Search results for: Absorbed Dose to Patient (ADP).
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 634

Search results for: Absorbed Dose to Patient (ADP).

604 Effective Dose and Size Specific Dose Estimation with and without Tube Current Modulation for Thoracic Computed Tomography Examinations: A Phantom Study

Authors: S. Gharbi, S. Labidi, M. Mars, M. Chelli, F. Ladeb

Abstract:

The purpose of this study is to reduce radiation dose for chest CT examination by including Tube Current Modulation (TCM) to a standard CT protocol. A scan of an anthropomorphic male Alderson phantom was performed on a 128-slice scanner. The estimation of effective dose (ED) in both scans with and without mAs modulation was done via multiplication of Dose Length Product (DLP) to a conversion factor. Results were compared to those measured with a CT-Expo software. The size specific dose estimation (SSDE) values were obtained by multiplication of the volume CT dose index (CTDIvol) with a conversion size factor related to the phantom’s effective diameter. Objective assessment of image quality was performed with Signal to Noise Ratio (SNR) measurements in phantom. SPSS software was used for data analysis. Results showed including CARE Dose 4D; ED was lowered by 48.35% and 51.51% using DLP and CT-expo, respectively. In addition, ED ranges between 7.01 mSv and 6.6 mSv in case of standard protocol, while it ranges between 3.62 mSv and 3.2 mSv with TCM. Similar results are found for SSDE; dose was higher without TCM of 16.25 mGy and was lower by 48.8% including TCM. The SNR values calculated were significantly different (p=0.03<0.05). The highest one is measured on images acquired with TCM and reconstructed with Filtered back projection (FBP). In conclusion, this study proves the potential of TCM technique in SSDE and ED reduction and in conserving image quality with high diagnostic reference level for thoracic CT examinations.

Keywords: Anthropomorphic phantom, computed tomography, CT-expo, radiation dose.

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603 Iterative Image Reconstruction for Sparse-View Computed Tomography via Total Variation Regularization and Dictionary Learning

Authors: XianYu Zhao, JinXu Guo

Abstract:

Recently, low-dose computed tomography (CT) has become highly desirable due to increasing attention to the potential risks of excessive radiation. For low-dose CT imaging, ensuring image quality while reducing radiation dose is a major challenge. To facilitate low-dose CT imaging, we propose an improved statistical iterative reconstruction scheme based on the Penalized Weighted Least Squares (PWLS) standard combined with total variation (TV) minimization and sparse dictionary learning (DL) to improve reconstruction performance. We call this method "PWLS-TV-DL". In order to evaluate the PWLS-TV-DL method, we performed experiments on digital phantoms and physical phantoms, respectively. The experimental results show that our method is in image quality and calculation. The efficiency is superior to other methods, which confirms the potential of its low-dose CT imaging.

Keywords: Low dose computed tomography, penalized weighted least squares, total variation, dictionary learning.

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602 Dosimetric Analysis of Intensity Modulated Radiotherapy versus 3D Conformal Radiotherapy in Adult Primary Brain Tumors: Regional Cancer Centre, India

Authors: Ravi Kiran Pothamsetty, Radha Rani Ghosh, Baby Paul Thaliath

Abstract:

Radiation therapy has undergone many advancements and evloved from 2D to 3D. Recently, with rapid pace of drug discoveries, cutting edge technology, and clinical trials has made innovative advancements in computer technology and treatment planning and upgraded to intensity modulated radiotherapy (IMRT) which delivers in homogenous dose to tumor and normal tissues. The present study was a hospital-based experience comparing two different conformal radiotherapy techniques for brain tumors. This analytical study design has been conducted at Regional Cancer Centre, India from January 2014 to January 2015. Ten patients have been selected after inclusion and exclusion criteria. All the patients were treated on Artiste Siemens Linac Accelerator. The tolerance level for maximum dose was 6.0 Gyfor lenses and 54.0 Gy for brain stem, optic chiasm and optical nerves as per RTOG criteria. Mean and standard deviation values of PTV98%, PTV 95% and PTV 2% in IMRT were 93.16±2.9, 95.01±3.4 and 103.1±1.1 respectively; for 3DCRT were 91.4±4.7, 94.17±2.6 and 102.7±0.39 respectively. PTV max dose (%) in IMRT and 3D-CRT were 104.7±0.96 and 103.9±1.0 respectively. Maximum dose to the tumor can be delivered with IMRT with acceptable toxicity limits. Variables such as expertise, location of tumor, patient condition, and TPS influence the outcome of the treatment.

Keywords: IMRT, 3D CRT, Brain, tumors, OARs, RTOG.

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601 Thyroids Dose Evaluation and Calculation of Backscatter Factors for Co-60 Irradiations

Authors: D. Kısınma, A. B. Tugrul

Abstract:

The aim of the study is evaluation of absorbed doses for thyroids by using neck phantoms. For this purpose, it was arranged the irradiation set with different phantoms. Three different materials were used for phantom materials as, water, parafine and wood. The phantoms were three different dimensions for simulation of different ages and human race for each material. Co-60 gammao source was used for irradiation and the experimental procedure applied rigorously with narrow beam geometry.  As the results of the experiments the relative radiation doses are evaluated for therapic applications for thyroids and backscattering factors were calculated and shown that water, parafine and wood can appropriate for phantom material with the converge values of backscattering factors.

Keywords: Co-60, Dosimetry, phantom, thyroids.

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600 Radioactivity Assessment of Sediments in Negombo Lagoon Sri Lanka

Authors: H. M. N. L. Handagiripathira

Abstract:

The distributions of naturally occurring and anthropogenic radioactive materials were determined in surface sediments taken at 27 different locations along the bank of Negombo Lagoon in Sri Lanka. Hydrographic parameters of lagoon water and the grain size analyses of the sediment samples were also carried out for this study. The conductivity of the adjacent water was varied from 13.6 mS/cm to 55.4 mS/cm near to the southern end and the northern end of the lagoon, respectively, and equally salinity levels varied from 7.2 psu to 32.1 psu. The average pH in the water was 7.6 and average water temperature was 28.7 °C. The grain size analysis emphasized the mass fractions of the samples as sand (60.9%), fine sand (30.6%) and fine silt+clay (1.3%) in the sampling locations. The surface sediment samples of wet weight, 1 kg each from upper 5-10 cm layer, were oven dried at 105 °C for 24 hours to get a constant weight, homogenized and sieved through a 2 mm sieve (IAEA technical series no. 295). The radioactivity concentrations were determined using gamma spectrometry technique. Ultra Low Background Broad Energy High Purity Ge Detector, BEGe (Model BE5030, Canberra) was used for radioactivity measurement with Canberra Industries' Laboratory Source-less Calibration Software (LabSOCS) mathematical efficiency calibration approach and Geometry composer software. The mean activity concentration was found to be 24 ± 4, 67 ± 9, 181 ± 10, 59 ± 8, 3.5 ± 0.4 and 0.47 ± 0.08 Bq/kg for 238U, 232Th, 40K, 210Pb, 235U and 137Cs respectively. The mean absorbed dose rate in air, radium equivalent activity, external hazard index, annual gonadal dose equivalent and annual effective dose equivalent were 60.8 nGy/h, 137.3 Bq/kg, 0.4, 425.3 mSv/year and 74.6 mSv/year, respectively. The results of this study will provide baseline information on the natural and artificial radioactive isotopes and environmental pollution associated with information on radiological risk.

Keywords: Gamma spectrometry, lagoon, radioactivity, sediments.

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599 The Emotional Life of Patients with Chronic Diseases: A Framework for Health Promotion Strategies

Authors: Leslie Beale

Abstract:

Being a patient with a chronic disease is both a physical and emotional experience. The ability to recognize a patient’s emotional health is an important part of a health care provider’s skills. For the purposes of this paper, emotional health is viewed as the way that we feel, and the way that our feelings affect us. Understanding the patient’s emotional health leads to improved provider-patient relationships and health outcomes. For example, when a patient first hears his or her diagnosis from a provider, they might find it difficult to cope with their emotions. Struggling to cope with emotions interferes with the patient’s ability to read, understand, and act on health information and services. As a result, the patient becomes more frustrated and confused, creating barriers to accessing healthcare services. These barriers are challenging for both the patient and their healthcare providers. There are five basic emotions that are part of who we are and are always with us: fear, anger, sadness, joy, and compassion. Living with a chronic disease however can cause a patient to experience and express these emotions in new and unique ways. Within the provider-patient relationship, there needs to be an understanding that each patient experiences these five emotions and, experiences them at different times. In response to this need, the paper highlights a health promotion framework for patients with chronic disease. This framework emphasizes the emotional health of patients.

Keywords: Health promotion, emotional health, patients with chronic disease, patient-centered care.

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598 The Study of Managing the Personal Consent in the Electronic Healthcare Environment

Authors: Yi-Yun Ko, Der-Ming Liou

Abstract:

The Electronic Health Record (EHR) system is very general and we should pay more attention to a patient-s privacy. The patient-s consent is one of the elements when dealing with privacy topics. This study focuses on the creating and managing of patient consent. The integration of the HL7 standards and the IHE BPPC profile provides a base for the creation of patient consent. Establishing the platform offers the patients a way to create, revoke or update their consents. Through this platform, they can manage their consents in an easier manner.

Keywords: consent, EHR, HL7, IHE

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597 Effect of Oral Administration of “Gadagi“ Tea on Liver Function in Rats

Authors: A. M. Gadanya, M. S. Sule, M. K. Atiku

Abstract:

Effect of oral administration of “Gadagi" tea on liver function was assessed on 50 healthy male albino rats which were grouped and administered with different doses(mg/kg) i.e low dose (380mg/kg, 415mg/kg, 365mg/kg, 315mg/kg for “sak", “sada" and “magani" respectively), standard dose ( 760mg/kg, 830mg/kg, 730mg/kg for “sak-, “sada" and “magani" respectively) and high dose (1500mg/kg, 1700mg/kg and 1460mg/kg for “sak--,"sada" and “magani" groups respectively) for a period of four weeks. Animals that were not administered with the tea constituted the control group. At the end of fourth week, the animals were sacrificed and their serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), total protein (TP), albumin (ALB), and globulins (GLO) were determined. Mean serum ALT and ALP activities were significantly higher (P<0.05) in rats orally administered with high dose of “sak" and those administered with standard dose of “sada" than those of the control group, suggesting a probable impairment of liver function due to liver cytolysis.Mean serum AST, ALT and ALP activities were significantly lower (P<0.05) in rats that were orally administered with high dose of “magani" than that of the control group, suggesting a probable improvement in liver function (due to decrease in liver cytolysis). Mean serum TP, ALB and GLO levels were significantly higher (P<0.05) in rats that were orally administered with the various doses of“sak", “sada" and “magani" than those of the control group. This also suggests a probable improvement in the synthetic function of the liver.Thus, some dosages of “sak" and “sada could be hepatotoxic, whereas “magani" especially at the high dose administered could have pharmacologically positive effect on the liver of the rats.

Keywords: Gadagi" tea, Liver function, Oral, Rats.

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596 Radiobiological Model in Radiotherapy Planning for Prostate Cancer Treatment

Authors: Pradip Deb

Abstract:

Quantitative radiobiological models can be used to assess the optimum clinical outcome from sophisticated therapeutic modalities by calculating tumor control probability (TCP) and normal tissue complication probability (NTCP). In this study two 3D-CRT and an IMRT treatment plans were developed with an initial prescription dose of 60 Gy in 2 Gy/fraction to prostate. Sensitivity of TCP and Complication free tumor control probability (P+) to the different values of α/β ratio was investigated for various prescription doses planned to be delivered in either a fixed number of fractions (I) or in a fixed dose per fraction (II) in each of the three different treatment plans. High dose/fraction and high α/β value result in comparatively smaller P+ and IMRT plans resulted in the highest P+, mainly due to the decrease in NTCP. If α/β is lower than expected, better tumor control can be achieved by increasing dose/fraction but decreasing the number of fractions.

Keywords: Linear Quadratic Model, TCP, NTCP, α/β ratio.

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595 Optimization of HALO Structure Effects in 45nm p-type MOSFETs Device Using Taguchi Method

Authors: F. Salehuddin, I. Ahmad, F. A. Hamid, A. Zaharim, H. A. Elgomati, B. Y. Majlis, P. R. Apte

Abstract:

In this study, the Taguchi method was used to optimize the effect of HALO structure or halo implant variations on threshold voltage (VTH) and leakage current (ILeak) in 45nm p-type Metal Oxide Semiconductor Field Effect Transistors (MOSFETs) device. Besides halo implant dose, the other process parameters which used were Source/Drain (S/D) implant dose, oxide growth temperature and silicide anneal temperature. This work was done using TCAD simulator, consisting of a process simulator, ATHENA and device simulator, ATLAS. These two simulators were combined with Taguchi method to aid in design and optimize the process parameters. In this research, the most effective process parameters with respect to VTH and ILeak are halo implant dose (40%) and S/D implant dose (52%) respectively. Whereas the second ranking factor affecting VTH and ILeak are oxide growth temperature (32%) and halo implant dose (34%) respectively. The results show that after optimizations approaches is -0.157V at ILeak=0.195mA/μm.

Keywords: Optimization, p-type MOSFETs device, HALO Structure, Taguchi Method.

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594 Researches Concerning Photons as Corpuscles with Mass and Negative Electrostatic Charge

Authors: Ioan Rusu

Abstract:

Let us consider that the entire universe is composed of a single hydrogen atom within which the electron is moving around the proton. In this case, according to classical theories of physics, radiation, photons respectively, should be absorbed by the electron. Depending on the number of photons absorbed, the electron radius of rotation around the proton is established. Until now, the principle of photons absorption by electrons and the electron transition to a new energy level, namely to a higher radius of rotation around the proton, is not clarified in physics. This paper aims to demonstrate that radiation, photons respectively, have mass and negative electrostatic charge similar to electrons but infinitely smaller. The experiments which demonstrate this theory are simple: thermal expansion, photoelectric effect and thermonuclear reaction.

Keywords: Electrostatic, electron, proton, photon, radiation.

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593 Profile Calculation in Water Phantom of Symmetric and Asymmetric Photon Beam

Authors: N. Chegeni, M. J. Tahmasebi Birgani

Abstract:

Nowadays, in most radiotherapy departments, the commercial treatment planning systems (TPS) used to calculate dose distributions needs to be verified; therefore, quick, easy-to-use and low cost dose distribution algorithms are desirable to test and verify the performance of the TPS. In this paper, we put forth an analytical method to calculate the phantom scatter contribution and depth dose on the central axis based on the equivalent square concept. Then, this method was generalized to calculate the profiles at any depth and for several field shapes regular or irregular fields under symmetry and asymmetry photon beam conditions. Varian 2100 C/D and Siemens Primus Plus Linacs with 6 and 18 MV photon beam were used for irradiations. Percentage depth doses (PDDs) were measured for a large number of square fields for both energies, and for 45º wedges which were employed to obtain the profiles in any depth. To assess the accuracy of the calculated profiles, several profile measurements were carried out for some treatment fields. The calculated and measured profiles were compared by gamma-index calculation. All γ–index calculations were based on a 3% dose criterion and a 3 mm dose-to-agreement (DTA) acceptance criterion. The γ values were less than 1 at most points. However, the maximum γ observed was about 1.10 in the penumbra region in most fields and in the central area for the asymmetric fields. This analytical approach provides a generally quick and fairly accurate algorithm to calculate dose distribution for some treatment fields in conventional radiotherapy.

Keywords: Dose distribution, equivalent field, asymmetric field, irregular field.

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592 Robotic Arm Allowing a Diabetic Quadriplegic Patient to Self-Administer Insulin

Authors: L. Parisi

Abstract:

A method which allows a diabetic quadriplegic patient that has had four limb amputations (above the knee and elbow) to self-administer injections of insulin has been designed. The aim of this research project is to improve a quadriplegic patient’s selfmanagement, affected by diabetes, by designing a suitable device for self-administering insulin. The quadriplegic patient affected by diabetes has to be able to selfadminister insulin safely and independently to guarantee stable healthy conditions. The device also should be designed to adapt to a number of different varying personal characteristics such as height and body weight.

Keywords: Robotics, diabetes, quadriplegia, self-management.

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591 Study on Compressive Strength and Setting Times of Fly Ash Concrete after Slump Recovery Using Superplasticizer

Authors: Chaiyakrit Raoupatham, Ram Hari Dhakal, Chalermchai Wanichlamlert

Abstract:

Fresh concrete has one of dynamic properties known as slump. Slump of concrete is design to compatible with placing method. Due to hydration reaction of cement, the slump of concrete is loss through time. Therefore, delayed concrete probably get reject because slump is unacceptable. In order to recover the slump of delayed concrete the second dose of superplasticizer (naphthalene based type F) is added into the system, the slump recovery can be done as long as the concrete is not setting. By adding superplasticizer as solution for recover unusable slump loss concrete may affects other concrete properties. Therefore, this paper was observed setting times and compressive strength of concrete after being re-dose with chemical admixture type F (superplasticizer, naphthalene based) for slump recovery. The concrete used in this study was fly ash concrete with fly ash replacement of 0%, 30% and 50% respectively. Concrete mix designed for test specimen was prepared with paste content (ratio of volume of cement to volume of void in the aggregate) of 1.2 and 1.3, water-to-binder ratio (w/b) range of 0.3 to 0.58, initial dose of superplasticizer (SP) range from 0.5 to 1.6%. The setting times of concrete were tested both before and after re-dosed with different amount of second dose and time of dosing. The research was concluded that addition of second dose of superplasticizer would increase both initial and final setting times accordingly to dosage of addition. As for fly ash concrete, the prolongation effect was higher as the replacement of fly ash increase. The prolongation effect can reach up to maximum about 4 hours. In case of compressive strength, the re-dosed concrete has strength fluctuation within acceptable range of ±10%.

Keywords: Compressive strength, Fly ash concrete, Second dose of superplasticizer, Slump recovery, Setting times.

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590 Development of a Tunisian Measurement Scale for Patient Satisfaction: Study case in Tunisian Private Clinics

Authors: M. Daoud-Marrakchi, S. Fendri-Elouze, Ch. Ill, B. Bejar-Ghadhab

Abstract:

The aim of this research is to propose a Measurement Scale for Patient Satisfaction (MSPS) in the context of Tunisian private clinics. This scale is developed using value management methods and is validated by statistic tools with SPSS.

Keywords: Functional analysis, Patient satisfaction, Questionnaire, Reliability, Validity.

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589 Optimizing Exposure Parameters in Digital Mammography: A Study in Morocco

Authors: Talbi Mohammed, Oustous Aziz, Ben Messaoud Mounir, Sebihi Rajaa, Khalis Mohammed

Abstract:

Background: Breast cancer is the leading cause of death for women around the world. Screening mammography is the reference examination, due to its sensitivity for detecting small lesions and micro-calcifications. Therefore, it is essential to ensure quality mammographic examinations with the most optimal dose. These conditions depend on the choice of exposure parameters. Clinically, practices must be evaluated in order to determine the most appropriate exposure parameters. Material and Methods: We performed our measurements on a mobile mammography unit (PLANMED Sofie-classic.) in Morocco. A solid dosimeter (AGMS Radcal) and a MTM 100 phantom allow to quantify the delivered dose and the image quality. For image quality assessment, scores are defined by the rate of visible inserts (MTM 100 phantom), obtained and compared for each acquisition. Results: The results show that the parameters of the mammography unit on which we have made our measurements can be improved in order to offer a better compromise between image quality and breast dose. The last one can be reduced up from 13.27% to 22.16%, while preserving comparable image quality.

Keywords: Mammography, image quality, breast dose.

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588 Impact of Flexibility on Patient Satisfaction and Behavioral Intention: A Critical Reassessment and Model Development

Authors: Pradeep Kumar, Shibashish Chakraborty, Sasadhar Bera

Abstract:

In the anticipation of demand fluctuations, services cannot be inventoried and hence it creates a difficult problem in marketing of services. The inability to meet customers (patients) requirements in healthcare context has more serious consequences than other service sectors. In order to meet patient requirements in the current uncertain environment, healthcare organizations are seeking ways for improved service delivery. Flexibility provides a mechanism for reducing variability in service encounters and improved performance. Flexibility is defined as the ability of the organization to cope with changing circumstances or instability caused by the environment. Patient satisfaction is an important performance outcome of healthcare organizations. However, the paucity of information exists in healthcare delivery context to examine the impact of flexibility on patient satisfaction and behavioral intention. The present study is an attempt to develop a conceptual foundation for investigating overall impact of flexibility on patient satisfaction and behavioral intention. Several dimensions of flexibility in healthcare context are examined and proposed to have a significant impact on patient satisfaction and intention. Furthermore, the study involves a critical examination of determinants of patient satisfaction and development of a comprehensive view the relationship between flexibility, patient satisfaction and behavioral intention. Finally, theoretical contributions and implications for healthcare professionals are suggested from flexibility perspective.

Keywords: Healthcare, flexibility, patient satisfaction, behavioral intention.

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587 The Removal of As(V) from Drinking Waters by Coagulation Process using Iron Salts

Authors: M. Donmez, F. Akbal

Abstract:

In this study arsenate [As(V)] removal from drinking water by coagulation process was investigated. Ferric chloride (FeCl3.6H2O) and ferrous sulfate (FeSO4.7H2O) were used as coagulant. The effects of major operating variables such as coagulant dose (1–30 mg/L) and pH (5.5–9.5) were investigated. Ferric chloride and ferrous sulfate were found as effective and reliable coagulant due to required dose, residual arsenate and coagulant concentration. Optimum pH values for maximum arsenate removal for ferrous sulfate and ferric chloride were found as 8 and 7.5. The arsenate removal efficiency decreased at neutral and acidic pH values for Fe(II) and at the high acidic and high alkaline pH for Fe(III). It was found that the increase of coagulant dose caused a substantial increase in the arsenate removal. But above a certain ferric chloride and ferrous sulfate dosage, the increase in arsenate removal was not significant. Ferric chloride and ferrous sulfate dose above 8 mg/L slightly increased arsenate removal.

Keywords: Arsenic removal, coagulation, ıron salts, drinking water.

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586 Verifying the Supremacy of Volume Modulated Arc Therapy Over Intensity Modulated Radiation Therapy: Pelvis Malignancies’ Perspective

Authors: M. Umar Farooq, T. Ahmad Afridi, M. Zia-Ul-Islam Arsalan, U. Hussain Haider, S. Ullah

Abstract:

Cancer, a leading fatal disease worldwide, can be treated with various techniques including radiation therapy. It involves the use of ionizing radiation to target cancer cells. On basis of source placement, radiation therapy is of two types i.e., Brachytherapy and External Beam Radiotherapy (EBRT). EBRT has evolved from 2-D conventional therapy to 3-D Conformal radiotherapy (3D-CRT) and then Intensity-Modulated Radiotherapy (IMRT). IMRT improves dose conformity and sparing of organs at risk. Volumetric Modulated Arc Therapy (VMAT) is a modern technique that uses treatment delivery in arcs with rotation of the gantry. In this report, a dosimetry comparison was performed between IMRT and VMAT. This study was conducted in the Radiotherapy Department of the Institute of Nuclear Medicine and Oncology Lahore (INMOL). Ten patients with Prostate Carcinoma were selected for this study to compare the methods. Simulation of these patients was done with help of a CT Simulator. All target volumes and organs were delineated by the oncologists. Then suitable fields/arcs were applied which cover volumes effectively. This was followed by the optimization of plans for both techniques for every patient. Finally, a comparison of evaluating parameters e.g., Conformity Index (CI), Volume Coverage, Homogeneity Index (HI), Organ Doses, and MUs (Monitor Units) was performed. We obtained better results of target conformity indices from VMAT (CI = 1.16) than IMRT (CI = 1.24). VMAT was better in organ sparing too. Also, VMAT shows fewer MUs (733 MUs) as compared to IMRT (2149 MUs). From this study, it is concluded that VMAT is a better treatment technique than IMRT. This technique will enhance treatment efficiency as it takes less time in obtaining the required results. Also, a very less scatter dose will be delivered to the patient.

Keywords: 2-D Conventional Radiotherapy, 3-D Conformal Radiotherapy, Intensity Modulated Radiotherapy, Prostate Carcinoma, Radiotherapy, Volumetric Modulated Arc Therapy.

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585 Strategies for Patient Families Integration in Caregiving: A Consensus Opinion

Authors: Ibrahim A. Alkali

Abstract:

There is no reservation on the outstanding contribution of patient families in restoration of hospitalised patients, hence their consideration as essential component of hospital ward regimen. The psychological and emotional support a patient requires has been found to be solely provided by the patient’s family. However, consideration of their presence as one of the major functional requirements of an inpatient setting design have always been a source of disquiet, especially in developing countries where policies, norms and protocols of healthcare administration have no consideration for the patients’ family. This have been a major challenge to the hospital ward facilities, a concern for the hospital administration and patient management. The study therefore is aimed at obtaining a consensus opinion on the best approach for family integration in the design of an inpatient setting.  A one day visioning charrette involving Architects, Nurses, Medical Doctors, Healthcare assistants and representatives from the Patient families was conducted with the aim of arriving at a consensus opinion on practical design approach for sustainable family integration. Patient’s family are found to be decisive character of hospital ward regimen that cannot be undermined. However, several challenges that impede family integration were identified and subsequently a recommendation for an ideal approach. This will serve as a guide to both architects and hospital management in implementing much desired Patient and Family Centred Care.

Keywords: Caregiving, Inpatient setting, Integration, Patient Families.

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584 Reverse Twin Block with Expansion Screw for Treatment of Skeletal Class III Malocclusion in Growing Patient: Case Report

Authors: Alfrina Marwan, Erna Sulistyawati

Abstract:

Class III malocclusion shows both skeletal and dentoalveolar component. Sketal Class III malocclusion can have variants in different region, maxilla or mandibular. Skeletal Class III malocclusion during growth period is considered to treat to prevent its severity in adulthood. Orthopedics treatment of skeletal Class III malocclusion in growing patient can be treated by using reverse twin block with expansion screw to modify the growth pattern. The objective of this case report was to describe the functional correction of skeletal Class III maloclussion using reverse twin block with expansion screw in growing patient. A patient with concave profile came with a chief complaint of aesthetic problems. The cephalometric analysis showed that patient had skeletal Class III malocclusion (ANB -50, SNA 75º, Wits appraisal -3 mm) with anterior cross bite and deep bite (overjet -3 mm, overbite 6 mm). In this case report, the patient was treated with reverse twin block appliance with expansion screw. After three months of treatment, the skeletal problems have been corrected (ANB -1°), overjet, overbite and aesthetic were improved. Reverse twin block appliance with expansion screw can be used as orthopedics treatment for skeletal Class III malocclusion in growing patient and can improve the aesthetic with great satisfaction which was the main complaint in this patient.

Keywords: Growing patient, maxilla retrognatism, reverse twin blocks, skeletal Class III malocclusion.

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583 Radon Concentration in the Water Samples of Hassan District, Karnataka, India

Authors: T. S. Shashikumar

Abstract:

Radon is a radioactive gas emitted from radium, a daughter product of uranium that occurs naturally in rocks and soil. Radon, together with its decay products, emits alpha particles that can damage lung tissue. The activity concentration of 222Ra has been analyzed in water samples collected from borewells and rivers in and around Hassan city, Karnataka State, India. The measurements were performed by Emanometry technique. The concentration of 222Rn in borewell waters varies from 18.49±1.89 to 397.26±12.3 Bql-1 with geometric mean 120.48±12.87 Bql-1 and in river waters it varies from 92.63±9.31 to 93.98±9.51 Bql-1 with geometric mean of 93.16±9.33 Bql-1. In the present study, the radon concentrations are higher in Adarshanagar and Viveka Nagar which are found to be 397.26±12.3 Bql-1 and 325.78±32.56 Bql-1. Most of the analysed samples show a 222Rn concentration more than 100 Bql-1 and this can be attributed to the geology of the area where the ground waters are located, which is predominantly of granitic characteristic. The average inhalation dose and ingestion dose in the borewell water are found to be 0.405 and 0.033 µSvy-1; and in river water it is found to be 0.234 and 0.019 µSvy-1, respectively. The average total effective dose rate in borewell waters and river waters are found to be 0.433 and 0.253 µSvy-1, which does not cause any health risk to the population of Hassan region.

Keywords: Borewell, effective dose, emanometry, 222Rn.

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582 Smartphones for In-home Diagnostics in Telemedicine

Authors: Nálevka Petr

Abstract:

Many contemporary telemedical applications rely on regular consultations over the phone or video conferencing which consumes valuable resources such as the time of the doctors. Some applications or treatments allow automated diagnostics on the patient side which only notifies the doctors in case a significant worsening of patient’s condition is measured. Such programs can save valuable resources but an important implementation issue is how to ensure effective and cheap diagnostics on the patient side. First, specific diagnostic devices on patient side are expensive and second, they need to be user-˜friendly to encourage patient’s cooperation and reduce errors in usage which may cause noise in diagnostic data. This article proposes the use of modern smartphones and various build-in or attachable sensors as universal diagnostic devices applicable in a wider range of telemedical programs and demonstrates their application on a case-study – a program for schizophrenic relapse prevention.

Keywords: Smartphones, Actigraphy, Telemedicine, In-home Diagnostics

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581 An ANN-Based Predictive Model for Diagnosis and Forecasting of Hypertension

Authors: O. O. Obe, V. Balanica, E. Neagoe

Abstract:

The effects of hypertension are often lethal thus its early detection and prevention is very important for everybody. In this paper, a neural network (NN) model was developed and trained based on a dataset of hypertension causative parameters in order to forecast the likelihood of occurrence of hypertension in patients. Our research goal was to analyze the potential of the presented NN to predict, for a period of time, the risk of hypertension or the risk of developing this disease for patients that are or not currently hypertensive. The results of the analysis for a given patient can support doctors in taking pro-active measures for averting the occurrence of hypertension such as recommendations regarding the patient behavior in order to lower his hypertension risk. Moreover, the paper envisages a set of three example scenarios in order to determine the age when the patient becomes hypertensive, i.e. determine the threshold for hypertensive age, to analyze what happens if the threshold hypertensive age is set to a certain age and the weight of the patient if being varied, and, to set the ideal weight for the patient and analyze what happens with the threshold of hypertensive age.

Keywords: Neural Network, hypertension, data set, training set, supervised learning.

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580 Antibiotic Prescribing in the Acute Care in Iraq

Authors: Ola A. Nassr, Ali M. Abd Alridha, Rua A. Naser, Rasha S. Abbas

Abstract:

Background: Excessive and inappropriate use of antimicrobial agents among hospitalized patients remains an important patient safety and public health issue worldwide. Not only does this behavior incur unnecessary cost but it is also associated with increased morbidity and mortality. The objective of this study is to obtain an insight into the prescribing patterns of antibiotics in surgical and medical wards, to help identify a scope for improvement in service delivery. Method: A simple point prevalence survey included a convenience sample of 200 patients admitted to medical and surgical wards in a government teaching hospital in Baghdad between October 2017 and April 2018. Data were collected by a trained pharmacy intern using a standardized form. Patient’s demographics and details of the prescribed antibiotics, including dose, frequency of dosing and route of administration, were reported. Patients were included if they had been admitted at least 24 hours before the survey. Patients under 18 years of age, having a diagnosis of cancer or shock, or being admitted to the intensive care unit, were excluded. Data were checked and entered by the authors into Excel and were subjected to frequency analysis, which was carried out on anonymized data to protect patient confidentiality. Results: Overall, 88.5% of patients (n=177) received 293 antibiotics during their hospital admission, with a small variation between wards (80%-97%). The average number of antibiotics prescribed per patient was 1.65, ranging from 1.3 for medical patients to 1.95 for surgical patients. Parenteral third-generation cephalosporins were the most commonly prescribed at a rate of 54.3% (n=159) followed by nitroimidazole 29.4% (n=86), quinolones 7.5% (n=22) and macrolides 4.4% (n=13), while carbapenems and aminoglycosides were the least prescribed together accounting for only 4.4% (n=13). The intravenous route was the most common route of administration, used for 96.6% of patients (n=171). Indications were reported in only 63.8% of cases. Culture to identify pathogenic organisms was employed in only 0.5% of cases. Conclusion: Broad-spectrum antibiotics are prescribed at an alarming rate. This practice may provoke antibiotic resistance and adversely affect the patient outcome. Implementation of an antibiotic stewardship program is warranted to enhance the efficacy, safety and cost-effectiveness of antimicrobial agents.

Keywords: Acute care, antibiotic misuse, Iraq, prescribing.

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579 Using Mixed Amine Solution for Gas Sweetening

Authors: Zare Aliabadi, Hassan, Mirzaei, Somaye

Abstract:

The use of amine mixtures employing methyldiethanolamine (MDEA), monoethanolamine (MEA), and diethanolamine (DEA) have been investigated for a variety of cases using a process simulation program called HYSYS. The results show that, at high pressures, amine mixtures have little or no advantage in the cases studied. As the pressure is lowered, it becomes more difficult for MDEA to meet residual gas requirements and mixtures can usually improve plant performance. Since the CO2 reaction rate with the primary and secondary amines is much faster than with MDEA, the addition of small amounts of primary or secondary amines to an MDEA based solution should greatly improve the overall reaction rate of CO2 with the amine solution. The addition of MEA caused the CO2 to be absorbed more strongly in the upper portion of the column than for MDEA along. On the other hand, raising the concentration for MEA to 11%wt, CO2 is almost completely absorbed in the lower portion of the column. The addition of MEA would be most advantageous. Thus, in areas where MDEA cannot meet the residual gas requirements, the use of amine mixtures can usually improve the plant performance.

Keywords: CO2, H2S, Methyldiethanolamine, Monoethanolamine

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578 Thread Lift: Classification, Technique, and How to Approach to the Patient

Authors: Panprapa Yongtrakul, Punyaphat Sirithanabadeekul, Pakjira Siriphan

Abstract:

Background: The thread lift technique has become popular because it is less invasive, requires a shorter operation, less downtime, and results in fewer postoperative complications. The advantage of the technique is that the thread can be inserted under the skin without the need for long incisions. Currently, there are a lot of thread lift techniques with respect to the specific types of thread used on specific areas, such as the mid-face, lower face, or neck area. Objective: To review the thread lift technique for specific areas according to type of thread, patient selection, and how to match the most appropriate to the patient. Materials and Methods: A literature review technique was conducted by searching PubMed and MEDLINE, then compiled and summarized. Result: We have divided our protocols into two sections: Protocols for short suture, and protocols for long suture techniques. We also created 3D pictures for each technique to enhance understanding and application in a clinical setting. Conclusion: There are advantages and disadvantages to short suture and long suture techniques. The best outcome for each patient depends on appropriate patient selection and determining the most suitable technique for the defect and area of patient concern.

Keywords: Thread lift, thread lift method, thread lift technique, thread lift procedure, threading.

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577 Effect of Gamma Irradiation on Structural and Optical Properties of ZnO/Mesoporous Silica Nanocomposite

Authors: K. Sowri Babu, P. Srinath, N. Rajeswara Rao, K. Venugopal Reddy

Abstract:

The effect of gamma ray irradiation on morphology and optical properties of ZnO/Mesoporous silica (MPS) nanocomposite was studied. The ZnO/MPS nanocomposite was irradiated with gamma rays of doses 30, 60, and 90 kGy and dose-rate of irradiation was 0.15 kGy/hour. Irradiated samples are characterized with FE-SEM, FT-IR, UV-vis, and Photoluminescence (PL) spectrometers. SEM pictures showed that morphology changed from spherical to flake like morphology. UV-vis analysis showed that the band gap increased with increase of gamma ray irradiation dose. This enhancement of the band gap is assigned to the depletion of oxygen vacancies with irradiation. The intensity of PL peak decreased gradually with increase of gamma ray irradiation dose. The decrease in PL intensity is attributed to the decrease of oxygen vacancies at the interface due to poor interface and improper passivation between ZnO/MPS.

Keywords: ZnO nanoparticles, photoluminescence, porous silicon, nanocomposites.

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576 A Novel Dosimetry System for Computed Tomography using Phototransistor

Authors: C. M. M. Paschoal, M. L. Sobrinho, D. do N. Souza, J. Antônio Filho, L. A. P. Santos

Abstract:

Computed tomography (CT) dosimetry normally uses an ionization chamber 100 mm long to estimate the computed tomography dose index (CTDI), however some reports have already indicated that small devices could replace the long ion chamber to improve quality assurance procedures in CT dosimetry. This paper presents a novel dosimetry system based in a commercial phototransistor evaluated for CT dosimetry. Three detector configurations were developed for this system: with a single, two and four devices. Dose profile measurements were obtained with them and their angular response were evaluated. The results showed that the novel dosimetry system with the phototransistor could be an alternative for CT dosimetry. It allows to obtain the CT dose profile in details and also to estimate the CTDI in longer length than the 100 mm pencil chamber. The angular response showed that the one device detector configuration is the most adequate among the three configurations analyzed in this study.

Keywords: Computed tomography, dosimetry, photo-transistor

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575 Experimental Validation of Treatment Planning for Multiple Radiotherapy Fields by EDR2 Film Dosimeter

Authors: Vahid Fayaz , Asieh Tavakol

Abstract:

To investigate the applicability of the EDR-2 film for clinical radiation dosimetry, percentage depth-doses, profiles and distributions in open and dynamically wedged fields were measured using film and compared with data from a Treatment Planning system.The validity of the EDR2 film to measure dose in a plane parallel to the beam was tested by irradiating 10 cm×10 cm and 4 cm×4 cm fields from a Siemens, primus linac with a 6MV beam and a source-to-surface distance of 100 cm. The film was placed Horizontally between solid water phantom blocks and marked with pin holes at a depth of 10 cm from the incident beam surface. The film measurement results, in absolute dose, were compared with ion chamber measurements using a Welhoffer scanning water tank system and Treatment Planning system. Our results indicate a maximum underestimate of calculated dose of 8 % with Treatment Planning system.

Keywords: 6MV Photon , EDR-2 film, Radiotherapy, TreatmentPlanning system

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