scholarly journals Implementation of a Novel Remote Physician SBRT Coverage Process during the Coronavirus Pandemic

2020 ◽  
Author(s):  
Alex Price ◽  
Lauren E. Henke ◽  
Borna Maraghechi ◽  
Taeho Kim ◽  
Matthew B. Spraker ◽  
...  
Keyword(s):  
Failure Modes ◽  
Alternative Methods ◽  
Treatment Coverage ◽  
Average Value ◽  
Comfort Levels ◽  
Coverage Process ◽  
Before And After ◽  
Novel Method ◽  
Pre Treatment ◽  
Process Failures

AbstractINTRODUCTIONDuring the COVID-19 pandemic, alternative methods of care are needed to reduce the relative risk of transmission in departments. Also needed is the ability to provide vital radiation oncological care if radiation oncologists (RO) are reallocated to other departments. We implemented a novel remote RO SBRT coverage practice, requiring it to be reliable, of high audio and visual quality, timely, and the same level of specialty care as our current in-person treatment coverage practice.METHODSAll observed failure modes were recorded during implementation over the first 15 sequential fractions. The time from CBCT to treatment was calculated before and after implementation to determine timeliness of remote coverage. Image quality metrics were calculated between the imaging console screen and the RO’s shared screen. Comfort levels with audio/visual communication as well as overall comfort in comparison to in-person RO coverage was evaluated using Likert scale surveys after treatment.RESULTSRemote RO SBRT coverage was successfully implemented in 14/15 fractions with 3 observed process failures that were all corrected before treatment. Average times of pre-treatment coverage before and after implementation were 8.74 and 8.51min, respectively. The cross correlation between the imaging console screen and RO’s shared screen was r=0.96 and lag was 0.05s. The average value for all survey questions was above 4.5, approaching in-person RO coverage comfort levels.CONCLUSIONSOur novel method of remote RO SBRT coverage permits reduced personnel and patient interactions surrounding RT procedures. This may help to reduce transmission of COVID-19 in our department and provides a means for SBRT coverage if ROs are reallocated to other areas of the hospital for COVID-19 support.

scholarly journals PENGGUNAAN MATEMATIKA REALISTIK UNTUK MENINGKATKAN DISPOSISI MATEMATIS SISWA SMP

2017 ◽  
Vol 2 (2) ◽  
pp. 147
Author(s):  
Vincentia Septi Puspitawati ◽  
Georgius Rocki Agasi
Keyword(s):  
Statistical Analysis ◽  
Mathematics Teaching ◽  
Mathematics Learning ◽  
Descriptive Statistics ◽  
Real Problem ◽  
Average Value ◽  
Realistic Mathematics ◽  
Before And After ◽  
Pre Treatment ◽  
Descriptive Statistical Analysis

The problem of mathematics learning often happens in mathematics teaching that seems far from the real problem. Realistic mathematics learning can help students to understand about mathematics concepts that abstract for them. If the teachers use real context in mathematics learning, students will be more attracted and interested. The purpose of this research is to look at the effect of realistic mathematics learning towards student's mathematical disposition. The method of this research is descriptive quantitative. The subjects were 35 students of SMP N 14 Yogyakarta grade 7 and this research held in one month. The instrument is students' mathematical disposition scale questionnaire. The students fill the questionnaire before and after they are given a treatment. The result of the questionnaire was analyzed using descriptive statistics, by looking at the average before and after treatment and categorized according to the average value. Based on the results of the descriptive statistical analysis showed that an average of students’ mathematical disposition has increased. The average value of students in pre-treatment is 96.02 with the medium category and then after treatment is given to the 109.44 with the high category

Cytoprotective Effect of Tocotrienol-Rich Fraction and α-Tocopherol Vitamin E Isoforms Against Glutamate-Induced Cell Death in Neuronal Cells

2014 ◽  
Vol 84 (3-4) ◽  
pp. 0140-0151 ◽  
Author(s):  
Thilaga Rati Selvaraju ◽  
Huzwah Khaza’ai ◽  
Sharmili Vidyadaran ◽  
Mohd Sokhini Abd Mutalib ◽  
Vasudevan Ramachandran ◽  
...  
Keyword(s):  
Vitamin E ◽  
Cell Viability ◽  
Neuronal Cells ◽  
Positive Control ◽  
Post Treatment ◽  
Mitochondrial Activity ◽  
Before And After ◽  
Pre Treatment ◽  
Tocotrienol Rich Fraction ◽  
Major Mediator

Glutamate is the major mediator of excitatory signals in the mammalian central nervous system. Extreme amounts of glutamate in the extracellular spaces can lead to numerous neurodegenerative diseases. We aimed to clarify the potential of the following vitamin E isomers, tocotrienol-rich fraction (TRF) and α-tocopherol (α-TCP), as potent neuroprotective agents against glutamate-induced injury in neuronal SK-N-SH cells. Cells were treated before and after glutamate injury (pre- and post-treatment, respectively) with 100 - 300 ng/ml TRF/α-TCP. Exposure to 120 mM glutamate significantly reduced cell viability to 76 % and 79 % in the pre- and post-treatment studies, respectively; however, pre- and post-treatment with TRF/α-TCP attenuated the cytotoxic effect of glutamate. Compared to the positive control (glutamate-injured cells not treated with TRF/α-TCP), pre-treatment with 100, 200, and 300 ng/ml TRF significantly improved cell viability following glutamate injury to 95.2 %, 95.0 %, and 95.6 %, respectively (p < 0.05).The isomers not only conferred neuroprotection by enhancing mitochondrial activity and depleting free radical production, but also increased cell viability and recovery upon glutamate insult. Our results suggest that vitamin E has potent antioxidant potential for protecting against glutamate injury and recovering glutamate-injured neuronal cells. Our findings also indicate that both TRF and α-TCP could play key roles as anti-apoptotic agents with neuroprotective properties.

GESTOGENS IN CORPUS LUTEUM OF CATTLE

1960 ◽  
Vol XXXIII (III) ◽  
pp. 417-427 ◽  
Author(s):  
John Kristoffersen
Keyword(s):  
Corpus Luteum ◽  
Average Value ◽  
Spectrophotometric Methods ◽  
The Third ◽  
Quantitative Measurements ◽  
Before And After ◽  
Luteal Tissue ◽  
In Pregnancy

ABSTRACT By means of chromatographic and spectrophotometric methods progesterone and a substance closely similar to 20β-hydroxy-pregn-4-ene-3-one has been detected in luteal tissue from non-pregnant and pregnant cows. In 21 animals quantitative measurements based on a method giving an average net recovery of 56 per cent showed that in pregnancy the average progesterone content in the corpus luteum reached a maximum in the third to fifth month, with low values before and after this period. For 6 nonpregnant cows, the average value was 20.2 μg/g tissue, which is considerably higher than previous values reported in the literature. The relation between these findings and the bovine dependence on a functional corpus luteum in pregnancy is discussed, and it is pointed out that more information about the metabolism of progesterone in cattle is highly desirable.

Failure Analysis Case Study of a 1.5 Meter Space Flex Harness

2017 ◽  
Author(s):  
Erick Kim ◽  
Kamjou Mansour ◽  
Gil Garteiz ◽  
Javeck Verdugo ◽  
Ryan Ross ◽  
...  
Keyword(s):  
Failure Analysis ◽  
Failure Modes ◽  
Field Of View ◽  
Area Of Interest ◽  
Air Stream ◽  
Novel Method ◽  
Temperature Controlled ◽  
Non Destructive ◽  
Failure Site

Abstract This paper presents the failure analysis on a 1.5m flex harness for a space flight instrument that exhibited two failure modes: global isolation resistances between all adjacent traces measured tens of milliohm and lower resistance on the order of 1 kiloohm was observed on several pins. It shows a novel method using a temperature controlled air stream while monitoring isolation resistance to identify a general area of interest of a low isolation resistance failure. The paper explains how isolation resistance measurements were taken and details the steps taken in both destructive and non-destructive analyses. In theory, infrared hotspot could have been completed along the length of the flex harness to locate the failure site. However, with a field of view of approximately 5 x 5 cm, this technique would have been time prohibitive.

scholarly journals Algorithmic prediction of failure modes in healthcare

2020 ◽  
Author(s):  
Ayala Kobo-Greenhut ◽  
Ortal Sharlin ◽  
Yael Adler ◽  
Nitza Peer ◽  
Vered H Eisenberg ◽  
...  
Keyword(s):  
Adverse Events ◽  
Failure Modes ◽  
Medical Center ◽  
Hazard Analysis ◽  
Working Hours ◽  
Hazard Identification ◽  
Patient Identification ◽  
Complete Identification ◽  
Before And After ◽  
Fmea Method

Abstract Background Preventing medical errors is crucial, especially during crises like the COVID-19 pandemic. Failure Modes and Effects Analysis (FMEA) is the most widely used prospective hazard analysis in healthcare. FMEA relies on brainstorming by multi-disciplinary teams to identify hazards. This approach has two major weaknesses: significant time and human resource investments, and lack of complete and error-free results. Objectives To introduce the algorithmic prediction of failure modes in healthcare (APFMH) and to examine whether APFMH is leaner in resource allocation in comparison to the traditional FMEA and whether it ensures the complete identification of hazards. Methods The patient identification during imaging process at the emergency department of Sheba Medical Center was analyzed by FMEA and APFMH, independently and separately. We compared between the hazards predicted by APFMH method and the hazards predicted by FMEA method; the total participants’ working hours invested in each process and the adverse events, categorized as ‘patient identification’, before and after the recommendations resulted from the above processes were implemented. Results APFMH is more effective in identifying hazards (P &lt; 0.0001) and is leaner in resources than the traditional FMEA: the former used 21 h whereas the latter required 63 h. Following the implementation of the recommendations, the adverse events decreased by 44% annually (P = 0.0026). Most adverse events were preventable, had all recommendations been fully implemented. Conclusion In light of our initial and limited-size study, APFMH is more effective in identifying hazards (P &lt; 0.0001) and is leaner in resources than the traditional FMEA. APFMH is suggested as an alternative to FMEA since it is leaner in time and human resources, ensures more complete hazard identification and is especially valuable during crisis time, when new protocols are often adopted, such as in the current days of the COVID-19 pandemic.

scholarly journals Transcriptomic analysis identifies differences in gene expression in actinic keratoses after treatment with imiquimod and between responders and non responders

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Megan H. Trager ◽  
Emanuelle Rizk ◽  
Sharon Rose ◽  
Kuixi Zhu ◽  
Branden Lau ◽  
...  
Keyword(s):  
Gene Expression ◽  
Squamous Cell Carcinoma ◽  
Distinct Pattern ◽  
Study Endpoint ◽  
Inflammatory Gene Expression ◽  
Immune Modulators ◽  
Actinic Keratoses ◽  
Before And After ◽  
Pre Treatment

AbstractThe presence of actinic keratoses (AKs) increases a patient’s risk of developing squamous cell carcinoma by greater than six-fold. We evaluated the effect of topical treatment with imiquimod on the tumor microenvironment by measuring transcriptomic differences in AKs before and after treatment with imiquimod 3.75%. Biopsies were collected prospectively from 21 patients and examined histologically. RNA was extracted and transcriptomic analyses of 788 genes were performed using the nanoString assay. Imiquimod decreased number of AKs by study endpoint at week 14 (p < 0.0001). Post-imiquimod therapy, levels of CDK1, CXCL13, IL1B, GADPH, TTK, ILF3, EWSR1, BIRC5, PLAUR, ISG20, and C1QBP were significantly lower (adjusted p < 0.05). Complete responders (CR) exhibited a distinct pattern of inflammatory gene expression pre-treatment relative to incomplete responders (IR), with alterations in 15 inflammatory pathways (p < 0.05) reflecting differential expression of 103 genes (p < 0.05). Presence of adverse effects was associated with improved treatment response. Differences in gene expression were found between pre-treatment samples in CR versus IR, suggesting that higher levels of inflammation pre-treament may play a part in regression of AKs. Further characterization of the immune micro-environment in AKs may help develop biomarkers predictive of response to topical immune modulators and may guide therapy.

scholarly journals Assessing baseline dependency of anchor-based minimal important change (MIC): don’t stratify on the baseline score!

2021 ◽  
Author(s):  
Berend Terluin ◽  
Ewa M. Roos ◽  
Caroline B. Terwee ◽  
Jonas B. Thorlund ◽  
Lina H. Ingelsrud
Keyword(s):  
Real Data ◽  
Patient Reported Outcome ◽  
Health Condition ◽  
Important Change ◽  
Alternative Methods ◽  
Minimal Important Change ◽  
Baseline Score ◽  
Patient Reported ◽  
Before And After ◽  
Parallel Tests

Abstract Purpose The minimal important change (MIC) of a patient-reported outcome measure (PROM) is often suspected to be baseline dependent, typically in the sense that patients who are in a poorer baseline health condition need greater improvement to qualify as minimally important. Testing MIC baseline dependency is commonly performed by creating two or more subgroups, stratified on the baseline PROM score. This study’s purpose was to show that this practice produces biased subgroup MIC estimates resulting in spurious MIC baseline dependency, and to develop alternative methods to evaluate MIC baseline dependency. Methods Datasets with PROM baseline and follow-up scores and transition ratings were simulated with and without MIC baseline dependency. Mean change MICs, ROC-based MICs, predictive MICs, and adjusted MICs were estimated before and after stratification on the baseline score. Three alternative methods were developed and evaluated. The methods were applied in a real data example for illustration. Results Baseline stratification resulted in biased subgroup MIC estimates and the false impression of MIC baseline dependency, due to redistribution of measurement error. Two of the alternative methods require a second baseline measurement with the same PROM or another correlated PROM. The third method involves the construction of two parallel tests based on splitting the PROM’s item set. Two methods could be applied to the real data. Conclusion MIC baseline dependency should not be tested in subgroups based on stratification on the baseline PROM score. Instead, one or more of the suggested alternative methods should be used.

Effect of Carbon Pre-Treatment on Pd Dispersion in Synthesis of Pd/C Catalyst

2014 ◽  
Vol 804 ◽  
pp. 149-152 ◽  
Author(s):  
Ji Sun Kim ◽  
Jae Ho Baek ◽  
Myung Hwan Kim ◽  
Seong Soo Hong ◽  
Man Sig Lee
Keyword(s):  
Surface Area ◽  
Nitrogen Adsorption ◽  
Area Ratio ◽  
High Dispersion ◽  
Co Chemisorption ◽  
Pd Dispersion ◽  
Before And After ◽  
Pre Treatment ◽  
Treated Carbon ◽  
Adsorption Desorption

In this study, we confirmed effect of carbon pre-treatment on Pd dispersion in synthesis of Pd/C catalyst. Physical characteristics on the surface of before and after pre-treated carbon were analyzed by nitrogen adsorption-desorption analysis. The dispersion and size of Pd particles were analyzed by XRD, FE-TEM and CO-chemisorption. After pre-treatment, surface area of carbon were decreased. And mesopore area ratio were increased with decreasing micropore area ratio. In the case of pre-treated carbon, we confirmed high dispersion of Pd particles.

scholarly journals On the Spectral and Polarimetric Signatures of a Bright Scatterer before and after Hardware Replacement

2021 ◽  
Vol 13 (5) ◽  
pp. 919
Author(s):  
Marco Gabella
Keyword(s):  
Low Noise ◽  
Low Noise Amplifiers ◽  
Doppler Velocity ◽  
Data Set ◽  
Differential Phase Shift ◽  
Spectral Signatures ◽  
Average Value ◽  
Before And After ◽  
Radar Calibration ◽  
Small Dispersion

A previous study has used the stable and peculiar echoes backscattered by a single “bright scatterer” (BS) during five winter days to characterize the hardware of C-band, the dual-polarization radar located at Monte Lema (1625 m altitude) in Southern Switzerland. The BS is the 90 m tall metallic tower on Cimetta (1633 m altitude, 18 km range). In this note, the statistics of the echoes from the BS were derived from other ten dry days with normal propagation conditions in winter 2015 and January 2019. The study confirms that spectral signatures, such as spectrum width, wideband noise and Doppler velocity, were persistently stable. Regarding the polarimetric signatures, the large values (with small dispersion) of the copolar correlation coefficient between horizontal and vertical polarization were also confirmed: the average value was 0.9961 (0.9982) in winter 2015 (January 2019); the daily standard deviations were very small, ranging from 0.0007 to 0.0030. The dispersion of the differential phase shift was also confirmed to be quite small: the daily standard deviation ranged from a minimum of 2.5° to a maximum of 5.3°. Radar reflectivities in both polarizations were typically around 80 dBz and were confirmed to be among the largest values observed in the surveillance volume of the Monte Lema radar. Finally, another recent 5-day data set from January 2020 was analyzed after the replacement of the radar calibration unit that includes low noise amplifiers: these five days show poorer characteristics of the polarimetric signatures and a few outliers affecting the spectral signatures. It was shown that the “historical” polarimetric and spectral signatures of a bright scatterer could represent a benchmark for an in-depth comparison after hardware replacements.

Fabrication and characterization of composite MoS2-TiO2 coating material

2021 ◽  
pp. 095440622110157
Author(s):  
Avinash V Borgaonkar ◽  
Ismail Syed ◽  
Shirish H Sonawane
Keyword(s):  
Bond Strength ◽  
Treatment Method ◽  
Optical Microscope ◽  
Scratch Resistance ◽  
Substrate Material ◽  
Coating Film ◽  
Tribological Behaviour ◽  
Molybdenum Disulphide ◽  
Before And After ◽  
Pre Treatment

Molybdenum disulphide (MoS2) is a popularly used solid lubricant in various applications due to its superior tribological behaviour. However, it possesses poor wear resistance which requires further improvement. In the present study efforts have been made to enhance the tribological properties of pure MoS2 coating film by doping TiO2 nanoparticles as a reinforcement material. The Manganese phosphating is selected as a pre-treatment method to improve the bond strength between coating and substrate. The coating is bonded with the substrate material employing sodium silicate as a binder. The effects of wt. % of TiO2 onto the mechanical properties of composite MoS2-TiO2 coating such as hardness and bond strength have been studied. In addition coating microstructure before and after experimental test was studied using optical microscope and scanning electron microscope. It was also found that with increase in wt. % addition of TiO2 upto 15% into MoS2 base matrix, the hardness of coating increases proportionally. Beyond 15 wt. % addition of TiO2, the coating becomes brittle in nature. This leads to reduction in the scratch resistance.

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