Livingston Reporting - page 84

The ongoing 2019 novel coronavirus outbreak reminds us how rapidly infectious agents can travel the globe. Today it is possible to be anywhere in the world within hours. Our increasingly mobile society means that diseases that used to seem exotic and distant can impact any population. Of the 50 most deadly infectious diseases, approximately a third may be transmitted by drinking water.

The top deadliest diseases from drinking water
The following is a summary of the top deadliest diseases known to infect humans that have a waterborne transmission route ranked from the least to most deadly (numbers in parentheses indicate ranking). Table 1 includes these and other infections that made the list, considering all transmission routes.¹

Lassa fever (49) was originally discovered in the late ’60s in Lassa, Nigeria. That country reported that a new outbreak began in January 2020 with over 1,700 new cases suspected. An estimated 300,000 infections occur annually.² Although primarily endemic in West Africa, rodents are an intermediate host and can transmit the disease to people. Ingestion of contaminated food and water is another common transmission route. Symptoms may progress to hemorrhaging, fever and multiple organ failure.

Rabbit fever (48), also known as tularemia, is caused by the bacterium Francisella tularensis. This highly contagious organism causes an average of 126 cases per year in the US. Tularemia can be spread through arthropod bites, contact with infected animal tissues, inhalation of contaminated aerosols and ingestion of contaminated food or water. Historically, F. tularensis has been utilized as a bioweapon. Thus, officials monitor carefully for increases that might indicate foul play.

Taenia solium (46) is a type of tapeworm found in pork whose larval stage causes a disease known as cysticercosis. The disease spreads through feces-contaminated food or water from an infected person. Larvae then invade the central nervous system tissues. Endemic in Latin America, cases are routinely diagnosed in US-born residents.³

Rotavirus (45) is the number one cause of childhood diarrhea worldwide. Although the availability of a vaccine dramatically reduced the number of rotavirus deaths, an estimated 215,000 are still attributed to this organism.⁴
The majority of cholera (42) cases can be treated with oral rehydration solutions but in many areas treatments for the severe, acute watery diarrhea is not available. It is estimated that up to four million cases and 143,000 deaths occur from the bacterium Vibrio cholerae annually. The current (seventh) pandemic hit South Asia in 1962, Africa in 1971 and the Americas in 1991.⁵

Typhoid fever (42) cases are estimated as high as 22 million with 210,000 deaths annually. Spread via food and water contaminated with Salmonella enterica serotype typhi and paratyphi, it’s the largest global burden in in the developing world.

Shiga toxin-producing Escherichia coli (E. coli) (40) causes severe outbreaks of food and waterborne disease. The disease is usually self-limiting but may progress to bloody diarrhea and the deadly haemolytic uraemic syndrome (HUS), which can result in acute renal failure. Children and the elderly are most at risk.

Botulism (31) is the most deadly toxin known. Produced by the bacterium Clostridium botulinum, the toxin is destroyed by conventional drinking water treatment but can spread via intentional acts of contamination. A powerful neurotoxin, botulism death usually occurs following muscular paralysis and respiratory failure.

Legionnaire’s disease (31) is spread via water aerosols from showers, cooling towers, fountains and hot tubs. The Legionella pneumophila bacteria grows in premise-plumbing systems. The 10,000 cases of Legionnaire’s disease reported in the US annually are thought to be a large underestimation of the true disease burden. The elderly, smokers and people with chronic lung disease are most at risk.

Anthrax (31) spores are produced by the bacterium Bacillus anthracis and are commonly found in soil and infect domestic and wild animals feeding on outdoor plants and grasses. Once inside the human body, the spores become active, multiply and produce potent toxins leading to severe illness and death.
SARS (29) or Severe Acute Respiratory Syndrome (which became a global threat in 2003), is caused by a strain of coronavirus. Symptoms similar to influenza complicate rapid and distinct diagnoses. Respiratory illness is often accompanied by severe diarrhea. Although rare, case-fatality rates may be as high as 50 percent.

Guillain-Barré syndrome (27) is a chronic autoimmune condition that attacks the nerves, causing a paralytic illness similar to polio that can progress to total body paralysis and death. Although the exact cause is unknown, the syndrome often occurs following acute infections from respiratory or waterborne microbes, including influenza, Zika and hepatitis A viruses.

Listeriosis (18) is caused by the food and waterborne bacterium Listeria monocytogenes. Found commonly in soft cheeses and ready-to-eat meat products, infections may become invasive and lead to severe health outcomes including septicemia, meningitis and spontaneous abortion.

MERS (Middle East Respiratory Syndrome) (15), like it’s relative SARS, may be spread by the respiratory and fecal-oral route. First reported in 2012, MERS is the most deadly virus with a possible waterborne route on our list of top 50 infections, with a death rate of over 34 percent.

Minimizing endemic and epidemic waterborne disease
The only disease that has been successfully eradicated from the globe is smallpox. As microbial hazards continue to emerge due to mutations or expanded routes of transmission, efforts to contain their spread will be promoted. Most microbial pathogens spread via potable water supplies can be removed or inactivated by the use of POU drinking water treatment devices. Therefore, POU device technology designed to remove microbes is recommended to control endemic and epidemic illness risks.

Original Article: http://wcponline.com/2020/03/15/25764/

By: Kelly A. Reynolds, MSPH, PhD

Posted on: Sunday, March 15th, 2020

This month big news has hit the medical radiation industry with the partnership between Siemens Healthineers and Varian Medical Systems. Although, according to the German stock market, little change has been observed with Siemens AG, and Varian has made it very clear that Siemens is ready to revolutionize the industry to a new set of standards very soon.

One of the most evident benefits is the strength in adding additional mature products and hardware to the already robust lineup that Varian is well known for in the market. In 2019, Varian’s business held 55% of the global installed base, and with combining the two companies, this move alone will create a product line no other competitor will be able to match. Secondly, the new joint plans will allow for Siemens’ growth to offset the gradual decrease of demand for its imaging modality business (MRI, CT). Lastly, as a company, Varian has grown to a size that, without further investment in operations and new market channels, would not be successful, so this opportunity will allow them to grow and remain steadfast in this sector.

The hardware aspect has gained the most attention with the real jewel being that Siemens possesses its software business, hitting almost $600 million in sales during 2019. Recent plans for Siemens have begun channeling its digital strategy to tap into the most significant challenges that most healthcare providers are struggling with today. This newly formed partnership will allow a radiation therapy linac fleet management system that no other vendor can offer or compete. Read this article to learn more about the three substantial benefits of this merger.

PRK (photorefractive keratectomy) is a type of refractive surgery to correct myopia (nearsightedness), hyperopia (farsightedness), and astigmatism. It was the first surgery developed for vision correction and came before the popular LASIK procedure. PRK works by reshaping the cornea using an excimer laser. It’s similar to LASIK in that they both use lasers during treatment; however, PRK surgery takes slightly longer to recover from. PRK’s are still commonly performed and, in some cases, offer advantages over LASIK eye surgery.  

Both LASIK and PRK work by reshaping the cornea using an excimer laser, allowing light to enter the eye to focus on the retina for clear vision. The main difference between PRK and LASIK is the first step of the procedure. During PRK, the thin layer of the cornea (epithelium) is removed before reshaping the underlying corneal tissue with an excimer laser. The epithelium regenerates itself (grows back over the cornea) within a few days after surgery. With LASIK, a thin flap is created on the cornea using a microkeratome or a femtosecond laser. The flap is lifted to expose the underlying corneal tissue and is replaced after the cornea is reshaped with an excimer laser. 

LASEK (with an e) is essentially another version of PRK; however, this procedure entails removing the outer layer of the epithelial layer of the cornea. As with PRK, LASEK involves lifting the epithelial layer by using a trephine, a type of surgical instrument. The epithelial layer is preserved during surgery and then placed back on the eye’s surface once the procedure is complete. LASEK has decreased in popularity due to the slower recovery of vision compared with PRK. The epithelial layer that is placed back on the eye takes longer to recover in LASEK than the growth of a new layer as in PRK. 

After Surgery: 

Outcomes of PRK and LASIK are very similar. Many people can achieve 20/20 vision once they have had the procedure, and almost all patients achieve a 20/40 visual acuity or better. After PRK and LASIK surgery, complications are rare but can occur. Complications can include infection and starbursts or halos around lights at night. Reading glasses may also still be required after PRK surgery once you reach your 40s, due to an age-related loss of near vision called presbyopia. 

When it comes to corrective vision, LASIK is by far the most popular option for the majority. However, it’s essential to follow the guidance and judgment of your eye surgeon regarding whether PRK or LASIK is the best option for your individual needs. 

A team of researchers from the Dept. of Physics and the Dept. of Chemistry have worked together to discover magnetism of a magnetic semiconductor called Cr2Ge2Te6 that shows a great response to applied electric fields. The material was found to exhibit a state of ferromagnetism with temperatures up to 200k (-73 C). These results were fascinatingly surprising because it was unknown to have ferromagnetic order at these temperatures. To read more on how these researchers were able to create this experiment, click here https://phys.org/news/2020-08-electrical-magnetism.html.

NUS physicists can show control of magnetism in a magnetic semiconductor through electrical use. This will continue to open the exploration for spintronic devices for future research with even more related materials systems.  

On July 26th, engineer William English passed away at the age of 91. He leaves behind a legacy in the computer technology field for his achievements alongside his partner, Douglas Engelbart, for creating the first computer mouse that revolutionized workstations that we all know and use today. According to this article, William and Douglas began their partnership in the late 1950s at the Stanford Research Institute. Douglas initially came up with the idea of a device that could move a cursor across a computer, but William oversaw the design and the creation of what was later called “the mouse.”

It’s not exactly clear how the mouse name has originated; however, some experts believe it referenced the cursor, which was at the time was called “cat,” that would chase the motions of the device. Others have said the name came from its physical appearance resembling a mouse tail attached to the device. The first version of the mouse was introduced at a 1968 convention with a wooden block that had wheels on the bottom. This convention was later known as “The Mother of All Demos” since there were multiple new demonstrations with significant impacts on the technological world such as the computer window, video call, and precursor to the hyperlink. A few years later, William English left Stanford to work at Xerox’s Palo Alto Research Center and polished the mouse design for personal use for both Microsoft and Apple.

Rich data sets have accumulated within the chemical process industry (CPI) throughout many years of production, and now, because of this data, there is a push to start utilizing artificial intelligence (AI) in modeling, optimization, advanced control, debottlenecking, troubleshooting, and more. AI/CPI is being looked at if a first-principles-based approach cannot efficiently solve the problem.

However, it’s not necessarily easy to interpret the AI data models, which hinders acceptance and adoption from most of the community. Developing an effective process is not an easy feat for the CPI. Budget constraints, time, human resources, and limited pilot tests are roadblocks for AI/CPI development. 

Design engineers can use process simulation packages to run different scenarios or build in-house models; however, the process’s inevitability becomes inefficient and suboptimal while also losing control of essential variables. 

Additionally, workable issues may not be uncovered until the mature product development stage. As the AI/CPI market conditions change, the original design purpose may not fit the intended use-case for the final product, making it hard to forecast reliable system processes. These factors make the developing AI/CPI industry challenging to predict and indicates that it’s only just developing. 

To learn more about specific discoveries such as models and datasets, explainable AI, and case studies within the AI/CPI industry, read the article here. 

RapidArc Rotational Radiation Therapy combines the most current technologies to decrease treatment times and radiation exposure for the patient. The technologies used in this process are Intensity Modulated Therapy (IMRT), Image-Guided Radiation Therapy (IGRT), On-Board Imaging (OBI), and Cone Beam CT Scanning (CBCT). 

Rapid Arc technology from Varian Medical Systems, a renowned leader in radiation research and development, has brought all of these technologies in their practice together to advance precision and targeted treatments to the next level. 

The RapidArc process emits radiation, usually in less than 90 seconds per fraction. IMRT Arc Therapy from RapidArc uses a single rotation of the linac gantry to execute a very targeted IMRT plan following IGRT and OBI targeting. This is considered a “volumetric arc” that is often labeled as VMAT (Volumetric Arc Therapy). It allows for a more effective, targeted, and faster treatment of prostate cancer radiation. Ultimately, the RapidArc treatment process is an evolved and more efficient treatment in its delivery, speed, and sophistication. 

To learn more about RapidArc therapy and its processes, read the full article here. 

You can save a ton of money if you demo your kitchen instead of getting it done; however, it’s not for everyone. Depending on your health and any available help you may have, you might consider paying for your demo work instead. For those considering ripping out their old kitchen on their own, this article gives you a quick rundown of a few tips to follow before grabbing the crowbar and hammer. 

Prep the Space. Turn off the kitchen power supply from your circuit breaker box. A good tip you’ll want to remember is putting a piece of tape over the breaker for the kitchen, so no one accidentally turns them on, giving you an unexpected shock when you reach for an outlet. 

Turn Off the Water. Demo work is messy enough without burst water pipes. Be sure to turn off the supply usually found under the kitchen sink with a value or handle.  

Turn Off the Gas Supply. If you have appliances that run on gas, you will need to turn them off with the valve located behind the appliance. Ensure that you pull the appliance out carefully so not to dislodge the hose out of the valve. 

Rent a Dolly for Heavy Appliances. Don’t break your back, get some assistance by renting a dolly typically found at rental centers or home improvement stores.  

Lay a Drop Cloth on the Floor. This will prevent scratches and other damage. If you are also renovating the floor, you obviously do not have to do this.

Rent a Dumpster. A typical average-sized kitchen will require you to rent a six-cubic yard dumpster. These can be rented from your local waste management centers. 

Now you’re ready to begin the demo, including the garbage disposal, sink, cabinets, countertops, backsplash, and dishwasher. For the next steps, read more from this article regarding the main kitchen demo.

These are just a few tips on prep work you will need to consider if you plan on remodeling your kitchen. Contact JFC Remodeling for your next kitchen renovation project at 810-923-1123. https://www.jfcremodeling.com/

The medical linear accelerator (linac) is a crucial piece of technology for the radiation oncology industry and is one of the most used machines in the field. The underlying principle of a linac is straightforward, but producing a consistent, stable beam of radiation and precise, sophisticated design for careful operation is essential.

A linear accelerator works by heating a filament that boils off a cloud of electrons; these electrons are then accelerated by an electric field applied between the filament (cathode) and a thin metal window (anode). The electrons then hit a target (where they produce Bremsstrahlung X-rays) or a scattering foil (to distribute an electron beam evenly.) 

Afterward, the beam can be shaped in the treatment head – a part of the LINAC machine. Below, we discuss the external and internal components of a Linear Accelerator.

External Components of a Linear Accelerator: 

Couch (Patient Positioning System) The couch supports and positions the patient during treatment. Modern LINAC couches allow for precise patient positioning for proper beam exposure, which can move on the x, y, and z-axis. More advanced couches may include the ability to allow a patient to be positioned to roll, pitch, and yaw.

Electronic Portal Imaging Device (EPID) The electronic portal imaging device forms an image using the MV treatment beam. EPIDs are valuable in tools for monitoring patient setup and quality assurance.

Gantry The linac is mounted on a rotating gantry that offers treatment from multiple angles.

kV Imaging System The kilovoltage imaging system consists of a kV X-ray generator and an electronic imaging device. Lower energies of the imaging system improve contrast, particularly when used to produce a cone-beam CT.

Stand Connected to the gantry, the stand contains electrons and other systems required for linac operation.

Read more on the internal components of Linear Accelerators such as the bending magnet, accelerating waveguide, circulator, and more.

RadParts is the world’s largest independent distributor of OEM replacement parts for Linear Accelerators and Radiation Oncology equipment. Our mission is to provide high quality, user friendly, low-cost parts for linear accelerators and radiation equipment. 

https://www.radparts.com  | 877-704-3838

Not long ago, it used to be that your business could get away with just a simple website and a few social media pages to compete in the online marketing space. However, in today’s online environment, it’s not enough. The digital marketing world demands that you always make efforts to get in front of your target audience by publishing content and digital ad campaigns. It’s also essential to stay ahead of emerging technologies and digital trends as the industry continually evolves and shifts. Below are five digital marketing trends for 2020 (and beyond) that you should be aware of:

• Facebook is Not the Kingpin of Social Media Anymore

About 5-10 years ago, Facebook was the king of social media and held the second position for the most popular website (just behind Google). It’s now been replaced with YouTube. This doesn’t mean that Facebook is no longer a hugely influential and authoritative site to market on. According to Forbes, 41% of Facebook’s users are over the age of 65, which means the younger audiences have migrated over to Instagram, Snapchat, and now the emerging new social giant, TikTok. If you’re a local business, advertising on Facebook may make sense if you have an older demographic you want to get in front of. However, if you need to reach a younger crowd, consider looking into other social media sites where they spend most of their time. 

• Instagram is Still One of the Top Choices to Reach Younger Audiences

Instagram has already passed one billion users and is one of the most rapidly growing social media platforms with a primarily younger crowd (typically under 30). However, one change that Instagram recently made was removing the “like” feature on posts to decrease competitive pressure among people who value popularity. Since Facebook owns Instagram, most likely, we might see Facebook follow suite. If you need to get in front of people under 30, Instagram should be considered a critical component in your marketing plan. 

• Chatbots Will Start to Become Ubiquitous in Customer Service

Artificial Intelligence (AI) will become a dominant factor in about 10-20 years as we’ll see smarter voice assistants embedded within our environments and robots’ services our stores. Many forms of AI are already here, even though they may not seem super-human yet. Several companies will start utilizing chatbots to help with customer service – acting like a virtual “concierge” by communicating with users and assisting them in completing their goals.  

It is said that 80% of businesses claim they want to start using chatbots this year. Some of the benefits are 24-hour service, instant responses to customer queries, and no need for break, vacation, or overtime pay. Tidio research company from January 2020 found that 43% of consumers prefer to message an online chatbot than talk to a person when it comes to customer service. With the benefits of chatbots becoming more cost-effective for business and consumers preferring it over typical customer support, this is one trend that is here to stay.

• Video Should be Considered a Necessity, Not an Option

The popularity of video cannot be overstated enough. If your business isn’t already utilizing videos, most likely, your competitors are. Static images and text-based content can’t compete with the multifaceted layers videos can accomplish. More people are consuming video content than ever before, and they are using their phones to share the content. Think about these stats from Impact BND:

• 70% of consumers have shared a brand’s video
• 52% of consumers claim that watching product videos makes them more confident and guides their online purchasing decisions 
• 72% of businesses believe video content has improved their conversion rates

Live streaming video is also a powerful way to engage your audience by posting live video updates about your products, services, and brand. Popular video sites like YouTube and now TikTok are great sites to get started if you’re considering video for your marketing. 

• Content Is Still King

For years, it has been said that content is king, which is more accurate now than ever, with a few modifications. The changes are coming in sub-niches and nuances in content. You must provide exactly the right information that users are looking for when they land on a page on your website. Google released its BERT update in November 2019, which helps the search engine understand the natural language in user search queries. All this means Google is getting smarter, and companies must keep this in mind as they develop content that is relevant to the user and good quality if they want to stay ahead on search engine rankings. 

To read more digital marketing trends for 2020, click here. 

If you need assistance in improving your website and increasing your online presence, Creative Programs and Systems are here to help! Our team of staff is locally employed, in-house, with a dedication to detail. Call CPS, open Monday – Friday, 9 am to 5 pm (810) 224-5252.