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PurposeCraniospinal irradiation (CSI) using tomotherapy has advantages over standard 3-dimensional techniques. However, there is a paucity of published data on craniospinal setup reproducibility to guide appropriate planning treatment volume (PTV) margins. We sought to evaluate the setup accuracy of patients undergoing CSI to optimize PTV margins.Methods and materialsWe measured residual setup deviation between simulation computed tomography (CT) and daily megavoltage CT after couch shifts made by therapists after megavoltage CT-based image registration for 10 patients who completed CSI at our institution. Translational displacement values were recorded at the sella, top of T1, and top of L5 in the anteroposterior (AP) and lateral planes. Systematic and random error were calculated from displacement values. Using z score analysis, we calculated minimal PTV margins to encompass 90% of recorded fractions at each level. We evaluated whether patient characteristics predict for increased setup error using standard statistical techniques.ResultsThe mean setup deviation in the AP plane across all treatments was 2.49, 3.40, and 3.83 mm at the sella, T1, and L5, respectively. Mean lateral setup error was 2.86, 4.02, and 5.46 mm at the sella, T1, and L5, respectively. Systematic error ranged from 0.75 to 1.01 mm at the sella, 1.09 to 1.37 mm at T1, and 1.30 to 1.50 mm at L5. Random error ranged from 1.35 to 1.41 mm at the sella, 1.48 to 1.73 mm at T1, and 2.26 to 2.37 mm at L5. The minimum margin to cover 90% of the treatments was 6.4, 8.2, and 10.5 mm at the sella, T1, and L5, respectively. There appeared to be a correlation between older age and lateral setup error in the L spine approaching statistical significance (R, 0.629; P = .052).ConclusionsSetup error increases in the caudal direction of the spine and is greater in the lateral plane compared with the AP plane. We recommend a PTV margin of 5 to 7 mm in the brain and 10 mm in the spine.

The conflict of the human-water relationships (HWR) has further increased the water-related risks, such as water environment deterioration, water shortages, and even regional violent conflicts for obtaining usable water resources. Knowing how to evaluate and regulate the discordant HWR to form a balanced growth between sustainable socio-economy and water resources protection has become a critical issue in water resources management. The harmony theory method, which provides a new perspective for solving the conflict between humans and water, has been widely used in current studies. However, this method focuses less on the quantitative study of the balance status of HWR. This study proposes a harmony theory-based HWR evaluation method that contains a systematic process of harmony assessment, indicator identification, harmony balance constraints, and harmony regulation for assessing and regulating the discordant HWR. The Henan Province of China, which has a complicated HWR, was selected as a case study to apply and verify the approach proposed in this study. The results indicated that (1) Henan Province showed a poor harmony status. The human–water harmony degree of 18 distinctions in the province varied from 0.41 to 0.76, showing an increasing trend from 2006 to 2018, indicating that the HWR was gradually improving in recent years. (2) The human–water harmony degree showed that HWR in the southwest part of Henan Province, with less human activities, was better than that in its northeast part, which had faster social development. Sanmenxia City, located in the west part of the province, had the highest human–water harmony degree because of the recent water control projects implemented in the city, indicating that human production measures could effectively help improve HWR. (3) At present, Henan Province has serious discordant indicators in these three aspects (water system health, humanistic system development, and human-water system coordination), which proves that it is still facing pressure from both socio-economy sustainable development and water resources protection. Our results provide insight into water resources management in Henan Province and other similar regions. [ABSTRACT FROM AUTHOR]

A reversed-phase high performance liquid chromatographic (RP-HPLC) method was developed for the simultaneous determination of the contents of adapalene and the preservatives (2-phenoxyethanol and methyl-4-hydroxybenzoate) in adapalene gels. The chromatographic analysis was carried out on a Tigerkin C18 column (150 mm x 4.6 mm, 5 microm). The mobile phase was 0.02 mol/L ammonium acetate buffer (pH 3.0) and tetrahydrofuran-acetonitrile with gradient elution, and the detection wavelength was set at 270 nm. The calibration curves were linear over the ranges of 10-100 mg/L (r = 0.9999), 4-40 mg/L (r = 0.9999) and 4-40 mg/L (r = 0. 9999) for 2-phenoxyethanol, methyl-4-hydroxybenzoate and adapalene, respectively. The average recoveries of the three substances were within 98.0%-98.6%. The method is simple, reliable and suitable for the simultaneous determination of adapalene, 2-phenoxyethanol and methyl-4-hydroxybenzoate in adapalene gels.