There is wide variability in the flow dynamics in ENFit connectors with significant potential impact on many facets of HEN, including medicine delivery, blenderized feeds, venting, and compliance with EN due to increased time to administer feeds. We highly recommend additional testing of flow dynamics, including gravity flow, as ENFit tubes are being developed and adopted.

A significant demand exists for a liver support device such as a Bioartifical Liver (BAL) to treat patients experiencing acute liver failure. This descriptive paper outlines the design and development of two of the key components of the Mayo Spheroid Reservoir Bioartificial Liver (SRBAL) system. One of the components is the multifunctional Spheroid Reservoir and the other is Multi-shelf Rocker. The Spheroid Reservoir provides an environment to support the viability and functionality of the hepatocyte spheroids at very high cell densities. The Spheroid Reservoir is the biologically active component of this extracorporeal liver support device. Since the Spheroid Reservoir is designed to support 200-400 grams of hepatocyte spheroids, a method to quickly produce large quantities of spheroids is required. The Multi-Shelf Rocker fulfills the production requirement by allowing the culturing of up to six liters of hepatocyte suspension in a conventional laboratory incubator. The SRBAL is designed to provide life sustaining liver-like function to patients in acute liver failure.

PURPOSE: A new Collaborative Ocular Melanoma Study (COMS)-like 24 mm eye plaque was experimentally characterized using physical and dosimetric measurements in preparation for clinical usage. The new eye plaque will enable surgeons and radiation oncologists to accommodate patients who have larger ocular melanoma tumors. METHODS AND MATERIALS: Physical measurement of the Modulay radius of curvature was performed using a FARO Edge, and the base thickness of the Silastic insert was measured with a depth gauge and Vernier caliper. Dosimetric measurements, using Gafchromic film, were used to determine the absolute dose as a function of the depth along the plaque's central axis, profiles as a function of polar angle, and basal coverage at the inner sclera. The measured results were compared with a theoretical model, which incorporated the plaque's heterogeneities using a modified TG-43 formalism. RESULTS: The Modulay radius of curvature measured 14.7 mm (specification 5 14.55 mm). The Silastic base thickness measured 0.9 mm (specification 5 1.0 mm). For a 24 mm plaque fully loaded with 1.27 U 125 I model 2301 seeds, the dose rate at a prescription depth of 5 mm from the inner sclera was measured to be 36 cGy U À1 hr À1. The basal coverage for the same prescription depth was 17.9 mm. The experimental measurements were in close agreement with the theoretical predictions. CONCLUSIONS: The new 24 mm COMS-like plaque was experimentally validated for clinical use. Physical and dosimetric measurements for the 24 mm plaque agreed with nominal specifications and theoretical predictions. The 24 mm plaque provides greater basal coverage and lower surface doses than existing COMS plaques.

A 24 mm COMS‐like eye plaque was developed to meet the treatment needs of our eye plaque brachytherapy practice. As part of commissioning, it was necessary to determine the new plaque's seed coordinates. The FARO Edge, a commercially available measurement arm, was chosen for this purpose. In order to validate the FARO Edge method, it was first used to measure the seed marker coordinates in the silastic molds for the standard 10, 18, and 20 mm COMS plaques, and the results were compared with the standard published Task Group 129 coordinates by a nonlinear least squares match in MATLAB version R2013a. All measured coordinates were within 0.60 mm, and root mean square deviation was 0.12, 0.23, and 0.35 mm for the 10, 18, and 20 mm molds, respectively. The FARO Edge was then used to measure the seed marker locations in the new 24 mm silastic mold. Those values were compared to the manufacturing specification coordinates and were found to demonstrate good agreement, with a maximum deviation of 0.56 mm and a root mean square deviation of 0.37 mm. The FARO Edge is deemed to be a reliable method for determining seed coordinates for COMS silastics, and the seed coordinates for the new 24 mm plaque are presented.PACS number: 87.53.Jw

Purpose: To design, fabricate and test a 3D‐printed filter for proton range spreading in scanned proton beams. The narrow Bragg peak in lower‐energy synchrotron‐based scanned proton beams can result in longer treatment times for shallow targets due to energy switching time and plan quality degradation due to minimum monitor unit limitations. A filter with variable thicknesses patterned on the same scale as the beam's lateral spot size will widen the Bragg peak. Methods: The filter consists of pyramids dimensioned to have a Gaussian distribution in thickness. The pyramids are 2.5mm wide at the base, 0.6 mm wide at the peak, 5mm tall, and are repeated in a 2.5mm pseudo‐hexagonal lattice. Monte Carlo simulations of the filter in a proton beam were run using TOPAS to assess the change in depth profiles and lateral beam profiles. The prototypes were constrained to a 2.5cm diameter disk to allow for micro‐CT imaging of promising prototypes. Three different 3D printers were tested. Depth‐doses with and without the prototype filter were then measured in a ~70MeV proton beam using a multilayer ion chamber. Results: The simulation results were consistent with design expectations. Prototypes printed on one printer were clearly unacceptable on visual inspection. Prototypes on a second printer looked acceptable, but the micro‐CT image showed unacceptable voids within the pyramids. Prototypes from the third printer appeared acceptable visually and on micro‐CT imaging. Depth dose scans using the prototype from the third printer were consistent with simulation results. Bragg peak width increased by about 3x. Conclusions: A prototype 3D printer pyramid filter for range spreading was successfully designed, fabricated and tested. The filter has greater design flexibility and lower prototyping and production costs compared to traditional ridge filters. Printer and material selection played a large role in the successful development of the filter.