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Background: Proximal humerus fractures (PHF) should be subject to standardized monitoring during treatment, whether non-operative or operative, to document and adequately assess bone healing. The purpose of this study was to develop a standardized protocol for an image-based monitoring of PHF for joint-preserving treatment options, including a minimum set of descriptors or definitions of features of radiographic images, to be applied in clinical routine practice and studies. Methods: A Delphi exercise was implemented with an international panel of experienced shoulder trauma surgeons self-selected after invitation of all AO Trauma members. Using open questions participants recommended the type and timing of desired diagnostic images, and formulated definitions for the imaging parameters they considered most important. Formulated recommendations for the type and timing of radiological fracture monitoring and clarification of the definitions of the proposed radiological parameter set were subjected to further survey. Consensus for each factor was considered to have been reached when there was at least a two-thirds agreement in the survey participants. Results: Response rates of 231 interested surgeons were 66% and 44% for the first and second survey respectively. Sixty percent of participants to the first survey responded to the second (131/219). 93% of respondents considered radiographic monitoring to be an important part of fracture care. 92% of respondents to the first survey considered that ‘malreduction’ should be assessed, and 165 of 189 respondents provided a suggestion for a definition for this parameter. 88% of respondents to the second survey agreed on a redefinition of the term ‘malreduction’ as ‘non-anatomical fracture reduction’. There was substantial agreement about the radiographic views and orientation of radiographs to be recorded (80%) and the timing of radiological reviews (67- 78% for time points during follow up). Just over half of respondents recommended cessation of radiological review when fracture healing was considered to have occurred by radiological evaluation. Conclusion: Our work confirmed the need for clear definitions of radiological features that should be considered in the follow-up of proximal humeral fractures. It has resulted in the development of an international consensus monitoring protocol for PHF treatment with a structured core set of radiological parameters. Clinical application and validation of the monitoring process are needed.

The development of artificial receptors for efficient recognition of analytes in water is a challenging task. Homooxacalix[3]arene-based receptor

A better understanding of the radiative transfer of solar visible light within sea ice is crucial to study the Arctic energy balance and marine ecosystems. In this work, we showcase the utilization of a compact, consumer-grade 360-degree camera for measuring the in-ice spectral angular radiance distribution. This novel technique allows for the instantaneous acquisition of all radiometric quantities at a given depth with a compact, non-intrusive probe. This gives the opportunity to monitor the light field structure (mean cosines) from the atmosphere to the underlying ocean beneath ice. In this study, we report vertical profiles of the light field geometric distribution measured at two sites representative of distinct ice types: High Arctic multi-year ice and Chaleur Bay (Quebec) land fast first-year ice. We show that it is possible to empirically retrieve the depth-resolved internal optical properties by matching simulated profiles of spectral irradiances calculated with the HydroLight radiative transfer model to the observed profiles. As reported in other studies, the inverted reduced scattering coefficients were high (25.5 m-1, 37.5 m-1) in the first 20 centimeters for both sites (High Arctic, Chaleur Bay) and lower in the interior part of the ice (0.8 to 4.8 m-1, 2.8 to 7.2 m-1). Finally, due to the underdetermined nature of the inversion problem, we emphasize the importance of using the similarity parameter that considers the absorption and reduced scattering coefficients.

The control of the selective transformation of a functional group on a substrate bearing multiple identical reactive functions is a major synthetic challenge. The use of macrocyclic molecular containers as supramolecular protecting units is in this context a promising strategy. We report here on a hexahomotrioxacalix[3]arene molecular container whose exceptional binding properties opens new directions for the supramolecular protection strategy. This macrocyclic receptor binds primary ammonium ions with high selectivity and affinity, allowing for the monofunctionalization of diamines. The reaction was readily achieved with various diamines and different types of reagents. The acid-base control of the protection/deprotection of the substrate furthermore allowed for the recovery and recycling of the molecular container and the subsequent in-situ accumulation of non-symmetric difunctionalized products, with remarkably no loss of selectivity over the reaction cycles. This recycling strategy considerably increases the synthetic viability of the supramolecular approach with only a catalytic amount of molecular container needed. The synthesis of products, such as non-symmetric diamino-diureas, which are difficult to obtain via classical synthetic routes, was also achieved through the one-pot reaction of mixtures of difunctional substrates monoprotected by the molecular container. The supramolecular protection strategy was finally extended to the selective functionalization of more complex polyamines such as a triamine and a lysine derivative. These results show that the use of a supramolecular protecting container for the functionalization of polyfunctional substrates presents many synthetic advantages over strategies using traditional protecting groups: i) it enables high chemo-, regio- and iteroselectivities through a one-pot protection/functionalization/deprotection sequence, ii) it avoids the introduction and removal of covalently linked protecting groups thus leading to high yield , iii) it allows the formation of unstable intermediates and the control of their reactivity, iv) it gives access to complex polyfunctional products whose synthesis remains challenging through classical synthetic methods.

PurposeIndigenous peoples represent one of the most vulnerable groups and need access as well as hands-on experience in the use of emerging Earth observations (EO)-based DRR solutions at the community level, while balancing this learning with traditional indigenous knowledge (IK). However, complicating any engagement between EO and IK is the reality that IKs are diverse and dynamic, with location-specific relevance and accuracy. Additionally, the COVID-19 pandemic caused complex risks and cascading effects for which the world was not prepared. Thus, there is a need to examine the lessons learned and motivate emerging EO-based innovations and demonstrations related to DRR and climate change adaptation.Design/methodology/approachHence, this study aims to undertake an in-depth assessment of IK related to DRR covering relevant UN instruments and provides state-of-the-art of opportunities presented by EO-based tools and solutions.FindingsThe overall research strategy was designed to integrate key components of IK for DRR in a coherent and logical way, with those offered by the EO technology developers and providers. There are several EO tools accessible that are relevant to integrate IK and complement DRR. The study examined and identified challenges and barriers to implement workable and replicable EO solutions in pursuit of resilience.Originality/valueThe key findings of this study will help create a balanced approach by acknowledging the importance of IK for DRR with co-development, co-creation and use of culturally relevant EO data and tools for sustainable innovation, capacity building and youth empowerment. The technological inequalities appear to be growing, and it would be challenging to meet the Sendai Framework indicators.

Der Vormarsch von Künstlicher Intelligenz ist unaufhaltsam: Von selbstfahrenden Autos über komplett automatisierten Produktionshallen bis hin zu Sprachassistenten am Mobiltelefon. Die Anwendungsbereiche scheinen grenzenlos. Dementsprechend hat KI auch schon längst im medizinischen Sektor Einzug gehalten. Die praktischen Einsatzmöglichkeiten reichen auch hier von Pflegerobotern bis hin zur Medikamentenentwicklung. Aber dieser rasante Fortschritt stellt auch die aktuelle Gesetzeslage auf die Probe, da diese (noch) nicht an derartig neue technische Entwicklungen angepasst ist. Solche riesige, teils nicht mehr nachvollziehbare Mengen an personenbezogenen Daten bzw Verarbeitungsvorgänge derselben, die für die einwandfreie Funktionsweise von KI erforderlich sind, konnten in der bisherigen Gesetzgebung noch nicht berücksichtigt werden. Im Rahmen von KI in der Medizin stellt sich vor allem die Frage der Zulässigkeit der Verarbeitung von (sensiblen) Daten, die zumeist für das Antrainieren von KI-Systemen auf diesem Gebiet benötigt werden. Die erste Frage, die in dieser Diplomarbeit nach einer kurzen technischen Einführung behandelt werden soll, ist dementsprechend welche datenschutzrechtlichen Grenzen die DSGVO KI-Anwendungen in dieser Trainingsphase auferlegt und unter welchen Umständen es dennoch gestattet ist, KI-Systeme in der Medizin einzusetzen bzw zuvor entsprechend zu trainieren.Neben datenschutzrechtlichen Fragen ergeben sich auch haftungsrechtliche Aspekte im Zusammenhang mit dem Einsatz in der Medizin. Veranschaulicht werden soll dieser in der vorliegenden Diplomarbeit durch ein Praxisbeispiel eines Pflegeroboters, der während des Einsatzes einen Patienten verletzt. Im Speziellen wird darauf eingegangen, welche Lösungsansätze die aktuelle Gesetzgebung hier bietet, konkret die Möglichkeiten des Schadenersatz- und Gewährleistungsrechts nach dem ABGB sowie jene einer verschuldensunabhängigen Haftung gem PHG. Folglich wird die Frage behandelt, unter welchen Voraussetzungen die genannten Rechtsinstrumente Abhilfe bezüglich der Haftung im Schadensfall zu bringen vermögen.Abschließend folgt eine Conclusio der gesamten Diplomarbeit, bei der auch auf aktuelle Bestrebungen der europäischen Gesetzgeber eingegangen wird. Diese beinhaltet ein Resümee, welches wünschenswerte Entwicklungen für die Zukunft des gesetzlichen Rahmens von KI mit dem derzeitigen Stand vergleicht. The advance of artificial intelligence is unstoppable: from self-driving cars to completely automated production halls to voice assistants on cell phones. The areas of application seem limitless. Accordingly, AI has also long since found its way into the medical sector. Here, too, the practical applications range from nursing robots to drug development. But this rapid progress also puts the current legal framework to the test, as it is not (yet) adapted to these kinds of new technical developments. Such huge, sometimes incomprehensible amounts of personal data or processing operations of the same, which are necessary for the proper functioning of AI, could not yet be taken into account in the previous legislation. In the context of AI in medicine, the main question is the permissibility of processing (sensitive) data, which are mostly needed for training AI systems in this field. The first question to be addressed in this thesis, after a brief technical introduction, is accordingly which data protection law limits the GDPR imposes on AI applications in this training phase and under which circumstances it is nevertheless permitted to use AI systems in medicine or to train them correspondingly beforehand.In addition to data protection law issues, liability law aspects also arise in connection with the use of AI in medicine. This will be illustrated in this thesis by a practical example of a nursing robot that injures a patient during use. In particular, it will be discussed which solutions are offered by the current legislation, specifically the possibilities of compensation and warranty law according to the ABGB as well as those of strict liability according to the PHG. Consequently, the question is addressed under which conditions the above-mentioned legal instruments are able to provide a remedy with regard to liability in the event of damage.Finally, a conclusion of the entire thesis follows, in which current efforts of the European legislators are also dealt with. This includes a résumé, which compares desirable developments for the future of the legal framework of AI with the current state. vorgelegt von Simon Lambert Oschounig Abweichender Titel laut Übersetzung des Verfassers/der Verfasserin Diplomarbeit Universität Graz 2023

The functions of the subclavius muscle (SM) are described as stabilization of the sternoclavicular joint (SCJ) and resisting elevation of the lateral end of the clavicle. During systematic cadaveric dissections, we observed additional fibrous structures, previously described as variants of the anatomy, extending from the SM and inserting into the coracoid process (CP). Due to the high incidence of these structures in our dissections, we hypothesized that the attachment at the CP is more common than appreciated and that, as a corollary, the function of the SM was (or has been) more complex than simply depressing the clavicle and generating stability at the SCJ. For our investigation, fifty‐two upper extremities of 26 human cadavers were dissected. The SM was demonstrated from costal to clavicular attachment. We documented additional fibrous structures apparently derived from the SM inserting into the CP. Measurements of the length of the SM, the length of its attachment, and the length of the clavicle were taken in situ, with the specimens supine and the upper extremity in the anatomical position. Variations in the anatomy of the SM and its coracoidal attachment were recorded, and potential correlations were investigated. For documentation purposes photographs and video sequences of passive motion of the shoulder girdle of the specimens were taken. In 49 of the 52 specimens we found additional fibrous structures passing from the SM to the CP. We differentiated three types: (1) a strong cord‐like structure; (2) a small or thin cord‐like structure or structures; and (3) a planar twisted sheet‐like structure. The SM and its extension to the CP appears to contribute to a ‘functional scapular suspension system’ together with the other muscles enveloped by the clavipectoral fascia (pectoralis minor, coracobrachialis and the short head of the biceps brachii). This system assists in the control of the position of the scapula in relation to the thorax, particularly in elevated positions of the upper extremity. We speculate that the differentiation of the fibrous structure depends on the functional demands of the individual. Level of Evidence: Basic science study., Dissections of the upper extremity showed a fibrous structure, extending from the subclavius muscle (SM) and inserting into the coracoid process. Due to the high incidence, we hypothesized that this structure is more common than appreciated and that the function of the SM was (or has been) more complex.

This thematic issue arises from the symposium ‘Tradition and Innovation in Franco-Belgian Bande dessinée’, held at the University of Leicester on 13 March 2020. Over three panels with a respective focus on ‘Revisiting the Classics’, ‘Contemporary Perspectives’, and ‘Reshaping Franco-Belgian Bande dessinée’, the symposium brought out a variety of perspectives on contemporary bande dessinée and its links to the Franco-Belgian tradition. The symposium saw the participation of a range of international contributors, including early career scholars, faculty, and artist contributors, based in Greece, Switzerland, Portugal, Canada, Panama, Israel, and the UK. We would like to thank our speakers for their contributions as well as for their flexibility in revising travel arrangements and, in some cases, arranging online delivery at short notice, as the start of the COVID-19 pandemic was unfolding in their respective countries at the time of the event. Our particular thanks go to Laurence Grove from the University of Glasgow for his keynote intervention entitled ‘The Relevance of Tintin’, and to graphic novelist Michel Kichka, who gave a keynote talk about the Franco-Belgian influences in his own work as well as a public seminar on his graphic novel Deuxième Génération. We are grateful to Wallonia-Brussels International (WBI), the Association for the Study of Modern and Contemporary France (ASMCF), the Society for French Studies (SFS), and the School of Arts at the University of Leicester for their sponsorship of the keynote sessions, the conference participation of comics artist Ilan Manouach, and travel and registration bursaries for early career researchers. For this follow-up publication, we express our particular thanks to all contributors and peer-reviewers, to Wallonia-Brussels International for support to the translation, and to the editors of European Comic Art, for their kind and patient assistance.

Background. Minimally invasive plate osteosynthesis (MIPO) is one of the generally accepted surgical techniques for the treatment of humeral shaft fractures. However, despite the high bone union rate, a variety of complications are still prevailing. Moreover, the current literature lacks data comparing the anterolateral MIPO approach using dynamic compression plates accommodating different numbers of screws. The aim of this study was to analyze the biomechanical performance of comminuted humeral shaft fractures fixed with dynamic compression plates using either two or three screws per fragment. Methods. Six pairs of fresh-frozen human cadaveric humeri from donors aged66.8±5.2years were randomized to two paired study groups for simulation of bridge-plated comminuted shaft fracture type AO/OTA 12-C1/2/3 without interfragmentary bony support, using a dynamic compression plate positioned on the anterolateral surface and fixed with two (group 1) or three (group 2) screws per fragment. All specimens underwent nondestructive quasistatic biomechanical testing under lateral bending, anterior bending, axial bending, and torsion in internal rotation, followed by progressively increasing cyclic torsional loading in internal rotation until failure. Results. Initial stiffness of the plated specimens in lateral bending, anterior bending, axial bending, and torsion was not significantly different between the groups (P≥0.22). However, cycles to 10°, 15°, and 20° torsional deformation and cycles to construct failure were significantly higher in group 2 compared with group 1 (P≤0.03). Conclusions. From a biomechanical perspective, no significant superiority is identified in terms of primary stability when using two or three screws per fragment for bridge compression plating of comminuted humeral shaft fractures. However, three-screw configurations provide better secondary stability and maintain it with a higher resistance towards loss of reduction under dynamic loading. Therefore, the use of a third screw may be justified when such better secondary stability is required.

To boost the circular economy of the electric vehicle battery industry, an accurate assessment of the state of health of retired batteries is essential to assign them an appropriate value in the post automotive market and material degradation before recycling. In practice, the advanced battery testing techniques are usually limited to laboratory benches at the battery cell level and hardly used in the industrial environment at the battery module or pack level. This necessitates developing battery recycling facilities that can handle the assessment and testing undertakings for many batteries with different form factors. Towards this goal, for the first time, this article proposes proof of concept to automate the process of collecting the impedance data from a retired 24kWh Nissan LEAF battery module. The procedure entails the development of robot end-of-arm tooling that was connected to a Potentiostat. In this study, the robot was guided towards a fixed battery module using visual servoing technique, and then impedance control system was applied to create compliance between the end-of-arm tooling and the battery terminals. Moreover, an alarm system was designed and mounted on the robot’s wrist to check the connectivity between a Potentiostat and the battery terminals. Subsequently, the electrochemical impedance spectroscopy test was run over a wide range of frequencies at a 5% state of charge. The electrochemical impedance spectroscopy data obtained from the automated test is validated by means of the three criteria (linearity, causality and stability) and compared with manually collected measurements under the same conditions. Results suggested the proposed automated configuration can accurately accomplish the electrochemical impedance spectroscopy test at the battery module level with no human intervention, which ensures safety and allows this advanced testing technique to be adopted in grading retired battery modules.

Hardware prominence remains a clinical challenge in focus for implant design in subcutaneous plate applications. Existing evaluation of hardware prominence relies on plate-to-bone distance at a single point or on average. A reproducible measure for plate prominence remains undefined. This study mathematically defines the plate prominence linked to the cross-sectional area change due to the plate presence on the bone. Two anatomical plate designs were fitted to 100 clavicles, and afterwards plate prominence parameters were evaluated and compared. This methodology enables the quantification of hardware prominence for different plate designs to inform the development of implants targeting low prominence.

The radiative transfer of shortwave solar radiation through the sea ice cover of the polar oceans is a crucial aspect of energy partitioning at the atmosphere–ice–ocean interface. A detailed understanding of how sunlight is reflected and transmitted by the sea ice cover is needed for an accurate representation of critical processes in climate and ecosystem models, such as the ice–albedo feedback. Due to the challenges associated with ice internal measurements, most information about radiative transfer in sea ice has been gained by optical measurements above and below the sea ice. To improve our understanding of radiative transfer processes within the ice itself, we developed a new kind of instrument equipped with a number of multispectral light sensors that can be frozen into the ice. A first prototype consisting of a 2.3 m long chain of 48 sideward planar irradiance sensors with a vertical spacing of 0.05 m was deployed at the geographic North Pole in late August 2018, providing autonomous, vertically resolved light measurements within the ice cover during the autumn season. Here we present the first results of this instrument, discuss the advantages and application of the prototype, and provide first new insights into the spatiotemporal aspect of radiative transfer within the sea ice itself. In particular, we investigate how measured attenuation coefficients relate to the optical properties of the ice pack and show that sideward planar irradiance measurements are equivalent to measurements of total scalar irradiance.

This article offers an overview of 10 years of institutional and human efforts led by ICCROM (the International Centre for the Study of the Preservation and Restoration of Cultural Property) and ot...

Stephan Perren's contributions to the understanding and application of the principles of bone pathobiology, healing, and fracture fixation to clinical care remain as a lasting legacy of a great creative mind. Less well appreciated perhaps were his important contributions to the dissemination and practical application of those principles through the use of technology as applied to the learning environment. This paper describes and pays tribute to a series of initiatives in which Perren was a leading mentor and collaborator in the development of methods and instruments through which the principles of bone mechano-pathobiology could be translated through active learning environments into the practical world of clinical musculoskeletal traumatology.

There is growing interest in recycling and re-use of electric vehicle batteries owing to their growing market share and use of high-value materials such as cobalt and nickel. To inform the subsequent applications at battery end of life, it is necessary to quantify their state of health. This study proposes an estimation scheme for the state of health of high-power lithium-ion batteries based on extraction of parameters from impedance data of 13 Nissan Leaf 2011 battery modules modelled by a modified Randles equivalent circuit model. Using the extracted parameters as predictors for the state of health, a baseline single hidden layer neural network was evaluated by root mean square and peak state of health prediction errors and refined using a Gaussian process optimisation procedure. The optimised neural network predicted state of health with a root mean square error of (1.729 ± 0.147)%, which is shown to be competitive with some of the most performant existing neural network–based state of health estimation schemes, and is expected to outperform the baseline model with ∼50 training samples. The use of equivalent circuit model parameters enables more in-depth analysis of the battery degradation state than many similar neural network–based schemes while maintaining similar accuracy despite a reduced dataset, while there is demonstrated potential for measurement times to be reduced to as little as 30 s with frequency targeting of the impedance measurements.

AC Input filters in high speed drives are generally large and can even exceed the mass of the motor. This article firstly seeks to reduce the volume and overall mass of the drive through integrating the input inductors with the magnetic circuit of the machine. The magnetic circuits are shared without cross-coupling through careful choice of the filter and motor pole numbers. Finite Element Analysis (FEA) is used to check that normal operation of the base PM machine is not affected by the integration and a demonstrator drive is built. Compared with discrete AC filters, the integration of the LCL filter inductors has given a very large volume reduction of 87.6%, producing a much more compact envelope than with the conventional filter inductors. Through a holistic approach to a combination of electrical, mechanical and thermal aspects of the drive system, the integrated drive exhibits significant mass and volume advantages over conventional discrete motor drives. Two major technical issues related to the power electronics development of the IMD are presented in the paper: investigation of a bus bar solution to manage a large number of winding terminals introduced from integrated LCL filters, and a compact SiC device based power electronics design.

The COVID-19 pandemic highlights the urgency and importance of monitoring, managing and addressing zoonotic diseases, and the acute challenges of doing so with sufficient inter-jurisdictional coordination in a dynamic global context. Although wildlife pathogens are well-studied clinically and ecologically, there is very little systematic scholarship on their management or on policy implications. The current global pandemic therefore presents a unique social science research imperative: to understand how decisions are made about preventing and responding to wildlife diseases, especially zoonoses, and how those policy processes can be improved as part of early warning systems, preparedness and rapid response. To meet these challenges, we recommend intensified research efforts towards: (i) generating functional insights about wildlife and zoonotic disease policy processes, (ii) enabling social and organizational learning to mobilize those insights, (iii) understanding epistemic instability to address populist anti-science and (iv) anticipating evolving and new zoonotic emergences, especially their human dimensions. Since policy processes for zoonoses can be acutely challenged during the early stages of an epidemic or pandemic, such insights can provide a pragmatic, empirically-based roadmap for enhancing their robustness and efficacy, and benefiting long-term decision-making efforts.

Poor access to care is a top patient-oriented research priority for youth with chronic pain in Canada, and the COVID-19 pandemic has exacerbated these concerns. Our patient-oriented project team engaged with marginalized and racialized youth with chronic pain (Black youth with sickle cell disease, Indigenous youth and youth with complex medical needs) and their families to ensure that best practice recommendations for virtual care are inclusive and equitable. Input provided through virtual round-table discussions improved recommendations for leveraging, implementing and selecting best platforms for virtual care for youth with chronic pain and identified new gaps for future research, practice and policy change.

Patient-reported outcomes (PROs) capture data related to patients' perception of their health status and aspects of health care delivery. In parallel, digital innovations have advanced the administration, storage, processing, and accessibility of PROs, allowing these data to become actively incorporated in day-to-day clinical practice along the entire patient care pathway. Further, the emergence of shared decision making, where patients are engaged in informed treatment selection aligned with their preferences, values, and needs, can be realized by PROs and technology. This technology-enabled, data-driven approach provides insights which, when actioned, can enhance musculoskeletal care of patients and populations, while enriching the clinician-patient experience of decision making. In this review, we provide an overview of the opportunities enabled by PROs and technology for the cycle of orthopedic care.

Good clinical practice guidelines are based on randomized controlled trials or clinical series; however, technical performance bias among surgical trials is under-assessed. The heterogeneity of technical performance within different treatment groups diminishes the level of evidence. Surgeon variability with different levels of experience—technical performance levels even after certification—influences surgical outcomes, especially in complex procedures. Technical performance quality correlates with the outcomes and costs and should be measured by image or video-photographic documentation of the surgeon’s view field during the procedures. Such consecutive, completely documented, unedited observational data—in the form of intra-operative images and a complete set of eventual radiological images—improve the surgical series’ homogeneity. Thereby, they might reflect reality and contribute towards making necessary changes for evidence-based surgery.

Objective. Adaptive radiotherapy techniques available on the MR-linac, such as daily plan adaptation, gating, and dynamic tracking, require versatile dosimetric detectors to validate end-to-end workflows. Plastic scintillator detectors (PSDs) offer great potential with features including: water equivalency, MRI-compatibility, and time-resolved dose measurements. Here, we characterize the performance of the HYPERSCINT RP-200 PSD (MedScint, Quebec, CA) in a 1.5 T MR-linac, and we demonstrate its suitability for dosimetry, including in a moving target. Approach. Standard techniques of detector testing were performed using a Beamscan water tank (PTW, Freiburg, DE) and compared to microDiamond (PTW, Freiburg, DE) readings. Orientation dependency was tested using the same phantom. An RW3 solid water phantom was used to evaluate detector consistency, dose linearity, and dose rate dependence. To determine the sensitivity to motion and to MRI scanning, the Quasar MRI4D phantom (Modus, London, ON) was used statically or with sinusoidal motion (A = 10 mm, T = 4 s) to compare PSD and Semiflex ionization chamber (PTW, Freiburg, DE) readings. Conformal beams from gantry 0° and 90° were used as well as a 15-beam 8 × 7.5 Gy lung IMRT plan. Main results. Measured profiles, PDD curves and field-size dependence were consistent with the microDiamond readings with differences well within our clinical tolerances. The angular dependence gave variations up to 0.8% when not irradiating directly from behind the scintillation point. Experiments revealed excellent detector consistency between repeated measurements (SD = 0.06%), near-perfect dose linearity (R 2 = 1) and a dose rate dependence Significance. This study demonstrates the suitability of the HYPERSCINT PSD for accurate time-resolved dosimetry measurements in the 1.5 T MR-linac, including during MR scanning and target motion.

Objective. This study aimed at investigating through Monte Carlo simulations the limitations of a novel hybrid Cerenkov-scintillation detector and the associated method for irradiation angle measurements. Approach. Using Monte Carlo simulations, previous experimental irradiations of the hybrid detector with a linear accelerator were replicated to evaluate its general performances and limitations. Cerenkov angular calibration curves and irradiation angle measurements were then compared. Furthermore, the impact of the Cerenkov light energy dependency on the detector accuracy was investigated using the energy spectra of electrons travelling through the detector. Main results. Monte Carlo simulations were found to be in good agreement with experimental values. The irradiation angle absolute mean error was found to be less than what was obtained experimentally, with a maximum value of 1.12° for the 9 MeV beam. A 0.4% increase of the ratio of electrons having an energy below 1 MeV to the total electrons was found to impact the Cerenkov light intensity collected as a function of the incident angle. The effect of the Cerenkov intensity variation on the measured angle was determined to vary according to the slope of the angular calibration curve. While the contribution of scattered electrons with a lower energy affects the detector accuracy, the greatest discrepancies result from the limitations of the calculation method and the calibration curve itself. Significance. A precise knowledge of the limitations of the hybrid detector and the irradiation angle calculation method is crucial for a clinical implementation. Moreover, the simulations performed in this study also corroborate hypotheses made regarding the relations between multiple Cerenkov dependencies and observations from the experimental measurements.

BACKGROUND Approximately 1 in 3 Canadians will experience an addiction or mental health challenge at some point in their lifetime. Unfortunately, there are multiple barriers to accessing mental health care, including system fragmentation, episodic care, long wait times, and insufficient support for health system navigation. In addition, stigma may further reduce an individual’s likelihood of seeking support. Digital technologies present new and exciting opportunities to bridge significant gaps in mental health care service provision, reduce barriers pertaining to stigma, and improve health outcomes for patients and mental health system integration and efficiency. Chatbots (ie, software systems that use artificial intelligence to carry out conversations with people) may be explored to support those in need of information or access to services and present the opportunity to address gaps in traditional, fragmented, or episodic mental health system structures on demand with personalized attention. The recent COVID-19 pandemic has exacerbated even further the need for mental health support among Canadians and called attention to the inefficiencies of our system. As health care workers and their families are at an even greater risk of mental illness and psychological distress during the COVID-19 pandemic, this technology will be first piloted with the goal of supporting this vulnerable group. OBJECTIVE This pilot study seeks to evaluate the effectiveness of the Mental Health Intelligent Information Resource Assistant in supporting health care workers and their families in the Canadian provinces of Alberta and Nova Scotia with the provision of appropriate information on mental health issues, services, and programs based on personalized needs. METHODS The effectiveness of the technology will be assessed via voluntary follow-up surveys and an analysis of client interactions and engagement with the chatbot. Client satisfaction with the chatbot will also be assessed. RESULTS This project was initiated on April 1, 2021. Ethics approval was granted on August 12, 2021, by the University of Alberta Health Research Board (PRO00109148) and on April 21, 2022, by the Nova Scotia Health Authority Research Ethics Board (1027474). Data collection is anticipated to take place from May 2, 2022, to May 2, 2023. Publication of preliminary results will be sought in spring or summer 2022, with a more comprehensive evaluation completed by spring 2023 following the collection of a larger data set. CONCLUSIONS Our findings can be incorporated into public policy and planning around mental health system navigation by Canadian mental health care providers—from large public health authorities to small community-based, not-for-profit organizations. This may serve to support the development of an additional touch point, or point of entry, for individuals to access the appropriate services or care when they need them, wherever they are. INTERNATIONAL REGISTERED REPORT PRR1-10.2196/33717

Background Approximately 1 in 3 Canadians will experience an addiction or mental health challenge at some point in their lifetime. Unfortunately, there are multiple barriers to accessing mental health care, including system fragmentation, episodic care, long wait times, and insufficient support for health system navigation. In addition, stigma may further reduce an individual’s likelihood of seeking support. Digital technologies present new and exciting opportunities to bridge significant gaps in mental health care service provision, reduce barriers pertaining to stigma, and improve health outcomes for patients and mental health system integration and efficiency. Chatbots (ie, software systems that use artificial intelligence to carry out conversations with people) may be explored to support those in need of information or access to services and present the opportunity to address gaps in traditional, fragmented, or episodic mental health system structures on demand with personalized attention. The recent COVID-19 pandemic has exacerbated even further the need for mental health support among Canadians and called attention to the inefficiencies of our system. As health care workers and their families are at an even greater risk of mental illness and psychological distress during the COVID-19 pandemic, this technology will be first piloted with the goal of supporting this vulnerable group. Objective This pilot study seeks to evaluate the effectiveness of the Mental Health Intelligent Information Resource Assistant in supporting health care workers and their families in the Canadian provinces of Alberta and Nova Scotia with the provision of appropriate information on mental health issues, services, and programs based on personalized needs. Methods The effectiveness of the technology will be assessed via voluntary follow-up surveys and an analysis of client interactions and engagement with the chatbot. Client satisfaction with the chatbot will also be assessed. Results This project was initiated on April 1, 2021. Ethics approval was granted on August 12, 2021, by the University of Alberta Health Research Board (PRO00109148) and on April 21, 2022, by the Nova Scotia Health Authority Research Ethics Board (1027474). Data collection is anticipated to take place from May 2, 2022, to May 2, 2023. Publication of preliminary results will be sought in spring or summer 2022, with a more comprehensive evaluation completed by spring 2023 following the collection of a larger data set. Conclusions Our findings can be incorporated into public policy and planning around mental health system navigation by Canadian mental health care providers—from large public health authorities to small community-based, not-for-profit organizations. This may serve to support the development of an additional touch point, or point of entry, for individuals to access the appropriate services or care when they need them, wherever they are. International Registered Report Identifier (IRRID) PRR1-10.2196/33717