医科达Versa HD直线加速器Agility治疗机头光学系统故障维修2例

简要介绍了医科达Versa HD直线加速器Agility治疗机头光学系统的工作原理,分析了该系统在日常使用中出现的2例故障的原因并给出了故障排除方法,为临床工程师排除类似故障提供了参考。

医科达加速器多叶光栏Agility与MLCi2在调强放射治疗计划中的剂量学比较

目的探究医科达Agility多叶准直器直线加速器在调强放射治疗计划中的剂量学优势。方法选择采用Monaco系统的30例肿瘤患者,其中男性14例,女性16例;年龄44~69岁,平均年龄58岁;肿瘤类型,头部肿瘤5例,颈部肿瘤5例,胸部肿瘤5例,乳腺癌5例,腹部肿瘤5例,盆腔肿瘤5例。先用MLCi2多叶准直器进行放射治疗设计(MLCi2 MLC计划)。不改变计划,再用Agility多叶准直器进行放射治疗设计(Agility MLC计划)。加速器升级成Agility多叶准直器前后调强放射治疗计划的适形度指数、均匀性指数及各类危及器官剂量的差异性进行比较。结果不同放射治疗设计下,30例癌症患者计划靶区的均匀性指数(0.13±0.07 vs 0.10±0.05)和适形度指数(0.73±0.17 vs 0.75±0.13),腹部肿瘤患者计划靶区的均匀性指数(0.12±0.09 vs 0.09±0.03)和适形度指数(0.78±0.05 vs 0.81±0.06),以及肺(V20)[(23.53±11.80)cm^(3)vs(20.85±9.23)cm^(3)]、小肠(D_(max))[(5344.67±407.89)cGy vs(5244.76±361.13)cGy]、腮腺(V_(50))[(18.34±7.72)cm^(3)vs(12.23±10.27)cm^(3)]重要危及器官差异具有统计学意义(P<0.05)。Agility多叶准直器会产生大量的孤岛野,孤岛野达到总射野数的50.0%、52.3%、55.6%,孤岛野会大幅度提高双靶区患者的靶区适形度和均匀性。结论Agility多叶准直器对肿瘤的调强放射治疗计划的靶区均匀性和危及器官的保护限制均具有优势,尤其针对腹部肿瘤和双靶区患者。

Canadian Agility and Movement Skill Assessment(CAMSA):Validity, objectivity, and reliability evidence for children 8–12 years of age

Purpose: The primary aim of this study was to develop an assessment of the fundamental, combined, and complex movement skills required to support childhood physical literacy. The secondary aim was to establish the feasibility, objectivity, and reliability evidence for the assessment.Methods: An expert advisory group recommended a course format for the assessment that would require children to complete a series of dynamic movement skills. Criterion-referenced skill performance and completion time were the recommended forms of evaluation. Children, 8–12 years of age, self-reported their age and gender and then completed the study assessments while attending local schools or day camps. Face validity was previously established through a Delphi expert(n = 19, 21% female) review process. Convergent validity was evaluated by age and gender associations with assessment performance. Inter-and intra-rater(n = 53, 34% female) objectivity and test–retest(n = 60, 47% female) reliability were assessed through repeated test administration.Results: Median total score was 21 of 28 points(range 5–28). Median completion time was 17 s. Total scores were feasible for all 995 children who self-reported age and gender. Total score did not differ between inside and outside environments(95% confidence interval(CI) of difference:-0.7 to 0.6;p = 0.91) or with/without footwear(95%CI of difference:-2.5 to 1.9; p = 0.77). Older age(p < 0.001, η2= 0.15) and male gender(p < 0.001, η2= 0.02)were associated with a higher total score. Inter-rater objectivity evidence was excellent(intraclass correlation coefficient(ICC) = 0.99) for completion time and substantial for skill score(ICC = 0.69) for 104 attempts by 53 children(34% female). Intra-rater objectivity was moderate(ICC = 0.52) for skill score and excellent for completion time(ICC = 0.99). Reliability was excellent for completion time over a short(2–4 days; ICC = 0.84) or long(8–14days; ICC = 0.82) interval. Skill score reliability was moderate(ICC = 0.46) over a short interval, and substantial(ICC = 0.74) over a long interval.Conclusion: The Canadian Agility and Movement Skill Assessment is a feasible measure of selected fundamental, complex and combined movement skills, which are an important building block for childhood physical literacy. Moderate-to-excellent objectivity was demonstrated for children 8–12 years of age. Test–retest reliability has been established over an interval of at least 1 week. The time and skill scores can be accurately estimated by 1 trained examiner.

The acute effects of vibration stimulus following FIFA 11+ on agility and reactive strength in collegiate soccer players

Purpose： The aim of this study was to assess the effects of combining the FIFA 11＋ and acute vibration training on reactive strength index （RSI） and 505 agility. Methods： Seventy-four male collegiate soccer players took part in the study and were randomly assigned to FIFA 11＋ with acute vibration group （FIFA ＋ WBV）, FIFA 11＋ with isometric squat group （FIFA ＋ IS） or a control group consisting of the F1FA 11＋ alone （Con）. The warm-up consisted of the FIFA 11＋ and was administered to all participants. The participants in the acute vibration group were exposed to 30 s whole body vibration in squat position immediately post warm-up. The isometric group completed an isometric squat for 30 s immediately post warm-up. Results： RSI significantly improved pre- to post-intervention amongst FIFA ＋ WBV （p 〈 0.001） due to a decrease in contact time （p 〈 0.001） in comparison to FIFA ＋ IS and Con, but 505 agility was not affected. Conclusion： The results of this study suggest the inclusion of an acute bout of WBV post FIFA 11＋ warm-up produces a neuromuscular response leading to an improvement in RSI. Future research is required to examine the exact mechanisms behind these improvements amongst other populations and over time course of the performance.

METHOD OF EVALUATING AIRCRAFT TORSIONAL AGILITY METRIC USING PILOT TRANSFER FUNCTION MODEL

The purpose of this paper is to calculate the torsional agility metric,the time-to-roll and capture a 90° bank angle change,using a simple pilot mathematical model obtained from simulator test. The metric mentioned above is determined by the aircraft maneuverability and controllability,or the pilot ability to roll and capture quickly and accurately a bank angle. Therefore, the time-to-roll and capture a 90° bank angle change can be obtained by calculating the open loop process with limited maximum stick denflect velocity and the man-machine closed loop precise tracking control. Results show that the calculated values are quite consistent with the manned simulation data. The dteterioration of torsional agility while the aircraft is poor or very maneuverable can be explained. It is suggested that this approach could provide the basis for the approxi mate evaluation of aircraft torsional agility metric.

Developing Agility from a Structured Perspective

Modeling plays an important role in understanding and implementation of manufacturing system under changing competitive environment. Agile manuincturing is a new pattern of production. It is the issue to identify, analyze and evaluate agility for involved people, information,process and organization. There is no commonly accepted analytical structure. The essence of agility is investigated and a model to develop agility is elucidated.

Agility evaluation in public sector

Agility metrics are difficult to define in general, mainly due to the multidimensionality and vagueness of the concept of agility itself. In this paper, a knowledge-based framework is utilized for the measurement and assessment of public sector＇s agility by A. T. Kearney model. In this research, the authors used Z2 test in SPSS software. So, the authors discovered that the General Office of Standards ＆ Industrial Research of Sistan ＆ Baluchestan Province in Iran is agile. Finally, the authors determine the weakness points of organization by Friedman test.

The Role of Agility in the Effect of Trust in Supply Chain on Firm Performance

Emerging technologies and innovative developments cause the supply chain management to change dramatically. Therefore the subjects regarding trust have become important. Trust established in Supply Chain causes effective relationships among definitive numbers of suppliers in the long-run. The effect of trust in supply chain on firm performance and the contribution of agility to this relation have been supported in the literature. In this research, the role of agility in the effect of trust in supply chain on firm performance will be investigated. According to the results of hypotheses tests, there are positive and significant relations between supply management integration and trust in supply chain, between trust in supply chain and supply chain agility, and between supply chain agility and firm performance.

A Framework to Support Agility Strategy Formulation

In the last decade, turbulent times and uncertainti es in the business environment have made ground for a new business era, and "chang e" has become a major characteristic of the new era. This has resulted in tirele ss evolution of business systems and the creation of new manufacturing and manag ement philosophies. Agile Manufacturing (AM) is a step forward in generation of new means for better performance and success of business, and in practice is a s trategic approach to manufacturing by considering the new conditions of the business environment. This paper discusses the concepts and development of a met hodology to achieve agility in manufacturing organisations. Following an introdu ction of the subject of agility, a discussion of the methodology and practical t ools to support the implementation of the methodology, including metrics for the assessment of agility drivers, capability and performance are given. Aspects of the tools are tested in an aerospace company.

On the Marketing Mode of Agility in the Marketing Management of Enterprises

Enterprise competition tends to be a topic of much significance in society with gradual development, especially when there exist hundreds and thousands of production and business activities of the establishment in current world. The enterprise must attach much importance to market so as to be in superiority and satisfy the needs of the broad masses of customers. This thesis shall propose the marketing mode of agility in marketing for many establishments hence the increase in competitiveness of enterprises and existence in the whole society.

Agility Evaluation of Mass Customization Product Manufacturing

Mass Customization (MC) is one of the importance en te rprise produces modes in information age progressively. Mass Customization produ ct manufacturing is aimed at the objection of agile responding to customer deman d, market changing and market opportunities to combine with modern management te chnology and advanced manufacture technology, and to use the development model o f design for product family and technology concurrent. Therefore, in the environ ment of market continuing to change with a high speed, MC enterprise is required to raise its ability of controlling future market by improving its "agility of product manufacturing". So it is necessary to research about the question of agi lity evaluation of MC product manufacturing. Base on the characteristics of the Mass Customization (MC) product manufacturing and the requirement of the agile m anufacturing, this paper establish an MC product manufacturing Agility evaluatio n index system through studying MC enterprise’s organization management agility evaluation and MC products design agility evaluation and MC manufacture agility evaluation. Also, with Xi Dian Casting limited company as an example, the multi -grade fuzzy assessment method is used to evaluate its agility.

AGILITY INDEXES AND APPLICATION OF PRODUCTION PLANNING

The agility of production planning is defined as two characters： synchronization and flexibility. Measurement indexes for evaluating agility are then divided into two dimensions separately. Synchronization includes two horizontal indexes： order lead time ratio and demand fulfilling rate; Two vertical indexes： instruction-reaction cycle time and resource matching rate. Flexibility includes five indexes： scope flexibility, delivery flexibility, variety flexibility, capacity buffer, inventory buffer and modification flexibility. Quantitative formulas for each measurement index are constructed. One application is discussed to illustrate the feasibility and reasonability of the indexes.

Agility光栅系统在眼眶淋巴瘤放疗剂量学研究

目的眼眶淋巴瘤靶区空间位置比较特殊,提高眼眶淋巴瘤计划的质量,保护眼睛是医生和物理师关注的焦点。本研究旨在探讨Agility光栅系统在眼眶淋巴瘤中的剂量学特点。方法选取2016-05-01-2018-05-30上海交通大学医学院附属第九人民医院放疗的10例眼眶淋巴瘤患者,选用monaco计划系统进行计算,光栅数据分别选择Mlci2和Agility,照射方式采用动态调强。计算时,固定其他组织的限量,仅改变患者患侧晶体的限量,限量范围从4～20Gy进行变化,函数采用Serial,每次变化为2Gy,根据计算结果,分别对眼睛整体、晶体、视神经、靶区的适形性指数(conformal index,CI)、均匀性指数(homogeneity idex,HI)以及计划跳数进行统计分析。结果随着患侧晶体限量增加,在CI、HI、患侧视神经、患侧晶体平均量、患侧眼睛平均量、计划跳数参数上,Agility更具优势,CI差别率从27.12%降到5.11%,HI差别率从11.52%降到1.57%,下降趋势逐渐变缓,差异有统计学意义,P<0.01;患侧视神经差别率从11.99%下降到1.53%,差异有统计学意义,P<0.01;患侧晶体平均值差别率从20.59%下降到3.55%,差异有统计学意义,P<0.01;患侧眼睛平均值在晶体限量低于10Gy时,差异有统计学意义,P<0.05;高于14Gy,差异无统计学意义。对侧晶体的计算结果,Mlci2更具优势。结论眼眶淋巴瘤放疗时,Agility光栅的计算结果比Mlci2光栅更具有剂量学优势,眼眶淋巴瘤的放疗应采用Agility光栅。

MASLD管理中无创检测替代肝活检添新证据:突破还是挑战?

代谢相关脂肪性肝病(MASLD)与肥胖、代谢综合征、2型糖尿病密切相关。随着全球肥胖和糖尿病的流行,MASLD疾病负担日益加重。肝活检一直被视为诊断MASLD和评估肝病严重程度的“金标准”,但侵入性和局限性限制其在临床应用。血清生物标志物、影像学技术等无创检测方法在评估MASLD纤维化方面显示巨大潜力。其中,结合了振动控制瞬时弹性成像(VCTE)与常规生物标志物的Agile评分系统,能够识别MASLD相关进展性纤维化和肝硬化,并预测MASLD患者肝脏相关事件,为临床监测肝病进展提供新的标志物。尽管这些无创方法同样存在一些局限性,但它们为MASLD的诊断和管理提供了新工具,未来的研究和技术创新有望进一步完善这些方法,从而为患者提供更准确、更安全的诊疗方案。

数字化转型赋能乡村教师专业发展:现实阻力与实践路向——基于“AGIL”模型视角的分析

乡村教师是乡村教育振兴的关键力量。教育数字化转型赋予乡村教师专业发展全新内涵和有利契机,同时对建设高质量乡村教师队伍提出更迫切要求。为进一步强化数字化转型赋能乡村教师专业发展效果,推动乡村教育数字化体系实现高效和标准化发展,运用帕森斯AGIL模型解析数字化转型赋能乡村教师专业发展实践的现实阻力,发现存在内生发展动力不足,数字行动进展迟缓;研修培训存在偏差,教师角色难以转变;共建主体参与有限,支持体系保障乏力;数字价值认同缺失,数字责任有待强化等困境。基于AGIL模型的乡村教师专业发展实践路向包括激活专业发展自觉,确保数字行动落地;创新教师培育方式,明确数字行动策略;释放主体支持活力,畅通资源支持体系;形塑数字价值认同,践行数字社会责任。

AGIL模型视域下普通高中学生发展指导的现实困境与应对之策

学生发展指导是促进学生全面和终身发展的重要举措,是现代学校教育的重要职能之一。高中阶段更加关注学生的差异性、选择性的指导,强调学生的体验性、动态性的指导,凸显自主性、系统性的指导。运用帕森斯AGIL模型理论,从“系统-功能”的视角分析学生发展指导面临的现实困境:学生发展指导制度需进一步完善,学生发展指导的系统适应功能较弱;学生发展指导师资的专业性有待提升,目标达成功能部分受限;内容体系和组织机构需进一步整合,系统功能优势发挥不足;评估系统需进一步健全,模式维持功能动力不强等。AGIL模型视域下普通高中学生发展指导可从制度建设增强系统功能适应性、师资培养维护系统专业供给目标的达成、资源整合发挥指导职能优势、健全评估系统维护系统模式有效运行等路径实现学生发展指导系统功能优化。

基于AGIL模型的地方人大立法辩论研究——以浙江丽水市人大为例

本文以浙江丽水市人大2016年和2018年开展的两次立法辩论为研究对象,以实地调研和访谈方式获得的一手资料为基础,运用AGIL模型的分析框架,从系统适应功能、目标达成功能、系统整合功能和模式维持功能对丽水市人大立法辩论的生长逻辑与困局进行研究,剖析了立法辩论在实践中存在的资源依赖、目标偏差、程序模糊以及公众参与意识和能力不强等问题,由此提出了扩充人大立法资源、坚持民主与效率相融合、构建规范化的立法辩论程序和培育公众立法参与能力等推动立法辩论发展的进路,为促进立法科学化与民主化提供更多的经验支持。

基于AGIL模型的高职院校劳动教育实施策略分析

劳动教育是提高国民素质和促进经济发展的重要手段,也是传承和发展劳动文化的重要途径。基于帕森斯AGIL模型,探讨高职院校劳动教育的适配性,针对劳动教育的适应、目标达成、整合和维持模式功能,分析其在高职院校中的问题,并提出顶层设计更新、育人机制构建、资源整合优化和文化推动激励等策略,以促进学生全面发展和适应劳动市场需求。