Abstract Background: The benefit of MR-only workflow compared to current CT-based workflow for prostate radiotherapy is reduction of systematic errors in the radiotherapy chain by 2–3 mm. Nowadays, MRI is used for target delineation while CT is needed for position verification. In MR-only workflows, MRI based synthetic CT (sCT) replaces CT. Intraprostatic fiducial markers (FMs) are used as a surrogate for the position of the prostate improving targeting. However, FMs are not visible on sCT. Therefore, a semi-automatic method for burning-in FMs on sCT was developed. Accuracy of MR-only workflow using semi-automatically burned-in FMs was assessed and compared to CT/MR workflow. Methods: Thirty-one prostate cancer patients receiving radiotherapy, underwent an additional MR sequence (mDIXON) to create an sCT for MR-only workflow simulation. Three sources of accuracy in the CT/MR- and MR-only workflow were investigated. To compare image registrations for target delineation, the inter-observer error (IOE) of FM-based CT-to-MR image registrations and soft-tissue-based MR-to-MR image registrations were determined on twenty patients. Secondly, the inter-observer variation of the resulting FM positions was determined on twenty patients. Thirdly, on 26 patients CBCTs were retrospectively registered on sCT with burned-in FMs and compared to CT-CBCT registrations. Results: Image registration for target delineation shows a three times smaller IOE for MR-only workflow compared to CT/MR workflow. All observers agreed in correctly identifying all FMs for 18 out of 20 patients (90%). The IOE in CC direction of the center of mass (COM) position of the markers was within the CT slice thickness (2.5 mm), the IOE in AP and RL direction were below 1.0 mm and 1.5 mm, respectively. Registrations for IGRT position verification in MR-only workflow compared to CT/MR workflow were equivalent in RL-, CC- and AP-direction, except for a significant difference for random error in rotation. Conclusions: MR-only workflow using sCT with burned-in FMs is an improvement compared to the current CT/ MR workflow, with a three times smaller inter observer error in CT-MR registration and comparable CBCT registration results between CT and sCT reference scans. Trial registry Medical Research Involving Human Subjects Act (WMO) does apply to this study and was approved by the Medical Ethics review Committee of the Academic Medical Center. Registration number: NL65414.018.18. Date of registration: 21–08-2018.
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Elke periode kent zijn eigen revolutie en elke revolutie brengt zijn eigen organisatorische model met zich mee. We bevinden ons nu in de 4e industri¨ele revolutie, waar het internet van dingen ons verbindt met autonome embedded systemen. Deze systemen zijn actief in de virtuele ’cyber’ wereld, alsook in de echte ’fysieke’ wereld om ons heen. Deze zogenoemde ’Cyber-Fysieke’ Systemen volgen daarmee een modern organisatorisch model, namelijk zelfmanagement, en zijn dan ook in staat zelf proactieve acties te ondernemen. Dit proefschrift belicht productiesystemen vanuit het Cyber-Fysieke perspectief. De productiesystemen zijn hier herconfigureerbaar, autonoom en zeer flexibel. Dit kan enkel worden bereikt door het ontwikkelen van nieuwe methodes en het toepassen van nieuwe technologie¨en die flexibiliteit verder bevorderen. Echter, effici¨entie is ook van belang, bijvoorbeeld door productassemblage zo flexibel te maken dat het daardoor kosteneffici¨ent is om de productie van diverse producten met een lage oplage, zogenaamde high-mix, low volume producten, te automatiseren. De mogelijkheid om zo flexibel te kunnen produceren moet bereikt worden door de creatie van nieuwe methoden en middelen, waarbij nieuwe technologie¨en worden gecombineerd; een belangrijk aspect hierbij is dat dit toepasbaar getest moet worden door gebruik van simulatoren en speciaal hiervoor ontwikkelde productiesystemen. Dit onderzoek zal beginnen met het introduceren van het concept achter de bijbehorende productiemethodologie, welke Grid Manufacturing is genoemd. Grid Manufacturing wordt uitgevoerd door autonome entiteiten (agenten) die zowel de productiesystemen zelf, als de producten representeren. Producten leven dan al in de virtuele cyber wereld voordat zij daadwerkelijk zijn gebouwd, en zijn zich bewust uit welke onderdelen zij gemaakt moeten worden. De producten communiceren en overleggen met de autonome herconfigureerbare productiesystemen, de zogenaamde equiplets. Deze equiplets leveren generieke diensten aan een grote diversiteit aan producten, die hierdoor op elk moment geproduceerd kunnen worden. Het onderzoek focust hierbij specifiek op de equiplets en de technische uitdagingen om dynamisch geautomatiseerde productie mogelijk te maken. Om Grid Manufacturing mogelijk te maken is er een set van technologische uitdagingen onderzocht. De achtergrond, onderzoeksaanpak en concepten zijn dan ook de eerste drie inleidende hoofdstukken. Daarna begint het onderzoek met Hoofdstuk 4 Object Awareness. Dit hoofdstuk beschrijft een dynamische manier waarop informatie uit verschillende autonome systemen gecombineerd wordt om objecten te herkennen, lokaliseren en daarmee te kunnen manipuleren. Hoofdstuk 5 Herconfiguratie beschrijft hoe producten communiceren met de equiplets en welke achterliggende systemen ervoor zorgen dat, ondanks | Dutch Summary 232 dat het product niet bekend is met de hardware van de equiplet, deze toch in staat is acties uit te voeren. Tevens beschrijft het hoofdstuk hoe de equiplets omgaan met verschillende hardwareconfiguraties en ondanks de aanpassingen zichzelf toch kunnen besturen. De equiplet kan dan ook aangepast worden zonder dat deze opnieuw geprogrammeerd hoeft te worden. In Hoofdstuk 6 Architectuur wordt vervolgens dieper ingegaan op de bovenliggende architectuur van de equiplets. Hier worden prestaties gecombineerd met flexibiliteit, waarvoor een hybride architectuur is ontwikkeld die het grid van equiplets controleert door het gebruik van twee platformen: Multi-Agent System (MAS) en Robot Operating System (ROS). Nadat de architectuur is vastgesteld, wordt er in Hoofdstuk 7 onderzocht hoe deze veilig ingezet kan worden. Hierbij wordt een controlesysteem ingevoerd dat het systeemgedrag bepaalt, waarmee het gedrag van de equiplets transparant wordt gemaakt. Tevens zal een simulatie met input van de sensoren uit de fysieke wereld ’live’ controleren of alle bewegingen veilig uitgevoerd kunnen worden. Nadat de basisfunctionaliteit van het Grid nu compleet is, wordt in Hoofdstuk 8 Validatie en Utilisatie gekeken naar hoe Grid Manufacturing gebruikt kan worden en welke nieuwe mogelijkheden deze kan opleveren. Zo wordt er besproken hoe zowel een hi¨erarchische als een heterarchische aanpak, waar alle systemen gelijk zijn, gebruikt kan worden. Daarnaast laat het hoofdstuk o.a. aan de hand van enkele voorbeelden en simulaties zien welke effecten herconfiguratie kan hebben, en welke voordelen deze aanpak zoal kan bieden.. Het proefschrift laat zien hoe met technische middelen geautomatiseerde flexibiliteit mogelijk wordt gemaakt. Hoewel het gehele concept nog volwassen zal moeten worden, worden er enkele aspecten getoond die op de korte termijn toepasbaar zijn in de industrie. Enkele voorbeelden hiervan zijn: (1) het combineren van gegevens uit diverse (autonome) bronnen voor 6D-lokalisatie; (2) een data-gedreven systeem, de zogeheten hardware-abstractielaag, die herconfigureerbare systemen controleert en de mogelijkheid biedt om deze productiesystemen aan te passen zonder deze te hoeven herprogrammeren; en (3) het gebruik van Cyber-Fysieke systemen om de veiligheid te verhogen.
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In this study we measured the performance times on the Wheelchair Mobility Performance (WMP) test during different test conditions to see if the performance times changed when wheelchair settings were changed. The overall performance time on the WMP test increased when the tire pressure was reduced and also when extra mass was attached to the wheelchair. It can be concluded that the WMP test is sensitive to changes in wheelchair settings. It is recommended to use this field-based test in further research to investigate the effect of wheelchair settings on mobility performance time. Objective: The Wheelchair Mobility Performance (WMP) test is a reliable and valid measure to assess mobility performance in wheelchair basketball. The aim of this study was to examine the sensitivity to change of the WMP test by manipulating wheelchair configurations. Methods: Sixteen wheelchair basketball players performed the WMP test 3 times in their own wheelchair: (i) without adjustments (“control condition”); (ii) with 10 kg additional mass (“weighted condition”); and (iii) with 50% reduced tyre pressure (“tyre condition”). The outcome measure was time (s). If paired t-tests were significant (p < 0.05) and differences between conditions were larger than the standard error of measurement, the effect sizes (ES) were used to evaluate the sensitivity to change. ES values ≥0.2 were regarded as sensitive to change. Results: The overall performance times for the manipulations were significantly higher than the control condition, with mean differences of 4.40 s (weight – control, ES = 0.44) and 2.81 s (tyre – control, ES = 0.27). The overall performance time on the WMP test was judged as sensitive to change. For 8 of the 15 separate tasks on the WMP test, the tasks were judged as sensitive to change for at least one of the manipulations. Conclusion: The WMP test can detect change in mobility performance when wheelchair configurations are manipulated. https://www.medicaljournals.se/jrm/content/html/10.2340/16501977-2341
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Author supplied: Abstract—The growing importance and impact of new technologies are changing many industries. This effect is especially noticeable in the manufacturing industry. This paper explores a practical implementation of a hybrid architecture for the newest generation of manufacturing systems. The papers starts with a proposition that envisions reconfigurable systems that work together autonomously to create Manufacturing as a Service (MaaS). It introduces a number of problems in this area and shows the requirements for an architecture that can be the main research platform to solve a number of these problems, including the need for safe and flexible system behaviour and the ability to reconfigure with limited interference to other systems within the manufacturing environment. The paper highlights the infrastructure and architecture itself that can support the requirements to solve the mentioned problems in the future. A concept system named Grid Manufacturing is then introduced that shows both the hardware and software systems to handle the challenges. The paper then moves towards the design of the architecture and introduces all systems involved, including the specific hardware platforms that will be controlled by the software platform called REXOS (Reconfigurable EQuipletS Operating System). The design choices are provided that show why it has become a hybrid platform that uses Java Agent Development Framework (JADE) and Robot Operating System (ROS). Finally, to validate REXOS, the performance is measured and discussed, which shows that REXOS can be used as a practical basis for more specific research for robust autonomous reconfigurable systems and application in industry 4.0. This paper shows practical examples of how to successfully combine several technologies that are meant to lead to a faster adoption and a better business case for autonomous and reconfigurable systems in industry.
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The aim of this report is to give an overview of current state of the art in the occurrence and policies regarding affordable age-friendly and eco-friendly solutions in the partner countries. The report consists of the findings from the literature review, the comparative analysis and the reporting of good practices. It aims for the consortium as a whole to gain an understanding of the state of the art and on affordable age and eco-friendly solutions in partner countries and particularly the home and community fields, and to present that knowledge in the form of a written report. The literature review, the analysis of barriers and facilitators, and the survey on existing or even planning good practices in the project countries, will help the partners to build and update a strong knowledge base in these fields. To be closer to the practical issues that define the adaptability of eco and age-friendly solutions in community, the consortium decided to use mostly grey literature and websites for tools and advice, such as governmental pages. Common grey literature publication types include reports (annual, research, technical, project, etc.), working papers, government documents, white papers and evaluations, which will help all partners to reach conclusions around the common field between age and eco-friendly developments. Barriers and facilitators found in each project country will be used for stipulating the right consequence of actions needed, to propose a sound methodology that could – in combination with other actions and stakeholders – promote the implementation of age and eco-friendly principles into the public and private sphere of care for older people. Finally, the selection of good representative practices by each project country can be the basis for a report, and a publication, that depicts the level of maturity and progress of the notions of age-friendliness and eco-friendliness, as well as their impact on the care of older people.
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To assess the reporting quality of interventions aiming at promoting physical activity (PA) using a wearable activity tracker (WAT) in patients with infammatory arthritis (IA) or hip/knee osteoarthritis (OA). A systematic search was performed in eight databases including PubMed, Embase and Cochrane Library) for studies published between 2000 and 2022. Two reviewers independently selected studies and extracted data on study characteristics and the reporting of the PA intervention using a WAT using the Consensus on Exercise reporting Template (CERT) (12 items) and Consolidated Standards of Reporting Trials (CONSORT) E-Health checklist (16 items). The reporting quality of each study was expressed as a percentage of reported items of the total CERT and CONSORT E-Health (50% or less=poor; 51–79%=moderate; and 80–100%=good reporting quality). Sixteen studies were included; three involved patients with IA and 13 with OA. Reporting quality was poor in 6/16 studies and moderate in 10/16 studies, according to the CERT and poor in 8/16 and moderate in 8/16 studies following the CONSORT E-Health checklist. Poorly reported checklist items included: the description of decision rule(s) for determining progression and the starting level, the number of adverse events and how adherence or fdelity was assessed. In clinical trials on PA interventions using a WAT in patients with IA or OA, the reporting quality of delivery process is moderate to poor. The poor reporting quality of the progression and tailoring of the PA programs makes replication difcult. Improvements in reporting quality are necessary.
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Manure application can spread antimicrobial resistance (AMR) from manure to soil and surface water. This study evaluated the role of the soil texture on the dynamics of antimicrobial resistance genes (ARGs) in soils and surrounding surface waters. Six dairy farms with distinct soil textures (clay, sand, and peat) were sampled at different time points after the application of manure, and three representative ARGs sul1, erm(B), and tet(W) were quantified with qPCR. Manuring initially increased levels of erm(B) by 1.5 ± 0.5 log copies/kg of soil and tet(W) by 0.8 ± 0.4 log copies/kg across soil textures, after which levels gradually declined. In surface waters from clay environments, regardless of the ARG, the gene levels initially increased by 2.6 ± 1.6 log copies/L, after which levels gradually declined. The gene decay in soils was strongly dependent on the type of ARG (erm(B) < tet(W) < sul1; half-lives of 7, 11, and 75 days, respectively), while in water, the decay was primarily dependent on the soil texture adjacent to the sampled surface water (clay < peat < sand; half-lives of 2, 6, and 10 days, respectively). Finally, recovery of ARG levels was predicted after 29–42 days. The results thus showed that there was not a complete restoration of ARGs in soils between rounds of manure application. In conclusion, this study demonstrates that rather than showing similar dynamics of decay, factors such as the type of ARG and soil texture drive the ARG persistence in the environment.
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Stefan Bengtsson's commentary about policy hegemony discusses the alternative discourses of socialism, nationalism, and globalism. However, Stefan does not adequately demonstrate how these discourses can overcome the Dominant Western Worldview (DWW), which is imbued with anthropocentrism. It will be argued here that most policy choices promoting sustainability, and education for it, are made within a predetermined system in which the already limiting notion of environmental protection is highly contingent on human welfare. What would really contest the dominant assumptions of Vietnamese policy and, more specifically, education for sustainable development (ESD) is an alternative discourse that challenges the DWW. That alternative discourse embraces philosophical ecocentrism and practices of ecological justice between all species, and deep ecology theory - all perspectives fundamentally committed to environmental protection. https://doi.org/10.1080/00958964.2015.1048502 LinkedIn: https://www.linkedin.com/in/helenkopnina/
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Background Psychological aspects of labor and birth have received little attention within maternity care service planning or clinical practice. The aim of this paper is to propose a model demonstrating how neurohormonal processes, in particular oxytocinergic mechanisms, not only control the physiological aspects of labor and birth, but also contribute to the subjective psychological experiences of birth. In addition, sensory information from the uterus as well as the external environment might influence these neurohormonal processes thereby influencing the progress of labor and the experience of birth. Methodology In this new model of childbirth, we integrated the findings from two previous systematic reviews, one on maternal plasma levels of oxytocin during physiological childbirth and one meta-synthesis of women´s subjective experiences of physiological childbirth. Findings The neurobiological processes induced by the release of endogenous oxytocin during birth influence maternal behaviour and feelings in connection with birth in order to facilitate birth. The psychological experiences during birth may promote an optimal transition to motherhood. The spontaneous altered state of consciousness, that some women experience, may well be a hallmark of physiological childbirth in humans. The data also highlights the crucial role of one-to-one support during labor and birth. The physiological importance of social support to reduce labor stress and pain necessitates a reconsideration of many aspects of modern maternity care. Conclusion By listening to women’s experiences and by observing women during childbirth, factors that contribute to an optimized process of labor, such as the mothers’ wellbeing and feelings of safety, may be identified. These observations support the integrative role of endogenous oxytocin in coordinating the neuroendocrine, psychological and physiological aspects of labor and birth, including oxytocin mediated. decrease of pain, fear and stress, support the need for midwifery one-to-one support in labour as well as the need for maternity care that optimizes the function of these neuroendocrine processes even when birth interventions are used. Women and their partners would benefit from understanding the crucial role that endogenous oxytocin plays in the psychological and neuroendocrinological process of labor.
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This magazine presents the highlights of the applied research project “Inclusive and climate-smart business models in Ethiopian and Kenyan dairy valuechains (CSDEK)”. The CSDEK applied research project was conducted in six case study areas, three in Ethiopia and three in Kenya. At the time of publishing this magazine, research was still ongoing in some of the study areas. The projectteam and researchers hope to contribute to creating awareness of climatesmartdairy practices and development of the dairy sector in Ethiopia and Kenya. In two of the study areas, collaboration between VHL and dairy stakeholders will continue, preferably through local networks in a Living Lab approach.
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