Scaling Options Research Articles

Superconducting Qubits above 20 GHz Operating over 200 mK

Current state-of-the-art superconducting microwave qubits are cooled to extremely low temperatures to avoid sources of decoherence. Higher qubit operating temperatures would significantly increase the cooling power available, which is desirable for scaling up the number of qubits in quantum computing architectures and integrating qubits in experiments requiring increased heat dissipation. To operate superconducting qubits at higher temperatures, it is necessary to address both quasiparticle decoherence (which becomes significant for aluminum junctions above 160 mK) and dephasing from thermal microwave photons (which are problematic above 50 mK). Using low-loss niobium-trilayer junctions, which have reduced sensitivity to quasiparticles due to the higher superconducting transition temperature of niobium, we fabricate transmons with higher frequencies than previously studied, up to 24 GHz. We measure decoherence and dephasing times of about 1μs, corresponding to average qubit quality factors of approximately 105, and find that decoherence is unaffected by quasiparticles up to 1K. Without relaxation from quasiparticles, we are able to explore dephasing from purely thermal sources, finding that our qubits can operate up to approximately 250mK while maintaining similar performance. The thermal resilience of these qubits creates new options for scaling up quantum processors, enables hybrid quantum experiments with high heat-dissipation budgets, and introduces a material platform for even-higher-frequency qubits. Published by the American Physical Society 2024

(Invited) Advanced Compute Scaling: A New Era of Exciting, Sustainability-Aware Innovations with Nanosheet-Based Devices, Increased Interdisciplinary Synergies, and (R)Evolution Towards Higher Versatility

The need for increased computing keeps growing at an ultra-fast speed, required to support an ever larger and wider range of applications [1]. Meanwhile, recent advances in 3D and photonic technologies are allowing new connectivity possibilities besides the typical on-chip interconnects at system-on-chip (SoC) level. This is enabling a system (r)evolution towards smart disintegration, moving away from a one-meets-all-requirements general-purpose CMOS platform, and allowing higher flexibility by separately designing and fabricating the blocks that are assembled in the final system [2]. Boosted by the novel scaling options enabled by this new approach, logic standard cell shrinkage remains at the core of the compute roadmap. Its momentum is expected to carry on by introducing new device architectures, materials, and scaling boosters such as backside (BS) power delivery (PD) [3-9]. Guided by design-technology-co-optimization (DTCO)-driven design improvements, in close interaction with the adoption of system-technology-co-optimization (STCO), the roadmap also increasingly requires EUV/high-NA EUV lithography for cost-effective, lower energy consumption, continued dimensional scaling.At transistor level, finFETs are being replaced by nanosheet (NS) FETs consisting of several vertically stacked NS per device [10,11]. Beyond that, 3D stacked CMOS, also called CFET [9,12,13], where different polarity NSFETs are folded on top of each other, appears as the ultimate scaling limit of the NS-based transistor’s family. Moreover, changes in how devices are connected are also being introduced. Moving PD to the wafer’s BS, though being a considerable disruptive technological change, is a game changer for on-chip power distribution, enabling smaller IR-drop values. This concept can be implemented in various ways, and has the potential to expand towards other functions, namely by addition of specific devices after BS processing, paving the way towards a truly functional BS [3,9,14]. Two examples of benefits brought by increased BS use are: 1) considerably more compact ESD diodes, with improved latch-up immunity, and BS contacts [9,15]; 2) lower clock latency values by moving the clock’s signal to the BS [9,16].Furthermore, as transistors are now sandwiched and accessed from levels above and below them, this also enables interesting new opportunities for device engineering. Focusing on the highly scalable BS PD scheme wherein the transistor’s source (S) (for bottom FET in case of CFET) is directly contacted from the BS (BSC-S) (Fig.1) [7,9,17,18], while the other terminals remain connected from the wafer’s frontside, several options to optimize the BSC-S’s contact resistance can be considered. These include ways to enlarge its contact surface area and the possible addition of an extra low-temperature, low-resistivity epitaxial layer [9,19,20] prior to metallization. Fig.2 also highlights the need to account for the impact on thermal performance when selecting (BSC-S)-based device configurations and materials [7,9]. Additionally, the intrinsically asymmetric S/drain (D) access with BSC-S can also be explored to enable a simpler path to build devices with differently doped S/D [9]. This can be especially interesting for high-mobility, low-bandgap FETs to mitigate IOFF concerns while still taking advantage of their high-drivability potential. CFET using, e.g., bonding technology for the bottom/top channels and their vertical isolation’s definition can also be particularly suitable for implementing distinct channel materials (like Ge-rich for bottom PMOS) as they are in separate planes.Overall, compute systems, guided by DTCO/STCO with the embrace of the use of both wafer sides, 3D stacking and sequential technologies, can potentially be assembled in ways enabling much more versatile, hybridized platforms. This can allow not only new paths for continued compute/logic scaling, but also ease the introduction of new/alternative device architectures (and materials) as they do not need to meet all the requirements of a general-purpose platform.

Product Positioning Evaluation and Exploitation of Nigerian Solid Mineral Resources: A Vile for Transformation Agenda for Third World Countries

The study focused on product positioning and exploitation of Nigerian solid mineral resources towards transforming third world countries. The specific objectives of the study were to examine the effect of product price, product quality and product differentiation on Nigerian solid mineral resources; Data were collected through a primary source. The population of the study was 218 which consisted of final year students of Marketing from University of Ilorin, Kwara State, Nigeria. These respondents were used due to their background knowledge in Marketing. The study utilized simple random sampling technique to select sample of 80 respondents for the study. 5-point likert scale option of structured questionnaire was used in the study to obtain respondents’ response. Content validity was used to determine the validity of the instrument by giving to research experts who modified and made the necessary correction to measure the instrument. Simple linear regression analysis was used to test the hypothesis. Three hypotheses were tested in line with the objectives of the study and it was revealed that there was a significant relationship between product price, product quality and product differentiation, and Nigerian solid mineral resources. The study suggested some recommendations as follows: Government agencies and major stakeholders affiliated with solid mineral resources in Nigeria should imbibe product price strategy in order to encourage high patronage for Nigerian solid mineral resources. Product quality should be embraced because it attracts foreign buyers to patronise Nigerian solid mineral resources. Government agencies and major stakeholders in charge of solid minerals in Nigeria should embark on product differentiation among mineral resources in Nigeria to command high patronage from foreign buyers.

Translation, cultural adaptation, and validation of Numerical Pain Rating Scale and Global Rating of Change in Tibetan musculoskeletal trauma patients

Tibetan-speaking patients seeking care in predominantly Mandarin-speaking healthcare settings frequently face communication barriers, leading to potential disparities and difficulties in accessing care. To address this issue, we translated, culturally adapted, and validated the Numerical Pain Rating Scale (NPRS) and the Global Rating of Change (GRoC) into Tibetan (NPRS-Tib and GRoC-Tib), aiming to facilitate cross-linguistic and cross-cultural interactions while examining potential challenges in the adaptation process. Using standard translation-backward translation methods, expert review, pilot testing, and validation through a cross-sectional study with a short-term longitudinal component, we engaged 100 Tibetan patients with musculoskeletal trauma for psychometric validation, including 37 women (aged 22–60 years, mean age 39.1 years). The NPRS-Tib and GRoC-Tib exhibited outstanding psychometric properties, with an Intraclass Correlation Coefficient (ICC) of 0.983 for NPRS-Tib indicating superb test–retest reliability, and expert review confirming good content validity for both instruments. A Spearman's correlation coefficient (Rho) of -0.261 (P = 0.0087) revealed a significant, albeit weak, correlation between changes in NPRS-Tib scores and GRoC-Tib scores. The adaptation process also presented notable challenges, including translation discrepancies from translators' diverse backgrounds and levels of expertise, ambiguity in scale options, and the lack of established tools for criterion validity assessment in Tibetan.

Plasma-derived extracellular matrix for xenofree and cost-effective organoid modeling for hepatocellular carcinoma

BackgroundHepatocellular carcinoma (HCC) causes significant cancer mortality worldwide. Cancer organoids can serve as useful disease models by high costs, complexity, and contamination risks from animal-derived products and extracellular matrix (ECM) that limit its applications. On the other hand, synthetic ECM alternatives also have limitations in mimicking native biocomplexity. This study explores the development of a physiologically relevant HCC organoid model using plasma-derived extracellular matrix as a scaffold and nutritive biomatrix with different cellularity components to better mimic the heterogenous HCC microenvironment. Plasma-rich platelet is recognized for its elevated levels of growth factors, which can promote cell proliferation. By employing it as a biomatrix for organoid culture there is a potential to enhance the quality and functionality of organoid models for diverse applications in biomedical research and regenerative medicine and to better replicate the heterogeneous microenvironment of HCC.MethodTo generate the liver cancer organoids, HUH-7 hepatoma cells were cultured alone (homogenous model) or with human bone marrow-derived mesenchymal stromal cells and human umbilical vein endothelial cells (heterogeneous model) in plasma-rich platelet extracellular matrix (ECM). The organoids were grown for 14 days and analyzed for cancer properties including cell viability, invasion, stemness, and drug resistance.ResultsHCC organoids were developed comprising HUH-7 hepatoma cells with or without human mesenchymal stromal and endothelial cells in plasma ECM scaffolds. Both homogeneous (HUH-7 only) and heterogeneous (mixed cellularity) organoids displayed viability, cancer hallmarks, and chemoresistance. The heterogeneous organoids showed enhanced invasion potential, cancer stem cell populations, and late-stage HCC genetic signatures versus homogeneous counterparts.ConclusionThe engineered HCC organoids system offers a clinically relevant and cost-effective model to study liver cancer pathogenesis, stromal interactions, and drug resistance. The plasma ECM-based culture technique could enable standardized and reproducible HCC modeling. It could also provide a promising option for organoid culture and scaling up.

'What would my peers say?' Comparing the opinion-based method with the prediction-based method in Continuing Medical Education course evaluation.

Although medical courses are frequently evaluated via surveys with Likert scales ranging from "strongly agree" to "strongly disagree," low response rates limit their utility. In undergraduate medical education, a new method with students predicting what their peers would say, required fewer respondents to obtain similar results. However, this prediction-based method lacks validation for continuing medical education (CME), which typically targets a more heterogeneous group than medical students. In this study, 597 participants of a large CME course were randomly assigned to either express personal opinions on a five-point Likert scale (opinion-based method; n = 300) or to predict the percentage of their peers choosing each Likert scale option (prediction-based method; n = 297). For each question, we calculated the minimum numbers of respondents needed for stable average results using an iterative algorithm. We compared mean scores and the distribution of scores between both methods. The overall response rate was 47%. The prediction-based method required fewer respondents than the opinion-based method for similar average responses. Mean response scores were similar in both groups for most questions, but prediction-based outcomes resulted in fewer extreme responses (strongly agree/disagree). We validated the prediction-based method in evaluating CME. We also provide practical considerations for applying this method.

HR policies and its impact on job satisfaction among employees in FMCGs in Karachi, Pakistan

The main purpose of this study is to analyze the impact of Human resource policies and practices on the job satisfaction. Because these are the guidelines that Human resource manager of the organizations adopts in managing its people. In this study a total of 384 Questionnaires were distributed among different participants in Karachi and 172 were received with a response rate of 51.67%. To collect the required information closed-ended questionnaire was used and were divided into three part; initially questionnaire identify the demographic factors of the respondents, then highlight the Likert scale options 1 being strongly disagreed and 5 strongly agree. In findings of the research we conclude that HR policies and practices have greater impact on job satisfaction. Findings revealed a positive relationship among independent and dependent variable and job satisfaction suggest how efficient and effective employees could be when they are highly satisfied on the job. Therefore, organizations need to apply these tested variable in their policies in order to make employees satisfy on their jobs.

A systematic approach for simulation-based dimensioning of production systems during the concept phase of factory planning

Due to increasing globalization, market penetration, and technological progress, more products are becoming highly standardized and interchangeable. This has led to fierce price competition, forcing companies to compete for declining margins. To remain competitive in the long term, it is essential to consider both changeability and profitability during the early planning phases. The article proposes an approach for simulation studies using discrete-event simulation during the concept phase of factory planning. This approach aims to systematically dimension production resources while considering alternative scaling options, such as a higher degree of automation. By doing so, the approach facilitates the demand-oriented deployment of resources during the ramp-up phase, which helps to control and reduce manufacturing costs. The simulation experiments yield scaling paths that indicate the timing and quantity of resources required to meet changing demands. These paths form the basis for subsequent factory planning steps. For instance, the layout can incorporate the necessary space for a future automation solution that will be profitable, enabling faster adaptation to demand changes and securing competitive advantages. This is demonstrated in a use case where the approach was applied to the factory planning of a new production system for a sensor product family.

The Participation Assessment with Recombined Tools-Objective (PART-O): measurement properties of the Norwegian version after traumatic brain injury

ABSTRACT Objective To translate and evaluate the validity of the Participation Assessment with Recombined Tools-Objective (PART-O) in a Norwegian context. Methods One hundred and twenty persons with TBI with verified intracranial lesions and persistent symptoms lasting more than 2 years, included in a randomized controlled trial, rated their participation using the PART-O at baseline. The PART-O with its three subscales (Productivity, Out and About, and Social Relations) was translated to Norwegian. Descriptive statistics, Cronbach's alpha, Rasch analysis, and correlation analysis were applied. Results The Rasch analysis indicated a unidimensional construct of PART-O and its subscales (χ2 < 12.69, p > 0.28). The internal consistency was moderate (Cronbach's alpha 0.48–0.52) and there was a need to reduce scaling options for most of the items. The Out and About and Productivity subscales had considerable floor effects. PART-O showed moderate positive correlation to TBI-related quality of life and global functioning. Conclusions PART-O and its subscales reflect unidimensional aspects of participation. In the present Norwegian TBI population the original scaling of PART-O was too detailed for all subscales. The floor effects and suboptimal targeting between items and subjects participation level of the Out and About subscale is a matter of concern.

What are the needs in oral antitumor therapy? An analysis of patients' and practitioners' preferences.

Since the European approval of CDK4/6 inhibitors in 2016, the treatment of patients with hormone-receptor-positive, HER2-negative metastatic breast cancer has changed significantly. Compared with chemotherapy, endocrine-based therapy has different treatment regimens and is associated with new side effects. Oral therapy aims for optimal drug efficacy and long treatment times while maintaining maximum independence and quality of life resulting in the conservation of medical staff resources. A monocentric analysis of therapy preferences of practitioners (25 nurses and physicians) and patients (11 on endocrine monotherapy, 17 on endocrine-based therapy, and 14 on intravenous chemotherapy) was performed using specific questionnaires. Preferences were assessed using a four-point Likert scale or bidirectional response options. All patients were highly supportive of oral therapy (mean agreement score on the Likert scale 1.3, p < 0.001 vs. all other options) and a consultation interval of 4 weeks (2.0, p = 0.015 vs. 3 weeks). Practitioners also preferred oral therapy (1.4) and visits every 4 weeks (1.6). In general, patients on oral therapies reported higher compatibility of their therapy with daily life than patients on chemotherapy (1.6 and 1.7 vs. 2.6, p = 0.006). Outpatient oncology is the main source of information for all patients, mainly in case of side effects (2.0) and open questions (1.8). Regarding oral antitumor therapy regimens, patients do not show a significant preference for a specific regimen, while practitioners prefer a continuous regimen (1.6) over a 21/7 regimen (21 days on and 7 days off therapy, 2.5). Patients are likely to accept mild side effects (e.g., neutropenia, diarrhea, polyneuropathy, fatigue) and would still adhere to their initial choice of regimen (continuous or 21/7). Only when side effects occur with a severity of CTCAE grade 3 do patients prefer the regimen in which the side effects occur for a shorter period of time. Patients and practitioners prefer oral antitumor therapy-both continuous and 21/7 regimens-over other application forms. Patient education and proper therapy management, supported by additional tools, contribute to the specific management of side effects and high adherence. This allows quality of life to be maintained during long-term therapy with CDK4/6 inhibitors in patients with metastatic breast cancer.

Chapter 10 - Scaling of cell and gene therapies to population

Cell and gene therapies (CGTs) are intended to address many different diseases, including widespread diseases with millions of patients. The success of CGTs thus depends on the practicability of scaling cell manufacturing to population. It is obvious that process integration and automation are key for the reproducibility, quality, cost-effectiveness, and scalability of cell manufacturing. Still, different manufacturing concepts can be considered depending on the characteristics of cell therapies such as the degree of ex vivo manipulation of cells, the intended treatment scheme for the underlying medical indication, the prevalence of the indication, and the cell dose per final drug product. Here, we explain the characteristics of cellular products and their implications from the perspective of a manufacturer. We outline and exemplify with a list of devices' different strategies and scaling options for CGT manufacturing considering technical and regulatory aspects in the early and late clinical development of cellular products. Finally, we address the need for appropriate in-process and quality controls and the regulatory requirements and options for improvements of a cellular product at different manufacturing stages.

Think aloud and tell us everything that comes to mind”: Results from cognitive testing of a patient-reported experience measure (PREM) for integrated home and community care.

Background: Ontario’s health system goal is to put clients at the centre with the right care, at the right time, in the right place. To do this there is a need to integrate home care with community-based services. This type of integration should, in theory, better support people to continue living well, with dignity and safety, in their homes and communities for as long as possible. A critical component of improving integrated home and community care is gathering self-reported data of client experience, through patient-reported experience measures (PREMs). When client reported data is integrated into health system improvement initiatives, there is a trend towards better health outcomes, including the adoption of safe practices, better communication, and improved clinical indicators. However, no PREM currently exists to measure client experience of integrated home and community care.&#x0D; Aims: We aimed to engage clients of home care services and family/friend caregivers to clients receiving home care in Ontario, Canada to tells us about the usability of a newly developed PREM for emerging models of integrated home and community care. This engagement should ensure the PREM is easy to comprehend and straightforward, making it more likely to generate reliable and valid information . &#x0D; Methods: We engaged with clients and caregivers (n=10) with diverse gender expressions, racial backgrounds, abilities, and socioeconomic status in one-to-one interviews to identify issues related to answering the questions on our newly developed PREM. Participants were asked to “think aloud and tell us everything that comes to mind, whether it seems important or not” while completing the PREM. This approach elicited information about the clarity of the instructions, their understanding of the questions, the item stem and scale match, and what led them to their answer. We asked additional question related to comprehension of terms, ambiguity, value-laden words, double-barreled questions, positive and negative wording, and length. Two members of the research team conducted thematic analysis of the generated transcripts and came to consensus regarding required changes to the scaling and items.&#x0D; Results: At the time of the conference, the detailed results of the cognitive testing will be available. We anticipate sharing recommendations from users of home care on 1) creating clear scaling options, 2) wording items clearly, 3) the appropriate length of the questions and overall survey, and 4) clarifying jargon or unintended meaning of questions. The finalized draft PREM will be shared.&#x0D; Learnings: Results will provide insight into how to clarify wording and scale a survey about client experience of integrated home and community. This will help to improve survey design and user experience, ultimately enhancing potential for a reliable and valid measure of patient experience. &#x0D; Next steps: The PREM will be adapted and psychometrically tested. If found to be reliable and valid for use in home and community care, it will be rolled out at a home care service provider organization across Canada in late 2023. This PREM data should be integrated with other metrics of the quadruple aim to best guide healthcare improvement.

An a priori analysis on principal component analysis based conditional source-term estimation model for Sandia jet flames

Data from all spatial locations and two turbulent flames in the Sandia/TUD database are used to explore the feasibility of adopting principal components (PC) as conditional variables in the conditional source-term estimation (CSE) model. Principal component analysis (PCA) is applied to both Flame C and F to generate the new set of controlling variables, PC-scores. Two PCA scaling methods have been adopted, namely Pareto and Auto-scaling (AS). Regardless of the scaling option selected and the flame investigated, it was found that a single principal component score (PC1-score) correlated with temperature accounts for the largest amount of variance. As such, the conditional space fluctuations and normalized RMS of both flames’ reactive scalars around PC1-Pareto and PC1-AS are examined and compared against the ones obtained with the mixture fraction, Z. The results indicate that both PC1-scores are not able to accurately quantify the thermo-chemical state-space of Flame C compared to mixture fraction, in particular for the fuel and all the intermediate species. Interestingly, using a single principal component score for Flame F significantly improved the conditional fluctuations, suggesting that a single PC-score well correlated with temperature can more effectively reduce the spatial gradient and Reynolds numbers effects than mixture fraction. The results are further depicted by comparing the trends obtained for Flame F with two-condition conditional averages around Z and four different progress variable definitions, c. While doubly conditioning enabled to detach the conditional averages of all the scalars from the physical domain, the results obtained with PC1-Pareto and PC1-AS were found to not deviate by much (excluding the mass fractions of CH4). This leads to believe that a conditional moment closure-based model such as CSE, coupled with PCA, can perhaps recover with satisfactory levels of approximation the thermo-chemical state-space of Flame F and separate the conditional manifold from the real domain.

Enhanced electrochemical activity of boron-doped nanocarbon functionalized reticulated vitreous carbon structures for water treatment applications

An extraordinary charge transfer kinetics and chemical stability make a boron-doped diamond (BDD) a promising material for electrochemical applications including wastewater treatment. Yet, with flat geometrical surfaces its scaling options are limited. In this study, the reticulated Vitreous Carbon (RVC) served as a substrate for boron-doped diamondized nanocarbons (BDNC) film growth resulting with complex heterogeneity carbon structures with different morphologies defined by using electron microscopy, microtomography, activation energy studies, and Raman spectroscopy.The proposed modification significantly boosted the electrochemical Fe(CN)63−/4− redox activity. The voltammetry and impedimetric studies revealed its origin as a significantly higher share of electrochemically active sites at the BDNC@RVC electrode (increased by 114 %) combined with enhanced heterogeneous rate constant (2× increase up to 8.24·10−4 cm s−1). Finally, to establish its applicability for water treatment, the BDNC@RVC was studied as the anode in electrochemical paracetamol decomposition. Boron-enriched nanoarchitecture formed at the RVC electrode surface substantially reduced the oxidation energy barrier manifested as a decrease in activation overpotential by 212 mV, which gave a consequence in a 78 % removal rate (in 4 h, at 0.7 mA cm−2), 12 % higher than bare RVC and yielding lower amounts of APAP decomposition intermediates.

Isolating the effect of Co and Ce on Ni–X–Y/Al2O3 bi- and trimetallic reforming catalysts for hydrogen generation

This work investigates the individual and combined promoting effects of ceria and cobalt on a nickel-based catalyst for steam reforming. First, the catalysts were synthesized using a fixed 20 wt% Ni content and variable Ce and Co, 0-10 wt% contents. We used a combined experimental (characterization and testing) and computational framework to assess the promoting role in catalytic activity and stability for nickel-alumina-based catalysts. The formation of Ni-Co alloy was approved by combining different characterization techniques. The Ni20Ce2Co10/Al catalyst exhibits superior conversion, H2 yield, and lifetime. The obtained catalytic activity is attributed to the presence of bare Co sites that reduces the Ni crystal size, enhances the accessibility of active sites, promotes the metal–support interaction, and facilitates C-C scission. In addition, the incorporation of Ce with low loading (2 wt %) to Ni-Co interface enhances the accessibility of oxygen vacancy, facilitates the reaction, prevents coke formation and maintains catalytic activity for prolonged lifetime. The simplicity and cost-effectiveness of this proposed catalyst make it an appealing option for scaling up.

Analysis of Tea Agroforestry System: The Case of Kyenjojo District in Uganda

Uganda is one of the countries in east Africa where agroforestry farming system has spread in twelve agro-ecological zones. Agroforestry practices are critical in all agro-based sectors like tea industry because of benefits like provision of fuel wood for curing tea. The purpose of this study was to understand the current agroforestry practices adopted by smallholder tea estate farmers and investigate options for scaling up the technology to alleviate the fuelwood scarcity faced by tea industries. The study involved a survey that was conducted in Kyenjojo district located in Western Uganda in June 2020. A total of 65 small holder tea farmers (respondents) were interviewed during the study. A purposive sampling method was used and data analyzed with SPSS to generate descriptive statistics that included frequencies, percentages, tables, graphs and charts. Results showed that shade was the most benefit of agroforestry trees by a proportion of 33% towards tea growing and followed by climate modification at 24%. Protection of the environment was also revealed as one of the leading benefits of tea agroforestry with a proportion of 34%, as well as trees acting as a source of poles at 23%. Eucalyptus at 34% was the most dominant agroforestry tree used at tea farm level as a woodlot, followed by Grevillea robusta at 28%. The most dominant adoption method of tea agroforestry practices at tea farm level was through farmers learning from fellow farmers at 34%, followed by adoption by trainings at 23%. Planting of agroforestry trees was the only remedy stated by farmers as an effort done to retain trees on farm. As a recommendation towards increased uptake of agroforestry at farm level, farmers identified certification and other factory-based incentives such as Rain Forest Alliance being the most important. Based on the identified benefits of tea-agroforestry systems, efforts should be made by Public, Private and Development partners to make all tea farmers aware of the existing and appropriate agroforestry practices while developing appropriate incentive models for increased adoption of tea agroforestry system in Uganda.

Comparative analysis of dose calculation algorithms for CyberKnife-based stereotactic radiotherapy in lung cancer.

The accuracy of dose calculation is the prerequisite for CyberKnife (CK) to implement precise stereotactic body radiotherapy (SBRT). In this study, CK-MLC treatment planning for early-stage non-small cell lung cancer (NSCLC) were compared using finite-size pencil beam (FSPB) algorithm, FSPB with lateral scaling option (FSPB_LS) and Monte Carlo (MC) algorithms, respectively. We concentrated on the enhancement of accuracy with the FSPB_LS algorithm over the conventional FSPB algorithm and the dose consistency with the MC algorithm. In this study, 54 cases of NSCLC were subdivided into central lung cancer (CLC, n=26) and ultra-central lung cancer (UCLC, n=28). For each patient, we used the FSPB algorithm to generate a treatment plan. Then the dose was recalculated using FSPB_LS and MC dose algorithms based on the plans computed using the FSPB algorithm. The resultant plans were assessed by calculating the mean value of pertinent comparative parameters, including PTV prescription isodose, conformity index (CI), homogeneity index (HI), and dose-volume statistics of organs at risk (OARs). In this study, most dose parameters of PTV and OARs demonstrated a trend of MC > FSPB_LS > FSPB. The FSPB_LS algorithm aligns better with the dose parameters of the target compared to the MC algorithm, which is particularly evident in UCLC. However, the FSPB algorithm significantly underestimated the does of the target. Regarding the OARs in CLC, differences in dose parameters were observed between FSPB and FSPB_LS for V10 of the contralateral lung, as well as between FSPB and MC for mean dose (Dmean) of the contralateral lung and maximum dose (Dmax) of the aorta, exhibiting statistical differences. There were no statistically significant differences observed between FSPB_LS and MC for the OARs. However, the average dose deviation between FSPB_LS and MC algorithms for OARs ranged from 2.79% to 11.93%. No significant dose differences were observed among the three algorithms in UCLC. For CLC, the FSPB_LS algorithm exhibited good consistency with the MC algorithm in PTV and demonstrated a significant improvement in accuracy when compared to the traditional FSPB algorithm. However, the FSPB_LS algorithm and the MC algorithm showed a significant dose deviation in OARs of CLC. In the case of UCLC, FSPB_LS showed better consistency with the MC algorithm than observed in CLC. Notwithstanding, UCLC's OARs were highly sensitive to radiation dose and could result in potentially serious adverse reactions. Consequently, it is advisable to use the MC algorithm for dose calculation in both CLC and UCLC, while the application of FSPB_LS algorithm should be carefully considered.

INDEX guidelines for extra-pulmonary tuberculosis: knowledge and practice among clinicians in Bengaluru, Karnataka

Background: Extra-pulmonary tuberculosis (EPTB) remains a major problem in developing countries, which acquire diagnostic and management challenges. The study was conducted to characterize the diagnosed EPTB cases, and to understand the perspectives of clinicians on diagnosis and challenges in its management. Methods: A total of 150 EPTB patients' medical records were reviewed at two tertiary hospitals in Bengaluru, Karnataka for the period January 2017 to December 2017. The questionnaire-based interview was conducted among clinicians (n=42) during the study period. Results: The mean age and weight of EPTB patients (females (77, 51%) and males (73, 49%) were 32.5 (±17.5) years and 44.5 (±16.3) kilograms, respectively. Pleural TB (44, 29%), cervical lymph node TB (LNTB) (32, 21%) and abdominal TB (17, 11%) were the most common sites of EPTB involvement, followed by bones and joints TB (11, 7%), spine TB (10, 7%), hilar/mediastinal TB (9, 6%), tuberculoma (8, 5%), TB meningitis (6, 4%), abdominal LNTB (6, 4%), urinary TB (4, 3%) and others (3, 2%). We found GeneXpert was the basis of EPTB diagnosis in 43.3% of cases followed by acid-fast bacilli (AFB) smear microscopy (20.7%) and culture (12.5%). Of 150 EPTB suspected cases, 73% (110) were started anti-TB treatment (ATT), including 8% (12) having received ATT previously. According to LIKERT scale options, 90% of clinicians agreed GeneXpert as a promising diagnostic tool for diagnosis as compared to other microbiological (79%) and histopathological tests (55%). Conclusions: The quality of EPTB diagnosis and management practices at these institutions is satisfactory according to the principles laid down in INDEX TB guidelines or the national guidelines.

HOT and Attractive? The Hazardous Organization Tool as an Instrument to Avoid Attracting and Retaining People with Low Ethical Standards

AbstractTo foster and sustain an ethical culture, organizations need to attract and retain people with high ethical standards. However, there is a lack of knowledge about which organizational characteristics influence the pre- and post-entry work attitudes and behaviors of people with high ethical standards. To fill this gap, we drew on person–organization fit (PO fit) theories and developed the Hazardous Organization Tool (HOT) based on a broad personality trait that is strongly related to ethical standards and predictive of unethical workplace behavior—honesty-humility from the HEXACO personality model. The HOT consists of 9 items that describe organizations that are rated as more attractive by people with low ethical standards. The HOT can be used to measure the extent to which people are attracted to hazardous organizations (HOT-A) and the extent to which people perceive an organization to be hazardous (HOT-P) with different instructions but identical scale options, ensuring commensurability for testing complex fit effects. We examined the validity of the HOT in four samples (total N = 1260). We found moderate to strong correlations between attractiveness ratings of the items (HOT-A) and honesty-humility (ranging from − .31 to − .56) and dark personality traits (ranging from .37 to .63). In addition, hazardous organization perceptions (HOT-P) were related to negative work attitudes and motivation, particularly for employees who were not attracted to hazardous organizations (those with high ethical standards). Overall, the current study suggests that the Hazardous Organization Tool is a valid measure. Implications for the PO fit literature and management practice are discussed.

EMobile internet protocol version six (IPv6) testbed for interoperability of Nigerian education services and networks

The diversity of educational methods, services and protocols promoted disparate educational services in Nigeria. The diversity has not promoted resource sharing and has encouraged duplication of efforts. There is no doubt that the University systems in Nigeria need to complement each other bearing in mind the limited resources available to individual University system. With the introduction of next generation internet protocol version six (IPv6), some of the divergent technologies can be brought to a platform to facilitate resource sharing, capacity development and optimization of resources. In order to solve these diversities of resources affecting Nigerian Education Services and Network, Route Optimization Techniques in IPv6 will provide the best option for scaling these diversities. The Nigeria ecosystem has come of age and attained maturity level to identify the futuristic roles of internet protocol version six (IPv6). Globally, Policy makers and Governments have recognized the enormous opportunities the Internet can create and its impact on economic growth and prosperity. The prime mission of the invention is to develop and provide an eMobile IPv6 testbed that supports optimization of resources for digital services in Nigeria Tertiary Education.