Evaluation of low-dose pediatric chest CT examination using in-house developed various age-size pediatric chest phantoms.

PURPOSE: This study aims to develop Various Age-size Pediatric Chest Phantoms (VAPC) to evaluate low-dose protocol that approximates clinical conditions achieved by low organ-specific doses and optimal image quality among the challenges of pediatric size variations. METHODS: Three original pediatric data aged 1, 4, and 7 years were used as a reference for developing VAPC phantoms. Six protocols, namely standard dose (STD) and low dose (low mA and low kV) reconstructed using Filtered Back Projection (FBP) and iterative reconstruction (IR) algorithms, were investigated. This study directly measured the lungs, heart, and spinal cord dose using LD-V1 film. Linearity, Modulation Transfer Function (MTF), Contrast to Noise Ratio (CNR), and Noise Power Spectrum (NPS) were evaluated to assess the CT image quality of the VAPC phantom. RESULTS: This study found that the mean organ-specific dose was higher than CTDIvol. A Comparison of mean lung doses showed VAPC phantom 1 (y.o.) received 74.8% and 137.2% more doses than 4 (y.o.) and 7 (y.o.), respectively. Low kV produces a lower organ dose than low mA. The linearity of CT numbers is not biased at low doses. Differences in age measures significantly influenced organ-specific dose, MTF, CNR, and NPS. CONCLUSION: Smaller pediatrics are still exposed to higher doses at low-dose examinations, whereas larger pediatrics have lower contrast resolution and increased image noise. CT number linearity is unbiased. The combination of low kV with FBP produces higher spatial resolution, while low mA with IR effectively reduces noise to detect low-contrast objects better.

Frequent Self-Monitoring Blood Glucose Correlated to Better Medication Adherence and Glycemic Control in Children with Type 1 Diabetes Mellitus.

Background: Type 1 diabetes mellitus (T1DM) is the most common chronic disease in children, with several severe short and long-term complications. Glycemic control is an important aspect of diabetes management with the most influential factor being compliance with self-monitoring blood glucose (SMBG). Mostly, in Indonesia, the finger stick devices as a glucose monitoring tool were frequently used. About 20% of children follow the recommendation to measure blood glucose four to six times daily. Methods: This is a single center, cross-sectional study that was conducted between July-November 2022. The Population is children with T1DM at the Pediatric Outpatient Clinic of Dr. Soetomo Hospital, Surabaya, Indonesia. Children with T1DM aged 4-18 years were enrolled using consecutive sampling. A compliance questionnaire was used to assess SMBG. Psychosocial conditions were assessed using the Pediatric Symptom Checklist 17, and medication adherence was evaluated using the Adherence to Refills and Medications Scale for Diabetes (ARMS-D). Pearson correlation and linear regression were employed for statistical analyses using Statistical Package for Social Sciences version 21.0, with p < 0.05 indicating statistical significance. Results: A total of 36 children were included in this study. SMBG frequency over 4x per day was significantly associated with increased medication adherence as measured by the ARMS-D score (p = 0.012). Higher SMBG frequency was also correlated with decreased HbA1c (p = 0.014, r = 0.406) and nutritional status (p = 0.031, r = 0.360). Less than 50% of the patients in Indonesia adhered to the recommended guidelines for SMBG (ie, ≥4 times per day). Conclusion: Higher SMBG frequency was correlated with better glycemic control. This finding suggests the need for further support in conducting SMBG based on the national guideline. However, due to it being conducted in a single center, we suggest increasing the sample size or conducting multi-centre collaborations in future studies. Originality/Value: By specifically investigating the relationship between adherence to self-monitoring of blood glucose (SMBG) and glycemic control in children with type 1 diabetes mellitus (T1DM), our study represents a novel contribution to the field of pediatric diabetes management in Indonesia. While previous research has explored similar relationships in other populations, our study focuses exclusively on the unique context of Indonesia, where rates of adherence to SMBG in pediatric patients have not been well studied and are relatively low compared to global standards.

Dosimetry Evaluation of Treatment Planning Systems in Patient-Specific 3D Printed Anthropomorphic Phantom for Breast Cancer after Mastectomy using a Single-Beam 3D-CRT Technique for Megavoltage Electron Radiation Therapy.

Background: The patient-specific 3D printed anthropomorphic phantom is used for breast cancer after mastectomy developed by the laboratory of medical physics and biophysics, Department of Physics, Institut Teknologi Sepuluh Nopember, Indonesia. This phantom is applied to simulate and measure the radiation interactions occurring in the human body either using the treatment planning system (TPS) or direct measurement with external beam therapy (EBT) 3 film. Objective: This study aimed to provide dose measurements in the patient-specific 3D printed anthropomorphic phantom using a TPS and direct measurements using single-beam three-dimensional conformal radiation therapy (3DCRT) technique with electron energy of 6 MeV. Material and Methods: In this experimental study, the patient-specific 3D printed anthropomorphic phantom was used for post-mastectomy radiation therapy. TPS on the phantom was conducted using a 3D-CRT technique with RayPlan 9A software. The single-beam radiation was delivered to the phantom with an angle perpendicular to the breast plane at 337.3° at 6 MeV with a total prescribed dose of 5000 cGy/25 fractions with 200 cGy per fraction. Results: The doses at planning target volume (PTV) and right lung confirmed a non-significant difference both for TPS and direct measurement with P-values of 0.074 and 0.143, respectively. The dose at the spinal cord showed statistically significant differences with a P-value of 0.002. The result presented a similar skin dose value using either TPS or direct measurement. Conclusion: The patient-specific 3D printed anthropomorphic phantom for breast cancer after mastectomy on the right side has good potential as an alternative to the evaluation of dosimetry for radiation therapy.

Evaluation of 3D Printed Anthropomorphic Head Phantom for Calibration of TLD in Eye Lens Dosimeter.

Background: Calibration of Thermo Luminescent Dosimetry (TLD) in eye lens dosimeter requires a standard phantom. The use of anthropomorphic phantoms in calibration needs evaluation. Objective: This study aimed to analyze the angular response of the TLD on the fabricated 3D anthropomorphic head phantom and Computerized Imaging Reference Systems (CIRS)- Computed Tomography (CT) dose phantom as a standard phantom irradiated with Cs-137 and to compare the absorbed dose and linear attenuation for both phantoms. Hp(3) analysis, conversion coefficient (hpK(3)), and calibration factor (CF) are also investigated. Material and Methods: In this experimental study, the fabricated 3D printed anthropomorphic head phantom was analyzed using polylactic acid (PLA) with the skull and then filled with the artificial brain and cerebrospinal fluid (CSF) as a test phantom. TLD-700H and TLD Reader Harshaw 6600 plus were used to analyze the angular response of Cs-137 radiation and to determine the absorbed dose and linear attenuation coefficient of test and standard phantoms. Results: The effect of the angle of radiation source towards TLD reading at the anthropomorphic head phantom has a similar value to the standard phantom with a calibration factor ranging from 0.82 to 1. The absorbed dose measurement and the linear attenuation coefficient of the anthropomorphic head phantom with the standard phantom have different values of 2.52 and 3.78%, respectively. Conclusion: The fabricated 3D printed anthropomorphic head phantom has good potential as an alternative to standard phantoms for TLD calibration in eye lens dosimeter.

Evaluation of Dosimetric Properties of Handmade Bolus for Megavoltage Electron and Photon Radiation Therapy.

BACKGROUND: The use of boluses for radiation therapy is very necessary to overcome the problem of sending inhomogeneous doses in the target volume due to irregularities on the surface of the skin. The bolus materials for radiation therapy need to be evaluated. OBJECTIVE: The present study aims to evaluate some handmade boluses for megavoltage electron and photon radiation therapy. Several dosimetric properties of the synthesized boluses, including relative electron density (RED), transmission factor, mass attenuation coefficient, percentage depth dose (PDD), and percentage surface dose (PSD) were investigated. MATERIAL AND METHODS: In this experimental study, we evaluated natural rubber, silicone rubber mixed either with aluminum or bismuth, paraffin wax, red plasticine, and play-doh as soft tissue equivalent. CT-simulator, in combination with ECLIPSE software, was used to determine bolus density. Meanwhile, Linear Accelerator (Linac) Clinac iX (Varian Medical Systems, Palo Alto), solid water phantom, and Farmer ionization chamber were used to measure and analyze of dosimetric properties. RESULTS: The RED result analysis has proven that all synthesized boluses are equivalent to the density of soft tissue such as fat, breast, lung, and liver. The dosimetric evaluation also shows that all synthesized boluses have a density similar to the density of water and can increase the surface dose with a value ranging from 6-20% for electron energy and 30-50% for photon energy. CONCLUSION: In general, all synthesized boluses have an excellent opportunity to be used as an alternative tissue substitute in the surface area of the body when using megavoltage electron and photon energy.

A Comparison between Silver Nanosquare Arrays and Silver Thin-Films as a Blood Cancer Prognosis Monitoring Electrode Design Using Optical and Electrochemical Characterization.

The development of silver (Ag) thin films and the fabrication of Ag nanosquare arrays with the use of an anodic aluminum oxide (AAO) template and leaf extracts were successfully carried out using the DC sputtering and spin coating deposition methods. Ag thin films and Ag nanosquare arrays are developed to monitor cancer prognosis due to the correlation between serum albumin levels and prognostic factors, as well as the binding of serum albumin to the surface of these electrodes. Nanosquare structures were fabricated using AAO templates with varying diameters and a gap distance between adjacent unit cells of 100 nm. The nanosquare array with a diameter of 250 nm and irradiated with electromagnetic waves with a wavelength of around 800 nm possessed the greatest electric field distribution compared to the other variations of diameters and wavelengths. The results of the absorption measurement and simulation showed a greater shift in absorption peak wavelength when carried out using the Ag nanosquare array. The absorption peak wavelengths of the Ag nanosquare array in normal blood and blood with cancer lymphocytes were 700-774 nm and 800-850 nm, respectively. The electrochemical test showed that the sensitivity values of the Ag thin-film electrode deposited using DC sputtering, the Ag thin-film electrode deposited using spin coating, and the Ag nanosquare array in detecting PBS+BSA concentration in the cyclic voltammetry (CV) experiment were 1.308 µA mM-1cm-2, 0.022 µA mM-1cm-2, and 39.917 µA mM-1cm-2, respectively. Meanwhile, the sensitivity values of the Ag thin film and the Ag nanosquare array in detecting the PBS+BSA concentration in the electrochemical impedance spectroscopy (EIS) measurement were 6593.76 Ohm·cm2/mM and 69,000 Ohm·cm2/mM, respectively. Thus, our analysis of the optical and electrochemical characteristics of Ag thin films and Ag nanosquare arrays showed that both can be used as an alternative biomedical technology to monitor the prognosis of blood cancer based on the concentration of serum albumin in blood.

Photoinactivation of bacteria attached to glass and acrylic surfaces by 405 nm light: potential application for biofilm decontamination.

Attachment of bacteria to surfaces and subsequent biofilm formation remains a major cause of cross-contamination capable of inducing both food-related illness and nosocomial infections. Resistance to many current disinfection technologies means facilitating their removal is often difficult. The aim of this study was to investigate the efficacy of 405 nm light for inactivation of bacterial attached as biofilms to glass and acrylic. Escherichia coli biofilms (10(3)-10(8) CFU mL(-1)) were generated on glass and acrylic surfaces and exposed for increasing times to 405 nm light (5-60 min) at ca 140 mW cm(-2). Successful inactivation of biofilms has been demonstrated, with results highlighting complete/near-complete inactivation (up to 5 log10 reduction on acrylic and 7 log10 on glass). Results also highlight that inactivation of bacterial biofilms could be achieved whether the biofilm was on the upper "directly exposed" surface or "indirectly exposed" underside surface. Statistically significant inactivation was also shown with a range of other microorganisms associated with biofilm formation (Staphylococcus aureus, Pseudomonas aeruginosa and Listeria monocytogenes). Results from this study have demonstrated significant inactivation of bacteria ranging from monolayers to densely populated biofilms using 405 nm light, highlighting that with further development this technology may have potential applications for biofilm decontamination in food and clinical settings.

Bactericidal effects of 405 nm light exposure demonstrated by inactivation of Escherichia, Salmonella, Shigella, Listeria, and Mycobacterium species in liquid suspensions and on exposed surfaces.

The bactericidal effect of 405 nm light was investigated on taxonomically diverse bacterial pathogens from the genera Salmonella, Shigella, Escherichia, Listeria, and Mycobacterium. High-intensity 405 nm light, generated from an array of 405-nm light-emitting diodes (LEDs), was used to inactivate bacteria in liquid suspension and on exposed surfaces. L. monocytogenes was most readily inactivated in suspension, whereas S. enterica was most resistant. In surface exposure tests, L. monocytogenes was more susceptible than Gram-negative enteric bacteria to 405 nm light when exposed on an agar surface but interestingly less susceptible than S. enterica after drying onto PVC and acrylic surfaces. The study findings, that 405 nm light inactivates diverse types of bacteria in liquids and on surfaces, in addition to the safety advantages of this visible (non-UV wavelength) light, indicate the potential of this technology for a range of decontamination applications.

High-intensity 405 nm light inactivation of Listeria monocytogenes.

The antimicrobial properties of light is an area of increasing interest. This study investigates the sensitivity of the significant foodborne pathogen Listeria monocytogenes to selected wavelengths of visible light. Results demonstrate that exposure to wavelength region 400-450 nm, at sufficiently high dose levels (750 J cm(-2)), induced complete inactivation of a 5 log(10) population. Exposure to wavelengths longer than 450 nm did not cause significant inactivation. Analysis of 10 nm bandwidths between 400 and 450 nm confirmed 405(± 5) nm light to be most effective for the inactivation of L. monocytogenes, with a lesser bactericidal effect also evident at other wavelengths between 400 and 440 nm. Identification of the optimum bactericidal wavelength enabled the comparison of inactivation using 405(± 5) nm filtered light and a 405 nm light-emitting diode (LED) array (14 nm FWHM). Results demonstrate similar inactivation kinetics, indicating that the applied dose of 405 nm light is the important factor. Use of the 405 nm LED array for the inactivation of L. monocytogenes and other Listeria species resulted in similar kinetics, with up to 5 log(10) reductions with a dose of 185 J cm(-2). Comparative data for the 405 nm light inactivation of L. monocytogenes and other important foodborne pathogens, Escherichia coli, Salmonella enteritidis and Shigella sonnei, are also presented, with L. monocytogenes showing higher susceptibility to inactivation through 405 nm light exposure.