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Background: The high tangent field (HTF) technique is used to provide radiation coverage of the inferior axillary nodal levels for breast cancer patients when the lower axilla is at risk for micrometastatic disease. Despite its use in clinical practice, there is concern about whether HTF provide sufficient coverage of level I and II axillary nodal regions. The purpose of this study is to quantify and evaluate the coverage of HTF at our institution. Methods: Patients diagnosed with early invasive breast carcinoma (pT1-2 pN0-1a) who received HTF radiation between January 1st, 2012, and December 31st, 2016 were retrospectively reviewed. Level I and II axillary nodal regions were contoured on each patient's simulation CT. Dosimetric parameters were recalculated to evaluate coverage. Statistical analysis was conducted using Mann-Whitney-U method. Results: Thirty-seven patients with low-risk breast adenocarcinoma were included. For level I and II, the mean V90% was 94.63% ± 7.60% and 73.33% ± 21.83% respectively. Twenty-nine patients received adequate V90% coverage of level I and had a mean level II V90% of 76% ± 18.71% while eight patients who did not receive adequate V90% level I coverage had a mean level II V90% of 63.64% ± 30.22%. The median level II V90% of patients receiving adequate and inadequate level I V90% was 77.74% and 71.11% respectively; the difference was not statistically significant (P = 0.33). Conclusion: HTF provides adequate coverage for level I nodes, but inadequate coverage for level II. Contouring nodal volumes may assist field placement and improve nodal volume coverage. [ABSTRACT FROM AUTHOR]

Objectives Grandpal Penpals (GP) is a unique community program that connects seniors living in residential care with elementary school students through pen pal letter writing and visits. A common belief is that seniors have a lower quality of life in residential care facilities. We qualitatively explored how this program related to the senior participants' quality of life in the domains of motivation, activities, relationships, and autonomy. Methods Among participants in the GP program, seniors who were sufficiently cognitively intact were chosen to participate in our study. In--person interviews were conducted with participants at the beginning and at the end of the program to determine major themes. Results Four major themes were identified: 1) GP strengthened the participants' pre--existing motivations, 2) participants perceived social programs like GP to be enjoyable and beneficial while actively involved, 3) most participants found that GP did not affect their interpersonal relationships, and 4) GP did not affect the participants' self--perceived level of autonomy. Conclusions While participants greatly enjoyed GP, they perceived little relation of the program to their overall quality of life. Our research suggests that other highly engaging, goal--oriented, long--term social programs with increased senior--senior or senior--family interaction may be of greater relevance and benefit. [ABSTRACT FROM AUTHOR]

Proposes an approach that allows low-cost concurrent detection of software and hardware data-access faults using an extension of the existing signature monitoring approach. Description of signature monitoring approach; Signature monitoring; Data-structure signatures (DSS); Scheduling DSS monitoring instructions; Architectural support for DSS checking; Experimental results for an emulation of DSS monitoring.