Impact of COVID-19 pandemic on radiographers in the Republic of Cyprus. A questionnaire survey.

INTRODUCTION: Imaging is essential for the initial diagnosis and monitoring of the novel coronavirus, which emerged in Wuhan, China. This study aims to assess the insight of radiographers on how the COVID-19 pandemic has affected their work routine and if protective measures are applied. METHOD: A prospective observational study was conducted among radiographers registered in the Cyprus Society of Registered Radiologic Technologists & Radiation Therapy Technologists. A questionnaire composed of 28 multiple choice questions was utilised, and the data analysis was performed using SPSS software with the statistical significance assumed as p-value < 0.05. RESULTS: Out of 350 registered radiographers, 101 responses were received. The results showed that there are statistically significant differences regarding the working hours, the feeling of stress, the work effectiveness, the average examination time, the presence of a protocol used among the different workplaces of the participants; a private radiology centre, a private hospital or a public hospital, with a p-value 0.0022, 0.015, 0.027, 0.001, 0.0001 respectively. Also, statistically significant differences were observed in the decontamination methods used for equipment (p-value 0.007), for air (p-value 0.04) and when decontamination takes place (p-value 0.00032) among the different workplaces of the participants. Nonetheless, the majority of radiographers believe that their workplace is sufficiently provided with PPE, cleaning supplies, equipment, and with cleaning personnel and are optimistic regarding the adequacy of these provisions in the next three months. CONCLUSION: This study showed that in the Republic of Cyprus, there are protocols regarding protective measures against COVID-19, and the radiographers are adequately trained on how to face an infectious disease outbreak. However, work is needed in order to develop protocols that reassure the safety of patients and medical personnel while managing the excess workload effectively. IMPLICATIONS FOR PRACTICE: This study indicates the importance of applying protective measures and protocols in the radiology departments in order to minimise the spread of the virus.

Assessing radiation protection knowledge in diagnostic radiography in the Republic of Cyprus. A questionnaire survey.

INTRODUCTION: Radiation protection knowledge is essential for medical personnel in ensuring that the possible risks do not outweigh the benefits of diagnostic imaging. This study aimed to assess the radiation protection knowledge of radiographers in Cyprus. METHODS: A cross-sectional study was carried out among radiographers in Cyprus through the Cyprus Society of Registered Radiologic Technologists & Radiation Therapy Technologists. The study was a quantitative descriptive analysis, using a questionnaire with 22 multiple-choice questions. Analysis of the data was done using the statistical software Stata, by performing mean knowledge score comparisons by different participants' characteristics, using t-test and analysis of variance test. Statistical significance was assumed as a p-value < 0.05. RESULTS: The answers provided for each question indicate that some areas of radiation protection are less known compared to others, as there is quite a wide range of correct-to-incorrect ratios. The analysis based on participant characteristics in relation to overall radiation effects knowledge, identified important determinants, namely the workplace of the participant (p = 0.006), the type of work licence the participant held at the time of the questionnaire (p = 0.024), and the years of clinical experience of the participant (p = 0.021). CONCLUSION: The study showed that the levels of knowledge in radiation protection are of a very good standard. However, work is needed to clarify the specifics of dose limits and the national radiation protection legislation with regards to informing patients about the possible effects of ionising radiation. IMPLICATIONS FOR PRACTICE: The study results indicate the importance of educating radiographers about the requirements of national radiation protection legislation and how this new knowledge can be linked with practise.

A patient-centric approach to quality control and dosimetry in CT including CBCT.

One measurement and an algebraic formula are used to calculate the incident air kerma (Ka,i) at the skin after any CT examination, including cone-beam CT (CBCT) and multi-slice CT (MSCT). Empty scans were performed with X-ray CBCT systems (dental, C-arm and linac guidance scanners) as well as two MSCT scanners. The accumulated Ka,i at the flat panel (in CBCT) or the maximum incident air kerma at the isocentre (in MSCT) were measured using a solid-state probe. The average Ka,i(skin), at the skin of a hypothetical patient, was calculated using the proposed formula. Additional measurements of dose at the isocentre (DFOV) and kerma-area product (KAP), as well as Ka,i(skin) from thermoluminiscence dosimeters (TLDs) and size-specific dose estimates are presented for comparison. The Ka,i(skin) for the standard head size in the dental scanner, the C-arm (high dose head protocol) and the linac (head protocol) were respectively 3.33 ±â€¯0.19 mGy, 15.15 ±â€¯0.76 mGy and 3.23 ±â€¯0.16 mGy. For the first MSCT, the calculated Ka,i(skin) was 13.1 ±â€¯0.7 mGy and the TLDs provided a Ka,i(skin) between 10.3 ±â€¯1.1 mGy and 13.8 ±â€¯1.4 mGy. Estimation of patient air kerma in tomography with an uncertainty below 7% is thus feasible using an empty scan and conventional measurement tools. The provided equations and website can be applied to a standard size for the sake of quality control or to several sizes for the definition of diagnostic reference levels (DRLs). The obtained incident air kerma can be directly compared to the Ka,i from other X-ray modalities as recommended by ICRU and IAEA.

Computational phlebology: reviewing computer models of the venous system.

Relatively little attention has been paid to the venous system and valves from a cardiovascular engineering perspective up to now. Given the involvement of venous valve haemodynamics in the development of deep vein thrombosis this is an area that needs more detailed investigation and close collaboration between clinicians and cardiovascular engineers. The purpose of this review article is to provide an indication of the physiological conditions that need to be included in any computational model of the venous system, based on recommendations from clinicians, and to summarize published computational models of the venous system by trying to explore their limitations and application range. A MEDLINE search was carried out on the relevant literature from 1940 until today. Several models have been developed with a specific purpose in mind to coincide with the aim of each individual study. The model complexity and laws used in each model vary significantly. There are more simplistic computational models based on electric circuit analogies, termed as lumped parameter models, which can be used to provide boundary conditions to one-dimensional (1D) and three-dimensional (3D) domain models, followed by 1D continuous models based on analytical equations, which allow the description of pressure wave and can be non-linear in nature. Finally, there are the more advanced 3D models, which are based on the principles of haemodynamics, and consider the compliance of the venous system and the effect that venous valves have on the cardiovascular system. In conclusion, it appears that computer modelling of the venous system can contribute greatly to our understanding of venous physiology and allow us to evaluate the haemodynamic interactions that occur in the venous system under different physiological conditions.

Design of a novel polymeric heart valve.

Polymeric heart valves could offer an optimum alternative to current prostheses, by joining the advantages of mechanical and bioprosthetic valves. Though a number of materials suitable for this application have recently become available, significant improvements in the valve design are still needed. In this paper, a novel polymeric heart valve design is proposed and its optimization procedure, based on the use of finite elements, is described. The design strategy was aimed at reducing the energy absorbed during the operating cycle, resulting in high hydrodynamic performances and reduced stress levels. The efficacy of the design strategy was assessed by comparing the valve dynamics and stress levels predicted numerically during the cycle with those of an existing and well qualified polymeric valve design. The improved hydrodynamic performance of the proposed design was confirmed experimentally, by in vitro testing in a pulse duplicator.

Adaptation and development of software simulation methodologies for cardiovascular engineering: present and future challenges from an end-user perspective.

This paper describes the use of diverse software tools in cardiovascular applications. These tools were primarily developed in the field of engineering and the applications presented push the boundaries of the software to address events related to venous and arterial valve closure, exploration of dynamic boundary conditions or the inclusion of multi-scale boundary conditions from protein to organ levels. The future of cardiovascular research and the challenges that modellers and clinicians face from validation to clinical uptake are discussed from an end-user perspective.

A simple Computational Model-Based Validation of Guyton's closed circuit analysis of the heart and the peripheral circulatory system.

A computer model of the human cardiovascular system has been created based on Guyton's closed circuit analysis of the heart and the peripheral circulatory system. This model was checked against Guyton's experiments performed in anesthetised dogs regarding the normal venous return curve, the effect of mean circulatory filling pressure (MCFP) and the importance of arterial venous and capillary resistance. These comparisons indicate that this simple model is valid for the study of Guyton's experimental work and also forms the bases of a more complex model of the cardiovascular model with specific attention to the venous system.