Practical Aspects Research Articles

GEC-ESTRO survey of 106Ru eye applicator practice for ocular melanoma – Physicist survey

Aim106Ru eye plaque brachytherapy (BT, interventional radiotherapy) is an eye-preserving treatment for uveal melanoma performed in about 100 clinics worldwide. Despite this relatively low number, there is a considerable variation in clinical practice. In 2022, the BRAPHYQS and Head & Neck and Skin GEC-ESTRO working groups conducted a survey to map the current clinical practice. The survey consisted of a physicist and a physician part. This paper describes the physicist results. However, three physician questions with overlapping interest are included here as well. Materials and MethodsThe survey questions pertained to commissioning and quality control (QC) of the plaques, treatment planning, radiobiological correction, as well as more general questions on practice improvement. The questions overlapping with the physician survey were related to dose prescription and margins. ResultsSixty-five physicist responses were included. A majority of the centres do not perform an independent measurement of the absorbed dose at reference depth, percentage depth dose (PDD) and off-axis data. A lack of calibration services and suitable equipment are the main reasons. About one third of the centres indicated that they do image based treatment planning. The use of margins and dose prescription showed a large variability, despite the availability of guidelines [1]. Many respondents expressed a strong wish for improvement in a wide range of aspects of clinical practice. ConclusionThe physics survey showed a wide variability regarding quality control of the 106Ru sources and treatment planning practice.

Enhancing Arabic Speaking Skills: A Societal Approach at an Indonesian Islamic Boarding School University - Implementation Challenges and Remedies

The research explores the implementation of teaching speaking skills to first-semester Arabic language students at the University of Islamic Boarding School in Indonesia, using a social approach. It aims to comprehensively describe the process, covering objectives, the roles of lecturers and students, discussion themes, teaching methods, media, and evaluation. The study employs a descriptive qualitative method with data collected through observation, interviews, and documentation. Insights from the findings highlight the sociological perspective of learning objectives, emphasizing the lecturer's role in fostering social interactions through discussions. Both the lecturer and students' roles are examined in a societal context, underlining the lecturer's societal responsibilities and students' readiness for societal engagement. Discussion themes include social elements such as good behavior, Islamic education, and youth. The teaching method involves a conversational approach with cooperative learning strategies. Classroom media is limited to books and boards, while dormitories are equipped with LED TVs broadcasting Arabic-language religious speeches. Challenges faced by students are categorized into internal (lack of personal motivation) and external problems (shortage of classrooms and inadequate bathroom facilities). The study provides insights into the practical and sociological aspects of teaching speaking skills in an Islamic educational environment.

The unavailability of the public electricity transmission service due to adverse weather conditions

This research aims to analyze the current understanding of the Brazilian National Electric Energy Agency in cases involving the unavailability of the public electricity transmission service due to adverse weather conditions. The methodology is qualitative and analytical, using bibliographical and documentary research. The normative and practical aspects of the Agency's decisions were explored, making it clear that there is a zone of uncertainty in the framing of certain events. Finally, the possible effects of this understanding were exposed. The article contributes to discussing a relevant and urgent issue to be addressed and explored by researchers and professionals in the sector.

The times of COVID-19 and beyond: how laboratory teaching evolved through the Pandemic

Abstract Pre–during–post lockdown waves, or how COVID-19 catalysed a change in practical chemistry instruction. This time-lined slogan reflects the University of Southampton’s response to recent imperatives in chemistry education. During the pandemic students had limited access to laboratory training. However, laboratory time has always been precious, and educators constantly have to rethink their approach to lab classes; how to best assess practical learning goals and focus students’ attention on the practical aspects during timetabled – and therefore time-limited – lab classes. The pre–during–post pandemic phases also govern the teaching split of our typical laboratory instruction, and the development during the three phases will be discussed. This article describes the evolution of the University of Southampton’s laboratory training, how resources changed, how in-laboratory student participation improved, how the pandemic influenced the scheduling of teaching activities and informed a development of our assessment strategy. It considers where the rethinking process has led to so far while acknowledging that the current laboratory course is not the end of the process but an interim position, subject to future improvements.

Nutrition of Newborns with Hypoxic-Ischaemic Encephalopathy during Therapeutic Hypothermia - A Survey of Practice in Polish Neonatal Care Units.

The nutritional practice for newborns with hypoxic-ischaemic encephalopathy during therapeutic hypothermia differs among Polish neonatal care units, as no guidelines are provided. We assessed the prevailing procedures. Data was collected through an anonymous, web-based questionnaire. We surveyed aspects of the current nutritional practices and the reasoning behind the choice of the feeding strategy. Thirty-one responses were obtained (31/33, 94%). Based on participants' estimations, 342 newborns are diagnosed with hypoxic-ischaemic encephalopathy and qualified for therapeutic hypothermia annually. Among them, almost ⅓ is fed exclusively parenterally, while 71% both ways-parenterally and enterally. In the vast majority of units, the introduction of enteral nutrition takes place during the first 48 hours of therapeutic hypothermia, and breast milk is primarily provided, although with substantial first feeding volume differentiation (an average of 2,9 ml/kg (0,3 - 10ml/kg)). Adverse events, such as necrotising enterocolitis, sepsis, and glycemia level disturbances that derive from the initiation of enteral nutrition, are difficult to estimate as no official statistics are provided. The majority of newborns after hypoxic-ischaemic encephalopathy treated with therapeutic hypothermia are fed both parenterally and enterally during the procedure, predominantly with expressed or donor breast milk. However, due to the lack of nutritional guidelines, significant variability of nutritional strategies concerning initiation time, type and volume of enteral feeds given is noted. Therefore, further studies are required to clarify feeding recommendations.

Bilateral High Division of Brachial Artery: A Case Report and Clinical Significance in Ayurvedic and Modern Medical Practice

The brachial artery is a major artery of arm and continuation of the axillary artery. It begins at the lower border of the teres major muscle and ends at the level of the neck of the radius in deeper part of cubital fossa by dividing into radial and ulnar arteries. The brachial artery variations were observed in its course, branching pattern and division. Higher division of brachial artery is one of the common variations ranging from 15% to 20% of population. The course, termination and precise knowledge of variations of Brachial Artery is an important aspect in the clinical practice of Physician, Vascular surgeons, and Radiologist.

Comparative Evaluation of Quality Management Practices in the Public and Private Hospitals in Visakhapatnam District: An Original Research

ABSTRACT Background: In the Visakhapatnam District, this study compares the quality management procedures used by public and private hospitals. Knowing how these practices are similar and different from one another can help inform policy decisions and improve the quality of health care. Materials and Methods: A cross-sectional study design was used, and 100 hospitals from both public (50 hospitals) and private (50 hospitals) were included in the sample size. A standardized questionnaire that evaluated different aspects of quality management practices was used to gather the data. Descriptive statistics and inferential tests were used in the quantitative analysis. Results: Significant variations in quality management procedures between public and private hospitals were found. In terms of patient happiness, service responsiveness, and technological use, private hospitals scored better. Regarding accessibility, cost, and equity of healthcare services, public hospitals fared better. Conclusion: The report emphasizes the necessity of focused initiatives to improve quality management procedures in both public and commercial institutions. Collaboration between the two sectors can make it easier to deploy evidence-based tactics and share best practices to raise overall healthcare quality in the Visakhapatnam area.

Speech-Language Pathologist's Pattern of Practice in the Rehabilitation of Head and Neck Cancer patients across Hospitals in India.

India has a significant burden of Head and Neck cancer (HNC) patients. Patients afflicted with HNC often encounter difficulties in speech, voice, and swallowing, either due to the disease itself or the treatment they receive. The rehabilitation of HNC patients is crucial, and Speech and Language Pathologists (SLPs) have a significant role in it. The current study aimed to understand the practices followed by SLPs in India while rehabilitating HNC patients. A questionnaire was developed and validated by five Speech-language pathologists, before circulation as an E-survey. The target participants were SLPs working in hospitals across India. The final online version of the questionnaire remained open for eight weeks. A total of 75 Hospital-based SLPs working in India participated in the survey. The responses depict notable trends and differences in the assessment and management approaches. HNC patients who had undergone surgery were more likely to be referred for rehabilitation than those who received non-surgical treatments. Only 36% of the SLPs reported getting pre-operative referrals for HNC patients. The time point for initial assessment and intervention, as well as the protocols used, varied across different hospitals. About 50% of participants had instrumental swallow evaluation facilities in their hospitals, and the majority of hospitals only used instrumental swallow evaluation for 1-3 assessments per week. Variability exists in several aspects of SLP practice for HNC patients offered across Hospitals in India. All HNC patients do not get access to speech-language pathology services. Developing standardized protocols towards early evaluation, intervention and enhancing compliance could improve SLP-led rehabilitation of HNC patients in India.

Classroom practices in primary schools’ mathematics teaching supported by the Interactive Mathematics Software for Rwanda

Over recent decades, the integration of technological resources in education increased growingly. However, studies about the assessment of information and communications technology integration in primary school mathematics activities remained few. This research intended to comparatively examine the aspects of classroom practices observed during the implementation of the Interactive Mathematics (IM) Software in primary schools in Rwanda. Designed as quasi-experimental, it involved the experimental groups from Primary-2, Primary-3, Primary-4, and Primary-5 and analyzed aspects of school statuses, the school years, and the educational cycles. Data collected using Likert-scale measurements from 63 classroom observations were analyzed using Microsoft Excel and a two-sample t-test analysis was conducted to determine if the significance of mean differences. The findings revealed no significant difference between lower and upper primary based on a p-value of 0.829368908 (p-value>.05) and between the 2019 and 2020 teaching periods (considering the same teacher) based on the p-value=0.324542 (p-value>.05). However, the findings revealed that private and public schools’ mean differences were significant based on the calculated p-value<em> </em>equal to 0.007144 (p-value<.01). The study made various recommendations towards using IM software to promote quality mathematics education in primary schools in Rwanda and pre-service teacher training to boost the initiation process of their technology-enhanced pedagogy knowledge to teach mathematics.

Obstacles to the Early Diagnosis and Management of Sarcopenia: Current Perspectives.

Research in sarcopenia has grown exponentially over the last 15 years in geriatrics and gerontology, as well as other specialties, including oncology and hepatology. There is now strong evidence for the role of resistance exercise to prevent declines in muscle strength and function, especially when combined with nutritional optimization with protein supplementation. However, there remains a disparity between research evidence and clinical practice. There are multiple factors for this, which relate to the current diagnostic criteria for sarcopenia, practical and logistical aspects of diagnosis of sarcopenia, clinician knowledge of both diagnosis and management, and the availability of pathways for interventions. Sarcopenia is currently defined based on the identification of muscle strength, in combination with muscle size or quality, below cut-off thresholds at a single timepoint. This defines sarcopenia as a binary process of either present or not present, thus early diagnosis can be challenging. In this article, we summarize current obstacles to early diagnosis and management of sarcopenia in clinical practice, and make recommendations to how these might be overcome. This includes our recommendation of incorporation of handgrip strength measurement into standard care, to enable dynamic assessment and identification of early declines in handgrip strength, so that interventions can be implemented to prevent disability.

Using the Skill of Noticing to Support Empathy for Third-Year Medical Students in Family Medicine.

Previous research has described a waning interest among third-year students to employ empathetic practice along with decreased opportunity to develop empathic communication skills. In this study we sought to address this decline using the skill of noticing (ie, the capacity to attune to specific aspects of practice and interactions) as an intervention for third-year medical students. We designed a qualitative study to address the following research question: How can a focused noticing tool encourage empathetic moments during the patient interview for third-year medical students? Eight third-year medical students used the Social Emotional Noticing Tool (SENT) during their 4-week family medicine rotation, then joined a focus group to share their experiences with SENT and articulate barriers and opportunities toward practicing empathy during clerkship. Student participants (a) described using the tool, including barriers and opportunities; (b) made connections between the practice of noticing using SENT and enacting empathy; and (c) emphasized how enacting empathy in their third year is largely influenced by interactions with clinical faculty. The use of SENT helped students notice empathy or lack thereof. However, making connections between individual capacity for empathic interactions and the impact of positive or negative role models is necessary. Based on our findings, we encourage the need for shared responsibility among students, faculty and preceptors, and organizations.

Incremental dialysis: two complementary views.

Franco Casino and Mariana Murea discuss today's knowledge about the 'incremental dialysis' concept. Franco Casino frames the problem by saying that, in the presence of substantial residual kidney function, kidney replacement therapy can begin with low doses and/or frequencies, to be gradually increased to compensate for any subsequent losses of residual kidney function, keeping the total clearance above the minimum levels of adequacy. He remarks that studies so far have documented that this approach is safe. He recognizes that adequate randomized controlled trials (RCTs) are necessary to confirm the safety and simplify and standardize the practical aspects of this approach. Mariana Murea objects that most of the evidence gathered so far primarily derives from retrospective and observational studies, which can be influenced by socioeconomic constraints. She argues for the need for RCTs to provide compelling empirical evidence on the efficacy of incremental dialysis. Nephrologists are still reluctant to adopt this approach for various reasons, including unfamiliarity with the method, lack of practical guidance and financial disincentives. Several countries have ongoing or planned RCTs comparing incremental dialysis with conventional dialysis. These trials can shift the haemodialysis paradigm if they validate the safety and effectiveness of this approach. The moderators believe that the results of ongoing trials must be carefully interpreted, and further validation may be needed across different patient populations or healthcare settings. The ultimate goal is to gather robust evidence that could lead to widespread adoption of incremental haemodialysis, optimizing treatment, reducing overtreatment, preserving resources and improving patients' quality of life.

Revisiting the wake-triggered secondary vortices over a circular-cylinder/flat-plate configuration

The wake-vortex/boundary-layer interaction is significant for both fundamental and practical aspects of fluid mechanics. The wake vortex triggered the well-known single-secondary vortex over a canonical circular-cylinder/flat-plate configuration. However, recent investigations reported wake-triggered double-secondary vortices over a multi-element airfoil or a simplified circular-cylinder/airfoil configuration. Motivated by this contrast, this paper revisits this topic with a circular-cylinder/flat-plate configuration and finally observes the double-secondary vortices in the boundary layer. The disturbances related to the shedding frequency of the wake vortex and its second harmonic are found to penetrate the boundary layer and be further amplified to form the double-secondary vortices.

Practical Aspects for Analog Compensators Design in Integrated DC–DC Converters

Practical Aspects for Analog Compensators Design in Integrated DC–DC Converters

Human-machine interactions based on hand gesture recognition using deep learning methods

Human interaction with computers and other machines is becoming an increasingly important and relevant topic in the modern world. Hand gesture recognition technology is an innovative approach to managing computers and electronic devices that allows users to interact with technology through gestures and hand movements. This article presents deep learning methods that allow you to efficiently process and classify hand gestures and hand gesture recognition technologies for interacting with computers. This paper discusses modern deep learning methods such as convolutional neural networks (CNN) and recurrent neural networks (RNN), which show excellent results in gesture recognition tasks. Next, the development and implementation of a human-machine interaction system based on hand gesture recognition is discussed. System architectures are described, as well as technical and practical aspects of their application. In conclusion, the article summarizes the research results and outlines the prospects for the development of hand gesture recognition technology to improve human-machine interaction. The advantages and limitations of the technology are analyzed, as well as possible areas of its application in the future.

PREIMPLANTATION GENETIC DIAGNOSIS FOR HUNTINGTON’S DISEASE - CASE REPORT AND LITERATURE REVIEW

Background: Huntington’s disease is a rare, neurodegenerative, autosomal dominant disorder with adult onset caused by an expansion of 36 or more CAG trinucleotide repeats in the HTT gene. In Brazil and in some other countries, carriers of HTT’s expanded allele of submitted to in vitro fertilization procedure can investigate embryos genetically to identify the ones that have inherited the expanded allele and the ones that inherited only the normal size alleles. In some instances, an individual has a positive familial history for the disease and do not want to know his/her personal carrier status but is willing to conceive children without the disease. Objective: to demonstrate the reproductive possibilities available to patients with Huntington disease through a case report and literature review. Methods: Here, we discussed the application and viability of the genetic screening techniques, based on a non-disclosure case of Preimplantation Genetic Testing (PGT). Results: a couple submitted to a non-disclosure test for Huntington disease was submitted to IVF, embryo biopsy and genetic analysis of the samples due to a familial history of the condition. Chromosome and mutation specific tests were applied, and one embryo was selected for uterine transfer. The couple was not informed why the other embryos were discharged. Conclusion: Although many ethical and practical aspects are involved in this decision, a non-disclosure PGT can be offered as an option for these couples, besides sperm, egg or embryo adoption, or child adoption.

SIX SIGMA METRICS: INDICATOR OF QUALITY ASSURANCE FOR CLINICAL BIOCHEMSITRY

Introduction: In present scenario Quality is the important aspect of laboratory practices. Mostly internal and external quality control are utilized to maintain quality in laboratory. Quality assurance of laboratory services is the need of present time in health care which require Quality Planning, Quality Control (QC), Quality Assessment (QA) and Quality Improvement . Aims & Objectives: 1. To quantify the defects and errors in analytical phase of laboratory testing by sigma metrics and to represent the calculated sigma value. 2. Application of six sigma test in laboratory with the IQC and EQAS to maintain quality laboratory services. Methodology: Study was conducted at Clinical Biochemistry Laboratory, GMC Akola. We run IQC samples on daily basis and EQAS samples are running on monthly basis. Retrospectively we utilized data of IQC and EQAS from January to October 2023 for 16 Biochemical Analytes. Sigma metrics for each parameter was calculated. Result: The sigma metrics for IQC indicated that 1 out of 16 analytes qualified six sigma quality performance. Of these 15 analytes performance with sigma metrics was beteween three and six. We found different sigma value like more than6 for only HDL cholesterol and more than 3 for Amylase, Total Bilirunbin, Creatinine, Cholesterol, Glucose, Phosphorus, total Protein , SGPT , TG, UA, Urea, SGOT, which is among the acceptable range of performance. Conclusion: In our study sigma value was highest for HDL cholesterol and other 15 analytes show sigma value between 3 to 6 which is acceptable range. Sigma analysis is a continuous procedure and by taking the help of method decision chart we can improve on decision on making in clinical chemistry laboratory regarding optimising QC procedure.

Managing Data from Maritime Archaeology Investigations: AIR at Gribshunden

Abstract Maritime archaeology excavations, even in a more complex environment, have the same objectives and requirements as terrestrial ones: documenting digging operations to analyze data in the best way, interpreting it, and producing new knowledge for the benefit of multiple communities. 3D documentation and management methodologies have spread widely among practitioners; however, 3D comprehensive tools for scholarly publications still require development. This article contributes to the discussion on archaeological data management and its need to encompass every aspect of the archaeological practice (Kansa & Kansa 2021). It presents the evolution of the documentation and data management strategies employed within the multidisciplinary project at the shipwreck site of Gribshunden (Rönnby 2021), profoundly conditioned by the project’s goals to optimize collection and analysis of its multidisciplinary nature. The use of the Archaeological Interactive Report (AIR) represents the most suitable solution for achieving such goals, as it addresses the issue of scattered data and allows for maintaining the connection between archaeological datasets and their interpretation and publication, which is crucial for performing archaeological Digital Data Curation (Dallas 2015a).

Linguistic Diversity in Education: Strategies for Inclusive Learning Environments

This research explores the intricate dynamics of linguistic diversity in junior high school education with the goal of shedding light on the experiences of students from diverse language origins. The study highlights the significance of acknowledging and valuing the different linguistic environments inside educational settings, as Bahasa Indonesia is predominantly used by 18 out of 30 students, alongside other languages such as Lampungnese and Javanese. The investigation on communication comfort uncovers that most students feel comfortable while using their native language but sometimes experience discomfort during intricate talks, highlighting the need for customised teaching methods. The challenges encountered by students, such as comprehending instructions and experiencing emotions of exclusion, emphasise the practical and emotional aspects of language diversity, hence requiring comprehensive support solutions. The importance of diverse instructional techniques is emphasised by a preference for interactive teaching methods and visual aids. The importance of teacher assistance is highlighted, as students emphasise the need to acknowledge and appreciate linguistic variety while also suggesting the provision of customised materials. The curriculum should accurately reflect the diverse cultural context, requiring a fair and comprehensive approach. Students' proactive use of solutions to overcome linguistic challenges demonstrates their perseverance and ingenuity. Ultimately, this research supports the implementation of inclusive strategies that recognise and address the unique requirements of linguistically varied junior high school children. It aims to create settings that embrace and appreciate linguistic variety

A Review of the International Music Conference Themed “Symbiosis of Arts and Cultures: Nurturing Expression, Connection, and Well-being”

The 5th International Conference of Faculty of Music, University of the Visual & Performing Arts 2023 (ICFM-2023) was held in the Faculty of Music premises in Colombo from 22 to 23 November 2023 with the main theme ‘Symbiosis of Arts and Cultures: Nurturing Expression, Connection, and Well-being’, brought together an assembly of over a hundred scholars and researchers from India and Sri Lanka and some other countries. The conference featured nineteen sessions delving into various dimensions of the musical landscape with the hope of fostering profound discussions across diverse areas such as music education, pedagogy, musicology, ethnomusicology, performing arts, music and technology, well-being and society, interdisciplinary connections in humanities, social and library sciences, exploring performing arts (including dance, theater and beyond), intangible cultural heritage with a focus on preservation and promotion, and visual art with interdisciplinary expression. Additionally, the program explored theoretical and practical aspects of music and dance therapy. Most participants shared their latest research in person, while some presented online. This conference enriched the knowledge of the participants as well as provided a platform for presenting studies on music and allied subject-related topics. Future music symposia can also introduce a wide variety of sessions to promote and inspire future researchers.