Radiation Oncology in the Face of Natural Disaster: The Experience of Houston Methodist Hospital
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Young patients, including pediatric, adolescent, and young adult (YA) patients, are most likely to benefit from the reduced integral dose of proton beam radiation therapy (PBT) resulting in fewer late toxicities and secondary malignancies. This study sought to examine insurance approval and appeal outcomes for PBT among YA patients compared with pediatric patients at a large-volume proton therapy center.
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Remapping is a conservative interpolation of a discretized intensive quantity between two meshes. In this article, we propose a novel multi-material flux remapping method that avoids the geometric computation of mesh-mesh intersections needed for an accurate intersection based remap. The flux remap is applicable to scalar quantities such as material density describing the multi-material flow between meshes with the same connectivity but small mesh displacements. Herein, the method is described for two- and three-dimensional polygonal/polyhedral meshes as it is implemented in Portage. Another open source library, Tangram, is used to calculate material interfaces in cells containing more than one material. Performance and accuracy of the flux remap are discussed with respect to Arbitrary Lagrangian-Eulerian simulations and compared to an accurate intersection based remap. In particular, cyclic remapping shows that the accuracy of the flux remap is limited to first order on material boundaries while maintaining second order accuracy in pure material regions.
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Reoccurring drought through the early 2000s has caused a serious water scarcity issue in the Colorado River Basin. Previous modeling studies have focused on the impact of climate change without considering the adaptive behaviors of farmers and under-utilized Indian water rights. Here, we use a coupled agent-based water resource model (ABM) to investigate how the adaptive decisions of farmers can affect water resource management under both climate change impacts and fully utilized Indian water right conditions. We used five General Circulation Model projections with RCP8.5 scenarios for the study. The results of farm-level decision-making showed different responses in irrigated areas that were changing due to climate change impact. While winter precipitation changes might partially explain the behavior changes, no specific pattern could be concluded based on their location. Also, farmers’ responses about annual water diversion showed more significant inter-year variation compared to irrigated areas. Basin-level metrics showed that climate change impacts will generally worsen water scarcity issues as measured in Navajo Reservoir storage, flow to Lake Powell, and instream flow requirement. But these basin-level water scarcity metrics cannot reflect individual farm-level impacts under climate change, which is why modeling the bottom-up management actions is necessary. When the under-utilized Indian water rights are fully used, it is more likely to trigger the shortage sharing agreement due to the higher tribal water depletion. Evaluation of model uncertainty and a more realistic setup for adaptive actions under drought contingency plans are suggested for future research.
The degree to which people worry about radiation exposure from medical imaging has not been quantified. Such concern is important for clinical decision making and policy generation.
Directed energy deposition (DED) is an additive manufacturing (AM) process based on welding technology and offers the advantages of large build volume, high deposition rate, and ability to fabricate multi-material parts. Epitaxial continuous columnar grain growth is a characteristic microstructural feature of DED processed alloys. In this study, a bamboo-like microstructure (periodic alternation of equiaxed and columnar structure) was produced by adopting an intermittent deposition strategy in 316L stainless steel and Inconel 625. The formation of a bamboo-like alternating microstructure was confirmed through electron backscattered diffraction (EBSD) analysis. Hardness mapping showed that the columnar to equiaxed transition (CET) occurred at the region right below the fusion line. A finite element (FE) model was used to investigate the relationship between the temperature gradient (G) and the solidification rate (R). The FE model showed a low G/R ratio at the region right below the interface promoting the CET. The grain size and material-dependent deformation behaviors are analyzed using digital image correlation (DIC). The lower deformation on the fine-grain regions observed in DIC analysis is attributed to a higher strain hardening rate, which is confirmed through dislocation density analysis on a tensile-interrupted specimen. The periodically alternating grain size coupled with the microstructural changes caused by intermittent deposition strategy result in a better strength-ductility synergy in both single-material and bimetallic specimens.
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