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Considering the cooperative sector capabilities in organizing rural people, primarily focusing on empowering manpower and adopting a sustainable approach to basic resources (water and soil), village-cooperative initiative has emerged as a new concept by registering and forming 4565 new cooperatives in Iran's rural regions. The present research which was conducted in two qualitative and quantitative phases designed a new model by integrating the new village-cooperative approach along with the sustainable livelihood's framework theory. The study sample of the qualitative phase included 32 theorists of the village-cooperative initiative. To analyze the data, the grounded theory and three-step process of open coding, axial coding and selective coding were used using MAXqda18 software. Finally, a paradigm model was designed whose most important components included causal conditions (shocks and seasonal conditions), contextual conditions (trends and governmental support), intervening conditions (control and market development), central categories (sustainable livelihoods with a village- cooperative approach), strategies (coping and adaptation) and consequences (creating jobs, establishing cooperatives, supporting smart agriculture and strengthening social capital). The statistical quantitative phase population consisted of cooperatives members in the village-cooperative initiative (N=405), being selected through Cochran's formula with proportional sampling method summing up to198 people from 5 provinces. The data collection tool was a researcher-made questionnaire whose validity and reliability were confirmed. The Bayesian structural equation modeling was used to analyze the data. The results of the research quantitative phase showed that the variables of financial capital, physical capital, social capital, coping and adaptation strategies, human capital and natural capital were the most effective variables on village-cooperative initiative members' sustainable livelihoods, respectively. Finally, a hybrid model based on the qualitative and quantitative studies was designed and suggestions were made; for instance, the creation of suitable grounds for off-farm activities such as rural industries and ecotourism.
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Aclimatação , Desenvolvimento Sustentável , Humanos , Teorema de Bayes , Reprodutibilidade dos Testes , AgriculturaRESUMO
Dose and range verification have become important tools to bring carbon ion therapy to a higher level of confidence in clinical applications. Positron emission tomography is among the most commonly used approaches for this purpose and relies on the creation of positron emitting nuclei in nuclear interactions of the primary ions with tissue. Predictions of these positron emitter distributions are usually obtained from time-consuming Monte Carlo simulations or measurements from previous treatment fractions, and their comparison to the current, measured image allows for treatment verification. Still, a direct comparison of planned and delivered dose would be highly desirable, since the dose is the quantity of interest in radiation therapy and its confirmation improves quality assurance in carbon ion therapy. In this work, we present a deconvolution approach to predict dose distributions from PET images in carbon ion therapy. Under the assumption that the one-dimensional PET distribution is described by a convolution of the depth dose distribution and a filter kernel, an evolutionary algorithm is introduced to perform the reverse step and predict the depth dose distribution from a measured PET distribution. Filter kernels are obtained from either a library or are created for any given situation on-the-fly, using predictions of the [Formula: see text]-decay and depth dose distributions, and the very same evolutionary algorithm. The applicability of this approach is demonstrated for monoenergetic and polyenergetic carbon ion irradiation of homogeneous and heterogeneous solid phantoms as well as a patient computed tomography image, using Monte Carlo simulated distributions and measured in-beam PET data. Carbon ion ranges are predicted within less than 0.5 mm and 1 mm deviation for simulated and measured distributions, respectively.
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Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Neoplasias de Cabeça e Pescoço/radioterapia , Radioterapia com Íons Pesados/métodos , Processamento de Imagem Assistida por Computador/métodos , Imagens de Fantasmas , Tomografia por Emissão de Pósitrons/métodos , Planejamento da Radioterapia Assistida por Computador/métodos , Algoritmos , Neoplasias de Cabeça e Pescoço/patologia , Humanos , Método de Monte CarloRESUMO
In the context of hadrontherapy, whilst ions are capable of effectively destroying radio resistant, deep seated tumors, their treatment localization must be well assessed to ensure the sparing of surrounding healthy tissue and treatment effectiveness. Thus, range verification techniques, such as online positron-emission-tomography (PET) imaging, hold great potential in clinical practice, providing information on the in vivo beam range and consequent tumor targeting. Furthermore, [Formula: see text] emitting radioactive ions can be an asset in online PET imaging, depending on their half-life, compared to their stable counterparts. It is expected that using these radioactive ions the signal obtained by a PET apparatus during beam delivery will be greatly increased, and exhibit a better correlation to the Bragg Peak. To this end, FLUKA Monte Carlo particle transport and interaction code was used to evaluate, in terms of annihilation events at rest and dose, the figure of merit in using [Formula: see text] emitter, radioactive ion beams (RI [Formula: see text]). For this purpose, the simulation results were compared with experimental data obtained with an openPET prototype in various online PET acquisitions at the Heavy Ion Medical Accelerator in Chiba (HIMAC), in collaboration with colleagues from the National Institute of Radiological Sciences' (NIRS) Imaging Physics Team. The dosimetry performance evaluation with FLUKA benefits from its recent developments in fragmentation production models. The present work estimated that irradiations with RI [Formula: see text], produced via projectile fragmentation and their signal acquisition with state-of-the-art PET scanner, lead to nearly a factor of two more accurate definition of the signals' peak position. In addition to its more advantageous distribution shape, it was observed at least an order magnitude higher signal acquired from 11C and 15O irradiations, with respect to their stable counterparts.
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Método de Monte Carlo , Tomografia por Emissão de Pósitrons , Doses de Radiação , Partículas beta , Humanos , Processamento de Imagem Assistida por Computador , RadiometriaRESUMO
OBJECTIVE: Totally endoscopic ear surgery is a relatively new method for managing chronic ear disease. This study aimed to test the null hypothesis that open and endoscopic approaches have similar direct costs for the management of attic cholesteatoma, from an Australian private hospital setting. METHODS: A retrospective direct cost comparison of totally endoscopic ear surgery and traditional canal wall up mastoidectomy for the management of attic cholesteatoma in a private tertiary setting was undertaken. Indirect and future costs were excluded. A direct cost comparison of anaesthetic setup and resources, operative setup and resources, and surgical time was performed between the two techniques. RESULTS: Totally endoscopic ear surgery has a mean direct cost reduction of AUD$2978.89 per operation from the hospital perspective, when compared to canal wall up mastoidectomy. CONCLUSION: Totally endoscopic ear surgery is more cost-effective, from an Australian private hospital perspective, than canal wall up mastoidectomy for attic cholesteatoma.
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Anestesia/economia , Colesteatoma da Orelha Média/economia , Colesteatoma da Orelha Média/cirurgia , Hospitais Privados/economia , Mastoidectomia/economia , Austrália , Colesteatoma da Orelha Média/diagnóstico , Custos e Análise de Custo , Endoscopia/economia , Hospitais Universitários , Humanos , Procedimentos Cirúrgicos Otológicos/economia , Estudos Retrospectivos , Resultado do TratamentoRESUMO
This paper presents an analytical method for the calculation of the neutron ambient dose equivalent H* (10) regarding patients, whereby the different concrete types that are used in the surrounding walls of the treatment room are considered. This work has been performed according to a detailed simulation of the Varian 2300C/D linear accelerator head that is operated at 18MV, and silver activation counter as a neutron detector, for which the Monte Carlo MCNPX 2.6 code is used, with and without the treatment room walls. The results show that, when compared to the neutrons that leak from the LINAC, both the scattered and thermal neutrons are the major factors that comprise the out-of field neutron dose. The scattering factors for the limonite-steel, magnetite-steel, and ordinary concretes have been calculated as 0.91±0.09, 1.08±0.10, and 0.371±0.01, respectively, while the corresponding thermal factors are 34.22±3.84, 23.44±1.62, and 52.28±1.99, respectively (both the scattering and thermal factors are for the isocenter region); moreover, the treatment room is composed of magnetite-steel and limonite-steel concretes, so the neutron doses to the patient are 1.79 times and 1.62 times greater than that from an ordinary concrete composition. The results also confirm that the scattering and thermal factors do not depend on the details of the chosen linear accelerator head model. It is anticipated that the results of the present work will be of great interest to the manufacturers of medical linear accelerators.
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Artefatos , Modelos Estatísticos , Método de Monte Carlo , Nêutrons , Aceleradores de Partículas/instrumentação , Radiometria/métodos , Radioterapia/instrumentação , Simulação por Computador , Desenho de Equipamento , Análise de Falha de Equipamento , Unidades Hospitalares , Doses de Radiação , Espalhamento de RadiaçãoRESUMO
Tragopogon buphthalmoides (DC.) Boiss, is widely used as a food additive with some imputed health effects in folk medicine of western Iran. Unfortunately, despite the prevalent medicinal uses of the plant, there are no reports on the toxic effects of T. buphthalmoides aerial parts. The present study evaluated the potential toxicity of dried hydroethanolic extract of the species in wistar rats. Also, we investigated antioxidant activity and total phenolic content (TPC) of the extract. In the acute study, single doses of extract were administered orally, and the rats were then monitored for 14 days. In the subchronic toxicity study, the sample was administered to the rats for 45 days. In the antioxidant capacity assays dried extract showed moderate to weak antioxidant activities. Also, the sample showed relatively notable TPC. The results of acute study indicated that the LD50 of T. buphthalmoides is higher than 2500 mg/kg. Biochemical analysis showed some significant changes including creatinine, glucose and triglyceride levels. Moreover, some significant abnormality of lung, kidney and liver organs was observed. Based on the results of this study, adverse effect level (AEL) of dried hydroethanolic extract of T. buphthalmoides considered to be less than 175 mg/kg/day for the male and female rats.
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INTRODUCTION: Doppler ultrasonography is a simple, noninvasive diagnostic tool for assessment and follow-up studies in renal transplantation. The aim of this study was to investigate the correlation between early changes in graft size and resistive index (RI) and 1-year graft function. METHOD: We recorded graft size, RI, and serum creatinine level in 25 living kidney donors (before transplantation) as well as early (1-week), and 1-year after transplantation (in kidney recipients). Then we assessed the correlation between early changes in graft size and RI and 1-year Scr. RESULTS: Repeated measurement tests showed a significant increase in graft size including length (initial, 107.6 ± 5.8 mm; average increase, 8.48 ± 5.61 mm; P < 0.001), anterior-posterior diameter (initial, 46.3 ± 4.7 mm; average increase, 6.16 ± 4.08 mm; P < 0.001), and parenchymal thickness (initial, 14.96 ± 2.1 mm; average increase, 3.04 ± 1.98 mm; P < 0.001) 1 week after transplantation. However, during the 1-year follow-up examinations the increase in graft size was not significant in contrast with 1-week follow-up values (P > 0.47). Pearson correlations showed significant correlation between early changes in graft size (eg, anterior-posterior diameter, r = -0.492; P = 0.013); and 1-year Scr levels. There was no significant correlation between graft size changes and RI or RI and Scr early or 1-year after transplantation. CONCLUSION: There was a significant increase in kidney size (including length, anterior-posterior diameter, and cortical thickness) early after transplantation. The amount of increase in size significantly correlated with Scr level 1-year after transplantation. There was no correlation between RI and Scr.
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Sobrevivência de Enxerto , Falência Renal Crônica/diagnóstico por imagem , Falência Renal Crônica/cirurgia , Transplante de Rim/métodos , Rim/diagnóstico por imagem , Ultrassonografia Doppler/métodos , Adulto , Feminino , Seguimentos , Humanos , Rim/patologia , Falência Renal Crônica/mortalidade , Doadores Vivos , Masculino , Pessoa de Meia-Idade , Período Pós-Operatório , Valor Preditivo dos Testes , Fatores de Tempo , Transplante Homólogo , Resultado do Tratamento , Adulto JovemRESUMO
AIM: The aim of this paper was to assess outcome of totally tubeless percutaneous nephrolithotomy (TPCNL) performing with and without preoperative computed tomography (CT) scan, in anomalous kidneys. METHODS: A total of 50 patients with renal anomaly were randomly divided into two groups. Exclusion criteria was stone size >3.5 cm. Twenty six had malrotation, 21 had horseshoe kidney and 3 had ectopic pelvic kidneys. For 25 patients, TPCNL was performed with preoperative CT scan and in the remnant only intravenous urography and renal ultrasonography were done, preoperatively. The incidence of complications and outcomes were compared between two groups in a 1 month period. RESULTS: In the group with preoperative CT scan, the mean (SD) stone size was 2.9 (0.75) vs. 2.7 (0.95) cm2. Between the two groups, there were not statistical differences in the mean (SD) analgesic requirement, hemoglobin drop, operation time, hospital stay, and return to normal activity. They were 7.5 (1.7) vs. 6.1 (1.9) mg of morphine, 1.20 (0.36) vs. 1.52 (0.27) mg/dl, 64 (13.2) vs. 59 (13.3) minutes, 1.9 (0.4) vs. 1.7 (0.45) and 12.4(2.9) vs. 10 (3.5) days, respectively. Only 2 patients required blood transfusion and one patient had postoperative pneumothorax in the group with CT while in the other group, three patients required postoperative transfusion and one showed postoperative fever. A successful outcome at the first attempt was 88% in group with CT vs. 80% in the other group. CONCLUSION: It seems that TPCNL could be done with safety in renal anomalies by omitting preoperative CT scan.
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Cálculos Renais/cirurgia , Rim/anormalidades , Rim/cirurgia , Nefrostomia Percutânea/efeitos adversos , Adulto , Feminino , Humanos , Cálculos Renais/complicações , Cálculos Renais/diagnóstico por imagem , Masculino , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Tomografia Computadorizada por Raios X , Resultado do Tratamento , UltrassonografiaRESUMO
We conducted an epidemiological and cost analysis for all 13 patients diagnosed with multaidrug-resistant tuberculosis (11 pulmonary, 2 extrapulmonary) in Oman from January 2000 to October 2005. The disease was secondary, or acquired, in 12 of 13 patients. A total of 140 contacts were screened (mean 10.8 persons per patient), but contact tracing revealed no secondary cases. The mean number of drugs that TB isolates were resistant to was 2.8 (range 2-5). A mean of 4.7 drugs were given to patients, the mean length of therapy was 8 months and all patients were cured. The cost of medications for these multidrug-resistant cases was 14 to 29 times higher than that for the standard drug-sensitive TB regimen.
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Efeitos Psicossociais da Doença , Tuberculose Resistente a Múltiplos Medicamentos/economia , Tuberculose Resistente a Múltiplos Medicamentos/epidemiologia , Adolescente , Adulto , Distribuição por Idade , Idoso , Antituberculosos/economia , Busca de Comunicante , Custos e Análise de Custo , Terapia Diretamente Observada/economia , Notificação de Doenças , Custos de Medicamentos/estatística & dados numéricos , Feminino , Humanos , Incidência , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , Omã/epidemiologia , Vigilância da População , Estudos Retrospectivos , Distribuição por Sexo , Análise de Sobrevida , Resultado do Tratamento , Tuberculose Resistente a Múltiplos Medicamentos/diagnóstico , Tuberculose Resistente a Múltiplos Medicamentos/tratamento farmacológicoRESUMO
We conducted an epidemiological and cost analysis for all 13 patients diagnosed with multaidrug-resistant tuberculosis [11 pulmonary, 2 extrapulmonary] in Oman from January 2000 to October 2005. The disease was secondary, or acquired, in 12 of 13 patients. A total of 140 contacts were screened [mean 10.8 persons per patient], but contact tracing revealed no secondary cases. The mean number of drugs that TB isolates were resistant to was 2.8 [range 2-5]. A mean of 4.7 drugs were given to patients, the mean length of therapy was 8 months and all patients were cured. The cost of medications for these multidrug-resistant cases was 14 to 29 times higher than that for the standard drug-sensitive TB regimen