<p>Quality assurance (QA) is a critical component of radiation oncology medical physics for both effective treatment and patient safety, particularly as innovations in technology allow movement toward advanced treatment techniques that require increasingly higher accuracy in delivery. Comprehensive 3D dosimetry with PRESAGE® 3D dosimeters read out via optical CT has the potential to detect errors that would be missed by current systems of measurement, and thereby improve the rigor of current QA techniques through providing high-resolution, full 3D verification for a wide range of clinical applications. The broad objective of this dissertation research is to advance and strengthen the standards of QA for radiation therapy, both by driving the development and optimization of PRESAGE® 3D dosimeters for specific clinical and research applications and by applying the technique of high resolution 3D dosimetry toward addressing clinical needs in the current practice of radiation therapy. The specific applications that this dissertation focuses on address several topical concerns: (1) increasing the quality, consistency, and rigor of radiation therapy delivery through comprehensive 3D verification in remote credentialing evaluations, (2) investigating a reusable 3D dosimeter that could potentially facilitate wider implementation of 3D dosimetry through improving cost-effectiveness, and (3) validating deformable image registration (DIR) algorithms prior to clinical implementation in dose deformation and accumulation calculations.</p><p>3D Remote Dosimetry: The feasibility of remote high-resolution 3D dosimetry with the PRESAGE®/Optical-CT system was investigated using two nominally identical optical-CT scanners for 3D dosimetry were constructed and placed at the base (Duke University) and remote (IROC Houston) institutions. Two formulations of PRESAGE® (SS1, SS2) were investigated with four unirradiated PRESAGE® dosimeters imaged at the base institution, then shipped to the remote institution for planning and irradiation. After each dosimeter was irradiated with the same treatment plan and subsequently read out by optical CT at the remote institution, the dosimeters were shipped back to the base institution for remote dosimetry readout 3 days post-irradiation. Measured on-site and remote relative 3D dose distributions were registered to the Pinnacle dose calculation, which served as the reference distribution for 3D gamma calculations with passing criteria of 5%/2mm, 3%/3mm, and 3%/2mm with a 10% dose threshold. Gamma passing rates, dose profiles, and dose maps were used to assess and compare the performance of both PRESAGE® formulations for remote dosimetry. Both PRESAGE® formulations under study maintained high linearity of dose response (R2>0.996) over 14 days with response slope consistency within 4.9% (SS1) and 6.6% (SS2). Better agreements between the Pinnacle plan and dosimeter readout were observed in PRESAGE® formulation SS2, which had higher passing rates and consistency between immediate and remote results at all metrics. This formulation also demonstrated a relative dose distribution that remained stable over time. These results provide a foundation for future investigations using remote dosimetry to study the accuracy of advanced radiation treatments.</p><p>A Reusable 3D Dosimeter: New Presage-RU formulations made using a lower durometer polyurethane matrix (Shore hardness 30-50A) exhibit a response that optically clears following irradiation and opens up the potential for reirradiation and dosimeter reusability. This would have the practical benefit of improving cost-effectiveness and thereby facilitating the wider implementation of comprehensive, high resolution 3D dosimetry. Three formulations (RU-3050-1.7, RU-3050-1.5, and RU-50-1.5) were assessed with multiple irradiations of both small volume samples and larger volume dosimeters, then characterized and evaluated for dose response sensitivity, optical clearing, dose-rate independence, dosimetric accuracy, and the effects of reirradiation on dose measurement. The primary shortcoming of these dosimeters was the discovery of age-dependent gradients in dose response sensitivity, which varied dose response by as much as 30% and prevented accurate measurement. This is unprecedented in the standard formulations and presumably caused by diffusion of a desensitizing agent into the lower durometer polyurethane. The effect of prior irradiation on the dosimeters would also be a concern as it was seen that the relative amount of dose delivered to any given region of the dosimeter will affect subsequent sensitivity in that area, which would in effect create spatially-dependent variable dose sensitivities throughout the dosimeter based on the distributions of prior irradiations. While a successful reusable dosimeter may not have been realized from this work, these studies nonetheless contributed useful information that will affect future development, including in the area of deformable dosimetry, and provide a framework for future reusable dosimeter testing.</p><p>Validating Deformable Image Registration Algorithms: Deformable image registration (DIR) algorithms are used for multi-fraction dose accumulation and treatment response assessment for adaptive radiation therapy, but the accuracy of these methods must be investigated prior to clinical implementation. 12 novel deformable PRESAGE® 3D dosimeter formulations were introduced and characterized for potential use in validating DIR algorithms by providing accurate, ground-truth deformed dose measurement for comparison to DIR-predicted deformed dose distributions. Two commercial clinical DIR software algorithms were evaluated for dose deformation accuracy by comparison against a measured deformed dosimeter dose distribution. This measured distribution was obtained by irradiating a dosimeter under lateral compression, then releasing it from compression so that it could return to its original geometry. The dose distribution within the dosimeter deformed along with the dosimeter volume as it regained to its original shape, thus providing a measurable ground truth deformed dose distribution. Results showed that intensity-based DIR algorithms produce high levels of error and physically unrealistic deformations when deforming a homogeneous structure; this is expected as lack of internal structure is challenging for intensity-based DIR algorithms to deform accurately as they rely on matching fairly closely spaced heterogeneous intensity features. A biomechanical, intensity-independent DIR algorithm demonstrated substantially closer agreement to the measured deformed dose distribution with 3D gamma passing rates (3%/3mm) in the range of 90-91%. These results underscore the necessity and importance of validating DIR algorithms for specific clinical scenarios prior to clinical implementation.</p> / Dissertation

Apesar dos avanços recentes na tecnologia dos aparelhos de ressonância magnética (RM) permitirem a aquisição de imagens de alta resolução, ainda não é possível delinear de forma confiável os limites entre regiões de diferentes citoarquiteturas baseando-se somente nesta modalidade. As imagens de histologia são mandatórias quando se necessita saber o limite exato entre diferentes regiões neuroanatômicas. Contudo, o processamento histológico inevitavelmente causa grandes deforma¸coes no tecido, o que torna a compara- ção direta entre as duas modalidades inviável. Os estudos de neuroimagem/neuroanatomia que necessitam de comparação com a histologia devem necessariamente incluir uma etapa de alinhamento entre as duas modalidades; tarefa que muitas vezes acaba sendo realizada manualmente. Entretanto, o registro manual ´e demorado e pouco acurado, se tornando inviável quando os exames de histologia geram centenas de imagens. Este trabalho propõe um método para registro de imagens de histologia e RM, composto por um conjunto de recomenda¸coes para o preparo das imagens cujo objetivo ´e otimizá-las para o registro; e por uma pipeline computacional capaz de registrar as imagens consideradas. O trabalho aqui descrito foi desenvolvido primeiramente com o intuito de registrar imagens de espécimens de hipocampo provenientes do projeto CINAPCE e, posteriormente, para registro de imagens de encéfalo inteiro provenientes do Banco de Cérebros da Faculdade de Medicina da Universidade de São Paulo. A pipeline computacional foi testada com sucesso em imagens reais de dois encéfalos inteiros. A avaliação quantitativa dos registros realizados foi feita comparando segmenta¸coes manuais do hipocampo direito, núcleo caudado esquerdo e ventrículos laterais superiores, realizadas no volume de RM e da histologia registrada. A quantificação do resultado foi feita através do cálculo das métricas coeficiente de Dice (CSD) e distancia espectral ponderada (DEP) sobre as segmentações. A pipeline obteve um CSD médio de aproximadamente 0,77 e um DEP médio de aproximadamente 0,003. Os resultados mostraram que o método foi capaz de registrar as imagens de histologia nas respectivas imagens de RM exigindo interação mínima com o usuário. / Although latest advances in MRI technology have allowed the acquisition of higher resolution images, reliable delineation of cytoarchitectural boundaries is not yet possible based solely on that modality. Histological images are regularly required to locate the exact limits between neuroanatomical structures. Histological processing is nevertheless prone to cause a high amount of tissue distortion, which prevents direct comparison between the two modalities. Neuroimage/neuroanatomy studies that require direct comparison between histology am MRI must include a registration step. Such task is usually manually performed, but that becames infeasible for large histology volumes. Moreover, manual registration is time consuming and inaccurate. This thesis proposes a set of tissue processing recommendations aiming at optimizing the registration proccess, together with a computational pipeline for registering histology to MRI. The herein described work was initially designed to proccess hippocampi specimens from the CINAPCE project and posteriorly improved to process full brain images from the Brain Bank of the Brazilian Aging Brain Study Group. The pipeline was tested on two full brain histology volumes from the Brain Bank of the Brazilian Aging Brain Study Group. Results were assessed by comparison of manual segmentations of the left caudate nucleus, right hippocampus and superior lateral ventricles, performend on both MRIs and registered histology volumes. Quatitative evaluation was performed by computing the Dice coeficient (DC) and normalized weighted spectral distance (WESD) on the segmentations. The pipeline precessing yielded mean DC of 0.77 and mean WESD of 0.0033. The described method was able to sucessfuly register histology to their corresponding MRI volumes with minimal user interaction.

Techniques described to date for the reproducible and noninvasive quantification of regional cardiac function have been largely relegated to research settings due to time-consuming and cumbersome image acquisition and analysis. In this thesis, feature tracking algorithms are developed for 2-D+Time cardiac magnetic resonance (CMR) and 3-D+Time cardiac computed tomography (CCT) image sequences that are easily acquired clinically, while emphasising reproducibility and automation in their design. First, a commercially-implemented CMR feature tracking algorithm for the analysis of steady state free precession (SSFP) cine series is evaluated in patients with hypertrophic cardiomyopathy (HCM) and arrhythmogenic right ventricular cardiomyopathy (ARVC), which primarily affect the left ventricle (LV) and right ventricle (RV), respectively, and functional impairment compared with control populations is found in both cases. The limitations of this implementation are then used to guide development of an automated algorithm for the same purpose, making use of fully convolutional neural networks (CNN) for segmentation and spline registration across all frames simultaneously for tracking. This study is performed in the subjects with HCM, and functional impairment is again identified in disease subjects. Finally, as myocardial contraction is inherently a 3-D phenomenon, a technique is developed for quantification of regional function from 3-D+Time functional CCT studies using simultaneous registration of automatically generated Loop subdivision surface models for tracking. This study is performed in canine mongrels, and compared with the current state of the art technique for CCT functional analysis. This work demonstrates the feasibility of automated, reproducible cardiac functional analysis from CMR and CCT image sequences. While work remains to be done in extending the principles demonstrated and modular components described to fully automated whole-heart analysis, it is hoped that this thesis will accelerate the clinical adoption of regional functional analysis.

In an era that national flags are dying off (Sletmo 2001) there is no dispute about the success of Greek flagged shipping. How can a small nation like Greece retain the highest percentage of all national fleets? Literature identifies that this success is due to several reasons. However, what are the elements that contribute to the success of Greek-flagged shipping? This study establishes that ‘the success of Greek ocean-going flagged shipping is a blend of a tendency for governments to experiment with various policies intended to promote national competitiveness, individual entrepreneurship, the cluster as well as culture, knowledge and skill’. Litrature from different disciplines and sources are summarised, compared, contrasted, and synthesised in order to develop a coherent outcome and gain a new perspective in the respective field. Since “policy is like beauty in the eye of the beholder…” (Roe 2007c) a multilevel, holistic, exploratory, inductive, deductive, abductive, and overall pragmatic methodological approach is considered, as the only viable option for complex research questions related to maritime policy. A three-method approach is applied with every method contributing to each other: the Timeline A to Ω and Literature Analysis, Delphi Method, and the Application of Porter’s diamond on national competitiveness. The belief that traditional flags are dying off, implies that they are not dead yet. The Greek Registry, and every ship registry is a system of people, organisations , and processes and it is that system that contributes to the success of the flag. Contrary to the belief of some players, government policy affects the size and the quality of the national flag ocean-going fleet undertaking various polices intented to promote national competitiveness. This study contributes to academic knowledge as well as to the Greek and any other registry’s competitiveness, as well as to the govenemental decision making and development of maritime policies. Recommendations are made for the Greek flag and the maritime policy, as well as for the application of the GREKON MODEL to the real maritime world and academia.

Integration of work-placements into undergraduate degrees is now established on awards linked to professional registration in healthcare. Pre-registration training forms the basis for development of capability and entry onto a professional register. This enquiry explores how key stakeholders on a programme leading to registration as a Biomedical Scientist (BMS) position themselves in their role and the subsequent impact of this upon the development of the capable BMS. It draws upon current knowledge of work-based pedagogy and utilises a constructivist grounded theory (CGT) approach to explore the perceptions and experiences of individuals and groups to develop an interpretative portrayal and deeper understanding of the implementation of pre-registration training in one region of England. Data gathering and analysis was divided into two stages. The first employed analysis of professional documents to provide an insight into current discourses around BMS training. This provided initial developing categories and directed the creation of a questionnaire. Questionnaire responses confirmed the relevance of the developing categories and a summary of responses provided an ‘ice-breaker’ to guide stage two of data gathering. This stage employed focus groups and interviews to enable a greater understanding of how individuals make sense of their experiences. Initial, focused and theoretical coding allowed synthesis and conceptualisation of the data gathered and presented direction for the enquiry. The findings expose the challenges of integrating professional registration training into an academic programme of study. Three theoretical categories were identified: Role conflict, Expectations and Ownership. Conceptualising the interactions and intersections of these categories enabled the recognition of ‘Doing the portfolio’ as a way of describing and conceptualising the stakeholders positioning within the current programme. The registration portfolio has become an objective reductionist measure of learning, reflecting the positivist typology of practice in this profession. This provides a theoretical explanation as to how the programme is delivered and why there is a need to rethink conceptualisation of the role of the programme in supporting pre-registration training and the development of the capable BMS. To ensure that BMS students are supported to develop not only technical skills but also professional capability there is a need for a paradigm shift from a positivist episteme to one that embraces both the positivist and socio-cultural paradigms, viewing them as complementary and parallel. The novel research approach used in this enquiry has generated rich insights into how stakeholders interact with the pressures of internal and external influences and the impact this has upon behaviours and strategies adopted. The theoretical understanding proposed, which recognises the tensions emerging from a positivist typology of practice, has a range of implications for practice and for the development of practitioner capability through pre-registration training and beyond.

abstract: Advancements in computer vision and machine learning have added a new dimension to remote sensing applications with the aid of imagery analysis techniques. Applications such as autonomous navigation and terrain classification which make use of image classification techniques are challenging problems and research is still being carried out to find better solutions. In this thesis, a novel method is proposed which uses image registration techniques to provide better image classification. This method reduces the error rate of classification by performing image registration of the images with the previously obtained images before performing classification. The motivation behind this is the fact that images that are obtained in the same region which need to be classified will not differ significantly in characteristics. Hence, registration will provide an image that matches closer to the previously obtained image, thus providing better classification. To illustrate that the proposed method works, naïve Bayes and iterative closest point (ICP) algorithms are used for the image classification and registration stages respectively. This implementation was tested extensively in simulation using synthetic images and using a real life data set called the Defense Advanced Research Project Agency (DARPA) Learning Applied to Ground Robots (LAGR) dataset. The results show that the ICP algorithm does help in better classification with Naïve Bayes by reducing the error rate by an average of about 10% in the synthetic data and by about 7% on the actual datasets used. / Dissertation/Thesis / M.S. Electrical Engineering 2011

O setor público brasileiro tem grande influência na economia, considerando o volume de tributos que arrecada e também pelo volume de bens públicos que administra, os quais, em matéria contábil, em parte, representam ativos patrimoniais. Este trabalho teve como objetivo propor um modelo de identificação e de classificação de Ativos para as entidades do setor público, harmonizando os conceitos constitucionais, legais e normativos, especialmente com as Normas Brasileiras de Contabilidade Aplicáveis ao Setor Público. Procurou-se evidenciar a possível convergência de conceitos de Ativos para entidades do setor público, as definições de bens da União e dos Estados, assim definidos no artigo 20 e 31 da Constituição Federal de 1988, bem como a convergência de conceitos de Ativos de entidades setor privado para com os de bens públicos. Para tanto, realizou-se uma revisão bibliográfica quanto à conceituação de bens, de bens públicos, de ativos e do patrimônio público, previstas nos diversos regramentos constitucionais e legais do país e na literatura. O trabalho resultou na identificação das diversas classes de ativos públicos, na estruturação de um modelo de identificação e classificação dos bens, com exemplos de utilização, visando a facilitar e qualificar os procedimentos de registro e o relevo dos bens públicos. O que, o caso, poderá ser útil para o entendimento dos eventos contábeis relacionados à identificação e sua classificação. / The Brazilian public sector has great influence on the economy, considering the amount of taxes it collects, and also by the volume of public goods that manages, which in accounting matters partly represent corporate assets. This study aimed to propose a model for the identification and classification of assets for the public sector entities, harmonizing the constitutional, legal and regulatory concepts, especially with the Brazilian Accounting Standards applicable to the Public Sector. It was essayed to evidence the possible convergence of Assets concepts for public sector entities to the (União) Federal Government and States assets definitions, as delineated in the Article 20 and 31 of the 1988’s Federal Constitution and the convergence of assets concepts of entities from private sector towards public goods. For that a literature review was conducted on the concept of goods, public goods, assets and public property, under the various constitutional and legal specific regulations of the country and in the literature. The work resulted in the identification of several classes of public assets and in the structuring of a model for identification and classification of goods, with examples of use, in order to facilitate and qualify registration procedures and disclosure of public goods, which could be useful for the understanding of accounting events related to their identification and classification.

Thesis (MTech (Business Administration in Project Management))--Cape Peninsula University of Technology, 2017. / The beginning of the 2011 academic year in South Africa saw a number of Institutions of Higher Learning introducing online registration for their students. The efficiency and effectiveness of Information Systems is increasingly becoming a necessity and not an option for many organizations. An information system should be able to allow end users to access information easily and navigate with ease. The selected University of Technology (UoT) in this research is one of the largest public institution of higher learning in the Western Cape Province and boasts of an enrolment of more than 30 000 students per academic year. An observation was made that, during registration students stand in long queues waiting to register or for assistance to register. The system tends to ‘freeze’ whilst students are registering and students are in most cases unfamiliar with the system interface. They constantly have to enquire what to do next when going through online registration process. This study adopted a quantitative approach. The study uses constructs of the updated DeLone and McLean IS success model (2003) to analyse and explain the student’s perceptions of the online registration system. The research was undertaken to establish the student’s perceptions of the online registration system. This research identifies the challenges and success factors of introducing an online registration system, from a students’ perspective, whilst highlighting the extent to which this system has been able to solve problems associated with the manual registration era. The study seeks to assist management and those responsible for managing the current system to determine how well the system is working or not working to achieve user satisfaction. It will also assist them going forward on what to consider before, during and after implementation of an information system. Stemming from the findings of this study, recommendations were made such as making online registration available on mobile devices, online registration orientation can assist students navigate the system easily. The UoT should also consider thorough training for staff that assist students during registration to ensure good service quality.

<b>BACKGROUND:</b> Evidence-based medicine has had a profound impact on healthcare. In the field of Plastic surgery, powerful examples include; less radical skin cancer excision margins and skin-sparing or even nipple-sparing mastectomies and microsurgical reconstruction. Sustained progression of the field, relies on the development of a high-quality evidence base, with strong use of peer-reviewed research protocols, which are publicly registered and completed studies transparently reported. The extent of compliance with these principles is currently unknown and the author hypothesised that it would be low. The author further hypothesised that registration could be improved by the development of a new global research registry and reporting quality can be improved by the mandatory implementation of reporting guidelines in a journal. <b>METHODS:</b> This thesis incorporated 11 studies. The first two studies used a literature review to determine; the levels of evidence, rates of study registration and protocol publication in the recent Plastic Surgery literature. Thirdly, the design, build and launch of a new global research registry to boost compliance with registration and to determine barriers to it using a survey amongst users. This would be followed by systematic reviews to determine compliance with the STROBE and PRISMA guidelines respectively. An analysis of each guide for authors (GFA) of the surgical journals listed in the Thomson Reuters journal citation report for surgery to determine support for reporting guidelines. The impact of the mandatory implementation of reporting guidelines in a surgical journal would be assessed using a before and after design. Finally, to develop a reporting guideline for surgical case reports (SCARE) and surgical case series (PROCESS) using a DELPHI consensus exercise amongst an expert panel. <b>RESULTS:</b> Protocols were registered in 4% of 595 recent research studies and 0.5% were published. There was a mean compliance of 12/22 for the STROBE guideline (n=94) and 16/27 for the PRISMA guideline (n=79). The Research Registry® was launched in February 2015. Analysis of the first 500 previously unregistered studies, showed they came from 57 countries and included 1.77 million patients. Key barriers to registration were a lack of awareness of the need to register and lack of time (n=149). In addition, 45% registered their study at the time of journal submission. The GFA analysis showed 62% didn’t mention reporting guidelines at all (n=193). Subsequent mandatory implementation in a single surgical journal, increased compliance with STROBE by 12% (n=152), with CONSORT by 40% (n=13) and with PRISMA by 58% (n=28). The SCARE and PROCESS reporting guidelines were developed and published in late 2016. According to Google Scholar, they have accumulated over 200 citations at the time of writing. <b>CONCLUSION:</b> Study registration, protocol use and reporting quality are poor in plastic surgery. Potential solutions to these long-standing problems have been developed and explored within this thesis. These include the development and use of the Research Registry® and the mandatory implementation of reporting guidelines, with both measures front-loaded within a gatekeeper framework for journals. It is now for Plastic Surgeons and the wider surgical community to pick up the gauntlet and drive forward high-quality research, evidence-based surgical practice and better outcomes for their patients and society at large.

This article analyzes two central points, which are the expropriation from a criticism on what the new Expropiation Law indicates; and from that law, the author will refer about the role of registration qualification and how it has developed in practice. Finally, the author concludes three important issues that they have been derived from the analysis of the law, and presents the conclusions through a critique to the issue of property in our country. / El presente artículo realiza un análisis sobre dos puntos centrales, que son la expropiación a partir de una crítica a lo que señala la nueva Ley de Expropiaciones; y a partir de dicha Ley el autor también se referirá sobre la función de calificación registral y cómo esta se ha desarrollado en la práctica. Finalmente, el autor concluye tres temas importantes derivados del análisis a dicha norma, y presenta las conclusiones haciendo una crítica al tema de la propiedad en nuestra en país.