The current status of uptake of European Basic Safety Standard (2013/59/Euratom) requirements: results of a follow-up survey in European radiology departments

The recently implemented European Council Basic Safety Standards Directive (BSSD), 2013/59/Euratom lays down core radiation protection standards for European radiology departments, including a mandatory requirement for supporting processes of clinical audit. A repeat survey on behalf of the European Society of Radiology (ESR) was undertaken in February 2021, involving the ESR EuroSafe Imaging Star department network, to re-assess compliance with selected key BSSD requirements following an initial survey in 2018 where variable compliance was demonstrated. 61% (78/128) of eligible departments participated and overall the survey results revealed a mixed picture in terms of implementation of BSSD requirements when compared to the 2018 survey with both improvement and deterioration observed. This pattern was seen also in relation to supporting processes of regulatory audit and re-audit. Higher levels of “skipping” of responses were also observed in 2021. These findings were unexpected in light of the interventions in relation to audit (clinical and regulatory) and radiation protection undertaken by the ESR and other organisations in recent years, but can reasonably be explained by the onset of the COVID-19 pandemic, with consequent significant disruption of radiology services. The 2021 survey results do serve to highlight again the need for co-ordinated intervention involving relevant European bodies, organisations and governmental agencies to address the important issues raised by this survey. The European Commission clinical audit and radiation protection initiatives, QuADRANT, led by the ESR, and SAMIRA will act as important drivers for improvement in patient safety, experience and outcomes across Europe.

Loading-Rate Dependency of Young’s Modulus for Class I and Class II Rocks

Understanding the time-dependent behavior of rocks is important for ensuring the long-term stability of underground structures. Aspects of such a time-dependent behavior include the loading-rate dependency of Young’s modulus, strength, creep, and relaxation. In particular, the loading-rate dependency of Young’s modulus of rocks has not been fully clarified. In this study, four different types of rocks were tested, and the results were used to analyze the loading-rate dependency of Young’s modulus and explain the underlying mechanism. For all four rocks, Young’s modulus increased linearly with a tenfold increase in the loading rate. The rocks showed the same loading-rate dependency of Young’s modulus. A variable-compliance constitutive equation was proposed for the loading-rate dependency of Young’s modulus, and the calculated results agreed well with measured values. Irrecoverable and recoverable strains were separated by loading-unloading-reloading tests at preset stress levels. The constitutive equations showed that the rate of increase in Young’s modulus increased with the irrecoverable strain and decreased with increasing stress. The increase in the irrecoverable strain was delayed at high loading rates, which was concluded to be the main reason for the increase in Young’s modulus with an increasing loading rate.

A Reconfigurable Variable-Stiffness Parallel Beam for Compliant Robotic Mechanisms Towards Safe Human Interaction

To co-work with humans, robotic mechanisms need to have variable stiffness with high rigidity for performance and low compliance for safe interactions. This paper introduces a reconfigurable variable-stiffness parallel beam (VSPB) which can be used in both robotic joints and links for variable compliance. The VSPB is a compliant cantilever mechanism with hollow parallel beams in the middle and solid connections at both ends. Stiffness adjusting can be realized by changing the cross-sectional area property of the hollow beam segment discretely through a bistable mechanism block or continuously by the block sliding. Detailed stiffness models of the two VSPB stiffness modes with the block on and off are derived using the approach of serially connected beam modeling and superposition combination. The developed model not only works for thin-walled flexure beams but also general thick beam models. The stiffness change relationship with various design parameters is investigated using the developed model and validated by finite element analysis (FEA) results. The correlation between parameters and errors between FEA and theoretical values is observed and analyzed to optimize the model. These methods and results provide a new concept and theoretical basis for developing new variable stiffness robotic mechanisms towards safe human-robot interaction applications.

Design of a variable stiffness index finger exoskeleton

This paper presents the design and experimentation of a variable stiffness index finger exoskeleton consisting of four-bar mechanisms actuated by a linear actuator. The lengths of the four-bar mechanism were optimized so that it can follow a recorded index fingertip trajectory. The mechanism has a fixed compliance at the coupler of the four-bar link and a variable compliance at the linear actuator that moves the four-bar. The skeletal shape of the coupler of the finger link has been optimized using FEM. The exoskeleton can apply a constant fingertip force irrespective of the position of the fingers.

Compliance to completion of sodium valproate annual risk acknowledgement form among women of child-bearing age prescribed sodium valproate in the intellectual disability (ID) services of an NHS trust

AimsTo determine the proportion of women of child-bearing age prescribed SV who have the SV ARF filled.BackgroundIn 2018, the Medicines and Healthcare products Regulatory Agency (MHRA) gave guidance regarding Sodium Valproate (SV) prescription. It acknowledged the significant risk of birth defects and developmental disorders in women of child-bearing age prescribed SV.Consequently, the MHRA recommendation is that SV must not be used in females of child-bearing age unless: conditions of pregnancy prevention programme are met; other treatments are ineffective or not tolerated; and evidence of discussion of risks with patient or carer and annual review of the risks are documented. The evidences of the above criteria are expected to be documented in an Annual Risk Acknowledgement Form (ARF).MethodRetrospective study involving systematic search of Trust database to identify women with ID, aged 16–50 years prescribed SV from 2018 to 2019.Result18 of 28 patients had ARF filled, a 64% compliance.The main indications for SV prescription were epilepsy; challenging behaviour; and mood stabilization.The distribution showed neurology and psychiatrist led prescription initiation equally distributed at 50%.The ARF compliance was higher in the neurology group (93%) compared to 36% in psychiatrist group.A review across the 5 ID teams (A,B,C,D and E) of the trust shows variable compliance to ARF compliance (17%,81%,100%,60%,0% respectively) with teams having higher proportion of neurology led SV prescription initiation also having higher proportion of ARF completion compliance (0%,55%,80%,80%,0% respectively).ConclusionConclusion / RecommendationARF compliance is below standard at 64%.Despite the SV prescription being equally distributed between neurology led and psychiatry led, patients whose prescription of SV is neurology led (prescription indication as epilepsy) had better ARF compliance outcome (93%) compared with patients whose prescription is psychiatry led (prescription indication as challenging behaviour or mood stabilization) with 36% ARF compliance.Organizational difference with dedicated epilepsy nurse in the ID service means patients with epilepsy had reviews of medication and compliance to MHRA guidance in completing the ARF.There is need to increase doctors’ awareness to review ARF status during patients’ appointment. Information Technology design to flag up out of date ARF may be helpful.The review of ARF may also flag up consideration of other alternatives: behavioural, psychological, functional and environmental interventions as well as alternative medications like Risperidone for challenging behaviours and other mood stabilizing options. This will minimize SV prescription, which is the original goal of the MHRA guidance.

COVID-19 Pandemic Response Simulation in a Large City: Impact of Nonpharmaceutical Interventions on Reopening Society

As the novel coronavirus (COVID-19) pandemic continues to expand, policymakers are striving to balance the combinations of nonpharmaceutical interventions (NPIs) to keep people safe and minimize social disruptions. We developed and calibrated an agent-based simulation to model COVID-19 outbreaks in the greater Seattle area. The model simulated NPIs, including social distancing, face mask use, school closure, testing, and contact tracing with variable compliance and effectiveness to identify optimal NPI combinations that can control the spread of the virus in a large urban area. Results highlight the importance of at least 75% face mask use to relax social distancing and school closure measures while keeping infections low. It is important to relax NPIs cautiously during vaccine rollout in 2021.

Variable Compliance Control for Robotic Peg-in-Hole Assembly: A Deep-Reinforcement-Learning Approach

Industrial robot manipulators are playing a significant role in modern manufacturing industries. Though peg-in-hole assembly is a common industrial task that has been extensively researched, safely solving complex, high-precision assembly in an unstructured environment remains an open problem. Reinforcement-learning (RL) methods have proven to be successful in autonomously solving manipulation tasks. However, RL is still not widely adopted in real robotic systems because working with real hardware entails additional challenges, especially when using position-controlled manipulators. The main contribution of this work is a learning-based method to solve peg-in-hole tasks with hole-position uncertainty. We propose the use of an off-policy, model-free reinforcement-learning method, and we bootstraped the training speed by using several transfer-learning techniques (sim2real) and domain randomization. Our proposed learning framework for position-controlled robots was extensively evaluated in contact-rich insertion tasks in a variety of environments.

HUBUNGAN ANTARA PENGETAHUAN MASYARAKAT DENGAN KEPATUHAN PENGGUNAAN MASKER SEBAGAI UPAYA PENCEGAHAN PENYAKIT COVID-19 DI NGRONGGAH

Covid-19 is a disease caused by a corona virus that makes a pandemic in all countries, especially Indonesia. Covid 19 disease can be prevented including knowledge and compliance of the public in the use of masks as an effort to prevent Covid-19 disease. Preliminary preliminary survey revealed that there were 3 respondents with bad knowledge and 6 people in RT03 / RW08 Ngronggah were not compliant to wear masks. The purpose of this study was to determine the relationship between community knowledge and compliance with the use of masks as an effort to prevent Covid-19 in Ngronggah. This research was conducted using a descriptive quantitative survey method with cross sectional study approach. The population and sample were taken in total sampling, that is, all 62 RT RT / RW 08 Ngronggah communities. The research instrument used questionnaires and observation guidelines. Quantitative data analysis uses the chi-square relationship test. The results of this study of 62 respondents based on the results of the Chi-Square test of significance of p between independent variables namely community knowledge with the dependent variable compliance with the use of masks by 0.004 (p <0.05) then Ho was rejected and stated there was a relationship. The conclusion is that there is a relationship between public knowledge and compliance with the use of masks as an effort to prevent Covid-19 disease in Ngronggah. Suggestions should provide education about the importance of using masks to prevent and avoid the risk of Covid-19 disease