Agreement Criteria Research Articles

The validation and assessment of a curriculum based GAIT App used in teaching bachelor of physiotherapy students: a cross sectional study

IntroductionThere has been an advent in the use of Mobile Apps in the academic space. The pandemic hastened their usage, and forced us to rapidly innovate in order to meet the educational needs of our students. Also, Mobile Apps have been known to facilitate self-learning, make it enjoyable, and personalize the pace of learning of the individual. Given the level of skill-learning in Physiotherapy education, the use of Mobile Apps can pose a challenge, as well as offer an opportunity to explore its scope to enhance learning, and create innovative pedagogic strategies. There are a very few learning mobile apps that have been assessed in Physiotherapy education.AimTo develop, establish content validity and internal consistency of a curriculum based App on the kinesiology of normal Gait for bachelor of physiotherapy students, and to evaluate the App with regards to use, quality, engagement, and overall experience.Materials & methodsIn the first phase, a mobile app based on a bachelor of physiotherapy Gait curriculum was developed and validated using Delphi procedure, with 80% agreement criteria, by a group of experts. Subsequently, the App was rated by 200 users on: engagement, aesthetics, information, subjective quality.ResultsThe content validity index following 2 rounds of Delphi was found to be 0.88. Also, therapists found the App easy to use, and 80% gave it a rating of > 3 stars.ConclusionCreating, designing, implementing, and evaluating the efficacy of a Gait App as a means to teaching the GAIT component to physiotherapy students was found to be appealing and beneficial.

Semi-automated vertex placement for lattice radiotherapy and dosimetric verification using 3D polymer gel dosimetry.

To evaluate the feasibility of an open-source, semi-automated, and reproducible vertex placement tool to improve the efficiency of lattice radiotherapy (LRT) planning. We used polymer gel dosimetry with a Cone Beam CT (CBCT) readout to commission this LRT technique. We generated a volumetric modulated arc therapy (VMAT)-based LRT plan on a 2 L NIPAM polymer gel dosimeter using our Eclipse Acuros version 15.6 AcurosXB beam model, and also recalculated the plan with a pre-clinical Acuros v18.0 dose calculation algorithm with the enhanced leaf modelling (ELM). With the assistance of the MAAS-SFRThelper software, a lattice vertex diameter of 1.5cm and center-to-center spacing of 3cm were used to place the spheres in a hexagonal, closed packed structure. The verification plan included four gantry arcs with 15°, 345°, 75°, 105° collimator angles. The spheres were prescribed 20Gy to 50% of their combined volume. The 6 MV Flattening Filter Free beam energy was used to deliver the verification plan. The dosimetric accuracy of the LRT delivery was evaluated with 1D dose profiles, 2D isodose maps, and a 3D global gamma analysis. Qualitative comparisons between the 1D dose profiles of the Eclipse plan and measured gel showed good consistency at the prescription dose mark. The average diameter measured 13.3±0.2mm (gel for v15.6), 12.6mm (v15.6 plan), 13.1±0.2mm (gel for v18.0), and 12.3mm (v18.0 plan). 3D gamma analysis showed that all gamma pass percent were>95% except at 1% and 2% at the 1mm distance to agreement criteria. This study presents a novel application of gel dosimetry in verifying the dosimetric accuracy of LRT, achieving excellent 3D gamma results. The treatment planning was facilitated by publicly available software that automatically placed the vertices for consistency and efficiency.

Analysis of 132 submandibular salivary glands using the Randox Evidence Investigator and Randox DOA ULTRA WB array.

Occasionally, obtaining an adequate or acceptable postmortem blood specimen for drug analysis is not possible due to factors such as decomposition, exsanguination, or embalming. Submandibular salivary gland tissue, one of three major types of salivary gland tissue in the oral cavity of humans, has been reported to be a viable alternative postmortem specimen for toxicological testing. In this study, we evaluated the performance of the Randox Evidence Investigator instrument and Randox DOA (Drugs of Abuse) Ultra Whole Blood Array for the semi-quantitative determination of 21 immunoassays in an alternative matrix, submandibular salivary gland tissue. We analyzed 132 submandibular salivary gland tissue specimens and compared the generated results to concomitantly collected postmortem whole blood specimen results. Oxycodone 2, meprobamate, barbiturate, benzodiazepine assay 1, zolpidem, and buprenorphine all showed perfect agreement (Cohen's kappa score = 1.00) between the submandibular salivary gland tissue results and the postmortem whole blood results; dextromethorphan, fentanyl, benzoylecgonine, methamphetamine, tricyclic antidepressants, oxycodone 1, and opiate showed an almost perfect agreement (Cohen's kappa score = 0.81-0.99); methadone, generic opioids, and amphetamine exhibited substantial agreement (Cohen's kappa score = 0.61-0.80). Tramadol demonstrated fair agreement (Cohen's kappa score = 0.41-0.60). The lowest measure of agreement was observed with cannabinoids, meeting criteria for slight agreement (Cohen's kappa score = 0.01-0.20). An application of the techniques described in this study could be implemented in postmortem toxicology laboratories as well as medical examiners offices to provide preliminary drugs of abuse test results that can be used to direct additional testing. This study highlights the successful integration of a novel specimen matrix and an "off-label" use of an established analytical technique.

BD Vaginal Panel assay results on the high-throughput BD COR system compared to the BD MAX system.

Molecular-based assays demonstrate excellent sensitivity for the detection of vaginitis causes. Here, the high-throughput BD Vaginal Panel for BD COR System (VP-COR) performance was compared to that of the predicate, BD MAX Vaginal Panel for BD MAX System (VP-MAX). Clinical or contrived samples were used to determine the agreement between VP-COR and VP-MAX. Acceptance criteria for VP-COR agreement were as follows: bacterial vaginosis (BV) required a positive percent agreement (PPA) point estimate of ≥95% and a negative percent agreement (NPA) point estimate of ≥98%; Candida group, Candida glabrata, Candida krusei, and Trichomonas vaginalis (TV) required a PPA and NPA point estimate of ≥95% [with lower bound of 95% confidence interval (95% CI) ≥90%]. PPA was 99.5% (95% CI: 97.5-100) and 97.9% (95% CI: 96.5-98.8) for BV contrived (n = 516) and BV clinical (n = 1,050) specimens, respectively. For the Candida group (clinical; n = 724), C. glabrata (contrived; n = 544), C. krusei (contrived; n = 522), and TV (clinical; n = 702), PPA was 99.4% (95% CI: 98.0-99.9), 100% (95% CI: 97.9-100), 100% (95% CI: 97.6-100), and 99.7% (95% CI: 98.3-100), respectively; the lowest lower bound CI value was 97.6%. NPA was >95% for BV contrived and BV clinical specimens. For the Candida group, C. glabrata, C. krusei, and TV, NPA was ≥98.9%; the lowest lower bound CI value was 97.3%. These results demonstrate the equivalent performance of the VP-COR assay when compared to VP-MAX.IMPORTANCEVaginitis is common among women of reproductive age, resulting in around 10 million office visits a year. Diagnosis is often difficult due to its multiple causes-including bacterial vaginosis, vulvovaginal candidiasis, and trichomoniasis-as well as variation in symptom presentation. Typically, cases are identified with a combination of symptomology, medical history, physical examination, and office- or laboratory-based testing. These traditional techniques involve subjective elements and demonstrate varying sensitivity and specificity. Inaccurate or delayed diagnosis leads to continued symptoms, repeat visits, inappropriate treatment, and unnecessary costs. Alternatively, the use of molecular-based assays increases sensitivity for the detection of vaginitis causes. With the validation of the vaginal panel molecular assay on COR (a high-throughput platform), a workflow can be streamlined in high-demand laboratories while providing high sensitivity for vaginitis detection.

A pipeline for processing hyperspectral images, with a case of melanin-containing barley grains as an example.

Analysis of hyperspectral images is of great interest in plant studies. Nowadays, this analysis is used more and more widely, so the development of hyperspectral image processing methods is an urgent task. This paper presents a hyperspectral image processing pipeline that includes: preprocessing, basic statistical analysis, visualization of a multichannel hyperspectral image, and solving classification and clustering problems using machine learning methods. The current version of the package implements the following methods: construction of a confidence interval of an arbitrary level for the difference of sample averages; verification of the similarity of intensity distributions of spectral lines for two sets of hyperspectral images on the basis of the Mann-Whitney U-criterion and Pearson's criterion of agreement; visualization in two-dimensional space using dimensionality reduction methods PCA, ISOMAP and UMAP; classification using linear or ridge regression, random forest and catboost; clustering of samples using the EM-algorithm. The software pipeline is implemented in Python using the Pandas, NumPy, OpenCV, SciPy, Sklearn, Umap, CatBoost and Plotly libraries. The source code is available at: https://github.com/igor2704/Hyperspectral_images. The pipeline was applied to identify melanin pigment in the shell of barley grains based on hyperspectral data. Visualization based on PCA, UMAP and ISOMAP methods, as well as the use of clustering algorithms, showed that a linear separation of grain samples with and without pigmentation could be performed with high accuracy based on hyperspectral data. The analysis revealed statistically significant differences in the distribution of median intensities for samples of images of grains with and without pigmentation. Thus, it was demonstrated that hyperspectral images can be used to determine the presence or absence of melanin in barley grains with great accuracy. The flexible and convenient tool created in this work will significantly increase the efficiency of hyperspectral image analysis.

СТАТИСТИЧЕСКИЙ АНАЛИЗ МНОГОЛЕТНИХ ДАННЫХ О СХОДЕ СНЕЖНЫХ ЛАВИН И СНЕЖНО-МЕТЕОРОЛОГИЧЕСКИХ УСЛОВИЙ В ГОРАХ ИЛЕ АЛАТАУ

Based on long-term observations at snow avalanche stations in the vicinity of Almaty, more than 5 thousand snow avalanches have been recorded since 1966. After statistical analysis of the data, the main characteristics of the avalanches were determined and snow and meteorological conditions were analyzed. The average volume of avalanches is 4 thousand m3, but this value is distorted due to the nonparametric distribution law. The median value of the volume of avalanches is 750-800 m3. 50% of cases within the upper and lower quartiles are 250-2500 m3. Catastrophic avalanches of more than 30 thousand m3 account for 3% of cases, and more than 100 thousand m3 only 0.3% of cases. Typical weather conditions during periods of avalanche danger are: snow height on the slopes 80-90 cm, on the meteorological site 50-60 cm, precipitation 15-19 mm, snow growth 25-30 cm. The dominant factors in avalanche formation were the height of the snow cover on the slopes, the amount of snowfall precipitation, snow cover increase, maximum air temperature. Spearman's correlation coefficients were found to be statistically significant for these parameters at the standard 5% significance level (a-level) with a probability of error (p-level) of less than 0.01. The results of factor analysis showed that avalanches are influenced by three groups of predictors: snow depth, precipitation and snow growth, and temperature conditions. Analysis of catastrophic avalanches in the indicator avalanche collection in the Kotyrbulak gorge showed typical conditions for mass avalanches in Ile Alatau in the spring - snow height at the weather site 50 cm, precipitation amount 53 mm, snow increase 28 cm. The agreement criteria we calculated turned out to be statistically significant by 5% level of significance. The standard errors of some data were within the recommended limits of 10%, which indicates the reliability of the results.

Development of the Clinical Placement Quality Survey – Educator (CPQS-E) Tool to Evaluate the Quality of Physiotherapy Clinical Placements

Background: Increasing demand for entry-level clinical education placements has resulted in changes to traditional models. In this evolving landscape, the ability to effectively assess clinical placement quality is critical. However, existing tools are not specific to physiotherapy and/or have focused on student’s perspectives. Purpose: To design a tool that can be utilised by clinical education providers to measure the quality of physiotherapy clinical placements. Methods: A survey was developed based on published recommendations for quality indicators in clinical education. Content and face validity were established using an expert panel of clinical educators (n=18). Test-retest reliability was tested via physiotherapy clinical educators (n=62) completing the survey twice over a two-week period. Reliability of the survey was assessed using intraclass correlation coefficients (ICC), test-retest percentage agreement, and Cronbach’s alpha. Results: The ICC of 0.87 indicated minimal measurement error. The majority (98%, n=62) of test items met criteria for close agreement. The correlation coefficient of reliability ranged from 0.73 to 0.87 across four defined constructs. Conclusion: Initial assessment of the Clinical Placement Quality Survey - Educator (CPQS-E) tool indicates that its properties provide a valid and reliable measure of entry-level physiotherapy placement quality from the perspective of the clinical educator.

Improving millimetre-wave path loss estimation using automated hyperparameter-tuned stacking ensemble regression machine learning

Path loss prediction is a crucial aspect of designing and operating wireless communication systems, especially in the millimetre-waves (mmWaves) frequency bands. However, these bands are associated with climate-related challenges: rain attenuation, and free space path loss. To address these challenges, an advanced stacking ensemble-regression machine learning (SEML) model with automated hyperparameter tuning (AHT) was proposed. The AHT-SEML model leverages multiple base regressors integrated with a meta-regressor. The model's performance was optimised using the AHT tuning technique. The AHT-SEML model's efficiency was tested using simulated path loss data from a Composite 3D Raytracing-Image-Method propagation model across four sub-Saharan cities, at mmWaves frequencies. The AHT-SEML model's performance was compared to three empirical path loss models, namely Close-In (CI), Floating Intercept (FI), and Alpha-Beta-Gamma (ABG), using evaluation metrics such as Mean Absolute Error (MAE) and Root Mean Squared Error (RMSE). AHT-SEML outperformed other models in the four cities across all frequencies and scenarios with the highest Index of Agreement and lowest Bayesian information criterion. Model confidence set (MCS) analysis with CI benchmark indicates that all the models except AHT-SEML performed below the critical t-value of 2.3530 at 95% confidence level with a degree of freedom of 3, implying no significant differences in their MAEs compared to the CI. However, AHT-SEML's t-statistic values exceed this critical t-value, indicating statistically significant differences and better performance than the CI benchmark models. Similarly, F-statistics of 29.45 and 26.54 correspond to p-values of 1.91×10−14 and 2.50×10−13 for MAE and RMSE, respectively, corroborating significant differences in the AHT-SEML's performance.

Mindfulness-Based Stress Reduction Health Insurance Coverage: If, How, and When? An Integrated Knowledge Translation (iKT) Delphi Key Informant Analysis

ObjectivesHundreds of trials have evaluated Mindfulness-Based Stress Reduction (MBSR), but in the United States, it is generally not covered by health insurance. Consequently, the aims were to identify the following: (1) key questions to make decisions about if, how, and when MBSR should be covered by health insurance; (2a) barriers and (2b) facilitators to understand and resolve for MBSR to be covered by health insurance; and (3) highest priority evidence needed to inform health insurance coverage decisions.MethodsKey informants (n = 26) included health insurers, healthcare administrators, policymakers, clinicians, MBSR instructors, and MBSR students. An initial pool of items related to the study aims was generated through qualitative interviews. Through the Delphi process, participants rated, discussed, and re-rated each item’s relevance. Items were required to reach a consensus of ≥ 80% agreement to be retained for final inclusion.ResultsOf the original 149 items, 42 (28.2%) met the ≥ 80% agreement criterion and were retained for final inclusion. The most highly rated items informing whether MBSR should be covered by health insurance included research demonstrating that MBSR works and that it is not harmful. The most highly rated barriers to coverage were that MBSR is not a medical treatment and patient barriers to attendance. Highly rated facilitators included the potential of MBSR to address common mental health and psychosomatic problems. Finally, understanding what conditions are effectively treated with MBSR and the impact of MBSR on stress were rated as the highest priority evidence needed to inform health insurance coverage decisions.ConclusionsFindings highlight priorities for future research and policy efforts to advance health insurance coverage of MBSR in the United States.

The Legal Certainty Of Waarmerking In Notarized Sale And Purchase Agreements: A Case Analysis Of Civil Proceedings (Case Research: District Court Decision No. 354/PDT.G/2019/PN.SDA)

The purpose of this research is to determine The Legal Certainty of Waarmerking in Notarized Sale and Purchase Agreements: A Case Analysis of Civil Proceedings (Case research: District Court Decision No. 354/Pdt.G/2019/PN.Sda). The research employed in this research is normative research, drawing from literature studies. Data collection techniques involve an extensive literature review. The outcomes indicate that a waarmerking agreement possesses robust legal evidentiary authority in civil cases, contingent upon the parties acknowledging the signatures within the agreement. This is attributed to the fact that the function of waarmerking deeds under the hand primarily ensures the accuracy of the date in the registration of deeds under the hand in a dedicated book within the notary office. In the Sidoarjo court decision, the waarmerking of the binding agreement of sale and purchase, once waarmerked, is deemed valid and binding for both parties by the judge. However, it is noteworthy that the binding agreement of sale and purchase, serving as the foundation for the lawsuit, fails to meet the essential criteria for a valid agreement concerning the specification of "a certain thing." The subject matter pledged in the agreement has undergone a transfer of ownership to a different entity. Consequently, the binding agreement of sale and purchase in the Sidoarjo Court's civil cases lacks legal evidentiary force, as it is deemed to fall short of meeting the essential requisites of the agreement. This situation introduces legal uncertainty for other parties currently exercising control over the land and building.

In vivo EPID-based daily treatment error identification for volumetric-modulated arc therapy in head and neck cancers with a hierarchical convolutional neural network: a feasibility study.

We proposed a deep learning approach to classify various error types in daily VMAT treatment of head and neck cancer patients based on EPID dosimetry, which could provide additional information to support clinical decisions for adaptive planning. 146 arcs from 42 head and neck patients were analyzed. Anatomical changes and setup errors were simulated in 17,820 EPID images of 99 arcs obtained from 30 patients using in-house software for model training, validation, and testing. Subsequently, 141 clinical EPID images from 47 arcs belonging to the remaining 12 patients were utilized for clinical testing. The hierarchical convolutional neural network (HCNN) model was trained to classify error types and magnitudes using EPID dose difference maps. Gamma analysis with 3%/2mm (dose difference/distance to agreement) criteria was also performed. The F1 score, a combination of precision and recall, was utilized to evaluate the performance of the HCNN model and gamma analysis. The adaptive fractioned doses were calculated to verify the HCNN classification results. For error type identification, the overall F1 score of the HCNN model was 0.99 and 0.91 for primary type and subtype identification, respectively. For error magnitude identification, the overall F1 score in the simulation dataset was 0.96 and 0.70 for the HCNN model and gamma analysis, respectively; while the overall F1 score in the clinical dataset was 0.79 and 0.20 for the HCNN model and gamma analysis, respectively. The HCNN model-based EPID dosimetry can identify changes in patient transmission doses and distinguish the treatment error category, which could potentially provide information for head and neck cancer treatment adaption.

Development and characterization of the first proton minibeam system for single-gantry proton facility.

Minibeam represents a preclinical spatially fractionated radiotherapy modality with great translational potential. The advantage lies in its high therapeutic index (compared to GRID and LATTICE) and ability to treat at greater depth (compared to microbeam). Proton minibeam radiotherapy (pMBRT) is a synergy of proton and minibeam. While the single-gantry proton facility has gained popularity due to its affordability and compact design, it often has limited beam time available for research purposes. Conversely, given the current requirement of pMBRT on specific minibeam hardware collimators, necessitates a reproducible and fast setup to minimize pMBRT treatment time and streamline the switching time between pMBRT and conventional treatment for clinically translation. The contribution of this work is the development and characterization of the first pMBRT system tailored for single-gantry proton facility. The system allows for efficient and reproducible plug-and-play setup, achievable within minutes. The single room pMBRT system is constructed based on IBA ProteusONE proton machine. The end of nozzle is attached with beam modifying accessories though an accessory drawer. A small snout is attached to the accessory drawer and used to hold apertures and range shifters. The minibeam aperture consists of two components: a fitting ring and an aperture body. Three minibeam apertures were manufactured. The first-generation apertures underwent qualitatively analysis with film, and the second generation aperture underwent more comprehensive quantitative measurement. The reproducibility of the setup is accessed, and the film measurements are performed to characterize the pMBRT system in cross validation with Monte Carlo (MC) simulations. We presented initial results of large field pMBRT aperture and the film measurements indicates the effect of source-to-isocenter distance=930cm in Y proton scanning direction. Consistent with TOPAS MC simulation, the dose uniformity of pMBRT field<2cm is demonstrated to be better than 2%, rendering its suitability for pre-clinical studies. Subsequently, we developed the second generation of aperture with five slits and characterized the aperture with film dosimetry studies and compared the results to the benchmark MC. Comprehensive film measurements were also performed to evaluate the effect of divergence, air gap and gantry-angle dependency and repeatability and revealing a consistent performance within 5%. Furthermore, the 2D gamma analysis indicated a passing rate exceeding 99% using 3% dose difference and 0.2mm distance agreement criteria. We also establish the peak valley dose ratio and the depth dose profile measurements, and the results are within 10% from MC simulation. We have developed the first pMBRT system tailored for a single-gantry proton facility, which has demonstrated accuracy in benchmark with MC simulations, and allows for efficient plug-and-play setup, emphasizing efficiency.

Statistical evaluation of the frequency of therapeutic and diagnostic devices used by prosthetic dentists for pathology of the temporomandibular joint

BACKGROUND: Occlusal splints are commonly used for treating myofascial and temporomandibular joint (TMJ) disorders. The success of their application depends on the knowledge of prosthetic dentists regarding TMJ disorders, device type used, splint manufacture method, treatment duration, and other factors.&#x0D; AIM: This study aimed to explore various approaches of prosthetic dentists to the diagnosis of myofascial disorders, bruxism, and TMG disorders and evaluate the methods of therapy used in clinical practice.&#x0D; MATERIALS AND METHODS: A survey and questionnaire was conducted among orthopedic dentists in the city of Voronezh working in private or state dental organizations, on the topic “Pathology of the temporomandibular joint and methods of therapy”. The question list consisting of 15 questions was developed for statistical evaluation of therapeutic and diagnostic constructions used by prosthetic dentists in their clinical practice in cases related to the pathology of the TMJ. During this study, specially designed questionnaires were filled out. Furthermore, the conversation with each participant was conducted for a direct analysis of orthopedic measures of TMJ disorders.&#x0D; To analyze the obtained values, the criterion χ2 or Pearson’s criterion of agreement, Fisher’s exact criterion, and Kramer’s V criterion were used. The confidence interval was set to 95%.&#x0D; RESULTS: Among the surveyed doctors, 78 (65.0%) had more than 15 years of experience, 27 (22.5%) had 5–15 years of experience, and 15 (12.5%) had less than 5 years of experience. When using a single-sample binomial criterion, the number of doctors working in different institutions significantly differed (p 0.001). Thus, majority of the surveyed doctors (n=102; 85%) worked in state-funded clinics and the remaining (n=18; 15%) in private clinics (p 0.001). Moreover, 25 respondents (20.8%) claimed that they do not use tires in their practice, whereas the remaining 95 (79.2%) do.&#x0D; CONCLUSIONS: The participation of prosthetic dentists in this study demonstrated their high interest in “Pathology of the temporomandibular joint and methods of therapy”. The results of the survey indicate a change in the level of dentists’ knowledge with increasing professional experience. The methods of therapy used by the study participants considerably differ and often do not comply with the basic recommendations of the Dental Association of Russia.

On the application of numerical differentiation methods to the determination of the fatigue crack growth rate

Using a sample of test results from 68 compact eccentric tensile specimens made of titanium alloys, nickel alloys and steel, the effect of the choice of numerical differentiation method (secant method and the method of differential polynomials on three, five and seven points) used to calculate the fatigue crack growth rate on characteristics of the linear section of the kinetic diagram of the fatigue failure. The purpose of the study is to determine the advantages, disadvantages and consistent patterns of the considered methods. The coefficient of determination R 2, integral criterion χ which characterizes the difference between the predicted and actual number of cycles corresponding to the section of stable crack growth, and correlation between the logarithms of the Paris constants for alloys of the same class were used as criteria for the correct choice of the method of numerical differentiation. The main results and conclusions of the study: the use of the method of differential polynomials over three points compared to the secant method slightly increases the correlation between the logarithms of the fatigue crack growth rate and the range of the stress intensity factor (an increase in R 2) and increases the difference between the calculated and experimental number of cycles corresponding to stable crack growth (an increase in χ). However, when determining the fatigue crack growth rate by the method of differential polynomials for five and seven points, a more significant smoothing of the experimental data is observed, accompanied by a significant increase in R 2 and a decrease in χ; proximity to zero of the integral accuracy parameter χ is a necessary but not sufficient criterion for good agreement between the test result and the mathematical model that describes it, while the combination of parameters χ and R 2 uniquely forms this criterion; the choice of the method of numerical differentiation does not affect the correlation of the logarithms of the constants of the Paris equation.

Statistical analysis of oil and oil product spills at sea

The influence of oil and its derivatives transportation processes, especially against the background of positive dynamics of their production, on the probability of environmental pollution is considered in the paper. It is noted that in such conditions it is very important to ensure timely preparedness for response and the ability to choose the most effective strategies, mainly using preventive measures to ensure emergency preparedness. The basis for the necessary set of measures is a forecast of the potential volume of a spill, allowing only the necessary number of technical or other assets to be planned for each area. It is emphasised that such a forecast is possible if the type of distribution by which it is described is understood. The type of distribution that best describes the behaviour of the oil spill volume as a random variable is defined in the paper. Statistical analysis methods have been used to examine the data presented in various databases. It is found that none of the common distributions that could theoretically describe the spill volume behaviour fulfil the accuracy condition. The observed chi-square (Pearson) criterion of agreement absolutely for all types of distributions exceeds the critical one many times, and it is obvious that the lognormal distribution law describes the behaviour of the considered random variable in the best way, which is visually confirmed by the frequency polygon and the smallest observed Pearson criterion. Using modern methods of hybridisation of distributions, it is proposed to conduct a study aimed at creating a universal distribution, presumably based on the lognormal distribution, which would accurately describe the behaviour of the random variable of oil spill volume. In addition, an approximate step function with a very high confidence coefficient can be used to predict the volume in each specific area.

USE OF ARTIFICAL INTELLIGENCE MODELS IN ACCEPTANCE TESTS

This paper describes the application of fuzzy perсeptron in acceptance testing problems. A study on the use of various fuzzy functions in solving the problem of approximation of probability densities was carried out. Experiments were conducted on time series with preset distribution laws, evaluating approximation quality using standard deviation in the series of 29 tests. As a result of the research, using Gaussian fuzzy function, the mean value of standard deviation equal to 0.00145 determined which confirms good approximative ability of the fuzzy perсeptron. The system was tested on the acceptance test data of the gas compressor engine. In this case, approximation quality was assessed using the Kolmogorov-Smirnov agreement criterion. Analysis results confirm the high approximative ability of the fuzzy perсeptron, emphasizing its applicability in real acceptance tests.

RapidBrachyTG43: A Geant4-based TG-43 parameter and dose calculation module for brachytherapy dosimetry.

The AAPM TG-43U1 formalism remains the clinical standard for dosimetry of low- and high-energy -emitting brachytherapy sources. TG-43U1 and related reports provide consensus datasets of TG-43 parameters derived from various published measured data and Monte Carlo simulations. These data are used to perform standardized and fast dose calculations for brachytherapy treatmentplanning. Monte Carlo TG-43 dosimetry parameters are commonly derived to characterize novel brachytherapy sources. RapidBrachyTG43 is a module of RapidBrachyMCTPS, a Monte Carlo-based treatment planning system, designed to automate this process, requiring minimal user input to prepare Geant4-based Monte Carlo simulations for a source. RapidBrachyTG43 may also perform a TG-43 dose to water-in-water calculation for a plan, substantially accelerating the same calculation performed using RapidBrachyMCTPS's Monte Carlo dose calculationengine. TG-43 parameters , , , and were calculated using three commercial source models, one each of I, Ir, and Co, and were benchmarked to published data. TG-43 dose to water was calculated for a clinical breast brachytherapy plan and was compared to a Monte Carlo dose calculation with all patient tissues, air, and catheters set towater. TG-43 parameters for the three simulated sources agreed with benchmark datasets within tolerances specified by the High Energy Brachytherapy Dosimetry working group. A gamma index comparison between the TG-43 and Monte Carlo dose-to-water calculations with a dose difference and difference to agreement criterion of 1%/1 mm yielded a 98.9% pass rate, with all relevant dose volume histogram metrics for the plan agreeing within 1%. Performing a TG-43-based dose calculation provided an acceleration of dose-to-water calculation by a factor of165. Determination of TG-43 parameter data for novel brachytherapy sources may now be facilitated by RapidBrachyMCTPS. These parameter datasets and existing consensus or published datasets may also be used to determine the TG-43 dose for a plan inRapidBrachyMCTPS.

Designing Entrustable Professional Activities for Treatment Planning of Oral Cancer by Maxillofacial Surgery Residents: A Modified Delphi Study.

The aim of this study was to develop a competency framework based on entrustable professional activities (EPAs) in oral cancer management by postgraduate trainees in oral and maxillofacial surgery through expert consensus. The study design was based on a modified Delphi technique and involved iterative online surveys with two rounds of data collection and analysis. Initial development of the questionnaire identified five EPAs based on 42 competencies along with supervision level and assessment strategies. The first Delphi round involved administration of the survey questionnaire online to maxillofacial surgeons meeting the inclusion criteria for experts. Consensus was achieved on five EPAs and 36 competencies (≥80% response rate). Six competencies were rephrased and sent again in the Round 2 questionnaire to achieve a consensus. A total of 45 experts participated in Round 1 followed by input from 27 experts in Round 2 of the Delphi panel. Following two iterative rounds of online surveys and feedback, expert consensus was achieved to develop an EPA framework in five EPA domains focused on the management of oral cancer by postgraduate trainees in maxillofacial surgery including 38 specific competencies, supervision level, and assessment strategies. High content validity of the study was established through a comprehensive literature search, and expert feedback was evidenced by an excellent response rate (93.34%, and 64.28%) and a stringent criteria of response agreement amongst experts (≥80%). In conclusion, this study employed expert consensus to identify five EPAs with 38 competencies along with the required supervision level of postgraduate maxillofacial trainees for the management of oral cancer. This EPA framework provides a roadmap for training supervisors to map the learning outcomes in oral oncology for postgraduate trainees in oral and maxillofacial surgery.

The Procedure for Selecting a Curve from the Johnson System by Percentile Matching and Maximum Likelihood and Least Squares Approaches in R

It describes the implementation and application of a procedure in the R language designed to select a distribution curve from the Johnson system. In the proposed procedure, unlike the already implemented function from the SuppDists package, the selection of a family of curves and the estimation of parameters is carried out using the percentile method and a combination of maximum likelihood and least squares methods. The ability to set the initial values of the quantile vector of the standard normal distribution allows the user to select the curve more flexibly. In addition, the assessment of the quality of the selection can be performed visually, using graphs of density functions and distribution functions, as well as formalized with the application of Pearson's chi-squared agreement criterion.

Dosimetric impact of CT metal artifact reduction for spinal implants in stereotactic body radiotherapy planning.

Metal artifacts due to spinal implants may affect the accuracy of dose calculation for radiotherapy. However, the dosimetric impact of metal artifact reduction (MAR) for spinal implants in stereotactic body radiotherapy (SBRT) plans has not been well studied. The objective of this study was to evaluate the dosimetric impact of MAR in spinal SBRT planning with three clinically common dose calculation algorithms. Gammex phantom and 10 patients' computed tomography (CT) images were studied to investigate the effects of titanium implants. A commercial orthopedic MAR algorithm was employed to reduce artifacts. Dose calculations for SBRT were conducted on both artifact-corrected and uncorrected images using three commercial algorithms [analytical anisotropic algorithm (AAA), Acuros XB (AXB), and Monte Carlo (MC)]. Dose discrepancies between artifact-corrected and uncorrected cases were appraised using a dose-volume histogram (DVH) and 3-dimensional (3D) gamma analysis with different distance to agreement (DTA) and dose difference criteria. The gamma agreement index (GAI) was denoted as G(∆D, DTA). Statistical analysis of t-test was utilized to evaluate the dose differences of different algorithms. The phantom study demonstrated that titanium metal artifacts can be effectively reduced. The patient cases study showed that dose differences between the artifact-corrected and uncorrected datasets were small evaluated by gamma index and DVH. Gamma analysis found that even the strict criterion local G(1,1) had average values ≥93.9% for the three algorithms. For all DVH metrics, average differences did not exceed 0.7% in planning target volume (PTV) and 2.1% in planning risk volume of spinal cord (PRV-SC). Statistical analysis showed that the observed dose differences of MC method were significantly larger than those of AAA (P<0.01 for D98% of PTV and P<0.001 for D0.1cc of spinal cord) and AXB methods (P<0.001 for D98% and P<0.0001 for D0.1cc). Dosimetric impact of artifacts caused by titanium implants is not significant in spinal SBRT planning, which indicates that dose calculation algorithms might not be very sensitive to CT number variation caused by titanium inserts.