The lack of radiotherapy linear accelerators (linacs) in low- and middle-income countries (LMICs) has been recognised as a major barrier to providing quality cancer care in these regions, together with a shortfall in the number of highly qualified personnel. It is expected that additional challenges will be faced in operating precise, high-technology radiotherapy equipment in these environments, and anecdotal evidence suggests that linacs have greater downtime and higher failure rates of components than their counterparts in high-income countries. To guide future developments, such as the design of a linac tailored for use in LMIC environments, it is important to take a data-driven approach to any re-engineering of the technology. However, no detailed statistical data on linac downtime and failure modes have been previously collected or presented in the literature. This work presents the first known comparative analysis of failure modes and downtime of current generation linacs in radiotherapy centres, with the aim of determining any correlations between linac environment and performance. Logbooks kept by radiotherapy personnel on the operation of their linac were obtained and analysed from centres in Oxford (UK), Abuja, Benin, Enugu, Lagos, Sokoto (Nigeria) and Gaborone (Botswana). By deconstructing the linac into 12 different subsystems, it was found that the vacuum subsystem only failed in the LMIC centres and the failure rate in an LMIC environment was more than twice as large in six of the 12 subsystems compared with the high-income country. Additionally, it was shown that despite accounting for only 3.4% of the total number of faults, linac faults that took more than 1 h to repair accounted for 74.6% of the total downtime. The results of this study inform future attempts to mitigate the problems affecting linacs in LMIC environments.
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http://dx.doi.org/10.1016/j.clon.2019.10.010 | DOI Listing |
Dent Mater
January 2025
Minnesota Dental Research Center for Biomaterials and Biomechanics, School of Dentistry, University of Minnesota, Minneapolis, MN, USA. Electronic address:
Objective: This study compared the fracture load, stress distribution, and survival probability under cyclic loading of extensively restored teeth treated with multisonic irrigation with those treated with conventional instrumentation, with or without a post.
Methods: Mesial-occlusal-distal cavities were prepared in 30 human mandibular premolars. The teeth were randomly divided into 3 groups of 10 based on the endodontic and restorative procedures: (1) Root canal treatment (RCT) followed by resin composite restoration (control group), (2) RCT followed by a glass fiber post restoration (conventional group), and (3) minimal instrumentation plus multisonic irrigation followed by resin composite restoration (GW group).
Mater Horiz
January 2025
Department of Materials Science and Engineering, Pohang University of Science and Technology (POSTECH), Pohang 37673, Republic of Korea.
Currently, it is a significant challenge to achieve long-term cyclability and fast chargeability in lithium-ion batteries, especially for the Ni-based oxide cathode, due to severe chemo-mechanical degradation. Despite its importance, the fast charging long-term cycling behaviour is not well understood. Therefore, we comprehensively evaluate the feasibility of fast charging applications for Co-free layered oxide cathodes, with a focus on the extractable capacity and cyclability.
View Article and Find Full Text PDFNat Commun
January 2025
State Key Laboratory of New Ceramics and Fine Processing, School of Materials Science and Engineering, Tsinghua University, Beijing, 100084, China.
Chronic allodynia stemming from peripheral stump neuromas can persist for extended periods, significantly compromising patients' quality of life. Conventional managements for nerve stumps have demonstrated limited effectiveness in ensuring their orderly termination. In this study, we present a spatially confined conduit strategy, designed to enhance the self-organization of regenerating nerves after truncation.
View Article and Find Full Text PDFPLoS One
December 2024
Departement of Restorative Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia.
Purpose: This study aimed to investigate the effect of chlorhexidine (CHX) cavity disinfectant on interfacial microleakage and micro-tensile bond strength (μTBS) of a universal adhesive bonded to dentin in both self-etch (SE) and etch-and-rinse (ER) modes.
Methods: Class I cavities were prepared in the coronal dentin of extracted human teeth and assigned to two etching modes (SE or ER), then subdivided by disinfection with or without CHX (n = 5). Cavities were restored using Single Bond Universal Adhesive and Filtek Z350 XT composite.
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