Moumita Mukherjee, Author at Adamas University

Medical Physics and Instrumentation: A Prospective Field for Job-Oriented Study

nCOVID-19 and Healthcare Technology

Since its first perceives in 1960s, enormous types of Corona virus are available in nature and in 2002 we witnessed the severity of Severe Acute Respiratory Syndrome CoV (SARS-CoV) that executed from southern China and affected world population severely. Later it tainted the Middle East areas as the Middle East Respiratory Syndrome CoV (MERS-CoV) that caused thousand people to die with an outstandingly high mortality rate of ~ 35%. In December 2019, it has returned in Wuhan, China, in mutated form of Novel Corona Virus and has spread over 180 countries and affected more than three million of world population till date with killing nearly three lakhs of people (Source: World Health Organization 2020) until this point of time. World Health Organization has declared this as ‘pandemic’ by the middle of March – 2020. The severity of the disease is increasing daily and the whole world is effectively under lockdown situation. To battle with this scenario, physicians are in frontiers and trying to provide their best to cure the diseased population. At one part the situation demands involvement of more doctors and healthcare person to combat with this unprecedented scenario, on the other hand, huge technological and scientific supports are required parallel for providing a curative measures. These include production of medicated masks, low cost ventilators, sanitizers, rapid diagnostic kits, life support equipment, medicines & more importantly vaccine.

The demand for medical physicists starts from here and as per the global scenario, within the next few years an estimated two crore job openings is expected, especially in the present era of COVID-19 healthcare and cancer treatment, particularly in coming technology of proton therapy.

Importance of Medical Physics & Instrumentation

Medical Physics is a unique combination of Physics and Medicine; on more specific language, this is the application of Physics in Medicine and this subject can be considered as a lifeline to the human population when it comes to the diagnosis and treatment of several diseases. It’s important to understand that a Bio-Medical Scientist/Physicist has a very different role to a physician, but still one could be able to make a significant difference to the patients’ lives and that would be a big motivator for the person in this field. However, the Medical physicist/ Biomedical instrumentation job itself doesn’t involve as much day-to-day contact with patients, they aren’t laboratory-bound people. However, in hospital or research center, bio-medical physicists are at the forefront of patient care, and helping to save lives by ensuring the maintenance of high-tech sophisticated equipment used for the diagnosis & treatment of patients; actively contributing to the R&D of cutting-edge medical equipment development, innovation in treatment and medical procedures, that is incredibly rewarding and challenging as well.

Skills Required for the Profession in Medical Physicist & Bio-Instrumentalist job

If someone has passion and fascination to work with some of the world’s most advanced & sophisticated machinery, who are interested to serve the mankind through their innovation, this is where one can really put the concept of Physics expertise to the test. The subject is multi-disciplinary in true sense, depending on the area of expertise, one can design specialized technology in radio-therapy for cancer treatment, may work with optical & laser technology to make surgery non-invasive as much as possible, may explore possibilities for the betterment of imaging modalities to detect disease at early stage, can do work in the field of prosthetics, implants and AI enabled Bio-telemetry, or even in developing image-guided surgery to treat disease and diagnose illnesses in patients.

Simply the technical know-how will not be enough when it comes to a career in bio-medical physics & instrumentation. Persons who are supposed to be in this field, have to work closely with healthcare professionals including doctors, radiologists on a daily basis, thus interpersonal and communication skills are vital and being able to demonstrate good leadership abilities. In nutshell following are the skills one need to have:

a strong interest in the integration of medicine and applied physics (i.e. engineering)
excellent communication skills in order to liaise with a variety of people
spatial awareness, 3D conceptual ability and knowledge in computer handling (particularly for design engineers)
the capacity to combine a high degree of technical knowledge with creativity
the skill to design new products, efficient and practical, also cost effective and aesthetically attracting.
Knowledge of market to estimate a product’s marketability
Good problem-solving skills and the ability to work under pressure.

Pre-Requisite Qualification

The prospective students who have got an undergraduate degree / are in the process of getting one, in the fields of physics, applied science, chemistry, life-science, pharmacy, engineering, or applied mathematics, are the ideal for enrolling in this medical physics & instrumentation post-graduate degree program. The program is conducted in collaboration with hospital / ISO certified diagnostic centres for the medical equipment / machinery training. To get excellence in this profession they must know a fair amount of physics, chemistry, biology, technology, medicine and engineering.

Course Contents:

Apart from the basic knowledge of Anotomy, Physiology, Physical and Chemical sciences, the postgraduate program in Medical Physics & Instrumentation covers the following important core topics:

Radiotherapy Equipment (treatment and imaging) and Quality Assurance
Dosimetry
Radiation Safety Measures
Clinical and OT instruments
Medical imaging
Artificial Intelligence and Data Science
IoHT and Bio-telemetry
Bio-Medical sensors, Laser and MEMS/ NEMS
Spectroscopy and imaging
Bio-informatics
Tissue Engineering

And many more…

Job-Scenario

As per the recent study, presently in developed counties 15-20 numbers of Medical Physicists are available and the number falls to 1-5 per million, in developing countries – this indicates the void of such specialised manpower in world scenario. Now-a-days Government has taken initiative to appoint at least one Medical Physicist in each hospitals/ healthcare sectors for the smooth running of multispecialty hospitals, high-tech equipment. Job opening is also there in teaching/research/health administration. A job in Medical Physics & Instrumentation means applying Physics & Engineering principles and techniques to the medical field. A successful career uses the skills of engineering to improve healthcare diagnosis and treatment. The field can be thought of as chemical, electrical, optics and optical, and/or mechanical engineering depending on the application. There are many jobs in Radiation Safety Officer, Bio-instrument engineering improving and using medical devices, which are healthcare products. There are some career opportunities with drug companies as well. In nutshell following are the job market:

Hospital , Laboratories and Healthcare units
Medical equipment manufacturing Unit / Industry
University and National Research departments / Centres
Other ( Public and Private) Research Units
Rehabilitation or health charities.
Heath –Administration

Job-Responsibilities

The responsibilities associated with the job vary depending on the employer and the seniority of the post one hold:

To use mathematical design tool and software to design, develop and test new materials, devices and equipment. This includes programming electronics, building and evaluating prototypes, troubleshooting problems, and rethinking the design until it works correctly.
To liaising with manufacturer and technical people to ensure the feasibility of a device / product in view of design and economic viability.
To pursue research to solve clinical problems using different techniques to collate the necessary information.
To work closely with doctors, healthcare people and therapists as well as with end-users (patients and patient parties)
To discuss and solve problems with manufacturing, quality, purchasing and marketing departments
To arrange for the clinical trials of medical products
To approach marketing and other industry companies for product sell.
To write reports and attending conferences and seminars to present latest development and latest designs to a range of technical and non-technical audiences
To meet with health service people and managers to exchange findings
To deal with technical queries from hospitals and doctors and to provide advice on new equipment
To test and maintain clinical equipment
To provide training to technical & clinical staffs
To ensure bio and radiation safety-related incidents
To keep up to date with new developments in the field, nationally and internationally.

Where to Study

Bhaba Atomic Research Centre (BARC) has a regulatory body for accreditation of Medical Physics / Radiation Physics courses in India. Selected Universities are offering this course in Master’s degree level now. Though in the eastern zone of India, the program is running in very few colleges/Universities. Only a few, including Adamas University, is presently conducting this multi-disciplinary program from 2018-’19 academic year and placement record is excellent. It offers a broad spectrum of career opportunities starting from radiation safety officer, clinical activities, quality assurance and research by including Machine learning / big data and AI within diagnostic radiology physics, radiation therapy physics, and nuclear medicine physics. Additionally the starting pay package is quite impressive. The associated faculty members of Adamas University are well qualified, mostly M.Tech. and PhD (Tech), for conducting this program. The state of the art laboratories, regular hands on training, industry internship program, special emphasis on Research & Development, have made this program attractive and job oriented for interested students. In addition to Adamas University program, CMC-Vellore, Manipal University, Punjab University, D Y Patil University and IIT Kharagpur are conducting two year postgraduate program in Medical Physics. In spite of offering the same M.Sc. program in Medical Physics, Adamas University program is bit different in the sense; they are offering the M.Sc. (Tech) program in Medical Physics and Instrumentation, keeping emphasis on instrument parts, so that the students could get trained in the instrument design, application and supervision.

COVID-19 Risk Assessment in India: A Predictive Model

Swarnava Biswas¹ and Moumita Mukherjee²

¹PhD Research Scholar, Department of Physics, Adamas University, India

²Associate Professor, Department of Physics, Adamas University, India

nCOVID 19: About the disease

Human Corona virus was first perceived during the 1960s. Enormous variety of this virus is available in nature and in 2002 we witnessed the severity of Severe Acute Respiratory Syndrome CoV (SARSCoV) that executed from southern China and affected world population severely^[1-3]. Later it tainted the Middle East areas as the Middle East Respiratory Syndrome CoV (MERS-CoV), that caused 919 people to die with an outstandingly high mortality rate of 35%^[4]. In December 2019, it has returned in Wuhan, China, in mutated form of Novel Corona Virus and has spread over 199 countries and affected more than three million of world population till date with killing more than 3 lakhs of people (Source: World Health Organization 2020) until this point of time. World Health Organization has declared this as ‘pandemic’ by the middle of March 2020. In absence of any antiviral treatments for nCOVID-19, the most important strategy to reduce the affected number of population (and in turn mortality) is by introducing classical lockdown mechanism. According to that health prescription, the major portion of world is now eventually locked down due to the outbreak of nCOVID-19.

The Basics of Mathematical Modelling:

The fast and relentless spread nCOVID-19 has segmented the populace into four classes, such as susceptible, exposed, infected and recovered. Adapting the classical SEIR- type epidemic model, using differential equations, appropriate boundary conditions, the direct person-to-person contact transmission is taken as the direct route of transmission of nCOVID-19 pandemic. The authors have developed a generalised self-consistent statistical model through Python and R- Programming language by adopting several real nodes of societal impacts for contaminations. The authors initially determined the parameters of the model from the accessible day to day information for Indian states from initial 35 days history of diseases, recuperations and deaths. The determined parameters have been amassed to extend future patterns for the Indian subcontinent, where we are still at the beginning of the contamination cycle peak.

Susceptible- Exposed- Infectious- Recovered (SEIR) – type epidemiological models for the modelling of the Infectious disease studies was first proposed by Kermack– McKendrick in 1927. Infectious diseases are caused when certain types of parasites invade into a host. In SEIR models, people in a population are partitioned into susceptible (?), exposed/latent (?), infectious (?) and recovered/removed (?) individuals, and the models are alluded to on the premise of the contamination’s statuses of included people. Susceptible people can be defined as the individuals who have a probability to get infected. Exposed people are those, who are not infectious, but they have been exposed to the disease and at the same time they are infected. Infectious people can spread the infection. Recovered people are those, who have recovered from the infection. The evaluation and propagation of nCOVID-19 infections in India can also be modelled and predicted with the help of said SEIR model.

What factors influence the spreading of pandemic?

The main parameters which are used to simulate the situation are as follows:

Growth rate, which is defined as the number of rise-in infections of nCOVID-19 in India due to the interactions between the susceptible and infected populations. It depends on various factors such as population, reproduction number of nCOVID-19, mobility, precautionary measures etc. Recovery rate is defined as, the rate at which the infected persons get recovered. Contact rates are defined as the number of susceptible people, an infectious person contact. Among 7,290 individuals in eight European nations, the normal contacts per individual was 13.4 with a nation scope of 7.95 (Germany) to 19.77 (Italy). Young people had the most noteworthy contact rate (18) contrasted with adults 20-60 (13), and olds 60+ (8) ^[5-6].For the case of India, we have assumed an initial contact rate of 12 to optimize the model. But gradually when the nation-wide lock-down is imposed from 24^th March 2020 and declared to be continued up to the 1^st week of May 2020, then the authors modified the contact rate in the model and decreases it by 60%. Transmissibility is defined as the probability that a contact between a susceptible person and an infected person results in infection. The value used, 1.7%, was estimated by comparing the Reproduction Number (R₀) in community settings (1.4 to 3.9) with a normal contact rate and a cruise ship (14.8) which has a high contact rate. R₀ varies with contact rate whereas transmissibility and removal rate (inverse of duration of infectiousness) were kept constant ^[7-8]. Reproduction Number (R₀) is defined as the number of secondary cases resulting from one case. Mathematically it can be obtained as the product of Contact Rate, Transmissibility and Removal Rate. Estimates for nCOVID-19 have been between 1.4 to 3.9. The inverse of R₀, (1-(1/R₀)) is the proportion of the population who need to be infected (or vaccinated) for transmission to no longer be self-sustaining. R₀ is also an indication of the effectiveness of community interventions. An R₀less than 1 indicates transmission has stopped ^[9].The authors have found that from 10 early cases in China showed the mean serial interval (time between successive cases) was 7.5 days with a Standard Deviation (SD) of 3.4 days. A more recent estimate among 468 cases was 3.96 days with a 4.75-day SD^[10].But in the current context of India, the authors noticed that, a patient is taking minimum 14 days to get recovered. So, for this case of nCOVID-19 modelling in India, the authors have taken duration of Infection as 14 days. Various errors such as square integral error, terminal error and terminal rate error between the actual data and predicted data are minimized by optimizing different set-parameters.

What is the predicted scenario for India from our study?

After 15^th March, 2020, nCOVID-19 infection in India started to show an exponential trend. The SEIR model has been simulated and all the parameters have been optimised based on infection trends obtained for India for nearly 50 days (up to 20th of May 2020). The differential equations have been solved by using Python and R- Programming languages. The forecasted data are showed graphically in Figure 1.

Figure 1: The prediction of COVID-19 pandemic in India with withdrawal of lock-down (in absence of test kit for asymptomatic population, migrated labour influence and considering full withdrawal of lockdown order (if full normalization is implemented by opening / running everything at its full strength)

Due to the unavailability of test kits and consequently lack of testing of all asymptomatic individuals in India, during this lockdown period,, migrated labour influence, withdrawal of lockdown and opening of public and private sectors to its full pace, the simulated peak may rise to as high as 10 Crore of total population by middle of July , after the lockdown is withdrawn on 17^th May. The effect of lockdown is clearly reflected in the flattening of curve, i.e. the peak will reach to 10 Crore within the time interval of 120 days after lock down get withdrawn on 17^th May, 2020. From Figure 2, the number of forecasted infected patients is significantly correlating with actual number of infected patients, till date, with a correlation coefficient of 0.99. Here the validity and novelty of the model is established. So, this model can be used to predict the future scenario of nCOVID-19 in India, under various adopted conditions. The authors outlined how these effects may shift, under various transmission and mediation situations.

Figure 2. Correlation of simulation result with actual scenario ( as on 14.5.2020)

If the nation-wide lock down was not enforced from 24^th March 2020, then as per the model, the contact rates of the susceptible individuals with the infected individuals would get altered. In that case the probable situation of India is forecasted in Figure 3, which is a comparison between forecasted Indian situation in lock-down (without kit test for all asymptomatic individual in India) and without lockdown scenario.

Figure 3. Comparison of (a) lock-down (in absence of test kit for asymptomatic population) and (b) no lockdown condition (s)

But the alarming fact is that, depending upon the future predictions through this model, India would be in a great danger zone, if we fail to provide test kit for all asymptomatic population in India, right now. Current Mortality rate till date in India is ~ 3%. If even this mortality rate persists then also a dangerous situation in India may arrive by mid of July, as predicted from the model. As the development pace of COVID-19 contaminations ascended on 21st March 2020, the Prime Minister of India Shri. Narendra Modi announced a supposed one-day lockdown on 22nd March 2020 in name ‘Janata Curfew’ which brought down the development pace of cases from 3.69 to 1(MOHFW, India). Being a nation of 100 million individuals the viability of conferring lockdown is a significant obstacle to the Government. A minor level of individuals despite everything act slack and careless about the lockdown have become super-spreaders of their locale. Indeed, even 0.1% of oblivious individuals of the nation are an immense populace that can spread the pandemic vivaciously.

Model suggests:

So, to control this situation, the authors are suggesting some points through the developed generalized SEIR model:

The main parameter which affects the total number of infected individuals is the contact rate. If a normal patient, by any chance goes near the vicinity of a nCOVID-19 patient without any preventive measure, then the probability of getting infected of a susceptible person increase rapidly. So, to overcome this situation, the contact rate should be taken care.
If the contact rate can be maintained within a range of 5, then the chance to control of this pandemic situation get increased. So social distancing and isolation of infected individual is the only way out to get rid of the pandemic.
The transmissibly is another major factor, which can control the situation. If the nation can maintain the probability of a susceptible people to get infected, below 10%, then it will help to overcome the pandemic in the context of India.

Such measures could reduce the peak prevalence substantially, thus minimizing the pressure on public health services. The total numbers of nCOVID-19 cases are also decreasing day by day and the reproduction number (R₀) reaches below 1. Therefore, the lock-down has the effect of ‘flattening’ the epidemic curve, distributing cases over a longer duration than in the absence of lock-down. The more intervention with testing for all asymptomatic population could reduce the cumulative incidence by nearly 60 per cent.

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