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Evaluation of Air-Kerma and Absorbed Dose to Water for External Radiotherapy Beam Using Ionization Chamber

Open Journal of Radiology 2024年第3期14卷 113-124页

作者： Collins Omondi margaret chege Samson Omondi Kenyatta University Nairobi Kenya Jomo Kenyatta University of Agriculture and Technology Nairobi Kenya

Radiotherapy is the most widely applied oncologic treatment modality utilizing ionizing radiation. A high degree of accuracy, reliability and reproducibility is required for a successful treatment outcome. Measurement using ionization chamber is a prerequisite for absorbed dose determination for external beam radiotherapy. Calibration coefficient is expressed in terms of air kerma and absorbed dose to water traceable to Secondary Standards Dosimetry Laboratory. The objective of this work was to evaluate the level of accuracy of ionization chamber used for clinical radiotherapy beam determination. Measurement and accuracy determination were carried out according to IAEA TRS 398 protocol. Clinical farmers type ionization chamber measurement and National Reference standard from Secondary Standards Dosimetry Laboratory were both exposed to cobalt-60 beam and measurement results compared under the same environmental conditions. The accuracy level between National Reference Standard and clinical radiotherapy standard was found to be −1.92% and −2.02% for air kerma and absorbed dose to water respectively. To minimize the effect of error and maximize therapeutic dose during treatment in order to achieve required clinical outcome, calibration factor was determined for air kerma (Nk) as 49.7 mGy/nC and absorbed dose to water ND, as 52.9 mGy/nC. The study established that radiotherapy beam measurement chain is prone to errors. Hence there is a need to independently verify the accuracy of radiation dose to ensure precision of dose delivery. The errors must be accounted for during clinical planning by factoring in calibration factor to minimize the systematic errors during treatment, and thereby providing enough room to achieve ±5% dose delivery to tumor target as recommended by ICRU.

关键词： Absorbed Dose to Water Air Kerma Co-60 Source Calibration SSDL Radiotherapy Beam Metrology Accuracy and Accuracy

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Evaluation of Dosimetric Impact of Uncertainty of Measurement in Estimating External Radiotherapy Dose

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Open Journal of Applied Sciences 2024年第8期14卷 1985-1995页

作者： Collins Omondi margaret chege Samson Omondi Physics Department Kenyatta University Nairobi Kenya College of Health Physics Jomo Kenyatta University of Agriculture and Technology Juja Kenya

Cancer is a major societal public health and economic problem, responsible for one in every six deaths. Radiotherapy is the main technique of treatment for more than half of cancer patients. To achieve a successful outcome, the radiation dose must be delivered accurately and precisely to the tumor, within ± 5% accuracy. Smaller uncertainties are required for better treatment outcome. The objective of the study is to investigate the uncertainty of measurement of external radiotherapy beam using a standard ionization chamber under reference conditions. Clinical farmers type ionization chamber measurement was compared against the National Reference standard, by exposing it in a beam 60Co gamma source. The measurement set up was carried out according to IAEA TRS 498 protocol and uncertainty of measurement evaluated according to GUM TEDDOC-1585. Evaluation and analysis were done for the identified subjects of uncertainty contributors. The expanded uncertainty associated with 56 mGy/nC ND,W was found to be 0.9% corresponding to a confidence level of approximately 95% with a coverage factor of k = 2. The study established the impact of dosimetry uncertainty of measurement in estimating external radiotherapy dose. The investigation established that the largest contributor of uncertainty is the stability of the ionization chamber at 36%, followed by temperature at 22% and positioning of the chamber in the beam at 8%. The effect of pressure, electrometer, resolution, and reproducibility were found to be minimal to the overall uncertainty. The study indicate that there is no flawless measurement, as there are many prospective sources of variation. Measurement results have component of unreliability and should be regarded as best estimates of the true value. .

关键词： Absorbed Dose to Water Radiotherapy Uncertainty of Measurement Secondary Standards Dosimetry Laboratory Ionizing Chamber

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Assessment of Occupational Radiation Exposure for Radiotherapy Healthcare Workers at Kenyatta National Hospital Using Thermoluminescence Dosimeter LiF:Mg,Ti

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Journal of Geoscience and Environment Protection 2024年第7期12卷 14-24页

作者： Collins Omondi margaret chege Samson Omondi Department of Physics Kenyatta University Nairobi Kenya College of Health Physics Jomo Kenyatta University of Agriculture and Technology Nairobi Kenya

Kenyatta National Hospital (KNH) is the largest public referral hospital with a comprehensive cancer treatment facility in East and Central Africa. Occupational radiation monitoring is a significant technique for demonstrating compliance of radiation regulatory limits. The objective of the study was to carry out assessment of occupational radiation exposure among radiotherapy personnel at KNH using thermoluminescence dosimeter, TLD. KNH staff were monitored using dosimeter type TLD-100 made of LiF:Mg,Ti, on monthly basis. The reader system used for analysis was Harshaw 8800. The measurement established the average monthly accumulated occupational personnel dose for KNH to be 0.21 mSv and 0.29 mSv for Hp (10) and Hp (0.07) respectively. The accumulated dose results were within the maximum acceptable dose of 1.67 mSv/month and 41.6 mSv/month for Hp (10) and Hp (0.07) respectively. The investigation results were higher than the acceptable public limit of 0.08 mSv/month. Moreover, incidences were noted where the fetus dose limit 0.42 was also exceeded. Evaluation of statistical dose exposure among doctors, nurses and radiographers’ measurement results were within ±0.02 mSv. The study established the average KNH occupational radiation exposure levels for both Hp (10) and Hp (0.07) were within the ICRU recommendation, validating radiation protection safe practice. Data analysis of healthcare workers did not indicate exposure trend biased to any healthcare profession. Hence radiation risk cut across all professional categories. It is recommended that Radiation Monitoring program be reviewed to include non-clinical staff who access the facility. Radiation reporting should not be limited to one facility, but reflect cases where workers are involved in multiple multiple jobs.

关键词： Occupational Monitoring Exposure Thermoluminescence Dosimeter and Radiotherapy

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Predictors of Bacterial Meningitis among Paediatric Patients Aged 0 - 5 Years at Kenyatta Hospital, Kenya

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Open Journal of Pediatrics 2018年第3期8卷 207-220页

作者： June J. Serem margaret chege Dorcas Maina College of Health Sciences School of Nursing Sciences University of Nairobi Nairobi Kenya

Introduction: Meningitis remains a common and serious problem in children worldwide. One million instances of meningitis are assessed to happen in children worldwide each year. In Africa, where outbreaks are common 70% of meningitis cases are diagnosed in children under the age of five (5) years. Though in most cases, doctors diagnose early and adequate treatment started, 5% to 10% of patients still succumb during the 24 - 48 hours after onset of clinical features. In 2009, the mortality rate in Africa was four thousand deaths. Study Objective: This study describes the predictors of bacterial meningitis among children aged 0 - 5 years admitted at Kenyatta National Hospital (K.N.H.) paediatric wards. Methodology: The study adopted a descriptive cross-sectional design. It was carried out in K.N.H. paediatric wards. Data were obtained from consenting parent or guardian and healthcare workers (nurses and registrars). Study participants were selected by convenient sam-pling method. A total of 104 study participants were included in the study sample. In-depth interviews of key informants were conducted on 7 health workers;5 nurses from the paediatric wards and paediatric emergency unit and 2 paediatric registrars. Ethical consideration included full disclosure to participants, confidentiality, security of health records and informed consent. Data were collected by use of researcher administered semi-structured ques-tionnaire and desk reviews of patients’ files were also used. Qualitative data from the interviews were audio-taped. Logistic regression analysis was used for data analysis. Quantitative data were cleaned, entered and analysed using Statistical Package for Social Sciences (SPSS) version 23. Results were displayed by utilization of tables, pie charts. Qualitative data were transcribed, grouped in themes and analysed manually. Study Results: The majority of the children (55.8%) were female. The highest percentage of the children (53.8%) was aged less than one yea

关键词： Meningitis Child Predictors Kenya

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The autophagy protein Atg9 functions in glia and contributes to parkinsonian symptoms in a Drosophila model of Parkinson’s disease

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Neural Regeneration Research 2024年第5期19卷 1150-1155页

作者： Shuanglong Yi Linfang Wang margaret S.Ho Shiping Zhang School of Life Science and Technology ShanghaiTech UniversityShanghaiChina College of Life Sciences University of Chinese Academy of SciencesBeijingChina

Parkinson’s disease is a progressive neurodegenerative disease characterized by motor deficits,dopaminergic neuron loss,and brain accumulation ofα-synuclein aggregates called Lewy *** in protein degradation pathways,such as autophagy,has been demonstrated in neurons as a critical mechanism for eliminating protein aggregates in Parkinson’s ***,it is less well understood how protein aggregates are eliminated in glia,the other cell type in the *** the present study,we show that autophagy-related gene 9(Atg9),the only transmembrane protein in the autophagy machinery,is highly expressed in Drosophila glia from adult *** from immunostaining and live cell imaging analysis reveal that a portion of Atg9 localizes to the trans-Golgi network,autophagosomes,and lysosomes in ***9 is persistently in contact with these *** glial atg9 reduces the number of omegasomes and autophagosomes,and impairs autophagic substrate *** suggests that glial Atg9 participates in the early steps of autophagy,and hence the control of autophagic ***,loss of glial atg9 induces parkinsonian symptoms in Drosophila including progressive loss of dopaminergic neurons,locomotion deficits,and glial *** findings identify a functional role of Atg9 in glial autophagy and establish a potential link between glial autophagy and Parkinson’s *** results may provide new insights on the underlying mechanism of Parkinson’s disease.

关键词： Atg9 autophagy glia Parkinson’s disease

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A Natural Catalytic Converter^® for Continuously Inactivating Air and Surface Pathogens with More Effect than Ventilation and Filtration

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Open Journal of Applied Sciences 2024年第5期14卷 1353-1363页

作者： margaret Scarlett Brett Duffy CAPT. (Ret.) US Public Health Service Centers for Disease Control and Prevention Atlanta GA United States of America ASHRAE (62.1 Standard Committee) Atlanta GA United States of America

Study Objective: The purpose of the study is to present independent laboratory testing for a novel technology in air and on surfaces. Since 2020, public health goals have focused on improving indoor air quality. This includes protection from airborne pathogens, such as tuberculosis, RSV, SARS-CoV-2, common cold or influenza viruses, measles, and others. Engineering controls are highly effective at reducing hazardous pathogens found in indoor air and from recontamination of surfaces. This occurs from a continuous cycle of settling of small, sustained airborne pathogens, which may become dehumidified, becoming airborne again, carried by room air currents around indoor spaces, then repeating the cycle. Methods: The novel technology utilizes a catalytic process to produce safe levels of hydrogen peroxide gas that are effective in reducing pathogens in the air and on surfaces. Air testing was performed with the MS2 bacteriophage, the test organism for ASHRAE standard 241, and methicillin-Resistant Staphylococcus aureus (MRSA). Surface testing was performed with SARS-COV-2 (Coronavirus COVID-19) and H1N1 (Influenza). Typical ventilation and filtration does not effectively remove disbursed pathogens from the entire facility, due to inconsistent air circulation and surface deposits of pathogens. Results: MS2 was reduced by 99.9%;MRSA was reduced by 99.9%;SARS-CoV-2 was reduced by 99.9%;H1N1 was reduced by 99.9%. Conclusion: This novel catalytic converter reduces a variety of pathogens in the air (99%) and on surfaces (99%), by actively disinfecting with the introduction of gaseous hydrogen peroxide. This active disinfection provides a strong solution for protecting the entire facility and its occupants.

关键词： Pathogen Bacteria Virus Reduction Gaseous Hydrogen Peroxide Disinfection Indoor Air Quality Surface

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Defining soft skills in nursing:a concept analysis

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Frontiers of Nursing 2024年第3期11卷 243-252页

作者： Luke Laari Oboshie Anim-Boamah margaret Nyame Department of Public Health Nursing School of Nursing and MidwiferyCollege of Health SciencesUniversity of GhanaLegonAccraGhana Department of Research Education and AdministrationSchool of Nursing and MidwiferyCollege of Health SciencesUniversity of GhanaLegonAccraGhana Emergency Unit Holy Family HospitalNkawkawEastern RegionGhana

Objective:To define soft skills in ***:This is a concept analysis using the Walker and Avant *** electronic databases in the English language including CINAHL,Science Direct,MEDLINE on EBSCOhost,and Scopus were ***:Soft skills in nursing include the intrapersonal attributes,interpersonal skills,and creativity of the nurse,which,when combined with professionalism,teamwork,and effective communication skills,improve the quality of nursing care and client ***:Although hard and soft skills are compatible and synergetic,soft skills are to be prioritized for the success of nursing care in the healthcare *** concept analysis adds to the body of knowledge by identifying the attributes of soft skills in nursing and revealing that a good nurse needs more than just good grades to be successful.

关键词： communication hard skills individual creativity interpersonal skills intrapersonal traits nursing care soft skills

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The Impact of Physiotherapy Interventions on the Elderly Population with Mental Health Conditions at Chainama Hills College Hospital in Zambia. A Pre-Post Single Sample Study Design

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Open Journal of Therapy and Rehabilitation 2024年第2期12卷 160-173页

作者： Bibi Mwanatambwe Phiri Martha Banda Chalwe margaret Mweshi Loveness Anila Nkhata Department of Physiotherapy Chainama Hills Hospital Lusaka Zambia School of Health Sciences Department of Physiotherapy University of Zambia Lusaka Zambia

Background: Physical functional decline is common among elderly individuals with mental disorders, worsening their symptoms. Physiotherapy interventions have shown some evidence in improving physical function and mental health outcomes in this population. This study aimed to assess the impact of physiotherapy interventions on the elderly with mental health conditions at Chainama Hills College Hospital in Zambia. Methods: A pre-post single sample design was used to track patient progress over six weeks, with 10 physiotherapy sessions. The study population (N = 30) comprised of all elderly individuals with mental health conditions, encompassing both men and women, who were hospitalized during the research period. The Katz Index of Activities of Daily Living and the six-minute walk test were evaluated before and after the intervention. The IBM SPSS version 26 was used to analyze data and results were presented as mean ± SD with a 95% confidence interval. The variables were described in terms of their mean, SD, and range. A significance level of 0.05 was used for a paired T-test to detect changes and multiple logistic regression was used to identify factors associated with mental health. Results: Following the intervention, the percentage of participants achieving full function and independence increased significantly to 96.7% from the initial 73.3%, supported by a 95% CI = [0.82 - 0.99]. There was also a notable decrease in the proportion of individuals experiencing moderate impairment, dropping from 26.7% to just 3.3%, with a corresponding 95% CI = [0.00 - 0.17]. Conclusion: The findings derived from this study illustrate an enhancement in the aspects of participants’ overall health and functional condition, including blood pressure, heart rate, and respiratory rate. Consequently, physiotherapy exercises can be employed as a tactic to ameliorate the functional status and physical well-being of older individuals afflicted with mental disorders in Zambia.

关键词： Elderly Mental Health Conditions Physiotherapy Exercise

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高薪VS激励薪酬:哪种更好?

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新理财（公司理财） 2024年第5期 76-79页

作者： margaret B.Shackell 不详

企业管理人员最大的责任就是确保员工发挥其最佳水平,但在当前劳动力市场紧张的情况下(这里主要指美国),你可能考虑的是如何吸引、留住员工,调动他们的积极性。包括绩效考核和决策权在内的激励薪酬研究告诉我们,基于绩效的薪酬管理是有... 详细信息

企业管理人员最大的责任就是确保员工发挥其最佳水平,但在当前劳动力市场紧张的情况下(这里主要指美国),你可能考虑的是如何吸引、留住员工,调动他们的积极性。包括绩效考核和决策权在内的激励薪酬研究告诉我们,基于绩效的薪酬管理是有效的。也就是说,考核和奖励机制会带来更多人的关注。但最近的一项研究颠覆了上述观点。这篇发表在Journal of Managemcnt Accounting Research杂志上的研究论文(以下简称“HMP”)提出。

关键词：企业管理人员激励薪酬绩效考核薪酬管理奖励机制最佳水平留住员工高薪

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Associations between health-related fitness and patient-reported symptoms in newly diagnosed breast cancer patients

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Journal of Sport and Health Science 2024年第6期13卷 851-862页

作者： Ki-Yong An Fernanda Z.Arthuso Myriam Filion Spencer J.Allen Stephanie M.Ntoukas Gordon J.Bell Jessica McNeil Qinggang Wang margaret L.McNeely Jeff K.Vallance Lin Yang S.Nicole Culos-Reed Leanne Dickau John R.Mackey Christine M.Friedenreich Kerry S.Courneya Faculty of Kinesiology Sportand RecreationCollege of Health SciencesUniversity of AlbertaEdmonton T6G 2H9Canada Department of Kinesiology School of Health and Human SciencesUniversity of North Carolina at GreensboroGreensboroNC 27412USA Department of Cancer Epidemiology and Prevention Research Cancer Care AlbertaAlberta Health ServicesCalgary T2S 3C3Canada Faculty of Rehabilitation Medicine University of AlbertaEdmonton T6G 2H9Canada Faculty of Health Disciplines Athabasca UniversityAthabasca T9S 3A3Canada Department of Oncology Cumming School of MedicineUniversity of CalgaryCalgary T2N 4N1Canada Faculty of Kinesiology University of CalgaryCalgary T2N 1N4Canada Faculty of Medicine and Dentistry University of AlbertaEdmonton T6G 2H9Canada

Background:Newly diagnosed breast cancer patients experience symptoms that may affect their quality of life,treatment outcomes,and *** and managing breast cancer-related symptoms soon after diagnosis is *** purpose of this study was to investigate the associations between health-related fitness(HRF)and patient-reported symptoms in newly diagnosed breast cancer ***:This study utilized baseline data from the Alberta Moving Beyond Breast Cancer Cohort Study that were collected within 90 days of *** measures included peak cardiopulmonary fitness(peak volume of oxygen consumption(VO_(2peak))),maximal muscular strength and endurance,flexibility,and body *** measures included depression,sleep quality,and *** multivariable logistic regression was performed for ***:Of 1458 participants,51.5%reported poor sleep quality,26.5%reported significant fatigue,and 10.4%reported moderate *** multivariable-adjusted models,lower relative VO_(2peak)was independently associated with a greater likelihood of all symptom measures,including moderate depression(p<0.001),poor sleep quality(p=0.009),significant fatigue(p=0.008),any symptom(p<0.001),and multiple symptoms(p<0.001).VO_(2peak)demonstrated threshold associations with all symptom measures such that all 3 lower quartiles exhibited similar elevated risk compared to the highest *** strength of the threshold associations varied by the symptom measure with odds ratios ranging from-1.5 for poor sleep quality to-3.0 for moderate depression and multiple ***,lower relative upper body muscular endurance was also independently associated with fatigue in a dose-response manner(p=0.001),and higher body weight was independently associated with poor sleep quality in an inverted U pattern(p=0.021).Conclusion:Relative VO_(2peak)appears to be a critical HRF component associated with multiple patient-reported symptoms in newly diag

关键词： Breast cancer Fatigue Depression Sleep quality Cardiorespiratory fitness

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