See one, teach yourself one, do one: Barriers and opportunities in self-administered training and assessment for global surgical education.

Objective: We aimed to determine the most important perceived barriers to the implementation of self-administered training and assessment in surgical education according to subject matter experts. With these findings, design thinking was used to explore possible interventions and develop a theory of change for overcoming identified barriers. Specifically, implementation was focused on expanding the surgical skills of associate clinicians (ACs) in low-to-middle-income countries (LMICs).

A Novel Method for Quick Assessment of Internal And External Radiation Exposure in the Aftermath of a Large Radiological Incident.

In the event of a significant radiological release in a major urban area where a large number of people reside, it is inevitable that radiological screening and dose assessment must be conducted. Lives may be saved if an emergency response plan and radiological screening method are established for use in such cases. Thousands to tens of thousands of people might present themselves with some levels of external contamination and/or the potential for internal contamination.

National diagnostic reference level initiative for computed tomography examinations in Kenya.

The purpose of this study was to estimate the computed tomography (CT) examination frequency, patient radiation exposure, effective doses and national diagnostic reference levels (NDRLs) associated with CT examinations in clinical practice. A structured questionnaire-type form was developed for recording examination frequency, scanning protocols and patient radiation exposure during CT procedures in fully equipped medical facilities across the country. The national annual number of CT examinations per 1000 people was estimated to be 3 procedures.

Punch card programmable microfluidics.

Small volume fluid handling in single and multiphase microfluidics provides a promising strategy for efficient bio-chemical assays, low-cost point-of-care diagnostics and new approaches to scientific discoveries. However multiple barriers exist towards low-cost field deployment of programmable microfluidics. Incorporating multiple pumps, mixers and discrete valve based control of nanoliter fluids and droplets in an integrated, programmable manner without additional required external components has remained elusive.

Patient radiation exposure during general fluoroscopy examinations.

The purpose of this study was to assess the level of patient radiation dose received in general fluoroscopy examinations, compare the findings with the international diagnostic reference levels (IDRLs), and establish the initial institutional (local) LDRLs. A comprehensive survey was conducted for general fluoroscopy examinations using the medical records of a Radiology Department of a leading regional hospital over a period close to one year. The cumulative reference point air kerma (K(a,r)), kerma area product (KAP) and fluoroscopy time (FT) were recorded for six hundred and fifty (30% pediatric and 70% adult) patients undergoing routine fluoroscopy examinations using X-ray equipment with built-in integrated dose measuring system.

Frequency and collective dose of medical procedures in Kenya.

The first comprehensive national survey on frequency and radiation dose imparted to the population from radiological procedures was carried out in Kenya and reported here. This survey involved assessment of frequency, typical patient radiation exposure, and collective effective dose from general radiography, fluoroscopy, interventional procedures (IPs), mammography, and computed tomography. About 300 x-ray facilities across the country were invited to participate in the survey, and a 31% response was recorded.

Establishment of local diagnostic reference levels in paediatric screen-film radiography at a children's hospital.

To assess the frequency of examination, image quality (IQ) and establishment of local diagnostic reference levels (LDRLs) in paediatric radiographic examinations. The X-ray device performance, film reject rate and IQ grading were assessed at Radiology Department of a referral and teaching children's hospital in Kenya. A questionnaire method was developed and used in recording the exposure factors used to indirectly calculate patient doses.

Radiation exposure in interventional procedures.

The aim of this study was to estimate radiation doses patients and staff are exposed to during interventional procedures (IPs), compare them with the international diagnostic reference levels and to develop initial National Diagnostic Reference Levels. The IP survey was undertaken as the initial task of which, retrospective data were collected from the only four Kenyan hospitals carrying out interventional radiology and cardiology procedures at the time of the study. Real-time measurement of radiation dose to patients and staff during these procedures was done.

Patient doses using multidetector computed tomography scanners in Kenya.

Assessment of patient dose attributed to multislice computed tomography (CT) examination. A questionnaire method was developed and used in recording the patient dose and scanning parameters for the head, chest, abdomen and lumbar spine examinations. The patient doses due to brain, chest and abdomen examination were above the international diagnostic reference levels (DRLs) by factors of between one and four.

Establishing the quality management baseline in the use of computed tomography machines in Kenya.

The objective of this study was to assess the level of compliance to quality assurance and image quality standards in computed tomography facilities in Kenyan hospitals. A quality assurance inspection and physical image quality assessment in eighteen representative computed tomography facilities were completed. A quantitative method was developed and used to score the results obtained from the physical image quality measurements using the American Association of Physicists in Medicine (AAPM) water phantom.

Isolation of circulating tumor cells using a microvortex-generating herringbone-chip.

Rare circulating tumor cells (CTCs) present in the bloodstream of patients with cancer provide a potentially accessible source for detection, characterization, and monitoring of nonhematological cancers. We previously demonstrated the effectiveness of a microfluidic device, the CTC-Chip, in capturing these epithelial cell adhesion molecule (EpCAM)-expressing cells using antibody-coated microposts. Here, we describe a high-throughput microfluidic mixing device, the herringbone-chip, or "HB-Chip," which provides an enhanced platform for CTC isolation.

A survey of computed tomography imaging techniques and patient dose in Kenya.

Objectives: To assess the level of patient dose in Computed Tomography examination in Kenya, compare with the international diagnostic reference levels and establish the initial national diagnostic reference levels.

Design: The patient doses for brain, chest, abdomen and pelvis examinations were assessed using typical exposure factors on head and body dosimetry phantoms. A log normal graphical method was developed and used in deriving the initial national diagnostic reference levels for the two dose quantities.

Optimisation of patient protection and image quality in diagnostic radiology.

Objective: To determine the examination frequencies, quality of radiographic images and the entrance surface dose (ESD) in patients undergoing general radiographic examinations.

Design: Prospective study on the device performance, film reject rate, patient dose, and image quality during the use of standard and fast speed film screen combination.

Setting: Radiology Department of Kenyatta National Hospital, a referral, teaching and research hospital in Kenya.

A spectral approach to determine location and orientation of azo dyes within surfactant aggregates.

The UV-vis absorption properties of azo dyes are known to exhibit a variation with the polarity and acidity of the dye environment. The spectral properties of a series of anionic azo dyes were characterized to further probe the interaction of these dyes with two types of surfactant aggregates: (1) the spherical micelles formed in aqueous solution by alkyltrimethylammonium bromide (C(n)TAB) surfactants with n=10-16 and (2) the unilamellar vesicles spontaneously formed in water from binary mixtures of the oppositely-charged double-tailed surfactants cationic didodecyldimethylammonium bromide (DDAB) and anionic sodium dioctylsulfosuccinate (Aerosol OT or AOT). The observed dye spectra reflect the solvatochromic behavior of the dyes and suggest the location and orientation of the dye within the surfactant aggregates.