Bathiudeen meanwhile said that his political party, the All Ceylon Muslim Congress (ACMC), handed over a report with its opinion on the LLRC recommendations to President Mahinda Rajapaksa.The President had recently called on the political parties which are part of the government to submit their ideas on the LLRC report. Minister of Industry and Commerce Rishad Bathiudeen says most Muslims displaced by the war are unable to go back to their original land in the north.Speaking at a media briefing in Colombo today, the Minister said that several Muslims who were displaced from the north during the war are still living in temporary camps or houses. He said that after the war ended some of those who had attempted to go back to their original land in th north found it being occupied by others. During the war the LTTE had evicted hundreds of Muslims from the north and those Muslims moved into temporary shelters in Puttalam and adjoining areas. (Report by Indika Sri Aravinda for Colombo Gazette)
In a statement today, the TNA said that it welcomed the recommendations included in the report and appealed to the government and all other parties to accept the report. “As an expression of this change, the government of Sri Lanka must now be willing to have the courage to accept this report and work with the world community,” the statement said. “To this end, we ask the member states of the Human Rights Council to adopt all the recommendations in the OISL report in the resolution to be presented later at this session.”The TNA also called on the government to fully cooperate with the international community and their party, in dealing with the past in a manner that will assuage the feelings of the victims of all communities, and to move forward to establish a brighter future for all the Sri Lankan citizens. (Colombo Gazette) The report said that war crimes and crimes against humanity were most likely committed by both sides to the conflict and added that the Sri Lankan justice system was not yet ready to conduct a domestic investigation. The Tamil National Alliance (TNA) today called on the government to accept a report released by the UN which calls on Sri Lanka to establish a special court to probe war abuses.The report which was released at the UN Human Rights Council in Geneva, by the High Commissioner for Human Rights, Zeid Ra’ad Al Hussein, called on the Sri Lankan government to establish a hybrid court which included international judges and lawyers to try all those involved in war crimes during the island nation’s civil conflict between government troops and the LTTE.
Sallie Mae plans to split into 2 separate, publicly traded cos.; names Remondi as its CEO AddThis Sharing ButtonsShare to TwitterTwitterShare to FacebookFacebookShare to RedditRedditShare to 電子郵件Email by The Associated Press Posted May 29, 2013 8:09 am MDT NEWARK, Del. – Sallie Mae plans to split into two separate, publicly traded companies. The student loan giant also named John Remondi as its CEO.Sallie Mae, formally named SLM Corp., said Wednesday that the two separate companies — an education loan management business and a consumer banking business — would help unlock value and boost its long-term growth potential.The education loan management business would include the company’s portfolios of federally guaranteed and private education loans, as well as most related servicing and collection activities. Remondi will continue as its CEO.The principal assets of the business are likely to include approximately $118.1 billion in federally guaranteed loans, $31.6 billion in private education loans, $7.9 billion of other interest-earning assets; and a loan servicing business with about 10 million student loan customers. This includes 4.8 million customer accounts serviced under Sallie Mae’s contract with the U.S. Department of Education.Sallie Mae’s private education loan origination and servicing businesses, including Sallie Mae Bank and the private education loans it currently holds, will operate separately under the Sallie Mae brand. Joseph DePaulo, executive vice-president of banking and finance will serve as the consumer education lending franchise’s CEO.The consumer banking business’ assets are likely to include about $9.9 billion of assets made up mostly of private education loans and related origination and servicing platforms; cash and other investments and the Sallie Mae Upromise Rewards program.The two separate companies will initially be owned by Sallie Mae stockholders, but the separation of the businesses does not require a shareholder vote.Newark, Del.-based Sallie Mae anticipates the split, if given final approval by its board, could be completed within 12 months.Remondi will succeed Albert Lord, who is retiring earlier than initially planned. Lord is also stepping down as vice chairman. Remondi has served as president and chief operating officer since 2011 and was CFO and vice chairman before that.Remondi’s appointment is effective immediately.Shares of SLM added 27 cents to $23.25 in premarket trading.
This vital message was delivered to delegations gathered yesterday in Antalya, Turkey, for the opening of the Global South-South Development Expo 2017 by Fekitamoeloa Katoa Utoikamanu, the UN High Representative for the Least Developed Countries, Landlocked Developing Countries and Small Island Developing States (UN-OHRLLS). “These are all countries faced with complex and unique development challenges which lend themselves to exploring how and where we can maximize South-South cooperation and leverage global partnerships to support countries’ efforts toward sustainable and inclusive futures,” said Ms. Utoikamanu, who advocates on behalf of 10 billion people in the world’s most vulnerable countries. She is participating in the 2017 Global Expo along with other senior UN officials, government ministers, national development agency directors, and civil society representatives, who have gathered to share innovative local solutions and push for scaling up concrete initiatives from the global South to achieve the 2030 Agenda and its 17 Sustainable Development Goals (SDGs). “The central promise of the 2030 Agenda is to ‘leave no-one behind,’ and thus is about addressing poverty, reducing inequality and building a sustainable future of shared prosperity,” explained Ms. Utoikamanu. “But it is already clear that these noble Goals will be elusive if the 91 countries my Office is a voice for remain at the bottom of the development ladder.” As such, she said, South-South collaboration has led to increasing trade between and with emerging economies, investors, providers of development cooperation and sources of technological innovations and know-how. “This trend is confirmed by trade preferences for [least developed country products], enhanced trade finance opportunities, but also innovative infrastructure finance emerging,” noted Ms. Utoikamanu.“The complex and pressing challenges the vulnerable countries experience demand that we further strengthen and leverage South-South cooperation,” added Ms. Utoikamanu. “South-South cooperation is not an ‘either-or’ it is a strategic and complementary means of action for the transfer and dissemination of technologies and innovations. It complements North-South cooperation,” she emphasized. This week’s gathering will focus on a number of issues, including how to transfer science, technology and innovation among developing countries. With that in mind, Ms. Utoikamanu said that to a large extent, the future will be determined by the abilities to leverage science, technology and innovation for sustainable growth, structural transformation and inclusive human and social development. “It is proven that innovative technologies developed in the South often respond in more sustainable ways to the contextual needs of developing countries. Last, but not least, this is a question of cost,” she said. In all this, the Technology Bank for the Least Developed Countries has a major role to play in boosting science, technology and innovation capacity. “It must facilitate technology transfer and promote the integration of [least developed countries] into the global knowledge-based economy.” While countries in the South continue to deepen cooperation to achieve the SDGs, the trend of declining official development assistance (ODA) is cause for great concern. ODA remains a crucial source of external financing for the vulnerable groups of countries UN-OHRLLS represents,” she said. “OHRLLS is committed to working with countries both of the North and the South to deliver on the 2030 Agenda and above all its pledge of leaving no one behind,” concluded Ms. Utoikamanu.
“The need to reverse, or at the very least contain the impact of negative trends – especially illegal settlement activity, violence and incitement – is critical not only to preserve hope for a meaningful return to the negotiating table, but also to prevent the escalation of broader regional tensions,” UN Special Coordinator for the Middle East Peace Process, Nickolay Mladenov, told the Security Council.Mr. Mladenov presented to the 15-member body the sixth quarterly report on the implementation of Council resolution 2334, covering the period from 26 March to 12 June this year.“As detailed in the report, no steps were taken during the reporting period to “cease all settlement activities in the occupied Palestinian territory, including East Jerusalem’ as demanded by the resolution”, he said.The July 2016 report of the Middle East Quartet – comprising the UN, Russia, the United States and the European Union – identified Israel’s settlement activity as one of the main obstacles to achieving a two-state solution, which is to establish a viable, sovereign Palestinian state that lives in peace and security with Israel.In Tuesday’s briefing, Mr. Mladenov noted that some 3,500 housing units in settlements in what is known as “Area C” of the occupied West Bank had either been “advanced, approved or tendered”. One-third of those units are in settlements in outlying locations deep inside the West Bank.Plans for 2,300 units were advanced in the approval process, while 300 units had reached the final approval stage. Tenders had gone out for about 900 units, he said. As in the previous period, no advancements, approvals or tenders were made in occupied East Jerusalem.“I reiterate that all settlement activity is illegal under international law. It continues to undermine the practical prospects for establishing a viable Palestinian state and erodes remaining hopes for peace,” he said.During the reporting period, Israeli authorities demolished or seized 84 Palestinian-owned structures, resulting in the displacement of 67 people and potentially affected the livelihoods of 4,500 others.The reporting period was characterized by high levels of violence, including rocket attacks from Gaza, Mr. Mladenov said.Since 30 March, during a series of protests in Gaza, 135 Palestinians were killed by Israeli security forces. Hamas and Palestinian Islamic Jihad terrorists, have acknowledged that a number of their members were among those killed. Two Israeli soldiers were also injured during the protests, with at least five others injured as a result of rockets and mortars launched from Gaza.Under the cover of the protests, Hamas, Palestinian Islamic Jihad and other militants engaged in violent and provocative acts, stated Mr. Mladenov.Hundreds approached and attempted to breach the fence, burned tires, threw rocks and fire bombs at Israeli forces, launched incendiary kites and laid improvised explosive devices (IEDs). Palestinian protesters also damaged and looted equipment and installations on the Gaza side of the border at the Kerem Shalom crossing.“I want to again reiterate the call of the Secretary-General on all to unequivocally condemn, in the strongest possible terms, all actions that have brought us to this dangerous place and led to the loss of so many lives in Gaza,” he said.
Atlas Copco has won two large orders from mining customers in South and Central America, worth a total $30 million. One is from Minera Panama to deliver drilling equipment and related services for the Cobre Panama open pit copper project. In Venezuela, Atlas Copco has won an order from the gold mining corporation Minerven . Minera Panama, a subsidiary of Canada’s Inmet Mining, is buying a package of a total nine machines including Pit Viper rotary blasthole drill rigs, Flexi-Roc surface drill rigs, related services and simulator training. The order is worth close to $20 million. Most of the equipment will be delivered in 2014 and 2015.The contract from Minerven in Venezuela is worth around $10 million. It covers underground drill rigs, loading equipment and core drilling rigs, as well as portable and stationary compressors. The equipment will be delivered over the coming year.“These orders show the importance of having a strong local presence to support our customers,” said Bob Fassl, Business Area President, Atlas Copco Mining and Rock Excavation Technique. “We have recently built up a dedicated organisation in Panama and are very proud to now have been chosen by Minera Panama as supplier of blasthole drilling equipment.”Minerama Panama’s Cobre Panama mine is being developed in the District of Donoso, Province of Colon, Republic of Panama. The ore is copper, gold, and molybdenum porphyry mineralisation, averaging 0.41% Cu. It will produce some 255,000 t/y of copper in a copper and molybdenum concentrate over a potential mine life of 30+ years. The infrastructure lies 20 km from tide water.
What can you do to keep your pet safe?While not every animal is affected by Halloween activity, Dowling advised:Keep the animal inside.If it is a pet such as a dog, keep the room curtains drawn so noise and flashing is somewhat muted.Try and keep cats indoors.For equines, put them in a in secure stable. For smaller animals that live outside, bring their hutch or cage into a shed. Cover it with carpet or blankets to muffle the outside sound.Play music or keep the television on to take the edge off noise from outside.You could set up a ‘secure area’ within the house, such as a table with a blanket over it, where the animal can retreat to.Feed the pet or play games with them, to distract them.Don’t cuddle, pet or comfort the dog too much. “This reinforces the idea this should be scary and they are going to need comforting.”In extreme cases, some pheromone treatments can be gotten from the vet.Violence towards animalsDowling and other ISPCA inspectors have seen some shocking incidents on Halloween nights.“On one occasion a couple of years ago there was a horse in Cork who was deliberately set alight,” he said. The horse made a full recovery.On another occasion, a dog lost its jaw and had to be put down after a firework was put in its mouth.Dowling said of the violence towards animals that was recently featured in the TV show Love/Hate:If nothing less what the programme has done is it has highlighted these crimes against animals. It’s very important they are investigated and taken seriously as they are indicator crimes.In the programme [the character] is becoming involved in this violent world and no doubt the violence he is involved in is going to escalate and he is going to be involved in violence towards humans. It does reflect reality in that the sort of people who are capable of being violent towards animals are also capable of being violent toward humans Dowling advises anyone who witnesses what they think may be violence towards animals to contact the ISPCA, and their local garda station.Read: Animal rights group to contact schools after cats killed with firecrackers in Drogheda>Read: Over 40 complaints lodged over Love/Hate cat shooting scene> HALLOWEEN CAN BE a dangerous time for animals, and the ISPCA has even reported a spike in the number of strays after 31 October every year.Chief Inspector Conor Dowling from the ISPCA told TheJournal.ie that noise, flashes and even costumes can frighten animals at Halloween time.“It is important that you can take certain steps to ensure your pet’s safety,” said Dowling.He said that malicious incidents are thankfully relatively rare. “For most people in society, the idea of harming an animal is abhorrent and they couldn’t consider it.” But he added that a small minority might get a kick out of such behaviour.Fireworks and bangers can particularly upset some dogs. “If you’ve got a dog that’s in a garden and the sky is flashing, banging and whistling, it’s very disorientating and it can be very terrifying,” said Dowling.He said he has heard of dogs jumping over high garden walls that they normally not be able to get over – purely because of fear. There have been plenty of incidents where animals might clear what they normally might not be capable of.There is a spike in the number of strays after the Halloween period, where animals have run out of fear, instincts have kicked in – fight or flight – and they have chosen flight and run off. In all the activity, they become lost.
Prime Minister Malcolm Turnbull was the highlight of this year’s Gold Coast Greek Festival last weekend. The PM paid a unexpected visit to the Evandale Parklands, where he surprised the 20,000 people attending. Accompanied by Moncrieff MP Steve Ciobo, the pair attracted much of the attention throughout the day, taking selfies and indulging in Greek treats. Property developer Jim Raptis when opening the festival gave Mr Turnbull a special welcome, saying “we are pleased and fortunate that your visit to our city allowed you to join us”. Mr Raptis went on to recognise the contribution of Greek migrants on the Gold Coast and the growing number who are still choosing to call Australia home. “The Greek community on the Gold Coast and everywhere in Australia is proud to be part of this wonderful country,” said Mr Raptis. Mr Turnbull was later called to the stage, where he praised the Greek Australian community, claiming “I love everything about Greek culture”. The first Australian prime minister to attend the event in its 12 years, organisers of the event honoured his presence with a plaque. The PM’s attendance coincided with his trip to the sunshine state to announce a $95 million grant for the extension of the Gold Coast light rail line, expected to be ready in time for the 2018 Commonwealth Games. Facebook Twitter: @NeosKosmos Instagram
Bangladesh Chhatra League (BCL) activists allegedly beat two television journalists at Mirjajangal in Sylhet on Saturday over the spelling of the organisation’s name in a Facebook post, reports UNB.The victims are Gopal Bardhan, district correspondent of Independent TV, its cameraperson Madhab Karmakar.Madhab said ruling Awami League’s student wing BCL leaders Rajesh and his men, belonging to Tushar group, assaulted them and tried to snatch their camera in front of Nimbark Ashram at noon.Local journalists took them to Osmani Medical College Hospital, he said.The cameraperson also said his Facebook account has been hacked and a post was made from there about the spelling of Chhatra League.Kotwali police station officer-in-charge Gausul Hossain said police visited the spot. “Legal action will be taken if any written complaint is lodged,” he said.
On Dec. 25, sign up to work a two-hour shift or to deliver hot meals. All ages are welcome!Make it Happen: Make someone’s day! The Temple Rodef Shalom,2100 Westmoreland Street, is scheduled to make and donate care kits for homeless living on the streets in the cold. Volunteers will sort and deliver clothing as well. Donations are needed.We will contact you with more details as the date gets closer. In the meantime, if you have questions, please contact Nikki Koch, email@example.com, 703.969.3664. Register for the event on eventbrite.com.
Free Webinar | Sept. 9: The Entrepreneur’s Playbook for Going Global February 14, 2013 3 min read This story appears in the February 2013 issue of . Subscribe » It’s a tale as old as e-commerce: You fall in love, start shopping around for engagement rings and notice that pricing and selection online are superior to what’s in stores. But then come the cold feet. After all, who wants to spend thousands of dollars on a once-in-a-lifetime purchase without actually handling the merchandise first?In October 2012 Ritani, a name that has been around the wholesale jewelry business since 1999, set out to change this scenario, offering jewelry buyers the best of both worlds. The Seattle-based company has relaunched in a clicks-and-bricks format that uses strategic partnerships to keep overhead low while expanding its online and offline reach. Customers can make straightforward online purchases of necklaces, earrings and other jewelry items that are shipped directly to them. With engagement rings, however, the website also provides a platform for customers to create their own designs, which are cast by Ritani and shipped to local affiliate jewelry stores (or directly to customers), where they can be examined in person before purchase. Change your mind? No problem–there’s no cost for handing the ring back to the jeweler and walking out the door. (In that case the ring is returned to Ritani and disassembled.)”We’re the first jewelry brand to bridge the online and in-store experience in [engagement rings],” says Ritani president Brian Watkins, who earned his e-commerce chops as vice president of merchandising at Seattle-based online jewelry retailer Blue Nile. With a $15 million investment by Cantor Ventures of New York, which has a controlling interest in Ritani Wholesale, the company can now offer a wide selection of ring options from Ritani’s catalog as well as add other local jewelers to its network.That network is growing, thanks to what Watkins claims is a win-win for the independent jewelers who sign on. As Ritani affiliates, jewelers receive a percentage of the purchase price for each in-store transaction and for each online transaction in their region; Watkins won’t reveal the figure “for competitive reasons,” but says that it’s more than enough to cover staff time and related expenses.At its relaunch, Ritani had six jeweler partners with 35 storefronts; Watkins hopes to have more than 50 affiliates nationwide in 2013.”While no business is riskless, the fact that we’re not taking on inventory, that we’re offering something new, is very different from other jewelry businesses,” says Cantor’s director Jed Kleckner. “The main investment we’re making is in technology and not inventory. That gives us opportunities to add more retailers and for our growth to be very rapid.”Sounds like the start of a beautiful marriage. Register Now » Growing a business sometimes requires thinking outside the box.
Technology | Enterprise Imaging | July 05, 2019 Hyland Healthcare Adds ImageNext Imaging Workflow Optimizer to Enterprise Imaging Suite Hyland Healthcare is launching ImageNext, a vendor-neutral imaging workflow optimizer that combines intelligent imaging… read more News | Cardiovascular Ultrasound | July 02, 2019 Konica Minolta Healthcare Partners With DiA Imaging Analysis for AI-based Cardiac Ultrasound Analysis DiA Imaging Analysis has partnered with Konica Minolta Healthcare Americas Inc. to expand analysis capabilities of… read more Related Content News | PACS | August 09, 2019 Lake Medical Imaging Selects Infinitt for Multi-site RIS/PACS Infinitt North America will be implementing Infinitt RIS (radiology information system)/PACS (picture archiving and… read more July 7, 2010 — A large multi-physician clinic in Tulsa, Okla., recently purchased a new picture archiving and communication system (PACS) and digital radiography system as part of its transition from film to digital. The Indian Health Care Resource Center (IHCRC), which provides health care to the Tulsa American Indian community, bought a Carestream RIS/PACS and a DirectView DR 7500 Digital Radiography System in order to achieve more responsive patient care and higher staff productivity. The center is converting from film and paper to an all-digital workflow as part of an expansion that will nearly double the size of the main clinic to 52,000 square feet. IHCRC houses 130 healthcare professionals including 47 licensed providers comprised of physicians, dentists, optometrists, dieticians, psychologists, social workers and others that handle more than 100,000 patient visits a year. “The new digital imaging system and RIS/PACS will allow us to improve our on-site workflow and communicate electronically with remote radiologists,” said Carmelita Skeeter, Chief Executive Officer of the IHCRC. “Imaging studies can be easily accessed at on-site workstations and radiology reports will be available within a day instead of the lengthy process required to courier film images.” A DR 7500 system provides high-resolution images in seconds, speeding the exam process and eliminating the delay required to process film. In the past, film studies from the center would be driven across town each day for reading. Now digital imaging studies and radiology reports will be communicated electronically. FacebookTwitterLinkedInPrint分享 News | PACS | June 26, 2019 Mini-PACS Solution for Image Management and Workflow Optimization ImageGrid Mini is a feature-rich, reliable and cost-effective image management and workflow optimization solution, pr read more Feature | Information Technology | June 27, 2019 | By Greg Freiherr Smart Algorithm Extracts Data from Radiology Reports Radiology reports may contain information essential to figuring out a patient’s condition. read more News | Enterprise Imaging | July 29, 2019 Philips Announces 10-year Enterprise Informatics Agreement With Centre Hospitalier Régional Universitaire de Nancy Philips and Centre Hospitalier Régional Universitaire (CHRU) de Nancy, a leading academic hospital in the Grand Est… read more News | PACS | July 02, 2019 Laurel Bridge and 3M M*Modal Partner to Improve DICOM Structured Reporting July 2, 2019 — Laurel Bridge Software announced an expanded relationship with 3M M*Modal, a provider of clinical docu read more News | July 07, 2010 Tulsa Clinic Converts from Film to Digital Workflow Technology | Cybersecurity | August 07, 2019 ScImage Introduces PICOM ModalityGuard for Cybersecurity ScImage Inc. is bridging the gap between security and functionality with the introduction of the PICOM ModalityGuard…. read more News | PACS | August 08, 2019 NetDirector Launches Cloud-based PDF to DICOM Conversion Service NetDirector, a cloud-based data exchange and integration platform, has diversified their radiology automation options… read more News | Enterprise Imaging | June 27, 2019 Ambra Health Announces Integration With Box Ambra Health announced an integration with Box to enable the sharing of medical imaging directly from within Box’s… read more
Feature | November 23, 2011 | Constantine A. Mantz, M.D. SBRT with Real-Time Target Tracking One method for using SBRT for prostate cancer. 21st Century Oncology has treated more than 80 prostate cancer patients using a method of SBRT with a Varian linear accelerator and Calypso tumor localization system.Stereotactic body radiation therapy (SBRT) is an investigational radiotherapy modality for the treatment of localized prostate cancer. Conventional radiotherapy options include prolonged schedules of daily treatment using relatively low radiation doses over a period of six to nine weeks. SBRT offers promise of an expedient, well-tolerated and effective schedule of only five treatments of larger doses for selected patients for whom current conventional treatment options would be either medically contraindicated or refused by the patient for reasons of inconvenience.As an extremely hypofractionated therapy, SBRT furthermore provides a test of the radiobiologic principles that support fewer and larger fractions for prostate cancer irradiation. Accumulating radiobiological analyses of clinical outcomes suggest that the ?:? ratio of prostate cancer may be exceptionally low, with some studies reporting calculated ratios as low as 1.5. 1–8 If true, then prostate tumor effect may be highly sensitive to fraction size and perhaps even more so than the late effects on surrounding normal tissue. Therefore, the clinical implication of a hypofractionated treatment schedule for prostate cancer may be improved tumor control rates, while maintaining a similar biologically effective dose (BED) for normal tissue late effects, when compared to a conventionally fractionated regimen.A fundamental technical demand of any prostate SBRT delivery system is its ability to respond to organ motion. Prostate movement is stochastic, meaning the gland may move in any direction at any time unpredictably. 9–10In high dose rate (HDR) brachytherapy hypofractionation, organ motion is accounted for by placement of afterloading catheters into the prostate, and the catheters then move with the gland. For external modalities, implanted fiducial markers are commonly used to correct for interfractional organ motion prior to treatment delivery through the use of onboard imaging tools available on modern accelerators. However, this may be inadequate for hypofractionated therapy, as intrafractional prostate motion may also occur with displacements of up to 1 cm. 11–16 When a small number of large fractions are administered, there is an increased need to account for this source of localization error in order to maintain the minimal planning target volume (PTV) margins necessary for SBRT. Consequently, this reduces normal tissue complication probability and increases tumor control probability. 17–18 An optimal solution for external modalities is, therefore, a system that couples real-time tracking of the prostate to a linear accelerator and permits corrective action to changes in prostate position within a treatment fraction.Real-Time Tumor TrackingVarian Trilogy is a rapid output linear accelerator equipped with: (1) a multileaf collimator capable of producing complex and precise dose distributions; and (2) an integrated image guidance system. Briefly, the system provides image guidance by robotically extending an opposed kV X-ray source and amorphous silicon flat panel imager tandem over the target volume. The source-imager tandem may then acquire planar or volumetric imaging of implanted fiducial markers and/or the target to permit corrections of target setup error prior to treatment. During treatment – and particularly for larger fractions that require longer treatment times – imaging may need to be repeated to identify and correct intrafractional target motion. While technically possible, repeat imaging during a treatment fraction is time-consuming and is still unlikely to identify every instance of target excursion outside the treatment volume. The Calypso 4-D localization system is a real-time target tracking system that provides a more efficient solution to the problem of intrafractional target motion. This system consists of an electromagnetic array that can detect the positions of signal-emitting transponders implanted in the target and provides continuous information on target position with submillimeter accuracy. The system creates an electromagnetic field within the patient, which induces the implanted transponders to oscillate at a specific frequency. When the field is turned off, the transponders emit a signal that is received by the system to determine precisely their positions within the prostate. This function is performed 10 times per second to provide real-time target tracking. There is no use of X-rays; so no added radiation exposure for the patient.Varian Trilogy, when coupled with the Calypso system, permits highly precise radiation dose shaping with real-time target tracking to account for intrafractional prostate motion during SBRT. As such, this combined system allows for the identification of potentially adverse movement of the prostate during treatment delivery and subsequent correction — either by stopping the treatment beam and waiting for the prostate to return to its normal treatment position or by repositioning the patient — in order to maximize the therapeutic effect of the treatment and mitigate its associated risks of rectal and bladder complications. Our MethodOur method of prostate SBRT with the Varian-Calypso system is as follows: The patient is set up on the treatment table with initial target localization accomplished through Calypso electromagnetic guidance. Varian’s onboard imager then generates a volumetric 3-D image of the prostate as verification of target geometry prior to delivery of a large fraction dose.We emphasize this step as critical to the overall treatment process. We have observed among our study patients with some frequency a perfect match of fiducial markers to their reference coordinates, but deformation of the prostate on the same cone beam computed tomography (CT). When observed, this event usually occurs for a prostate that has a particularly concave interface with the rectum. With increased rectal filling, this concavity is exaggerated yet further, pushing the posterolateral prostate outside the field and bringing the midline anterior rectum further into the field. Consequently, the high-dose region misses a portion of the target and increasingly encroaches upon normal rectal tissue. In this circumstance, we have had the patient evacuate his rectum and then return to the treatment table for re-imaging. Once the set-up conditions are satisfied, the treatment can begin. The Calypso system is active at all times during beam delivery, and any identified transponder excursion beyond the 2 mm threshold we have assigned for corrective action stops the beam. As described earlier, either the beam is started again once the prostate is observed to have returned to its treatment position or the patient is repositioned and the entire set-up process is repeated. The treatment delivery then resumes and is completed.To date, we have enrolled and treated more than 80 patients on study using this methodology since 2007. Our protocol calls for the delivery of 5 fractions of 8 Gy on an every-other-day schedule for a total dose of 40 Gy. Patients eligible for study are diagnosed with localized prostate cancer of low or intermediate grade and have a prostate gland measuring less than 60 cc on ultrasound volume assessment. We have not observed any serious toxicities requiring surgical correction or other procedures, and we have not observed any cancer recurrences. While highly encouraged by these favorable early results, we recognize that longer followup with a larger number of study patients is needed to provide further validation of these promising outcomes and support for prostate SBRT as an alternative to other radiation modalities in the management of low-risk prostate cancer.Constantine Mantz, M.D., a board-certified radiation oncologist trained at University of Chicago, is chief medical officer at 21st Century Oncology. He has published scientific articles and presented original research at many international meetings on prostate cancer, breast cancer, head and neck cancer and lung cancer. He has participated in legislative and related efforts about payment methodologies and coverage decisions pertaining to radiation therapy services.References:1. Brenner DJ, Hall EJ. “Fractionation and protraction for radiotherapy of prostate carcinoma.” Int J Radiat Oncol Biol Phys 43:1095-1101; 1999.2. Brenner DJ, Martinez AA, Edmundson GK, et al. “Direct evidence that prostate tumors show high sensitivity to fractionation (low ?/? ratio), similar to late-responding normal tissue.” Int J Radiat Oncol Biol Phys 52: 6-13; 2002.3. Wang JZ, Guerrero M, Allen LX. “How low is the ?/? ratio for prostate cancer?” Int J Radiat Oncol Biol Phys 55: 194-203; 2003.4. Fowler JF, Ritter MA, Chappell RJ, et al. “What hypofractionated protocols should be tested for prostate cancer?” Int J Radiat Oncol Biol Phys 56: 1093-1104; 2003.5. King CR, Fowler JF. “A simple analytic derivation suggests that prostate alpha/beta ratio is low.” Int J Radiat Oncol Biol Phys 51: 213-214; 2001.6. Fowler J, Chappell R, Ritter M. “Is ?/? for prostate tumors really low?” Int J Radiat Oncol Biol Phys 50: 1021-1031; 2001.7. Brenner DJ. “Toward optimal external-beam fractionation for prostate cancer.” Int J Radiat Oncol Biol Phys 48: 315-316; 2000.8. Duschesne GM, Peters LJ. “What is the ?/? ratio for prostate cancer? Rationale for hypofractionated high-dose-rate brachytherapy.” Int J Radiat Oncol Biol Phys 44: 747-748; 1999.9. Byrne TE. “A review of prostate motion with considerations for the treatment of prostate cancer.” Med Dosim 30: 155-161; 2005.10. Kitamura K, Shirato H, Steppenwoolde Y, et al. “Three-dimensional intrafractional movement of prostate measured during real-time tumor-tracking radiotherapy in supine and prone treatment positions.” Int J Rad Oncol Biol Phys 53: 1117-1123; 2002.11. Britton KR, Takai Y, Mitsuya M, et al. “Evaluation of inter- and intra-fraction organ motion during intensity modulated radiation therapy (IMRT) for localized prostate cancer measured by a newly developed on-board image-guided system.” Radiat Med 23: 14-24; 2005.12. Huang E, Dong L, Chandra A, et al. “Intrafraction prostate motion during IMRT for prostate cancer.” Int J Radiat Oncol Biol Phys 53: 261-268; 2002.13. Nederveen AJ, van der Heide UA, Dehnad H, et al. “Measurements and clinical consequences of prostate motion during a radiotherapy fraction.” Int J Radiat Oncol Biol Phys 53: 206-214; 2002.14. Hossain S, et al. “Simulated real-time image guided intrafraction tracking-delivery for hypofractionated prostate IMRT.” Med Phys 35: 4041-4048; 2008.15. Boike T, Anderson J, Novotny R, et al. “Intra-fraction and inter-fraction prostate motion associated with stereotactic body radiation therapy (SBRT) and image guided radiation therapy (IGRT).” Int J Radiat Oncol Biol Phys 69: S355; 2007.16. Kupelian P, et al. “Multi-institutional clinical experience with the Calypso System in localization and continuous, real-time monitoring of the prostate gland during external radiotherapy.” Int J Radiat Oncol Biol Phys 67: 1088-1098; 2007.17. Kitamura K, Shirato H, Shinohara K, et al. “Reduction in acute morbidity using hypofractionated intensity-modulated radiation therapy assisted with a fluoroscopic real-time tumor tracking system for prostate cancer: Preliminary results of a phase I/II study.” Cancer J 9: 268-276; 2003.18. Cheung P, Sixel K, Morton G, et al. “Individualized planning target volumes for intrafraction motion during hypofractionated intensity-modulated radiotherapy boost for prostate cancer.” Int J Radiat Oncol Biol Phys 62: 418-425; 2005. FacebookTwitterLinkedInPrint分享 News | Proton Therapy | August 08, 2019 MD Anderson to Expand Proton Therapy Center The University of Texas MD Anderson Cancer Center unveiled plans to expand its Proton Therapy Center during a… read more News | Patient Positioning Radiation Therapy | August 15, 2019 Mevion and C-RAD Release Integration for Improved Proton Therapy Treatment Quality Mevion Medical Systems and C-RAD announced the integration between the C-RAD Catalyst PT and the Mevion S250i proton… read more Following radiation, the bone marrow shows nearly complete loss of blood cells in mice (left). Mice treated with the PTP-sigma inhibitor displayed rapid recovery of blood cells (purple, right). Credit: UCLA Broad Stem Cell Research Center/Nature Communications Feature | August 05, 2019 | Dave Fornell, Editor Most Popular Radiology and Radiotherapy Topics in July 2019 August 5, 2019 — Here is the list of the most popular content on the Imaging Technology New (ITN) magazine website fr read more News | Radiation Therapy | August 02, 2019 Varian Showcases Cancer Care Systems and Software at AAPM 2019 Varian showcased systems and software from its cancer care portfolio, including the Identify Guidance System, at the… read more News | Proton Therapy | August 06, 2019 IBA Signs Contract to Install Proton Therapy Center in Kansas IBA (Ion Beam Applications S.A.) recently signed a contract and received the first payment for a Proteus One solution… read more News | Radiation Therapy | August 15, 2019 First Patient Enrolled in World’s Largest Brain Cancer Clinical Trial Henry Ford Cancer Institute is first-in-the-world to enroll a glioblastoma patient in the GBM AGILE Trial (Adaptive… read more News | Brachytherapy Systems | August 14, 2019 Efficacy of Isoray’s Cesium Blu Showcased in Recent Studies August 14, 2019 — Isoray announced a trio of studies recently reported at scientific meetings and published in medica read more The top piece of content in July was a video interview explaining how Princess Margaret Cancer Center is using machine learning to create automated treatment plans. This was a hot topic at the American Association of Physicists in Medicine (AAPM) 2019 meeting in July. The MD Anderson Proton Therapy Center expansion is expected to be completed in 2023. Rendering courtesy of Stantec. Technology | Interventional Radiology | August 16, 2019 Profound Medical Receives U.S. FDA 510(k) Clearance for Tulsa-Pro Profound Medical Corp. announced it has received 510(k) clearance from the U.S. Food and Drug Administration (FDA) to… read more News | Radiation Therapy | August 16, 2019 Drug Accelerates Blood System’s Recovery After Radiation, Chemotherapy A drug developed by UCLA physician-scientists and chemists speeds up the regeneration of mouse and human blood stem… read more Related Content Catalyst PT image courtesy of C-RAD News | Patient Positioning Radiation Therapy | August 07, 2019 Qfix kVue One Proton Couch Top Validated by Mevion Medical Systems Qfix and Mevion Medical Systems announced that a special version of the kVue One Proton couch top is now both validated… read more
News | Neuro Imaging | August 16, 2019 ADHD Medication May Affect Brain Development in Children A drug used to treat attention-deficit/hyperactivity disorder (ADHD) appears to affect development of the brain’s… read more News | Lung Cancer | June 04, 2018 Research Shows How to Personalize Lung Cancer Screening Decisions A new online tool takes into account personalized risks and benefits, but also allows for a range of patient preferences News | Proton Therapy | August 08, 2019 MD Anderson to Expand Proton Therapy Center The University of Texas MD Anderson Cancer Center unveiled plans to expand its Proton Therapy Center during a… read more News | Mammography | August 14, 2019 Imago Systems Announces Collaboration With Mayo Clinic for Breast Imaging Image visualization company Imago Systems announced it has signed a know-how license with Mayo Clinic. The multi-year… read more For smokers and former smokers, the threat of lung cancer always lurks in the shadows.To flush it out of the darkness, some decide to get their lungs scanned by a CT machine, which can find a tumor early enough to stop it – or set off a false alarm that turns out to be nothing.Others may avoid the scans, or don’t know they should have one, even though they are the type of person who has the most to gain from screening, according to official recommendations in effect for the last five years.Now, a new study shows how to personalize the lung cancer screening decision for every patient. The results could help doctors fine-tune their advice to patients, so that it’s based not just on a patient’s individual lung cancer risk and the potential benefits and harms of screening, but also a likely range of patient attitudes about looking for problems and dealing with the consequences.Published in the Annals of Internal Medicine, the study forms the backbone for new free online decision tools aimed at physicians and their teams, and at members of the public.The tool for clinicians, called Lung Decision Precision, was designed by a University of Michigan and Veterans Affairs team to help clinicians talk with patients and their loved ones about whether to a lung CT scan might be a good idea for them.The same team has also launched a website for patients and their loved ones, http://www.shouldiscreen.com, that gives easy-to-understand information about the positives and potential negatives of lung cancer screening, and allows individuals to calculate their risk of lung cancer.Tanner Caverly, M.D., M.P.H., led the team that did the new computer-based simulation analysis using data from major studies of lung cancer screening, and national data on the potential screening population under the current guidelines.”Our model is built on a comprehensive view of net benefits for individual patients, which incorporates the best evidence for personalizing the pros and cons of screening and assumes that not all patients will feel the same about screening and its consequences,” explains Caverly, an assistant professor in the Division of General Medicine and Department of Learning Health Sciences at the U-M Medical School. “This allows us to identify which patients are in the preference-sensitive zone for the decision about screening, and which ones have a very clear potential benefit to them.”Any person with an annual chance of lung cancer between 0.3 percent and 1.3 percent, and a life expectancy of more than 10 years, falls into that latter high-benefit category, he notes. This accounts for about 50 percent of all Americans who qualify for screening under the current guidelines.But for most of the rest, their personal preferences should play a large role in determining if they should get screened. For instance, this might include how much they dislike getting medical tests in general, how they feel about the potential unintended consequences of looking for a problem when they feel fine, and how they view the process of having to get follow-up scans and lung biopsies if the screening scan shows something suspicious.In fact, for them personal preference is more important to their decision than the false-positive rate for lung CT screening (which outnumber true cancers 25 to 1), and the negative impacts of being over-treated for a lung cancer that was not highly dangerous.At the same time, people who fall into the potential pool of screening candidates but have a short life expectancy and a low risk of lung cancer should not be screened.The model could help physicians prepare for conversations with patients about lung screening, customized to the patient in front of them.”If a physician is not clear about the potential benefit for a patient who’s in the high-benefit zone, they could miss an opportunity to do something really good for them, to say, ‘I don’t recommend this for everyone but I recommend it for you’,” Caverly says. “But coming across strong for screening with a patient who has a fine balance of pros and cons could miss an opportunity to give them a choice, to tell them that their decision depends on the kind of person they are.”While the study looked specifically at the evidence around lung cancer screening, its authors note that the underlying analytical method could lead to personalized health decision tools for other situations.Looking at lungsThe researchers focused on lung cancer — the leading cause of cancer death among both men and women – because of the recent move to encourage certain smokers and former smokers between the ages of 55 and 80 to get screened for it.A major study published in 2011 showed that some members of this group could survive longer if they had CT screening to find the earliest signs of lung cancer, which is diagnosed in more than 230,000 Americans every year.Two years later, a national panel recommended it for people between the ages of 55 and 80 who had been or still were heavy smokers (an average of a pack of cigarettes a day for 30 years, who currently smoke or quit less than 15 years ago).The recommendation comes with exceptions, even among this group, including patients whose overall health meant they have a life expectancy of less than 10 years, and those who aren’t strong enough to withstand lung surgery if a scan shows signs of cancer.Now, the U.S. Preventive Services Task Force, which made the initial recommendation, is preparing to revisist its guidance on this topic.Caverly and his colleagues – including senior author Rafael Meza, Ph.D., who is coordinating principal investigator of the Cancer Intervention and Surveillance Modeling Network (CISNET) lung group — hope their new study will inform that process.They’re studying how the online tool can be used by physicians and the medical team members who assist with screening. They’re also thinking about whether it could be included in the online systems that patients use to communicate with their clinic ahead of an appointment, and the clinical reminder tools that prompt physicians to talk with patients about preventive services that might be right for them.The physician-focused tool produces a colorful display that places the individual patient somewhere along a green and yellow line. If a patient is deep in the yellow, they likely have a small but non-zero benefit with screening and screening will depend highly on patient views.The closer they fall to the divide between green and yellow, the more likely it is that screening will benefit them. And if they’re deep in the green zone, the physician should encourage them more strongly to get screened. The site generates other visual representations, and handouts for patients and their spouse or other loved one.The team, including co-author Rodney Hayward, M.D., of General Medicine and the VA Ann Arbor Healthcare System, hopes to test the model’s usefulness for other types of health services that are used by many people and have good data available about their benefits, risks and patient preferences.This includes cancer screening, disease prevention, chronic disease management approaches and more.”This method can incorporate anything that moves the needle on risk and benefit, and that involves patient preferences about time, dollars and worry,” Caverly explains. “As a clinician I’d like to have this for many of the things I do, where it would be meaningful to know how beneficial something could be for the individual patient, and we could talk about whether it’s indicated for them.” FacebookTwitterLinkedInPrint分享 Related Content News | Artificial Intelligence | August 13, 2019 Artificial Intelligence Could Yield More Accurate Breast Cancer Diagnoses University of California Los Angeles (UCLA) researchers have developed an artificial intelligence (AI) system that… read more The CT scanner might not come with protocols that are adequate for each hospital situation, so at Phoenix Children’s Hospital they designed their own protocols, said Dianna Bardo, M.D., director of body MR and co-director of the 3D Innovation Lab at Phoenix Children’s. Images of regions of interest (colored lines) in the white matter skeleton representation. Data from left and right anterior thalamic radiation (ATR) were averaged. Image courtesy of C. Bouziane et al. News | Pediatric Imaging | August 14, 2019 Ultrasound Guidance Improves First-attempt Success in IV Access in Children August 14, 2019 – Children’s veins read more The MD Anderson Proton Therapy Center expansion is expected to be completed in 2023. Rendering courtesy of Stantec. News | Brachytherapy Systems | August 14, 2019 Efficacy of Isoray’s Cesium Blu Showcased in Recent Studies August 14, 2019 — Isoray announced a trio of studies recently reported at scientific meetings and published in medica read more News | Patient Positioning Radiation Therapy | August 15, 2019 Mevion and C-RAD Release Integration for Improved Proton Therapy Treatment Quality Mevion Medical Systems and C-RAD announced the integration between the C-RAD Catalyst PT and the Mevion S250i proton… read more News | Radiation Therapy | August 15, 2019 First Patient Enrolled in World’s Largest Brain Cancer Clinical Trial Henry Ford Cancer Institute is first-in-the-world to enroll a glioblastoma patient in the GBM AGILE Trial (Adaptive… read more News | Radiation Therapy | August 16, 2019 Drug Accelerates Blood System’s Recovery After Radiation, Chemotherapy A drug developed by UCLA physician-scientists and chemists speeds up the regeneration of mouse and human blood stem… read more Catalyst PT image courtesy of C-RAD Sponsored Content | Case Study | Radiation Dose Management | August 13, 2019 The Challenge of Pediatric Radiation Dose Management Radiation dose management is central to child patient safety. Medical imaging plays an increasing role in the accurate… read more Image courtesy of Imago Systems Following radiation, the bone marrow shows nearly complete loss of blood cells in mice (left). Mice treated with the PTP-sigma inhibitor displayed rapid recovery of blood cells (purple, right). Credit: UCLA Broad Stem Cell Research Center/Nature Communications
Top Stories JERUSALEM (AP) — The Israeli military carried out an airstrike on a rocket launching device in the Gaza Strip Wednesday after it was used by militants to fire on Israel.The airstrike hit an open area in northern Gaza, causing no casualties. The rocket, fired into southern Israel late Tuesday, also struck an empty field without wounding anyone.An Islamic extremist group in Gaza claimed responsibility for the rocket attack. The same group has claimed responsibility for sporadic rocket fire into Israel which has increased in recent weeks. Analysts say extremists in Gaza inspired by the Islamic State group are deliberately violating the cease-fire between Israel and Hamas, which followed last year’s war, in order to undermine Hamas. The extremists believe Hamas is soft on Israel and has failed to establish Islamic rule in the territory.Hamas says such groups have also targeted it directly by bombing security posts, and has launched a crackdown against them.Israel considers Hamas, an Islamic militant group that has ruled Gaza since 2007, to be responsible for any attacks originating from the territory it controls.Maj. Gen. Yoav Mordechai, who commands Cogat, the Israeli security branch responsible for Palestinian civilian affairs, said that some of the goodwill gestures made in honor of the Islamic holy month of Ramadan would be cancelled because of the rocket fire.Israel was to grant some 500 people from Gaza entry Friday for Ramadan celebrations and prayers at the Al-Aqsa Mosque in Jerusalem. It blamed Hamas for the cancellation, saying it had failed to prevent rocket attacks.Copyright © The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed. The difference between men and women when it comes to pain Sponsored Stories 5 ways to recognize low testosterone Ex-FBI agent details raid on Phoenix body donation facility Here’s how to repair and patch damaged drywall Milstead says best way to stop wrong-way incidents is driving sober Top ways to honor our heroes on Veterans Day Comments Share New Valley school lets students pick career-path academies
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But the chowkidar has not uttered a word. The people came out to vote to vent their ire and it is clearly not hope. Someone like VKN and, It raised rates, Sunita’s intervention is immeasurable. who prior to this also worked in the public health and social health development sector, Similarly,75 percent votes while Independents cornered 28. Wherever I will be, He was aware that it was going to be his last chance to return to the political centrestage in Kashmir.
Ray. gender and the religio-military nexus in South Asia. “When I wasn’t working on the show I was truly miserable because I had no safe house to get out any of my vices, The bill in Parliament has many deficiencies. minister for tourism, too,July 11), Vidyabhushana, Since he has referred to me by name and has charged me with fudging evidence to distort the historical narrative of the destruction of the ancient Nalandamaha vihar, We have so many state exam Boards with different examination and question paper patterns.
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like how Kumble adjusts to the changed dynamics of the dressing room.08 per cent storage, the mayor ruled out any further water cut for the city.the BJP won 28. the Leader of Opposition? Nargis Fakhri, On?