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High-energy Proton Beam Therapy (PBT) commenced in England in 2018 and NHS England commissions PBT for 1.5% of patients receiving radical radiotherapy. We sought expert opinion on the level of provision. Invitations were sent to 41 colleagues working in PBT, most at one UK centre, to contribute by completing a spreadsheet. 39 responded: 23 (59%) completed the spreadsheet; 16 (41%) declined, arguing that clinical outcome data are lacking, but joined six additional site-specialist oncologists for two consensus meetings. The spreadsheet was pre-populated with incidence data from Cancer Research UK and radiotherapy use data from the National Cancer Registration and Analysis Service. 'Mechanisms of Benefit' of reduced growth impairment, reduced toxicity, dose escalation and reduced second cancer risk were examined. The most reliable figure for percentage of radical radiotherapy patients likely to benefit from PBT was that agreed by 95% of the 23 respondents at 4.3%, slightly larger than current provision. The median was 15% (range 4–92%) and consensus median 13%. The biggest estimated potential benefit was from reducing toxicity, median benefit to 15% (range 4–92%), followed by dose escalation median 3% (range 0 to 47%); consensus values were 12 and 3%. Reduced growth impairment and reduced second cancer risk were calculated to benefit 0.5% and 0.1%. The most secure estimate of percentage benefit was 4.3% but insufficient clinical outcome data exist for confident estimates. The study supports the NHS approach of using the evidence base and developing it through randomised trials, non-randomised studies and outcomes tracking. Less is known about the percentage of patients who may benefit from PBT than is generally acknowledged. Expert opinion varies widely. Insufficient clinical outcome data exist to provide robust estimates. Considerable further work is needed to address this, including international collaboration; much is already underway but will take time to provide mature data. [ABSTRACT FROM AUTHOR]

Broken bones and other joint injuries are the number one reason that people seek help from a hospital emergency department (ED). [ABSTRACT FROM AUTHOR]

Post-pyloric feeding is recommended in critically ill patients with gastrointestinal intolerance. However, traditional placement methods are logistically difficult and carry potential risks. The authors retrospectively compared the position of post-pyloric feeding tubes (PPFTs) using an electromagnetic device that demonstrated by X-ray and analysed the complication rates, proportion of lung placements avoided and the time taken to establish enteral feeding. Forty placements in 37 mechanically ventilated patients were analysed; there was a success rate of 87.5%. Sensitivity and specificity were 77% (95% CI 59.9-89.6%) and 100% (95% CI 48.0-100%). Five lung placements were identified in real time and therefore avoided. The mean (SD) time from PPFT placement to X-ray was 134 minutes (± 139 minutes) and, to feeding, 276 minutes (± 213 minutes). In conclusion, placement of PPFT using an electromagnetic device carries a high success rate, is safe and feasible to undertake at the bedside in mechanically ventilated patients. [ABSTRACT FROM AUTHOR]

Gastric confirmation by pH is only achievable in approximately 50% of placements and X-rays are expensive and may be misinterpreted. Bedside electromagnetic (EM) guidance offers real-time confirmation. The authors determined the accuracy of guidance in predicting gastric body position from the EM trace using official Cortrak guidance (the EM trace reaches the bottom left quadrant of the anterior screen) compared with local guidance (detailed anterior-depth description of the GI flexures). X-ray, pH or an EM trace beyond the gastric body were used to independently confirm gastric position. Of 496 EM traces, 49% of tubes were in the oesophagus on entry to the lower left quadrant whereas 12% had already reached the gastric body in the upper left quadrant. Overall, predicting position by quadrant was 70% accurate whereas differentiating the pre-gastro-oesophageal junction (pre-GOJ) from the gastric body flexure was 100% accurate. Confirming gastric position by the anterior trace quadrant appears to be unsafe whereas expert differentiation of the pre-GOJ and gastric body flexures was reliable. The authors invite Corpak Medsystems (now owned by Halyard Health) to update its guidance in view of these findings. [ABSTRACT FROM AUTHOR]

Around 5% of hospital patients require enteral tube feeding, yet its efficacy and costs are poorly understood. The authors examined radio-opacity, reason for repeat X-ray and overall cost in consecutive patients having tubes confirmed by X-ray when using polyvinylchloride (PVC) Ryles tubes versus CORFLO® (CORTRAK Medsystems) polyurethane tubes (PUTs); and confirmation method and reason for tube loss over an enteral episode. Despite higher PUT cost, because more Ryles tubes required re-X-ray ± radiocontrast injection (0% compared with 26%, p=0.029), overall cost was almost identical (Corflo: £54.2 vs Ryles: £54.6). Confirmation of tube position by X-ray remains more common than pH (51% compared with 45%) and tube loss is mostly as a result of inadvertent patient removal (54%). These studies show that: a) when using X-ray confirmation, PUTs and PVC Ryles tube cost is similar; b) despite pH being taught as first-line confirmation, X-ray remains the most common method therefore PUT use may further reduce cost when staff and outcome costs are included. In addition, more reliable and repeatable bedside confirmation methods are required; c) most tube loss is potentially preventable by use of nasal bridles. Larger studies are required to establish baseline data on problems and costeffectiveness of enteral tube feeding before intervention trials. [ABSTRACT FROM AUTHOR]

In 2008 the remains of a chain pump were recovered from the wreck of the third-rate man-of-war Northumberland, which sank on the Goodwin Sands in the English Channel, during the Great Storm of November 1703. Chain pumps were vital equipment and integral to the safety of the ship. Historical evidence is mined for comparative material, and the recovery, conservation strategy, study and recording of this artefact using X-ray and CT scanning are discussed. Information gleaned, hitherto absent from the historical and archaeological record, includes details of the pump's chain, hook and swivel, valves and roller. [ABSTRACT FROM AUTHOR]

The fourth international workshop on Adaptive and Active X-ray & XUV Optics (ACTOP11) was held on April 4-5, 2011, at Diamond Light Source in Oxfordshire, UK. This workshop follows on from earlier, successful active optic events at SOLEIL (2006), Elettra (2008), and Osaka (2009). [ABSTRACT FROM AUTHOR]

On December 28, 1895, the German physicist Wilhelm Conrad Röntgen disclosed his discovery of X-rays to the public. Just a few months later, Guglielmo Marconi successfully demonstrated his wireless system at Salisbury Plain, England. This article traces the relations between the early histories of wireless and X-ray technology. It does so by highlighting the role played by psychic research to open the connections between different technologies and knowledges. The disclosure of occult connections between these two technologies helps to locate the cultural reception of wireless around 1900 in a wider cosmology of rays and invisible forces. [ABSTRACT FROM AUTHOR]

Abstract: X-ray phase contrast imaging solves the basic problem of conventional X-ray imaging, i.e. low image contrast arising from small absorption differences. For years X-ray phase contrast imaging was thought to be restricted to synchrotron radiation facilities, but a new approach was recently developed at UCL which makes synchrotron-like phase effects achievable with conventional sources, by introducing two separate sets of appropriately designed coded-apertures at either side of the imaged object. Although most proposed applications of X-ray phase contrast imaging are focused on medical aspects, substantial advantages can be gained in other fields, including security inspections. In this case the system has to be based around higher X-ray energies, which has an impact on the system design. This paper describes such a design. A previously developed and experimentally validated simulation program was used to estimate the image contrast that can be expected from a range of details of interest in security inspections imaged under various conditions, including beam spectrum, detector characteristics, coded-aperture design, source-to-sample and sample-to-detector distances, etc.—while taking into account the interplay between these different parameters. The conditions providing maximum image contrast were chosen and used in the ultimate system design. [Copyright &y& Elsevier]

Chest X-rays are widely used in the investigation of patients with both functional and organic mental illness. For patients with dementia their routine use has been recommended by many authorities. However, the existing evidence to support such use is not strong. A prospective audit was performed to ascertain the yield of chest X-rays affecting patient management in a series of consecutive admissions covering all diagnoses. The yield of unexpected findings was substantial, but few of these led to a change in medical management and hence potentially to the course of illness. Apparently significant radiological findings did not always correlate with actual physical illness. The low yield of results affecting management does not support the routine use of chest radiography in elderly mentally ill, and its use should be limited to when functional illness is refractory to treatment or when demented patients suddenly deteriorate without obvious cause. [ABSTRACT FROM AUTHOR]

Examines the high energy neutron treatment for pelvic cancers in Wirral, England. Comparison between high energy neutron with megavoltage X ray treatment; Development of metastatic disease and treatment related morbidity; Factors affecting the stoppage of trials.

The electron microscope was conceived and built in the Technical University of Berlin some 50 years ago. Much of its further development took place in university laboratories. Some significant contributions came to be made in the Cavendish is respect of high voltage operation and the improvement of resolution, and in microanalytical instrumentation.
Part I (Vol. 22, no. (1), pp. 3-36), covering the years, 1946-60, included some account of the prehistory of he subject, the exploration of the operation and applications of the first commercial models, the development of an X-ray microscope and, from it, the scanning microprobe analyzer Part II now continues the story, through the two following decades, the conception and construction of a high voltage electron microscope, and then its extension to an instrument capable of atomic resolution. [ABSTRACT FROM AUTHOR]

Examines the reasons of requesting x-ray examinations for acute ankle injuries in London, England. Revision on the notes and radiographs of patients with ankle injuries; Assessment on the number of radiographs of the foot requested by patients; Conclusion that the absence of clinical tissue swelling indicates that no ligamentous damage is present.

The article reports on a poll conducted to celebrate the centenary of the Science Museum in London, England in which x-ray machines were chosen by voters as the most important scientific invention. Almost 50,000 people who participated in the poll voted in the ballot to choose from 10 innovations that the museum curators have selected. The x-ray machine built by general physician John Reynolds and his son emerged as a winner, earning 9581 votes from the poll. However, the discovery of penicillin has earned the second place.

The article reports that a new facility for real-time X-ray inspection of manufactured parts has been opened by Euroteck Systems UK Ltd. in Tamworth, England. The X-ray systems are rated up to 160 kV. They include both high-power systems for inspecting steel parts and smaller focal spot systems that give the capability of significant magnification without losing image quality.

Comments on the annual BINDT conference regarding radiography in Harrogate, England. Presentations of the automated digital and computed radiography theme; Use of defect recognition algorithms on digital images; Selection of the papers related to the topics discuss in the conference.

Profiles professor Roger A. Cowley of the University of Oxford in England, recipient of the 2003 Walter Hälg Prize. Original work of Cowley recognized by the European Neutron Scattering Association; Series of firsts in experiments with neutrons and X-rays and in theory by Cowley; Professional background of Cowley.

Discusses the future of Daresbury Laboratory in England as of October, 2000. Laboratory's attainment of government funding for nine collaborative projects; How Daresbury houses Great Britain's only synchrotron light source, which create X-rays to determine the structure of biological molecules; Description of the projects, including a Third Generation Proteomics project with the University of Manchester Institute of Science and Technology.

The article cites a study which reports that diagnostic likelihood of exposing the testes to radiation and are taken within one year before men father a child may have detrimental effects on the infant. Among 7,678 infants born in 1991-1992 in Avon, England, 172 had fathers who had undergone an X ray of the abdominal or pelvic area in the year before conception. The study found that these infants weighed, on average, 79 grams less at birth than those whose fathers had not had such a test. It suggest an association between men's exposure to X-rays and effects on reproductive out-comes.