Search results for: breast board

Authors: Jinsiang Shaw, Sheng-Xiang Xu

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This paper presents the development of an autonomous automated guided vehicle (AGV) with a robot arm attached on top of it within the framework of robot operation system (ROS). ROS can provide libraries and tools, including hardware abstraction, device drivers, libraries, visualizers, message-passing, package management, etc. For this reason, this AGV can provide automatic navigation and parts transportation and pick-and-place task using robot arm for typical industrial production line use. More specifically, this AGV will be controlled by an on-board host computer running ROS software. Command signals for vehicle and robot arm control and measurement signals from various sensors are transferred to respective microcontrollers. Users can operate the AGV remotely through the TCP / IP protocol and perform SLAM (Simultaneous Localization and Mapping). An RGBD camera and LIDAR sensors are installed on the AGV, using these data to perceive the environment. For SLAM, Gmapping is used to construct the environment map by Rao-Blackwellized particle filter; and AMCL method (Adaptive Monte Carlo localization) is employed for mobile robot localization. In addition, current AGV position and orientation can be visualized by ROS toolkit. As for robot navigation and obstacle avoidance, A* for global path planning and dynamic window approach for local planning are implemented. The developed ROS AGV with a robot arm on it has been experimented in the university factory. A 2-D and 3-D map of the factory were successfully constructed by the SLAM method. Base on this map, robot navigation through the factory with and without dynamic obstacles are shown to perform well. Finally, pick-and-place of parts using robot arm and ensuing delivery in the factory by the mobile robot are also accomplished.

Keywords: automated guided vehicle, navigation, robot operation system, Simultaneous Localization and Mapping

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Authors: Jinlu Sun, Shouxiang Lu, Siuming Lo

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Large passenger ship, especially luxury cruise, is one of the most prevalent means of marine transportation and tourism nowadays. In case of an accident, an effective evacuation would be the ultimate way to minimize the consequence. Ship heeling and trim has a considerable influence on passenger walking speed and posture during ship evacuation. To investigate passenger movement pattern under the combined effect of ship heeling and trim, a ship corridor simulator was developed. Both fast and freely individual walking experiments by male and female experimental subjects under heeling and trim conditions were conducted and recorded therein. It is found that routes of experimental subjects would change due to the heeling and trim angles, although they always walk along the right side because of cultural factors. Experimental subjects would also change their posture to adapt the combined heeling and trim conditions, such as leaning forward, adopting larger arm swaying, shorter and more frequent steps. While for individual walking speed, the speed would decrease with the increasing heeling and trim angles. But the maximum individual walking speed is achieved at heeling angle of 0° with trim angle ranging from -15° to -5 °, instead of on level ground, which may be attributable to the effect of the gravitational acceleration. Female is approximately 10% slower than male due to the discrepancy in physical quality. Besides, individual walking speed shows similar trends in both fast and freely walking modes, and the speed value in freely walking mode is about 78% of that in fast walking mode under each experimental condition. Furthermore, to designate the movement pattern of passengers in heeling and trim conditions, a model of the walking speed reduction was proposed. This work would provide guidance on the development of evacuation models and the design of evacuation facilities on board.

Keywords: evacuation, heeling, individual walking speed, ship corridor simulator, trim

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Authors: Govind Ji Pandey

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The divergent opinions in the society are important for its development but with reasonable restrictions. The world recently witnessed one of the most violent protests by a group against the editor and publisher of the magazine ‘Charlie Hebdo’ for publishing cartoon of their religious leader. The supporter of freedom of speech and expression around the world were in shock and termed it the strongest attack against the free speech. People all around the world condemned the killing of the journalists but many soft voices from several corners were also coming for reasonable restrictions on the freedom of speech and expression. Of late, Indian society has witnessed many protests and supports of films with controversial content. It is the beauty of the Indian democracy which gives an opportunity to all for discussion and debate on any issue that challenges established social norms. However, many organizations as well as individuals misuse it for their personal benefits. There have been many film directors who faced protest from several quarters for their controversial themes. This research aims at analyzing the controversial contents published in print media and shown in films. To understand the nature and frequency of such media reports, content analysis technique is used. The research also highlights the perception of the public regarding the controversies. For getting the popular opinion on the coverage of controversial content in cinema and print media, five hundred people from Lucknow, UP, India were randomly selected. The findings of this research are important to understand the response of media and society towards the controversial content presented in cinema and print media. The research highlights that how a handful of people curb free speech in a democratic country like India.

Keywords: cinema, censor board, free speech, liberty, social-religious beliefs

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Authors: Akram Boubakri, Fethi Choubani, Tan Hoa Vuong, Jacques David

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Nowadays, microwave hyperthermia is considered as an effective treatment for the malignant tumors. This microwave treatment which comes to substitute the chemotherapy and the surgical intervention enables an in-depth tumor heating without causing any diseases to the sane tissue. This technique requires a high precision system, in order to effectively concentrate the heating just in the tumor, without heating any surrounding healthy tissue. In the hyperthermia treatment, the temperature in cancerous area is typically raised up to over 42◦C and maintained for one hour in order to destroy the tumor sufficiently, whilst in the surrounding healthy tissues, the temperature is maintained below 42◦C to avoid any damage. Metamaterial lenses are widely used in medical applications like microwave hyperthermia treatment. They enabled a subdiffraction resolution thanks to the amplification of the evanescent waves and they can focus electromagnetic waves from a point source to a point image. Metasurfaces have been used to built metamaterial lenses. The main mechanical advantages of those structures over three dimensional material structures are ease of fabrication and a smaller required volume. Here in this work, we proposed a metasurface based lens operating at the frequency of 6 GHz and designed for microwave hyperthermia. This lens was applied and showed good results in focusing and heating the tumor inside a breast tissue with an increased and maintained temperature above 42°C. The tumor was placed in the focal distance of the lens so that only the tumor tissue will be heated. Finally, in this work, it has been shown that the hyperthermia area within the tissue can be carefully adjusted by moving the antennas or by changing the thickness of the metamaterial lenses based on the tumor position. Even though the simulations performed in this work have taken into account an ideal case, some real characteristics can be considered to improve the obtained results in a realistic model.

Keywords: focusing, hyperthermia, metamaterial lenses, metasurface, microwave treatment

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Authors: Joshna Rani S., Ahmadi Banu

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Artificial Intelligence (AI) has a significant task to carry out in the medical care contributions of things to come. As AI, it is the essential capacity behind the advancement of accuracy medication, generally consented to be a painfully required development in care. Albeit early endeavors at giving analysis and treatment proposals have demonstrated testing, we anticipate that AI will at last dominate that area too. Given the quick propels in AI for imaging examination, it appears to be likely that most radiology, what's more, pathology pictures will be inspected eventually by a machine. Discourse and text acknowledgment are now utilized for assignments like patient correspondence and catch of clinical notes, and their utilization will increment. The best test to AI in these medical services areas isn't regardless of whether the innovations will be sufficiently skilled to be valuable, but instead guaranteeing their appropriation in day by day clinical practice. For far reaching selection to happen, AI frameworks should be affirmed by controllers, coordinated with EHR frameworks, normalized to an adequate degree that comparative items work likewise, instructed to clinicians, paid for by open or private payer associations, and refreshed over the long haul in the field. These difficulties will, at last, be survived, yet they will take any longer to do as such than it will take for the actual innovations to develop. Therefore, we hope to see restricted utilization of AI in clinical practice inside 5 years and more broad use inside 10 years. It likewise appears to be progressively evident that AI frameworks won't supplant human clinicians for a huge scope, yet rather will increase their endeavors to really focus on patients. Over the long haul, human clinicians may advance toward errands and work plans that draw on remarkably human abilities like sympathy, influence, and higher perspective mix. Maybe the lone medical services suppliers who will chance their professions over the long run might be the individuals who will not work close by AI

Keywords: artificial intellogence, health care, breast cancer, AI applications

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Authors: Eny Suastuti

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This paper is about state’s capital equity in establishing State-owned Company (PT Merpati Persero). Under private law regime, PT Merpati Persero equity is a state asset allocated separately from the State Budget. Consequently, it is no longer a state asset; rather, it becomes a part of company assets. The adoption of Act No. 17 of 2003 on State Finance, Act No. 31 of 1999, which is amended by Act No. 20 of 2001 on Eradication of Corrupt Practices, Act No. 15 of 2004 on Auditing, Management, and Accountability of State Finance, and Act No. 15 of 2006 Audit Board raises legal issues of whether State-owned Company’s (PT Merpati Persero) loss may be deemed as loss on state finance made by the Directors of PT Merpati Persero, which implication leads to corrupt practices conducted by the Directors. The principle of civil law states that state assets are separated from the state budget is not a government asset. Therefore the case of a lease agreement 2 (two) units of Boeing 737-400 and Boeing 737-500 between PT Merpati Nusantara Airlines with companies Third Stone Aircraft Leasing Group (TALG) the United States cannot be prosecuted under Articles 2 and 3 of Act No. 31 of 1999 Jo Act No. 20 of 2001 on Eradication of Corrupt Practices (Law PTPK). From this paper, three things are found. First, state’s capital equity, which has been allocated separately from state assets in establishing the PT Merpati Perserois not state asset; rather, it is company’s asset. Second, in the case of mismanagement leading to company loss, the Directors of PT Merpati Persero may not be charged with committing corrupt practice as prescribed in Articles 2 and 3 of Corrupt Practices Eradication Law. Third, misperception has been made by judicial practices since the courts consider loss in certain transaction made by Directors of PT Merpati Persero to be loss of state finance whose implication is applicability of Articles 2 and 3 of Corrupt Practices Eradication Law.

Keywords: corrupt practice, loss, state's capital equity, state finance (PT Merpati Persero)

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Authors: Ivana Hrebickova, Maria Sevcikova, Romana Slamberova

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The present study was aimed at evaluation of cognitive changes following scheduled neonatal methamphetamine exposure in combination with long-term exposure in adulthood of female Wistar rats. Pregnant mothers were divided into two groups: group with indirect exposure (methamphetamine in dose 5 mg/ml/kg, saline in dose 1 ml/kg) during early lactation period (postnatal day 1–11) - progeny of these mothers were exposed to the effects of methamphetamine or saline indirectly via the breast milk; and the second group with direct exposure – all mothers were left intact for the entire lactation period, while progeny was treated with methamphetamine (5 mg/ml/kg) by injection or the control group, which was received needle pick (shame, not saline) at the same time each day of period of application (postnatal day 1–11). Learning ability and memory consolidation were tested in the Morris Water Maze, which consisted of three types of tests: ‘Place Navigation Test ‘; ‘Probe Test ‘; and ‘Memory Recall Test ‘. Adult female progeny were injected daily, after completion last trial with saline or methamphetamine (1 mg/ml/kg). We compared the effects of indirect/direct neonatal methamphetamine exposure and adult methamphetamine treatment on cognitive function of female rats. Statistical analyses showed that neonatal methamphetamine exposure worsened spatial learning and ability to remember the position of the platform. The present study demonstrated that direct methamphetamine exposure has more significant impact on process of learning and memory than indirect exposure. Analyses of search strategies (thigmotaxis, scanning) used by females during the Place Navigation Test and Memory Recall Test confirm all these results.

Keywords: methamphetamine, Morris water maze, neonatal exposure, strategies, Wistar rats

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Authors: Thais Cavalheri Santos, Pedro Jose Gabriel Ferreira, Alexandre Daliberto Frugoli, Lucio Leonardo, Pedro Americo Frugoli

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This paper presents a low cost education proposal to be used in engineering courses. The engineering education in universities of a developing country that is in need of an increasing number of engineers carried out with quality and affordably, pose a difficult problem to solve. In Brazil, the political and economic scenario requires academic managers able to reduce costs without compromising the quality of education. Within this context, the elaboration of a physics principles teaching method with the construction of an electronic balance is proposed. First, a method to develop and construct a load cell through which the students can understand the physical principle of strain gauges and bridge circuit will be proposed. The load cell structure was made with aluminum 6351T6, in dimensions of 80 mm x 13 mm x 13 mm and for its instrumentation, a complete Wheatstone Bridge was assembled with strain gauges of 350 ohms. Additionally, the process involves the use of a software tool to document the prototypes (design circuits), the conditioning of the signal, a microcontroller, C language programming as well as the development of the prototype. The project also intends to use an open-source I/O board (Arduino Microcontroller). To design the circuit, the Fritizing software will be used and, to program the controller, an open-source software named IDE®. A load cell was chosen because strain gauges have accuracy and their use has several applications in the industry. A prototype was developed for this study, and it confirmed the affordability of this educational idea. Furthermore, the goal of this proposal is to motivate the students to understand the several possible applications in high technology of the use of load cells and microcontroller.

Keywords: Arduino, load cell, low-cost education, strain gauge

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Authors: Claire Norman-Maillet

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Insider fraud is a major financial crime threat whereby an employee defrauds (or attempts to defraud) their current, prospective, or past employer. ‘Employee’ covers anyone employed by the company, including Board members and part-time staff. Insider fraud can take many forms, including an employee working alone or in collusion with others. Insider fraud has been on the rise since the Coronavirus pandemic and shows no signs of slowing. The objective of the research is to better understand how FinTechs are impacted by insider fraud and, therefore, how to stop it. This research will make an original contribution to the financial crime field, given the timing of this research being intertwined with the cost-of-living crisis in the UK and the global Coronavirus pandemic. This research focuses on insider fraud within FinTechs specifically, as they are arguably a modern phenomenon in the financial institutions space and have cutting-edge technology at their disposal. To achieve the research objective, the researcher held semi-structured interviews with over 20 individuals who deal with insider fraud perpetration in a practitioner, recruitment, or advisory capacity. The interviews were subsequently transcribed and analysed thematically. Main findings in the research suggest that FinTechs are arguably in the best position to combat insider fraud, given their focus on using recent technologies, as this can be used to combat the threat. However, insider fraud has been ignored owing to the denial of accepting the possibility that colleagues would defraud their employer, as well as the idea that external fraud is the most important threat. The research concludes that, whilst the technology is understandably prioritised by FinTechs for providing an agreeable customer experience, insider fraud needs to be given a platform upon which to be recognised as a significant threat to any company. Moreover, insider fraud needs to be given the same level of weighting and attention by Executive Committees and Boards as the customer experience.

Keywords: insider fraud, occupational fraud, COVID-19, COVID, Coronavirus, pandemic, internal fraud, financial crime, economic crime

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Authors: Rosana Goncalves Das Dores, Maira Fonseca, Fernando Finger, Vicente Casali

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Equisetum hyemale L. (horsetail, Equisetaceae) is a medicinal plant used and commercialized in simple paper bags or non-ecological packaging in Brazil. The aim of this work was to evaluate the relation between the bioactive compounds of horsetail stems stored in ecological packages (multi-ply paper sacks) at room temperature. Stems in primary and secondary stage were harvested from an organic estate, on December 2016, selected, measured (length from the soil to the apex (cm), stem diameter at ground level (DGL mm) and breast height (DBH mm) and cut into 10 cm. For the post-harvest evaluations, stems were stored in multi-ply paper sacks and evaluated daily to the respiratory rate, fresh weight loss, pH, presence of fungi / mold, phenolic compounds and antioxidant activity. The analyses were done with four replicates, over time (regression) and compared at 1% significance (Tukey test). The measured heights were 103.7 cm and 143.5 cm, DGL was 2.5mm and 8.4 mm and DBH of 2.59 and 6.15 mm, respectively for primary and secondary stems stage. At both stages of development, in storage in multi-ply paper sacks, the greatest mass loss occurred at 48 h, decaying up to 120 hours, stabilizing at 192 hours. The peak respiratory rate increase occurred in 24 hours, coinciding with a change in pH (temperature and mean humidity was 23.5°C and 55%). No fungi or mold were detected, however, there was loss of color of the stems. The average yields of ethanolic extracts were equivalent (approximately 30%). Phenolic compounds and antioxidant activity were higher in secondary stems stage in up to 120 hours (AATt0 = 20%, AATt30 = 45%), decreasing at the end of the experiment (240 hours). The packaging used allows the commercialization of fresh stems of Equisetum for up to five days.

Keywords: paper sacks, phenolic content, antioxidant activity, medicinal plants, post-harvest, ecological packages, Equisetum

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Authors: Abdullah Almulhim

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The International Accounting Standards Board (IASB) was established in 2001 to develop International Financial Reporting Standards (IFRS) that bring transparency, accountability, and efficiency to financial markets around the world. In addition, the IFRS provide a unified accounting language, which is especially important in the era of globalization. However, the establishment of a single set of high-quality international accounting standards is a matter of growing importance, as participants in the increasingly integrated world capital market demand comparability and transparency of financial reporting worldwide. Saudi Arabia became the 149th member of the World Trade Organization (WTO) on 11 December 2005, which has increased the need to convert to IFRS. Currently, the Saudi Arabian Monetary Authority (SAMA) requires banks and insurance companies in Saudi Arabia to report under IFRS Standards. However, until the end of 2016, SOCPA standards were applied to all other companies, listed and unlisted. From 2017, listed Saudi companies would be required to report under IFRS Standards as adopted by SOCPA effective 2017. This paper is to investigate the expected benefits gained and highlight the challenges faced by adopting IFRS by the listed companies in the Saudi Stock Exchange. Questionnaires were used as the main method of data collection. They were distributed to listed companies in the Saudi Capital Market. Data obtained through the questionnaires have been imported into SPSS statistical software for analysis. The expected results of this study will show the benefits of adopting IFRS by Saudi Listed Companies. However, this study will investigate the challenges faced by adopting IFRS by the listed companies in the Saudi Arabian Stock Market. Findings will be discussed later upon completion of initial analysis.

Keywords: challenges, IAS, IFRS, opportunities, Saudi, SOCPA

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Authors: Magdy Roman, Mostafa Shoeib, Mostafa Rostom

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Global vision, whether provided by overhead fixed cameras, on-board aerial vehicle cameras, or satellite images can always provide detailed information on the environment around mobile robots. In this paper, an intelligent vision-based method of path planning and obstacle avoidance for mobile robots is presented. The method integrates visual perception with a new proposed field-based path-planning method to overcome common path-planning problems such as local minima, unreachable destination and unnecessary lengthy paths around obstacles. The method proposes an exponential angle deviation field around each obstacle that affects the orientation of a close robot. As the robot directs toward, the goal point obstacles are classified into right and left groups, and a deviation angle is exponentially added or subtracted to the orientation of the robot. Exponential field parameters are chosen based on Lyapunov stability criterion to guarantee robot convergence to the destination. The proposed method uses obstacles' shape and location, extracted from global vision system, through a collision prediction mechanism to decide whether to activate or deactivate obstacles field. In addition, a search mechanism is developed in case of robot or goal point is trapped among obstacles to find suitable exit or entrance. The proposed algorithm is validated both in simulation and through experiments. The algorithm shows effectiveness in obstacles' avoidance and destination convergence, overcoming common path planning problems found in classical methods.

Keywords: path planning, collision avoidance, convergence, computer vision, mobile robots

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Authors: Jobo Dubihlela, Kofi Boamah

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The inimitable role of the internal auditing, challenges and the predicament of state-owned enterprises in emerging markets are acknowledged. Study sought to address the inter-related questions, about how does IAF complement the performance and sustainability of SOEs? How can effective IA control systems be implemented to improve the performance results and culture of SOEs in Namibia? The weaknesses inherent in the SOE sector, unfortunately, impacts on the IAF ability to effectively support the SOEs. Despite these challenges, the study has unearthed IAF potential capabilities to contribute to SOE survival in Namibia by complementing the governance practices of the sector. Using a quantitative research approach, the dataset was collected and analysed from SOEs to confirm the role of the internal auditing function (IAF) as an indispensable concomitant of SOE performance. The study adopted a data approach supported by the literary evidence, which enabled generalisation and connectedness of the issues being addressed. The outcome of the data analysis contributed to achieving the results, which are discussed and eventually support the conclusions reached. Results show that the intractable task of internal auditing depends on the leadership of the board of directors of the SOEs. Study also revealed critical priorities needed to influence policymakers and oversight bodies to overcome the iniquities influencing SOE operations, understand and embrace IAF to salvage a sector that has a lot to offer and yet is severely mismanaged. Results support literature on IA’s contribution to SOE development from a developing country’s point of view and is the first of its kind in Namibia. Findings suggest ways to possibly enhance knowledge development of future researchers and ‘wet their appetite’ for further research in emerging markets and on a global scale.

Keywords: internal auditing activity, state-owned enterprises, emerging markets, auditing function

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Authors: Mark Joseph Quinto, Roan Beronilla, Guiller Damian, Eliza Camaso, Ronaldo Alberto

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Forest inventories are essential to assess the composition, structure and distribution of forest vegetation that can be used as baseline information for management decisions. Classical forest inventory is labor intensive and time-consuming and sometimes even dangerous. The use of Light Detection and Ranging (LiDAR) in forest inventory would improve and overcome these restrictions. This study was conducted to determine the possibility of using LiDAR derived data in extracting high accuracy forest biophysical parameters and as a non-destructive method for forest status analysis of San Manual, Pangasinan. Forest resources extraction was carried out using LAS tools, GIS, Envi and .bat scripts with the available LiDAR data. The process includes the generation of derivatives such as Digital Terrain Model (DTM), Canopy Height Model (CHM) and Canopy Cover Model (CCM) in .bat scripts followed by the generation of 17 composite bands to be used in the extraction of forest classification covers using ENVI 4.8 and GIS software. The Diameter in Breast Height (DBH), Above Ground Biomass (AGB) and Carbon Stock (CS) were estimated for each classified forest cover and Tree Count Extraction was carried out using GIS. Subsequently, field validation was conducted for accuracy assessment. Results showed that the forest of San Manuel has 73% Forest Cover, which is relatively much higher as compared to the 10% canopy cover requirement. On the extracted canopy height, 80% of the tree’s height ranges from 12 m to 17 m. CS of the three forest covers based on the AGB were: 20819.59 kg/20x20 m for closed broadleaf, 8609.82 kg/20x20 m for broadleaf plantation and 15545.57 kg/20x20m for open broadleaf. Average tree counts for the tree forest plantation was 413 trees/ha. As such, the forest of San Manuel has high percent forest cover and high CS.

Keywords: carbon stock, forest inventory, LiDAR, tree count

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Authors: Dilliram Paudyal

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The history of taxation in Nepal dates back to antiquity. However, the modern tax system gained its momentum after the establishment of democracy in 1951, which initially focused only land tax and tariff on foreign trade. In the due time, several taxes were introduced, such as direct taxes, indirect taxes, and non-taxes. However, the tax structure in Nepal is heavily dominated by indirect taxes that contribute more than 60 % of the total revenue. The government has been mobilizing revenues through a series of tax reforms during the Tenth Five-year Plan (2002 – 2007) and successive Three-year Interim Development Plans by introducing several tax measures. However, these reforms are regressive in nature, which does not lead the overall economy towards short-run stability as well as in the long run development. Based on the literature review and discussion among government officials and few taxpayers individually and groups, this paper aims to major issues and challenges that hinder the tax reform effective in Nepal. Additionally, this paper identifies potential way and process of tax reform in Nepal. The results of the study indicate that transparency in a major problem in Nepalese tax system in Nepal, where serious structural constraints with administrative and procedural complexities envisaged in the Income Tax Act and taxpayers are often unaware of the specific size of tax which is to comply them. Some other issues include high tax rate, limited tax base, leakages in tax collection, rigid and complex Income Tax Act, inefficient and corrupt tax administration, limited potentialities of direct taxes and negative responsiveness of land tax with higher administrative costs. In the context, modality of tax structure and mobilize additional resources is to be rectified on a greater quantum by establishing an effective, dynamic and highly power driven Autonomous Revenue Board.

Keywords: corrupt, development, inefficient, taxation

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Authors: Amit Kumar

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Accurate identification of deteriorated air quality regions is very helpful in devising better environmental practices and mitigation efforts. In the present study, an attempt has been made to identify the air pollutant dispersion patterns especially NOX due to vehicular and industrial sources over a rapidly developing urban city, Visakhapatnam (17°42’ N, 83°20’ E), India, during April 2009. Using the emission factors of different vehicles as well as the industry, a high resolution 1 km x 1 km gridded emission inventory has been developed for Visakhapatnam city. A dispersion model AERMOD with explicit representation of planetary boundary layer (PBL) dynamics and offline coupled through a developed coupler mechanism with a high resolution mesoscale model WRF-ARW resolution for simulating the dispersion patterns of NOX is used in the work. The meteorological as well as PBL parameters obtained by employing two PBL schemes viz., non-local Yonsei University (YSU) and local Mellor-Yamada-Janjic (MYJ) of WRF-ARW model, which are reasonably representing the boundary layer parameters are considered for integrating AERMOD. Significantly different dispersion patterns of NOX have been noticed between summer and winter months. The simulated NOX concentration is validated with available six monitoring stations of Central Pollution Control Board, India. Statistical analysis of model evaluated concentrations with the observations reveals that WRF-ARW of YSU scheme with AERMOD has shown better performance. The deteriorated air quality locations are identified over Visakhapatnam based on the validated model simulations of NOX concentrations. The present study advocates the utility of tNumerical Simulation of Air Pollutant Using Coupled AERMOD-WRF Modeling System over Visakhapatnam: A Case Studyhe developed gridded emission inventory of NOX with coupled WRF-AERMOD modeling system for air quality assessment over the study region.

Keywords: WRF-ARW, AERMOD, planetary boundary layer, air quality

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Authors: Chodidjah, Edi Dharmana, Hardhono, Sarjadi

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Breast cancer treatment options including surgery, radiation therapy, chemotherapy, and immunotherapy have not been effective. Besides, they have side effects. Keladi Tikus (Typhonium flagelliforme) has been shown to improve immune system, suppress tumor growth and induce apoptosis. One of the parameters for immune system, tumor growth and apoptosis is IFNγ (Interferon γ), VEGF (Vascular Endothelial Growth Factor) and Caspase 3 respectively. The aim of this study was to examine the effect of the administration of Keladi Tikus tuber extract at the dose of 200 mg/kgBW, 400 mg/KgBW, and 800 mg/kgBW on the level of IFNγ, VEGF and caspase 3 expression. In this experimental study using post test randomized control group design, 24 CH3 mice with tumor were randomly divided into 4 groups including control group and treated groups: Treated with 0.2 cc extract of Keladi Tikus at the dose of 200 mg/kgBW, 400 mg/kgBW, 800 mg/kgBW, respectively for 30 days. On day 31 the lymphatic tissue was taken and evaluated for its level of IFNγ, using ELISA. The tumor tissue was taken and subjected to immunohistochemistry staining for VEGF and caspase 3 expression evaluation. The data on IFNγ, VEGF and Caspase 3 expression were analyzed using One Way Anova with significant level of 0.05. One Way Anova resulted in p<0.05. LSD test showed that the level of IFNγ and Caspase 3 for control group was different from that of treated groups. There was no significant different between the treated group of 400 mg/KgBW and 800mg/KgBW. VEGF expressions for all the treated groups were significant. In conclusion, the oral administration of ethanolic extract of Keladi Tikus (Typhonium flagelliforme) at the dose of 200mg/kgBW, 400 mg/kgBW,800 mg/kgBW increases IFNγ, Caspase 3 and decreases VEGF expression in C3H mice with adenocarsinoma mamma.

Keywords: Typhonium flagelliforme, IFNγ, caspase 3, VEGF

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Authors: Mualla McManus, Jenna Luche Thaye

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World Health Organisation International Classification of Disease codes were created to define disease including infections in order to guide and educate diagnosticians. Most infectious diseases such as syphilis are clearly defined by their ICD 10 codes and aid/help to educate the clinicians in syphilis diagnosis and treatment globally. However, current ICD 10 codes for relapsing fever Borreliosis and Lyme disease are less clearly defined and can impede appropriate diagnosis especially if the clinician is not familiar with the symptoms of these infectious diseases. This is despite substantial number of scientific articles published in peer-reviewed journals about relapsing fever and Lyme disease. In the USA there are estimated 380,000 people annually contacting Lyme disease, more cases than breast cancer and 6x HIV/AIDS cases. This represents estimated 0.09% of the USA population. If extrapolated to the global population (7billion), 0.09% equates to 63 million people contracting relapsing fever or Lyme disease. In many regions, the rate of contracting some form of infection from tick bite may be even higher. Without accurate and appropriate diagnostic codes, physicians are impeded in their ability to properly care for their patients, leaving those patients invisible and marginalized within the medical system and to those guiding public policy. This results in great personal hardship, pain, disability, and expense. This unnecessarily burdens health care systems, governments, families, and society as a whole. With accurate diagnostic codes in place, robust data can guide medical and public health research, health policy, track mortality and save health care dollars. Better defined ICD codes are the way forward in educating the diagnosticians about relapsing fever and Lyme diseases.

Keywords: WHO ICD codes, relapsing fever, Lyme diseases, World Health Organisation

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Authors: Nurunnahar Akter, Elena Kulinskaya, Nicholas Steel, Ilyas Bakbergenuly

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Although Hormone Replacement Therapy (HRT) is an effective treatment in ameliorating menopausal symptoms, it has mixed effects on different health outcomes, increasing, for instance, the risk of breast cancer. Because of this, many symptomatic women are left untreated. Untreated menopausal symptoms may result in other health issues, which eventually put an extra burden and costs to the health care system. All-cause mortality analysis may explain the net benefits and risks of the HRT therapy. However, it received far less attention in HRT studies. This study investigated the impact of HRT on all-cause mortality using electronically recorded primary care data from The Health Improvement Network (THIN) that broadly represents the female population in the United Kingdom (UK). The study entry date for this study was the record of the first HRT prescription from 1984, and patients were followed up until death or transfer to another GP practice or study end date, which was January 2017. 112,354 HRT users (cases) were matched with 245,320 non-users by age at HRT initiation and general practice (GP). The hazards of all-cause mortality associated with HRT were estimated by a parametric Weibull-Cox model adjusting for a wide range of important medical, lifestyle, and socio-demographic factors. The multilevel multiple imputation techniques were used to deal with missing data. This study found that during 32 years of follow-up, combined HRT reduced the hazard ratio (HR) of all-cause mortality by 9% (HR: 0.91; 95% Confidence Interval, 0.88-0.94) in women of age between 46 to 65 at first treatment compared to the non-users of the same age. Age-specific mortality analyses found that combined HRT decreased mortality by 13% (HR: 0.87; 95% CI, 0.82-0.92), 12% (HR: 0.88; 95% CI, 0.82-0.93), and 8% (HR: 0.92; 95% CI, 0.85-0.98), in 51 to 55, 56 to 60, and 61 to 65 age group at first treatment, respectively. There was no association between estrogen-only HRT and women’s all-cause mortality. The findings from this study may help to inform the choices of women at menopause and to further educate the clinicians and resource planners.

Keywords: hormone replacement therapy, multiple imputations, primary care data, the health improvement network (THIN)

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Authors: R. M. Rajapaksa

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Construction industry is one of the key players in driving the economy of a country to achieve its prosperity. However, a dispute is one of the crucial factors which prevent the completion of construction contracts within the budgeted cost, scheduled time, and accepted quality. Disputes are inevitable in the construction contract. Accordingly, a study has been undertaken to identify the factors affecting contractual disputes in construction projects in Sri Lanka. The study was a mixed approach with major qualitative and minor quantitative. Qualitative study was set in the form of in-depth interviews with eighteen participants, and quantitative study was conducted using a questionnaire with twenty-four respondents from previously implemented projects by the National Water Supply & Drainage Board representing the employer, engineer and the Contractor to identify the factors affecting contractual disputes and to verify most critical factors respectively. Data analysis for qualitative and quantitative studies was carried out by means of transcribing, code & categorizeand average score methods, respectively. The study reveals that there are forty factors affecting the contractual disputes in construction contracts in Sri Lanka. The finding further illustrates that conflicting decisions by inexperience personnel in the higher position of the Employer, ambiguities resulting inadequate descriptions of the preliminary/general items in price schedule, unfair valuation and late confirmation of variations, unfair determination due to lack of experience of the Engineer/Consultant, under certification of progress payments, unfair grant of EOT & application of delay damages, unreasonable claims for variation of works, errors/discrepancies/ambiguities in the contract conditions and discrepancies & errors in designs & specifications are the most critical factors affecting contractual disputes. Finally, the study proposed remedial measures to most critical factors affecting contractual disputes.

Keywords: dispute, contractual, factors, employer, engineer, contractor, construction projects

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Authors: Lin Feng, Ling-Ling E., Hong-Chen Liu

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The development of chemoresistance in patients represents a major challenge in cancer treatment. Lactate dehydrogenase‑A (LDHA) is one of the principle isoforms of LDH that is expressed in breast tissue, controlling the conversion of pyruvate to lactate and also playing a significant role in the metabolism of glucose. The aim of this study was to identify whether LDHA was involved in oral cancer cell resistance to Taxol and whether the downregulation of LDHA, as a result of cisplatin treatment, may overcome Taxol resistance in human oral squamous cells. The OECM‑1 oral epidermal carcinoma cell line was used, which has been widely used as a model of oral cancer in previous studies. The role of LDHA in Taxol and cisplatin resistance was investigated and the synergistic cytotoxicity of cisplatin and/or Taxol in oral squamous cells was analyzed. Cell viability was analyzed by MTT assay, LDHA expression was analyzed by western blot analysis and siRNA transfection was performed to knock down LDHA expression. The present study results showed that decreased levels of LDHA were responsible for the resistance of oral cancer cells to cisplatin (CDDP). CDDP treatments downregulated LDHA expression and lower levels of LDHA were detected in the CDDP‑resistant oral cancer cells compared with the CDDP‑sensitive cells. By contrast, the Taxol‑resistant cancer cells showed elevated LDHA expression levels. In addition, small interfering RNA‑knockdown of LDHA sensitized the cells to Taxol but desensitized them to CDDP treatment while exogenous expression of LDHA sensitized the cells to CDDP, but desensitized them to Taxol. The present study also revealed the synergistic cytotoxicity of CDDP and Taxol for killing oral cancer cells through the inhibition of LDHA. This study highlights LDHA as a novel therapeutic target for overcoming Taxol resistance in oral cancer patients using the combined treatments of Taxol and CDDP.

Keywords: cisplatin, Taxol, carcinoma, oral squamous cells

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Authors: Kyung-Sook Bang

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Background: The health status of school-age children has a great influence on their growth and life-long health. The purposes of this study were to identify physical and mental health status of late school-age children in Seoul, South Korea and to investigate the related factors for their health. Methods: After gaining the approval from Institutional Review Board (IRB), a cross-sectional study was conducted with elementary students in grade 4 or 5. Questionnaires were distributed to eight elementary schools located different regions of Seoul in November, 2016, and 302 participants were finally included. From all participants, informed consents from the parents, and assents from children were received. Children's socioeconomic status, family functioning, peer relations, physical health symptoms, and depression were measured with self-reported questionnaires. Data were analyzed with descriptive statistics, t-test, Pearson’s correlations, and multiple regression. Results: Children's physical health symptoms and depression were not significantly different, and only their peer relations were significantly different according to their socioeconomic status (t=-3.93, p<.001). Depression showed significant positive correlation with physical health symptoms (r=.720, p<.001) and negative correlations with family functioning (r=-.428, p<.001) and peer relations (r=-.775, p<.001). The multiple regression model, which explained 73.5% of variance, showed peer relations (r2 =.604), physical health symptoms (r2 change=.125), and family functioning (r2 change=.005) as significant predictors for depression. Only the peer relations was significant predictor for their physical health symptoms and explained 50.6% of it. Conclusions: The peer relations was the most important factor in their physical and mental health at this age, and it can be affected by their socioeconomic status. Nursing interventions for promoting social relations and family functioning are required to improve children’s physical and mental health, especially for vulnerable population.

Keywords: child, depression, health, peer relation

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Authors: Roohallah Fallah-Moshkani, Mohammad Ali Mohsenpour, Reza Ghiasvand, Hossein Khosravi-Boroujeni, Seyed Mehdi Ahmadi, Paula Brauer, Amin Salehi-Abargouei

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Purpose: Several investigations have proposed the protective association between dietary approaches to stop hypertension (DASH) style diet and risk of cancers; however, they have led to inconsistent results. The present study aimed to systematically review the prospective cohort studies conducted in this regard and, if possible, to quantify the overall effect of using meta-analysis. Methods: PubMed, EMBASE, Scopus, and Google Scholar were searched for cohort studies published up to December 2017. Relative risks (RRs) which were reported for fully adjusted models and their confidence intervals were extracted for meta-analysis. Random effects model was incorporated to combine the RRs. Results: Sixteen studies were eligible to be included in the systematic review from which 8 reports were conducted on the effect of DASH on the risk of mortality from all cancer types, four on the risk of colorectal cancer, and three on the risk of colon and rectal cancer. Four studies examined the association with other cancers (breast, hepatic, endometrial, and lung cancer). Meta-analysis showed that high concordance with DASH significantly decreases the risk of all cancer types (RR=0.83, 95% confidence interval (95%CI):0.80-0.85); furthermore participants who highly adhered to the DASH had lower risk of developing colorectal (RR=0.79, 95%CI: 0.75-0.83), colon (RR=0.81, 95%CI: 0.74-0.87) and rectal (RR=0.79, 95%CI: 0.63-0.98) cancer compared to those with the lowest adherence. Conclusions: DASH-style diet should be suggested as a healthy approach to protect from cancer in the community. Prospective studies exploring the effect on other cancer types and from regions other than the United States are highly recommended.

Keywords: cancer, DASH-style diet, dietary patterns, meta-analysis, systematic review

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Authors: Freyedon Ahmadi

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Corporate citizenship is considered as one of the most discussed topics in the developed countries, in which a citizen considers a Corporate just like a usual citizen with every civil right as respectful for corporate as for actual citizens, and in return citizens expect that corporate would pay a reciprocal respect to them. The current study’s purpose is to identify the impact of the current state of corporate citizenship along effective factors on its condition on industrial producing units, in order to find an accession plane for corporate citizenship development. In this study corporate citizenship is studied in four dimensions like legal corporate, economical corporate, ethical corporate and voluntary corporate. Moreover, effective factors’ impact on corporate citizenship is explored based on threefold dimensional model: behavioral, structural, and content factors, as well. In this study, 50 corporate of Food industry and of petrochemical industry, along with 200 selected individuals from directors’ board on Tehran province’s scale with stratified random sampling method, are chosen as actuarial sample. If based on functional goal and compilation methods, the present study is a description of correlation type; questionnaire is used for accumulation of initial Data. For Instrument Validity expert’s opinion is used and structural equations and its reliability is qualified by using Cronbach Alpha. The results of this study indicate that close to 70 percent of under survey corporate have not a good condition in corporate citizenship. And all of structural factors, behavioral factors, contextual factors, have a great deal of impression and impact on the advent corporate citizenship behavior in the producing Units. Among the behavioral factors, social responsibility; among structural factors, organic structure and human centered orientation, medium size, high organizational capacity; and among the contextual factors, the clientele’s positive viewpoints toward corporate had the utmost importance in impression on under survey Producing units.

Keywords: corporate citizenship, structural factors, behavioral factors, contextual factors, producing units

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Authors: Hannah Patricia S., Louise Margarrette R., Josking Oliver L., Denisse Katrina C., Justine Kali O.

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Aims: In the Philippines, there has been an astronomical increase in the population of elderly sent to nursing home facilities which has been studied to induce despair and loss of self-worth. Nurses in institutionalized facilities generally care for the elderly. Although supportive group therapy has been explored to mend this psychological disparity, nursing research has limited published studies about this in the institutionalized setting. Hence, the study determined the effectiveness of supportive group therapy in depression, self-esteem and quality of life among institutionalized elderly. Methodology: A one-group pre-test-post-test design was conducted among 20-purposively selected institutionalized elderly after the Ethics Research Board approval. All eligible participants underwent the supportive group therapy after being subdivided into session groups. The Geriatric Depression Scale, which has a Cronbach’s alpha coefficient of 0.90; the Rosenberg Self-Esteem, which has a Cronbach’s alpha coefficient = 0.84; and the Older People Quality of Life, which has a Cronbach’s alpha coefficient =0.88, were utilized to measure depression, self-esteem, and quality of life, respectively. Descriptive statistics and Repeated Measures-Multivariate Analysis of Variance (RM-MANOVA) analyzed gathered data. Results: Results showed that the supportive group therapy significantly decreased post-test depression scores (F(1,19)=78.69,p=0.0001,partial η2=0.805), significantly improved post-test self-esteem score (F(1,19)=28.07,p=0.0001,partial η2=0.596), and significantly increased the post-test quality of life (F(1,19)=79.73,p=0.0001,partial η2=0.808) after the intervention has been rendered. Conclusion: Supportive group therapy is effective in alleviating depression and in improving self-esteem and quality of life among institutionalized elderly and can be utilized by nursing homes as an intervention to improve the over-all psychosocial status of elderly patients.

Keywords: supportive group therapy, institutionalized elderly, depression, self-esteem, quality of life

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Authors: Hamed Karimian, Noraziah Nordin, Mohamad Ibrahim Noordin, Syam Mohan, Mahboubeh Razavi, Najihah Mohd Hashim, Happipah Mohd Ali

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Satureja bachtiarica Bunge is a perennial medicinal plant belonging to the Lamiaceae family and endemic species in Iran. Satureja bachtiarica Bunge with the local name of Marzeh koohi is edible vegetable use as flavoring agent, anti-bacterial and to relieve cough and indigestion. In this study, the anti-cancer effect of Satureja bachtiarica Bunge on the MDA-MB-231 cell line as an Breast cancer cell model has been analyzed for the first time. Satureja bachtiarica Bunge was extracted using different solvents in the order of increasing polarity. Cytotoxicity activity of hexane extract of Satureja bachtiarica Bunge (SBHE) was observed using MTT assay. Acridine orange/Propidium iodide staining was used to detect early apoptosis; Annexin-V-FITC assay was carried out to observe the detection of cell-surface Phosphatidylserine (PS), with Annexin-Vserving as a marker for apoptotic cells. Caspase 3/7, 8 and-9 assays showed significantly activation of caspase-9 where lead intrinsic mitochondrial pathway. Bcl-2/Bax expressions and cell cycle arrest were also investigated. SBHE had exhibited significantly higher cytotoxicity against MDA-MB-231 Cell line compare to other cell lines. A significant increase in chromatin condensation in the cell nucleus was observed by fluorescence analysis. Treatment of MDA-MB-231 cells with SBHE encouraged apoptosis, by down-regulating Bcl-2 and up-regulating Bax, which lead the activation of caspase 9. Moreover, SBHE treatment significantly arrested MDA-MB-231 cells in the G1 phase. Together, the results presented in this study demonstrated that SBHE inhibited the proliferation of MDA-MB-231 cells, leading cell cycle arrest and programmed cell death, which was confirmed to be through the mitochondrial pathway.

Keywords: Satureja bachtiarica Bunge, MDA-MB-231, apoptosis, annexin-V, cell cycle

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Authors: Gabrielle O'Donoghue

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Background: Pre-operative radiographs facilitate assessment and treatment planning in minor oral surgery. Quality assurance for dental radiography advocates the As Low As Reasonably Achievable (ALARA) principle in collecting accurate diagnostic information. Aims: To audit the quality of digital intraoral periapicals (IOPAs) taken prior to dental extractions in a metropolitan general dental practice setting. Standards: The National Radiological Protection Board (NRPB) guidance outlines three grades of radiograph quality: excellent (Grade 1 > 70% of total exposures), diagnostically acceptable (Grade 2 <20%), and unacceptable (Grade 3 <10%). Methodology: A study of pre-operative radiographs taken prior to dental extractions across 12 private general dental practices in a large metropolitan area by 44 practitioners. A total of 725 extractions were assessed, allowing 258 IOPAs to be reviewed in one audit cycle. Results: First cycle: Of 258 IOPAs: 223(86.4%) scored Grade 1, 27(10.5%) Grade 2, and 8(3.1%) Grade 3. The standard was met. 35 dental extractions were performed without an available pre-operative radiograph. Action Plan & Recommendations: Results were distributed to all staff and a continuous professional development evening organized to outline recommendations to improve image quality. A second audit cycle is proposed at a six-month interval to review the recommendations and appraise results. Conclusion: The overall standard of radiographs met the published guidelines. A significant improvement in the number of procedures undertaken without pre-operative imaging is expected at a six-month interval period. An investigation into undiagnostic imaging and associated adverse patient outcomes is being considered. Maintenance of the standards achieved is predicted in the second audit cycle to ensure consistent high quality imaging.

Keywords: audit, oral radiology, oral surgery, periapical radiographs, quality assurance

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Authors: Paras Agarwal

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Background: Initially believed to be rare, metastases to the eye are the most common ocular malignancy. The choroid’s high perfusion rate not only makes it the most susceptible ocular site for tumour seeding, but also promotes its growth. The cancers most frequently responsible for choroidal metastases originate from the breast and lung, although a significant proportion have unidentified primaries at the time of presentation. Case Presentation: This case report describes a 34 year old female presenting to the ophthalmology department with a one month history of painless distorted vision. On fundus examination, she was noted to have bilateral choroidal lesionsand subsequently underwent a comprehensive diagnostic work-up. The patient was diagnosed with metastatic pulmonary adenocarcinoma, despite lacking conventional risk factors. As she was found to have a mutation in EGFR, the patient was commenced on tyrosine-kinase inhibition with afatinib. The choroidal lesions regressed with a significant improvement in visual acuity and a dramatic anatomical reduction of the choroidal masses. Conclusions: Our case demonstrates the importance of considering metastases as a differential diagnosis for choroidal lesions. Appropriate and thorough history-taking, examination and investigations may be required in order to deduce the underlying cause. Our case is unusual in view of the choroidal lesion being the primary manifestation of metastatic lung cancer in a young patient with no known risk factors. Early recognition of choroidal metastases is important as it is often the first sign of tumour dissemination and will prompt earlier treatment with systemic medications such as chemotherapy, immunotherapy, targeted therapy or hormonal therapy. Our case report also demonstrates the efficacy of afatinib for the treatment of choroidal metastases, with morphological and functional improvements observed with regard to the choroidal metastatic tumour.

Keywords: choroidal neoplasm, choroidal naevus, pulmonary adenocarcinoma, metastases, lung cancer

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Authors: Yasuyuki Takahashi, Hirotaka Shimada, Kyoko Saito

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Bone scintigraphy is widely used as a screening tool for bone metastases. However, the 180 to 240 minutes (min) waiting time after the intravenous (i.v.) injection of the tracer is both long and tiresome. To solve this shortcoming, a bone scan with a shorter waiting time is needed. In this study, we applied the Maximum Intensity Projection (MIP) and triple energy window (TEW) scatter correction to a whole body bone SPECT (Merged SPECT) and investigated shortening the waiting time. Methods: In a preliminary phantom study, hot gels of 99mTc-HMDP were inserted into sets of rods with diameters ranging from 4 to 19 mm. Each rod set covered a sector of a cylindrical phantom. The activity concentration of all rods was 2.5 times that of the background in the cylindrical body of the phantom. In the human study, SPECT images were obtained from chest to abdomen at 30 to 180 min after 99mTc- hydroxymethylene diphosphonate (HMDP) injection of healthy volunteers. For both studies, MIP images were reconstructed. Planar whole body images of the patients were also obtained. These were acquired at 200 min. The image quality of the SPECT and the planar images was compared. Additionally, 36 patients with breast cancer were scanned in the same way. The delectability of uptake regions (metastases) was compared visually. Results: In the phantom study, a 4 mm size hot gel was difficult to depict on the conventional SPECT, but MIP images could recognize it clearly. For both the healthy volunteers and the clinical patients, the accumulation of 99mTc-HMDP in the SPECT was good as early as 90 min. All findings of both image sets were in agreement. Conclusion: In phantoms, images from MIP with TEW scatter correction could detect all rods down to those with a diameter of 4 mm. In patients, MIP reconstruction with TEW scatter correction could improve the detectability of hot lesions. In addition, the time between injection and imaging could be shortened from that conventionally used for whole body scans.

Keywords: merged SPECT, MIP, TEW scatter correction, 99mTc-HMDP

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Authors: Asawari Alok Pawaskar

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This study was aimed at investigating quality assurance (QA) done with IBA matrix, the discrepan­cies observed for helical tomotherapy plans. A selection of tomotherapy plans that initially failed the with Matrix process was chosen for this investigation. These plans failed the fluence analysis as assessed using gamma criteria (3%, 3 mm). Each of these plans was modified (keeping the planning constraints the same), beamlets rebatched and reoptimized. By increasing and decreasing the modula­tion factor, the fluence in a circumferential plane as measured with a diode array was assessed. A subset of these plans was investigated using varied pitch values. Factors for each plan that were examined were point doses, fluences, leaf opening times, planned leaf sinograms, and uniformity indices. In order to ensure that the treatment constraints remained the same, the dose-volume histograms (DVHs) of all the modulated plans were compared to the original plan. It was observed that a large increase in the modulation factor did not significantly improve DVH unifor­mity, but reduced the gamma analysis pass rate. This also increased the treatment delivery time by slowing down the gantry rotation speed which then increases the maximum to mean non-zero leaf open time ratio. Increasing and decreasing the pitch value did not substantially change treatment time, but the delivery accuracy was adversely affected. This may be due to many other factors, such as the complexity of the treatment plan and site. Patient sites included in this study were head and neck, breast, abdomen. The impact of leaf tim­ing inaccuracies on plans was greater with higher modulation factors. Point-dose measurements were seen to be less susceptible to changes in pitch and modulation factors. The initial modulation factor used by the optimizer, such that the TPS generated ‘actual’ modulation factor within the range of 1.4 to 2.5, resulted in an improved deliverable plan.

Keywords: dose volume histogram, modulation factor, IBA matrix, tomotherapy

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