Radiation Protection of Personnel in Contact Radiation Therapy in Ophthalmology

Purpose: To ensure radiation safety of medical staff personal protective equipment (PPE). Material and methods: In order to not make assumptions of possible protective materials optical distortion, estimated the dependence of light transmission in the wavelength range 330–660 nm leaded glass brands of TF-1 and TF-5, as well as the intensity of glow glasses when exposed to light and X-rays. Results: We trace the degree of browning and the nature of the recovery of transparency of glass after irradiation. To determine the optimum thickness of lead glass for eyewear experimentally evaluated attenuation of X-rays with energy efficiency 30 and 80 keV. Lead equivalent values for lead glass, was determined so for Eeff ~ 20 keV at a multiplicity of weakening k = 10 lead glass brand TF-5 thickness 2.0 mm equivalent 0.8 mm Pb, etc. For the possible use of other additives in the window shows the curves of the attenuation of photon radiation radionuclide 241Am (20–60 keV) filters from 9Be, 26Al, 56Fe, 64Cu, 99Mo, 112Cd, 184W, 207Pb Conclusion: Possible introduction of new dose limits for the lens of the eye can be successful only in case of both existing and newly developed PPE. To reduce the impact of domestic lead glass radiation can be used for staff in the form of screens and glasses.

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Impact of COVID-19 on Nuclear Medicine in Germany, Austria and Switzerland: An International Survey in April 2020

Nuklearmedizin ◽

10.1055/a-1163-3096 ◽

2020 ◽

Vol 59 (04) ◽

pp. 294-299 ◽

Cited By ~ 4

Author(s):

Lutz S. Freudenberg ◽

Ulf Dittmer ◽

Ken Herrmann

Keyword(s):

Nuclear Medicine ◽

Health Systems ◽

Personal Protective Equipment ◽

Large Scale ◽

Diagnostic Procedures ◽

Protective Equipment ◽

Current Crisis ◽

Web Based ◽

Public Versus Private ◽

The Impact

Abstract Introduction Preparations of health systems to accommodate large number of severely ill COVID-19 patients in March/April 2020 has a significant impact on nuclear medicine departments. Materials and Methods A web-based questionnaire was designed to differentiate the impact of the pandemic on inpatient and outpatient nuclear medicine operations and on public versus private health systems, respectively. Questions were addressing the following issues: impact on nuclear medicine diagnostics and therapy, use of recommendations, personal protective equipment, and organizational adaptations. The survey was available for 6 days and closed on April 20, 2020. Results 113 complete responses were recorded. Nearly all participants (97 %) report a decline of nuclear medicine diagnostic procedures. The mean reduction in the last three weeks for PET/CT, scintigraphies of bone, myocardium, lung thyroid, sentinel lymph-node are –14.4 %, –47.2 %, –47.5 %, –40.7 %, –58.4 %, and –25.2 % respectively. Furthermore, 76 % of the participants report a reduction in therapies especially for benign thyroid disease (-41.8 %) and radiosynoviorthesis (–53.8 %) while tumor therapies remained mainly stable. 48 % of the participants report a shortage of personal protective equipment. Conclusions Nuclear medicine services are notably reduced 3 weeks after the SARS-CoV-2 pandemic reached Germany, Austria and Switzerland on a large scale. We must be aware that the current crisis will also have a significant economic impact on the healthcare system. As the survey cannot adapt to daily dynamic changes in priorities, it serves as a first snapshot requiring follow-up studies and comparisons with other countries and regions.

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X-ray Shielding, Mechanical, Physical, and Water Absorption Properties of Wood/PVC Composites Containing Bismuth Oxide

Polymers ◽

10.3390/polym13132212 ◽

2021 ◽

Vol 13 (13) ◽

pp. 2212

Author(s):

Worawat Poltabtim ◽

Ekachai Wimolmala ◽

Teerasak Markpin ◽

Narongrit Sombatsompop ◽

Vichai Rosarpitak ◽

...

Keyword(s):

Impact Strength ◽

Water Absorption ◽

Attenuation Coefficient ◽

Bismuth Oxide ◽

Morphological Properties ◽

Linear Attenuation Coefficient ◽

X Rays ◽

Equivalent Thickness ◽

X Ray ◽

The Impact

The potential utilization of wood/polyvinyl chloride (WPVC) composites containing an X-ray protective filler, namely bismuth oxide (Bi2O3) particles, was investigated as novel, safe, and environmentally friendly X-ray shielding materials. The wood and Bi2O3 contents used in this work varied from 20 to 40 parts per hundred parts of PVC by weight (pph) and from 0 to 25, 50, 75, and 100 pph, respectively. The study considered X-ray shielding, mechanical, density, water absorption, and morphological properties. The results showed that the overall X-ray shielding parameters, namely the linear attenuation coefficient (µ), mass attenuation coefficient (µm), and lead equivalent thickness (Pbeq), of the WPVC composites increased with increasing Bi2O3 contents but slightly decreased at higher wood contents (40 pph). Furthermore, comparative Pbeq values between the wood/PVC composites and similar commercial X-ray shielding boards indicated that the recommended Bi2O3 contents for the 20 pph (40 ph) wood/PVC composites were 35, 85, and 40 pph (40, 100, and 45 pph) for the attenuation of 60, 100, and 150-kV X-rays, respectively. In addition, the increased Bi2O3 contents in the WPVC composites enhanced the Izod impact strength, hardness (Shore D), and density, but reduced water absorption. On the other hand, the increased wood contents increased the impact strength, hardness (Shore D), and water absorption but lowered the density of the composites. The overall results suggested that the developed WPVC composites had great potential to be used as effective X-ray shielding materials with Bi2O3 acting as a suitable X-ray protective filler.

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The impact of COVID-19 pandemic on training and mental health of residents: a cross-sectional study

BMC Medical Education ◽

10.1186/s12909-021-02655-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Eman Alshdaifat ◽

Amer Sindiani ◽

Wasim Khasawneh ◽

Omar Abu-Azzam ◽

Aref Qarqash ◽

...

Keyword(s):

Mental Health ◽

Residency Training ◽

Training Programs ◽

Cross Sectional Study ◽

Protective Equipment ◽

Sectional Study ◽

Cross Sectional ◽

Surgical Residents ◽

Tertiary Center ◽

The Impact

Abstract Background Residency programs have been impacted by the Coronavirus disease 2019 (COVID-19) pandemic. In this study we aim to investigate and evaluate the impact of the pandemic on residents as well as residency training programs. Methods This was a cross-sectional study including a survey of 43 questions prepared on Google forms and electronically distributed among a convenience sample of residents training at a tertiary center in North Jordan during the COVID-19 pandemic. Data were collected in the period between October 30th and November 8th of 2020. The survey included questions that addressed the impact of the pandemic on residents’ health as well as training programs. The study participants included residents in training at KAUH in 2020 and were stratified according to the type of residency program (surgical residents (SRs) and non-surgical residents (NSRs)). Statistical methods included descriptive analysis, Chi-square or Fisher’s exact test, Mann Whitney U test, and Cramer’s V and r statistics as measures of effect sizes. Results Of all 430 residents, 255 (59%) responded to the survey. A total of 17 (7%) of residents reported being infected with COVID-19 and a significant difference was reported between SRs and NSRs (10% vs 4%, V = .124 “small effect” (95% CI; .017–.229), p = 0.048). Approximately, 106 (42%) reported a decrease in the number of staff working at the clinic and 164 (64%) reported limited access to personal protective equipment during the pandemic. On a 4-point Likert scale for the feeling of anxiety, the median was 2 (2–3 IQR) in the NSRs group, vs 2 (1–2 IQR) in the SRs groups, with the NSRs being more likely to feel anxious (r = 0.13 “small effect” (95% CI; 0.007–0.249), p = .044). Similarly, the proportion of residents who reported feeling anxious about an inadequacy of protective equipment in the work area was significantly greater in the NSRs group (90.3% vs 75.2%; V = .201 “small effect” (95% CI; .078–.313), p = .001), as well as the proportion of residents who reported feeling increased stress and anxiety between colleagues being also significantly higher in the NSRs group (88.1% vs 76%; V = .158 “small effect” (95% CI; .032–.279), p = .012). Conclusion The burden of the ongoing pandemic on the mental health status of residents is very alarming and so providing residents with psychological counseling and support is needed. Also, critical implications on the flow of residency training programs have been noticed. This necessitates adapting and adopting smart educational techniques to compensate for such limitations.

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Imaging with Coherent X-rays: From the Early Synchrotron Tests to SYNAPSE

Journal of Imaging ◽

10.3390/jimaging7080132 ◽

2021 ◽

Vol 7 (8) ◽

pp. 132

Author(s):

Giorgio Margaritondo ◽

Yeukuang Hwu

Keyword(s):

Human Brain ◽

International Collaboration ◽

Phase Contrast ◽

Asia Pacific ◽

X Rays ◽

New Techniques ◽

Simple Description ◽

Contrast Radiography ◽

The Impact ◽

Extract Information

The high longitudinal and lateral coherence of synchrotron X-rays sources radically transformed radiography. Before them, the image contrast was almost only based on absorption. Coherent synchrotron sources transformed radiography into a multi-faceted tool that can extract information also from “phase” effects. Here, we report a very simple description of the new techniques, presenting them to potential new users without requiring a sophisticated background in advanced physics. We then illustrate the impact of such techniques with a number of examples. Finally, we present the international collaboration SYNAPSE (Synchrotrons for Neuroscience—an Asia-Pacific Strategic Enterprise), which targets the use of phase-contrast radiography to map one full human brain in a few years.

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Aspirin I.V. Loading during Elective Percutaneous Coronary Intervention

Pharmacology ◽

10.1159/000517994 ◽

2021 ◽

pp. 1-5

Author(s):

David Naguib ◽

Carolin Helten ◽

Saif Zako ◽

Philipp Mourikis ◽

René M’Pembele ◽

...

Keyword(s):

Pilot Study ◽

Light Transmission ◽

Platelet Reactivity ◽

Coronary Intervention ◽

Bleeding Complications ◽

Loading Dose ◽

Bleeding Events ◽

Elective Percutaneous Coronary Intervention ◽

Percutaneous Coronary ◽

The Impact

Additional loading dose of acetylsalicylic acid (ASA) during percutaneous coronary interventions (PCIs) despite permanent oral ASA medication is frequently applicated. The impact on platelet reactivity and clinical events is not known. In this pilot study, we aimed to analyze high on-treatment platelet reactivity (HTPR) to aspirin in patients undergoing elective PCI. Platelet reactivity was measured using light-transmission aggregometry in 100 patients on permanent low-dose ASA medication undergoing elective PCI. Platelet reactivity measured by arachidonic acid-induced maximum of aggregation (MoA) in patients with versus without additional peri-procedural ASA loading (500 mg i.v.) was compared. HTPR was defined as MoA >20% for ASA. Major adverse cerebro- and cardiovascular events (MACCEs) and bleeding events were evaluated during hospital course. HTPR rate was similar in both groups (HTPR to ASA: loading vs. control 6% vs. 16%, odds ratio [OR] = 0.33, 95% confidence interval [CI] 0.08–1.35, <i>p</i> = 0.12). In-hospital MACCEs were not different between groups (MACCE: loading vs. control: 0 vs. 0 patient, OR = 1.32, 95% CI 0.03–67.95, <i>p</i> = 0.89). Thrombolysis in myocardial infarction minimal bleedings were numerically higher in patients without ASA loading dose. In this pharmacodynamic pilot study, additional ASA loading did not reduce HTPR to ASA. Furthermore, ASA loading did not increase in-hospital MACCE and bleeding complications.

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Impact of aging on gene expression response to x-ray irradiation using mouse blood

Scientific Reports ◽

10.1038/s41598-021-89682-7 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Constantinos G. Broustas ◽

Axel J. Duval ◽

Sally A. Amundson

Keyword(s):

Gene Expression ◽

Differentially Expressed Genes ◽

Differentially Expressed ◽

X Rays ◽

Gene Expression Response ◽

X Ray ◽

The Impact ◽

Old Mice ◽

Radiation Biodosimetry ◽

Young Mice

AbstractAs a radiation biodosimetry tool, gene expression profiling is being developed using mouse and human peripheral blood models. The impact of dose, dose-rate, and radiation quality has been studied with the goal of predicting radiological tissue injury. In this study, we determined the impact of aging on the gene expression profile of blood from mice exposed to radiation. Young (2 mo) and old (21 mo) male mice were irradiated with 4 Gy x-rays, total RNA was isolated from whole blood 24 h later, and subjected to whole genome microarray analysis. Pathway analysis of differentially expressed genes revealed young mice responded to x-ray exposure by significantly upregulating pathways involved in apoptosis and phagocytosis, a process that eliminates apoptotic cells and preserves tissue homeostasis. In contrast, the functional annotation of senescence was overrepresented among differentially expressed genes from irradiated old mice without enrichment of phagocytosis pathways. Pathways associated with hematologic malignancies were enriched in irradiated old mice compared with irradiated young mice. The fibroblast growth factor signaling pathway was underrepresented in older mice under basal conditions. Similarly, brain-related functions were underrepresented in unirradiated old mice. Thus, age-dependent gene expression differences should be considered when developing gene signatures for use in radiation biodosimetry.

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Occupational burnout following the first wave of coronavirus disease at a Welsh district general hospital

Journal of the Intensive Care Society ◽

10.1177/17511437211010039 ◽

2021 ◽

pp. 175114372110100

Author(s):

Gayathri Chinnappa Srinivas ◽

Anwen Whitham ◽

Rachel Rouse ◽

Vincent Hamlyn ◽

Matthew Williams

Keyword(s):

Health Care Professionals ◽

Response Rate ◽

District General Hospital ◽

Learning Opportunities ◽

Direct Patient Care ◽

Protective Equipment ◽

Positive Outcomes ◽

Occupational Burnout ◽

Staff Burnout ◽

The Impact

A survey was conducted to identify the prevalence of occupational burnout amongst health care professionals caring for COVID-19 patients in the Intensive Care Unit (ICU) of a Welsh hospital. The response rate was 79%. Nurses and other staff reassigned to work in the ICU had higher levels of burnout. Working in Personal Protective Equipment was most distressing, followed by direct patient care. There were positive outcomes including learning opportunities, professional development and job satisfaction. The impact of the pandemic on staff burnout may have been mitigated by acknowledging the contribution of staff, improving communication and encouraging them to access support.

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The COVID-19 Pandemic and nursing challenges: A review of the early literature

Work ◽

10.3233/wor-213458 ◽

2021 ◽

pp. 1-14

Author(s):

Mojtaba K. Danesh ◽

Ehsan Garosi ◽

Hamedeh Golmohamadpour

Keyword(s):

Health Systems ◽

Personal Protective Equipment ◽

Qualitative Studies ◽

Systematic Search ◽

Current Paper ◽

Protective Equipment ◽

Early Literature ◽

The Face ◽

Physical Distress ◽

The Impact

BACKGROUND: The COVID-19 pandemic has put health systems under unprecedented pressure, challenging their workforce, especially nurses. OBJECTIVE: The current paper presented a review of the early literature concerning emerging nursing challenges during the early stages of the COVID-19 pandemic. METHODS: A systematic search of the published literature between January and May 2020 was carried out in Medline, Science Direct, and Google Scholar to identify relevant quantitative and qualitative studies. RESULTS: Twenty-two original articles were retrieved, the majority of which were survey studies from China. Synthesis of the evidence resulted in four overarching themes including “being physically and mentally drained in the face of fear and uncertainty,” “shortage of personal protective equipment and usability issues,” “psychosomatic disturbances among nurses,” and “moderators to mitigate nurses’ challenges.” CONCLUSIONS: Providing care for demanding COVID-19 patients, nurses experienced a gruelling situation, during which a significant amount of psychological and physical distress was inflicted to them. However, receiving proper support from their organization and society could improve the condition substantially. Further research is required to explore the impact of the COVID-19 pandemic on nurses, especially from Western countries.

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Selecting pH cut-offs for the safe verification of nasogastric feeding tube placement: a decision analytical modelling approach

BMJ Open ◽

10.1136/bmjopen-2017-018128 ◽

2017 ◽

Vol 7 (11) ◽

pp. e018128 ◽

Cited By ~ 3

Author(s):

Melody Zhifang Ni ◽

Jeremy R Huddy ◽

Oliver H Priest ◽

Sisse Olsen ◽

Lawrence D Phillips ◽

...

Keyword(s):

Care Pathway ◽

Feeding Tube ◽

Tube Placement ◽

X Rays ◽

Clinical Environment ◽

Nasogastric Feeding ◽

Relative Safety ◽

Checking Procedure ◽

The Impact ◽

Modelling Approach

ObjectivesThe existing British National Patient Safety Agency (NPSA) safety guideline recommends testing the pH of nasogastric (NG) tube aspirates. Feeding is considered safe if a pH of 5.5 or lower has been observed; otherwise chest X-rays are recommended. Our previous research found that at 5.5, the pH test lacks sensitivity towards oesophageal placements, a major risk identified by feeding experts. The aim of this research is to use a decision analytic modelling approach to systematically assess the safety of the pH test under cut-offs 1–9.Materials and methodsWe mapped out the care pathway according to the existing safety guideline where the pH test is used as a first-line test, followed by chest x-rays. Decision outcomes were scored on a 0–100 scale in terms of safety. Sensitivities and specificities of the pH test at each cut-off were extracted from our previous research. Aggregating outcome scores and probabilities resulted in weighted scores which enabled an analysis of the relative safety of the checking procedure under various pH cut-offs.ResultsThe pH test was the safest under cut-off 5 when there was ≥30% of NG tube misplacements. Under cut-off 5, respiratory feeding was excluded; oesophageal feeding was kept to a minimum to balance the need of chest X-rays for patients with a pH higher than 5. Routine chest X-rays were less safe than the pH test while to feed all without safety checks was the most risky.DiscussionThe safety of the current checking procedure is sensitive to the choice of pH cut-offs, the impact of feeding delays, the accuracy of the pH in the oesophagus, as well as the extent of tube misplacements.ConclusionsThe pH test with 5 as the cut-off was the safest overall. It is important to understand the local clinical environment so that appropriate choice of pH cut-offs can be made to maximise safety and to minimise the use of chest X-rays.Trial registration numberISRCTN11170249; Pre-results.

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RADIATION HAZARDS IN THE FIELD OF PEDIATRICS

PEDIATRICS ◽

10.1542/peds.20.5.921 ◽

1957 ◽

Vol 20 (5) ◽

pp. 921-940

Author(s):

Meinhard Robinow ◽

Frederic N. Silverman

Keyword(s):

Radiation Injury ◽

Radiation Safety ◽

The United States ◽

Point Of View ◽

Public Understanding ◽

X Rays ◽

Tissue Destruction ◽

Radiation Hazards ◽

External Sources ◽

Radiation Induced

The different types of injury from external sources of ionizing radiation are briefly described and the manifestations of radiation injury in the fetus, the infant and the child are reviewed. If radiation therapy for malignant disease is excluded from consideration, it is found that x-ray damage to skin, other tissue destruction, and growth impairment are relatively minor radiation hazards compared to the dangers of leukemia and other malignancy and of radiation-induced genetic damage. Consideration is given to somatic radiation injury as largely an individual problem and genetic injury as a population problem. This point of view is reflected in the differing recommendations concerning "permissible doses" for individuals and for populations. Medical radiation represents a major and presumably growing source of exposure to individuals and to the population in the United States. Various ways are shown in which excessive diagnostic exposure to x-rays, especially in children, can be reduced without interference with requirements of diagnosis. Control of avoidable radiation can be accomplished by combined attack from different fronts. The more important approaches to radiation safety are discussed. They include attention to technical detail, personnel monitoring, maintenance of radiation records, radiation safety through legislative control and public education. The responsibility of the physician in promoting public understanding of radiation hazards is emphasized.

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