35 Kalibracja źródła irydowego – analiza 3 różnych metod pomiarowych

Przedstawiono 6-letnie doświadczenia związane z kalibracją źródła Ir 192 stosowanego w brachyterapii HDR. Stosowano 3 metody kalibracji źródła irydowego: kalibrację „w wodzie”, Kalibrację w „powietrzu” oraz kalibrację metodą studzienkową.Analizowano następujące problemy związane z kalbracją źródła irydowego wymienionymi metodami:-Wybór optymalnej odległości źródła – komora-Wybór optymalnej geometrii układu pomiarowego i schemat fantomu pomiarowego-Geometryczna dokładność fantomu pomiarowego-Wybór współczynników korekcyjnych związanych z komorą jonizacyjną, gradientem dawki, anizotropią-Korekta związana z zastąpieniem wody przez PMMA (kalibracja w wodzie)-Uwzględnienie rozproszeń zewnętrznych (kalibracja w powietrzu)-Kalibracje komory studzienkowej wraz z elektrometrem.Przedstawiono wyniki kalibracji kilkunastu źródeł irydowych. Oszacowano błędy pomiaru stosowanych metod. Błędy wynikające z geometrycznej niedokładności układów pomiarowych stosowanych podczas kalibracji „w powietrzu” sięgały 3% co stawia pod znakiem zapytania przydatność tej metody (precyzję układu pomiarowego?). Niedokładności geometryczne były również podstawą błędu pomiaru podczas kalibracji w „wodzie”. Kalibracja komorą studzienkową przeprowadzona dla czterech źródeł irydowych dała wyniki powtarzalne a różnica między certyfikatem źródła nie przekraczała 1,5%.Otrzymane wyniki oraz prostota pomiaru pozwalają na rekomendację ostatniej metody dom standardowej kalibracji źródła irydowego

COMPARATIVE ANALYSIS OF ENERGY ACCUMULATION SYSTEMS AND DETERMINATION OF OPTIMAL APPLICATION AREAS FOR MODERN SUPER FLYWHEELS

The paper presents a review and comparative analysis of late years native and foreign literature on various energy storage devices: state of the art designs, application experience in various technical fields. Comparative characteristics of energy storage devices are formulated: efficiency, quality and stability. Typical characteristics are shown for such devices as electrochemical batteries, super capacitors, pumped hydroelectric storage, power systems based on compressed air and superconducting magnetic energy storage systems. The advantages and prospects of high-speed super flywheels as means of energy accumulation in the form of rotational kinetic energy are shown. High output power of a super flywheels energy storage system gives the possibility to use it as a buffer source of peak power. It is shown that super flywheels have great life cycle (over 20 years) and are environmental. A distinctive feature of these energy storage devices is their good scalability. It is demonstrated that super flywheels are especially effective in hybrid power systems that operate in a charge/discharge mode, and are used particularly in electric vehicles. The most important factors for space applications of the super flywheels are their modularity, high efficiency, no mechanical friction and long operating time without maintenance. Quick response to network disturbances and high power output can be used to maintain the desired power quality and overall network stability along with fulfilling energy accumulation needs

Medical Radioisotopes Produced with Cyclotron Beams in Warsaw

The various production routes of the prospective medical radioisotopes 43Sc, 44gSc, 44mSc, 47Sc, 44Ti/44gSc, 99mTc, 72Se/72As and 211At were investigated by a team from the Heavy Ion Laboratory, University of Warsaw (HIL-UW), the University of Silesia (US) and the National Centre for Nuclear Research (NCNR). Three cyclotrons were employed: the K=160 heavy-ion cyclotron with an internal 32 MeV alpha particle beam and the p/d PETtrace medical cyclotron at HIL and the C30 proton cyclotron at NCNR in Świerk, near Warsaw. The Thick Target Yields, activity at the End of Bombardment (EOB) and the impurities produced in addition to the main isotope are reported. The possible medical applications of these radioisotopes are briefly discussed

People with diabetes need a lower cut-off than others for depression screening with PHQ-9

Aims: This study evaluated the psychometric characteristics of the Polish version of the PHQ-9 in detecting major depression (MDD) and ‘MDD and/or dysthymia’ in people with and without type 2 diabetes. Methods: Participants were randomly selected from a diabetes outpatient facility (N = 216) and from among patients admitted to a medical center and psychiatric hospital (N = 99). The participants completed the PHQ-9. The Hamilton Depression Rating Scale and the Mini International Neuropsychiatric Interview were used to identify the presence of psychiatric symptoms. The optimal cut-offs for PHQ-9 in people with and without type 2 diabetes were investigated based on two methods: 1) Youden’s index which identifies cut-off points useful in scientific research; 2) a second method of two-stage screening for depressive disorders to provide guidance for clinical practice. Results: The Polish version of the PHQ-9 is a reliable and valid screening tool for depression in people with and without type 2 diabetes. An optimal cut-off of ≥ 7 was indicated by Youden’s index and ≥ 5 by the two-stage method for screening for MDD and ‘MDD and/or dysthymia’ in the group with type 2 diabetes. A cut-off of ≥ 11 was optimal for screening for both MDD and ‘MDD and/or dysthymia’ among people without diabetes (Youden’s index). The two-stage approach suggested a ≥ 10 score for screening for MDD and ≥ 9 for screening for ‘MDD and/or dysthymia’ in people without diabetes. Conclusions: A lower cut-off score of the PHQ-9 is recommended for people with type 2 diabetes as compared to the general population

Medical radioisotopes produced using the alpha particle beam from the Warsaw Heavy Ion Cyclotron

The internal alpha particle beam of the heavy ion cyclotron operated by the Heavy Ion Laboratory (HIL) of the University of Warsaw has a maximum energy of 32 MeV and currently an intensity of up to 1 p A. This beam is used by the HIL-University of Silesia collaboration for the production of research quantities of 211At, 72Se/72As and 43;44Sc radioisotopes. The produced activities are transported to the Institute of Nuclear Chemistry and Technology inWarsaw where research on therapeutic and imaging radiopharmaceuticals based on these radioisotopes is pursued

His bundle pacing, learning curve, procedure characteristics, safety, and feasibility: Insights from a large international observational study

Background His‐bundle pacing (HBP) provides physiological ventricular activation. Observational studies have demonstrated the techniques feasibility however, data has come from a limited number of centres. Objectives We set out to explore contemporary global practise in HBP focusing on learning curve, procedural characteristics and outcomes. Methods This is a retrospective, multi‐centre observational study of patients undergoing attempted HBP at seven centres. Pacing indication, fluoroscopy time, HBP thresholds and lead re‐intervention and deactivation rates were recorded. Where centres had systematically recorded implant success rates from the outset, these were collated. Results 529 patients underwent attempted HBP during the study period (2014‐19) with mean follow‐up of 217±303 days. Most implants were for bradycardia indications. In the three centres with systematic collation of all attempts, overall implant success rate was 81% which improved to 87% after completion of 40 cases. All seven centres reported data on successful implants. Mean fluoroscopy time was 11.7±12.0 minutes, His‐bundle capture threshold at implant was 1.4±0.9V at 0.8±0.3 ms and was 1.3±1.2V at 0.9±0.2ms at last device check. HBP lead re‐intervention or deactivation (for lead displacement or rise in threshold) occurred in 7.5% of successful implants. There was evidence of a learning curve: fluoroscopy time and HBP capture threshold reduced with greater experience, plateauing after ~30‐50 cases. Conclusion We found that it is feasible to establish a successful HBP program, using the currently available implantation tools. For physicians who are experienced at pacemaker implantation the steepest part of the learning curve appears to be over the first 30‐50 cases

Validation of standard and new criteria for the differential diagnosis of narrow QRS tachycardia in children and adolescents

To establish an appropriate treatment strategy and determine if ablation is indicated for patients with narrow QRS complex supraventricular tachycardia (SVT), analysis of a standard 12-lead electrocardiogram (ECG) is required, which can differentiate between the 2 most common mechanisms underlying SVT: atrioventricular nodal reentry tachycardia (AVNRT) and orthodromic atrioventricular reentry tachycardia (OAVRT). Recently, new, highly accurate electrocardiographic criteria for the differential diagnosis of SVT in adults were proposed; however, those criteria have not yet been validated in a pediatric population. All ECGs were recorded during invasive electrophysiology study of pediatric patients (n = 212; age: 13.2 ± 3.5, range: 1–18; girls: 48%). We assessed the diagnostic value of the 2 new and 7 standard criteria for differentiating AVNRT from OAVRT in a pediatric population. Two of the standard criteria were found significantly more often in ECGs from the OAVRT group than from the AVNRT group (retrograde P waves [63% vs 11%, P < 0.001] and ST-segment depression in the II, III, aVF, V1–V6 leads [42% vs 27%; P < 0.05]), whereas 1 standard criterion was found significantly more often in ECGs from the AVNRT group than from the OAVRT group (pseudo r′ wave in V1 lead [39% vs 10%, P < 0.001]). The remaining 6 criteria did not reach statistical significance for differentiating SVT, and the accuracy of prediction did not exceed 70%. Based on these results, a multivariable decision rule to evaluate differential diagnosis of SVT was performed. These results indicate that both the standard and new electrocardiographic criteria for discriminating between AVNRT and OAVRT have lower diagnostic values in children and adolescents than in adults. A decision model based on 5 simple clinical and ECG parameters may predict a final diagnosis with better accuracy

Metabolic control level and glucose variability in adolescents with type 1 diabetes during low and high-intensity exercise

OBJECTIVE The main purpose of this study was to characterize the determinants of metabolic changes in young type 1 diabetes (T1DM) and to determine glycemic variability during low and high-intensity exercise. PATIENTS AND METHODS 20 young male T1DM patients were divided into two subgroups characterized by levels of glycated hemoglobin (HbA1c): HbA1c7.3% (worse HbA1c subgroup, n=10). All participants performed a maximal oxygen uptake test and two efforts of various intensities (45 minutes of aerobic exercise and 30 minutes of mixed aerobic-anaerobic intensity exercise). Continuous glucose monitors (CGM) were used to control the glucose concentration. RESULTS Changes in biomarkers describing the metabolic response were similar in both groups. A comparison of applied efforts exhibited that maximal capacity effort resulted in the highest values of blood glucose (BG) at the end (150.9-160.6 mg/dl) and 1 hour after the exercise (140.2-161.3 mg/dl). BG concentration before, during, 1 hour, and 24 hours after each exercise was insignificantly higher in the worse Hb1Ac group. CONCLUSIONS HbA1c levels are insufficient to confirm whether the applied effort is performed in acceptable glycemic values. The CGM monitors allow for precise control of BG variations and accurate planning of physical activity by adjusting the insulin and carbohydrate consumption dose

Are the weak channels really weak?

The transfer probabilities for 20Ne + 90Zr and 20Ne + 92Zr at energies near the Coulomb barrier were measured. This quantity turned out to be very similar for both Zr isotopes and does not explain the observed differences in the barrier height distributions for these systems

Guidelines from the Polish Surgical Society and Polish Society of Oncological Surgery Concerning Quality Assurance for Centres Performing Cytoreductive Procedures and HIPEC Procedures in the Treatment of Primary and Secondary Peritoneal Tumours

Surgical treatment of patients with peritoneal metastases in combination with Hyperthermic intraperitoneal Chemotherapy (HIPEC) and systemic treatments is applied with increasing frequency and, with correct patient qualification, allows for obtaining 5-year survival at a level of 32–52%. The conditions necessary for positive results of such treatment include the high experience of a given centre, its appropriate infrastructure, and appropriate patient qualification for the procedure. As a result of the debate connected with the need to evaluate treatment quality and results, at the request of the Peritoneal Cancer Section of the Polish Society of Oncological Surgery, the conditions for quality assurance were worked out and a Quality Assurance Commission was set up for the centres performing cytoreductive procedures and HIPEC procedures in the treatment of primary and secondary peritoneal tumours