Medicine and Health Sciences Commons^™

The Development Of Sexual Health Educational Canvas Modules For Cal Poly Students, Alexa Jordan Asson, Dillan Isabella Chiewpanich, Amanda Hodges, Tanya Patil

Kinesiology and Public Health

Purpose: Sexual health education continues to be a taboo topic underrepresented in young adult health education. Many high school students do not receive the sexual health education they need. One study found that 34% of girls and 42% of boys left high school without education on birth control methods (Wong et al., 2019). Furthermore, students entering college have varying, often inadequate, levels of sexual health knowledge. After examining sexual health data at California Polytechnic State University (Cal Poly), the Cal Poly Sexual and Reproductive Health (SRH) Lab found that students engage in risky sexual behaviors. For example, nearly one quarter …

Development Of Rp-Hplc Method For Simultaneous Determination Of Nebivolol Hydrochloride, Valsartan And Hydrochlorothiazide In Co-Administrated Antihypertensive Agents And Human Plasma, Shereen Mowaka, M. Rizk, Maha M. Abou El‐Alamin, Mariam Mohamed

Pharmacy

Reversed phase high performance liquid chromatography combined with photodiode array (HPLC-PDA) detector method was developed for simultaneous determination of two binary antihypertensive combinations; either Nebivolol (NEB) with Hydrochlorothiazide (HCZ) or with Valsartan (VAL) in pharmaceutical formulation and spiked human plasma. The method was successfully applied to separate the three drugs on one chromatogram under the same chromatographic conditions that used for two binary combinations. The separation was established on Xterra C18 column using gradient mobile phase which composed of acidified water of pH = 3.0 (adjusted with 0.1% orthophosphoric acid) and acetonitrile with flow rate of 1.0 mL/min. The drugs …

Influence Of Age And Gender On Alveolar Bone Healing Post Tooth Extraction In 129 Sv Mice: A Microtomographic, Histological, And Biochemical Characterization, Cláudia Cristina Biguetti, Bhuvana Lakkasetter Chandrashekar, Gustavo Baroni Simionato, Nataira Regina Momesso, Marco Antonio Hungaro Duarte, Danieli C. Rodrigues, Mariza Akemi Matsumoto

School of Podiatric Medicine Publications

Objectives

To analyze the effect of biological sex and aging on craniofacial bone features in 129 Sv mice and their influence on dental socket healing post tooth extraction.

Materials and methods

A total of 52 129 Sv mice were used, of which 28 were young (3–4 months) and 24 were aged (17–18 months), equally distributed according to biological sex. After an upper right incisor extraction, mice specimens were collected at 7, 14, and 21-days post-surgery for microtomographic (microCT) and comprehensive histological analysis. Mandible, skull bones, and maxillae at 21 days were analyzed by microCT, while blood plasma samples were collected …

Cervical Steroid Injections Are Not Effective For Prevention Of Surgical Treatment Of Degenerative Cervical Myelopathy., Mustfa K. Manzur, Andre M Samuel, Avani Vaishnav, Catherine Himo Gang, Evan D Sheha, Sheeraz A Qureshi

Student Papers, Posters & Projects

STUDY DESIGN: Retrospective cohort study.

OBJECTIVE: The objective of this study is to determine how often patients with degenerative cervical myelopathy (DCM) and initially treated with cervical steroid injections (CSI) and to determine whether these injections provide any benefit in delaying ultimate surgical treatment.

METHODS: All patients with a new diagnosis of DCM, without previous cervical spine surgery or steroid injections, were identified in PearlDiver, a large insurance database. Steroid injection and surgery timing was identified using Current Procedural Terminology (CPT) codes. Multivariate logistic regression identified associations with surgical treatment.

RESULTS: A total of 686 patients with DCM were identified. …

A Word From The Writing Team (June 2023), Pam Walter, Mfa, Liz Declan, Ma, Mfa

A Word From the Writing Team (Newsletter)

This issue includes:

• Happy Pride Month!
• Faculty Days 2023
• Publication Spotlight
• Reminders

Adult Female With A Painful And Pruritic Lower Extremity Skin Lesion., Chase Silvers, Christopher Lloyd

Ambulatory and Primary Care Articles

No abstract provided.

The Co-Occurrence Of Adverse Childhood Experiences And Mental Health Among Latina/O Adults: A Latent Class Analysis Approach, Michael Niño, Kazumi Tsuchiya, Shaun Thomas, Christian Vazquez

Sociology and Criminology Faculty Publications and Presentations

Adverse childhood experiences (ACEs) have been linked to poor mental health among Latina/os. Few studies, however, have attempted to understand the extent to which ACEs co-occur and whether different forms of ACE co-occurrence differentially shape poor mental health patterns among Latina/os. The present study begins to address this gap by (1) identifying latent classes of ACEs and (2) determining whether and how different ACE classes shape high depressive symptoms among Latina/o adults. Data were drawn from two waves of the Hispanic Community Health Study/Study of Latinos, a longitudinal, community-based sample of Latina/os living in four urban communities. Latent Class Analysis …

Effect Of Different Surface Treatment Protocols On Microtensilebond Strength Of Cad/Cam Composite Blocks To Dentin (In-Vitro Study), Shadwa Kabil

Dentistry

No abstract provided.

57 Yo Man With High Grade Astrocytoma With Piloid Features And 2 Other Cns Lesions, Joseph Fullmer

Conference Presentation Abstracts

Patient is a 57 yo man who presented with periodic headaches and lower back pain, initially attributed to lifting heavy weights but symptoms persisted. Eventual imaging was performed and revealed a 4 cm heterogeneously enhancing left cerebellar mass, 1 cm enhancing lateral right frontal subcortical lesion, and enhancing T12-L1 spinal cord lesion and multiple smaller spinal cord lesions suggestive of drop metastasis. The cerebellar lesion was first resected and final results, including methylome profiling, were consistent with high grade astrocytoma with piloid features (HGAP). The T12-L1 spinal lesion was later resected and had somewhat distinct histology although intraoperatively surgeon felt …

Metals And Metal Complexes In Diseases With A Focus On Covid-19: Facts And Opinions, Agnieszka Ścibior, Manuel Aureliano, Alvin A. Holder, Juan Llopis

Chemistry & Biochemistry Faculty Publications

In the present Special Issue on “Metals and Metal Complexes in Diseases with a Focus on COVID-19: Facts and Opinions”, an attempt has been made to include reports updating our knowledge of elements considered to be potential candidates for therapeutic applications and certain metal-containing species, which are extensively being examined towards their potential biomedical use due to their specific physicochemical properties. The Special Issue compiles data on the role of metals in COVID-19 and focuses on other illnesses and biological processes that affect metal metabolism. It consists of eight manuscripts, including five review articles and three original research papers (Figure …

A Guide To The Brain Initiative Cell Census Network Data Ecosystem, Michael Hawrylycz, Maryann E Martone, Giorgio A Ascoli, Jan G Bjaalie, Hong-Wei Dong, Satrajit S Ghosh, Jesse Gillis, Ronna Hertzano, David R Haynor, Patrick R Hof, Yongsoo Kim, Ed Lein, Yufeng Liu, Jeremy A Miller, Partha P Mitra, Eran Mukamel, Lydia Ng, David Osumi-Sutherland, Hanchuan Peng, Patrick L Ray, Raymond Sanchez, Aviv Regev, Alex Ropelewski, Richard H Scheuermann, Shawn Zheng Kai Tan, Carol L Thompson, Timothy Tickle, Hagen Tilgner, Merina Varghese, Brock Wester, Owen White, Hongkui Zeng, Brian Aevermann, David Allemang, Seth Ament, Thomas L Athey, Cody Baker, Katherine S Baker, Pamela M Baker, Anita Bandrowski, Samik Banerjee, Prajal Bishwakarma, Ambrose Carr, Min Chen, Roni Choudhury, Jonah Cool, Heather Creasy, Florence D'Orazi, Kylee Degatano, Benjamin Dichter, Song-Lin Ding, Tim Dolbeare, Joseph R Ecker, Rongxin Fang, Jean-Christophe Fillion-Robin, Timothy P Fliss, James Gee, Tom Gillespie, Nathan Gouwens, Guo-Qiang Zhang, Yaroslav O Halchenko, Nomi L Harris, Brian R Herb, Houri Hintiryan, Gregory Hood, Sam Horvath, Bingxing Huo, Dorota Jarecka, Shengdian Jiang, Farzaneh Khajouei, Elizabeth A Kiernan, Huseyin Kir, Lauren Kruse, Changkyu Lee, Boudewijn Lelieveldt, Yang Li, Hanqing Liu, Lijuan Liu, Anup Markuhar, James Mathews, Kaylee L Mathews, Chris Mezias, Michael I Miller, Tyler Mollenkopf, Shoaib Mufti, Christopher J Mungall, Joshua Orvis, Maja A Puchades, Lei Qu, Joseph P Receveur, Bing Ren, Nathan Sjoquist, Brian Staats, Daniel Tward, Cindy T J Van Velthoven, Quanxin Wang, Fangming Xie, Hua Xu, Zizhen Yao, Zhixi Yun, Yun Renee Zhang, W Jim Zheng, Brian Zingg

Faculty, Staff and Student Publications

Characterizing cellular diversity at different levels of biological organization and across data modalities is a prerequisite to understanding the function of cell types in the brain. Classification of neurons is also essential to manipulate cell types in controlled ways and to understand their variation and vulnerability in brain disorders. The BRAIN Initiative Cell Census Network (BICCN) is an integrated network of data-generating centers, data archives, and data standards developers, with the goal of systematic multimodal brain cell type profiling and characterization. Emphasis of the BICCN is on the whole mouse brain with demonstration of prototype feasibility for human and nonhuman …

Cutaneous Graft-Versus-Host Disease Within Chronic Photodamaged Skin: A Case Series Demonstrating Role For Topical 5-Fluorouracil., Ashley N Gray, Christina Avila, Catherine G Chung, Lucia Seminario-Vidal, Alice Mims, Brittany Dulmage, Karilyn Larkin, Hannah Choe, Samantha Jaglowski, Sumithira Vasu, Benjamin H Kaffenberger

Ambulatory and Primary Care Articles

No abstract provided.

Does Proton Arc Therapy Has Potential Clinical Benefits For Hepatocellular Carcinoma?, Peilin Liu, R Dalfsen, M Soukup, Shupeng Chen, Lewei Zhao, Z Wang, X S. Gao, Thomas Quinn, Craig Stevens, Rohan Deraniyagala, Xiaoqiang Li, Xuanfeng Ding

Conference Presentation Abstracts

Purpose: To investigate the potential clinical benefits and dose-averaged Linear Energy Transfer (LETd) sparing, utilizing proton arc plan for Hepatocellular carcinoma (HCC) patients in comparison with Intensity Modulated Proton Therapy (IMPT). Methods: Ten HCC patients have been retrospectively selected. Two planning groups were created: Proton Arc plans using Monaco ver. 6 and the clinical IMPT plan. Both planning groups used the same robustness parameters. The prescription dose is 67.5 Gy (RBE) in 15 fractions/ 66 GyE in 10 fractions of the Clinical Target Volume (CTV) following clinical IMPT plan. Robustness evaluations were performed to ensure target dose coverage. Normal Tissue …

A Novel Planning Framework For The Efficient Spot-Scanning Proton Arc Therapy Via The Particle Swarm Optimization (Sparc-Particle Swarm), Y Qian, R Dao, G Liu, Xiaoqiang Li, H Quan, Xuanfeng Ding

Conference Presentation Abstracts

Purpose: The delivery efficiency is the bottleneck of spot-scanning proton arc therapy (SPArc) because of the numerous energy layers (EL) ascending switches. This study aims to develop a new algorithm to mitigate the need of EL ascending via water equivalent thickness (WET) sector selection followed by the particle swarm optimization (SPArc- particle swarm). Methods: SPArc- particle swarm divided the full arc trajectory into the optimal sectors based on the K-means clustering analysis of the relative mean WET. Within the sector, particle swarm optimization was used to minimize the total energy switch time, in which it optimized the energy selection integrated …

Application Of A Novel Optical Tool For Linac Calibrations, Cory S. Knill, Brian Loughery, Raminder P. Sandhu, Lifeng Lin, Mark Stefani

Conference Presentation Abstracts

Purpose: Maintaining a linac within tight stereotactic isocentricity tolerances requires minimizing errors in individual components of the linac. However, while isocentricity can be measured using a Winston-Lutz test, contributions from individual components can be difficult to discern. The disconnect between how individual components contribute to isocentricity can lead to lengthy troubleshooting exercises when isocentricity is outside tolerance. To provide more info rmation to physicists and increase the speed of isocentricity adjustments, a new tool that uses optical tracking to investigate and adjust individual linac components that contribute to isocentricity was tested on three clinical linacs. Methods: The optical tracking tool …

Individual Vmat Beam Complexity Indices Have Limited Predictive Value For Qa Pass-Rates, Jian Liang, Q Liu, David T. To, Michael G. Snyder

Conference Presentation Abstracts

Purpose: Previous studies with sample sizes <400 have indicated that VMAT beam complexity indices may have a relationship with measured QA pass-rates. The aim of this study is to evaluate such relationships on a large scale to further investigate their strength. Methods: Total of 17,273 VMAT QA results across 8 Elekta Agility machines were used in this study. All beams were flattened 6MV or 10MV. Sun Nuclear ArcCheck was used for QA measurements with γ-analysis parameters of 10% threshold, 3% dose difference, 2mm distance to agreement, and 95% passing threshold. A total 214 Beams (1.23%) failed QA. QA distributions in Pinnacle were calculated with 2 degree gantry intervals and a dose grid of 2mm. Four complexity indices (MCSv, MU weighted Segment Area, Segment Area/Perimeter, and Average Leaf Gap) were computed. Spearman’s correlations were evaluated for each, and cut-off values for the indices were sought to indicate values above which no QA failures would be expected. Results: Evaluation of the 4 complexity metrics showed weak correlation with QA pass rates (< ±0.42) with high significance (p < 0.001). When metrics were evaluated independently, cut-off values from correlation plots separated only 0.67%, 0.72%, 2.2%, 6.3% guaranteed passing beams from the total sample, respectively. When evaluating whether anymetric for a given beam exceeded its cut-off, the fraction of guaranteed passing beams rose to only 6.6%. However, when cut-off values for one metric were allowed to be functionally dependent upon another, the fraction of guaranteed passing beams increased. For MU weighted Segment Area andAverage Leaf Gap, a dependent approach separated 19.1% guaranteed passing beams from the sample. Conclusion: Individual complexity metrics have weak predictive utility in assessing plan performance. However, using multiple complexity cut-off functions with dependence upon more than one metric increased the fraction of predicted passing beams by around 300%.

A Comprehensive Investigation Of Linear Energy Transfer Optimization Effectiveness In Intensity-Modulated Proton Therapy Via Alternating Direction Method Of Multipliers (Impt Let-Admm), Q Fan, G Liu, Lewei Zhao, Xiaoqiang Li, Xuanfeng Ding, S Dai

Conference Presentation Abstracts

Linear energy transfer (LET)-guided optimization in intensity-modulated proton therapy (IMPT) via alternating direction method of multipliers (ADMM) has the potential to improve its biological effectiveness (IMPTLET- ADMM), in which the LET distribution in target can be escalated, while the LET distribution in the organs at risk can be mitigated. This study aims to quantitatively investigate the effectiveness of LET optimization in IMPT via ADMM with different solvers in its iteration loop. Methods: The clinical dose-volume-histogram (DVH) constraint noted dose sub-problem and clinical LET -volume-histogram (LVH) constraint noted LET sub-problem are combined to generate a composite objective function, which is available …

Integrative Analysis Of Metabolome And Methylome Identifies The Correlation Of Aminoacyl-Trna Biosynthesis Metabolitesand Sepsecs Gene Methylation In Huntington’S Disease Brain Tissue, Sangeetha Vishweswaraiah, Ali Yilmaz, Nadia Ashrafi, Nazia Saiyed, Abdulla Khalid, Purvesh R. Koladiya, Xiaobei Pan, Shirin Macias, Uppala Radhakrishna, Stewart F. Graham

Conference Presentation Abstracts

No abstract provided.

Particle Arc Single-Isocenter Stereotactic Radiosurgery Of Multiple Brain Metastases, L Volz, S Mein, T Tessonnier, Peilin Liu, A Mairani, M Durante, Xuanfeng Ding, C Graeff, T Li

Conference Presentation Abstracts

Purpose: To develop spot-scanning proton (SPArc) and heavy ion (SHArc) arc therapy for single-isocenter stereotatic radiosurgery (SISRS) of multiple brain metastases (MBMs). First results achieved with dedicated planning infrastructure are compared to state-of-the -art volumetric modulated photon arc therapy (HA-VMAT). Methods: A multi-institutional collaboration was established to develop bespoke SPArc and SHArc SISRS infrastructure with available research and commercial treatment planning systems. Devised planning and delivery methods considered dedicated energy, spot, and multi-arc selection strategies. SPArc and SHArc (carbon and helium ions) plans were generated for MBM patients exhibiting 3-12 intracranial lesions with GTV volumes between 0.03ccm and 19.8ccm, at …

Human Serum Metabolites Signature The Prodromal Biomarkers Of Parkinson’S Disease: Lrkk2 Longitudinal Stu, Ali Yilmaz, Nadia Ashrafi, Sumeyya Akyol, Ieva Kerševičiūtė, Milda Milčiūtė, Juozas Gordevicius, Stewart Graham

Conference Presentation Abstracts

BACKGROUND: The complex and heterogeneous nature of Parkinson’s disease (PD) and variability in their progression hampers its early diagnosis and treatment. Consequently, there is much interest in developing models that can predict PD progression and help to deepen our understanding of PD pathology. Metabolomics might shed light on the PD imprint seeking a broader view of the biochemical remodeling induced by this disease in an early and pre-symptomatic stage, unveiling potential biomarkers and developing new novel therapeutic targets

METHODS: In this novel study utilizing ¹H NMR and DI-LC-MS/MS we conducted metabolomics investigation on the serum samples from a clinically well …

Evidence-Based Practices And Self-Efficacy: A Quantitative Study Of Mental Health Counselors Treating Clients With Substance Use Disorder, Carl Bastien

Dissertations

Substance use disorder affects a substantial number of individuals in the United States. The specific problem of this research is that it was not known to what extent their use of evidence-based practices is driven by their sense of self-efficacy. The purpose of this quantitative correlational research was to examine to what extent the use of evidence-based practices covary with a sense of self-efficacy for mental health counselors treating individuals diagnosed with a substance use disorder. The study population was 121 mental health counselors who specialized in substance use disorder treatment who completed a digital survey. The study findings did …

Impact Of Covid-19 On Latinx And Black Communities, Carolina Zuluaga

Dissertations

This critical literature review project explored the impact of COVID-19 on Latinx and Black communities. According to the Centers for Disease Control and Prevention, as of September 28, 2022, around 16% of COVID-19 cases in the United States were among Latinx people, and 14% of cases were among Black people (Centers for Disease Control and Prevention, 2022). Since COVID-19 began, clinicians have become more conscious of the effects of health disparities within racial and ethnic minorities, which has warranted increased advocacy by educating health and mental health providers and creating and providing resources to these communities and clinicians. The review …

Metabolic Profiling Reveals Differential Alterations In Serum And Brain Metabolites During The Progression Of Huntington’S Disease In An R6/2 Transgenic Mouse Model, Nadia Ashrafi, Sumeyya Akyol, Sangeetha Vishweswaraiah, Ali Yilmaz, Leva Kerševičiūtė, Juozas Gordevicius, Stewart Graham

Conference Presentation Abstracts

No abstract provided.

Urinary Cytokines As Potential Biomarkers Of Mild Cognitive Impairment And Alzheimer’S Disease: A Pilot Study, Nazia Saiyed, Ali Yilmaz, Sangeetha Vishweswaraiah, Abhishek Maiti, Ilyas Ustun, Sarah Bartolone, Travonia Brown-Hughes, Roland Thorpe Jr, Tammy Osentoski, Stacey Ruff, Amita Pai, Michael E. Maddens, Khaled Imam, Stewart Graham

Conference Presentation Abstracts

No abstract provided.

An Analytic Model Of The External Beam Dose Rate Effect On Immune Cells In Blood Dosimetry, Lewei Zhao, Peilin Liu, G Liu, Xuanfeng Ding

Conference Presentation Abstracts

Purpose: Radiation therapy is a double-edged sword with regard to its immunomodulatory effect. It is critical to find how it is affected by dose rate. Thus, we developed an analytic model for calculating the number of immune cells receiving radiation. Methods: Suppose the blood is received radiation by constant dose rate. The blood is one-way flow without circulation in the radiation delivery at a constant velocity. Two kinds of lung treatment regimens were considered standard delivery 2Gy per fx total 30fx and hypo-fractionation SBRT 12 Gy per fx total 5 fx. Two different dose rates were simulated for standard treatment: …

Investigate The Delivery Efficiency Improvement For Sparc Compared To Impt, Peilin Liu, B A. De Jong, S Chang, Lewei Zhao, G Liu, Craig Stevens, Rohan Deraniyagala, E W. Korevaar, J A. Langendijk, Xiaoqiang Li, Xuanfeng Ding

Conference Presentation Abstracts

Purpose: To assess the efficiency improvement of SPArc compared to IMPT in proton clinical operation.Methods: A random clinical operation day at a proton therapy center with a two room system. Aa total of 10 Head & Neck cancer cases treated on Jan 6th, 2021were selected and SPArc plans were generated for all the cases with similar target coverage and dose constraints of organ at risk (OARs). 3% range uncertainties and 3mm setup uncertainties were applied for robust optimization. The log files of clinical IMPT were exported to calculate true treatment delivery time. The machine-specific delivery sequence model was utilized to …

Develop A Novel Beam Orientation Optimization Algorithm For Let (Linear Energy Transfer) Incorporated Impt (Intensity Modulated Proton Therapy) (Imptlet, R Dao, Y Qian, Xiaoqiang Li, H Quan, Xuanfeng Ding, G Liu

Conference Presentation Abstracts

Purpose: To improve the dose and LET distribution in the IMPTLET, we introduce a new optimization algorithm to search for the optimal beam orientation and count through the arc trajectory (BOC-IMPTLET). Methods: We introduce kmeans clustering analysis in the BOC-IMPTLET algorithm by analyzing the distribution of LET in the target from the full arc trajectory. The optimal of cluster count was used as beam count, which was determined based on the SSE (Sum of Square Error) value and the angle of the corresponding centroid of each cluster was used as beam orientation, respectively. The BOC-IMPTLET algorithm was implemented in the …

Predicting Tumor Voxel Dose-Response Using Deep Learning On Serial Fdg-Pet Feedback Images, Shupeng Chen, Di Yan, An Qin, Rohan Deraniyagala, Daniel Krauss, Peter Chen, Craig Stevens

Conference Presentation Abstracts

Purpose: Tumor voxel dose-response matrix (DRM) can be assessed using a series of FDG-PET/CT feedback images acquired during radiotherapy. Predicting the tumor voxel DRM earlier is crucial for treatment adaptation. However, it is also challenging due to FDG fluctuation in tumor cells. This study investigated the feasibility of predicting DRM during early treatment weeks using deep learning (DL). Methods: FDG-PET images were acquired at the pretreatment (preTx), the 2nd and 4th weeks during chemo-radiotherapy (35×2Gy) from 50 head and neck patients. The reference value of tumor voxel DRM (DRMref), representing the average metabolic change ratio during the treatment, was determined …

Pcra-Icra Pre-Construction Risk Assessment/Infection Control Risk Assessment Course, Nicholas Dean Schorno

Construction Management

The Preconstruction Risk Assessment and Infection Control Risk Assessment (PCRA/ICRA) course is a collaboration between Cal Poly San Luis Obispo’s Construction Management Department, Cal Poly’s California Center for Construction Education, Green Advantage, LLC and Thomas Kommer, J.D. The goal is to create a certification course in which industry professionals become certified, signifying their knowledge and understanding of PCRA/ICRA practices associated with construction in the environment of patient care. The project began with the PCRA/ICRA manual authored by Stellar Performance, LLC. Working with Devin Deiranieh, the author developed the learning material for the course. The learning material consists of power point …

Linac-Based Srs Treatments Slow Down Unnecessarily Due To Parked Leaf Optimization, Brian Loughery, Cory S. Knill, Raminder P. Sandhu, Lifeng Lin, Jian Liang

Conference Presentation Abstracts

Purpose: It was observed on a VersaHD that clinical SRS deliveries created in the Elements treatment planning system (TPS) slowed gantry rotation and dose rate to allow parked MLC leaves to move into position for use in an upcoming control point. Gantry rotation slowed suddenly, visibly backtracking to previous gantry angles. The purpose of this work is to study the effect of parked MLC positioning parameters in Elements on cranial SRS delivery speed and gantry motion on a VersaHD. Methods: To study the effect of parked MLC leaf positions on VersaHD deliverability, cranial SRS plans were generated with different TPS …