Simple Measures Research Articles

Shape of Pulmonary Artery Doppler Flow Profile and Right Ventricular Hemodynamics in Neonates

To characterize pulmonary artery Doppler flow profile (PAFP) patterns among infants receiving care in neonatal intensive care units (NICUs) and to examine the association of PAFP patterns with pulmonary and right ventricular (RV) hemodynamics. This is a retrospective study at two tertiary NICUs over 4 years that included neonates who demonstrated a complete tricuspid regurgitation envelope on targeted neonatal echocardiography (TNE). Separate personnel reviewed TNEs to characterize PAFP patterns, divide cohort into PAFP groups, and measure quantitative indices of RV hemodynamics (RV systolic pressure [RVSP], pulmonary artery acceleration time [PAAT] and its ratio with RV ejection time [RVET/PAAT], tricuspid annular plane systolic excursion [TAPSE] and RV output [RVO]), for intergroup comparisons. We evaluated TNEs from 186 neonates with median (IQR) gestational age of 28.5 weeks (25.9-35.9) weeks. Four distinct PAFP patterns were identified: A. near-isosceles triangle (22%), B. right-angled triangle (29%), C. notching (40%), and D. low peak velocity (<0.4 m/s; 9%). Groups A-C demonstrated a stepwise worsening in all indices of PH, while pattern D was associated with lower TAPSE and RVO. Using common definitions of pulmonary hypertension (PH), pattern A performed best to rule out PH [sensitivity range 81-90%] and pattern C for diagnosing PH [specificity range 63-78%]. Inspection of PAFP is a simple bedside echocardiography measure that provides clinically meaningful information on underlying RV hemodynamics and may aid in screening and monitoring of patients for PH in NICUs.

Exploring EFL Supervisors' Feedback on Postgraduates' Research Proposals: Functions and Foci

Supervisory feedback plays a crucial role in supervising research in higher education. Feedback is a crucial component of successful teaching practices in the context of postgraduate research proposal writing. Effective supervisory feedback can promote supervisees' academic writing and enhance the quality of their research proposals. Therefore, this study aimed to examine the feedback functions and feedback foci that EFL supervisors employ in their written feedback when refining postgraduate research proposals. A qualitative approach and simple descriptive quantitative measures were adopted to address the study's aims and estimate the prevalence of feedback forms. The study's sample included (N = 5) supervisors (4 male and 1 female supervisor) supervising postgraduate students as part of the M.A. in Applied Linguistics program. Data were collected from five supervisory feedback reports on postgraduates' research proposals and proposal drafts. The finding revealed that the EFL supervisors predominantly used directive feedback (52%) in their feedback provision instead of referential (30%) and expressive feedback (18%). Additionally, the findings showed that the EFL supervisors primarily focused on content issues (53%), followed by organization (29%) and appropriateness (19%), and the lowest number of supervisory feedback focused on linguistic accuracy (16%). The study provides pedagogical implications for supervisors and recommendations for further studies.

T1w/T2w MRI ratio brain signature across degenerative syndromes and their cognitive impairment continuum and mixed presentations

AbstractBackgroundWe aimed to investigate the ratio’s signature in diverse clinically‐defined neurodegenerative syndromes and their cognitive impairment continuum. Our hypothesis was that higher cognitive impairment would be associated with lower cortical T1w/T2w ratio in all clinical subtypes.MethodWe used standardized MRI data obtained from participants in the COMPASS‐ND study of the Canadian Consortium on Neurodegeneration in Aging. T1w images were resampled down to T2w resolution; after co‐registration, intensities were standardized between 1‐100 and the ratio computed. Brain segmentation was then performed using FreeSurfer 6.0 on T1w images with the Desikan‐Killiany‐Tourville and default subcortical atlases. Participants included 109 cognitively intact elderly (CIE), 131 subjective cognitive decline (SCD), 252 mild cognitive impairment (MCI), 113 vascular‐MCI (V‐MCI), 55 mixed vascular‐Alzheimer’s dementia (V‐AD), 76 Alzheimer’s disease (AD), 21 Lewy‐body dementia (LBD), 33 fronto‐temporal‐dementia (FTD), 77 Parkinson’s disease (PD), 35 PD‐MCI and nine PD with dementia (PDD). Since the between‐vendor distributions differed (Fig1), Z scores were computed separately for each scanner vendor (GE, Philips, or Siemens) with CIE as a reference group. ANCOVA with age as covariate and FDR correction were conducted between each group and CIE.ResultNo significant effect of age was observed. Compared to CIE, significantly higher T1w/T2w ratios were observed in SCD for most of the brain (57/86 regions), in MCI for six frontal areas only, while decline was observed in AD throughout the brain (Fig1). V‐MCI showed lower ratios in subcortical areas only while V‐AD had pronounced lower ratios in subcortical areas as well as in 11 cortical areas. PD had marked lower ratios throughout the brain with the exception of an intact corpus callosum (Fig2). Contrariwise, FTD only displayed a lower ratio in the corpus callosum whereas PD‐MCI and LBD did not show any significant difference with CIE.ConclusionWe observed clear distinct patterns of T1w/T2w ratios for SCD, MCI, AD and PD groups. Since this ratio does not seem specific to a neural biological substrate, the meaning of these differences remains to be determined. Nevertheless, these results suggest that simple MRI measures such as the T1w/T2w ratio can highlight underlying mechanisms in various neurodegenerative processes.

Asymmetric Dependence in Hydrological Extremes

AbstractExtremal dependence describes the strength of correlation between the largest observations of two variables. It is usually measured with symmetric dependence coefficients that do not depend on the order of the variables. In many cases, there is a natural asymmetry between extreme observations that cannot be captured by such coefficients. An example for such asymmetry is large discharges at an upstream and a downstream stations on a river network: an extreme discharge at the upstream station will directly influence the discharge at the downstream station, but not vice versa. Simple measures for asymmetric dependence in extreme events have not yet been investigated. We propose the asymmetric tail Kendall's τ as a measure for extremal dependence that is sensitive to asymmetric behavior in the largest observations. It essentially computes the classical Kendall's τ but conditioned on the extreme observations of one of the two variables. We show theoretical properties of this new coefficient and derive a formula to compute it for existing copula models. We further study its effectiveness and connections to causality in simulation experiments. We apply our methodology to a case study on river networks in the United Kingdom to illustrate the importance of measuring asymmetric extremal dependence in hydrology. Our results show that there is important structural information in the asymmetry that would have been missed by a symmetric measure. Our methodology is an easy but effective tool that can be applied in exploratory analysis for understanding the connections among variables and to detect possible asymmetric dependencies.

Field acoustical measurements for sound insulation residences against aircraft noise

In this paper, we have investigated measurement methods of the sound insulation performance for residences treated with increased sound insulation near airports in Japan. The flyover measurement method and the loudspeaker measurement method are conducted to verify the performance. The first one provides the performance of the whole facades of a house using aircraft noise, approximately similar to the FAA method described in ASTM E966. The pressure level outdoors is measured at enough high position to ignore the interference with sound from the ground or the house roof. However, the microphone is sometimes put on the roof surface because of being in the house's shadow in the overcrowded residential area. Thus, we have investigated the sound pressure level difference between the high and surface positions using simple numerical analysis and field measurement. On the other hand, the outdoor and indoor loudspeaker methods are conducted for facade elements such as windows and doors, according to JIS A 1520. The sound insulation performance for facade walls is also measured with ISO 16283-3; however, the loudspeaker sometimes cannot be positioned far enough from the wall. Thus, we have proposed the measuring method for the facade wall by applying the indoor loudspeaker method.

The Effect of Psychological Capital on Entrepreneurial Performance in MSME District in Jatinangor District

MSMEs or Small, Micro and Medium Units are businesses owned by individuals that have an important role both on a national and international scale. This research aims to find out whether there is an influence from Psychological Capital on Entrepreneurial Performance among MSMEs in Jatinangor District. This study examines MSME actors in terms of their psychological capacity, namely Psychological Capital and the performance of MSME actors. The research design carried out is descriptive research with a quantitative non-experimental approach. This study used convenience sampling and was conducted on 145 MSME actors in Jatinangor sub-district using a questionnaire. The measuring instruments used were the Psychological Capital Questionnaire (PCQ-24) and the Entrepreneurial Performance Questionnaire (EPQ). The data analysis method used is the simple linear regression measurement method. Based on the results of the study, Psychological Capital has a positive influence on Entrepreneurial Performance with a value of 53.2% to measure the contribution of the influence of Psychological Capital on Entrepreneurial Performance where this can also indicate that the higher the Psychological Capital of MSME entrepreneurs in Jatinangor sub-district, the higher the performance of the MSME folder.

Risk factors for oral frailty among community-dwelling pre-frail older adults in Japan: A cross-sectional analysis.

Oral frailty is a well-established risk factor for frailty and plays a significant role in progression to frailty. However, the association between oral frailty and pre-frailty in elderly individuals remains unclear. This cross-sectional study aimed to clarify the characteristics and risk factors of pre-frailty in elderly individuals with oral frailty. A total of 377 elderly individuals participated. Oral examinations comprised simple and non-invasive measures of chewing function, self-reported swallowing function, and oral moisture. The frailty screening index was used to assess frailty phenotypes. The overall prevalence of pre-frailty was 63.1%, after excluding 40 frail and 99 robust individuals. The mean age of the pre-frail participants was 76.6 ± 5.8 years; 70.6% were women. 10.5% of the pre-frail elderly participants had oral frailty. In multivariate analysis diabetes mellitus, history of cancer, denture wearing, and malnutrition were independently associated with oral frailty among pre-frail elderly individuals (adjusted odds ratio (OR) 3.8, 95% confidence interval (CI) 1.06-13.54; OR 4.5, CI 1.32-15.36; OR 8.8, CI 1.76-43.78; and OR 3.6, CI 1.30-9.67; respectively). The prevalence of oral frailty was low among community-dwelling pre-frail elderly individuals. Early interventions involving oral, nutritional, and disease management may prevent or improve oral frailty in pre-frail elderly individuals and may prevent progression to frailty. Further studies are required to elucidate the underlying mechanisms.

Electrical detection and modulation of magnetism in a Dy-based ferroelectric single-molecule magnet

Electrical control of magnetism in single-molecule magnets with peculiar quantum magnetic behaviours has promise for applications in molecular electronics and quantum computing. Nevertheless, such kind of magnetoelectric effects have not been achieved in such materials. Herein, we report the successful realization of significant magnetoelectric effects by introducing ferroelectricity into a dysprosium-based single-molecule magnet through spatial cooperation between flexible organic ligands and halide ions. The stair-shaped magnetization hysteresis loop, alternating current susceptibility, and magnetic relaxation can be directly modulated by applying a moderate electric field. Conversely, the electric polarization can be modulated by applying a small magnetic field. In addition, a resonant magnetodielectric effect is clearly observed, which enables detection of quantum tunnelling of magnetization by a simple electrical measurement. The integration of ferroelectricity into single-molecule magnets not only broadens the family of single-molecule magnets but also makes electrical detection and modulation of the quantum tunnelling of magnetization a reality.

IMPROVING QUALITY AND EFFICIENCY PERFORMANCE OF ANALYTICAL TESTING PROCESS USING SIGMA METRICS IN EMERGENCY LABORATORY OF KING FAHD ARMED FORCES HOSPITAL, JEDDAH, SAUDI ARABIA

Background: Six Sigma is a popular quality management system tool used for process improvement. Using that, the clinical technologist can directly intervene to improve the quality of test reporting during the analytical phase of the total testing process in the medical laboratory. The present study aimed to assess and continuously improve the performance of individual biochemical and hematological parameters on a Sigma Scale by calculating the Sigma metrics for individual parameters redesigning and customizing the internal quality control (IQC). A sigma metric is a simple measurement of assay quality that compares an assays precision and bias performance to a total allowable error (TEa) goal. This analysis uses the Alinity-ci system, Alinityhq, and Stag for 47 assays from the Emergency Department of King Fahd Armed Forces Hospital. Methods:The present study is retrospective-prospective conducted in a clinical Emergency laboratory of King Fahd Armed Forces Hospital (KFAFH) Medical Pathology, Jeddah, Saudi Arabia, from May 2021 to September 2022. A retrospective secondary data analysis of eight months duration was carried out in an ED laboratory with a follow-up prospective study for more than six months. During this period, 47 analyses were tabulated to analyze the Internal Quality Control (IQC) coefficient of variation percentage and external Quality Control (CAP). Bias %) and total error allowable for the same analytic were obtained monthly, and the sigma metrics were calculated for each analytic. Standardized QC sigma charts were established with these parameters.Root cause analysis (RCA) was used to discover potential problems for the analytes.For analytes with a sigma value &lt;4, appropriate measures were taken to improve the quality of laboratory investigations. Results: At critical decision levels, all data analyzed those parameters and identified the assays that were four Sigma or better. Those assays which meet these criteria are now considered to be verified. The method decision chart showed that out of 47 analyses, 57 % demonstrated a world-class performance of 6 sigma level, whereas 2 % showed an Excellence of 5 σ performance, and 12.0 % showed a good performance of 4 sigma level. In contrast, 30 % showed poor performance of less than four sigma at the QC levels. From root cause analysis, the source of error was detected and corrected. However, for all analyses of less than four sigma levels, indicating the area requiring improvement. In contrast, the SQC control rules have been redesigned for the improvement. Conclusions:For the analyses listed in this report, under the circumstances detailed in the report, Westgard QC, Inc. is proud to re‐verify that the Sigma performance of KFAFH, ED laboratory is achieving the appropriate goals of analytical quality performance. For QC procedure, sigma metric analysis is helpful to evaluate the performance and optimize the protocol for improvement and cost-effectiveness.

Quantifying directed dependence via dimension reduction

Studying the multivariate extension of copula correlation yields a dimension reduction principle, which turns out to be strongly related with the ‘simple measure of conditional dependence’ T recently introduced by Azadkia and Chatterjee (2021). In the present paper, we identify and investigate the dependence structure underlying this dimension reduction principle, provide a strongly consistent estimator for it, and demonstrate its broad applicability. For that purpose, we define a bivariate copula capturing the scale-invariant extent of dependence of an endogenous random variable Y on a set of d≥1 exogenous random variables X=(X1,…,Xd), and containing the information whether Y is completely dependent on X, and whether Y and X are independent. The dimension reduction principle becomes apparent insofar as the introduced bivariate copula can be viewed as the distribution function of two random variables Y and Y′ sharing the same conditional distribution and being conditionally independent given X. Evaluating this copula uniformly along the diagonal, i.e., calculating Spearman’s footrule, leads to an unconditional version of Azadkia and Chatterjee’s ‘simple measure of conditional dependence’ T. On the other hand, evaluating this copula uniformly over the unit square, i.e., calculating Spearman’s rho, leads to a distribution-free coefficient of determination (also known as ‘copula correlation’). Several real data examples illustrate the importance of the introduced methodology.

AI-Generated Information for Vascular Patients: Assessing the Standard of Procedure-Specific Information Provided by the ChatGPT AI-Language Model.

Introduction Ensuring access to high-quality information is paramount to facilitating informed surgical decision-making. The use of the internet to access health-related information is increasing, along with the growing prevalence of AI language models such as ChatGPT. We aim to assess the standard of AI-generated patient-facing information through a qualitative analysis of its readability and quality. Materials and methods We performed a retrospective qualitative analysis of information regarding three common vascular procedures: endovascular aortic repair (EVAR), endovenous laser ablation (EVLA), and femoro-popliteal bypass (FPBP). The ChatGPT responses were compared to patient information leaflets provided by the vascular charity, Circulation Foundation UK. Readability was assessed using four readability scores: the Flesch-Kincaid reading ease (FKRE) score, the Flesch-Kincaid grade level (FKGL), the Gunning fog score (GFS), and the simple measure of gobbledygook (SMOG) index. Quality was assessed using the DISCERN tool by two independent assessors. Results The mean FKRE score was 33.3, compared to 59.1 for the information provided by the Circulation Foundation (SD=14.5, p=0.025) indicating poor readability of AI-generated information. The FFKGL indicated that the expected grade of students likely to read and understand ChatGPT responses was consistently higher than compared to information leaflets at 12.7 vs. 9.4 (SD=1.9, p=0.002). Two metrics measure readability in terms of the number of years of education required to understand a piece of writing: the GFS and SMOG. Both scores indicated that AI-generated answers were less accessible. The GFS for ChatGPT-provided information was 16.7 years versus 12.8 years for the leaflets (SD=2.2, p=0.002) and the SMOG index scores were 12.2 and 9.4 years for ChatGPT and the patient information leaflets, respectively (SD=1.7, p=0.001). The DISCERN scores were consistently higher in human-generated patient information leaflets compared to AI-generated information across all procedures; the mean score for the information provided by ChatGPT was 50.3 vs. 56.0 for the Circulation Foundation information leaflets (SD=3.38, p<0.001). Conclusion We concluded that AI-generated information about vascular surgical procedures is currently poor in both the readability of text and the quality of information. Patients should be directed to reputable, human-generated information sources from trusted professional bodies to supplement direct education from the clinician during the pre-procedure consultation process.

Experimental Study of Aerodynamic Noise Source Measurement around an Automobile Door Mirror by Hot-film Sensor

In order to the evaluation and identification of the aerodynamic sound source generated from a door mirror of an automobile, the simple measurement technique using the film-type hot film sensor is proposed. In the wind tunnel test of the actual vehicle model, the feasibility on the qualitative evaluation of the aerodynamic sound sources with the hot film sensor is discussed experimentally. From the results of this experiment, author could explain that the low-frequency broadband noise is one of the features of its aerodynamic noise. The qualitative evaluation of the hot-film sensor indicated that the low-frequency aerodynamic noise is caused by fluctuations formed at the tips of the door mirrors. Although the location of the low-frequency broadband noise source was identified by evaluating the signal of the hot film sensor, the quantitatively evaluation of the strength of the aerodynamic sound source could not achieve.

Fluorescent actinometers for fast and simple quantitative measurement of light intensity.

Fluorescent actinometers for fast and simple quantitative measurement of light intensity.

A low-field ceramic magnet design for magnetic resonance

We describe the design of a low-field portable magnet, based on two ceramic magnets, separated by a distance, with their magnetic poles aligned to create a large homogeneous region with a field strength of 425 gauss. Ceramic magnets are an uncommon choice compared to Neodymium Iron Boron magnets for low-field magnetic resonance but are preferable for our purposes to create a homogeneous region at lower field strength. The low cost of large ceramic magnets results in an inexpensive design with a large measurement volume. The magnets rest in a 3D-printed structure, which allows for the magnets to be moved by hand so the experimentalist has control over the field topology. To test the utility of the design, we explored an Overhauser dynamic nuclear polarization experiment with an aqueous solution of 4-Hydroxy-TEMPO. We also explored a simple flow measurement employing the ceramic magnets at a 6-degree pitch, creating a 14.6 gauss/cm constant gradient.

Incidence, temporal trends and risk factors of puerperal infection in Mainland China: a meta-analysis of epidemiological studies from recent decade (2010–2020)

BackgroundPuerperal infection (PI) is a severe threat to maternal health. The incidence and risk of PI should be accurately quantified and conveyed for prior decision-making. This study aims to assess the quality of the published literature on the epidemiology of PI, and synthesize them to identify the temporal trends and risk factors of PI occurring in Mainland China.MethodsThis review was registered in PROSPERO (CRD42021267399). Putting a time frame on 2010 to March 2022, we searched Cochrane library, Embase, Google Scholar, MEDLINE, Web of Science, China biology medicine, China national knowledge infrastructure and Chinese medical current contents, and performed a meta-analysis and meta-regression to pool the incidence of PI and the effects of risk factors on PI.ResultsA total of 49 eligible studies with 133,938 participants from 17 provinces were included. The pooled incidence of PI was 4.95% (95%CIs, 4.46–5.43), and there was a statistical association between the incidence of PI following caesarean section and the median year of data collection. Gestational hypertension (OR = 2.14), Gestational diabetes mellitus (OR = 1.82), primipara (OR = 0.81), genital tract inflammation (OR = 2.51), anemia during pregnancy (OR = 2.28), caesarean section (OR = 2.03), episiotomy (OR = 2.64), premature rupture of membrane (OR = 2.54), prolonged labor (OR = 1.32), placenta remnant (OR = 2.59) and postpartum hemorrhage (OR = 2.43) have significant association with PI.ConclusionsMaternal infection remains a crucial complication during puerperium in Mainland China, which showed a nationwide temporal rising following caesarean section in the past decade. The opportunity to prevent unnecessary PI exists in several simple but necessary measures and it’s urgent for clinicians and policymakers to focus joint efforts on promoting the bundle of evidence-based practices.

The effect of microstructure and film composition on the mechanical properties of linear antenna CVD diamond thin films

This study reports the impact of film microstructure and composition on the Young’s modulus and residual stress in nanocrystalline diamond (NCD) thin films (≈250nm thick) grown on silicon substrates using a linear antenna microwave plasma-enhanced chemical vapor deposition (CVD) system. Combining laser acoustic wave spectroscopy to determine the elastic properties with simple wafer curvature measurements, a straightforward method to determine the intrinsic stress in NCD films is presented. Two deposition parameters are varied: (1) the substrate temperature from 400°C to 900°C, and (2) the [P]/[C] ratio from 0ppm to 8090ppm in the H2/CH4/CO2/PH3 diamond CVD plasma. The introduction of PH3 induces a transition in the morphology of the diamond film, shifting from NCD with larger grains to ultra-NCD with a smaller grain size, concurrently resulting in a decrease in Young’s modulus. Results show that the highest Young’s modulus of (1130±50)GPa for the undoped NCD deposited at 800°C is comparable to single crystal diamond, indicating that NCD with excellent mechanical properties is achievable with our process for thin diamond films. Based on the film stress results, we propose the origins of tensile intrinsic stress in the diamond films. In NCD, the tensile intrinsic stress is attributed to larger grain size, while in ultra-NCD films the tensile intrinsic stress is due to grain boundaries and impurities.

Matrix redox interference-free nanozyme-amplified detection of Hg2+ using thiol-modified phosphatase-mimetic nanoceria

Given heavy metals pose huge threats to ecological system and human health, it is significant to monitor them. With the favorable feature of catalytic signal amplification, redox-type nanozymes have been widely used to detect heavy metals. However, the presence of redox substances in samples can interfere with these catalytic reactions, impacting the accuracy and repeatability of detection. To avoid the situation, here we designed a non-redox nanozyme (3-mercaptopropionic acid modified nanoceria, MPA-CeO2) and developed a novel approach free from matrix redox interference to detect Hg2+. The well-dispersed MPA-CeO2 showed high and stable phosphatase-mimetic activity to catalyze the hydrolysis of colorless p-nitrophenyl phosphate (p-NPP) to yellow p-nitrophenol (p-NP). The addition of Hg2+ could bind specifically onto the MPA-CeO2 particles through S–Hg bond and cause the latter to aggregate, thereby suppressing the ability of MPA-CeO2 with shielded active surfaces to hydrolyze p-NPP. According to the simple principle, highly sensitive and specific colorimetric measurement of Hg2+ was achieved, and excellent reliability and practicability were demonstrated by real sample analysis. To our best knowledge, this study is the first one of detecting Hg2+ using phosphatase-mimicking nanozymes, and it will inspire the exploration of new analytical methods via designing non-redox nanozymes for various targets.

Explainable offline automatic signature verifier to support forensic handwriting examiners

Signature verification is a critical task in many applications, including forensic science, legal judgments, and financial markets. However, current signature verification systems are often difficult to explain, which can limit their acceptance in these applications. In this paper, we propose a novel explainable offline automatic signature verifier (ASV) to support forensic handwriting examiners. Our ASV is based on a universal background model (UBM) constructed from offline signature images. It allows us to assign a questioned signature to the UBM and to a reference set of known signatures using simple distance measures. This makes it possible to explain the verifier’s decision in a way that is understandable to non-experts. We evaluated our ASV on publicly available databases and found that it achieves competitive performance with state-of-the-art ASVs, even when challenging 1 versus 1 comparisons are considered. Our results demonstrate that it is possible to develop an explainable ASV that is also competitive in terms of performance. We believe that our ASV has the potential to improve the acceptance of signature verification in critical applications such as forensic science and legal judgments.

“Whenever I tell her to wear slippers, she turns a deaf ear. She never listens”: a qualitative descriptive research on the barriers to basic lymphedema management and quality of life in lymphatic filariasis patients in a rural block of eastern India

BackgroundChronic lymphatic filariasis patients in Bihar, India, need management of lymphedema to live a disability-free life. For patients who have recurrent attacks of acute dermato-lymphangio-adenitis (ADLA), World Health Organization (WHO) has recommended simple home-based measures that include maintaining hygiene, skin care, and limb movement. However, patients in rural areas are unable to adopt them, resulting in a vicious cycle of ADLA attacks. There might be multiple realities from patients’ and healthcare workers’ perspectives that were unexplored. Qualitative research was deemed best suitable to identify the barriers to carrying out home-based lymphedema practices that adversely affected quality of life.MethodsThe qualitative descriptive study was conducted in two villages in the rural field practice area under a tertiary care hospital in Bihar. Researchers purposively selected ten participants, including patients affected by lymphedema, their caregivers, the grassroots healthcare workers, and the block health manager. In-depth interviews were conducted using a semi-structured interview guide. Data were entered into QDA Miner Lite, where researchers did attribute, in-vivo, process, descriptive, emotion, and holistic coding, followed by content analysis, where categories and themes emerged from the codes.ResultsThree themes emerged: the inherent nature of disease, patient-related factors, and healthcare system-related factors. The fifteen identified barriers were low awareness, low adherence, low health-seeking behavior, poor personal hygiene, and categories like signs and symptoms, seasonal factors, hampered activities of daily living, hopelessness from not getting cured, psychosocial difficulty, lack of capacity building and receipt of incentives by healthcare workers, unavailability of laboratory diagnosis and management of complications at the facility, inconsistent drug supply, and no financial assistance.ConclusionsAccessibility to WaSH, regular training of home-based care, increasing the capacity and motivation of grassroots workers, and the generation of in-depth awareness among the patients are required to achieve the elimination of filariasis, with MMDP as a key component of that strategy for endemic districts across the whole country.Graphical

Optical system for precise isocenter measurement

Abstract Introduction: The geometrical precision of the machines is essential for effective and safe radiotherapy. Methods currently used for the measurement of the mechanical isocenter have many limitations. In this work, the optical system NaviRation for very precise measurement of mechanical accelerator isocenter is described. The results of the measurement of the isocenter for linear accelerator are also presented. Materials and methods: An optical system for measuring the accelerator isocenter was designed and built. The optical system consists of two cameras recording the target position made according to a patented Zeiss technology. About 1,200 pairs of images are recorded during the rotation of the gantry, collimator and treatment table. Mathematical analysis of these images makes it possible to determine the location of the target center during rotation. In order to verify the accuracy of the measurements, a device simulating rotational motion was designed. The measurement results were also verified at the Central Office of Measures. The system must be calibrated each time before taking measurements. In this article, we present the results of measurements for the Versa HD accelerator. Results: The accuracy of determining the current position of the axis of rotation was 0.15 mm. The time of taking measurements of all rotations does not exceed 20 minutes. Measurement results for the Versa HD accelerator showed that this accelerator met the criteria described by TG142 of the AAPM. The diameter of the gantry, collimator and table isocenter spheres were 1.5 mm, 0.3 mm and 0.4 mm, respectively. Conclusions: The system enables precise, fast and simple mechanical isocenter measurement of the gantry, collimator and treatment table. It is also possible to perform all tests related to the measurements of distances, e.g. quality control of distance indicator, and distance of the table movement. The isocenter is measured independently of the accelerator for which measurements are made.