The increasing complexity of modern radiation therapy planning and delivery challenges traditional prescriptive quality management (QM) methods, such as many of those included in guidelines published ...by organizations such as the AAPM, ASTRO, ACR, ESTRO, and IAEA. These prescriptive guidelines have traditionally focused on monitoring all aspects of the functional performance of radiotherapy (RT) equipment by comparing parameters against tolerances set at strict but achievable values. Many errors that occur in radiation oncology are not due to failures in devices and software; rather they are failures in workflow and process. A systematic understanding of the likelihood and clinical impact of possible failures throughout a course of radiotherapy is needed to direct limit QM resources efficiently to produce maximum safety and quality of patient care. Task Group 100 of the AAPM has taken a broad view of these issues and has developed a framework for designing QM activities, based on estimates of the probability of identified failures and their clinical outcome through the RT planning and delivery process. The Task Group has chosen a specific radiotherapy process required for “intensity modulated radiation therapy (IMRT)” as a case study. The goal of this work is to apply modern risk-based analysis techniques to this complex RT process in order to demonstrate to the RT community that such techniques may help identify more effective and efficient ways to enhance the safety and quality of our treatment processes. The task group generated by consensus an example quality management program strategy for the IMRT process performed at the institution of one of the authors. This report describes the methodology and nomenclature developed, presents the process maps, FMEAs, fault trees, and QM programs developed, and makes suggestions on how this information could be used in the clinic. The development and implementation of risk-assessment techniques will make radiation therapy safer and more efficient.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
The cell cortex of syncytial Drosophila embryos is patterned into cap and intercap regions by centrosomes, specific sets of proteins that are restricted to their respective regions by unknown ...mechanisms. Here, we found that Kinesin-1 is required for the restriction of plus- and minus-ends of centrosomal and non-centrosomal microtubules to the cap region, marked by EB1 and Patronin/Shot, respectively. Kinesin-1 also directly or indirectly restricts proteins and Rho signaling to the intercap, including the RhoGEF Pebble, Dia, Myosin II, Capping protein-α, and the polarity protein Par-1. Furthermore, we found that Par-1 is required for cap restriction of Patronin/Shot, and vice versa Patronin, for Par-1 enrichment at the intercap. In summary, our data support a model that Kinesin-1 would mediate the restriction of centrosomal and non-centrosomal microtubules to a region close to the centrosomes and exclude Rho signaling and Par-1. In addition, mutual antagonistic interactions would refine and maintain the boundary between cap and intercap and thus generate a distinct cortical pattern.
Shopping center redevelopment is inevitable to remain attractive for consumers. In this paper, we investigate the external effects of shopping center redevelopment on nearby residential property ...prices. Using a difference‐in‐difference empirical framework, we find the redevelopment has positive external effects on nearby property prices. We find the price of a property located next to a redeveloped shopping center increases by 1.43% on average just after redevelopment. Our results indicate that these positive external effects wear off rather rapidly across space and over time. This suggests that shopping center redevelopment plays a substantial, but limited, role in combating neighborhood deprivation.
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BFBNIB, DOBA, FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, UILJ, UKNU, UL, UM, UPUK
In view of the 2020 global health crisis and its repercussions on the global economy, the need to redirect conventional economic thinking towards securing global economic sustainability is most ...critical. The Sustainable Development Goals (SDGs) are a significant move in this direction. However, in the past few years, a clearer understanding of inclusive economics and sustainability indicators have progressed our ability to reduce economic exclusion, chiefly represented by global inequality. Collective wellbeing within the “global village” is shaped largely by these avenues/directions, thus presenting the question: can an improved combination of sustainability priorities be identified that would substantially enhance countries’ adoption of the SDGs? New, inclusive paths to economic progress are essential to a world economy in crisis recovery mode. The aim of the paper is to qualitatively identify key indicators from these different directions to, collectively, address some of the most significant drivers of global inequality, thus improving the adoption rate of the SDGs. As its main contribution, the study found that for economic inclusivity to realistically reduce global inequality its full integration into three areas is necessary: business models, public policy and community development. This should also be supported by “social covenants” to facilitate improved SDG adoption by countries.
Health care's grand challenges, such as continuously increasing costs, challenge the sustainability of health systems. Purpose-oriented networks are considered a favorable mode of organization to ...address these grand challenges. Therefore, it is crucial that they are effective. While network effectiveness is a heavily theorized, multi-dimensional concept that is often measured as a perception of actors, little is known about how network actors perceive effectiveness in practice and how this influences their behavior. In this study, we explored how network actors perceive network effectiveness using 32 interviews with representatives from network member organizations and regulatory agencies actor, 28 h of network meeting observations, and 1.272 pages of documents such as meeting minutes and media outlets. Our results show that actors primarily see hard outcomes (e.g. changes in cost or quality of care) as effectiveness but given the temporal nature of these goals and difficulties quantifying them, they resort to the collaborative process as a proxy to assess effectiveness. Actors engage in networks to solve grand challenges. However, conforming to expectations and environmental pressures also play a substantial role for actors to (continue to) participate in networks. In the absence of hard outcomes, actors legitimize their continued participation in networks using the collaborative process of networks. Actors therefore take purpose-oriented networks for granted as a legitimate way of organizing. Besides attempting to solve grand challenges, networks thus also seem to be adopted because of powerful institutional rules that function as rationalized myths, to gain legitimacy. Future research should be aware of and further unravel the institutional pressures in networks.
•Policy pushes call for collaboration in networks to keep health systems sustainable.•Measuring hard outcomes of networks is deemed necessary yet difficult in practice.•The collaborative process is used as proxy to legitimize ineffective networks.•Normative and coercive pressures force stakeholders to keep collaborating.•Purpose-oriented networks are established, partly, as institutionalized myths.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Selective plane illumination microscopy (SPIM) represents a preferred method in dynamic tissue imaging, because it combines high spatiotemporal resolution with low phototoxicity. The OpenSPIM system ...was developed to provide an accessible and flexible microscope set-up for non-specialist users. Here, we report Structured SPIM (SSPIM), which offers an open-source, user-friendly and compact toolbox for beam shaping to be applied within the OpenSPIM platform. SSPIM is able to generate digital patterns for a wide range of illumination beams including static and spherical Gaussian beams, Bessel beams and Airy beams by controlling the pattern of a Spatial Light Modulator (SLM). In addition, SSPIM can produce patterns for structured illumination including incoherent and coherent array beams and tiling for all types of the supported beams. We describe the workflow of the toolbox and demonstrate its application by comparing experimental data with simulation results for a wide range of illumination beams. Finally, the capability of SSPIM is investigated by 3D imaging of Drosophila embryos using scanned Gaussian, Bessel and array beams. SSPIM provides an accessible toolbox to generate and optimize the desired beam patterns and helps adapting the OpenSPIM system towards a wider range of biological samples.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Intercellular signalling via growth factors plays an important role in controlling cell differentiation and cell movements during the development of multicellular animals. Fibroblast Growth Factor ...(FGF) signalling induces changes in cellular behaviour allowing cells in the embryo to move, to survive, to divide or to differentiate. Several examples argue that FGF signalling is used in multi-step morphogenetic processes to achieve and maintain a transitional state of the cells required for the control of cell fate. In the genetic model Drosophila melanogaster, FGF signalling via the receptor tyrosine kinases Heartless (Htl) and Breathless (Btl) is particularly well studied. These FGF receptors affect gene expression, cell shape and cell-cell interactions during mesoderm layer formation, caudal visceral muscle (CVM) formation, tracheal morphogenesis and glia differentiation. Here, we will address the current knowledge of the biological functions of FGF signalling in the fly on the tissue, at a cellular and molecular level.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
•Activity of PtRe/C in APR of glycerol increases with Re.•Acetaldehyde decomposition: PtRe more active in C–C bond cleavage than Pt/C.•Formation of acid sites (Re-OH) in PtRe: increased C–O cleavage ...rates.•Water activation promoted by Re confirmed by CO stripping voltammetry.•High APR activity of PtRe correlates with high WGS activity.
The synergy between Pt and Re in aqueous-phase reforming (APR) of glycerol and the water–gas shift (WGS) reaction was investigated for a series of carbon-supported Pt, Re, and PtRe catalysts. The overall activity of the bimetallic catalysts in APR of glycerol increases with Re content. The ratio of products obtained via C–O bond cleavage to those obtained by C–C bond cleavage also increases with Re content. H2-TPR studies and EXAFS show that Pt and PtRe catalysts are well reduced and remain so during gas- and aqueous-phase reactions. PtRe catalysts are substantially more active in C–C bond cleavage (acetaldehyde decomposition) than their monometallic counterparts, although there is no strong dependence on the Pt/Re ratio. Higher dehydration rates for PtRe alloys correlate with the increasing concentration of steam-treating-induced Brønsted acidic sites (NH3 TPD and FTIR of adsorbed pyridine). The higher glycerol conversion rate of PtRe catalysts compared to Pt mainly stems from the higher rate of CO removal from the surface by the WGS reaction. Pt and Re exhibit a very strong synergy in the gas-phase WGS reaction. Consistent with this, CO stripping voltammetry points to lower onset of CO electro-oxidation for PtRe than for Pt. It is argued that the main influence of Re is its stronger binding of oxygen species facilitating water activation, producing OH species which are involved in the WGS reaction and in C–O bond cleavage reactions.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
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