Search results for: patient knowledge

Authors: Sombol Mokhles

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Tackling climate change requires expanding networking opportunities between a diverse range of cities to accelerate climate actions. Existing climate city networks have limitations in actively engaging “ordinary” cities in networking processes between cities, as they encourage a few powerful cities to be followed by the many “ordinary” cities. To reimagine the networking opportunities between cities beyond global cities, this paper incorporates “cosmopolitan comparison” to expand our knowledge of a diverse range of cities using a data-driven approach. Through a cosmopolitan perspective, a framework is presented on how to utilise large data to expand knowledge of cities beyond global cities to reimagine the existing hierarchical networking practices. The contribution of this framework is beyond urban climate governance but inclusive of different fields which strive for a more inclusive and cosmopolitan comparison attentive to the differences across cities.

Keywords: cosmopolitan city comparison, data-driven approach, climate city networking, urban climate governance

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Authors: Dan W. Rhodes, Juliane Hey, Magali Karagueuzian, Florianne Martinez, Yael Sandowski, Vanessa Roulet, Mahmoud Badawi, Mohammed-Amine Chakir, Valérie Simon, Jérémie Gautier, Françoise Le Boulaire, Catherine Coignard, Claire Vincent, Sandrine Greaume, Isabelle Voisin

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Background: Beckman Coulter, Inc. (BEC) has recently developed a fully automated second-generation anti-HCV test on a new immunoassay platform. The objective of this multicenter study conducted in Europe was to evaluate the performance of the ACCESS anti-HCV assay on the recently CE-marked DxI 9000 ACCESS Immunoassay Analyzer as an aid in the diagnosis of HCV (Hepatitis C Virus) infection and as a screening test for blood and plasma donors. Methods: The clinical specificity of the ACCESS anti-HCV assay was determined using HCV antibody-negative samples from blood donors and hospitalized patients. Sample antibody status was determined by a CE-marked anti-HCV assay (Abbott ARCHITECTTM anti-HCV assay or Abbott PRISM HCV assay) with an additional confirmation method (Immunoblot testing with INNO-LIATM HCV Score - Fujirebio), if necessary, according to pre-determined testing algorithms. The clinical sensitivity was determined using known HCV antibody-positive samples, identified positive by Immunoblot testing with INNO-LIATM HCV Score - Fujirebio. HCV RNA PCR or genotyping was available on all Immunoblot positive samples for further characterization. The false initial reactive rate was determined on fresh samples from blood donors and hospitalized patients. Thirty (30) commercially available seroconversion panels were tested to assess the sensitivity for early detection of HCV infection. The study was conducted from November 2019 to March 2022. Three (3) external sites and one (1) internal site participated. Results: Clinical specificity (95% CI) was 99.7% (99.6 – 99.8%) on 5852 blood donors and 99.0% (98.4 – 99.4%) on 1527 hospitalized patient samples. There were 15 discrepant samples (positive on ACCESS anti-HCV assay and negative on both ARCHITECT and Immunoblot) observed with hospitalized patient samples, and of note, additional HCV RNA PCR results showed five (5) samples had positive HCV RNA PCR results despite the absence of HCV antibody detection by ARCHITECT and Immunoblot, suggesting a better sensitivity of the ACCESS anti-HCV assay with these five samples compared to the ARCHITECT and Immunoblot anti-HCV assays. Clinical sensitivity (95% CI) on 510 well-characterized, known HCV antibody-positive samples was 100.0% (99.3 – 100.0%), including 353 samples with known HCV genotypes (1 to 6). The overall false initial reactive rate (95% CI) on 6630 patient samples was 0.02% (0.00 – 0.09%). Results obtained on 30 seroconversion panels demonstrated that the ACCESS anti-HCV assay had equivalent sensitivity performances, with an average bleed difference since the first reactive bleed below one (1), compared to the ARCHITECTTM anti-HCV assay. Conclusion: The newly developed ACCESS anti-HCV assay from BEC for use on the DxI 9000 ACCESS Immunoassay Analyzer demonstrated high clinical sensitivity and specificity, equivalent to currently marketed anti-HCV assays, as well as a low false initial reactive rate.

Keywords: DxI 9000 ACCESS Immunoassay Analyzer, HCV, HCV antibody, Hepatitis C virus, immunoassay

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Authors: Shuen-Tai Wang, Yu-Ching Lin

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With more and more workflow systems adopting cloud as their execution environment, it presents various challenges that need to be addressed in order to be utilized efficiently. This paper introduces a method for resource provisioning based on our previous research of dynamic allocation and its pipeline processes. We present an abstraction for workload scheduling in which independent tasks get scheduled among various available processors of distributed computing for optimization. We also propose an integrated web-based workflow designer by taking advantage of the HTML5 technology and chaining together multiple tools. In order to make the combination of multiple pipelines executing on the cloud in parallel, we develop a script translator and an execution engine for workflow management in the cloud. All information is known in advance by the workflow engine and tasks are allocated according to the prior knowledge in the repository. This proposed effort has the potential to provide support for process definition, workflow enactment and monitoring of workflow processes. Users would benefit from the web-based system that allows creation and execution of pipelines without scripting knowledge.

Keywords: workflow systems, resources provisioning, workload scheduling, web-based, workflow engine

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Authors: Matthew Pleshaw, Caroline Lynch, Caleb Eaton, Ali Kiapour

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The problem addressed in this proposal is that of the lacking comfort and safety of inpatient rooms, specifically at Boston Children’s Hospital, with the implementation of a system that will allow inpatient children to feel more comfortable in the unfamiliar environment of a hospital. The focus is that of advancing and enhancing the healing process for children in a long-term inpatient stay at the hospital, though a combination of announcing a clinician or hospital staff’s arrival utilizing RFID (Fig. 1), and improving communication between clinicians, parents/guardians, patients, etc. by integrating a mobile application.

Keywords: Pediatrics, Hospital, RFID, Technology

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Authors: Mohammad Javad Behzadnia, Amir Bahador Boroumand

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Introduction: Limited facility situations require allocating the most available resources for most casualties. Accordingly, Traumatic Brain Injury (TBI) is the one that may need to transport the patient as soon as possible. In a mass casualty event, deciding when the facilities are restricted is hard. The Extended Glasgow Outcome Score (GOSE) has been introduced to assess the global outcome after brain injuries. Therefore, we aimed to evaluate the prognostic factors associated with GOSE. Materials and Methods: In a multicenter cross-sectional study conducted on 144 patients with TBI admitted to trauma emergency centers. All the patients with isolated TBI who were mentally and physically healthy before the trauma entered the study. The patient’s information was evaluated, including demographic characteristics, duration of hospital stays, mechanical ventilation on admission laboratory measurements, and on-admission vital signs. We recorded the patients’ TBI-related symptoms and brain computed tomography (CT) scan findings. Results: GOSE assessments showed an increasing trend by the comparison of on-discharge (7.47 ± 1.30), within a month (7.51 ± 1.30), and within three months (7.58 ± 1.21) evaluations (P < 0.001). On discharge, GOSE was positively correlated with Glasgow Coma Scale (GCS) (r = 0.729, P < 0.001) and motor GCS (r = 0.812, P < 0.001), and inversely with age (r = −0.261, P = 0.002), hospitalization period (r = −0.678, P < 0.001), pulse rate (r = −0.256, P = 0.002) and white blood cell (WBC). Among imaging signs and trauma-related symptoms in univariate analysis, intracranial hemorrhage (ICH), interventricular hemorrhage (IVH) (P = 0.006), subarachnoid hemorrhage (SAH) (P = 0.06; marginally at P < 0.1), subdural hemorrhage (SDH) (P = 0.032), and epidural hemorrhage (EDH) (P = 0.037) were significantly associated with GOSE at discharge in multivariable analysis. Conclusion: Our study showed some predictive factors that could help to decide which casualty should transport earlier to a trauma center. According to the current study findings, GCS, pulse rate, WBC, and among imaging signs and trauma-related symptoms, ICH, IVH, SAH, SDH, and EDH are significant independent predictors of GOSE at discharge in TBI patients.

Keywords: field, Glasgow outcome score, prediction, traumatic brain injury.

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Authors: Fátima Gonçalves, Joaquim Brigas, Jorge Gonçalves

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The proliferation of mobile devices in society enables the media to disseminate information and knowledge more rapidly. Higher education students access these contents and share them with each other, in the most diverse platforms, allowing the ubiquity in access to information. This article presents the results and respective quantitative analysis of a survey applied to communication students of two higher education institutions: one in Portugal and another in Spain. The results show that, in this sample, higher education students regularly access news content believing traditional news sources to be more credible. Regarding online sources, it was verified that the access was mostly to free news contents. This study intends to promote the knowledge about the changes that occur in the relationship of higher education students with the media, characterizing how news consumption is processed by these students, considering the resulting effects of the digital media evolution. It is intended to present not only the news sources they use, but also to know some of their habits and relationship with the news media.

Keywords: students' perceptions, communication design, mass media, higher education, digital media

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Authors: Abhijit Dasgupta

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This paper explores the everyday lives of the Christians residing in a Bengali Christian neighborhood in Kolkata, termed here as the larger Christian para (para meaning neighborhood in Bengali). Through ethnography and reading of secondary sources, the paper discerns how various Christians across denominations – Protestants, Catholics and Pentecostals implicate the role of bishwas (faith and belief) in their interpersonal neighborhood relations. The paper attempts to capture the role of bishwas in producing, transforming and revising the meaning of 'neighbourhood' and 'neighbours' and puts forward the argument of the neighbourhood as a theological product. By interrogating and interpreting bishwas through everyday theological discussions and reflections, the paper examines and analyses the ways everyday theology becomes an essential source of power and knowledge for the Bengali Christians in reimagining their neighbourhood compared to the nearby Hindu neighbourhoods. Borrowing literature from everyday theology, faith and belief, the paper reads and analyses various interpretations of theological knowledge across denominations to probe the prominence of bishwas within the Christian community and its role in creating a difference in their place of dwelling. The paper argues that the meaning of neighbourhood is revisited through prayers, sermons and biblical verses. At the same time, the divisions and fissures are seen among Protestants and Catholics and also among native Bengali Protestants and non-native Protestant pastors, which informs us about the complexity of theology in constituting everyday life. Thus, the paper addresses theology's role in creating an ethical Christian neighbourhood amidst everyday tensions and hostilities of diverse religious persuasions. At the same time, it looks into the processes through which multiple theological knowledge leads to schism and interdenominational hostilities. By attempting to answer these questions, the paper brings out Christians' negotiation with the neighbourhood.

Keywords: anthropology, bishwas, christianity, neighbourhood, theology

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Authors: Selma Aitsaid

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Disney canon texts, mainly animations, are believed to have authority over children’s identities. However, most research on Disney tends to focus either on textual analysis, or Western and non-western adult audiences. In fact, there is a lack of scholarship on Disney child audiences from non-western countries though children are believed to be Disney‘s main target audience, and Disney is a global corporation that appeals to audiences from all over the world as well. Therefore, qualitative research was conducted by interviewing around twenty five Algerian disabled tweens between the age 11 to 14 on their familiarity and identification with Disney animations. The reason behind choosing disabled children is because minority groups have not been interviewed on their possible interpretations of Disney animations despite the fact that these texts have been interpreted by some scholars as being inclusive of minority groups such as queer and disabled people. To that end, this project aims to decolonize disability and Global Southern Academia by three ways. The first way is to uncover inequalities of the metropolitan thought enshrined in the global power of the metropole vis a vis the subaltern. This approach was called postcolonialism. The second way is to value non-western academic and non-academic resources. This is the project of ‘indigenous knowledge. The third way is to analyse the forms of knowledge that were produced by intellectuals in colonized countries as a response to Western Academic hegemony. Consequently, this research endeavored to unravel the inequality, the dynamics of neocolonialism and subordination to colonial discourses within the Algerian discourse on disability and other knowledge such as tweenhood, childhood and non-western viewership, which are mainly defined through Western lenses. Algerian resources were included with the aim of enhancing an academic collaboration between the North and South as well. The findings showed that the postcolonial context had an impact on how children perceive Disney animations. They also demonstrated that children are able to negotiate the meaning of Disney texts within their own context.

Keywords: child audiences, Algeria, childhood, disability, Disney animations, global South, postcolonialism, tweens, Western hegemony

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Authors: Abhay Vir Singh Kanwar

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The pharmaceutical industry today is a multi-billion dollar business and yet disadvantages people in many corners of the globe who are still dying in large numbers from curable illnesses for lack of access to drugs. The astronomical prices of essential and life-saving drugs is not just an economic problem that can be settled through clever market strategies but is an ethical issue, given the accumulated wealth of today’s humanity and the sense of global justice that it increasingly comes to share. In this paper, I make a very practical argument for what I shall call ‘the ethical healthcare paradigm’, which, I propose, can replace the economistic paradigm that can still drive the healthcare sector without creating spillover effects on the market. Taking off from the ethical-philosophical argument for recognizing every individual’s right to capability to be healthy, I shall come to the focused practical proposal of the cost-rationalization and universal availability of essential, life-saving drugs through the undertaking of research and development funding for drug innovation by the business establishment as such in terms of the concept of CSR. The paper will first expose the concepts of basic and fundamental capabilities in relation to education and health, after which it will focus on the right to capability to be healthy of every person. In the third section, it will discuss the ‘ethical healthcare paradigm’ as opposed to the economistic health paradigm and will argue that the patient will have to be considered the primary stakeholder of this paradigm or the very ‘subject’ of healthcare. The next section will be on an ethical-historical critique of the pharmaceutical industry’s profit driven economism. The section after that will look at the business operation and the stages in the life cycle of a drug that comes to the market in order to understand the risks, strengths and problems of the pharmaceutical industry. Finally, the paper will discuss the concept of CSR in relation to the ethical healthcare paradigm in order to propose CSR funding in research and development for innovation on drugs so that life-saving drugs can be made available to every sick person cost-effectively.

Keywords: capability approach, healthcare, CSR, patient

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Authors: R. Tudugala, B. M. A. I. Balasooriya, W. M. Ediri Arachchi, R. W. M. W. K. Rathnayake, T. D. Premaratna

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Brachytherapy involves placing a source of radiation near the cancer site which gives promising prognosis for cervical cancer treatments. The purpose of this study was to evaluate the effect of random variation of treated volumes in between fractions in the 2D image based fractionated high dose rate brachytherapy for cervical cancer at National Cancer Institute Maharagama, Sri Lanka. Dose plans were analyzed for 150 cervical cancer patients with orthogonal radiographs (2D) based brachytherapy. ICRU treated volumes was modeled by translating the applicators with the help of “Multisource HDR plus software”. The difference of treated volumes with respect to the applicator geometry was analyzed by using SPSS 18 software; to derived patient population based estimates of delivered treated volumes relative to ideally treated volumes. Packing was evaluated according to bladder dose, rectum dose and geometry of the dose distribution by three consultant radiation oncologist. The difference of treated volumes depends on types of the applicators, which was used in fractionated brachytherapy. The means of the “Difference of Treated Volume” (DTV) for “Evenly activated tandem (ET)” length” group was ((X_1)) -0.48 cm3 and ((X_2)) 11.85 cm3 for “Unevenly activated tandem length (UET) group. The range of the DTV for ET group was 35.80 cm3 whereas UET group 104.80 cm3. One sample T test was performed to compare the DTV with “Ideal treatment volume difference (0.00cm3)”. It is evident that P value was 0.732 for ET group and for UET it was 0.00 moreover independent two sample T test was performed to compare ET and UET groups and calculated P value was 0.005. Packing was evaluated under three categories 59.38% used “Convenient Packing Technique”, 33.33% used “Fairly Packing Technique” and 7.29% used “Not Convenient Packing” in their fractionated brachytherapy treatments. Random variation of treated volume in ET group is much lower than UET group and there is a significant difference (p<0.05) in between ET and UET groups which affects the dose distribution of the treatment. Furthermore, it can be concluded nearly 92.71% patient’s packing were used acceptable packing technique at NCIM, Sri Lanka.

Keywords: brachytherapy, cervical cancer, high dose rate, tandem, treated volumes

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Authors: Nir Nissim, Erez Shalom, Tomer Lancewiki, Yuval Elovici, Yuval Shahar

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Background: A Medical Device (MD) is an instrument, machine, implant, or similar device that includes a component intended for the purpose of the diagnosis, cure, treatment, or prevention of disease in humans or animals. Medical devices play increasingly important roles in health services eco-systems, including: (1) Patient Diagnostics and Monitoring; Medical Treatment and Surgery; and Patient Life Support Devices and Stabilizers. MDs are part of the medical device eco-system and are connected to the network, sending vital information to the internal medical information systems of medical centers that manage this data. Wireless components (e.g. Wi-Fi) are often embedded within medical devices, enabling doctors and technicians to control and configure them remotely. All these functionalities, roles, and uses of MDs make them attractive targets of cyber-attacks launched for many malicious goals; this trend is likely to significantly increase over the next several years, with increased awareness regarding MD vulnerabilities, the enhancement of potential attackers’ skills, and expanded use of medical devices. Significance: We propose to develop and implement Cyber-Med, a unique collaborative project of Ben-Gurion University of the Negev and the Clalit Health Services Health Maintenance Organization. Cyber-Med focuses on the development of a comprehensive detection framework that relies on a critical attack repository that we aim to create. Cyber-Med will allow researchers and companies to better understand the vulnerabilities and attacks associated with medical devices as well as providing a comprehensive platform for developing detection solutions. Methodology: The Cyber-Med detection framework will consist of two independent, but complementary detection approaches: one for known attacks, and the other for unknown attacks. These modules incorporate novel ideas and algorithms inspired by our team's domains of expertise, including cyber security, biomedical informatics, and advanced machine learning, and temporal data mining techniques. The establishment and maintenance of Cyber-Med’s up-to-date attack repository will strengthen the capabilities of Cyber-Med’s detection framework. Major Findings: Based on our initial survey, we have already found more than 15 types of vulnerabilities and possible attacks aimed at MDs and their eco-system. Many of these attacks target individual patients who use devices such pacemakers and insulin pumps. In addition, such attacks are also aimed at MDs that are widely used by medical centers such as MRIs, CTs, and dialysis engines; the information systems that store patient information; protocols such as DICOM; standards such as HL7; and medical information systems such as PACS. However, current detection tools, techniques, and solutions generally fail to detect both the known and unknown attacks launched against MDs. Very little research has been conducted in order to protect these devices from cyber-attacks, since most of the development and engineering efforts are aimed at the devices’ core medical functionality, the contribution to patients’ healthcare, and the business aspects associated with the medical device.

Keywords: medical device, cyber security, attack, detection, machine learning

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Authors: Rachel Byrne

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Background: Due to patient and student safety concerns, combined with clinical teachers being redeployed to clinical practice, COVID-19 has resulted in a reduction in face-to-face teaching sessions for medical students. Traditionally such sessions are particularly important for final year medical students, especially in preparing for their final practical exams. A reduced student presence on the wards has also resulted in fewer opportunities for junior doctors to provide teaching sessions. This has implications for junior doctors achieving their own curriculum outcomes for teaching, as well as potentially hindering the development of a future interest in medical education. Aims: The aims of the study are 1) To create a safe face-to-face teaching environment during COVID-19 which focussed on exam preparation for final year medical students, 2) To provide a platform for doctors to gain teaching experience, 3 ) to enable doctors to gain feedback or assessments on their teaching, 4) To create beginners guide to designing a new teaching program for future junior doctors. Methods: We created a program of timed clinical stations consisting of four sessions every five weeks during the student’s medicine attachment. Each session could be attended by 6 students and consisted of 6 stations ran by junior doctors, with each station following social distancing and personal protective equipment requirements. Junior doctors were asked to design their own stations. The sessions ran out-of-hours on weekday evenings and were optional for the students. Results: 95/95 students and 20/40 doctors involved in the programme completed feedback. 100% (n=95) of students strongly agreed/agreed that sessions were aimed at an appropriate level and provided constructive feedback. 100% (n=95) of students stated they felt more confident in their abilities and would recommend the session to peers. 90% (n=18) of the teachers strongly agreed/agreed that they felt more confident in their teaching abilities and that the sessions had improved their own medical knowledge. 85% (n=17) of doctors had a teaching assessment completed, and 83% (n=16) said the program had made them consider a career in medical education. The difficulties of creating such a program were highlighted throughout, and a beginner’s guide was created with the hopes of helping future doctors who are interested in teaching address the common obstacles.

Keywords: COVID-19, education, safety, medical

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Authors: Sunny Deo, Eve Barnes, Peter Arnold-Smith

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Introduction: Healthcare technology is a rapidly expanding field in healthcare, with enthusiasts suggesting a revolution in the quality and efficiency of healthcare delivery based on the utilisation of better e-healthcare, including the move to paperless healthcare. The role and use of computers and programmes for healthcare have been increasing over the past 50 years. Despite this, there is no standardised method of assessing the quality of hardware and software utilised by frontline healthcare workers. Methods and subjects: Based on standard Patient Related Outcome Measures, a questionnaire was devised with the aim of providing quantitative and qualitative data on clinicians’ perspectives of their hospital’s Information Technology (IT). The survey was distributed via the Institution’s Intranet to all contracted doctors, and the survey's qualitative results were analysed. Qualitative opinions were grouped as positive, neutral, or negative and further sub-grouped into speed/usability, software/hardware, integration, IT staffing, clinical risk, and wellbeing. Analysis was undertaken on the basis of doctor seniority and by specialty. Results: There were 196 responses, with 51% from senior doctors (consultant grades) and the rest from junior grades, with the largest group of respondents 52% coming from medicine specialties. Differences in the proportion of principle and sub-groups were noted by seniority and specialty. Negative themes were by far the commonest stated opinion type, occurring in almost 2/3’s of responses (63%), while positive comments occurred less than 1 in 10 (8%). Conclusions: This survey confirms strongly negative attitudes to the current state of electronic documentation and IT in a large single-centre cohort of hospital-based frontline physicians after two decades of so-called progress to a paperless healthcare system. Greater use would provide further insights and potentially optimise the focus of development and delivery to improve the quality and effectiveness of IT for clinicians and their patients.

Keywords: information technology, electronic patient records, digitisation, paperless healthcare

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Authors: Frederick Anlimah, Vinod Gopaldasani, Catherine MacPhail, Brian Davies

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The construction industry, particularly tunnel construction, exposes workers to respirable crystalline silica (RCS), which can cause incurable illnesses such as silicosis and lung cancer. Despite various control measures, exposures remain inadequately controlled. This research aimed to identify the barriers and challenges hindering the implementation of effective controls and the adoption of safe work practices to protect workers from RCS exposure in tunnelling. A mixed-method approach was employed for this research. Tunnel construction workers were observed, surveyed and interviewed to gauge their knowledge and attitudes and understand their challenges in reducing RCS exposure. The preliminary analysis of the data reveals a diverse array of sociotechnical factors interacting to influence RCS exposure. It is noteworthy that participants consistently emphasised the project as the most exemplary one they have been involved in, although there is room for improvement. While there is a commendable level of knowledge about RCS exposure and control in tunnelling, there is a striking lack of perceived satisfaction regarding dust control. Several factors were identified as interacting to prevent the effective management of dust. These include perceived time pressure, absence of on-tool dust controls, low risk perceptions among workers, and inadequate enforcement of controls. Moreover, participants highlighted communication and heat-related challenges as hindrances to the continuous wear of respirators. This research highlights the need for a paradigm shift in tunnel construction to address the barriers associated with RCS exposure reduction. It emphasises the importance of collaboration among various stakeholders, advocating for more effective controls and enforcement strategies and enhanced worker education through knowledge sharing.

Keywords: respirable crystalline silica, dust control, worker practices, exposure prevention, silicosis

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Authors: Dieter Veldsman, Theo Heyns Veldsman

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The knowledge economy demands an organisation that is flexible, adaptable and able to navigate the ever-changing environment. This fast-paced environment has however resulted in an organizational landscape that battles to engage employees, retain top talent and create meaningful work for its members. In the knowledge economy, the concept of organizational identity has become an important consideration as organisations aim to create a compelling and inviting narrative for all stakeholders across the business value chain. Values are often seen as the behavioural framework that informs organisational culture, yet often values are perceived to be inauthentic and misaligned with the true character or identity of the organisation and how it is perceived by different role players. This paper focuses on exploring the relationship between organisational identity and value systems by focusing on a case study within a multi-national organisation within South Africa. The paper evaluates the implementation of mixed methods OD approach that gathered collaborative inputs of more than 4500 employees who participated in crafting the newly established values system post a retrenchment process. The paper will evaluate the relationship between the newly crafted value system and the identity of the organisation as described by various internal and external stakeholders in order to explore potential alignment, dissonance and key insights into understanding the relationship between organisational identity and values. The case study will be reported from the perspective of an OD consultant who supported the transformation process over a period of 8 months and aims to provide key insights into values and identity alignment within knowledge economy organisations. From a practical perspective, the paper provides insights into how values are created, perceived and lived within organisations and the impact on employee engagement and culture.

Keywords: culture, organisational development, organisational identity, values

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Authors: Edite Kulmane, Mara Pilmane, Romans Lacis

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Introduction: Acquired heart diseases remain one of the leading health care problems in the world. Changes in myocardium of the diseased hearts are complex and pathogenesis is still not fully clear. The aim of this study was to identify appearance and distribution of apoptosis, homeostasis regulating factors, and innervation and ischemia markers in right atrial tissue in different acquired heart diseases. Methods: During elective open heart surgery were taken right atrial tissue fragments from 12 patients. All patients were operated because of acquired heart diseases- aortic valve stenosis (5 patients), coronary heart disease (5 patients), coronary heart disease and secondary mitral insufficiency (1 patient) and mitral disease (1 patient). The mean age was (mean±SD) 70,2±7,0 years (range 58-83 years). The tissues were stained with haematoxylin and eosin methods for routine light-microscopical examination and for immunohistochemical detection of protein gene peptide 9.5 (PGP 9.5), human atrial natriuretic peptide (hANUP), vascular endothelial growth factor (VEGF), chromogranin A and endothelin. Apoptosis was detected by TUNEL method. Results: All specimens showed degeneration of cardiomyocytes with lysis of myofibrils, diffuse vacuolization especially in perinuclear region, different size of cells and their nuclei. The severe invasion of connective tissue was observed in main part of all fragments. The apoptotic index ranged from 24 to 91%. One specimen showed region of newly performed microvessels with cube shaped endotheliocytes that were positive for PGP 9.5, endothelin, chromogranin A and VEGF. From all fragments, taken from patients with coronary heart disease, there were observed numerous PGP 9.5-containing nerve fibres, except in patient with secondary mitral insufficiency, who showed just few PGP 9.5 positive nerves. In majority of specimens there were regions observed with cube shaped mixed -VEGF immunoreactive endocardial and epicardial cells. Only VEGF positive endothelial cells were observed just in few specimens. There was no significant difference of hANUP secreting cells among all specimens. All patients operated due to the coronary heart disease moderate to numerous number of chromogranin A positive cells were seen while in patients with aortic valve stenosis tissue demonstrated just few factor positive cells. Conclusions: Complex detection of different factors may indicate selectively disordered morphopathogenetical event of heart disease: decrease of PGP 9.5 nerves suggests the decreased innervation of organ; increased apoptosis indicates the cell death without ingrowth of connective tissue; persistent presence of hANUP proves the unchanged homeostasis of cardiomyocytes probably supported by expression of chromogranins. Finally, decrease of VEGF detects the regions of affected blood vessels in heart affected by acquired heart disease.

Keywords: heart, apoptosis, protein-gene peptide 9.5, atrial natriuretic peptide, vascular endothelial growth factor, chromogranin A, endothelin

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Authors: Purnima Pandit

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Malaria remains one of the world’s most deadly infectious disease and arguably, the greatest menace to modern society in terms of morbidity and mortality. To choose the right treatment and to ensure a quality of life suitable for a specific patient condition, early and accurate diagnosis of malaria is essential. It reduces transmission of disease and prevents deaths. Our work focuses on designing an efficient, accurate fuzzy inference system for malaria diagnosis.

Keywords: fuzzy inference system, fuzzy logic, malaria disease, triangular fuzzy number

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Authors: Jayashree And Gajjam

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Intellectual humility (IH) is defined as a virtuous mean between intellectual arrogance and intellectual self-diffidence by the ‘Doxastic Account of IH’ studied, researched and developed by western scholars not earlier than 2015 at the University of Edinburgh. Ancient Indian philosophical texts or the Upanisads written in the Sanskrit language during the later Vedic period (circa 600-300 BCE) have long addressed the virtue of being humble in several stories and narratives. The current research paper questions and revisits these character traits in an Indian context following an experimental method. Based on the subjective reports of more than 400 Indian teenagers and adults, it argues that while a few traits of IH (such as trustworthiness, respectfulness, intelligence, politeness, etc.) are panhuman and pancultural, a few are not. Some attributes of IH (such as proper pride, open-mindedness, awareness of own strength, etc.) may be taken for arrogance by the Indian population, while other qualities of Intellectual Diffidence such as agreeableness, surrendering can be regarded as the characteristic of IH. The paper then gives the reasoning for this discrepancy that can be traced back to the ancient Indian (Upaniṣadic) teachings that are still prevalent in many Indian families and still anchor their views on IH. The name Upanisad itself means ‘sitting down near’ (to the Guru to gain the Supreme knowledge of the Self and the Universe and setting to rest ignorance) which is equivalent to the three traits among the BIG SEVEN characterized as IH by the western scholars viz. ‘being a good listener’, ‘curious to learn’, and ‘respect to other’s opinion’. The story of Satyakama Jabala (Chandogya Upanisad 4.4-8) who seeks the truth for several years even from the bull, the fire, the swan and waterfowl, suggests nothing but the ‘need for cognition’ or ‘desire for knowledge’. Nachiketa (Katha Upanisad), a boy with a pure mind and heart, follows his father’s words and offers himself to Yama (the God of Death) where after waiting for Yama for three days and nights, he seeks the knowledge of the mysteries of life and death. Although the main aim of these Upaniṣadic stories is to give the knowledge of life and death, the Supreme reality which can be identical with traits such as ‘curious to learn’, one cannot deny that they have a lot more to offer than mere information about true knowledge e.g., ‘politeness’, ‘good listener’, ‘awareness of own limitations’, etc. The possible future scope of this research includes (1) finding other socio-cultural factors that affect the ideas on IH such as age, gender, caste, type of education, highest qualification, place of residence and source of income, etc. which may be predominant in current Indian society despite our great teachings of the Upaniṣads, and (2) to devise different measures to impart IH in Indian children, teenagers, and younger adults for the harmonious future. The current experimental research can be considered as the first step towards these goals.

Keywords: ethics and virtue epistemology, Indian philosophy, intellectual humility, upaniṣadic texts in ancient India

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Authors: Wongwarit Nipitwittaya

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The objectives of this research is bringing folk song with the teaching of Western music were to examine to investigate, to compare, develop the skill, technique, knowledge of Thai folk song and to preserve folk song of Thailand to be known more widely also learn Thai culture from Thai folk song. Study by bringing Thailand folk song is widely known for learning with Western music in course brass performance. Bringing the melody of Thai folk music and changing patterns to western music notes for appropriate on brass performance. A sample was selected from brass students, using research by assessment of knowledge from test after used Thai folk song lesson. The lesson focus for scales and key signature in western music by divided into two groups, the one study by used research tools and another one used simple lesson and a collection of research until testing. The results of the study were as follows: 1. There are good development skill form research method 2. Sound recognition can be even better. The study was a qualitative research and data collection by observation.

Keywords: Thai folk song, brass instrument, key signature, western music

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Authors: William Michael Short

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Semantic Web’ technologies such as the Unified Medical Language System Metathesaurus, SNOMED-CT, and MeSH have been touted as transformational for the way users access online medical and health information, enabling both the automated analysis of natural-language data and the integration of heterogeneous healthrelated resources distributed across the Internet through the use of standardized terminologies that capture concepts and relationships between concepts that are expressed differently across datasets. However, the approaches that have so far characterized ‘semantic bioinformatics’ have not yet fulfilled the promise of the Semantic Web for medical and health information retrieval applications. This paper argues within the perspective of cognitive linguistics and cognitive anthropology that four features of human meaning-making must be taken into account before the potential of semantic technologies can be realized for this domain. First, many semantic technologies operate exclusively at the level of the word. However, texts convey meanings in ways beyond lexical semantics. For example, transitivity patterns (distributions of active or passive voice) and modality patterns (configurations of modal constituents like may, might, could, would, should) convey experiential and epistemic meanings that are not captured by single words. Language users also naturally associate stretches of text with discrete meanings, so that whole sentences can be ascribed senses similar to the senses of words (so-called ‘discourse topics’). Second, natural language processing systems tend to operate according to the principle of ‘one token, one tag’. For instance, occurrences of the word sound must be disambiguated for part of speech: in context, is sound a noun or a verb or an adjective? In syntactic analysis, deterministic annotation methods may be acceptable. But because natural language utterances are typically characterized by polyvalency and ambiguities of all kinds (including intentional ambiguities), such methods leave the meanings of texts highly impoverished. Third, ontologies tend to be disconnected from everyday language use and so struggle in cases where single concepts are captured through complex lexicalizations that involve profile shifts or other embodied representations. More problematically, concept graphs tend to capture ‘expert’ technical models rather than ‘folk’ models of knowledge and so may not match users’ common-sense intuitions about the organization of concepts in prototypical structures rather than Aristotelian categories. Fourth, and finally, most ontologies do not recognize the pervasively figurative character of human language. However, since the time of Galen the widespread use of metaphor in the linguistic usage of both medical professionals and lay persons has been recognized. In particular, metaphor is a well-documented linguistic tool for communicating experiences of pain. Because semantic medical knowledge-bases are designed to help capture variations within technical vocabularies – rather than the kinds of conventionalized figurative semantics that practitioners as well as patients actually utilize in clinical description and diagnosis – they fail to capture this dimension of linguistic usage. The failure of semantic technologies in these respects degrades the efficiency and efficacy not only of medical research, where information retrieval inefficiencies can lead to direct financial costs to organizations, but also of care provision, especially in contexts of patients’ self-management of complex medical conditions.

Keywords: ambiguity, bioinformatics, language, meaning, metaphor, ontology, semantic web, semantics

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Authors: Peyman Rezaei Hachesu, Vahideh Zareh Gavgani, Zahra Salahzadeh

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To survey the attitudes, awareness, and practice of Evidence Based Medicine (EBM), and to determine the barriers that influence apply’ EBM in therapeutic process among clinical residents in Iran.We conducted a cross sectional survey during September to December 2012 at the teaching hospitals of Tehran University of Medical Sciences among 79 clinical residents from different medical specialties. A valid and reliable questionnaire consisted of five sections and 27 statements were used in this research. We applied Spearman and Mann Whitney test for correlation between variables. Findings showed that the knowledge of residents about EBM is low. Their attitude towards EBM was positive but their knowledge and skills in regard with the evidence based medical information resources were mostly limited to PubMed and Google scholar. The main barrier was the lack of enough time to practicing EBM. There was no significant correlation between residency grade and familiarity and use of electronic EBM resources (Spearman, P = 0.138). Integration of training approaches like journal clubs or workshops with clinical practice is suggested.

Keywords: evidence-based medicine, clinical residents, decision-making, attitude, questionnaire

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Authors: Yasar Samet Gokceoglu, Ayse Nur Incesu, Furkan Okatar, Berk Nimetoglu, Serkan Bayram, Turgut Akgul

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Ankle syndesmosis injuries pose a significant challenge in orthopedic practice due to their potential for prolonged recovery and chronic ankle dysfunction. Accurate diagnosis and management of these injuries are essential for achieving optimal patient outcomes. The use of radiological methods, such as X-ray, computed tomography (CT), and magnetic resonance imaging (MRI), plays a vital role in the accurate diagnosis of syndesmosis injuries in the context of ankle fractures. Treatment options for ankle syndesmosis injuries vary, with surgical interventions such as screw fixation and suture-button implantation being commonly employed. The choice of treatment is influenced by the severity of the injury and the presence of associated fractures. Additionally, the mechanism of injury, such as pure syndesmosis injury or specific fracture types, can impact the stability and management of syndesmosis injuries. Ankle fractures with syndesmosis injury present a complex clinical scenario, requiring accurate diagnosis, appropriate reduction, and tailored management strategies. The interplay between the mechanism of injury, associated fractures, and treatment modalities significantly influences the outcomes of these challenging injuries. The long-term outcomes and patient satisfaction following ankle fractures with syndesmosis injury are crucial considerations in the field of orthopedics. Patient-reported outcome measures, such as the Foot and Ankle Outcome Score (FAOS), provide essential information about functional recovery and quality of life after these injuries. When diagnosing syndesmosis injuries, standard measurements, such as the medial clear space, tibiofibular overlap, tibiofibular clear space, anterior tibiofibular ratio (ATFR), and the anterior-posterior tibiofibular ratio (APTF), are assessed through radiographs and computed tomography (CT) scans. These parameters are critical in evaluating the presence and severity of syndesmosis injuries, enabling clinicians to choose the most appropriate treatment approach. Despite advancements in diagnostic imaging, challenges remain in accurately diagnosing and treating ankle syndesmosis injuries. Traditional diagnostic parameters, while beneficial, may not capture the full extent of the injury or provide sufficient information to guide therapeutic decisions. This gap highlights the need for exploring additional diagnostic parameters that could enhance the accuracy of syndesmosis injury diagnoses and inform treatment strategies more effectively. The primary goal of this research is to evaluate the usefulness of traditional radiographic measurements in comparison to new CT-based measurements for diagnosing ankle syndesmosis injuries. Specifically, this study aims to assess the accuracy of conventional parameters, including medial clear space, tibiofibular overlap, tibiofibular clear space, ATFR, and APTF, in contrast with the recently proposed CT-based measurements such as the delta and gamma angles. Moreover, the study intends to explore the relationship between these diagnostic parameters and functional outcomes, as measured by the Foot and Ankle Outcome Score (FAOS). Establishing a correlation between specific diagnostic measurements and FAOS scores will enable us to identify the most reliable predictors of functional recovery following syndesmosis injuries. This comparative analysis will provide valuable insights into the accuracy and dependability of CT-based measurements in diagnosing ankle syndesmosis injuries and their potential impact on predicting patient outcomes. The results of this study could greatly influence clinical practices by refining diagnostic criteria and optimizing treatment planning for patients with ankle syndesmosis injuries.

Keywords: ankle syndesmosis injury, diagnostic accuracy, computed tomography, radiographic measurements, Tibiofibular syndesmosis distance

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Authors: Redouane Tlemsani, Redouane, Belkacem Kouninef, Abdelkader Benyettou

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In this paper, our system is a Markovien system which we can see it like a Dynamic Bayesian Networks. One of the major interests of these systems resides in the complete training of the models (topology and parameters) starting from training data. The Bayesian Networks are representing models of dubious knowledge on complex phenomena. They are a union between the theory of probability and the graph theory in order to give effective tools to represent a joined probability distribution on a set of random variables. The representation of knowledge bases on description, by graphs, relations of causality existing between the variables defining the field of study. The theory of Dynamic Bayesian Networks is a generalization of the Bayesians networks to the dynamic processes. Our objective amounts finding the better structure which represents the relationships (dependencies) between the variables of a dynamic bayesian network. In applications in pattern recognition, one will carry out the fixing of the structure which obliges us to admit some strong assumptions (for example independence between some variables).

Keywords: Arabic on line character recognition, dynamic Bayesian network, pattern recognition, networks

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Authors: Atje Setiawan Abdullah, Budi Nurani Ruchjana, I. Gede Nyoman Mindra Jaya, Eddy Hermawan

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Ethnoscience is used to see the culture with a scientific perspective, which may help to understand how people develop various forms of knowledge and belief, initially focusing on the ecology and history of the contributions that have been there. One of the areas studied in ethnoscience is etno-informatics, is the application of informatics in the culture. In this study the science of informatics used is data mining, a process to automatically extract knowledge from large databases, to obtain interesting patterns in order to obtain a knowledge. While the application of culture described by naming database village on the island of Java were obtained from Geographic Indonesia Information Agency (BIG), 2014. The purpose of this study is; first, to classify the naming of the village on the island of Java based on the structure of the word naming the village, including the prefix of the word, syllable contained, and complete word. Second to classify the meaning of naming the village based on specific categories, as well as its role in the community behavioral characteristics. Third, how to visualize the naming of the village to a map location, to see the similarity of naming villages in each province. In this research we have developed two theorems, i.e theorems area as a result of research studies have collected intersection naming villages in each province on the island of Java, and the composition of the wedge theorem sets the provinces in Java is used to view the peculiarities of a location study. The methodology in this study base on the method of Knowledge Discovery in Database (KDD) on data mining, the process includes preprocessing, data mining and post processing. The results showed that the Java community prioritizes merit in running his life, always working hard to achieve a more prosperous life, and love as well as water and environmental sustainment. Naming villages in each location adjacent province has a high degree of similarity, and influence each other. Cultural similarities in the province of Central Java, East Java and West Java-Banten have a high similarity, whereas in Jakarta-Yogyakarta has a low similarity. This research resulted in the cultural character of communities within the meaning of the naming of the village on the island of Java, this character is expected to serve as a guide in the behavior of people's daily life on the island of Java.

Keywords: ethnoscience, ethno-informatics, data mining, clustering, Java island culture

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Authors: Prabesh Karki, Shyam Thapa Chettri, Bajarang Prasad Sah, Manoj Bhattarai, Sudeep Mishra

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Introduction: Frontal sinus is frequently described as the most difficult sinus to access surgically due to its proximity to the cribriform plate, orbit, and anterior ethmoid artery. Frontal sinus surgery requires a detailed understanding of the cellular structure and FSDP unique to each patient, making high-resolution CT scans an indispensable tool to assess the difficulty of planned sinus surgery. International Frontal Sinus Anatomy Classification (IFAC) was developed to provide a more precise nomenclature for cells in the frontal recess, classifying cells based on their anatomic origin. Objectives: To assess the proportion of frontal cell variants defined by IFAC, variation with respect to age and gender. Methods: 54 cases were enrolled after a detailed clinical history, thorough general and physical examinations, and CT a report ordered in a film. Assessment and tabulation of the presence of frontal cells according to the IFAC analyzed. The prevalence of each cell type was calculated, and data were entered in MS Excel and analyzed using Statistical Package for the Social Sciences (SPSS). Descriptive statistics and frequencies were defined for categorical and numerical variables. Frequency, percentage, the mean and standard deviation were calculated. Result: Among 54 patients, 30 (55.6%) were male and 24 (44.4%) were female. The patient enrolled ranged from 18 to 78 years. Majority33.3% (n=18) were in age group of >50 years.According to IFAC, Agger nasi cells (92.6%) were most common, whereas supraorbital ethmoidal cells were least common 16 (29.6%). Prevalence of other frontoethmoidal cells was SAC- 57.4%, SAFC- 38.9%, SBC- 74.1%, SBFC- 33.3%, FSC- 38.9% of 54 cases. Conclusion: IFAC is an international consensus document that describes an anatomically precise nomenclature for classifying frontoethmoidal cells' anatomy. This study has defined the prevalence, symmetry and reliability of frontoethmoidal cells as established by the IFAC system as in other parts of the world.

Keywords: frontal sinus, frontoethmoidal cells, international frontal sinus anatomy classification

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Authors: Vega Erdiana Dwi Fransiska, Abyan Rai Fauzan Machmudin

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Particularly, space configuration zoning is the very first juncture of a complete space configuration and region planning. Zoning is aimed to define discrete knowledge based on a local wisdom. Ancient predecessor scientifically study the sign of natural disaster towards ethnography approach by operating this knowledge. There are three main functions of space zoning, which are control function, guidance function, and additional function. The control function refers to an instrument for development control and as one of the essentials in controlling land use. Hence, the guidance function indicates as guidance for proposing operational planning and technical development or land usage. Any additional function is useful as a supplementary for region or province planning details. This phase likewise accredits to define boundary in an open space based on geographical appearance. Informant who is categorized as an elder lives in earthquake prone area, to be precise the area is the surrounding of Mount Krakatau. The collected data is one of method for analyzed with thematic model. Later on, it will be verified. In space zoning, long-range distance sensor is applied to determine visualization of the area, which will be zoned before the step of survey to validate the data. The data, which is obtained from long-range distance sensor and site survey, will be overlaid using GIS Platform. Comparing the knowledge based on a local wisdom that is well known by elderly in that area, some of it is relevant to the research, while the others are not. Based on the site survey, the interpretation of a long-range distance sensor, and determining space zoning by considering various aspects resulted in the pattern map of space zoning. This map can be integrated with disaster mitigation affected by volcano eruption.

Keywords: elderly, GIS platform, local wisdom, space zoning

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Authors: Sven Ratković

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The survey of public attitudes and knowledge was conducted as part of the Dinara back to LIFE project during June and July 2020. The aim of the research was to collect public opinions and knowledge on the topics of the biodiversity of Dinara, perception of tourist potential, sustainable development, and acceptance of the project. The research was conducted using the survey method in the cities of Sinj, Knin, Vrlika, and Trilj, and the municipalities of Hrvace, Otok, Kijevo, and Civljane, where a total of 404 people were surveyed. The respondents perceive the cultural and recreational potential of Dinara and recognize it as a potential for agriculture and tourism. According to respondents, the biological diversity of Dinara is most affected by fires and human activity. When it comes to nature protection, the majority of respondents don’t trust local self-government units and relevant ministries. The obtained results indicate the need for informing and educating the community, and they serve to adjust the project activities and better guide the touristic development of the project area. The examination will be repeated in the last project year (2023).

Keywords: protected area tourism, Dinara Nature Park, dry grasslands, touristic infrastructure

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Authors: Wilfred Elliam

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Background: Pain is a prevalent and debilitating symptom among breast cancer patients, impacting their quality of life and overall well-being. The experience of pain in this population is multifaceted, influenced by a combination of disease-related factors, treatment side effects, and individual characteristics. Despite advancements in cancer treatment and pain management, many breast cancer patients continue to suffer from chronic pain, which can persist long after the completion of treatment. Understanding the progression of pain in breast cancer patients over time and identifying its correlates is crucial for effective pain management and supportive care strategies. The purpose of this research is to understand the patterns and progression of pain experienced by breast cancer survivors over time. Methods: Data were collected from breast cancer patients at Hartford Hospital at four time points: baseline, 3, 6 and 12 weeks. Key variables measured include pain, body mass index (BMI), fatigue, musculoskeletal pain, sleep disturbance, and demographic variables (age, employment status, cancer stage, and ethnicity). Binomial generalized linear mixed models were used to examine changes in pain and symptoms over time. Results: A total of 100 breast cancer patients aged  18 years old were included in the analysis. We found that the effect of time on pain (p = 0.024), musculoskeletal pain (p= <0.001), fatigue (p= <0.001), and sleep disturbance (p-value = 0.013) were statistically significant with pain progression in breast cancer patients. Patients using aromatase inhibitors have worse fatigue (<0.05) and musculoskeletal pain (<0.001) compared to patients with Tamoxifen. Patients who are obese (<0.001) and overweight (<0.001) are more likely to report pain compared to patients with normal weight. Conclusion: This study revealed the complex interplay between various factors such as time, pain, sleep disturbance in breast cancer patient. Specifically, pain, musculoskeletal pain, sleep disturbance, fatigue exhibited significant changes across the measured time points, indicating a dynamic pain progression in these patients. The findings provide a foundation for future research and targeted interventions aimed at improving pain in breast cancer patient outcomes.

Keywords: breast cancer, chronic pain, pain management, quality of life

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Authors: Onyeka Nkwonta, Theo Haupt, Karana Padayachee

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This study aims primarily to identify potential causes of the bottlenecks in the public sector that affect delivery and formulate evidence-based interventions to improve delivery and management of infrastructure projects. An initial literature review was carried out on infrastructural development and delivery in South Africa, with the aim to formulate evidence-based interventions to improve delivery within the sector. The infrastructure delivery management model was developed to map out best practice delivery processes. These will become the backbone on which improvement initiatives that will be developed within participating stakeholders. The model will, in turn, support a range of methodologies, including the risk system and a knowledge management framework. It will also look at key challenges facing departments with the ability to ensure knowledge and skills transfer at various sectors. The research is limited because the findings were based on existing literature. This study adopted an indirect approach for infrastructure management by focussing on the challenges faced and approaches adopted to overcome these challenges. This may narrow the consideration of some of the viewpoints, thereby limiting the richness of experience available to this research.

Keywords: infrastructure, management, challenges, South Africa

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Authors: Liyun Chang, Cheng-Hsiang Tsai

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To ensure the radiation precisely delivering to the target of cancer patients, the linear accelerator equipped with the pretreatment on-board imaging system is introduced and through it the patient setup is verified before the daily treatment. New generation radiotherapy using beam-intensity modulation, usually associated the treatment with steep dose gradients, claimed to have achieved both a higher degree of dose conformation in the targets and a further reduction of toxicity in normal tissues. However, this benefit is counterproductive if the beam is delivered imprecisely. To avoid shooting critical organs or normal tissues rather than the target, it is very important to carry out the quality assurance (QA) of this on-board imaging system. The QA of the On-Board Imager® (OBI) system of one Varian Clinac-iX linear accelerator was performed through our procedures modified from a relevant report and AAPM TG142. Two image modalities, 2D radiography and 3D cone-beam computed tomography (CBCT), of the OBI system were examined. The daily and monthly QA was executed for five months in the categories of safety, geometrical accuracy and image quality. A marker phantom and a blade calibration plate were used for the QA of geometrical accuracy, while the Leeds phantom and Catphan 504 phantom were used in the QA of radiographic and CBCT image quality, respectively. The reference images were generated through a GE LightSpeed CT simulator with an ADAC Pinnacle treatment planning system. Finally, the image quality was analyzed via an OsiriX medical imaging system. For the geometrical accuracy test, the average deviations of the OBI isocenter in each direction are less than 0.6 mm with uncertainties less than 0.2 mm, while all the other items have the displacements less than 1 mm. For radiographic image quality, the spatial resolution is 1.6 lp/cm with contrasts less than 2.2%. The spatial resolution, low contrast, and HU homogenous of CBCT are larger than 6 lp/cm, less than 1% and within 20 HU, respectively. All tests are within the criteria, except the HU value of Teflon measured with the full fan mode exceeding the suggested value that could be due to itself high HU value and needed to be rechecked. The OBI system in our facility was then demonstrated to be reliable with stable image quality. The QA of OBI system is really necessary to achieve the best treatment for a patient.

Keywords: CBCT, image quality, quality assurance, OBI

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