Action Limit Research Articles

NHS action on social and economic development in England: Vague national policy expectations

Under recent reforms to the National Health Service (NHS) in England, NHS organizations have been given new objectives to contribute to social and economic development. Health systems in other high-income countries are pursuing related approaches. This paper analyses national policy documents to understand the framing of the NHS's new policy priorities on social and economic development. We focus on the role of NHS integrated care systems—area-based planning bodies responsible for managing NHS resources and coordinating local services. National policy is vague about what social and economic development means in practice. There is limited guidance on which approaches local organizations should prioritize, and which organisations are responsible for implementation. Greater clarity from national policymakers and an overarching framework to guide local action is needed to reduce the risk of inaction, poorly targeted interventions, and missed opportunities for learning and evaluation. Policymakers and health system leaders also need to be realistic about the limits of local action given the importance of national public policy choices in shaping the social determinants of health. Coordinated policy action and investment across government is needed to address underlying social and economic conditions.

Zinc nano and zinc ethylenediaminetetraacetic acid (EDTA) mediated water deficit stress alleviation in pearl millet (Pennisetum glaucum (L.) R. Br.): Photosystem II electron transport and pigment dynamics

Water stress adversely affects the photosynthetic apparatus and pigment composition in plants, leading to reduced yields and compromised plant health. Zinc (Zn) foliar spray in nano form presents a potential solution to ameliorate water deficit stress. We attempt here a detailed dissection of electron transport in Photosystem II (PSII) through studies on chlorophyll a fast fluorescence kinetics and non-photochemical quenching (NPQ) and pigment dynamics in response to water stress. We also investigated the possible changes in these processes and the regulation of it by Zn Nano and Zn Ethylenediaminetetraacetic acid (EDTA) foliar sprays that may lead to amelioration of stress. Our results indicated that water stress created a "traffic jam" like situation in the electron transport system of Photosystem II, leading to decreased photosynthetic efficiency. Treatments with water deficit stress + Zn Nano (particle size < 90 nm) spray with Zn concentration at 20 mg L−1 and water deficit stress + Zn EDTA spray (solid material size ∼ 100 µm) with Zn concentration at 240 mg L−1 effectively ameliorated water deficit stress by its action on flux ratio parameters viz., quantum yield for electron transport (φE0), probability of electron transport beyond QA (ψ0) and quantum yield of electron transport from QA⁻ to PS1 end electron acceptors (ϕR0) and also the specific fluxes and phenomenological fluxes. These treatments positively influenced chlorophyll content, and xanthophyll components, including violaxanthin, antheraxanthin, and zeaxanthin, and reduced NPQ and the de expoxidation state. Higher concentrations of Zn Nano foliar spray (water stress + Zn Nano spray Zn @ 30 mg L⁻¹) did not ameliorate water deficit stress as effectively as the lower concentrations, although this higher concentration was not in any way toxic. This lack of stress amelioration at higher concentrations of Zn Nano spray may be due to physiological limitations of elemental zinc action within the plant. Our findings suggest that Zn foliar sprays in Nano and EDTA form at optimum concentrations can significantly improve plant resilience to water stress.

Evaluation of hand-arm vibration (HAV)exposure among groundskeepers in the southeastern United States.

The objectives of this study were to evaluate daily hand-arm vibration (HAV)exposure among groundskeepers, characterize power tools used, and estimate lifetime cumulative HAV exposure dose. Seventeen groundskeepers and ten office workers employed at two US southeasterrn institutions were recruited as a target exposure group and a reference group, respectively. A 6-dexposure assessment of HAV was scheduled, and vibration dosimeters were used to obtain daily vibration exposure value, A(8). Information on power tools used and corresponding operation duration was recorded to assign the real-time vibration data collected from the dosimeters for tool characterization in terms of vibration total value (ahv) and frequency. Lifetime cumulative exposure dose, ahv-lifetime, was determined using ahv for all tools used and lifetime exposure duration obtained through a questionnaire. The individual groundskeepers' average A(8) ranged from0.8 to 2.6 and from1.0 to 2.6 m/s2 for the right hand and left hands, respectively. Among 11 power tools used by the groundskeepers, grass trimmers contributed the most to the vibration exposure. The average ahv of the individual tools ranged from 8.0 (chainsaws) to 1.9 m/s2 (seating mowers and handheld blowers) for the right hand and from 6.4 (push mowers) to 1.4 m/s2 (backpack blowers) for the left hand. The highest acceleration peak of grass trimmers, edgers, backpack blowers, pole saws, riding blowers, and hedgers was observed between 100 and 200 Hz while riding mowers, seating mowers, push mowers, and chainsaws showed the highest acceleration peak at lower frequencies (≤63.5 Hz). The groundskeepers' average ahv-lifetime was 76,520.6 and 61,955.5 h m/s2 for the right and left hands, respectively. The average ahv-lifetime of office workers was 2,306.2 and 2,205.8 h m/s2 for the right and left hands, respectively, which was attributed to personal hobby activities. Three groundskeepers' average A(8) reached 2.5 m/s2, the Action Limit recommended by the American Conference of Governmental Industrial Hygienists (ACGIH). The highest contribution to the vibration exposure was observed during grass trimmer operations with a major acceleration peak at 100 Hz. The groundskeepers' ahv-lifetime was 33 and 28 times higher for the right and left hands, respectively, than the office workers.

Renormalization flow of nonlinear electrodynamics

We study the renormalization flow of generic actions that depend on the invariants of the field strength tensor of an Abelian gauge field. While the Maxwell action defines a Gaussian fixed point, we search for further non-Gaussian fixed points or rather fixed functions, i.e., globally existing Lagrangians of the invariants. Using standard small-field expansion techniques for the resulting functional flow equation, a large number of fixed points is obtained, which—in analogy to recent findings for a shift-symmetric scalar field—we consider as approximation artifacts. For the construction of a globally existing fixed function, we pay attention to the use of proper initial conditions. Parametrizing the latter by the photon anomalous dimension, both the coefficients of the weak-field expansion are fully determined and those of the large-field expansion can be matched such that a global fixed function can be constructed for magnetic fields. The anomalous dimension also governs the strong-field limit. Our results provide evidence for the existence of a continuum of non-Gaussian fixed points parametrized by a small positive anomalous dimension below a critical value. We discuss the implications of this result within various scenarios with and without additional matter. For the strong-field limit of the 1PI QED effective action, where the anomalous dimension is determined by electronic fluctuations, our result suggests the existence of a singularity free strong-field limit, circumventing the standard conclusions connected to the perturbative Landau pole. Published by the American Physical Society 2024

Antineoplastic drugs in healthcare settings: Occupational exposure and risk graduation

Antineoplastic drugs (ADs) are hazardous medicinal products highlighted in the EU strategic framework on health and safety at work 2021–2027. To minimize workers' chronic exposure in oncologic settings, regular monitoring programs for these drugs are crucial and mandatory in the EU (Directive 2004/37/EC). No surveillance exists in Portugal, thus we intended to assess environmental contamination and to perform occupational exposure and risk graduation in a Portuguese tertiary hospital. Wipe sampling and liquid chromatography–tandem mass spectrometry were employed to analyze thirteen drugs of concern (bicalutamide, capecitabine, cyclophosphamide, cyproterone, doxorubicin, etoposide, flutamide, ifosfamide, imatinib, megestrol, mycophenolate mofetil, paclitaxel, prednisone), eight for the first time worldwide, in 152 surface samples over three sampling campaigns. Surface contamination before general cleaning (worst-case scenario) was higher and more widespread in the pharmacy (84%–98 % positive samples) than in the day-care hospital (40%–72 %). No samples were found above the “action limit” (10000 pg/cm2), but concentrations were frequently above the “safe”/alert level (100 pg/cm2), particularly for cyclophosphamide and ifosfamide (largest campaign's 90th percentiles: 2197 pg/cm2 and 1898 pg/cm2). Despite the approach's nuances, the maximum daily dermal intake calculated (1.6 μg/day, considering a single genotoxic drug) was lower than the acceptable daily intake. This study provided knowledge regarding surface contamination in a European hospital, where occupational exposure to some ADs of concern cannot be ruled out and follow-up monitoring is recommended, even if workers seem unlikely to develop cancer from handling them. Furthermore, this work contributes to the implementation of regular environmental monitoring programs for ADs in Portugal, enhancing compliance with EU recommendations.

Diagnosis Based on Population Data versus Personalized Data: The Evolving Paradigm in Laboratory Medicine.

The diagnosis of diseases is a complex process involving the integration of multiple parameters obtained from various sources, including laboratory findings. The interpretation of laboratory data is inherently comparative, necessitating reliable references for accurate assessment. Different types of references, such as reference intervals, decision limits, action limits, and reference change values, are essential tools in the interpretation of laboratory data. Although these references are used to interpret individual laboratory data, they are typically derived from population data, which raises concerns about their reliability and consequently the accuracy of interpretation of individuals' laboratory data. The accuracy of diagnosis is critical to all subsequent steps in medical practice, making the estimate of reliable references a priority. For more precise interpretation, references should ideally be derived from an individual's own data rather than from population averages. This manuscript summarizes the current sources of references used in laboratory data interpretation, examines the references themselves, and discusses the transition from population-based laboratory medicine to personalized laboratory medicine.

Cartan-like formulation of electric Carrollian gravity

We present a Cartan-like first-order action principle for electric Carrollian gravity. The action is invariant under the local homogeneous Carroll group, albeit in a different representation than the one obtained by gauging the Carroll algebra. Additionally, we show that this first-order action can be derived from a smooth Carrollian limit of the Einstein-Cartan action. The connection with the Hamiltonian and metric forms of the action for electric Carrollian gravity, as well as with previous works in the literature, is also discussed.

Isolation, characterization, and potential application of Acinetobacter baumannii phages against extensively drug-resistant strains.

One of the significant issues in treating bacterial infections is the increasing prevalence of extensively drug-resistant (XDR) strains of Acinetobacter baumannii. In the face of limited or no viable treatment options for extensively drug-resistant (XDR) bacteria, there is a renewed interest in utilizing bacteriophages as a treatment option. Three Acinetobacter phages (vB_AbaS_Ftm, vB_AbaS_Eva, and vB_AbaS_Gln) were identified from hospital sewage and analyzed for their morphology, host ranges, and their genome sequences were determined and annotated. These phages and vB_AbaS_SA1 were combined to form a phage cocktail. The antibacterial effects of this cocktail and its combinations with selected antimicrobial agents were evaluated against the XDR A. baumannii strains. The phages exhibited siphovirus morphology. Out of a total of 30 XDR A. baumannii isolates, 33% were sensitive to vB_AbaS_Ftm, 30% to vB_AbaS_Gln, and 16.66% to vB_AbaS_Eva. When these phages were combined with antibiotics, they demonstrated a synergistic effect. The genome sizes of vB_AbaS_Ftm, vB_AbaS_Eva, and vB_AbaS_Gln were 48487, 50174, and 50043 base pairs (bp), respectively, and showed high similarity. Phage cocktail, when combined with antibiotics, showed synergistic effects on extensively drug-resistant (XDR) strains of A. baumannii. However, the need for further study to fully understand the mechanisms of action and potential limitations of using these phages is highlighted.

Possibilities and limitations of anticipatory action in complex crises: acting in advance of flooding in South Sudan.

Little evidence exists on the design and implementation of anticipatory action (AA) in complex crises. This article examines a 2022 United Nations 'early action' pilot in South Sudan in advance of extreme flooding. As a case study of efforts to act in a complex crisis, it contributes to learning on assisting conflict-affected and displaced populations in advance of extreme weather events. The research points towards the possibility and value of implementing forecast-informed early action in complex contexts with limited forecast skills and multiple hazards when trigger-based AA is not possible. It also argues for the need to link AA implemented in complex crises to development and peacebuilding actors and processes. More broadly, examining the perceptions and processes of AA in the form of early action, rather than a formal AA framework, is highly relevant for the AA community as attention is increasingly placed on providing AA in countries affected by fragility and conflict.

English Prepositions Expressing Temporal Limits: Semantic Features and Functioning

This article explores the semantics and usage of prepositions in the English that denote temporal limits of actions. A review of various lexicographical sources, reference literature, and grammars is conducted, highlighting that not all sources provide comprehensive information on the meanings and functioning of prepositions, often offering only general information. Practical material for the study is extracted from the British National Corpus, comprising approximately two thousand contexts. It is established that making a definitive conclusion about including a temporal limit within the timeframe allocated for an action is not always possible. This semantic ambiguity is noted in around 20% of the total number of analyzed contexts. The study demonstrates that to resolve ambiguity and ensure successful communication, addressees often resort to using clarifying elements or complete / partial paraphrasing of the message text. Clarifications are found to be most typical in texts of a scientific research nature, schedules, legal and economic documents. The article concludes on the necessity of further research related to the semantics and usage of prepositions.

Freecycling Markets as Sustainable Materialist Movements?

This paper seeks to redress the over-emphasis on state-driven circular policies in public and academic discourses by attending to two physical community-based freecycling markets at the emerging frontiers of circular waste/resource management in Singapore. Freecycling markets that close short reuse loops are a counterpoint to policies that close long recycling loops. Drawing primarily on empirical data from ethnographic fieldwork, we argue that freecycling markets exemplify a sustainable materialist movement concerned about the sustainability of material resources vis-à-vis the closing/shortening of material circularity loops. This is achieved through the reconfiguration of (a) material flows and (b) material relations. The redirection of unwanted but reusable household objects away from the incinerator and towards potential reusers animates a shift from a linear to circular material flow. We contend that this redirection of material resources for reuse is augmented by rescue and recirculation, which are relatively neglected within the scholarship on circular R-behaviours. Additionally, freecycling markets seek to transform material relations by encouraging care and stewardship, instead of use and disposal. Crucially, we highlight how freecycling markets may be plagued with material constraints that render them not-so-sustainable-and-scalable, thereby shedding light on the practical limits of sustainable materialist action. Taken together, this paper extends the scholarship on circular economies by bringing work on sustainable materialism into a productive dialogue with that on circular activisms and R-behaviours.

Chance, probability, and uncertainty at the edge of human reasoning: What is Knightian uncertainty?

AbstractResearch SummaryFor more than a century, Frank Knight's Risk, Uncertainty, and Profit has significantly influenced entrepreneurship theory development by exploring the nature of uncertainty and the epistemic limits of entrepreneurial action. Knight's work highlights how economic actors cannot fully predict the consequences of their actions. Despite its broad influence, debates persist regarding the nature of Knightian uncertainty. This study addresses these debates through a comprehensive analysis of RUP and Knight's other published and unpublished writings to offer new insights into the nature and meaning of Knightian uncertainty, revealing Knight's holistic theory that integrates “real indeterminism,” “partial knowledge,” and “subjective beliefs.” This analysis provides much needed construct clarity to advance contemporary theories of entrepreneurial action and the role of uncertainty in business venturing processes.Managerial SummaryThis article revisits Frank Knight's foundational work, Risk, Uncertainty, and Profit, a cornerstone in entrepreneurship research for over a century. We highlight Knight's holistic approach to uncertainty, which integrates the concepts of real indeterminism (the inherent unpredictability of future events), partial knowledge (the incomplete understanding of the present and future), and subjective beliefs (individual perceptions and interpretations). The study offers new perspectives on how Knightian uncertainty influences entrepreneurial decision‐making and action, highlighting how this unique type of uncertainty plays a critical role in the business venturing process. These insights provide valuable contributions to contemporary theories of entrepreneurship, emphasizing the complexity and multifaceted nature of navigating uncertainty in business.

Applying the six-sigma methodology to determine the limits of quality control (QC) tests for a specific linear accelerator.

We aimed to show the framework of the six-sigma methodology (SSM) that can be used to determine the limits of QC tests for the linear accelerator (Linac). Limits for QC tests are individually determined using the SSM. The SSM is based on the define-measure-analyze-improve-control (DMAIC) stages to improve the process. In the "define" stage, the limits of QC tests were determined. In the "measure" stage, a retrospective collection of daily QC data using a Machine Performance Check platform was performed from January 2020 to December 2022. In the "analyze" stage, the process of determining the limits was proposed using statistical analyses and process capability indices. In the "improve" stage, the capability index was used to calculate the action limits. The tolerance limit was established using the larger one of the control limits in the individual control chart (I-chart). In the "control" stage, daily QC data were collected prospectively from January 2023 to May 2023 to monitor the effect of action limits and tolerance limits. A total of 798 sets of QC data including beam, isocenter, collimation, couch, and gantry tests were collected and analyzed. The Collimation Rotation offset test had the min-Cp, min-Cpk, min-Pp, and min-Ppk at 2.53, 1.99, 1.59, and 1.25, respectively. The Couch Rtn test had the max-Cp, max-Cpk, max-Pp, and max-Ppk at 31.5, 29.9, 23.4, and 22.2, respectively. There are three QC tests with higher action limits than the original tolerance. Some data on the I-chart of the beam output change, isocenter KV offset, and jaw X1 exceeded the lower tolerance and action limit, which indicated that a system deviation occurred and reminded the physicist to take action to improve the process. The SSM is an excellent framework to use in determining the limits of QC tests. The process capability index is an important parameter that provides quantitative information on determining the limits of QC tests.

P-768 Is it time for a consensus on key performance indicators for cycles involving donation and surrogacy?

Abstract Study question As there are no agreed standards for bench marking in cycles involving donation and surrogacy, how do we measure performance for these treatment types? Summary answer Until an international consensus is undertaken, we must define benchmarks using both in-house and published data from the Human Fertilisation and Embryology Authority (HFEA) register. What is known already Treatment cycles involving donor gametes or surrogacy have increased exponentially in recent years (Horsey, 2023; HFEA, 2020). Key performance indicators (KPIs) are critical for monitoring treatment effectiveness and safety. The Vienna Consensus (2017) is the accepted standard against which clinics should measure performance. However, the publication does not include data on cycles involving donation and surrogacy. In the absence of agreed standards, it is difficult for clinics to measure efficacy for these patient groups. Defining benchmarks for such cohorts is particularly challenging as the gametes used in donation and surrogacy treatment types may come from both fertile and sub-fertile populations. Study design, size, duration Retrospective analysis of anonymised United Kingdom (UK) data, published by the HFEA, from 2014 to 2018, was performed. Outcomes for 26290 donor intrauterine insemination (DIUI), 12262 in vitro fertilisation (IVF), 11341 intracytoplasmic sperm injection (ICSI) and 12453 frozen embryo transfer (FET) cycles, all using donor gametes, were included in this study. In cycles where surrogacy was indicated, gamete origin could not be determined, preventing the data from being included in this study. Participants/materials, setting, methods Using the complete HFEA data set, the average live birth rate, for each treatment type (excluding surrogacy), was calculated. This average was considered the target benchmark when comparing the average live birth rates at the clinic. Each quarter, a rolling 12 months of in-house retrospective data was used to assess clinic performance. Warning and action limits were set using standard deviations calculated using the 5 averages obtained from each year of HFEA data included. Main results and the role of chance The average live birth rates determined using the HFEA data, to be used as benchmarks for performance, were as follows; DIUI (13.7%), IVF (42%), ICSI (37%) and FET (36%). It is noteworthy that live birth rates reported by the HFEA were per embryo transfer (ET), rather than per embryo, meaning more than one live birth could be reported per ET. Discrepancies in outcome reporting meant that the national clinical pregnancy rate could not be determined for all treatment types, nor could fertilisation rate. Therefore, the clinic used in-house data to set benchmarks, action, and warning limits for these donor KPIs. Our findings whilst mining the national published data were that no cycle outcomes had been published beyond 2018, meaning these data may not be reflective of current national rates. Also, the national averages calculated will have been affected by individual clinic success rates. Knowing each clinic’s average would create a larger range, from which real world standard deviations could be determined, resulting in more meaningful warning and action limits. Such data was unavailable. The result being that, whilst UK national data is publicly available, it is flawed and insufficient for creating robust benchmarks that clinics can measure themselves against. Limitations, reasons for caution No national data, beyond 2018, is available for use in bench marking. Waiting for live birth data will delay any actions prompted by under-performance. Individual clinic success rate will have impacted the national average. Both fertile and sub-fertile populations will be included in both data sets. Wider implications of the findings The available UK data cannot be used to set robust benchmarks for donor or surrogacy KPIs. Small and new clinics are therefore unable to adequately measure their performance. With the increasing uptake of treatments involving donation and surrogacy, it is time for an international consensus on expected outcomes. Trial registration number not applicable

Consistency between the ACGIH TLV for hand activity and proposed action levels for wrist velocity and forearm muscular load based on objective measurements: an example from the assembly industry

Objectives. This study aimed to investigate the consistency between results of the American Conference for Governmental Occupational Hygienists (ACGIH) threshold limit value (TLV) for hand activity and proposed action levels of objective measurements in risk assessments of work-related musculoskeletal disorders. Methods. Wrist velocities and forearm muscular load were measured for 11 assemblers during one working day. Simultaneously, each assembler’s hand activity level (HAL) during three sub-cycles was rated twice on two separate occasions by two experts, using a HAL scale. Arm/hand exertion was also rated by the assemblers themselves using a Borg scale. In total, 66 sub-cycles were assessed and assigned to three exposure categories: A) below ACGIH action limit (AL) (green); B) between AL and TLV (yellow); and C) above TLV (red). The median wrist velocity and the 90th percentile of forearm muscular load obtained from the objective measurements corresponding to the sub-cycles were calculated and assigned to two exposure categories: A) below or C) above the proposed action level. Results. The agreement between ACGIH TLV for hand activity and the proposed action level for wrist velocity was 87%. Conclusions. The proposed action level for wrist velocity is highly consistent with the TLV. Additional studies are needed to confirm the results.

A non-perturbative and background-independent formulation of quadratic gravity

A non-perturbative and background-independent quantum formulation of quadratic gravity is provided. A canonical quantization procedure introduced in previous works, named after Dirac and Pauli, is here applied to quadratic gravity to obtain, as required by consistency, a well-defined Euclidean path integral. The theory is unitary: all probabilities are non negative and they sum up to one. We obtain path-integral expressions for the transition amplitudes, Green's functions and generic matrix elements of time-ordered products of the metric. As a byproduct, similar results are also obtained for a scalar-field four-derivative interacting model. In this way, among other things, previous perturbative and background-dependent calculations are justified. The (quantum) quadratic gravity effective action, whose field equations determine the vacuum expectation value of the metric in the presence of a generic energy-momentum tensor, is constructed. The classical limit of the effective action turns out to be equivalent to the starting classical action of quadratic gravity, whose runaway rates were previously shown to be slow enough to be compatible with observations. Finally, the constructed non-perturbative and background-independent quantum quadratic gravity is applied to quantum cosmology to obtain a path-integral expression for the wave function of the universe, which satisfies a sort of Wheeler-DeWitt equation. This application allows us to understand at the quantum level why our universe is nearly homogeneous and isotropic.

Lower Back &amp; Comfortability Analysis of Driving Posture to Mitigate Musculoskeletal Disorders: An Ergonomics Study using Digital Human Modelling in JACK Software

In this paper, the crucial aspect of driver comfort was explored by investigating the prevailing driving postures among individuals, aiming to discern their ergonomic implications and ascertain whether the commonly adopted postures are conducive to musculoskeletal health or pose potential risks. From the last decade vehicle like cars have become one of the common modes of personal transport. Car has high relevance in day-to-day activities like commuting, economic activities and sports etc. The continuous driving of vehicle can lead the driver prone to musculoskeletal disorders such as back pain, spine injury and posture issues. This study is conducted to address the ergonomic aspects of posture of the driver to highlight the risk of Musculoskeletal disorders (MSDs) and to optimize the driving posture. Lower Back Analysis (LBA) and Comfortability Analysis is performed in JACK Software to analyze the driving posture. A DHM (Digital Human Model) is created in JACK Simulation Software according to the collected anthropometric data of an average Pakistani man. A virtual Environment is created in JACK Simulation Software. The posture of the subject is analyzed by taking measurements of the subject’s angle of joints when they are sitting in a driving posture. For Ergonomic Analysis the Driving Posture is evaluated on JACK software to Mitigate Musculoskeletal Disorders. Results show that the subject is having low back compression force of 672 which is below the NIOSH Back Compression Action Limit of 3400N representing a nominal risk of low back injury.

Time-resolved clinical dose volume metrics, calculations and predictions based on source tracking measurements and uncertainties to aid treatment verification and error detection for HDR brachytherapy—a proof-of-principle study

Objective. High-dose-rate (HDR) brachytherapy lacks routinely available treatment verification methods. Real-time tracking of the radiation source during HDR brachytherapy can enhance treatment verification capabilities. Recent developments in source tracking allow for measurement of dwell times and source positions with high accuracy. However, more clinically relevant information, such as dose discrepancies, is still needed. To address this, a real-time dose calculation implementation was developed to provide more relevant information from source tracking data. A proof-of-principle of the developed tool was shown using source tracking data obtained from a 3D-printed anthropomorphic phantom. Approach. Software was developed to calculate dose-volume-histograms (DVH) and clinical dose metrics from experimental HDR prostate treatment source tracking data, measured in a realistic pelvic phantom. Uncertainty estimation was performed using repeat measurements to assess the inherent dose measuring uncertainty of the in vivo dosimetry (IVD) system. Using a novel approach, the measurement uncertainty can be incorporated in the dose calculation, and used for evaluation of cumulative dose and clinical dose-volume metrics after every dwell position, enabling real-time treatment verification. Main results. The dose calculated from source tracking measurements aligned with the generated uncertainty bands, validating the approach. Simulated shifts of 3 mm in 5/17 needles in a single plan caused DVH deviations beyond the uncertainty bands, indicating errors occurred during treatment. Clinical dose-volume metrics could be monitored in a time-resolved approach, enabling early detection of treatment plan deviations and prediction of their impact on the final dose that will be delivered in real-time. Significance. Integrating dose calculation with source tracking enhances the clinical relevance of IVD methods. Phantom measurements show that the developed tool aids in tracking treatment progress, detecting errors in real-time and post-treatment evaluation. In addition, it could be used to define patient-specific action limits and error thresholds, while taking the uncertainty of the measurement system into consideration.

Sengupta transformations and Carrollian relativistic theory

A detailed and systematic formulation of Carrollian relativity is provided. Based on the transformations, first provided by Sengupta (Nuovo Cim, 54:512, 1966), we construct a mapping between Lorentz relativistic and Carrollian relativistic vectors. Using this map the Carroll theory is built from the standard Maxwell action. We show that we get self-consistent equations of motion from the action, both in electric and magnetic limits. We introduce Carroll electric and magnetic fields. A new set of maps is derived that connects Carroll electric and magnetic fields with the usual Maxwell ones and yields Carroll equations in terms of fields. Consistency of results with the potential formulation is shown. Carroll version of symmetries like duality, gauge, shift, Noether and boost are treated in details and their implications elaborated. Especially, boost symmetry provides a link to the various maps used in this paper.

Accuracy, potential, and limitations of probabilistic record linkage in identifying deaths by gender identity and sexual orientation in the state of Rio De Janeiro, Brazil

BackgroundGlobally, the counting of deaths based on gender identity and sexual orientation has been a challenge for health systems. In most cases, non-governmental organizations have dedicated themselves to this work. Despite these efforts in generating information, the scarcity of official data presents significant limitations in policy formulation and actions guided by population needs. Therefore, this manuscript aims to evaluate the accuracy, potential, and limits of probabilistic data relationships to yield information on deaths according to gender identity and sexual orientation in the State of Rio de Janeiro.MethodsThis study evaluated the accuracy of the probabilistic record linkage to obtain information on deaths according to gender and sexual orientation. Data from two information systems were used from June 15, 2015 to December 31, 2020. We constructed nine probabilistic data relationship strategies and identified the performance and cutoff points of the best strategy.ResultsThe best data blocking strategy was established through logical blocks with the first and last names, birthdate, and mother’s name in the pairing strategy. With a population base of 80,178 records, 1556 deaths were retrieved. With an area under the curve of 0.979, this strategy presented 93.26% accuracy, 98.46% sensitivity, and 90.04% specificity for the cutoff point ≥ 17.9 of the data relationship score. The adoption of the cutoff point optimized the manual review phase, identifying 2259 (90.04%) of the 2509 false pairs and identifying 1532 (98.46%) of the 1556 true pairs.ConclusionWith the identification of possible strategies for determining probabilistic data relationships, the retrieval of information on mortality according to sexual and gender markers has become feasible. Based on information from the daily routine of health services, the formulation of public policies that consider the LGBTQ + population more closely reflects the reality experienced by these population groups.