Daily Plan Research Articles

The Influence of Introducing Autonomous Vehicles on Conventional Transport Modes and Travel Time

Introducing autonomous vehicles (AVs) on the market is likely to bring changes in the mobility of travelers. In this work, extensive research is conducted to study the impact of different levels of automation on the mobility of people, and full driving automation needs further study because it is still under development. The impacts of AVs on travel behavior can be studied by integrating AVs into activity-based models. The contribution of this study is the estimation of AVs’ impacts on travelers’ mobility when different travel demands are provided, and also the estimation of AVs’ impact on the modal share considering the different willingness of pay to travel by AVs. This study analyses the potential impacts of AVs on travel behavior by investigating a sample of 8500 travelers who recorded their daily activity plans in Budapest, Hungary. Three scenarios are derived to study travel behavior and to find the impacts of the AVs on the conventional transport modes. The scenarios include (1) a simulation of the existing condition, (2) a simulation of AVs as a full replacement for conventional transport modes, and (3) a simulation of the AVs with conventional transport modes concerning different marginal utilities of travel time in AVs. The simulations are done by using the Multi-Agent Transport Simulation (MATSim) open-source software, which applies a co-evolutionary optimization algorithm. Using the scenarios in the study, we develop a base model, determine the required fleet size of AVs needed to fulfill the demand of the different groups of travelers, and predict the new modal shares of the transport modes when AVs appear on the market. The results demonstrate that the travelers are exposed to a reduction in travel time once conventional transport modes are replaced by AVs. The impact of the value of travel time (VOT) on the usage of AVs and the modal share is demonstrated. The decrease in the VOT of AVs increases the usage of AVs, and it particularly decreases the usage of cars even more than other transport modes. AVs strongly affect the public transport when the VOT of AVs gets close to the VOT of public transport. Finally, the result shows that 1 AV can replace 7.85 conventional vehicles with acceptable waiting time.

Analysis of Weather Forecasting Techniques

Weather forecasting is one of the important science application in our daily planning activities. This application has played a significant role to humans from a long time. Every human relied on their philosophical experience and other weather phenomenon to predict the weather and infer what was coming their way. This was the knowledge gathered over many years observations and has been passed from one generation to another. To predict the future’s weather condition, the variation in the conditions in past year must be utilized. The probability that the weather condition of the day in consideration will match the same day in previous year is very less. But the probability that it will match within the spam of adjacent fortnight of previous year is very high. In this paper, we analyse the use of various data mining techniques in forecasting maximum temperature, rainfall and wind speed.

On-line daily plan optimization combined with a virtual couch shift procedure to address intrafraction motion in prostate magnetic resonance guided radiotherapy.

Background and purposeIn daily adaptive magnetic resonance (MR)-guided radiotherapy, plans are adapted based on the patient's daily anatomy. During this adaptation phase, prostate intrafraction motion (IM) can occur. The aim of this study was to investigate the efficacy of always applying a subsequent virtual couch shift (VCS) to counter IM that occurred during the daily contour and plan adaption (CPa) procedure.Material and MethodsOne hundred fifty patients with low and intermediate risk prostate cancer were treated with 5x7.25 Gy fractions on a 1.5 T MR-Linac. In each fraction, contour adaptation and dose re-optimization was performed using the session’s first MR-scan. IM that occurred here was countered using two methods. One patient group had selective VCS (sVCS) applied if the CTV reached outside the PTV on a second MR acquired during plan optimization. The other group had always VCS (aVCS) applied for any prostate shift greater than 1 mm. Remaining IM during beam delivery was determined using 3D cine-MR.ResultsPercentage of fractions where a VCS was applied was 28% (sVCS) vs 78% (aVCS). Always applying VCS significantly reduced influences of systematic prostate IM. Population random and systematic median values in all translations directions were lower for the aVCS than sVCS group, but not for the population random cranial-caudal direction.ConclusionApplying VCS after daily CPa reduced impact of systematic prostate drift in especially the posterior and caudal translation direction. However, due to the continuous and stochastical nature of prostate IM, margin reduction below 4 mm requires fast intrafraction plan adaption methods.

Feasibility of ablative stereotactic body radiation therapy of pancreas cancer patients on a 1.5 Tesla magnetic resonance-linac system using abdominal compression.

Background and PurposeStereotactic body radiation therapy delivered using MR-guided radiotherapy (MRgRT) and automatic breathold gating has shown to improve overall survival for locally advanced pancreatic cancer (LAPC) patients. The goal of our study was to evaluate feasibility of treating LAPC patients using abdominal compression (AC) and impact of potential intrafraction motion on planned dose on a 1.5T MR-linac.Methods & MaterialsTen LAPC patients were treated with MRgRT to 50 Gy in 5 fractions with daily online plan adaptation and AC. Three orthogonal plane cine MRI were acquired to assess stability of AC pressure in minimizing tumor motion. Three sets of T2w MR scans, pre-treatment (MRIpre), verification (MRIver) and post-treatment (MRIpost) MRI, were acquired for every fraction. A total of 150 MRIs and doses were evaluated. Impact of intrafraction organ motion was evaluated by propagating pre-treatment plan and structures to MRIver and MRIpost, editing contours and recalculating doses. Gross tumor volume (GTV) coverage and organs-at-risk (OARs) doses were evaluated on MRIver and MRIpost.ResultsMedian total treatment time was 75.5 (49–132) minutes. Median tumor motion in AC for all fractions was 1.7 (0.7–7), 2.1 (0.6–6.3) and 4.1 (1.4–10.0) mm in anterior-posterior, left–right and superior-inferior direction. Median GTV V50Gy was 78.7%. Median D5cm3 stomach_duodenum was 24.2 (18.4–29.3) Gy on MRIver and 24.2 (18.3–30.5) Gy on MRIpost. Median D5cm3 small bowel was 24.3 (18.2–32.8) Gy on MRIver and 24.4 (16.0–33.6) Gy on MRIpost.ConclusionDose-volume constraints for OARs were exceeded for some fractions on MRIver and MRIpost. Longer follow up is needed to see the dosimetric impact of intrafraction motion on gastrointestinal toxicity.

PELATIHAN MENYUSUN RENCANA PELAKSANAAN PEMBELAJARAN HARIAN DALAM MENINGKATKAN KINERJA GURU NONFORMAL DI ‎KORWIL BIDANG PENDIDIKAN KECAMATAN KOKOP KABUPATEN BANGKALAN

The Daily Learning Implementation Plan describes the procedures and organization of learning activities that will be carried out to achieve a basic competency that has been defined in the content standards and described in the Daily Activity Plan. This research is a School Action Research which aims to improve teacher performance in preparing the Daily Learning Implementation Plan. The results of this study indicate that in the pre-cycle implementation, the participants were only able to get an average score of 64 to 72 for each individual, this means that in the Kokop sub-district, the participants have not been able to prepare the Daily Learning Implementation Plan properly. While in the first cycle it was found that the teacher's performance began to increase, this can be seen from the results of the implementation of the first cycle, the participants were able to get an average score of 70 to 80 for each individual, meaning that they had not been able to make the Daily Learning Implementation Plan well and did not meet the criteria set out in the first cycle. expected, therefore the training was continued in the next cycle. Based on the results of the implementation of the second cycle, the participants were able to get an average score of 80 to 90 for each individual. From the results of the second cycle, the objectives of the training were achieved, therefore the cycle was stopped.

Communicative Language Teaching (CLT) Strategies in Daily Lesson Plans of Oral Communication Teachers and their Alignment to Standards in Curriculum Guide

Communicative Language Teaching (CLT) is an approach that has been the subject of many practitioners and researchers in the field of language teaching and applied linguistics in many countries like the Philippines because of the recent changes and educational reforms, including lessons and curriculum innovations. Anchored to the CLT theory, this study used quantitative-qualitative content analysis of the daily lesson plans of the 7 purposively sampled Senior High School (SHS) language teachers teaching Oral Communication in Context (OCC). This aimed to identify the activities by cluster, assess which activities are CLT strategies, and determine their alignment to standards in the curriculum guide. Results revealed that the strategies used as classified through content analysis, and according to type and frequency included task-completion activity, opinion-sharing activity, mechanical practice activity, information-transfer activity, reasoning-gap activity, information-gap activity, communicative activity, information-gathering activity, fluency activity, accuracy activity, meaningful practice activity, and others. A number of strategies matched the CLT principles and features but vary on their respective percentages in each of the four phases, i.e., Activity-Analysis-Abstraction-Application (4As) of the lesson. These CLT strategies were found to be aligned to the Department of Education’s curriculum guide in terms of content standards, performance standards and assessment types. Implications of the findings to language teaching in the Philippines were drawn.

Amalan Induksi Set dalam Pengajaran dan Pembelajaran Guru Prasekolah bagi disiplin Ilmu Pendidikan Islam (Teaching and Learning Preparation Practice among Islamic Education Preschool Teachers)

This study was conducted with the aim to explore the teaching and learning practice among preschool Islamic Education teachers. Eight participants from four public and four private preschools participated along the research process including interview, observation and document analysis throughout a number of teaching and learning sessions. This qualitative research had been done in the area of Johor Baharu district. Data were analysed using NVivo software version 12. The validity of the data was obtained through triangulation of different sources of data, long duration of data collection which was six months and validated by the participants of the research. Meanwhile, the reliability of the data was obtained through trail audit and experts validation based on Cohen Kappa correlation validation. From the finding, eight elements of teachers’ preparation before the teaching and learning sessions were found, and they are; preparing the Annual Lesson Plan, timetable, Daily Lesson Plan, referring to module, teacher and students’ classroom preparation, preparing activity, teaching aids and teachers’ personality. It is a hope that this Teaching and Learning Preparation Model will be a guide for teachers and lecturers in Malaysia.

UPAYA GURU DALAM MELATIH KEMANDIRIAN ANAK USIA DINI

The purpose of this research is to reveal about: Teachers' efforts in training early childhood independence, supporting and inhibiting factors in the process of early childhood independence education This research was conducted using a qualitative approach with descriptive research type. The data sources used were teachers, children and school principals. Data collection techniques by interview, observation and documentation. The results showed that the teacher can improve the child's overall independence so that students can become independent children, namely children who can carry out their own activities, are able to socialize, show empathy, and can make decisions with actions, prepare RPPH (Daily Learning Implementation Plan) , integrating independent learning with children's learning activities, creating a conducive and attractive learning atmosphere, and teachers always providing concrete examples in every activity. Supporting and inhibiting factors in the process of early childhood independence education, namely: a. Supporting factors Referring to the 2013 curriculum, PAUD teachers are very enthusiastic about indicators that are in accordance with the needs and development of children, very high enthusiasm and awareness of teachers, adequate facilities and infrastructure and b. The inhibiting factors for parents who are overprotective or spoil their children, and the lack of teachers in the classroom, the existing teachers do not match the ratio of the number of students.

Restrictions’ acceptance and risk perception by young generations in a COVID-19 context

Purpose The purpose of this study is to analyze the impact of the acceptance of national governments’ restrictions imposed due to the COVID-19 pandemic on the citizens’ safety perceptions of daily life and future plans. In particular, the aim is to examine the relationship among the citizens who belong to Generations Y and Z and who represent the future of tourism markets, as tourists and as host communities, in three important receiving countries, namely, Egypt, Portugal and Turkey. Design/methodology/approach This pilot project gathers data from three important receiving countries located on two continents involving 348 residents from Generations Y and Z. To identify the factors underlying the “acceptance of restrictions and measures” and the “Impacts of the COVID-19 threat on safety perceptions” a factor analysis was carried out. Notably, Pearson's correlation coefficient and a multiple linear regression analysis allowed to analyze the relationships between the two factors and a Kruskal–Wallis test was used to assess the influence of individuals’ country of residence. Findings The results reveal that in general, young generations accepted the measures and restrictions imposed by the respective governments. In addition, the present pandemic has a strong impact on their safety perception in daily lives and future plans to travel. Moreover, results prove that between the three countries there are dissimilarities showing that the countries' situation regarding COVID-19 influences those two dimensions. Research limitations/implications This study adds to the development of studies on the impacts of health risks in tourism activity, specifically on the safety measures adopted and their impacts on local receiving communities. It shows that the current pandemic is severely affecting the daily lives and plans for the future of citizens and tourists, which is in accordance with previous studies. Practical implications The outcome of this study paves the way for policy-makers in the tourism industry because it presents experiences from Generations Y and Z members, future customers and tourist products consumers, but also from receiving communities. Social implications The results of this study bring some light on how local communities, specifically, the younger generations, are facing this pandemic period and on the impact it has on the way they face daily life, future plans and on their level of acceptance of a sector as important as tourism. Originality/value To the knowledge, besides the relevant studies already conducted on the impact of the COVID-19 crisis on the tourism field, no study has yet been carried out to analyze how residents have reacted and accepted the restrictions and security measures imposed by their national governments and their impact on residents’ feelings and perceptions, daily lives and travel plans. Furthermore, the specific impacts of this crisis will have on the younger generations are yet to be analyzed.

Tackling constipation in patients on high dose antipsychotics

AimsThe aim of this audit was to look into patients on high dose antipsychotics who had developed complications of constipation in the PICU setting .BackgroundAntipsychotics are usually used in the treatment of Schizophrenia and other psychotic illnesses. Drug such as Clozapine mainly has a higher risk profile due to gastrointestinal hypo motility. It could present as constipation, fecal impaction or a bowel obstruction and could even lead to death.MethodDuring ward rounds enquired on bowel habits and diet.Physical examination of patients complaining of abdominal pain.Screened notes in past to see how many patients complained of constipation and interventions suggested and used.I65.Result3 of the 10 patients on PICU were on high dose antipsychotics and 2 of them had reported constipation. Of which one required daily review and vigorous treatment with laxatives and dietary changes.RecommendationBristol stool chart introduced as part of care plan for all patients.Teaching presentation of constipation and its treatment management was given to the PICU team.Involving medical team early on for assessment and prophylactic laxatives prescription.Liaison with the pantry team to include more options of fruits and vegetables into daily meal plan for patients.Data and material handed over to next trainee to Re-audit and complete audit cycle.ConclusionAppropriate prevention and early management of side effects can enhance the benefits of antipsychotics. Bowel function monitoring and the use of prophylactic laxatives for patient on high dose antipsychotics such as clozapine is advisable to prevent complications related to it.

Missed appointment at specialist outpatient clinics: The Federal Medical Centre Bida, Northern Nigeria experience

Background/Objective: Thousands of patients miss their appointments every year in all kind of practices including specialists’ cares. Timely access at scheduled clinic appointment is important for achieving good medical outcomes to smoothen workflow, reduce crowding and waiting period, and often determines patient’s satisfaction. However, the after effect of missed appointment include; disruption of daily work planning of both physicians and administrative staff, interfered with adequate medical care, time lost and decreased efficiency on the part of physicians and as well as prolonged waiting time at the clinic. This study aims to determine the rate of missed appointments, reasons for missing appointments, the predisposing factors and aftereffect of missed appointments at specialist outpatient clinics of the hospital. Methods/Design: This was a cross-sectional study carried out at the consultative outpatient clinics of FMC Bida. Out of 38,837 patients’ population, a total of 380 patients were systematically co-opted into the study using a stratified sampling technique. A semi structured questionnaire was used to collect data. The questionnaires comprised of questions that assessed the participant’s demographic characteristics, rate, reasons and predisposing factors of missed appointment. Results: out of 380 participants co-opted into the study, 315 responses were obtained. The result showed that the majority of the participants was within the age range of 25-34 (105, 33.3%), mostly female (220, 69.8%) and predominately Nupe dialect. A total of 139(44.1%) participants claimed to have ever missed their appointment. The reasons for the missed are; forgetfulness, lack of money for treatment, lack of money for transport and work commitment respectively. The majority who missed their appointment attend gyne infertility, orthopedic and psychiatric clinics. They are uneducated, artisans and from villages outside Bida town. Conclusion: since the reasons of missed appointment and predisposing factors have been identified, healthcare professionals and hospital management will need to pay serious attention with regards to the following; reduce waiting time at the clinic, restructure appointment scheduling system, educate patients on appointment, subsidize the cost of treatment for

Applicability of the Philosophy and Mission-Vision of The Schools of Select Teachers to their Learning Plans

This study focused on the applicability of the philosophy, mission, and vision statements on their learning plans of the different schools of select MA students enrolled in The National Teachers College’s The study only included the randomly picked 20 teachers as respondents. They were teaching in both public and private schools around Metro Manila. This study aimed to give the schools information as to what extent the teachers apply their respective philosophy, mission, vision and how the teachers integrate them in their daily learning plans. It also gave them insights about the common problems that teachers encountered in the integration of these statements in the learning plans. The study revealed that the teachers almost always applied or integrated their school’s philosophy, mission-vision to their learning objectives, to their lesson proper or activities, and to evaluation part of their learning plans. The study also had shown that the teachers considered the schools’ philosophy, mission-vision as highly influential in their choice of activities as it is reflected in the grand average in terms of the availability of the resources, students’ diversity, time consumption, nature/ content of the activity and difficulty of the subject matter. The teachers regarded the problems such as insufficient instructional time, practicality of the schools’ philosophy, mission-vision, and the irrelevance of the school’s curriculum in the integration of these statements to their learning plans as quite serious.

A personalized activity-based spatiotemporal risk mapping approach to the COVID-19 pandemic

ABSTRACT The outbreak of the unprecedented Coronavirus Disease 2019 (COVID-19) pandemic calls for innovative risk assessment and mapping approaches to prompt public messaging. Most of the existing approaches aim to present population risks associated with geographic areas (e.g., county), thus providing limited values to guide individuals to take proactive measures against COVID-19. To better facilitate the general public to make informed decisions on daily activity plans, we propose an activity-based spatiotemporal risk mapping approach to capture and represent exposure risk at a personal level. This approach leverages the classical space-time representations to capture personal activity space and measures exposure risk in such activity space. This approach further implements geovisualization designs to communicate measured exposure information. To illustrate the usability of the approach, we have conducted a case study in Denver, Colorado with COVID-19 data from October 2020 and four representative travel profiles.

A study protocol of a randomized trial evaluating the effect of using defined menu plans within an intensive personal nutritional counseling program on cardiovascular risk factors: The MoKaRi (modulation of cardiovascular risk factors) trial

ImportanceChanges in dietary habits and lifestyle can reduce the risk of cardiovascular disease which is the leading cause of death worldwide. Objectives of the MoKaRi study The MoKaRi (modulation of cardiovascular risk factors) intervention study is designed to evaluate the effectiveness and potential of the developed MoKaRi concept. The MoKaRi concept comprises three components, each designed to improve dietary behavior. The first component entails using daily menu plans to implement a defined “cardioprotective diet”. This diet consists of seasonal menu plans which are characterized by:(i) a personalized energy supply depending on his or her age, gender, level of physical activity.(ii) an adequate intake of carbohydrates, protein, fat, vitamins, minerals, and trace elements according to the guidelines of the German Society of Nutrition (DGE).(iii) a recommended intake of saturated fatty acids (SFA; < 7% of caloric intake (En%)), monounsaturated fatty acids (MUFA; > 10 En%), polyunsaturated fatty acids.(PUFA; approx. 10 En%), and long-chain n-3 PUFA (≥500 mg per day).(iv) measures to encourage consumption of vegetables and fruits, and.(v) eating more than 40 g dietary fiber every day.Half of the participants will be scheduled to consume an additional 3 g of long-chain n- 3 PUFA every day in the form of fish oil.The second component consists of regular one-on-one nutritional counseling, while a variety of further incentives make up the third component of the MoKaRi concept.The MoKaRi study will provide essential insights into the relationship between defined nutrient intake, markers of food intake and health status. Our specific aim is to investigate the influence of dietary and lifestyle choices have on cardiovascular health.The information and practical tools suitable for daily use, such as the personalized menu plans, could help to transfer knowledge on nutritional facts to the general population. In this way, the validated MoKaRi concept may contribute to the prevention and therapy of cardiovascular diseases. MethodsIn line with our power calculation, we will enroll 60 participants and randomly assign them to one of two parallel arms. Each participant will receive personalized menu plans for each day of the study and will be provided with one-on-one nutritional counseling sessions every two weeks for a study period of 20 weeks (140 days). During this period, blood samples will be taken every 14 days (11 time points) and twice during a 20-weeks follow-up period. Incentives such as a supply of foods approved according t the standards of the study, a sports program, individual feedback on study parameters reflecting health status, and group activities round off the MoKaRi concept.Low-density cholesterol is the primary outcome measure of the MoKaRi study, and the secondary endpoints comprise markers of nutrient status (e.g. fatty acid distribution in plasma and erythrocyte lipids), a metabolomic profiling, diabetes risk markers, clotting markers, and further cardiovascular risk factors, such as blood lipids, homocysteine and high-sensitive c-reactive protein.The MoKaRi study was registered before launch at ClinicalTrials.gov (identifier NCT02637778; https://clinicaltrials.gov/ct2/show/NCT02637778).

Transportation mobility and health among older adults: Examining missed trips and latent demand

ObjectivesTo investigate the frequency of both actual and missed transportation among lower-income older adults within the context of physical health status. MethodsThis study utilizes an ecological momentary assessment (EMA) design. EMA occurs in real world settings, using real-time data collection with repeated assessments. Ten adults (70% female, 50% African American, mean age = 69.56, SD = 3.75) logged trips completed and trips missed, including destinations and impact on perceived well-being in a custom-designed app, MyAmble, for 14 days. Results: Participants logged an average of about 5 trips, the plurality to grocery stores. The ten participants logged a total of 95 daily trip plans throughout the two-week study period. Of those trips, more than half were planned (n = 54, 56.8%%), and most were reported as very important to participants (n = 59, 71.1%). Trip destinations most often included the grocery store (n = 28, 29.5%), medical appointments (n = 11, 11.6%), social visits (n = 10, 10.5%), and the bank (n = 12, 12.6%). Nearly half of grocery store trips were unplanned, and a fourth of planned grocery store trips were missed. The pattern was similar for doctor appointment destinations. DiscussionFindings show that older adults were unable to complete nearly 16% of the trips that they planned during the two-week study period, or nearly one in five trips. This rate of missing desired transportation is troubling given the destinations and the self-reported importance of the planned trips and suggests that individuals may be missing out on opportunities that directly relate to their health. Findings imply that healthy, livable communities must offer access to equitable, quality transportation. Future research ought to also investigate the link between transportation mobility, access to nutritious food, and its impact on health promotion and disease management.

Synthetic CT for single-fraction neoadjuvant partial breast irradiation on an MRI-linac

A synthetic computed tomography (sCT) is required for daily plan optimization on an MRI-linac. Yet, only limited information is available on the accuracy of dose calculations on sCT for breast radiotherapy. This work aimed to (1) evaluate dosimetric accuracy of treatment plans for single-fraction neoadjuvant partial breast irradiation (PBI) on a 1.5 T MRI-linac calculated on a) bulk-density sCT mimicking the current MRI-linac workflow and b) deep learning-generated sCT, and (2) investigate the number of bulk-density levels required. For ten breast cancer patients we created three bulk-density sCTs of increasing complexity from the planning-CT, using bulk-density for: (1) body, lungs, and GTV (sCTBD1); (2) volumes for sCTBD1 plus chest wall and ipsilateral breast (sCTBD2); (3) volumes for sCTBD2 plus ribs (sCTBD3); and a deep learning-generated sCT (sCTDL) from a 1.5 T MRI in supine position. Single-fraction neoadjuvant PBI treatment plans for a 1.5 T MRI-linac were optimized on each sCT and recalculated on the planning-CT. Image evaluation was performed by assessing mean absolute error (MAE) and mean error (ME) in Hounsfield Units (HU) between the sCTs and the planning-CT. Dosimetric evaluation was performed by assessing dose differences, gamma pass rates, and dose-volume histogram (DVH) differences. The following results were obtained (median across patients for sCTBD1/sCTBD2/sCTBD3/sCTDL respectively): MAE inside the body contour was 106/104/104/75 HU and ME was 8/9/6/28 HU, mean dose difference in the PTVGTV was 0.15/0.00/0.00/−0.07 Gy, median gamma pass rate (2%/2 mm, 10% dose threshold) was 98.9/98.9/98.7/99.4%, and differences in DVH parameters were well below 2% for all structures except for the skin in the sCTDL. Accurate dose calculations for single-fraction neoadjuvant PBI on an MRI-linac could be performed on both bulk-density and deep learning sCT, facilitating further implementation of MRI-guided radiotherapy for breast cancer. Balancing simplicity and accuracy, sCTBD2 showed the optimal number of bulk-density levels for a bulk-density approach.

Critical Care Outreach Team During COVID-19: Ventilatory Support in the Ward and Outcomes.

During the coronavirus disease 2019 (COVID-19) outbreak, a critical care outreach team was implemented in our hospital to guarantee multidisciplinary patient assessment at admission and prompt ICU support in medical wards. In this paper, we report the activity plan results and describe the baseline characteristics of the referred subjects. We retrospectively evaluated data from 125 subjects referred to the critical care outreach team from March 22 to April 22, 2020. We considered subjects with a ceiling of care decision, with those deemed eligible assigned to level 3 care (ward subgroup), and those deemed ineligible admitted to the ICU (ICU subgroup). Quality indicators of the outreach team plan delivery included number of cardiac arrest calls, number of intubations in level 2 areas, and ineffective palliative support. We enrolled 125 consecutive adult subjects with a confirmed diagnosis of COVID-19. We did not report any emergency endotracheal intubations in the clinical ward. In the care ceiling subgroup, we had 2 (3.3%) emergency calls for cardiac arrest, whereas signs of ineffective palliative support were reported in 5 subjects (12.5%). Noninvasive forms of respiratory assistance were delivered to 40.0% of subjects in the ward subgroup (median 3 d [interquartile range (IQR) 2-5]), to 45.9% of subjects in the care ceiling subgroup (median 5 d [IQR 3-7]), and to 64.7% of subjects in the ICU subgroup (median 2.5 d [IQR 1-3]). Thirty of the 31 ward subjects (96.7%), 26 of the 34 ICU subjects, (76.4%), and 19 of the 61 ceiling of care subjects (31.1%) were discharged. In the context of a hospital and ICU surge, a multidisciplinary daily plan supported by a dedicated critical care outreach team was associated with a low rate of cardiac arrest calls, no emergency intubations in the ward, and appropriate palliative care support for subjects with a ceiling of care decision.

Cost Optimization of Food Diet for Adult Filipino Patients With Stage 1 or Stage 2 Chronic Kidney Diseases

Chronic kidney disease (CKD) is a very common disease in the Philippines. Some of its main causes are hypertension and diabetes. This study is aimed to develop an optimal food dietary model from ninety (90) combinations of linear programming models for adult Filipino patients with Stage 1 or Stage 2 Chronic Kidney Disease. This process will search for the lowest possible cost of their daily food plan while satisfying their daily nutritional requirements. The diet contains six nutritional requirements which are protein, sodium, potassium, phosphorous, calcium and calories. The thirteen cooked food commodities are the following: pork, milkfish, chicken, tilapia, egg, white rice, roasted green beans with garlic, sautéed cabbage, stir-fry bitter gourd, coconut meat, avocado, mango, and oat bran. Using the selected linear programming model which consist of chicken, tilapia, white rice, roasted green beans with garlic, stir-fry bitter gourd, coconut meat, and oat bran, the minimized daily dietary plan cost for adult male is ₱134.23, and adult female with ₱133.2

Attitudes of preoperative cardiac surgery patients toward COVID-19: A cause for concern

IntroductionDuring the pandemic, many surveys studied people’s attitude to COVID-19. However, less information is available about the peculiarities of such attitude of the most vulnerable groups including chronic somatic patients who are in need of operative treatment.ObjectivesTo identify the specificity of preoperative cardiac surgery patients’ attitudes toward COVID-19 as compared to that of healthy people.MethodsWe used the Attitudes towards COVID-19 questionnaire (Nikolaev E.) to survey 60 preoperative cardiac patients and 327 healthy university students. Difference validity was assessed with significance level of p&lt;0.05.ResultsCardiac patients are more likely to trust the government measures to fight COVID-19 (t=3.131; p=.002), and their COVID-19-related fears for their life are higher (t=2.793; p=.005). As compared to healthy people, patients are less likely to think that pandemic broke their customary way of life (t=-2.793; p=.005) and plans for the future (t=-3.337; p=.000). Credibly more often than healthy people, cardiac surgery patients consider that it is useless to wear a mask and limit contacts, as any person will eventually catch the virus (t=2.401; p=.017). We did not reveal any more evidently expressed COVID-19-related anxiety in preoperative cardiac surgery patients.ConclusionsAttitudes of cardiac surgery patients toward COVID-19 manifest in an adequate assessment of threat to their personal health, trust in the government measures, and readiness to change their daily plans. It is latent fatalistic ideas about ultimate uselessness of restrictive measures that pose threat to people’s own health and the health of the people around them, which health professionals should remember in their preventive actions.DisclosureNo significant relationships.

Machine QA for the Elekta Unity system: A Report from the Elekta MR-linac consortium.

Over the last few years, magnetic resonance image‐guided radiotherapy systems have been introduced into the clinic, allowing for daily online plan adaption. While quality assurance (QA) is similar to conventional radiotherapy systems, there is a need to introduce or modify measurement techniques. As yet, there is no consensus guidance on the QA equipment and test requirements for such systems. Therefore, this report provides an overview of QA equipment and techniques for mechanical, dosimetric, and imaging performance of such systems and recommendation of the QA procedures, particularly for a 1.5T MR‐linac device. An overview of the system design and considerations for QA measurements, particularly the effect of the machine geometry and magnetic field on the radiation beam measurements is given. The effect of the magnetic field on measurement equipment and methods is reviewed to provide a foundation for interpreting measurement results and devising appropriate methods. And lastly, a consensus overview of recommended QA, appropriate methods, and tolerances is provided based on conventional QA protocols. The aim of this consensus work was to provide a foundation for QA protocols, comparative studies of system performance, and for future development of QA protocols and measurement methods.