increases by wet compression effect, and the increasing degree of stalling flow rate is positively correlated with the increasing level of pressure ratio. The evaporative and cooling effect of droplets reduces the airflow temperature at rotor outlet, leading to the increase of airflow density, the decrease of axial velocity, which results in the promotion of rotor specific work—this is the main reason for the improvement of pressure ratio under constant flow rate conditions. Under wet compression condition, the enhanced blade loading near tip strengthens the tip leakage flow, making the compressor achieve stall criteria at larger flow rate, which is the cause for wet compression influencing the compressor stall boundary.

The Role of Multimodality Imaging in Left-Sided Prosthetic Valve Dysfunction.

Prosthetic valve (PV) dysfunction (PVD) is a complication of mechanical or biological PV. Etiologic mechanisms associated with PVD include fibrotic pannus ingrowth, thrombosis, structural valve degeneration, and endocarditis resulting in different grades of obstruction and/or regurgitation. PVD can be life threatening and often challenging to diagnose due to the similarities between the clinical presentations of different causes. Nevertheless, identifying the cause of PVD is critical to treatment administration (thrombolysis, surgery, or percutaneous procedure). In this report, we review the role of multimodality imaging in the diagnosis of PVD. Specifically, this review discusses the characteristics of advanced imaging modalities underlying the importance of an integrated approach including 2D/3D transthoracic and transesophageal echocardiography, fluoroscopy, and computed tomography. In this scenario, it is critical to understand the strengths and weaknesses of each modality according to the suspected cause of PVD. In conclusion, for patients with suspected or known PVD, this stepwise imaging approach may lead to a simplified, more rapid, accurate and specific workflow and management.

A pragmatic methodical framework for the user-centred development of an electronic process support for the sleep laboratory patients’ management

Limited capacities and ineffective care pathways result in long waiting times for patients and sporadic treatment controls in sleep medicine. As one objective of the 'Telesleep Medicine' project, a portal should be developed, which supports sleep specialists in an efficient and resource-saving patient management. On account of the limited project timeframe, the 'classical' user-centred design and evaluation methods could not be comprehensively implemented. Therefore, a pragmatic methodical framework was developed. For the iterative development of the portal, a combination of low-cost and quick-to-implement methods was used. In chronological order, these were: context interviews, personas, the development of an as-is model, a web search of design standards and good design aspects of similar systems, the development of a to-be model, the creation of an overarching mind map, and the iterative creation of mockups with simplified usability walkthroughs. The feasibility of the pragmatic methodological framework for the development of a prototype for the portal was demonstrated. The used method combination resulted in a prototype based on the needs and requirements of the sleep specialists, taking into account their specific workflow and the technical implementation conditions. The presented pragmatic methodological framework can be a valuable resource for developers of comparable projects. The combination of methods worked well together regarding the limited timeframe and resources for concept development. For the future, we plan to implement and test the portal in the clinical field and thus enrich our framework with additional methods.

Trsper: a web-based application for Archimedes spiral analysis.

We built a web-based application of the Archimedes spiral exam that implements clinically validated spiral metrics and tested drawing instructions to define a clinical workflow. We designed an HTML5 and Javascript implementation of the spiral exam to run on mobile touchscreen devices. We then recruited 10 volunteers each for 2 experiments designed to validate the programmed spiral metrics and assess how instructions or drawing implement affect the results. In task one, volunteers drew 5 spirals each while following 6 different instruction sets (n=30 spirals each, n=300 spirals total) that varied by support of the drawing hand and tracing condition (either tracing a spiral template, drawing in-between it, or freehand). In task two, volunteers drew 5 spirals each while following 2 instruction sets and drawing using a stylus or their dominant index finger (n=20 spirals each, n=200 spirals total). Principal components analysis of calculated metrics revealed that the experiments grouped by instruction set and by subject. Mean Euclidean distance between experiments represented as 11-dimensional vectors revealed that consistency varied among instruction tasks and that drawing with a stylus produced more consistent results than did using the dominant index finger. Using experimental data and simulated abnormal spirals, we designed a decision support system that accurately identifies potentially abnormal spirals. We built and validated a robust digital implementation of the Archimedes spiral exam and recommend a sensitive and specific workflow on the basis of data gathered from healthy volunteers.

ВЕРИФИКАЦИЯ ОШИБОК ДЕНОТАТИВНОЙ И СИГНИФИКАТИВНОЙ СЕМАНТИК В ДИАГРАММНЫХ СПЕЦИФИКАЦИЯХ ПОТОКОВ РАБОТ В АВТОМАТИЗИРОВАННОМ ПРОЕКТИРОВАНИИ

The author describes semantic errors of denotative and significative classes in the diagrammatic specifications of workflows (DWS), and reveals signs of synonymy and antonymy of temporal graphic words, conversivity and nesting of routes in the DWS. The article develops new methods of verification (an analysis with proved properties required) of DWS for errors in synonyms and antonyms of graphic words, conversivity and nesting of routes in the automated design of hardware and software of radio electronics. New methods contribute to the replacement of the designer’s manual labor during the verification of denotative, significative errors in the DWS with a computerized one, thereby reducing the development time of radio electronics hardware and software in computer-aided design and increasing the correctness of the DWS. The results of comparative studies of the DWS verification in the automated design of hardware and software manually and based on the proposed automated methods showed a reduction in the time spent on the DWS verification in the range from 17 minutes to 2 hours and 8 minutes, and also revealed errors in the DWS that were not found during the examination of the DWS by specialists. The proposed method is used at a large radio-electronic design and industrial enterprise JSC ‘Ulyanovsk Mechanical Plant’, Ulyanovsk in the development of hardware and software for the products of the enterprise. The material of this work is related to the author’s publication in the previous issue of the journal «Automation of Management Processes» No. 4 (65) of 2021.

A Security Framework for Scientific Workflow Provenance Access Control Policies

The notion of collaborative scientific workflow is coined to address the increasing need for collaborative data analytics. In collaborative environments, access control policies are necessary for controlling the sharing of workflows, data products, and provenance information among collaborating parties. In particular, the protection of workflow provenance is critical because it often encodes the detailed protocol of a scientific experiment and carries the intellectual property of the respective stakeholders. In addition, since scientific workflows often evolve quickly, the corresponding access control policies for workflow provenance have to evolve as well. It is important to ensure that the evolution of workflow provenance access control policies maintain certain properties, in order to guarantee the correctness and performance of the corresponding policy enforcement. In this paper, we 1) propose a role-based access control model for scientific workflow provenance; 2) define three quality requirements for scientific workflow provenance access control policies - consistency, completeness, and conciseness; 3) develop a mechanism mapping from specifications of workflows to their counterparts in a provenance that preserves such quality properties, and 4) conduct a case study on a scientific workflow for autism behavioral data analysis that demonstrates the feasibility of our proposed analysis algorithms.

Analysis of technical development of small-sized loaders with on-board swing system

Due to the spread of small-sized loaders with on-board swing system (SLOS), it has become necessary to determine the level of their technical development. To understand the set task, a review of small-sized loaders, their classifications, performance parameters and implements was made. Modern SLOS manufacturers were analysed; their design features; main operating parameters: engine power, load capacity, speed and vehicle weight. An analysis of recent papers describing SLOS performance was conducted. It should be noted that most of them consider specific workflow processes, design features that do not reflect the full range of such machines. To solve this problem, a statistical analysis of theSLOS nomenclature data was performed depending on the classification features and performance indicators. This article presents the assessment of the impact of SLOS performance parameters and classification features on their level of technical development. Based on statistical data, the regression equations of the dependences were obtained: engine power on load capacity; loader weight on load capacity; dependences of performane parameters were plotted. General trends in the technical development of small-sized loaders were established. The vast majority of manufacturers focus on the production of medium-capacity loaders, as they are in the greatest demand. The analysis of the graphs suggests that in the future production of small-sized loaders with the load capacity of up to 1.5 tons, engine power of 60-70 kW and weight of up to 5 tons will increase. We can also predict growing production of compact SLOS with the load capacity of up to 0.5 tons, engine power of 20-30 kW and weighing up to 2 tons, which are widely used in urban landscaping. With the help of the present paper we can predict development trends, establish weaknesses of modern SLOSs and avoid competition when designing new loaders.

Design of computer aided translation system for English communication language based on grey clustering evaluation

In order to facilitate communication and communication, this paper studies the optimization of the current computer-aided translation system, and proposed a design method of English communication language computer-aided translation system based on grey clustering evaluation. By optimizing the hardware configuration and algorithm function keys of the system, the English translation mechanism of multilanguage interaction, the design idea of editing and modifying after English translation and knowledge database management are realized, and the system function framework was constructed, including the system transceiver unit, automatic translation unit, manual correction unit, task management unit and memory management unit, the performance of task management unit and memory management unit is analyzed. On this basis, the specific work flow of the design system mainly includes the English translation service flow integrating multilanguage interaction and the project-based multilanguage interaction English translation service flow design, which realizes the English translation online assistance under the multilanguage interaction environment. The experimental results show that the design system has the advantages of high online translation speed, pronunciation success rate and multilanguage translation success rate.

The Collaborative Research Center FONDA

Today’s scientific data analysis very often requires complex Data Analysis Workflows (DAWs) executed over distributed computational infrastructures, e.g., clusters. Much research effort is devoted to the tuning and performance optimization of specific workflows for specific clusters. However, an arguably even more important problem for accelerating research is the reduction of development, adaptation, and maintenance times of DAWs. We describe the design and setup of the Collaborative Research Center (CRC) 1404 “FONDA -– Foundations of Workflows for Large-Scale Scientific Data Analysis”, in which roughly 50 researchers jointly investigate new technologies, algorithms, and models to increase the portability, adaptability, and dependability of DAWs executed over distributed infrastructures. We describe the motivation behind our project, explain its underlying core concepts, introduce FONDA’s internal structure, and sketch our vision for the future of workflow-based scientific data analysis. We also describe some lessons learned during the “making of” a CRC in Computer Science with strong interdisciplinary components, with the aim to foster similar endeavors.

Standardisation of pathogenicity classification for somatic alterations in solid tumours and haematologic malignancies

BackgroundThe difficulty in interpreting somatic alterations is correlated with the increase in sequencing panel size. To correctly guide the clinical management of patients with cancer, there needs to be accurate classification of pathogenicity followed by actionability assessment. Here, we describe a specific detailed workflow for the classification of the pathogenicity of somatic variants in cancer into five categories: benign, likely benign, unknown significance, likely pathogenic and pathogenic. MethodsClassification is obtained by combining a set of eight relevant criteria in favour of either a pathogenic or a benign effect (pathogenic stand-alone, pathogenic very strong, pathogenic strong, pathogenic moderate, pathogenic supporting, benign supporting, benign strong and benign stand-alone). ResultsOur guide is concordant with the ACMG/AMP 2015 guidelines for germline variants. Interpretation of somatic variants requires considering specific criteria, such as the disease and therapeutic context, co-occurring genomic events in the tumour when available and the use of cancer-specific variant databases. In addition, the gene role in tumorigenesis (oncogene or tumour suppressor gene) also needs to be taken into consideration. ConclusionOur classification could contribute to homogenize best practices on somatic variant pathogenicity interpretation and improve interpretation consistency both within and between laboratories.

Evaluation of Atlas Based Segmentation in Accelerated Partial Breast Irradiated Patients

Accelerated partial breast irradiation (APBI) provides a convenient treatment option for patients with early-stage breast cancer, reducing treatment duration and the volume of breast treated. Automated contouring tools can decrease contouring time and improve consistency in contours of organs at risk (OARs). The purpose of this study was to evaluate the efficacy of atlas-based contours created by a commercially available software compared with manually contoured left breast, right breast, and heart OARs.Thirty-one patients treated with APBI were randomly selected to generate an OAR atlas. The manually contoured left breast, right breast, heart, left lung, right lung, and spinal cord were included to construct the atlas using commercially available software. Since the atlas-based contour for lungs and spinal cord are well established at our clinic, our evaluation focused on the left/right breast and heart OARs. Using a specific workflow for partial breast irradiation, atlas-based OAR contours were automatically generated upon uploading of the image set. For left and right breast contours, this workflow automatically contracted breast contours 5mm away from skin surface. A twenty-one patient dataset was used to test the atlas. Dice Similarity Coefficient (DSC) and the mean Hausdorff distance (MSHD) were used for quantitative comparison to contoured breast and heart OARs. In addition to quantitative analysis, atlas-based segmentation was evaluated qualitatively by two staff radiation oncologists. They evaluated the contours using a four scaled score, defined as no change, minor change, major change, or not acceptable.The median and range DSC for the left breast, right breast and the heart were 0.85 ± 0.06 (0.71-0.94), 0.85 ± 0.06 (0.77-0.94), and 0.93 ± 0.03 (0.83-0.97), respectively. The average MSHD were 0.39 cm for the left breast, 0.36 cm for the right breast, and 0.20 cm for the heart. Qualitatively, among 21 test cases, each contour was assigned to whichever was the lower score from the two radiation oncologists. No atlas-based contours were rated not clinically acceptable by the radiation oncologists, consistent with all DSC > 0.7. 71% of atlas-based left breast contours were rated minor change, 81% for the right breast, and 76% for the heart, also consistent with the DSC values observed above.Atlas-based segmentation used for patients receiving APBI is clinically useful with minor contour editing required from physicians. Our results from using a commercially available software program can be readily applied to other centers and may be tested for patients undergoing whole breast irradiation.

Management of Metadata Types in Basic Cardiological Research.

Ensuring scientific reproducibility and compliance with documentation guidelines of funding bodies and journals is a topic of greatly increasing importance in biomedical research. Failure to comply, or unawareness of documentation standards can have adverse effects on the translation of research into patient treatments, as well as economic implications. In the context of the German Research Foundation-funded collaborative research center (CRC) 1002, an IT-infrastructure sub-project was designed. Its goal has been to establish standardized metadata documentation and information exchange benefitting the participating research groups with minimal additional documentation efforts. Implementation of the self-developed menoci-based research data platform (RDP) was driven by close communication and collaboration with researchers as early adopters and experts. Requirements analysis and concept development involved in person observation of experimental procedures, interviews and collaboration with researchers and experts, as well as the investigation of available and applicable metadata standards and tools. The Drupal-based RDP features distinct modules for the different documented data and workflow types, and both the development and the types of collected metadata were continuously reviewed and evaluated with the early adopters. The menoci-based RDP allows for standardized documentation, sharing and cross-referencing of different data types, workflows, and scientific publications. Different modules have been implemented for specific data types and workflows, allowing for the enrichment of entries with specific metadata and linking to further relevant entries in different modules. Taking the workflows and datasets of the frequently involved experimental service projects as a starting point for (meta-)data types to overcome irreproducibility of research data, results in increased benefits for researchers with minimized efforts. While the menoci-based RDP with its data models and metadata schema was originally developed in a cardiological context, it has been implemented and extended to other consortia at GÃűttingen Campus and beyond in different life science research areas.

Effective protein extraction combined with data independent acquisition analysis reveals a comprehensive and quantifiable insight into the proteomes of articular cartilage and subchondral bone

The objectives of this study was to establish a sensitive and reproducible method to map the cartilage and subchondral bone proteomes in quantitative terms, and mine the proteomes for proteins of particular interest in the pathogenesis of osteoarthritis (OA). The horse was used as a model animal. Protein was extracted from articular cartilage and subchondral bone samples from three horses in triplicate by pressure cycling technology or ultrasonication. Digested proteins were analysed by data independent acquisition based mass spectrometry. Data was processed using a pre-established spectral library as reference database (FDR 1%). We identified to our knowledge the hitherto most comprehensive quantitative cartilage (1758 proteins) and subchondral bone (1482 proteins) proteomes in all species presented to date. Both extraction methods were sensitive and reproducible and the high consistency of the identified proteomes (>97% overlap) indicated that both methods preserved the diversity among the extracted proteins. Proteome mining revealed a substantial number of quantifiable cartilage and bone matrix proteins and proteins involved in osteogenesis and bone remodeling, including ACAN, BGN, PRELP, FMOD, COMP, ACP5, BMP3, BMP6, BGLAP, TGFB1, IGF1, ALP, MMP3, and collagens. A number of proteins, including COMP and TNN, were identified in different protein isoforms with potential unique biological roles. We have successfully developed two sensitive and reproducible non-species specific workflows enabling a comprehensive quantitative insight into the proteomes of cartilage and subchondral bone. This facilitates the prospect of investigating the molecular events at the osteochondral unit in the pathogenesis of OA in future projects.

Cell Type–Specific Nuclei Markers: The Need for Human Brain Research to Go Nuclear

Identifying and interrogating cell type–specific populations within the heterogeneous milieu of the human brain is paramount to resolving the processes of normal brain homeostasis and the pathogenesis of neurological disorders. While brain cell type–specific markers are well established, most are localized on cellular membranes or within the cytoplasm, with limited literature describing those found in the nucleus. Due to the complex cytoarchitecture of the human brain, immunohistochemical studies require well-defined cell-specific nuclear markers for more precise and efficient quantification of the cellular populations. Furthermore, efficient nuclear markers are required for cell type–specific purification and transcriptomic interrogation of archived human brain tissue through nuclei isolation–based RNA sequencing. To sate the growing demand for robust cell type–specific nuclear markers, we thought it prudent to comprehensively review the current literature to identify and consolidate a novel series of robust cell type–specific nuclear markers that can assist researchers across a range of neuroscientific disciplines. The following review article collates and discusses several key and prospective cell type–specific nuclei markers for each of the major human brain cell types; it then concludes by discussing the potential applications of cell type–specific nuclear workflows and the power of nuclear-based neuroscientific research.

Conceptualization and scalable execution of big data workflows using domain-specific languages and software containers

Big Data processing, especially with the increasing proliferation of Internet of Things (IoT) technologies and convergence of IoT, edge and cloud computing technologies, involves handling massive and complex data sets on heterogeneous resources and incorporating different tools, frameworks, and processes to help organizations make sense of their data collected from various sources. This set of operations, referred to as Big Data workflows, requires taking advantage of Cloud infrastructures’ elasticity for scalability. In this article, we present the design and prototype implementation of a Big Data workflow approach based on the use of software container technologies, message-oriented middleware (MOM), and a domain-specific language (DSL) to enable highly scalable workflow execution and abstract workflow definition. We demonstrate our system in a use case and a set of experiments that show the practical applicability of the proposed approach for the specification and scalable execution of Big Data workflows. Furthermore, we compare our proposed approach’s scalability with that of Argo Workflows – one of the most prominent tools in the area of Big Data workflows – and provide a qualitative evaluation of the proposed DSL and overall approach with respect to the existing literature.

Selected Topics in Management and Modeling of Complex Systems: Editorial Introduction to Issue 27 of CSIMQ

The 27th issue of CSIMQ presents four articles that cover a wide range of research topics. The articles are extended versions of previous publications. The topics of this issue start with the discussion of sound workflow specifications. It suggests control-flow-based methods. The range of topics ends with the discussion of literature results about the relations of Big Data algorithms and Microservices. Additionally, an approach for modeling the prediction of bankruptcy for Latvian companies is discussed. Within the range of topics is also an article about identity management in organizations. It discusses a case study and the Fractal Enterprise Model.

Forensic Post-Mortem Investigation in AAS Abusers: Investigative Diagnostic Protocol. A Systematic Review.

Anabolic–androgenic steroids (AASs) are a group of synthetic molecules derived from testosterone and its precursors. AASs are widely used illicitly by adolescents and athletes, especially by bodybuilders; AASs are among the most used drugs for improving physical performance, as well as for aesthetic purposes. The use of AASs by professional and recreational athletes is increasing worldwide. This review focused on deaths related to AAS abuse and to investigation of the autopsy results and histopathological findings using a rigorous methodology protocol covering: a complete autopsy, histological analysis, and a broad toxicological investigation. Moreover, we aimed to define an investigative diagnostic protocol supporting forensic pathologists during the post-mortem investigation of AAS abusers. This review was conducted using PubMed Central and Google Scholar databases to find articles published between 1 January 1968 and 30 June 2021, using the following key terms: “(anabolic-androgenic steroids) AND (autopsy); (anabolic-androgenic steroids) AND (forensic)”. A total of 939 articles were screened and 926 did not meet the inclusion criteria. In conclusion, 14 articles were included in this systematic review, reporting 137 fatal cases of AAS abuse in total. The histopathologic studies showed myocardial damage characterized by myocyte hypertrophy, focal myocyte damage with myofibrillar loss, interstitial fibrosis, mostly subepicardial, and small vessel disease. Indeed, in AAS-related cases, autopsy plays a pivotal role in the study of AAS adverse effects and organ damage related to their use or abuse. This systematic review aimed to define a specific workflow in death cases related to AASs, suggesting important future insights to better clarify sudden deaths related to AASs, such as the use of miRNAs. The forensic community needs a unified approach in cases of suspected death related to the use of AASs. There are several occasions to apply this workflow, for example in cases of death of bodybuilders and of young people who die in gymnasiums or during sports activities.

Provenance-and machine learning-based recommendation of parameter values in scientific workflows.

Scientific Workflows (SWfs) have revolutionized how scientists in various domains of science conduct their experiments. The management of SWfs is performed by complex tools that provide support for workflow composition, monitoring, execution, capturing, and storage of the data generated during execution. In some cases, they also provide components to ease the visualization and analysis of the generated data. During the workflow’s composition phase, programs must be selected to perform the activities defined in the workflow specification. These programs often require additional parameters that serve to adjust the program’s behavior according to the experiment’s goals. Consequently, workflows commonly have many parameters to be manually configured, encompassing even more than one hundred in many cases. Wrongly parameters’ values choosing can lead to crash workflows executions or provide undesired results. As the execution of data- and compute-intensive workflows is commonly performed in a high-performance computing environment e.g., (a cluster, a supercomputer, or a public cloud), an unsuccessful execution configures a waste of time and resources. In this article, we present FReeP—Feature Recommender from Preferences, a parameter value recommendation method that is designed to suggest values for workflow parameters, taking into account past user preferences. FReeP is based on Machine Learning techniques, particularly in Preference Learning. FReeP is composed of three algorithms, where two of them aim at recommending the value for one parameter at a time, and the third makes recommendations for n parameters at once. The experimental results obtained with provenance data from two broadly used workflows showed FReeP usefulness in the recommendation of values for one parameter. Furthermore, the results indicate the potential of FReeP to recommend values for n parameters in scientific workflows.

Task group 284 report: magnetic resonance imaging simulation in radiotherapy: considerations for clinical implementation, optimization, and quality assurance.

The use of dedicated magnetic resonance simulation (MR-SIM) platforms in Radiation Oncology has expanded rapidly, introducing new equipment and functionality with the overall goal of improving the accuracy of radiation treatment planning. However, this emerging technology presents a new set of challenges that need to be addressed for safe and effective MR-SIM implementation. The major objectives of this report are to provide recommendations for commercially available MR simulators, including initial equipment selection, siting, acceptance testing, quality assurance, optimization of dedicated radiation therapy specific MR-SIM workflows, patient-specific considerations, safety, and staffing. Major contributions include guidance on motion and distortion management as well as MRI coil configurations to accommodate patients immobilized in the treatment position. Examples of optimized protocols and checklists for QA programs are provided. While the recommendations provided here are minimum requirements, emerging areas and unmet needs are also highlighted for future development.