• Journal of Appropriate Technology
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• v.6 no.1
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• pp.37-44
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• 2020

Medical waste is any kind of waste that contains infectious material and recommended not to be transferred for infection control. As a means of disposal, incineration has better points than dumping or landfill in the quantity reduction, odorless and nonhazardous. However, open burning and incineration of health care wastes under bad circumstances, can result in the emission of environmental pollutants to air. A burial of biological waste brings pollution of soil and water. Most of sub divisional hospitals in Fiji transfer their medical wastes to divisional hospitals for incineration. In 2011, 62,518 kg of medical waste was incinerated in the three divisional hospitals. However, some medical wastes are considered as general waste and burnt or sent to landfill site, some are buried on site in some sub-divisional hospitals. In this regards, urgent education is necessary for awareness promotion to relevant personnel in medical waste treatment. On site incineration using small scale incinerator is more recommended than transportation of medical wastes treatment in Fiji. Moreover, remotely controllable and fixable small scale of incinerator is more desirable in sub-divisional hospitals. It is recommended that Fiji government to set up a legal framework for medical waste management (MWM), to develop specific guidelines for MWM, to set up a training system for MWM to ensure that all relevant personnel are trained, to develop a monitoring and supervision system for MWM, to clarify the future financing of MWM activities, and to improve the MWM infrastructure.

• Journal of Appropriate Technology
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• v.6 no.2
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• pp.163-173
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• 2020

For the successful execution of an ODA project, it is necessary to know what areas are weak and necessary to the country of demand exactly. The health sector is also a top priority in most of developing countries. This study was carried out to introduce non-communicable disease (NCD) in Fiji for ODA projects planning. The major causes of death in Fiji in 2016 are diabetes, ischemic heart disease, cerebrovascular disease, chronic kidney disease, lower respiratory infect, asthma in ranking. The major causes of death in Korea in same year are cancer, ischemic heart diseases, cerebrovascular diseases, pneumonia, suicide, diabetes in the order of ranking. The chronic disease as non-communicable disease (NCD) has been increasing continuously due to changes in lifestyle and consumption patterns and population aging in prevalence rate. This global trend is also apparent in Fiji and Korea, reflected in increasing mortality and personal costs for the treatment and management of NCD. The need for a sustained comprehensive treatment tailored for individual patients has suggested from many studies and the development of a systematic program to manage NCD patients to provide such care have been recommended. The Fiji government developed Non-communicable Diseases Strategic Plan 2015-2019 and has tried to reduce the prevalence rate of non-communicable diseases by factors. The WHO global action plan guiding national-level NCD policies requires an NCD prevention and control model at the community level, presenting strategic goals and detailed options for the introduction and application of the approach to communities. It is necessary to develop an NCD prevention and control model, consisting of a strategy of community intervention, education for students and NCD patients, and the legal enactment of NCD that adequately meets the needs of community members.

• Journal of the Daesoon Academy of Sciences
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• v.44
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• pp.53-96
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• 2023

This article apprehends Yeongdae (靈臺), the most sacred shrine of Daesoon Jinrihoe which has earlier historical precedents, as an example of material religion. In East Asia, the first Yeongdae was a structure that King Wen of Zhou commissioned to be built. As the time passed by, the meaning of Yeongdae was changed to signify a mental yeongdae, the object and the aim of cultivation, and the notional mindset that appears in the Daoist meditation, Cunsi (存思, visualization). This implies that Yeongdae has signified both material and non-material objects. Throughout most of history, these two concepts had never been related to each other, but shifted in form and meaning depending on context. Daesoon Jinrihoe, which emerged in the modern era of Korea, used the concept of investiture of gods and combined the two into one. Accordingly, the Yeongdae, referred to by King Wen to indicate his shrine, was expressed as a spot wherein the gods were enshrined on the earth. As an innovation, Daesoon Jinrihoe argued that gods correspond to properly eligible human beings according to the degree of their cultivation and that sacred space was instead defined a spot within the human mind, a mental yeongdae, where the gods could be enshrined into humanity (神封於人). From the perspective of Lévi-Strauss, the factors that are discovered in the tradition of East Asia, namely, the Yeongdae of King Wen and the mental yeongdae of Zhuangzi can combined with consistency and established in the doctrinal system of Daesoon Jinrihoe. Such an attempt refers to bricolage which re-creates the traditional concepts of the past. In this regard, the concept of invented tradition coined by Eric Hobsbawm could also be used to conclude that the Yeongdae (the shrine of gods) of Daesoon Jinrihoe can be expressed as an invented Yeongdae, which transcends the existing categories of material yeongdae and non-material yeongdae.

• Nuclear Engineering and Technology
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• v.55 no.5
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• pp.1593-1603
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• 2023

In deterministic and Monte Carlo transport codes, b-delayed emission is included using a group structure where all of the precursors are grouped together in 6 groups or families, but given the increase in computational power, nowadays there is no reason to keep this structure. Furthermore, there have been recent efforts to compile and evaluate all the available b-delayed neutron emission data and to measure new and improved data on individual precursors. In order to be able to perform a transient Monte Carlo simulation, data from individual precursors needs to be implemented in a transport code. This work is the first step towards the development of a tool to explore the effect of individual precursors in a fissile system. In concrete, individual precursor data is included by expanding the capabilities of the open source Monte Carlo code OpenMC. In the modified code - named Time Dependent OpenMC or OpenMC(TD)- time dependency related to β-delayed neutron emission was handled by using forced decay of precursors and combing of the particle population. The data for continuous energy neutron cross-sections was taken from JEFF-3.1.1 library. Regarding the data needed to include the individual precursors, cumulative yields were taken from JEFF-3.1.1 and delayed neutron emission probabilities and delayed neutron spectra were taken from ENDF-B/VIII.0. OpenMC(TD) was tested in a monoenergetic system, an energy dependent unmoderated system where the precursors were taken individually or in a group structure, and in a light-water moderated energy dependent system, using 6-groups, 50 and 40 individual precursors. Neutron flux as a function of time was obtained for each of the systems studied. These results show the potential of OpenMC(TD) as a tool to study the impact of individual precursor data on fissile systems, thus motivating further research to simulate more complex fissile systems.

• Archives of Plastic Surgery
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• v.51 no.1
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• pp.42-51
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• 2024

Background Increasing concerns regarding the safety of textured surface implants have resulted in surgeons transitioning from textured tissue expanders (TEs) to smooth TEs. Given this change has only recently occurred, this study evaluated outcomes between smooth and textured TEs. Methods Women who underwent two-stage breast reconstruction using TEs from 2013 to 2022 were included. TE-specific variables, perioperative information, pain scores, and complications were collected. Chi-squared, t-test, and linear regression analyses were performed. Results A total of 320 patients received a total of 384 textured and 152 smooth TEs. Note that 216 patients received bilateral reconstruction. TEs were removed in 9 cases. No significant differences existed between groups regarding comorbidities. Smooth TEs had a higher proportion of prepectoral placement (p < 0.001). Smooth TEs had less fills (3±1 vs. 4±2, p < 0.001), shorter expansion periods (60±44 vs. 90±77 days, p < 0.001), smaller expander fill volumes (390±168 vs. 478±177 mL, p < 0.001), and shorter time to exchange (80±43 vs. 104±39 days, p < 0.001). Complication rates between textured and smooth TEs were comparable. Smooth TE had a greater proportion of TE replacements (p = 0.030). On regression analysis, pain scores were more closely associated with age (p = 0.018) and TE texture (p = 0.046). Additional procedures at time of TE exchange (p < 0.001) and textured TE (p = 0.017) led to longer operative times. Conclusion As many surgeons have transitioned away from textured implants, our study shows that smooth TEs have similar outcomes to the textured alternatives.

• Journal of Cardiovascular Imaging
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• v.31 no.3
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• pp.125-132
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• 2023

BACKGROUND: There is limited data on the residual echocardiographic findings including strain analysis among post-coronavirus disease (COVID) patients. The aim of our study is to prospectively phenotype post-COVID patients. METHODS: All patients discharged following acute COVID infection were systematically followed in the post-COVID-19 Recovery Clinic at Vancouver General Hospital and St. Paul's Hospital. At 4-18 weeks post diagnosis, patients underwent comprehensive echocardiographic assessment. Left ventricular ejection fraction (LVEF) was assessed by 3D, 2D Biplane Simpson's, or visual estimate. LV global longitudinal strain (GLS) was measured using a vendor-independent 2D speckle-tracking software (TomTec). RESULTS: A total of 127 patients (53% female, mean age 58 years) were included in our analyses. At baseline, cardiac conditions were present in 58% of the patients (15% coronary artery disease, 4% heart failure, 44% hypertension, 10% atrial fibrillation) while the remainder were free of cardiac conditions. COVID-19 serious complications were present in 79% of the patients (76% pneumonia, 37% intensive care unit admission, 21% intubation, 1% myocarditis). Normal LVEF was seen in 96% of the cohort and 97% had normal right ventricular systolic function. A high proportion (53%) had abnormal LV GLS defined as < 18%. Average LV GLS of septal and inferior segments were lower compared to that of other segments. Among patients without pre-existing cardiac conditions, LVEF was abnormal in only 1.9%, but LV GLS was abnormal in 46% of the patients. CONCLUSIONS: Most post-COVID patients had normal LVEF at 4-18 weeks post diagnosis, but over half had abnormal LV GLS.

• Journal of Cardiovascular Imaging
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• v.30 no.4
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• pp.292-304
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• 2022

BACKGROUND: Calcium is a determinant of paravalvular leakage (PVL) after transcatheter aortic valve implantation (TAVI). This is based on a fixed contrast attenuation value while X-ray attenuation is patient-dependent and without considering frame expansion and PVL location. We examined the role of calcium in (site-specific) PVL after TAVI using a patient-specific contrast attenuation coefficient combined with frame expansion. METHODS: 57 patients were included with baseline CT, post-TAVI transthoracic echocardiography and rotational angiography (R-angio). Calcium load was assessed using a patient-specific contrast attenuation coefficient. Baseline CT and post-TAVI R-angio were fused to assess frame expansion. PVL was assessed by a core lab. RESULTS: Overall, the highest calcium load was at the non-coronary-cusp-region (NCR, 436 mm³) vs. the right-coronary-cusp-region (RCR, 233 mm³) and the left-coronary-cusp-region (LCR, 244 mm³), p < 0.001. Calcium load was higher in patients with vs. without PVL (1,137 vs. 742 mm³, p = 0.012) and was an independent predictor of PVL (odds ratio, 4.83, p = 0.004). PVL was seen most often in the LCR (39% vs. 21% [RCR] and 19% [NCR]). The degree of frame expansion was 71% at the NCR, 70% at the RCR and 74% at the LCR without difference between patients with or without PVL. CONCLUSIONS: Calcium load was higher in patients with PVL and was an independent predictor of PVL. While calcium was predominantly seen at the NCR, PVL was most often at the LCR. These findings indicate that in addition to calcium, specific anatomic features play a role in PVL after TAVI.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.8
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• pp.3769-3776
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• 2016

Background: Breast cancer is the leading cause of cancer deaths among women worldwide. High breast cancer mortality has been attributed to lack of public awareness of the disease. Little is known about the level of knowledge of breast cancer in Central African Republic. This study aimed to investigate the knowledge of health professionals on breast cancer. Materials and Methods: This cross-sectional study was conducted among 158 health professionals (27 medical; 131 paramedical) in 17 hospitals in Bangui using a self-administered questionnaire. Descriptive statistical analysis, Person's ${\chi}^2$ test and ANOVA were applied to examine associations between variables with p < 0.05 being considered significant. Results: Data analyzed using SPSS version 20 indicates that average knowledge about breast cancer perception of the entire population was 47.6%, diagnosis method 45.5%, treatment 34.3% and risk factors 23.8%. Most respondents (65.8%) agreed that breast cancer is important in Central African Republic and that family history is a risk factor (44.3%). Clinical assessments and mammography were considered most suitable diagnostic methods, and surgery as the best treatment. The knowledge level was significantly higher among medical than paramedical staff with regard to risk factors, diagnosis and treatment. However the trainee group had very high significant differences of knowledge compared with all other groups. Conclusions: There is a very urgent need to update the various training programs for these professionals, with recommendations of retraining. Health authorities must create suitable structures for the overall management of cancer observed as a serious public health problem.

• Investigative Magnetic Resonance Imaging
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• v.18 no.2
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• pp.107-119
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• 2014

Purpose : To efficiently evaluate phased array coil performance using a software tool box with which we can make visual comparison of the sensitivity of every coil element between the real experiment and EM simulation. Materials and Methods: We have developed a $C^{{+}{+}}$- and MATLAB-based software tool called Phased Array Coil Evaluator (PACE). PACE has the following functions: Building 3D models of the coil elements, importing the FDTD simulation results, and visualizing the coil sensitivity of each coil element on the ordinary Cartesian coordinate and the relative coil position coordinate. To build a 3D model of the phased array coil, we used an electromagnetic 3D tracker in a stylus form. After making the 3D model, we imported the 3D model into the FDTD electromagnetic field simulation tool. Results: An accurate comparison between the coil sensitivity simulation and real experiment on the tool box platform has been made through fine matching of the simulation and real experiment with aids of the 3D tracker. In the simulation and experiment, we used a 36-channel helmet-style phased array coil. At the 3D MRI data acquisition using the spoiled gradient echo sequence, we used the uniform cylindrical phantom that had the same geometry as the one in the FDTD simulation. In the tool box, we can conveniently choose the coil element of interest and we can compare the coil sensitivities element-by-element of the phased array coil. Conclusion: We expect the tool box can be greatly used for developing phased array coils of new geometry or for periodic maintenance of phased array coils in a more accurate and consistent manner.

• Progress in Medical Physics
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• v.17 no.1
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• pp.24-31
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• 2006

Automated analysis software was developed to measure the magnitude of the intrafractional and interfractional errors during breast radiation treatments. Error analysis results are important for determining suitable planning target volumes (PTV) prior to Implementing breast-conserving 3-D conformal radiation treatment (CRT). The electrical portal imaging device (EPID) used for this study was a Portal Vision LC250 liquid-filled ionization detector (fast frame-averaging mode, 1.4 frames per second, 256X256 pixels). Twelve patients were imaged for a minimum of 7 treatment days. During each treatment day, an average of 8 to 9 images per field were acquired (dose rate of 400 MU/minute). We developed automated image analysis software to quantitatively analyze 2,931 images (encompassing 720 measurements). Standard deviations ($\sigma$) of intrafractional (breathing motion) and intefractional (setup uncertainty) errors were calculated. The PTV margin to include the clinical target volume (CTV) with 95% confidence level was calculated as $2\;(1.96\;{\sigma})$. To compensate for intra-fractional error (mainly due to breathing motion) the required PTV margin ranged from 2 mm to 4 mm. However, PTV margins compensating for intefractional error ranged from 7 mm to 31 mm. The total average error observed for 12 patients was 17 mm. The intefractional setup error ranged from 2 to 15 times larger than intrafractional errors associated with breathing motion. Prior to 3-D conformal radiation treatment or IMRT breast treatment, the magnitude of setup errors must be measured and properly incorporated into the PTV. To reduce large PTVs for breast IMRT or 3-D CRT, an image-guided system would be extremely valuable, if not required. EPID systems should incorporate automated analysis software as described in this report to process and take advantage of the large numbers of EPID images available for error analysis which will help Individual clinics arrive at an appropriate PTV for their practice. Such systems can also provide valuable patient monitoring information with minimal effort.