Accurate Delivery Research Articles

The DERMIS Study: Methodologies, Results, and Implications for the Future.

Ongoing innovation in diabetes technologies has led to the development of advanced tools such as automated insulin delivery (AID) systems that adjust insulin delivery in response to current and predicted glucose levels, residual insulin action, and other inputs (eg, meal and exercise announcements). However, infusion sets continue to be the "Achilles heel" of accurate and precise insulin delivery and continued device use. A recent study by Kalus et al (DERMIS Study) revealed higher vessel density and signals of inflammation by optical coherence tomography (OCT), in addition to increased inflammation, fat necrosis, fibrosis, and eosinophilic infiltration by histopathology. Although the study provided a comprehensive description of what was happening, the results raise important questions that require additional research. On February 29, 2024, the Leona M. and Harry B. Helmsley Charitable Trust sponsored a conference to begin addressing these issues. This article summarizes the DERMIS study findings and testing methodologies discussed at the conference and proposes the next steps for developing insulin infusion sets that reduce the variability in insulin delivery and extend wear.

Unsupervised Modelling of E-Customers’ Profiles: Multiple Correspondence Analysis with Hierarchical Clustering of Principal Components and Machine Learning Classifiers

The rapid growth of e-commerce has transformed customer behaviors, demanding deeper insights into how demographic factors shape online user preferences. This study performed a threefold analysis to understand the impact of these changes. Firstly, this study investigated how demographic factors (e.g., age, gender, education) influence e-customer preferences in Serbia. From a sample of n = 906 respondents, conditional dependencies between demographics and user preferences were tested. From a hypothetical framework of 24 tested hypotheses, this study successfully rejected 8/24 (with p < 0.05), suggesting a high association between demographics with purchase frequency and reasons for quitting the purchase. However, although the reported test statistics suggested an association, understanding how interactions between categories shape e-customer profiles was still required. Therefore, the second part of this study considers an MCA-HCPC (Multiple Correspondence Analysis with Hierarchical Clustering on Principal Components) to identify user profiles. The analysis revealed three main clusters: (1) young, female, unemployed e-customers driven mainly by customer reviews; (2) retirees and older adults with infrequent purchases, hesitant to buy without experiencing the product in person; and (3) employed, highly educated, male, middle-aged adults who prioritize fast and accurate delivery over price. In the third stage, the clusters are used as labels for Machine Learning (ML) classification tasks. Particularly, Gradient Boosting Machine (GBM), Decision Tree (DT), k-Nearest Neighbors (kNN), Gaussian Naïve Bayes (GNB), Random Forest (RF), and Support Vector Machine (SVM) were used. The results suggested that GBM, RF, and SVM had high classification performance in identifying user profiles. Lastly, after performing Permutation Feature Importance (PFI), the findings suggested that age, work status, education, and income are the main determinants of shaping e-customer profiles and developing marketing strategies.

Optical Automatic Contour Tracing (O-ACT) - A novel optical image-guided contour tracing method for electron beam shaping.

Electron therapy, vital for treating skin lesions and superficial tumors, demands precise electron cutouts to ensure accurate dose delivery. Traditional manual tracing methods introduce uncertainties and inefficiencies, necessitating innovative solutions for custom block creation. To introduce and validate the Optical Automatic Contour Tracing (O-ACT) method, enhancing electron cutout generation's accuracy and efficiency through optical imaging and software automation. Utilizing a 3D-printed holder, a centrally-mounted charge-coupled device (CCD) camera on the electron applicator secured two distinct perspective images of the skin's contour at varying heights. Through image binarization and skeletonization, we identified the clinical target contour's region-of-interests (ROIs) in each setup image. Employing distances from each ROI's center, assessed at 5-degree intervals from both images, we reconstructed the target contour on the skin. The magnification factor, set at a 95cm source-to-point distance, determined the final cutout shape. We crafted an in-house software in MATLAB for camera calibration and image processing and juxtaposed our results against the standard clinical cutout from the treatment planning system (TPS) using a correlation coefficient based on masked binary images' mutual information. Additionally, we performed dosimetric evaluations using abstract shapes to compare O-ACT with other methods. Our methodology yielded cutout shapes exhibiting remarkable alignment with the TPS clinical cutout. O-ACT demonstrated superior precision in generating cutout shapes that closely align with the contours in TPS, improving upon other methods in terms of adaptability to patient body shapes and contour accuracy. Dosimetric evaluations showed minimal differences between methods, with O-ACT providing slightly more consistent results. Dose profile analyses in penumbra regions indicated O-ACT's improved accuracy compared to conventional methods. Pushing the boundaries of traditional practices, our O-ACT offers a more accurate, efficient, and reproducible method for custom electron cutout creation from clinical setup images. This innovation promises not only to streamline clinical workflow but also to potentially uplift clinical outcomes in radiation oncology by providing more accurate patient-specific treatment accessary.

Dietary counselling to increase soluble fibre in patients with gynaecological cancers undergoing pelvic radiotherapy: A feasibility study.

This study aimed to determine the feasibility of increasing soluble fibre intake via dietary counselling to improve gastrointestinal toxicity and quality of life in patients with gynaecological cancers undergoing pelvic radiotherapy without adverse consequences on radiation treatment (RT) delivery accuracy. A single-arm, single-centre intervention feasibility trial included patients with gynaecological cancers undergoing pelvic RT ± chemotherapy at a tertiary hospital. Participants were provided weekly dietary counselling over the duration of their RT (5-6 weeks) to increase soluble fibre intake incrementally each week. Stakeholder surveys were also completed. In total, 9 of 14 eligible patients participated (55 years old [SD 13.2], diagnosis: cervical [n = 3], endometrial/uterine [n = 5] and vaginal [n = 1]), with the majority categorised as low fibre consumers at baseline (n = 6). On average, soluble fibre intake increased by 150% throughout treatment. There were no adverse events or major adjustments required for RT delivery. There were improving trends in the functional subset identified. Results may be confounded by the sample size resulting from limited eligibility (n = 14) and a high attrition rate (n = 4). Most participants successfully increased their soluble fibre intake throughout treatment, without significant adverse events noted for RT delivery accuracy. These results provide preliminary data to calculate the sample size required to produce meaningful effect sizes. However, this study highlighted challenges in participant recruitment and retention, with limited organisational support and perceived compatibility.

Endoluminal photodynamic therapy with a photoreactive stent‐based catheter system to treat malignant colorectal obstruction

AbstractPhotodynamic therapy (PDT) using photosensitizer (PS)‐embedded silicone membrane‐covered self‐expandable metallic stents (SEMSs) can function in palliative therapeutic option for malignant gastrointestinal tract obstruction. However, stent‐related complications should be considered, and accurate delivery of light sources is technically difficult. Here, a Chlorin e6 (Ce6)‐an embedded stent‐based catheter is developed to improve its therapeutic efficacy and safety. PDT using Ce6‐embedded stent successfully induced cell death of colorectal cancer cell line. PDT‐treated liver tissues showed an increase in ablation depth in proportion to irradiation energy, and 600 J/cm2 demonstrates an even and sufficient ablation depth. Endoluminal PDT using the Ce6‐embedded stent‐based catheter was technically successful in a rat colon model without procedure‐related complications such as colonic perforation or stricture formation. The results in colonoscopy, colonography, and histological examination, along with statistical analysis, suggest that a novel PDT modality using a Ce6‐embedded stent‐based catheter was safely conducted and demonstrated apoptotic cell death at 12 h after PDT, and it gradually recovered from 2 to 4 weeks. Thus, the PDT using the Ce6‐embedded stent‐based catheter may represent a promising new approach for the treatment of malignant colorectal obstruction.

Development of targeted nanocapsules using pomegranate peel extract with enhanced bioavailability and anti-inflammatory activity for ulcerative colitis: In vitro studies

The study aimed to establish an accurate drug delivery system with a tailored mechanism for the efficient management of Ulcerative Colitis (UC). Using the solvent evaporation technique, nanoencapsulation of pomegranate peel extract (PPE) in biodegradable enteric polymer methacrylic acid-ethyl acrylate copolymer (Eudragit L-100) was prepared. In vitro drug release investigations indicated a greater percentage of drug released at 6.8 pH in contrast to 7.4 pH (96.98 ± 0.80 % vs. 93.97 ± 0.711 %), indicating its applicability in the region of the human intestine. The mechanism of drug release from the nanoformulations (NFR) exhibited a process controlled by Fickian diffusion. The results suggest efficient encapsulation of PPE within Eudragit L100 and may be used for targeted drug release in the intestinal region. Anti-inflammatory studies on the HIEC-6 cell line showed that tumour necrosis factor-α (TNF-α) expression was significantly (p < 0.001) decreased in all NFRs. Additionally, NFRs exhibited antioxidant activity and enhanced in vitro bioavailability (in intestinal pH compared to gastric pH).

A novel injection device to administer repository corticotropin injection for inflammatory disease treatment: findings from a market research study.

Aim: The goal of this market research study was to determine the usability of a single-dose prefilled injector (SelfJect™) for administration of Acthar® Gel (manufactured by Mallinckrodt Pharmaceuticals, UK) in patients with inflammatory diseases by obtaining feedback from patient and practitioner user groups in the US. Materials & methods: Patients and healthcare professionals (HCPs) representing relevant therapeutic areas were enrolled in the study between February and March 2021. SelfJect was mailed to patients and HCPs prior to 90-minvirtual video-recorded focus group sessions and 60-min1:1 virtual interviews, respectively. Patients completed an online assignment prior to the group session, which included instructions on how to use SelfJect and questions about their initial reaction while handling the device. HCPs were instructed to not open the package until the interview. Feedback from patients and HCPs were captured by open-ended questions and ranking scales. Results: Twelve patients and 42 HCPs participated in the study. Most patients (9/12 [75%]) and HCPs (38/42 [90%]) had experience with injectable medications, and 7/12 (58%) and 30/42 [71%] had experience with Acthar injections, respectively. Most patients and HCPs reported that key benefits of SelfJect were accurate dose delivery and ease of use, including the ergonomic handle and elimination of drawing Acthar from a vial into a syringe. Patients expressed some concerns about storage and disposal, but the need to store SelfJect would not deter them from using it. Most patients (9/12 [75%]) felt prepared to inject Acthar after reviewing the instructions. HCPs anticipated that 75% to 100% of patients would benefit switching from the vial to SelfJect. Conclusion: All participants expressed positive perceptions for SelfJect including easy use, few preparation steps and potential reduced anxiety due to needle phobia. These attributes may help treatment adherence for patients and caregivers.

OpenPrep: Sensor Event-driven Open Column Chromatographic Sample Preparation System.

We propose a sensor event-driven, open-column chromatographic sample preparation system─OpenPrep. This system replaces the problematic flow selector valve with a noncontact built-in sensor, eliminating carryover and clogging issues, which are commonly encountered in pump-driven chromatographic systems. The innovative valveless column-flow design, combined with a compact gantry dispenser and motion stage-based fraction collector, reduces the sample flow path to a disposable component with a postcolumn dead volume of only 0.5 mL. This configuration is superior to conventional dynamic flow systems owing to its ability to minimize sample consumption, eluent loss, and cleaning waste generation. Thus, OpenPrep can be ideal for preventing cross-contamination. Owing to the rapid flow-transfer and stop approach, OpenPrep achieves higher reagent delivery accuracy and precision compared to ISO 8655-2 piston-operated pipettes, by minimizing liquid residue on the dispensing tip. Sensor-driven flow control ensures precise eluent collection and automatic regulation of the mobile-phase flow rate through an online calibration algorithm, meeting all the requirements for accurate and reproducible column flow control. OpenPrep features an open architecture for both hardware and software, offering high flexibility for analyzing samples with considerable variations in radioactivity and matrix compositions, such as radioactive waste. The proof-of-concept implementation of a multistage sequential separation strategy, using five resin columns to separate Re, Sr, Fe, and Ni from a single sample, demonstrates that OpenPrep provides enhanced flexibility and reconfigurability, improved operational efficiency, and cost-effective customization. Excellent chemical yields were obtained for Re, Sr, and Ni in the range of 83-97%, with less than 2.6% relative standard deviation at a flow rate three times faster than the gravity method. Additionally, improved recovery performance of Fe was achieved by applying a slower flow rate compared to gravity flow.

Neuroimaging Applications for the Delivery and Monitoring of Gene Therapy for Central Nervous System Diseases.

Neurological disease due to single-gene defects represents a targetable entity for adeno-associated virus (AAV)-mediated gene therapy. The delivery of AAV-mediated gene therapy to the brain is challenging, owing to the presence of the blood-brain barrier. Techniques in gene transfer, such as convection-enhanced intraparenchymal delivery and image-guided delivery to the cerebrospinal fluid spaces of the brain, have led the field into highly accurate delivery techniques, which provide correction of genetic defects in specific brain regions or more broadly. These techniques commonly use magnetic resonance imaging (MRI), computed tomography, and fluoroscopic guidance. Even more, the neuroimaging changes evaluated by MRI, MR spectroscopy, diffusion tensor imaging, and functional MRI can serve as important biomarkers of therapy effect and overall disease progression. Here, we discuss the role of neuroimaging in delivering AAV vectors and monitoring the effect of gene therapy.

Optimizing normal tissue objectives (NTO) in eclipse treatment planning system (TPS) for stereotactic treatment of multiple brain metastases using non-coplanar RapidArc and comparison with HyperArc techniques.

To optimize NTO parameters in non-coplanar RapidArc (RA) stereotactic radiosurgery (SRS) for multiple brain metastases and compare them with HyperArc (HA) plans. Thirty patients with multiple brain metastases, receiving 21Gy prescriptions, were retrospectively enrolled, with lesions ranging from two to eight and volumes between 0.27 and 10.56 cm3. Non-coplanar RapidArc plans utilized manual NTO (RA-mNTO) with varying dose fall-off values (0.1mm-1, 0.5mm-1, 1.0mm-1, 2.0mm-1, 3.0mm-1) and end doses (50%, 25% & 10%). Additionally, two HyperArc plans were generated: HA-ALDO used Automatic Lower Dose Objectives with SRS NTO, while HA-mNTO used the same beam geometry with manual NTO parameters optimized from RA-mNTO plans. TrueBeam with High-Definition Multi-leaf Collimators (HDMLC), 6 MV Flattening Filter Free (FFF) Beam at a maximum dose rate of 1400 MU/min, and Eclipse version 16.1 TPS were used. Plans were assessed for Paddick Conformity Index (CI), Gradient Index (GI), Homogeneity Index (HI), normal brain doses (V18Gy, V15Gy, and V12Gy), Monitor Units (MUs), and delivery accuracy using aS1200 Digital Megavolt Imager (DMI) with 2%/2mm gamma criteria. Statistical analysis utilized integrated scoring and the Wilcoxon signed-rank test. RA-mNTO plans with 0.5mm⁻1 dose fall-off and 10% end-dose showed superior dosimetric outcomes: CI (0.85 ± 0.08), GI (3.63 ± 0.87), and HI (0.36 ± 0.06) compared to HA-ALDO (CI 0.84 ± 0.09, GI: 3.97 ± 0.85, HI: 0.39 ± 0.07) and HA-mNTO (CI 0.83 ± 0.08, GI: 3.60 ± 0.93, HI: 0.40 ± 0.06). MUs were comparable: RA-mNTO (9679 ± 1882), HA-ALDO (9509 ± 1315), and higher for HA-mNTO (10,457 ± 1980). RA-mNTO plans exhibited significantly lower normal brain doses (V18Gy: 1.78 ± 1.23, V15Gy: 3.54 ± 2.37, V12Gy: 6.21 ± 4.09) compared to HA-ALDO (V18Gy: 2.02 ± 1.34, V15Gy: 4.09 ± 2.66, V12Gy: 7.15 ± 4.56) and HA-mNTO (V18Gy: 1.85 ± 1.20, V15Gy: 3.68 ± 2.33, V12Gy: 6.36 ± 3.97). All techniques achieved > 98% gamma pass rate. Non-coplanar RA plans with optimized mNTO settings outperformed HyperArc plans in all studied dosimetric parameters for SRS treatment of multiple brain metastases.

Optimization of emergency material distribution routes in flood disaster with truck‐speedboat‐drone coordination

AbstractTo improve the effectiveness of flood disaster relief operations, by ensuring timely and accurate delivery of urgently needed supplies to affected areas, this study focuses on the problem of emergency material distribution during floods. With the objective of minimizing the overall delivery time of emergency materials, we propose a coordinated optimization model that integrates trucks, speedboats, and drones for effective distribution of emergency supplies in flood‐affected areas. To solve this optimization problem, we introduce an improved adaptive large neighborhood search (IALNS) algorithm, which builds on the traditional ALNS framework through refined tuning of deletion and insertion operators. Comparative analyses are conducted with a genetic algorithm, simulated annealing algorithm, and tabu search algorithm. The results reveal that the average performance gap of IALNS compared to these methods is 91.13%, 152.72%, and 16.92%, respectively. The experimental results demonstrate that the efficiency of the proposed model and algorithm in addressing the emergency supply distribution problem during flood disasters, highlighting the superior performance of IALNS. This research contributes to enhancing disaster response strategies, ultimately leading to improved outcomes for flood‐affected communities.

Chinese Consumers' Satisfaction with Online Shopping Platforms

With the rapid development of Internet technology, China's online shopping industry is also expanding rapidly, becoming an important part of global e-commerce. This article investigates Chinese consumers' satisfaction levels with Taobao, Jingdong (JD.com), and Pinduoduo, three of the country's most popular e-commerce sites. The article reviews the historical development of these platforms, their market positioning, and some of the unique spending habits of Chinese consumers. This paper analyzes several key factors that affect consumer satisfaction, including delivery accuracy, price, information quality, payment convenience, and security. The way that these aspects are handled by each platform greatly affects the buying experience of users. Technological innovations on platforms such as Taobao, such as AI-driven recommendations, have dramatically improved user experience and satisfaction. Jingdong has improved its delivery efficiency and customer satisfaction by building its own logistics system, and Pinduoduo's logistics are both slightly inadequate in comparison. However, Jingdong's logistics during peak hours still needs to be improved. The paper also points out that while price is a very important factor for consumers when choosing a platform, Pinduoduo still needs to find a balance between low price and service quality. Lastly, future studies can explore how cross-border e-commerce and the behavioral inclinations of various user groups could impact the platform's subsequent development stage. These findings suggest that continued attention to these factors can provide online shopping platforms with strategies to increase consumer satisfaction and improve service quality, as well as provide new ideas for academic research.

Advancing Proton Therapy: A Review of Geant4 Simulation for Enhanced Planning and Optimization in Hadron Therapy.

Proton therapy is a cancer treatment method that uses high-energy proton beams to target and destroy cancer cells. In recent years, the use of proton therapy in cancer treatment has increased due to its advantages over traditional radiation methods, such as higher accuracy and reduced damage to healthy tissues. For accurate planning and delivery of proton therapy, advanced software tools are needed to model and simulate the interaction between the proton beam and the patient's body. One of these tools is the Monte Carlo simulation software called Geant4, which provides accurate modeling of physical processes during radiation therapy. The purpose of this study is to investigate the effectiveness of the Geant4 toolbox in proton therapy in the conducted research. This review article searched for published articles between 2002 and 2023 in reputable international databases including Scopus, PubMed, Scholar, Google Web of Science, and ScienceDirect. Geant4 simulations are reliable and accurate and can be used to optimize and evaluate the performance of proton therapy systems. Obtaining some data from experiments carried out in the real world is very effective. This makes it easy to know how close the values obtained from simulations are to the behavior of ions in reality.

Nurse-led framework to improve the safety and quality of residential aged care (HIRAID® Aged Care): protocol for a stepped-wedge cluster randomised controlled trial

BackgroundThe health issues experienced by older people can often be severe and complex, and an increasing number are using residential aged care services to meet their care needs. High-quality nursing care is fundamental to the health and safety of aged care residents and is contingent on nurses’ accurate assessment, informed decision-making, and delivery of timely interventions. However, the role of the aged care nurse is often challenging, impeded by factors such as understaffing, high workloads, and a lack of access to clinical infrastructure and resources. When these challenges mount, residents are put at greater risk of adverse outcomes, such as avoidable clinical deterioration and hospital transfers. This study describes the adaptation and implementation of the emergency nursing framework, HIRAID® (History including Infection risk, Red Flags, Assessment, Interventions, Diagnostics, reassessment, communication and plan)—a tool to assist nurses’ assessment, decision-making and care in residential aged care.MethodsThe HIRAID® framework will be adapted for residential aged care using a real-time Delphi and panel of aged care and nursing experts. The co-designed HIRAID® Aged Care framework will be trialled in 23 residential aged care homes in Sydney, Australia, in a modified stepped-wedge cluster randomised controlled trial design. All homes will be randomised into one of four clusters. Outcomes of interest include the rate of clinical deterioration events resulting from nurses’ actions, the rate of hospital transfers determined to be inappropriate, performance against the national mandatory aged care quality indicators, resident satisfaction with care, nurse and medical staff satisfaction with communication, and the quality of nursing documentation. These outcomes will be evaluated using a combination of qualitative and quantitative analysis of routinely collected resident data, expert assessments of facility documentation events against validated criteria, and pre- and post-intervention surveys of residents, family carers, nurses, and medical staff.DiscussionThis protocol describes a pragmatic trial that aims to translate an evidence-based framework from the emergency care context into residential aged care. The adapted HIRAID® Aged Care framework will be the first of its kind to standardise and guide holistic nursing assessment, decision-making, and documentation in residential aged care in Australia.Ethics and disseminationThis research has been approved by the Western Sydney Local Health District Human Research Ethics Committee: 2023/ETH00523. A waiver of consent has been approved to access resident health data and nursing documentation at each participating site.Trial registrationAustralian and New Zealand Clinical Trial Registry, ACTRN12623000481673. Registered 12 May 2023.Protocol versionVersion 1.0 6 February 2024.

Assessment of pencil beam scanning proton therapy beam delivery accuracy through machine learning and log file analysis

PurposeComprehensive Quality Assurance (QA) protocols are necessary for complex beam delivery systems like Pencil Beam Scanning (PBS) proton therapy. This study focuses on automating the evaluation of beam delivery accuracy using irradiation log files and machine learning (ML) models. MethodsIrradiation log files of 935 clinical treatment fields and routine QA beams were analysed to evaluate spot parameters and Monitor Unit (MU) accuracy. ML models predicted spot size along the X, Y, major, and minor axes. In-house scripts automated log file analysis and spot size predictions. Predicted spot sizes were compared with expected baselines, and the accuracy of spot position, symmetry, and MU for each spot in the beam was evaluated. ResultsMore than 99.5 % of spot positions were accurate within a 1 mm. The mean and Standard Deviation (SD) of X positional error were −0.021 mm (SD: 0.181 mm), and for Y positional error, they were −0.002 mm (SD: 0.132 mm). ML models accurately predicted spot sizes, with over 95 % of spots demonstrating size variations within 10 % of the baseline. The Root Mean Squared Error (RMSE) of X and Y spot size differences were 0.15 mm and 0.16 mm, respectively. Spot symmetry was within 10 %, and MU accuracy showed 95 % of spots with MU per spot variation less than 2 %. ConclusionThis method can validate the vendor’s beam delivery safety interlock system and serve as a quick alternative to patient-specific QA in adaptive treatment, where time is limited, as well as for routine QA spot parameter evaluations.

A multi-institutional trial evaluating the use of an integrated quality assurance phantom for frameless single-isocenter multitarget stereotactic radiosurgery.

Brain radiosurgery treatments require multiple quality-assurance (QA) procedures to ensure accurate and precise treatment delivery of ablative doses. As single-isocenter multitarget radiosurgery treatments become more popular for treating patients with multiple brain metastases, quantifying off-axis accuracy of linear accelerators is crucial. In this study, we developed a novel brain radiosurgery integrated phantom and validated this phantom at multiple institutions to enable radiosurgery QA with a single phantom to facilitate implementation of a frameless single-isocenter, multitarget radiosurgery program. The phantom combines multiple independent verification system tests including the Winston-Lutz test, off-axis accuracy evaluation (i.e., off-axis Winston-Lutz), as well as dosimetric measurements utilizing both point dose and film measurement. A novel 3D-printed phantom, coined OneIso, was designed with a movable insert which can switch between Winston-Lutz test targets and dose measurement without moving the phantom itself. In total, four phantoms were printed, and eight institutions participated in this study, which included both Varian TrueBeam (n=6) and Elekta Versa (n=2) linear accelerators. For off-axis Winston-Lutz measurements, a row of off-axis ball-bearings (BBs) was integrated into the OneIso. To quantify the spatial accuracy versus distance from isocenter, two-dimensional displacements were calculated between the planned and delivered BB locations relative to their respective MLC-defined field borders. For dose verification, brain radiosurgery clinical treatment plans previously treated were delivered at multiple cancer centers (six of eight centers). Radiochromic film and pinpoint ion chamber comparison measurements were obtained with OneIso. Dose verification performed using the OneIso phantom across the different centers were all within on average 3% agreement, for both film and point-dose measurements. OneIso identified a reduction in spatial accuracy further away from isocenter for all eight radiosurgery machines. Differences increased as distance from isocenter increased, exceeding recommended radiosurgery accuracy tolerances (<1mm) at different distances for each machine (2-7cm), indicating that the tolerance is machine-dependent. OneIso provides a streamlined, single-setup workflow for single-isocenter multitarget frameless linac-based radiosurgery QA that can be easily translated to multiple institutions. Additionally, quantifying off-axis spatial discrepancies allows for determination of the maximum distance between targets and iso that meet single-isocenter multitarget radiosurgery program recommendations.

Monitoring and Control of Irradiation with Carbon Ions During Radiobiological Experiments at the RBS Experimental Set-Up

The RBS experimental set-up has been working in every accelerator session of the U-70 accelerator complex since 2015. The main users of the set-up are radiobiologists and physicians. The direction of research is radiobiological experiments with extracted beams of accelerated carbon ions and preclinical studies aimed at the development of domestic methods of ion therapy. The requirements for irradiation of samples with carbon ions are very high: irradiation uniformity is no worse than 95%, positioning accuracy is no worse than 0.1 mm, dose delivery accuracy is no worse than ±2.5%. The article describes the instruments and devices that are used to support radiobiological experiments at the RBS installation: a plane-parallel ionization chamber, a mosaic ionization chamber, a water phantom with a 3D movement system, a 6-axis table, a degrader, a laser positioning system, clinical dosimeters. Programs for working with this equipment and archiving the data obtained are described.

Nanomedicine Innovations for Diabetes Management: Revolutionizing Diagnosis, Treatment, and Monitoring

Diabetes mellitus, a widespread metabolic disease characterized by high blood sugar levels, affects many people globally. The limitations of conventional diagnostic and therapeutic approaches necessitate exploring innovative strategies. Nanotechnology shows remarkable potential for revolutionizing the field of diabetes theranostics (combined diagnosis and treatment) by enabling accurate diagnosis and precise treatment delivery. This article provides a comprehensive review of the latest advancements in nanomaterials for diagnosing and treating diabetes. It explores the applications of various nanomaterials, including inorganic and organic nanoparticles, nanocomposites, and nanostructured biosensors, in biomarker detection, glucose monitoring, insulin delivery, and addressing diabetes-related complications. The study focuses on the synthesis and functionalization of nanomaterials for diabetes, covering both traditional and environmentally friendly synthesis methods. This study looks into how nanomaterials can be used to carry natural antidiabetic extracts, recombinant insulin, and other antidiabetic drugs, to make them more bioavailable, targetable, and effective. However, the review also talks about the problems that come with using nanosensors to diagnose diabetes. It also looks at the newest developments in nanosensors for biomarker detection, implantable devices, and continuous glucose monitoring. Additionally, the review examines the potential of nanomaterials in the management of diabetic sequelae, including diabetic nephropathy, cardiovascular disorders, retinopathy, and wound healing. We underscore the significance of nanomaterials in islet transplantation, as they provide immunological protection and enhance the viability and efficacy of islets. This study provides useful insights into the prospects and challenges connected with the rapidly growing field of nanotechnology in diabetic theranostics through a comprehensive examination of the current landscape. Academics, clinicians, and stakeholders engaged in developing innovative nanomaterial-based approaches to accurately diagnose and effectively manage diabetes will find this resource highly helpful.

Method for Determining the Conditions for Ensuring Stable Rearward Movement of a Semi-trailer Combination with Non-turning Semi-trailer Wheels

The efficiency of organising freight transport and using motor transport in a Smart City depends on a set of its properties, which in the process of operation determine its suitability for use in given operating conditions. Vehicles have different overall dimensions and designs, which determine their maneuverability and directional stability, their ability to make a curve-line movement in the city, as well as to move safely in reverse. Nowadays, tractor-trailer combinations with non-turning semi-trailer wheels are widely used for freight transport. Such a scheme of vehicle construction does not ensure its directional stability when reversing, which can lead to the folding of the tractor and semi-trailer and loss of mobility of the combination. In the absence of additional special systems, the driver controls the rearward movement of the road train using the steering wheel and rear-view mirrors, and the accuracy of delivery to the object depends on the level of the driver's training. The research of driver's reaction time spent on situation assessment, decision making, and realisation has been carried out. It has been revealed that with manual control, there are difficulties connected with training of drivers to estimate the parameters of movement and control of the road train, in particular, with the process of parking and its accurate delivery to the object. With the help of the developed mathematical model of the rearward movement of the road train and the proposed new turn control law, the research of maneuvering of the road train during its delivery to the object has been carried out and the results confirming the possibilities of building an automated system allowing to reduce the influence of the human factor on the parking process, as well as to reduce the time required to perform the maneuver have been obtained. The conducted analysis of system stability with the help of Routh–Hurwitz criterion has determined the conditions of providing stability of the system moving in reverse. The method of controlling the backward movement of the road train and the design of the device realising it has been developed. The results of simulation modeling allowed us to find the necessary values for the control law for the movement of road trains of different lengths, as well as the preferred variants of the initial positions of the road train for the realisation of its precise delivery to the object.

Closed-loop workload input–output control of production systems: A hybrid simulation study

Workload Control (WLC) is a method of adjusting the overall workload in the production system by controlling the input of production orders and the output of produced items. It contributes to the predictability of lead times and more accurate delivery date commitments in make-to-order manufacturing. Input control relates to order release and output control to capacity adjustment. In a recent previous work, a novel approach to integrated input–output control has been proposed: a dynamic closed-loop model where automatic feedback control is added and where order release and capacity decisions are based on the observed shop floor state. In this paper, this approach is further investigated in a more realistic hybrid simulation setting, combining discrete-time controllers and a discrete-event model of a manufacturing shop. The hybrid model was applied to two different systems: an elementary 4-machine shop floor (as a proof of concept) and a more complex real system, a manufacturing cell of cylinder liners. The results show that simultaneous input–output control is effective and enables the systems to maintain WIP balance, absorb demand fluctuations, and effectively reject disturbances. The simulations of the complex system showed that it might be advantageous to provide more local or more global information to the controllers, depending on the variability of the processing times and on the managerial focus. Closed-loop discrete-event models for WLC production control are unprecedented. Also, a simultaneous input and output control setting is much less reported in WLC literature than settings with input control only (i.e., order release only). This paper contributes in both ways.