bluuebunny/crossref_metadata_2025 huggingface dataset:
Un maestro, una scelta
Authors: Burlini Annamaria
Published: May 2024

Il testo proposto è soprattutto un ricordo personale della capacità analitica di Gino Pagliarani e della sua straordinaria sensibilità umana e clinica. Alcuni dei temi cui si fa cenno sono cardini del suo pensiero: il trauma, l'amore primario, l'ango-scia della bellezza.
Breve riflessione sulla contiguità/distanza tra la gruppoanalisi foulksiana e l'analisi gruppale bioniana
Authors: Tucci Sorrentino Paolo
Published: May 2024

La Gruppo Analisi Foulksiana e l'Analisi Gruppale Bioniana – due tracce teoriche e applicative attive entrambe nella seconda metà del novecento in Inghilterra e in Europa – hanno avuto vite parallele, peculiarmente diverse, definite dall'autore complementari: «mentre Bion si interessava anzitutto degli Universi Relazionali Protomentale e Simbo-lico», con conseguenti interventi sul situema gruppale, «Foulkes preferiva l'analisi del transfert, l'universo immaginario», con conseguenti suoi interventi sui singoli pazienti e in misura molto minore sull'intero gruppo. Il racconto dell'autore accompagna chi leg-ge in questa avventura intellettuale e terapeutica, pervenendo anche a un ritratto "quasi privato" dei due capiscuola dell'analisi di gruppo europea.
Ai margini del sindacato, il sindacato nei margini: democratizzazione, demercificazione e disinquinamento tra alleanze possibili e nuove pratiche
Authors: Marrone Marco , Borghi Paolo
Published: May 2024

Questo paper riflette sulle sfide economiche, sociali e ambientali che le organizzazioni sindacali si trovano ad affrontare guardando ai margini del proprio campo tradizionale d'azione misurandosi con nuovi ordini discorsivi, pratiche e alleanze. È proprio in contesti come quelli delle piattaforme digitali, delle politiche abitative o delle crisi industriali, in cui l'azione sindacale viene spinta a intrecciarsi con nuovi attori e a sperimentare nuove pratiche, che emergono le direttrici di rinnovamento organizzativo più promettenti. Più che cercare nuove formule in grado di costruire un "sindacato 2.0", ciò che appare necessario per affrontare le sfide del futuro è quindi tradurre tali sperimentazioni in apprendimento organizzativo, aspetto sul quale permangono invece ancora delle difficoltà. Le domande di ricerca saranno le seguenti: in quali contesti vengono sperimentate forme innovative di alleanza e azione? Quali sono le potenzialità e i limiti di tali sperimentazioni? In che modo queste esperienze possono tradursi in apprendimento organizzativo per le organizzazioni sindacali e in un rinnovamento del sistema delle relazioni industriali?
Il tornante del 1945, la storia politica e la fragilità di una categoria. Nuove (e vecchie) sfide degli studi sul neofascismo
Authors: Martini Andrea
Published: May 2024

Complice l'accresciuta popolarità di formazioni di estrema destra nel panorama politico globale, gli studi sul cosiddetto neofascismo sono aumentati in maniera significativa negli ultimi anni, pur trascinandosi una serie di criticità. Non potrebbe essere altrimenti nel momento in cui è la stessa categoria di neofascismo a suscitare più di una perplessità per una molteplicità di ragioni, tra cui l'eccessivo utilizzo della parola nel dibattito pubblico per etichettare una vasta gamma di personalità e partiti. La presente nota, tuttavia, suggerisce come il ricorso a specifiche buone pratiche da parte di alcuni lavori dedicati al neofascismo apparsi in anni recenti — quali per esempio la propensione a rivisitare il tornante del 1945, allargare l'orizzonte della ricerca a una storia non esclusivamente evenemenziale e adottare un approccio transnazionale — stia aiutando a conferire maggiore solidità a questo campo di studi.
Il ridisegno dei processi di cura secondo l'approccio value-based: quali insegnamenti da un multiple case study?
Authors: Laratro Simone , Rizzo Marco Giovanni , Villa Stefano
Published: May 2024

L'obiettivo di questo lavoro è quello di investigare, mediante un multiple-case study, l'impatto e le condizioni organizzative dell'implementazione del modello value-based healthcare. In particolare, è stata analizzata la condizione clinica del Mieloma Multiplo (MM), una patologia oncologica che ben rappresenta le principali sfide e criticità dell'organizzazione dei sistemi sanitari nel post-pandemia. Per raggiungere gli obiettivi del lavoro: (i) è stata analizzata la modalità di organizzazione per processi del percorso di cura del MM; (ii) è stato misurato il costo del percorso di cura mediante la tecnica del time driven activity based costing; (iii) sono state identificate le condizioni organizzative per l'implementazione del modello value-based healthcare con particolare riferimento al modello del focused-hospital e delle équipe multidisciplinari. I risultati dello studio possono sintetizzarsi attorno a due macromessaggi chiave. Innanzitutto, l'analisi dei costi mostra che, a parità di case-mix clinico assistenziale, differenti scelte clinico-assistenziali hanno un impatto economico e organizzativo rilevante. Risulta, quindi, necessario standardizzare, laddove è possibile, i processi di cura con strumenti come i Percorsi Diagnostici Terapeutici e Assistenziali. Come peraltro abbiamo appreso sul campo nella recente pandemia COVID-19, il modello delle équipe multidisciplinari e quello del focused-hospital rappresentano sicuramente soluzioni efficaci per la gestione di patologie complesse. Lo studio, però, evidenzia la presenza di almeno due condizioni rilevanti, è necessario infatti: (i) sviluppare sistemi informativi "orizzontali" capaci di fornire dati tempestivi e accurati sui processi di cura; (ii) trasferire sul territorio, laddove possibile, anche attraverso la tecnologia (e.g. telemedicina), le competenze specialistiche del focused-hospital all'interno di una presa in carico il più possibile complessiva (the full cycle of care) e integrata.
Etica e leadership nel sistema sanitario italiano: risultati di una ricerca empirica
Authors: Di Marcantonio Marzia , Valentini Ilaria
Published: May 2024

Nonostante le organizzazioni sanitarie siano intrinsecamente basate su principi etici e sui valori dei loro professionisti, la ricerca sulla leadership etica nel settore sanitario è ancora limitata. Il presente studio si pone l'obiettivo di esaminare l'adozione della leadership etica tra 48 professionisti sanitari con incarichi manageriali nel contesto del Servizio Sanitario italiano. I risultati dell'indagine hanno rivelato un'orientazione positiva verso la leadership etica, ma anche differenze di genere nella gestione dei ruoli manageriali, indicando possibili disuguaglianze etiche. Questo enfatizza l'importanza di promuovere l'uguaglianza di genere e di diffondere valori etici coerenti all'interno delle organizzazioni sanitarie, il che avrebbe un impatto significativo non solo sulla gestione ma anche sullo sviluppo della leadership nel settore sanitario.
Acquistare innovazione in sanità: condividere responsabilità e ruoli. Il caso degli acquisti dei servizi di diagnostica tumorale attraverso il Value-Based Procurement (VBP)
Authors: Amatucci Fabio , Brusoni Manuela
Published: May 2024

Nei processi di acquisto di beni e servizi in sanità si è di recente affermato un approccio innovativo, denominato Value-Based Procurement (VBP), che rappresenta un cambiamento dal tradizionale modello di risparmio sui costi a breve termine verso un approccio più completo, in cui le prestazioni del sistema sanitario, i risultati per il paziente, nonché l'efficienza e l'efficacia a lungo termine delle decisioni sono elementi fondamentali. Nel presente articolo, viene applicato questo modello all'acquisto del servizio di diagnosi per tumore, per il quale si sta affermando l'utilizzo del "modello mutazionale", caratterizzato dall'utilizzo di test diagnostici per la ricerca non tanto della sede tumorale, quanto della tipologia di mutazione genetica. Finalità del lavoro è la costruzione di un modello di acquisto basato sul valore, definendo obiettivi da perseguire, indicatori chiave per valutare gli effetti dell'innovazione, modalità di misurazione del valore generato per i diversi attori in gioco (sistema sanitario; pazienti; fornitori), in un contesto di particolare complessità scientifica, organizzativa e di impatto economico e sanitario.
Verso la riforma della Medicina Generale: conoscersi per rinnovarsi Risultati del questionario relativo alla conoscenza della Medicina Generale e alle sue prospettive future
Authors: Liberali Cesare , Rubino Alessandro , Colombo Alessandro , Antonio Vendramini Emanuele
Published: May 2024

Il rinnovamento dei sistemi sanitari è da tempo al centro del dibattito istituzionale e la recente crisi epidemica ne ha acuito la rilevanza. Una riforma della sanità territoriale sembra ormai improcrastinabile, ed è essenziale che gli attori del sistema conoscano i propri stakeholder. Si è voluto, quindi, cambiare il punto di vista provando a indagare la Medicina Generale attraverso gli altri protagonisti del SSN. I corsisti DIAS e DSC della Lombardia hanno risposto a un questionario, validato da un panel di esperti, al fine di indagare le loro conoscenze e prospettive future riguardo la figura del MMG. I risultati offrono molti spunti di riflessione. Le risposte sono state eterogenee, dimostrando una parziale conoscenza della MG e una grande differenza di aspettative sul futuro di questa professione. Esistono però alcuni fondamentali punti di convergenza, utili per la riorganizzazione delle cure primarie.
Lo sport come intervento complementare nei programmi di tutela della salute mentale e in quelli orientati al recupero
Authors: Rullo Santo
Published: May 2024

In psicologia ed in psichiatria il rapporto tra mente e corpo è stato prevalentemente trattato nell'ottica di come le tensioni emotive si riflettano sulla funzionalità somatica. In questo lavoro l'autore sottolinea le potenzialità dell'esercizio corporeo e delle attività sportive come riattivatori di risposte psicofisiologiche, come mediatori delle relazioni intra ed inter-personali, come strumenti di implementazione delle social skills e di inclusione sociale. Gli elementi esposti, tratti dalla letteratura e dalla prassi comune, si estendono dal wellness della prevenzione primaria in salute mentale ai programmi di riabilitazione psichiatrica, passando per gli interventi psicosociali nei trattamenti per le acuzie e subacuzie delle psicopatologie maggiori.
Quo vado, ovvero sul perché in Puglia chi emigra per studio o per lavoro tende a tornare
Authors: Manieri Gregorio , Ruggiero Marta
Published: May 2024

L'articolo che segue si pone come principale obiettivo quello di dar vita a una riflessione su quanto sia fondamentale, nella vita di chi è nato e cresciuto in Puglia, il ritorno, dopo essersi allontanati, alla propria terra e alle proprie origini. Si partirà da una analisi storico-sociologica e geografica prima, per poi arrivare a un'analisi psicologica attraverso la focalizzazione su uno dei fenomeni che da sempre caratterizzano il nostro Paese, quello della migrazione. Quindi si cercherà di mettere in luce quali sono quegli elementi, culturali e familiari, che spingono chi vive in territori pugliesi prima di tutto ad allontanarsi e poi, per ragioni multiple, a ritornare. Parlando di separazioni e appartenenze, miti e tradizioni, distanze e ri-unioni, si esporranno le ragioni sottostanti la voglia e il bisogno, soprattutto tra i più giovani, di andar via dalla terra d'origine, alla ricerca tanto di se stessi quanto di una maggiore stabilità, per poi decidere di farvi ritorno, diversi, cambiati, ma con la necessità di dare ascolto a quel forte richiamo delle proprie radici. Attraverso il racconto di una coterapia e l'espressione di elementi propri dei terapeuti stessi, si metteranno in luce quegli aspetti che caratterizzano le famiglie pugliesi, famiglie culturalmente invischiate, matriarcali, dai confini non sempre ben definiti, cercando di comprendere quali siano quei fattori che, anche grazie e attraverso il fenomeno migratorio, possono consentire il giusto equilibrio tra appartenenza e separazione.
DISPUTE SETTLEMENT ANALYSIS AND REFUSED CLAIMS IN PAYMENT GATEWAY TRANSACTIONS ON PAYPAL INDONESIA
Authors: Recca Ayu Hapsari  , Bambang Hartono  , Yana Listiyani
Published: May 2024

In transactions using Paypal, of course, there are many reasons for the risk of disputes occurring, ranging from delays in delivery, damaged goods, and transactions without authorization. The problem will be different when they carry out business transactions in different regions of the country and they have different nationalities. The research method uses a normative and empirical juridical approach, a normative juridical approach is carried out by studying legal norms or rules, while the empirical approach is carried out by direct interviews with sources who will relate to research problems, the data analysis used is qualitative. In trading transactions via the internet, trade is generally carried out by people who are located and subject to different countries and jurisdictionsThe legal relationship between Payment Gateway Users and Payment Gateway Providers At Fintech Paypal Indonesia is where the parties involved in the electronic payment system include consumers, business actors, acquirers, issuers and payment gateway providers. legal relationships that arise between consumers, business actors, acquirers, issuers and payment gateway operators are born from agreements made by the parties. Dispute Resolution and Chargeback Claims in Payment Gateway Transaction activities on Paypal Fintech where the paypal system provides services can communicate directly with the seller by opening a dispute at the Paypal Dispute Settlement Center. if it is not completed in following the policies provided by paypal services, consumers or business actors can ask for recommendations to mediate to the paypal service center but if they are not finished, business actors and consumers can resolve disputes through litigation, which usually business actors are subject to the applicable law, applies where the consumer is a national.
Utilizing Eurocentric Temporary Protection Directive as a Global Approach of Refugee Protection
Authors: Sejan Sakhawat Sajjat , Hossain Shakhawat
Published: May 2024

The temporary protection directive is one of the noblest mechanisms of the European refugee protection regime. The European Union has designed it following the principle of temporary protection and non-refoulement of international refugee law. The United Nations Refugee Convention is the institutional root of these principles. In 2001, the EU has adopted the directive to improve its refugee protection mechanism. But they have never activated the directive until the current Ukrainian refugee crisis. This has remained as a piece of paper or unnecessary tool for the European countries. Their reluctance towards activating the directive seems to be hegemonic and political to some extent. Though they had all the grounds for activating the directive during the Syrian, Afghan or Tunisian refugee crisis, they did not choose to activate it. The paper doesn’t oppose the activation of TPD for Ukrainian refugees. It only explores and discusses the dualist role of the EU in activating TPD. The paper is also asking for its universal application for any refugees irrespective of their origin and the EU’s geopolitical interest. Lastly, it solicits for the utilization of the ‘doctrine of temporary refuge’ across the countries in the best possible manner considering the example of EU’s TPD.
Nuevo acercamiento a la iconografía de los vasos con perfiles de animales fantásticos
Authors: Ochoa Castillo Patricia
Published: May 2024

Perfiles de un animal fantástico, o ser sobrenatural, con
rasgos que lo asocian al jaguar, combinado con líneas,
rectángulos, las cejas en forma rectangular, ojos almenados,
la cabeza con hendidura en la parte superior, así
como la presencia de un óvalo bajo la nariz, o banda
nasal, son elementos que se repiten en algunas representaciones
plasmadas en vasos de base y paredes ligeramente
cóncavos. A través del análisis de cada uno de
sus elementos se intentará definir el personaje o ser ahí
representado y su simbología, que se desarrolla durante
el Preclásico.
Profiles of a fantastic animal, or supernatural being,
with features associating it with the jaguar, combined
with lines, rectangles, eyebrows in a rectangular shape,
almond-shaped eyes, a head with a cleft at the top, as
well as the presence of an oval below the nose, or nasal
band, are elements that are repeated in some representations
depicted on slightly concave base vessels and
walls. Through the analysis of each of its elements, an
attempt will be made to define the character or being
represented there and its symbolism, which develops
during the Preclassic period.
Plant Based Watering System Internet of Things Arduino and Monitoring with Telegram
Authors: Amanda Rico
Published: May 2024

Watering plants is very important if plants are to grow healthy and fertile. Many plant owners do not water their plants because they are busy at work and busy activities outside the home. Watering plants in the form of a system that can work automatically is an integrated design that can help human work. The aim of this research is the application of the Internet of Things and Telegram in watering plants, as well as creating an application for monitoring plant growth and care using the Telegram application. The method used in this research is the internet of things. Internet of Things is a concept where certain objects have the ability to transfer data via a WiFi network, so this process does not require human-to-human or human-to-computer interaction. Everything is run automatically with the program. The Internet of Things is usually called LoT and this technology has developed rapidly starting from wireless technology, micro-electromechanical systems (MEMS) and the internet. The results of this research are that by using an automatic plant watering system based on the internet of things, plants can remain well maintained and the development of the plants can also be monitored via telegram. The results of the questionnaire respondents' answers were on average above 50% in choosing the answer "Strongly Agree". These results show that this application is easy to use and meets user needs.
Kombinasi Metode AHP dan CPI Pada Sistem Pendukung Keputusan Pemilihan Guru Teladan
Authors: Usfinit Elisabeth Glodia Isulti , Kelen Yoseph P.K. , Manek Siprianus S
Published: May 2024

Saat ini teknologi sangat berpengaruh terhadap seluruh aspek kehidupan manusia baik dalam bidang pendidikan, ekonomi, bisnis, maupun organisasi lainnya. Terkhusus dalam bidang pendidikan yang tidak bisa dijalankan dengan mengandalkan cara yang sangat manual sehingga pengetahuan manusia itu sendiri didukung oleh teknologi saat ini. Salah satunya adalah penggunaan komputer sebagai alat bantu untuk menyelesaikan pekerjaan di bidang teknologi informasi. Teknologi informasi saat ini semakin berkembang di segala bidang, terutama dalam bidang pendidikan, khususnya pada Guru. Pemilihan guru teladan di SMA Negeri Insana Tengah saat ini masih dilakukan dengan sangat manual sehingga penilaiannya kurang tepat dan kurang baik. Sehingga hasil keputusan kurang berkualitas dan kurang adil bagi guru lain yang memenuhi standar. Metode yang digunakan dalam pemilihan guru teladan ini yaitu dengan menggunakan metode AHP dan CPI, metode AHP digunakan untuk menentukan bobot dari setiap kriteria sedangkan metode CPI digunakan untuk menentukan perangkingan dari setiap alternatif atau dari setiap guru yang mendapatkan perangkingan. Oleh karena itu peneliti merancang sebuah sistem pendukung keputusan sehingga mempermudah kepala sekolah dalam memilih guru manakah yang merupakan guru teladan di sekolah SMAN Insana Tengah. Untuk mengantisipasi pemilihan Guru teladan yang kurang tepat dan akurat maka diperlukan suatu sistem pengambil keputusan yang berdasarkan pada 6 kriteria utama dengan nilai bobotnya masing-masing yaitu Dokumen portofolio 0.08%, Karya tulis 0.25%, Disiplin 0.11%, Kinerja Guru 0.14%, Guru pluss 024% dan Penampilan 0.18%.
Design and Develop Interactive Multimedia Applying Problem-Based Learning to Enhance Problem-Solving Skills
Authors: Putra Johannes Alexander , Enjang Ali Nurdin  , Nusuki Syariati Fathimah  , Wahyudin
Published: May 2024

Informatics is intricately intertwined with the mastery of problem-solving. Within this discipline, one of the fundamental areas of study revolves around the concepts of branching and looping. During field studies, several student problems were identified, such as difficulty solving programming problems presented in the form of stories. This resulted in a lack of problem-solving skills among students when it comes to story problems. Additionally, there were issues with instructional media and less interactive teaching methods. The aim of this research is to design multimedia that implements a problem-based learning model to enhance students' problem-solving abilities. The research method used is Research and Development (R&D) with the ADDIE development model. The study involved 36 students from class X-B RPL at SMKN 1 Cimahi. The data obtained are as follows:  1) The development of interactive multimedia achieved an average score of 88. 2) There is an increase in students' problem-solving indicators, with an average pretest score of 40.13 rising to 68.38 in the posttest. Additionally, an N-Gain of 0.47 was obtained, with details as follows: understanding the problem at 0.60, devising a plan at  0.41, carrying out the plan at 0.35, and looking back at 0.34. The overall N-Gain falls within the moderate category. 3) The response to the multimedia is 83, categorized as excellent. The N-Gain results and multimedia assessment indicate that both the multimedia and this research achieved good outcomes.
Prototype of Automatic Door and Fire Alarm System Based on IoT
Authors: Adams Donny , Giap Yo Ceng
Published: May 2024

This research discusses the development of a prototype of an automatic door and fire alarm system based on the Internet of Things (IoT) utilizing IR sensors to detect people, servo motors to automate door opening, flame detectors for fire detection, MQ-2 sensors for smoke detection, and Telegram as a notification medium. The integration of these technologies aims to enhance security and automation in home or office environments. IR sensors are used to detect people approaching the door, while servo motors provide a solution for door automation. Flame detectors and MQ-2 are employed to detect potential fires by issuing early warnings. This system communicates through the Telegram application to notify users. Testing conducted indicates that IR sensors can detect the presence of people up to a distance of 5cm to activate the micro servo opening the door. The flame detector effectively detects fire up to a distance of 30cm, while the MQ-2 sensor detects smoke up to a distance of 20cm; both generate output signals to activate the micro servo, LED, and buzzer for fire alarms, as well as sending notifications via Telegram to the building owner. With this approach, it is hoped to create an effective, efficient, and reliable system to enhance security and response to emergency situations.
Business Model Canvas for Internet of Things Application on Hydroponic in Tangerang
Authors: Wijaya Dellih , Riki Riki , Daniawan Benny , Lorenza Annisa
Published: May 2024

Internet of Thing (IoT) in hydroponics was developed to monitor and control the hydroponic environment for efficiency and effectiveness with maximum results purpose. Many papers expose about IoT application on hydroponic, this article completed it with business model so it will sustain as valuable business especially in Tangerang Banten Indonesia. It is interesting and necessary to analyze the business model, so that this valuable system of the solution can sustain and growth, also proper for the big picture purpose. Of seventeen (17) goals SDGs, hydroponic using IoT application is related to solving point number two (2) about zero hunger and point number thirteen (13) about climate action. This paper uses qualitative descriptive methodology which analyzes and provides points of BMC for IoT application on hydroponic. The result of this paper found that BMC is proper tool to analyze and describe business model for IoT of hydroponic. Then this paper also finds there are several points of revenue streams with some different customer segments, support from hydroponic community, and some collaboration with key partners is needed, which means the business cannot stand alone. This paper has limitations which could be further interesting topics for the next paper.
Google Assistant-Enabled Smart Lock System Using NodeMCU ESP8266 for IoT
Authors: Dwifians Arditya
Published: May 2024

Security is an important aspect that needs to be considered in a smart lock system. Conventional key tools currently have low security levels and are vulnerable to attacks. Therefore, this research aims to design a smart lock security system that utilizes Google Assistant features from Google and the NodeMCU ESP8266 module based on the Internet of Things (IoT). By using Google Assistant, users can control this smart lock with voice commands. The NodeMCU ESP8266 is used as the main controller in this system, responsible for receiving commands from Google Assistant and controlling the smart lock mechanism. A prototype implementation was conducted to test the performance of this smart lock security system. In the testing phase, the system's performance was measured based on voice command responsiveness, response speed, and the security it provides. The test results show that this smart lock security system offers a higher level of security compared to conventional key tools, with a security satisfaction rate of up to 90% among the 10 respondents related to the use of this device. With this research, it is expected to enhance community security by introducing a safer and more reliable smart lock tool based on virtual assistant. This security system, utilizing Google Assistant features and the NodeMCU ESP8266, can provide ease and convenience for users while maintaining optimal security.
Analysis and Design of Breeding Management Information System in Poultry Farms
Authors: Gunawan Alexius Hendra , Kuswanto Verry , Junaedi
Published: May 2024

Breeding management is indispensable in business development in the field of poultry farming where companies are required to keep up with the development of the digitalization era. Companies must be able to take advantage of opportunities in advances in information technology in obtaining accurate, fast and reliable information so that management can make decisions. PT. Peternakan Ayam Manggis has been using manual methods in recording the results of production or the process of breeding chicken farms. in making records using office software, namely excel, so that errors often occur and are often not realtime in making records. Records generated by poultry production include depletion, quarantine, culling, feed and egg production. in processing data generated manually can make it difficult for management to make decisions. The purpose of this research is to design an application that can be used by companies to obtain information during the breeding process.The research method in developing this application uses waterfall and design role analysis with data collection and using UML modeling. This information system application produces information about Breeding management including depletion, quarantine, feed, egg production, movement of chickens from one cage to another, culling. this information system application uses a database and application blackbox testing is carried out so that the application runs as needed.
Development of an Irradiation/Shielding Cavity for In Vivo Neutron Activation Analysis of Manganese in Human Bone
Authors: Pejović-Milić Ana , Byun Soo Hyun , Chettle David R. , E. McNeill Fiona , Prestwich William V
Published: May 2024

Manganese is essential to human life for normal neurological and skeletal functions. Longstanding, excessive exposure to Mn compounds may result in manganism, a Parkinson's disease like syndrome. Prolonged exposure to Mn at low levels can result in memory deficit, loss of motor control and reduction in the refinement of certain bodily motions. A feasibility study of measuring Mn concentrations in human bone with in vivo neutron activation analysis (IVNAA) was previously reported.1 Since then, an irradiation/shielding cavity, consisting of moderator, gamma-ray filter, neutron reflector, and shield walls, was constructed for the clinical application of Mn IVNAA,2 and an upgraded IVNAA system is reported here. The minimum detectable limit is 0.081 mg in the hand, which is toward the lower end of the estimated bone Mn level of 0.065 to 1 mg in the hand of healthy subjects. A significantly lower radiation dose is delivered than in the reported feasibility study.
Improvement of in vivo Neutron Activation Analysis of Mn using a 4p NaI(Tl) detector array
Authors: Byun Soo Hyun , Pejović-Milić Ana , Prestwich William V. , R. Chettle David , E. McNeill Fiona
Published: May 2024

Manganese contents in hand phantoms were analyzed by in vivo neutron activation analysis using a 4p NaI(Tl) detector array. Solution-type phantoms with varying amount of Mn and fixed amounts of physiological normal elements (Na, Cl, Ca) were prepared in a cylindrical shape to simulate fisted hands and were irradiated with the 7Li(p,n) neutron beam. The proton energy and polyethlyene cavity were set at optimized conditions established before. The g-ray spectra were accumulated under the anticoincidence mode. The calibration was done both for the 847 keV full-energy peak area and for the total area of 56Mn, which is defined as the total number of counts anywhere in the g-ray spectrum from 56Mn. From the analysis of the 847 keV peak, the Mn detection limit has been improved by a factor of 1.6 compared to the previous feasibility test thanks to a significant gain in the g-ray detection efficiency. Further improvement by a factor of 1.2 was identified when the total area of 56Mn was used for the calibration. The final sensitivity and detection limit for a 20 mSv hand dose reached 12,050 counts/mg Mn, and 86 mg, respectively. The overall improvement achieved in this study will be a considerable contribution toward realization of the clinical application.
Evaluation of Geometries Appropriate for I-125 in vivo bone strontium X-ray Fluorescence Measurement
Authors: Zamburlini Mariangela , Pejović-Milić Ana , R. Chettle David
Published: May 2024

In this study, we present a significant improvement in the minimum detection limit (MDL) for strontium measurement in bone with X-ray fluorescence using 125I as the excitation source. The improvement was achieved thanks to a new collimator in the 90 degree geometry and a different source positioning in the 180 degree geometry. The achieved MDL in the 90 degree geometry is 0.0426±0.0006 mg Sr/g Ca, which is 5.5 times better than the one previously reported. In the 180 degree geometry, the new source positioning improved the MDL from 0.118±0.004 to 0.0446±0.0009 mg Sr/g Ca.
Evaluation of MCNP5 and EGS4 for the simulation of in-vivo strontium XRF measurements
Authors: Zamburlini Mariangela , Byun Soo Hyun , Pejović-Milić Ana , Prestwich William V. , R. Chettle David
Published: May 2024

In order to optimize x-ray fluorescence (XRF) experiments, Monte Carlo (MC) simulations provide a valuable tool that allows different system setups and experimental conditions to be explored in a controlled way. Electron gamma shower (EGS4) and Monte Carlo N-Particle5 (MCNP5) are two widely used MC programs that simulate the photon and electron transport in great detail and allow for the simulation of an arbitrary experimental geometry. Tested in 2001 by Al-Ghorabie et al.,1 earlier versions of these programs failed in reproducing the outcome of a platinum XRF in vivo measurement. The authors found that the discrepancy between measured and simulated results could be attributed to the free electron approximation made by the programs in simulating the Compton scattering. More recent versions of EGS4 and MCNP have updated their treatment for photon transport at low energies and have included Doppler broadening in the Compton profile. In this study we test the capability of these new versions of EGS4 and MCNP in reproducing the outcome of an in vivo strontium XRF measurement. Copyright © 2007 John Wiley & Sons, Ltd.
The use of teeth as the site for the in vivo or ex vivo quantification of skeletal strontium by energy-dispersive X-ray fluorescence spectrometry: A feasibility study
Authors: Silva Eric Da , Pejović-Milić Ana , Heyd Darrick V
Published: May 2024

The use of an energy-dispersive X-ray fluorescence spectrometry (EDXRF) system equipped with an 125I source was validated for in vivo and ex vivo quantification of strontium in human teeth. The mean concentration of enamel strontium for an area with a high influx of immigration (Toronto, Ontario, Canada) is also reported. It was found that the mass attenuation of the strontium and calcium X-rays allows for a probing depth of 1.8 mm (Sr Kα) allowing the front central incisors to act as the site for the in vivo or ex vivo quantification of strontium as well as for molars to be used ex vivo for the quantification of enamel strontium. The calcium signal for all teeth studied (n = 42) was found to have a relative standard deviation of 5.7% which allowed for successful normalization of the strontium signal to that of calcium. Validation of the EDXRF method was performed on human molars (enamel thickness of (1.9 ± 0.7) mm, p < 0.05), by graphite furnace atomic absorption spectrometry (GFAAS). The EDXRF method was found to produce equivalent strontium determinations to that of GFAAS (p < 0.05). Our results also demonstrate that for a sample from a large metropolitan area, the fresh enamel strontium concentrations range from 42–301 ppm with a mean strontium concentration of (169 ± 80) ppm (p < 0.05).
In vivo Measurement of Bone Aluminum in Population Living in Southern Ontario, Canada
Authors: Davis K. , Aslam  , Pejović-Milić Ana , R. Chettle David
Published: May 2024

The harmful biological effect of excessive aluminum (Al) load in humans has been well documented in the literature. Al stored in bone, for instance due to dialysis treatment or occupational exposure, can interfere with normal bone remodeling leading to osteodystrophy, osteoarthritis, or osteomalacia. On the other hand, the relationship between chronic Al exposure and the risk of Alzheimer's disease remains controversial. In this work, the feasibility of in vivo neutron activation analysis (IVNAA) for measuring Al levels in the human hand bone, using the thermal neutron capture reaction 27Al(n, gamma)28 Al, is reported. This noninvasive diagnostic technique employs a high beam current Tandetron accelerator based neutron source, an irradiation/shielding cavity, a 47pi NaI(Tl) detector system, and a new set of hand bone phantoms. The photon spectra of the irradiated phantom closely resemble those collected from the hands of nonexposed healthy subjects. A protocol was developed using the newly developed hand phantoms, which resulted in a minimum detectable limit (MDL) of 0.29 mg Al in the human hand. Using the ratio of Al to Ca as an index of Al levels per unit bone mass, the MDL was determined as 19.5 +/- 1.5 microg Al/g Ca, which is within the range of the measured levels of 20-27 microg Al/g Ca [ICRP Report of the Task Group on Reference Man, Publication 23 (Pergamon, Oxford, 1975)] found in other in vivo and in vitro studies. Following the feasibility studies conducted with phantoms, the diagnostic technique was used to measure Al levels in the hand bones of 20 healthy human subjects. The mean hand bone Al concentration was determined as 27.1 +/- 16.1 (+/-1 SD) microg Al/g Ca. The average standard error (1sigma) in the Al/Ca is 14.0 microg Al/g Ca, which corresponds to an average relative error of 50% in the measured levels of Al/Ca. These results were achieved with a dose equivalent of 17.6 mSv to a hand and an effective dose of 14.4 microSv. This effective dose is approximately half of that received in a chest radiograph examination. It is recommended to investigate the use of the bone Al IVNAA diagnostic technique for in vivo measurements of patients with documented overload of Al in bone.
Bone manganese as a biomarker of manganese exposure: A feasibility study
Authors: Pejović-Milić Ana , Aslam  , R. Chettle David , Oudyk John , Pysklywec Michael W , Haines Ted
Published: May 2024

Background: There is a need for a diagnostic tool with the ability to measure cumulative exposure to manganese (Mn) in the workplace. Measuring bone Mn levels with in vivo neutron activation analysis (IVNAA) could serve as a biomarker of past exposure. Bone Mn levels of welders were measured and compared to the levels found in subjects without exposure to the element.

Method: Forty subjects (30 welders and 10 controls) were recruited. An occupational history was obtained and subjects underwent IVNAA bone Mn measurements.

Results: The mean bone Mn levels were (2.9 +/- 0.4) and (0.1 +/- 0.7) microg Mn/g Ca for welders and controls, respectively (P < 0.05).

Conclusions: This project, the first of its kind, reports differences in bone Mn between Mn-exposed welders and non-occupationally exposed subjects. It appears that bone Mn levels do reflect differences in the occupational exposure of welders.
Blood lead levels and cumulative blood lead index (CBLI) as predictors of late neurodevelopment in lead poisoned children
Authors: Nie Linda H , Wright Robert O. , Bellinger David C. , Hussain Javed , Amarasiriwardena Chitra , R. Chettle David , Pejović-Milić Ana , Woolf Alan , Shannon Michael
Published: May 2024

Objective: To find the best lead exposure assessment marker for children.

Methods: We recruited 11 children, calculated a cumulative blood lead index (CBLI) for the children, measured their concurrent BLL, assessed their development, and measured their bone lead level.

Results: Nine of 11 children had clinically significant neurodevelopment problems. CBLI and current blood lead level, but not the peak lead level, were significantly or marginally negatively associated with the full-scale IQ score.

Conclusion: Lead exposure at younger age significantly impacts a child's later neurodevelopment. CBLI may be a better predictor of neurodevelopment than are current or peak blood lead levels.
Accumulation of Bone Strontium Measured by In Vivo XRF in Rats Supplemented with Strontium Citrate and Strontium Ranelate
Authors: Wohl Gregory R. , Chettle David R. , Pejović-Milić Ana , Druchok Cheryl , Webber Colin E , Adachi Jonathan D. , Beattie Karen A.
Published: May 2024

Strontium ranelate is an approved pharmacotherapy for osteoporosis in Europe and Australia, but not in Canada or the United States. Strontium citrate, an alternative strontium salt, however, is available for purchase over-the-counter as a nutritional supplement. The effects of strontium citrate on bone are largely unknown. The study's objectives were 1) to quantify bone strontium accumulation in female Sprague Dawley rats administered strontium citrate (N=7) and compare these levels to rats administered strontium ranelate (N=6) and vehicle (N=6) over 8 weeks, and 2) to verify an in vivo X-ray fluorescence spectroscopy (XRF) system for measurement of bone strontium in the rat. Daily doses of strontium citrate and strontium ranelate were determined with the intention to achieve equivalent amounts of elemental strontium. However, post-hoc analyses of each strontium compound conducted using energy dispersive spectrometry microanalysis revealed a higher elemental strontium concentration in strontium citrate than strontium ranelate. Bone strontium levels were measured at baseline and 8 weeks follow-up using a unique in vivo XRF technique previously used in humans. XRF measurements were validated against ex vivo measurements of bone strontium using inductively coupled plasma mass spectrometry. Weight gain in rats in all three groups was equivalent over the study duration. A two-way ANOVA was conducted to compare bone strontium levels amongst the three groups. Bone strontium levels in rats administered strontium citrate were significantly greater (p<0.05) than rats administered strontium ranelate and vehicle. ANCOVA analyses were performed with Sr dose as a covariate to account for differences in strontium dosing. The ANCOVA revealed differences in bone strontium levels between the strontium groups were not significant, but that bone strontium levels were still very significantly greater than vehicle.
The quantification of total lead in lipstick specimens by total reflection X-ray fluorescence spectrometry
Authors: DaSilva Eric , Matthews David Alison , Pejović-Milić Ana
Published: May 2024

Lipstick is known to contain lead, and this has been a general area of concern. Methods of quantifying lead in lipstick currently require the use of rather harsh digestion procedures given that lipstick specimens are high in their lipid content and contain many refractory materials. A simple method of performing lead analysis in lipstick specimens based on total reflection X-ray fluorescence spectrometry (TXRF) is presented here. Samples were prepared by melting lipstick specimens along with a non-ionic surfactant and an yttrium internal standard followed by homogenization. Solid prepared samples were then finely streaked directly onto a quartz reflector, and TXRF measurements made for 900-s live time. The method was found to produce a mean limit of detection for lead of 0.04μg/g. Precisions were found to be on the order of 11–38% relative standard deviation (RSD) and apparent recoveries for lead between 92% and 106% (n = 8). Although the spreading technique may result in thickness variations that may contribute to the higher than expected variances about the determined lead concentrations, the method presented in this work does show promise as a means of performing routine lead analysis in lipstick specimens without the need for harsh digestion procedures.
Feasibility of measuring arsenic and selenium in human skin using in vivo X-Ray Fluorescence (XRF) – a comparison of methods
Authors: Shehab H , Desouza E , O'Meara J , Pejović-Milić Ana , R. Chettle David , Fleming David E. B. , E. McNeill Fiona
Published: May 2024

In recent years, in vivo measurement systems of arsenic in skin by K-shell x-ray fluorescence (XRF) have been developed, including one which was applied in a pilot study of human subjects. Improved tube-based approaches suggest the method can be further exploited for in vivo studies. Recently, it has been suggested that selenium deficiency is correlated with arsenic toxicity. A non-invasive measurement of both elements could therefore be of potential interest. The main aim of this current study was to evaluate and compare the performance of an upgraded portable XRF system and an advanced version of the benchtop XRF system for both selenium and arsenic. This evaluation was performed in terms of arsenic and selenium Kα detection limits for a 4W gold anode Olympus InnovX Delta portable analyzer (40 kVp) in polyester resin skin-mimicking phantoms. Unlike the polychromatic source earlier reported in the literature, the benchtop tube-based technique involves monochromatic excitation (25 W silver anode, manufactured by x-ray optics, XOS) and a higher throughput detector type. Use of a single exciting energy allows for a lower in vivo dose delivered and superior signal-noise ratio. For the portable XRF method, arsenic and selenium minimum detection limits (MDLs) of 0.59 ± 0.03 ppm and 0.75 ± 0.02 ppm respectively were found for 1 min measurement times. The MDLs for arsenic and selenium using the benchtop system were found to be 0.35 ± 0.01 ppm and 0.670 ± 0.004 ppm respectively for 30 min measurement times. In terms of a figure of merit (FOM), allowing for dose as well as MDL, the benchtop system was found to be superior for arsenic and the two systems were equivalent, within error, for selenium. We shall discuss the performance and possible improvements of each system, their ease of use and potential for field application.
The preparation of strontium-substituted hydroxyapatite bone phantoms with high strontium concentrations
Authors: Silva Eric Da , Heyd Darrick V , Rizvi Bisma , Pejović-Milić Ana
Published: May 2024

The current in vivo x-ray fluorescence spectrometry (IVXRF)-based method of bone strontium quantification is dependent on calibration against plaster of Paris (poP; CaSO4⋅12H2O) calibrators/phantoms. Issues with the dissimilarity of the poP in comparison to bone mineral and the known issue with high levels of strontium contamination in commercial poP materials has led to the development of a strontium-free hydroxyapatite bone mineral phantom material. The analyte is introduced into this material by doping of a high concentration HPO42− setting solution. This phantom material is not particularly well suited for the preparation of strontium containing bone phantoms which are high in strontium concentration (in the mol % concentration range) and thus when the (Ca + Sr)/P mole ratio is to be kept at 1.67: that of hydroxyapatite. This work thus evaluates the feasibility of preparing high concentration strontium-substituted hydroxyapatite phantoms using a CaHPO4 · 2H2O/Ca(OH)2/Sr(OH)2 · 8H2O cement mixture. It was found that a strontium-substituted HAp phantom material can be prepared by mixing suitable quantities of CaHPO4 · 2H2O, Ca(OH)2 and Sr(OH)2 · 8H2O to a (Ca + Sr)/P mole ratio of 1.67. Setting of the phantom using a 1 M HPO42− setting solution (to increase phosphate concentration) produced a phantom composed of (Ca1−𝑥Sr𝑥)5(PO4)3OH of known strontium concentration. The final phantom material was found to be a strontium-substituted product (through x-ray diffraction and Raman spectroscopy measurements) to the degree of substitution expected. This work thus describes the preparation of a bone phantom material which can be used for the calibration of IVXRF systems of bone strontium quantification, as well as for other modalities (i.e. dual energy x-ray absorptiometry and quantitative ultrasound) in the case that bone strontium concentrations are expected to be high such as in the case of individuals taking strontium salts for the treatment/prevention of osteoporosis.

 