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Search indexed NASA NTRS and DOE OSTI research on propulsion, heat transfer, battery materials and energy systems. Follow report and document links to the original sources.

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All sourcesNASA NTRSDOE OSTI
DOE OSTI2019

Was Reexcision Less Frequent for Patients with Lobular Breast Cancer After Publication of the SSO-ASTRO Margin Guidelines?

Background: The Society of Surgical Oncology and American Society for Radiation Oncology consensus guidelines defined a negative margin for breast-conserving surgery (BCS) as no ink on tumor, and implementation has reduced rates of additional surgery for patients with invasive ductal cancer (IDC). The outcomes for invasive lobular cancer (ILC) patients are uncertain. Methods: This study identified patients who had stage 1 or 2 ILC treated with BCS from January 2010 to February 2018. The guidelines were adopted 1 January 2014. Clinicopathologic characteristics, margin status, and reexcisions were compared before and after adoption of the guidelines and with those of IDC patients treated from May 2013 to February 2015. Results: Among 745 early-stage ILC patients undergoing BCT, 312 (42%) were treated before the guidelines and 433 (58%) after the guidelines. Most clinicopathologic characteristics were similar between the two groups, with differences in lobular carcinoma in situ, lymphovascular invasion, and node-positivity rates. The overall rates of additional surgery declined significantly after the guidelines (31.4 to 23.1%; p = 0.01), but the difference did not reach significance for reexcisions (19.9 to 15.2%; p = 0.12) or conversions to mastectomy (11.5 to 7.9%; p = 0.099) individually. Between eras, no difference in incidence or number of tumor on ink or ≤ 2 mm margins was observed (all p = 0.2). Larger tumors, younger age, and pre-guideline era were independently associated with additional surgery. Only younger age was predictive of mastectomy. Among 431 pre-guideline and 601 post-guideline IDC patients, reexcisions declined from 21.3 to 14.8% (p = 0.008), and conversion to mastectomy was rare (0.6%). The magnitude of reduction in any additional surgery (interaction, p = 0.92) and reexcisions (interaction, p = 0.56) was similar between ILC and IDC. Conclusions: Despite differences in growth pattern and conspicuity, guideline adoption significantly reduced additional surgery among ILC patients, with a magnitude of benefit similar to that among IDC patients.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2021

ESS-DIVE guidelines for archiving terrestrial model data

This dataset contains supporting documents and images for ESS-DIVE terrestrial model data archiving guidelines.Terrestrial models are broadly defined as numerical models that couple both land dynamics and energy, water, carbon, or nutrient fluxes. We created these guidelines based on input from the U.S. Department of Energy’s Biological and Environmental Research land modeling community. The guidelines are intended to help modelers determine which components of their terrestrial model data associated with publication should be archived. Based on input from the land modeling community, the guidelines recommend archiving both model input and testing data, as well as code, script, and metadata. The guidelines also recommend archiving model data output, depending on the limitations set by data repositories. Lastly, we provide recommendations for bundling data files for publication as well as a discussion about tools that can facilitate model data archiving and reuse.This dataset is an archive of the associated GitHub repository for our model archiving guidelines (https://github.com/ess-dive-community/essdive-model-data-archiving-guidelines). The ‘README.pdf’ file gives a general introduction to the guidelines, and the ‘instructions.pdf’ file provides more detailed steps for following the guidelines. We also provide 2 figures in this data package: 1) a decision tree (model_data_guidelines_decision_tree.png) that can help users determine which components of their model data to archive. and 2) the ‘model_data_guidelines_flmd.png’ file depicts the different files that can be archived in addition to the model data itself. Lastly, we include 3 digitized tables from our associated manuscript and 3 CSV files with anonymized input from DOE scientists about the importance of different aspects of model data archiving from which we developed the guidelines.Dataset updates for v1.1.0: We updated this data package on 2021-11-22 in response to review comments on our related manuscript. In this update we removed one figure so that the model archiving guidelines are conveyed in text rather than an image. We updated the file-level metadata (FLMD) figure to be in accord with the most recent FLMD recommendations. We made minor edits to the README file to update the recommended citation and added two co-authors. We also added 6 new data files (3 are anonymized input from DOE scientists that helped to inform guidelines, and 3 are digitized tables from our manuscript.

54 ENVIRONMENTAL SCIENCES↗
DOE OSTI2019

Impact of the SSO-ASTRO Margin Guideline on Rates of Re-excision After Lumpectomy for Breast Cancer: A Meta-analysis

Background: One in five patients undergoing initial lumpectomy for invasive breast cancer subsequently undergoes re-excision or mastectomy. A lack of clarity of when to re-excise based on lumpectomy margin width contributes to this high rate of reoperation. We sought to determine the impact of the Society of Surgical Oncology (SSO) and American Society of Radiation Oncologist (ASTRO) margin guideline on reoperation rates after lumpectomy. The guideline recommended omission of routine re-excision in specimens with “no ink on tumor”. Methods: A systematic literature review was performed. For eligible studies, a random-effects model was used for a meta-analysis of lumpectomy re-excision prevalence before and after publication of the SSO-ASTRO margin guideline. Study heterogeneity was measured by the Cochran’s Q test. Results: Five institutional, one population-based, and one national registry study met inclusion requirements. Sample size per study ranged from 237 to 26,102. There was significant interstudy heterogeneity (Q = 19.779; p = 0.003). Pooled re-excision prevalence was 22% (confidence interval [CI] 20–23) before and 14% (CI 12–15) after guideline publication. With the pre-guideline re-excision prevalence used as the reference value, the associated odds ratio for re-excision after the guideline was 0.65 (CI 0.54–0.78; p < 0.0001). Conclusions: The findings of a 35% reduction in the odds of re-excision after the guideline publication and a reduction in re-excision prevalence from 22 to 14% supports the notion that the SSO-ASTRO margin guideline was impactful. These findings are congruent with the projected reductions in re-excision at the time of guideline publication.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2019

Accuracy of Fukuoka and American Gastroenterological Association Guidelines for Predicting Advanced Neoplasia in Pancreatic Cyst Neoplasm: A Meta-Analysis

Background: A differential diagnosis of advanced pancreatic cystic neoplasms (PCNs) is critical to determine optimal treatment. The Fukuoka and American Gastroenterological Association (AGA) guidelines are the most widely accepted criteria for the management of PCNs. Objective: This study aimed to evaluate the diagnostic value of these guidelines in predicting advanced neoplasia (AN). Methods: A comprehensive electronic search of the PubMed, EMBASE, Web of Science, Cochrane Library, and Scopus databases was conducted to identify all relevant studies evaluating the Fukuoka and AGA guidelines in surgically resected and histologically confirmed PCNs. Pooled sensitivity, specificity, and diagnostic odds ratios (DORs) were calculated as compound measures of diagnostic accuracy using the random-effects model. Summary of receiver operating characteristic (SROC) curves and the area under the curve (AUC) were also performed. Results: A total of 21 studies with 3723 patients were included in this meta-analysis. Of these studies, 15, 4, and 2 evaluated the Fukuoka guidelines, the AGA guidelines, and both guidelines, respectively. For AN prediction, the Fukuoka guidelines had a pooled sensitivity of 0.67 (95% confidence interval [CI] 0.64–0.70), pooled specificity of 0.64 (95% CI 0.62–0.66), and pooled DOR of 6.28 (95% CI 4.38–9.01), with an AUC of the SROC of 0.78. AGA guidelines showed a pooled sensitivity of 0.59 (95% CI 0.52–0.65), pooled specificity of 0.77 (95% CI 0.74–0.80), and pooled DOR of 5.84 (95% CI 2.60–13.15), with an AUC of 0.79 (95% CI 0.70–0.88). Conclusion: When used alone, the Fukuoka and AGA guidelines showed similar but unsatisfactory diagnostic accuracy in the risk stratification of malignant potential of PCN. Thus, we recommend that they be applied only as a broad framework in clinical practice.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
NASA NTRS2013

Human Factors Guidelines for UAS in the National Airspace System

The ground control stations (GCS) of some UAS have been characterized by less-than-adequate human-system interfaces. In some cases this may reflect a failure to apply an existing regulation or human factors standard. In other cases, the problem may indicate a lack of suitable guidance material. NASA is leading a community effort to develop recommendations for human factors guidelines for GCS to support routine beyond-line-of-sight UAS operations in the national airspace system (NAS). In contrast to regulations, guidelines are not mandatory requirements. However, by encapsulating solutions to identified problems or areas of risk, guidelines can provide assistance to system developers, users and regulatory agencies. To be effective, guidelines must be relevant to a wide range of systems, must not be overly prescriptive, and must not impose premature standardization on evolving technologies. By assuming that a pilot will be responsible for each UAS operating in the NAS, and that the aircraft will be required to operate in a manner comparable to conventionally piloted aircraft, it is possible to identify a generic set of pilot tasks and the information, control and communication requirements needed to support these tasks. Areas where guidelines will be useful can then be identified, utilizing information from simulations, operational experience and the human factors literature. In developing guidelines, we recognize that existing regulatory and guidance material will, at times, provide adequate coverage of an area. In other cases suitable guidelines may be found in existing military or industry human factors standards. In cases where appropriate existing standards cannot be identified, original guidelines will be proposed.

Guidelines↗
DOE OSTI2014

The changing Chinese SEA indicator guidelines: Top-down or bottom-up?

In the last decades, China has introduced a set of indicators to guide the Strategic Environmental Assessment (SEA) practice. The most recent indicator system proposed in 2009 is based on sector-specific guidelines and it found its justification in past negative experiences with more general guidelines (from 2003), which were mostly inspired by, or copied from, international experiences. Based on interviews with practitioners, researchers and administrators, we map and analyse the change in the national guidelines. This analysis is based on a description of the indicators that makes it possible to discern different aggregation levels of indicators and then trace the changes occurring under two sets of guidelines. The analysis also reveals the reasons and rationales behind the changes found in the guidelines. This analysis is inspired by implementation theory and a description of some of the more general trends in the development of SEA and other environmental policies in a recent Chinese context. Beside a more top-down, intentional approach specifying indicators for different sectors based on Chinese experiences from the preceding years, another significant change, following the new guidelines, is a more bottom-up approach which gives more discretion to practitioners. This entails a call for practitioners to make decisions on indicators, which involves an interpretation of the ones present in sector guidance. Highlights: • Focusing on the new Chinese national SEA guidelines proposed in 2009 • Mapping and analysing the most recent change in the indicator system • Revealing the reasons and rationales behind the changes found in the new guidelines • A top-down intention specifying indicators for different sectors • A bottom-up effect in giving discretion and interpretation of using indicators.

54 ENVIRONMENTAL SCIENCES↗
DOE OSTI2015

SU-E-P-09: Compliance With Evidence-Based Treatment Planning DVH Guidelines In An Academic Multi-Site Radiation Oncology Practice Setting

Purpose: To evaluate the compliance with evidence-based treatment planning organ-at-risk (OAR) guidelines in a single institution with four practice sites. Methods: Two hundred thirteen head and neck cancer patients treated between September 2009 and September 2013 were retrospectively selected. Consensus treatment planning guidelines, including OAR dose constraints, were established based on institutional experience and published data. Data spanned a time period of 2 years prior to (n=112) and 2 years post-enactment (n=101) of the guidelines. We investigated the differences in the frequency with which (1) OARs were contoured and (2) OAR DVH goals were met. Trends in the proportion with OAR contours over time was tested using linear regression. Trends in the proportion of contoured OARs achieving clinical DVH goals were similarly tested. The proportion of patients contoured and meeting DVH goals before and after guidelines was compared using a test of proportions. Results: When the proportion of cases with OAR contours before and after guidelines were compared, we observed an increase from 75% to 87% (p=0.02) for the brainstem, decrease from 97% to 88% (p=0.01) for the cord and increase from 47% to 77% (p<0.001) for the mandible. For the proportion of cases with OAR contours in which clinical goals were met, a significant decrease from 99% to 90% was observed for the cord V48<0.3% (p=0.001). A significant decrease in the proportion of cases with left parotid contours (from 92% to 73% (p=0.03)) was observed over 2 years after guideline enactment and the proportion meeting the clinical DVH goal of V30<50% increased significantly from 36% to 50% (p=0.007) over the 2 years after guidelines. Conclusion: The enactment of OAR planning guidelines resulted in an increase in OAR contour compliance, overall. In cases with OAR contours, there was little to no change in the proportion that met clinical goals.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2012

Strategy Guideline: Proper Water Heater Selection

This Strategy Guideline on proper water heater selection has been developed to provide step-by-step procedures for evaluating preferred cost-effective options for energy efficient water heater alternatives based on local utility rates, climate, and anticipated loads. These procedures, developed both for individual water heater applications (both single and multi-family) and multifamily central systems, provide users with projections on operating cost savings over a 10- year time horizon for retrofit applications and on a cash flow basis for new construction. The savings information, combined with installation cost estimates, allows one to determine which alternatives make sense for a particular application. The information presented in this guideline is based on latest monitoring results from residential field assessments of advanced gas water heater systems and heat pump water heater (HPWH) systems. The methodology presented here can be further refined as more data becomes available on emerging water heating technologies. The tool is targeted at both single and multifamily new and retrofit applications. The intended audience includes: • Builders and Building Owners • Plumbers • General Contractors • Homeowners. This guideline fills an important need because it moves beyond a simplified approach of comparing alternative water heating systems based on a single performance metric. By recognizing the load variations on equipment performance, climate differences, and retail fuel rates, one can develop a more customized performance assessment of competing technologies. This guideline represents the first step in the process of developing a comprehensive system-based evaluation of optimal water heater system design, which will hopefully be developed in the near future. Other Building America-sponsored activities will lead to measure guidelines that focus on technology-specific implementation details related to installation issues in new and existing homes. These guidelines will address issues related to combustion air, venting requirements, space conditioning impacts, safety issues, and other implementation details. The CARB team has developed such a guideline on HPWHs, entitled “Heat Pump Water Heaters in New and Existing Homes”, and IBACOS is in the process of finalizing a tankless water heater guideline.

32 ENERGY CONSERVATION, CONSUMPTION, AND UTILIZATI↗
DOE OSTI2023

Supplement to M&V Guidelines: Measurement and Verification for Performance-Based Contracts Version 4.0

Measurement and verification (M&V) are key to determining and confirming the continued operation of, and savings associated with, performance-based contracts. The Federal Energy Management Program (FEMP) updates these guidelines to reflect the evolution of M&V to incorporate industry best practices and ensure that savings from these performance-based projects are properly planned, communicated, and realized. FEMP released M&V Guidelines: Measurement and Verification for Federal Energy Projects Version 3.0 in 2008. This document was developed with input from industry-government working groups, previous M&V guideline authors, and national laboratory subject matter experts. The document provided the methods and guidelines, with a focus on federal energy savings performance contracts (ESPCs). When FEMP released M&V Guidelines: Measurement and Verification for Performance-Based Contracts Version 4.0 in 2015, FEMP expanded the intended audience to include anyone (energy managers, procurement officers, and contractors) involved in implementing performance-based contracts. The streamlined M&V Guidelines Version 4.0 provided the procedures and guidelines needed to quantify savings resulting from installing energy-efficient equipment, water conservation, improved operation and maintenance (O&M), renewable energy, and cogeneration projects with a performance-based contract; however, it removed some of the associated details on topics such as developing regression models and sampling plans. The details and information provided in M&V Guidelines v. 3.0 are still pertinent to M&V for performance-based contracts. The objective is to keep FEMP M&V version 4.0 condensed, providing the reference document for specifying M&V methods and procedures and a resource for developing project-specific M&V plans; this supplement provides additional details. The content of this supplement has been updated to include pertinent revisions between M&V version 3.0 and M&V version 4.0 by providing details and updating the content to ensure relevancy.

29 ENERGY PLANNING, POLICY, AND ECONOMY↗
DOE OSTI2016

Measure Guideline: Deep Energy Enclosure Retrofit for Interior Insulation of Masonry Walls and Flat Roofs

Measure Guideline: Deep Energy Enclosure Retrofit for Zero Energy Ready House Flat Roofs BSC TO5 Task 7.4 Deep Energy Enclosure Retrofit (DEER) for Interior Insulation of Masonry Walls Lawrence, MA 01840 This Measure Guideline describes a deep energy enclosure retrofit solution for insulating mass masonry buildings from the interior. It describes the retrofit assembly, technical details, and installation sequence for retrofitting masonry walls. Interior insulation of masonry retrofits might adversely affect the durability of the wall. This guideline includes a review of decision criteria pertinent to retrofitting masonry walls from the interior and the possible risk of freeze-thaw damage. This Measure Guideline is intended to support contractors who are implementing an interior insulation-based high-performance enclosure retrofit for masonry buildings and designers who are looking to design such retrofits. It may also be helpful to building owners who wish to learn more about strategies that are available for deep energy enclosure retrofit of masonry residential buildings on the interior. This Measure Guideline is important to the high-performance retrofit industry because the solution described here provides an opportunity to retrofit masonry buildings with ambitious energy performance goals by insulating them from the interior without disturbing their exterior appearance. BSC TO5 Task 7.4 Deep Energy Enclosure Retrofit (DEER) for Zero Energy Ready House (ZERH) Flat Roofs House Jamaica Plain, MA 02130 This Measure Guideline provides design and construction information for a deep energy enclosure retrofit solution of a flat roof assembly. It describes the strategies and procedures for an exterior retrofit of a flat wood-framed roof with brick masonry exterior walls using exterior and interior (framing cavity) insulation. The approach supported in this guide could also be adapted for use with flat wood-framed roofs with wood-framed exterior walls. Designers, contractors, and building code officials will benefit from the information contained in this Measure Guideline. The guide may also be helpful to building owners who wish to learn more about strategies for deep energy enclosure retrofit of flat roofs. This Measure Guideline is important to the high-performance retrofit industry because it demonstrates techniques for retrofitting flat roofs from the exterior, which is less disruptive to the living space and allows the structure to remain occupied during the project. It also illustrates a solution for preparing homes to become zero energy ready.

Array↗
DOE OSTI2016

WE-AB-207B-08: Exploring and Refining the QUANTEC Guideline to Reduce Severe Hyposalivation Following IMRT for Head and Neck Cancer

Purpose: The aim of this study was to investigate the usefulness of the QUANTEC guideline to prevent xerostomia after intensity-modulated radiotherapy (IMRT) for head and neck cancer (HNC) with respect to follow-up time. In addition, we explored alternative guidelines to further reduce xerostomia. Methods: The QUANTEC guideline suggests a mean dose to the contralateral (Dmeancontra) parotid<20 Gy, or Dmeancontra and Dmean to the ipsilateral parotid (Dmeanipsi)<25 Gy. Stimulated whole mouth saliva flow measurements (WMSFM) were conducted at a median of 11 (3–24) months for 63 patients treated with IMRT for HNC to a median dose of 70 Gy in 2006–2015. Severe hyposalivation/xerostomia was defined as WMSFM ≤25% post- relative to pre-RT. Patients were stratified into a <6m (xerostomia: 27% (n=15)), and a 6–24m (xerostomia: 19% (n=10)) follow-up group. Dose-response modeling was performed using logistic regression including Dmeancontra, or Dmeancontra and Dmeanipsi. The area under the receiver-operating characteristics curve (AUC) was used to assess discriminative ability, and the agreement between the estimated and observed rate of xerostomia was given by Spearman’s rank correlation coefficient (Rs), and related p-values. Results: Of the non-xerostomia patients, 65% (<6m) and 56% (6–24m) fulfilled Dmeancontra<20 Gy. The estimated and observed rate of xerostomia agreed at <6m (AUC=0.78; Rs=0.46; p=0.001), and was 28% at Dmeancontra=20 Gy. A smaller number of non-xerostomia patients fulfilled the two-gland guideline (33% (<6m) and 26% (6–24m)), but the AUC was higher than using Dmeancontra only (<6m: AUC=0.90; Rs=0.63; p<0.0001; 6–24m: AUC=0.84; Rs=0.25; p=0.08), and the following amendment of the two-gland guideline was suggested: (0.17*Dmeancontra+0.11*Dmeanipsi-8.13)<-1.60 (<6m), and (0.05*Dmeancontra+0.02*Dmeanipsi-3.10)<-1.60 (6–24m). Conclusion: The QUANTEC guideline is effective to prevent xerostomia <6m post-RT, but its usefulness is reduced at later follow-up times. The suggested amendment to the two-gland QUANTEC guideline should be further investigated in an independent cohort of HNC patients treated with IMRT.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

Guidelines for Posting Soil Contamination Areas

All soil guidelines were determined using RESRAD, version 6.1. All offsite guidelines are based on 15 mrem/year. This dose rate is sufficiently low to protect human health and is in accordance with DOE guidance and the proposed EPA 40-CFR-196 regulations for members of the public (never promulgated). For those onsite areas where general employees (non-radiological workers) could have routine access, soil concentrations should be based on a dose rate of 30 mrem/year (approximately one-third of the onsite LANL non-radiological worker dose of 100 mrem/year). In this case, soil concentration guidelines may be obtained by doubling the 15 mrem/year guidelines. Several scenarios were developed to provide maximum flexibility for application of the guidelines. The offsite guidelines were developed using: residential scenarios for both adults and children; a construction worker scenario; a resource user (e.g., a hunter) scenario; a child playing within canyon reaches scenario, a trail using jogger within canyon reaches scenario, and a trail using hiker within canyon reaches scenario. The residential guidelines represent the lowest values from both the adult residential scenario and the child residential scenario.

58 GEOSCIENCES↗
NASA NTRS1984

Guidelines for assessment and control of noise

There is an obvious need for guidelines and standards with respect to what intensities and durations of noise exposure is considered incompatible with the health and well-being of the people exposed. These guidelines would presumably be useful for the zoning of land areas to avoid overexposure of people to environmental noise and for legislative-judicial adjudication of liabilities for possible damages to individuals and groups from exposure to noise. A number of guidelines for noise exposure were promulgated by various governmental agencies for these purposes. Partly because of the need for an integrated and consistent program of noise control for all elements of the government, the United States Environmental Protection Agency (EPA) was established. In addition to previously issuing some specific documents regarding safe noise exposure limits, the EPA joined several Federal operating and regulatory agencies in issuing guidelines for considering noise in land use planning and control. Government guideline documents, as well as some issued by non-government agencies, are examined. Also, newly proposed guidelines for noise in residential areas, and the scientific basis for these guidelines, are presented.

Source record↗
NASA NTRS1989

Formulation of design guidelines for automated robotic assembly in outerspace

The approach for arriving at design guidelines for assembly by robots in outerspace is illustrated. The use of robots in a zero gravity environment necessitates that extra factors over and above normal design guidelines be taken into account. Besides, many of the guidelines for assembly by robots on earth do not apply in space. However, considering the axioms for normal design and assembly as one set, guidelines for design and robotic assembly as another, and guidelines for design and assembly in space as the third set, unions and intersections of these sets can generate guidelines for two or more of these conditions taken together - say design and manual assembly in space. Therein lies the potential to develop expert systems in the future, which would use an exhaustive database and similar guidelines to arrive at those required by a superposition of these conditions.

Dwivedi, Suren N.↗
NASA NTRS1994

Guidelines for lighting of plants in controlled environments

These guidelines for lighting of plants, established by the organizing committee, provided a focus for the discussions at the workshop. The guidelines served as a basis for discussion amongst the workshop attendees and led to a number of recommendations that were recorded by the session chairpersons. The organizing committee indicated they would incorporate the recommendations and suggestions into a revised set of guidelines for additional discussion. It was understood that these guidelines will not be standards and will require upgrading and modifications as lamps and equipment become available and as new insights are obtained on plants' response to light. Revised draft guidelines are included as Tables 1 and 2 that have been developed by the organizing committee following the suggestions obtained at the workshop. The guidelines for growth chambers are in Table 1 and guideines for greenhouses are given in Table 2. These have been distributed to the participants who indicated a willingness to review proposals that were developed. It is hoped that these proposals will lead to the development of guidelines that will have general acceptance by plant scientists.

Dietzer, Gerald↗
DOE OSTI2015

SPSP Phase III Recruiting, Selecting, and Developing Secure Power Systems Professionals: Behavioral Interview Guidelines by Job Roles

The Secure Power Systems Professional Phase III final report was released last year which an appendix of Behavioral Interview Guidelines by Job Roles. This new report is that appendix broken out as a standalone document to assist utilities in recruiting and developing Secure Power Systems Professionals at their site. The complete list of knowledge, skills, and abilities required in each of the studied job roles was assembled into the Behavioral Interview Guidelines. The guidelines were developed to apply the results of Phases I and II in a format that can be used in part or in whole to align workforce capabilities with the strategic goals and tactical focus of a power grid organization. These guidelines may 1) be applied to develop performance reviews or to produce individual professional development programs for existing staff; 2) assist in specifying learning objectives for a training or education program; and 3) be easily incorporated into most human capital software to facilitate development of job descriptions that comply with guidelines established by the Society of Human Resource Management. The guidelines can be immediately applied by human resources professionals, recruiters, and hiring managers to assist in recruiting and interviewing candidates for new SPSP position openings.

24 POWER TRANSMISSION AND DISTRIBUTION↗
DOE OSTI2012

Australasian Gastrointestinal Trials Group (AGITG) Contouring Atlas and Planning Guidelines for Intensity-Modulated Radiotherapy in Anal Cancer

Purpose: To develop a high-resolution target volume atlas with intensity-modulated radiotherapy (IMRT) planning guidelines for the conformal treatment of anal cancer. Methods and Materials: A draft contouring atlas and planning guidelines for anal cancer IMRT were prepared at the Australasian Gastrointestinal Trials Group (AGITG) annual meeting in September 2010. An expert panel of radiation oncologists contoured an anal cancer case to generate discussion on recommendations regarding target definition for gross disease, elective nodal volumes, and organs at risk (OARs). Clinical target volume (CTV) and planning target volume (PTV) margins, dose fractionation, and other IMRT-specific issues were also addressed. A steering committee produced the final consensus guidelines. Results: Detailed contouring and planning guidelines and a high-resolution atlas are provided. Gross tumor and elective target volumes are described and pictorially depicted. All elective regions should be routinely contoured for all disease stages, with the possible exception of the inguinal and high pelvic nodes for select, early-stage T1N0. A 20-mm CTV margin for the primary, 10- to 20-mm CTV margin for involved nodes and a 7-mm CTV margin for the elective pelvic nodal groups are recommended, while respecting anatomical boundaries. A 5- to 10-mm PTV margin is suggested. When using a simultaneous integrated boost technique, a dose of 54 Gy in 30 fractions to gross disease and 45 Gy to elective nodes with chemotherapy is appropriate. Guidelines are provided for OAR delineation. Conclusion: These consensus planning guidelines and high-resolution atlas complement the existing Radiation Therapy Oncology Group (RTOG) elective nodal ano-rectal atlas and provide additional anatomic, clinical, and technical instructions to guide radiation oncologists in the planning and delivery of IMRT for anal cancer.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2014

Receipt of Guideline-Concordant Treatment in Elderly Prostate Cancer Patients

Purpose: To examine the proportion of elderly prostate cancer patients receiving guideline-concordant treatment, using the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database. Methods and Materials: A total of 29,001 men diagnosed in 2004-2007 with localized prostate cancer, aged 66 to 79 years, were included. We characterized the proportion of men who received treatment concordant with the National Comprehensive Cancer Network guidelines, stratified by risk group and age. Logistic regression was used to examine covariates associated with receipt of guideline-concordant management. Results: Guideline concordance was 79%-89% for patients with low- or intermediate-risk disease. Among high-risk patients, 66.6% of those aged 66-69 years received guideline-concordant management, compared with 51.9% of those aged 75-79 years. Discordance was mainly due to conservative management—no treatment or hormone therapy alone. Among the subgroup of patients aged ≤76 years with no measured comorbidity, findings were similar. On multivariable analysis, older age (75-79 vs 66-69 years, odds ratio 0.51, 95% confidence interval 0.50-0.57) was associated with a lower likelihood of guideline concordance for high-risk prostate cancer, but comorbidity was not. Conclusions: There is undertreatment of elderly but healthy patients with high-risk prostate cancer, the most aggressive form of this disease.

62 RADIOLOGY AND NUCLEAR MEDICINE↗