One of the common challenges in delivering complex healthcare procedures such as radiation oncology is the organization and sharing of information in ways that facilitate workflow and prevent treatment delays. Within the major vendors of Oncology Information Systems (OIS) is a lack of tools and displays to assist in task timing and workflow processes. To address this issue, we developed an electronic whiteboard integrated with a local OIS to track, record, and evaluate time frames associated with clinical radiation oncology treatment planning processes.
We developed software using an R environment hosted on a local web-server at Seattle Cancer Care Alliance (SCCA) in 2017. The planning process was divided into stages, and time-stamped moves between planning stages were recorded automatically via Mosaiq (Elekta, Sweden) Quality Check Lists (QCLs). https://www.selleckchem.com/products/abbv-cls-484.html Whiteboard logs were merged with Mosaiq-extracted diagnostic factors and evaluated for significance. Interventional changes to task time expectations were evaluated for 6 months in 2021 and compared with 6 month periods in 2018 and 2019.
Whiteboard/Mosaiq data from the SCCA show that treatment intent, number of prescriptions, and nodal involvement were main factors influencing overall time to plan completion. Contouring and Planning times were improved by 2.6 days (p<10
) and 2.5 days (p<10
), respectively. Overall time to plan completion was reduced by 33% (5.1 days; p<10
).
This report establishes the utility of real-time task tracking tools in a radiotherapy planning process. The whiteboard results provide data-driven evidence to add justification for practice change implementations.
This report establishes the utility of real-time task tracking tools in a radiotherapy planning process. The whiteboard results provide data-driven evidence to add justification for practice change implementations.N-terminal pro-B-type natriuretic peptide is a major cardiac biomarker for early diagnosis and prognosis of heart failure. Herein, a novel label-free electrochemical immunosensor was developed based on home-made branched AuPd nanocrystals/N-doped porous carbon (AuPd NCS/NPC) for ultrasensitive and high-selective detection of N-terminal pro-B-type natriuretic peptide. Specifically, the AuPd NCS/NPC was prepared by a one-pot wet-chemical strategy by using thymine as a green structural directing agent, whose morphology, structures, and properties were strictly examined, showing high-efficiency catalysis towards electro-reduction of hydrogen peroxide. Under the optimized conditions, the fabricated sensor exhibited a dynamic linear range of 0.001 ∼ 10 ng mL-1 and a low limit of detection (0.34 pg mL-1, S/N = 3) for immunoassay of N-terminal pro-B-type natriuretic peptide. Furthermore, this platform was explored for detection of the biomarker in human serum sample with satisfactory results. Thus, the built biosensor can render valuable guidance for prospective clinical diagnostic applications.This paper analyzes the impact of possible subsidy and preferential tax policies on mobile phone (MP) recycling industries in China using system dynamics methodology, aiming to offer a reference for the construction of a reasonable policy system for MP recycling. First, different subsidy and preferential tax policies were introduced to establish a system dynamics model. Then the impact of policies proposed on MP recycling industries was analyzed using the model. The results showed that (1) newly discarded MPs could be completely recycled annually if recyclers could achieve a RMB10 recycling subsidy for each MP formally recycled; (2) an initial subsidy policy can effectively increase the number of remanufacturers, but is harmful to remanufacturing capacity; (3) stage R&D subsidy policy outperforms equalization R&D subsidy policy. Additionally, more subsidies allocated to remanufactures means more profit when R&D subsidy is limited; (4) more tax benefits provide more output and profit. Remanufacturers are more sensitive to tax benefits than recovery enterprises in the short run. Finally, several suggestions related to the construction of MP recycling policy systems were put forward based on evaluation results.The environmental issues relating to disposable of infant nappies have received considerable attention. However, adult absorbent hygiene products (AHPs) receive less attention, despite having comparable or greater environmental impact. Here we quantify and compare current and future flows of continence related AHPs entering waste streams from both infant and adult populations. Importantly our study accounts for current waste management and landfilling practices across Australia and the environmental implications of AHP disposal. Absorbent hygiene product use from infants and adults was modelled from 2020 to 2030 for Australia, and it's predicted that AHP waste generated by adults will account for between 4 and 10 times that of infants by 2030 due to an aging population. Our results indicate that 50% of used AHPs end up in landfill with both leachate and biogas collection, the remainder going to landfills without biogas collection or without both leachate and biogas collection, based on the most recent national data set, which is over a decade old. The average composition of used absorbent hygiene product (including 60% urine and faeces by mass) is estimated to contain 20% non-biodegradable material, which may complicate the biodegradability of absorbent hygiene products in landfill. Without additional regulatory incentive, the current waste management practices in Australia are likely to continue, with absorbent hygiene products typically entering landfill as municipal solid waste, rather than industrial composting or recycling facilities. More accurate estimation of environmental implications from these disposal pathways requires further work including biodegradation experiments currently unavailable in the literature.A route based on pyrolysis and physical activation with H2O and CO2 was proposed to reuse citrus waste traditionally discarded. The citrus wastes were orange peel (OP), mandarine peel (MP), rangpur lime peel (RLP), and sweet lime peel (SLP). The main aim was to use the solid products of this new route as adsorbents for Cu(II) ions. Copper ions are among the most important water pollutants due to their non-degradability, toxicity, and bioaccumulation, facilitating their inclusion and long persistence in the food chain. Besides the solid products, the liquid and gaseous fractions were evaluated for possible applications. Results showed that the citrus waste composition favored the thermochemical treatment. In addition, the following yields were obtained from the pyrolysis process approximately 30 % wt. of biochar, 40 % wt. of non-condensable gases, and 30 % wt. of bio-oil. The biochars did not present a high specific surface area. Nevertheless, activated carbons with CO2 and H2O presented specific surface areas of 212.4 m2/g and 399.4 m2/g, respectively, and reached Cu(II) adsorption capacities of 28.2 mg g-1 and 27.8 mg g-1. The adsorption kinetic study revealed that the equilibrium was attained at 60 min and the pseudo-second-order model presented a better fit to the experimental data. The main generated gases were CO2, which could be employed as an activating agent for activated carbon production. d-limonene, used for food and medicinal purposes, was the main constituent of the bio-oil.
Obstetrical anal sphincter injuries (OASIS) are complications of vaginal delivery. Unrepaired anal sphincter after delivery increases the risk of anal incontinence. The aim of our study is to search for residual defect after OASI repair by 4D introital ultrasound (US). We hypothesised that imaging prior to hospital discharge would show the same number of defects as assessment at 3months.
This is a retrospective analysis of 138 patients with immediate repair after OASIS. Since 2009, we have been routinely inviting all our patients with OASIS to the perineal clinic for postoperative follow-up. We scheduled the first visit before discharge from hospital and followed up with a second visit after three months. During both visits, patients underwent transperineal 4D ultrasound examination. We provided examination while at rest and during contraction; volumes were saved for further evaluation.
Eighty-one patients (58.7%) completed both exams and were included in the analysis. Residual external anal sphincter defect was found in 17.3% at the first visit versus 13.6% at the second (delayed) visit. We were not able to assess the sphincter in 9.9% at early versus none in the delayed examination. In 9.9%, the residual defect was not confirmed by the second examination, and in 4.9% the residual defect was missed by the first examination.
In conclusion, we have found that a 3month scan yields a smaller number of defects than a scan before discharge.
In conclusion, we have found that a 3 month scan yields a smaller number of defects than a scan before discharge.Bioreduction is an efficient approach to in-situ remediate Cr(VI)-contaminated soil, but further strengthening methods are still urgently needed. Herein, a novel immobilized biocomposite (B-HA-VE-SA) was successfully synthesized by embedding a efficient strain Bacillus sp. CRB-7 with humic acid (HA) combined vermiculite (VE) and sodium alginate (SA). The performance and enhancement mechanism of the immobilized biocomposite on remediating Cr(VI)-contaminated soil were also investigated by analyzing the whole-genome of CRB-7, Cr(VI) detoxification, soil microecological regulation, and subsequent crop growth response. Genomic annotation demonstrated that CRB-7 contains multiple genes contributed to Cr(VI) tolerance, Cr(VI) reduction and other metals resistance. Results showed that embedded CRB-7 biocomposites exhibited more effective reduction of Cr(VI) in soil compared with control and free CRB-7 treatment, especially B-HA-VE-SA achieved the highest Cr(VI) removal efficiency (96.18%) and the residual Cr proportion (49.04%) via multiple mechanisms including carrier effects, nutrient sustained-release, and electron-shuttle effect enhanced the bioremediation process. Furthermore, the synergies of CRB-7 and immobilizers (HA, VE and SA) significantly improved soil microecology (soil enzyme activities, microbial quantity and diversity), and engendered the evolution of microbial community composition and functional pathways. Consequently, pot experiments (Brassica napus L.) verified the plant-growth-promoting (12.00-18.00% and 43.82-69.00% higher in emergence rate and biomass) and Cr-accumulation-reducing effects (19.47-91.09% and 29.11-89.80% lower in root and aerial parts) of free and immobilized CRB-7. Taken together, these findings highlighted the superiority of B-HA-VE-SA in simultaneous remediation, microecological improvement and safe utilization of Cr(VI)-contaminated soil.
To chart peer-reviewed literature regarding the psychological and social health outcomes of physical activity (PA) around menopause in a systematic manner.
Nine electronic databases and 10 core journals were searched using specific search strings to identify eligible articles. Manual checking of reference lists was also performed. The selection process was guided by the stages in PRISMA-ScR.
Eighty peer-reviewed articles representing 67 studies from 25 countries were included. All articles were published between 1994 and 2021. For all studies, surveys were the primary method of measuring psychological and social health outcomes, in cross-sectional studies (36 papers), intervention studies (33), longitudinal cohort studies (10) and one paper reporting a mixed-method study. The dataset comprised a total of 103,826 women, with an average age of 52.6 and a variety of menopausal states. Most of the studies involved primarily Caucasian, relatively healthy, married and employed participants. Nineteen psychological and social health outcomes were assessed, including psychological menopause symptoms (N=34), quality of life (N=33), depression (N=30), anxiety (N=11), mental wellbeing (N=21), perceived stress (N=9), satisfaction with life (N=7) and self-esteem (N=5).