Strengthening education and training programmes for medical physics in Asia and the Pacific: the IAEA non-agreement technical cooperation (TC) regional RAS6088 project.

This article documents the work conducted in implementing the IAEA non-agreement TC regional RAS6088 project "Strengthening Education and Training Programmes for Medical Physics". Necessary information on the project was collected from the project counterparts via emails for a period of one month, starting from 21st September 2023, and verified at the Final Regional Coordination Meeting in Bangkok, Thailand from 30th October 2023 to 3rd November 2023. Sixty-three participants were trained in 5 Regional Training Courses (RTCs), with 48%, 32% and 20% in radiation therapy, diagnostic radiology, and nuclear medicine, respectively. One RTC was successfully organised to introduce molecular biology as an academic module to participants. Three participating Member States, namely United Arab Emirates (UAE), Nepal and Afghanistan have initiated processes to start the postgraduate master medical physics education programmes by coursework, adopting the IAEA TCS56 Guidelines. UAE has succeeded in completing the process while Nepal and Afghanistan have yet to initiate the programme. The postgraduate master medical physics programmes by coursework were strengthened in Indonesia, Jordan, Malaysia, Pakistan, Syria, and Thailand, along with the national registration of medical physicists. In particular, Thailand has revised 6 postgraduate master medical physics programmes by coursework during the tenure of this project. Home Based Assignment and RTCs have resulted in two publications. In conclusion, the RAS6088 project was found to have achieved its planned outcomes despite challenges faced due to the COVID-19 pandemic. It is proposed that a follow up project be implemented to increase the number of Member States who are better prepared to improve medical physics education and training in the region.

Employing T-Cell Memory to Effectively Target SARS-CoV-2.

Well-trained T-cell immunity is needed for early viral containment, especially with the help of an ideal vaccine. Although most severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected convalescent cases have recovered with the generation of virus-specific memory T cells, some cases have encountered T-cell abnormalities. The emergence of several mutant strains has even threatened the effectiveness of the T-cell immunity that was established with the first-generation vaccines. Currently, the development of next-generation vaccines involves trying several approaches to educate T-cell memory to trigger a broad and fast response that targets several viral proteins. As the shaping of T-cell immunity in its fast and efficient form becomes important, this review discusses several interesting vaccine approaches to effectively employ T-cell memory for efficient viral containment. In addition, some essential facts and future possible consequences of using current vaccines are also highlighted.

Deployable designs to temporarily convert subacute hospital rooms into palliative care rooms.

OBJECTIVE: To explore the design of deployable articles that can turn subacute hospital rooms into palliative care rooms to provide better patient-centred care and to meet the shortage of dedicated palliative care spaces in Australia. METHODS: Clinicians and a design researcher collaborated to review the literature, obtain clinical/practitioner feedback on needs and use design research methods to produce design concepts and prototypes for use in the subacute care hospital setting. RESULTS: A design solution that included: (a) A guest-bed module for improved family togetherness and room personalisation; and (b) A digital connectivity module designed to provide family togetherness virtually. CONCLUSIONS: Informed design solutions for palliative care spaces were derived from clinical feedback and literature evidence. Clinicians expressed great interest and support for further development and implementation in Victorian hospitals. This exploratory concept also provides insights for future research and innovation in the design of palliative care environments.

Impact of an extreme monsoon on CO2 and CH4 fluxes from mangrove soils of the Ayeyarwady Delta, Myanmar.

Mangrove ecosystems can be both significant sources and sinks of greenhouse gases (GHGs). Understanding variability in flux and the key factors controlling emissions in these ecosystems are therefore important in the context of accounting for GHG emissions. The current study is the first to quantify GHG emissions using static chamber measurements from soils in disused aquaculture ponds, planted mangroves, and mature mangroves from the Ayeyarwady Delta, Myanmar. Soil properties, biomass and estimated net primary productivity were also assessed. Field assessments were conducted at the same sites during the middle of the dry season in February and end of the wet season in October 2019. Rates of soil CO2 efflux were among the highest yet recorded from mangrove ecosystems, with CO2 efflux from the 8 year old site reaching 86.8 ± 17 Mg CO2 ha-1 yr-1 during February, an average of 862% more than all other sites assessed during this period. In October, all sites had significant rates of soil CO2 efflux, with rates ranging from 31.9 ± 4.4 Mg CO2 ha-1 yr-1 in a disused pond to 118.9 ± 24.3 Mg CO2 ha-1 yr-1 in the 8 year old site. High soil CO2 efflux from the 8 year old site in February is most likely attributable to high rates of primary production and belowground carbon allocation. Elevated CO2 efflux from all sites during October was likely associated with the extreme 2019 South Asian monsoon season which lowered soil pore salinity and deposited new alluvium, stimulating both autotrophic and heterotrophic activity. Methane efflux increased significantly (50-400%) during the wet season from all sites with mangrove cover, although was a small overall component of soil GHG effluxes during both measurement periods. Our results highlight the critical importance of assessing GHG flux in-situ in order to quantify variability in carbon dynamics over time.

Estrogenic action by tris(2,6-dimethylphenyl) phosphate impairs the development of female reproductive functions.

Developmental exposure to environmental chemicals with estrogen-like activity is suspected to permanently impair women's health. In this study, a mouse model was used to evaluate whether tris(2,6-dimethylphenyl) phosphate (TDMPP), a chemical with a putative estrogen-like action, impairs sexual differentiation of the brain. Either TDMPP and 17ß-estradiol (E2) as positive controls or sesame oil as a negative control were administered subcutaneously to dams from gestational day (GD) 14 to parturition, and to pups from postnatal day (PND) 0 to 9. Precocious puberty, irregular estrous cycles, and a lowered lordosis response were found in the TDMPP- and E2-treated groups. A certain amount of TDMPP and its metabolites in the perinatal brain and the masculinization of sexual dimorphic nuclei in the hypothalamus of female mice after treatment were also detected. The experimental evidence demonstrates that TDMPP directly enters the fetal and neonatal brain, thereby inducing changes of sex-related brain structures and impairing female reproductive functions.

A systems approach to trauma care in Myanmar: from health partnership to academic collaboration.

Experience from a variety of disciplines suggests that improving healthcare, particularly in resource-poor environments, can benefit from a systems approach. However, putting this into practice is challenging, especially in the context of an international institutional health partnership. In this article, we outline how a systems approach to the improvement of trauma care has informed both clinical improvement and academic collaboration as part of an ongoing partnership involving Cambridge University Hospitals NHS Foundation Trust, the University of Cambridge, and Cambridge Global Health Partnerships in the UK, and Yangon General Hospital, University of Medicine 1, and the Tropical Health and Education Trust (THET) in Myanmar. Improving and researching trauma care is an exemplar of a systems problem, requiring an understanding of the relevant people, equipment, processes, institutions, and power structures that result in the delivery of care at all points of the patient's journey from injury to rehabilitation. Exploring this in the explicit context of traumatic brain injury is one of the research themes of the NIHR Global Health Research Group on Neurotrauma, allowing systems research to directly inform efforts at practical improvement.

Diagnosing delirium in very elderly intensive care patients.

OBJECTIVE: To determine the incidence of delirium in elderly intensive care patients and to compare incidence using two retrospective chart-based diagnostic methods and a hospital reporting measure (ICD-10). DESIGN: Retrospective study. SETTING: An ICU in a large metropolitan private hospital in Melbourne, Australia. PATIENTS: English-speaking participants (n=348) 80+ years, admitted to ICU for >24 hours. MEASUREMENTS AND MAIN RESULTS: Medical files of ICU patients admitted October 2009-October 2012 were retrospectively assessed for delirium using the Inouye chart review method, DSM-IV diagnostic criteria and ICD-10 coding data. General patient characteristics, first onset of delirium symptoms, source of delirium information, administration of delirium medication, hospital and ICU length of stay, 90 day mortality were documented. Delirium was found in 11-29% of patients, the highest incidence identified by chart review. Patients diagnosed with delirium had higher 90 day mortality, and those meeting criteria for all three methods had longer hospital and ICU length of stay. CONCLUSIONS: ICU delirium in the elderly is often under-reported and strategies are needed to improve staff education and diagnosis.

Bacillus methylotrophicus Strain NKG-1, Isolated from Changbai Mountain, China, Has Potential Applications as a Biofertilizer or Biocontrol Agent.

Chemical pesticides are widely used in agriculture, which endangers both environmental health and food safety. Biocontrol is an environmentally-friendly and cost-effective green technique in environmental protection and agricultural production; it generally uses selected bioresources, including beneficial microorganisms. We isolated a novel bacterial strain (NKG-1) from the rare dormant volcanic soils of Changbai Mountain in China's Jilin Province. The strain was identified as Bacillus methylotrophicus using morphological, biochemical, physiological, and phylogenetic 16S rDNA sequencing data. This strain was able to suppress mycelial growth and conidial germination of numerous plant pathogenic fungi on solid media. A greenhouse experiment showed that application of NKG-1 fermentation broth prior to inoculation of Botrytis cinerea, the cause of gray tomato mold, inhibited growth of the mold by 60%. Furthermore, application of a 100× dilution of NKG-1 fermentation broth to tomato seedlings yielded a significant increase in seedling fresh weight (27.4%), seedling length (12.5%), and root length (57.7%) compared to the control. When the same dosage was applied in the field, we observed increases in tomato plant height (14.7%), stem diameter (12.7%), crown width (16.3%), and maximum fruit diameter (11.5%). These results suggest that NKG-1 has potential commercial application as a biofertilizer or biocontrol agent.

Biochemical markers of bone turnover - uses and limitations.

Bone turnover markers of resorption and formation are released during the process of bone remodelling. These markers have been extensively studied in a number of therapeutic trials of osteoporosis during the past decade. This has led to better understanding of their physiology, clinical applications and possible ways to optimize analytical techniques. Bone markers can complement the results of bone mineral density in the management of osteoporosis, but their use in clinical practice is challenged by pre-analytical and analytical variability. This review will discuss different types of bone markers, their limitations, use in different metabolic bone diseases and current recommendations from the International Osteoporosis Foundation and the International Federation of Clinical Chemistry and Laboratory Medicine bone marker standards working group.