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Comparison of the integral dose (ID) delivered to organs at risk (OAR), non-target body and target body by using different techniques of craniospinal irradiation (CSI).
Materials and methods:
Ten CSI patients (medulloblastoma) already planned and treated either with linear accelerator three-dimensional conformal radiation therapy (Linac-3DCRT) technique or with linear accelerator RapidArc (Linac-RapidArc) technique by Novalis-Tx Linac machine have been analysed. Retrospectively, these patients are again planned on Radixact-X9 Linac with Helical, Direct-3DCRT and Direct-intensity-modulated radiation therapy (Direct-IMRT) techniques. The dose prescription to planning target volume brain (PTV-Brain) and PTV-Spine is 36 Gy in 20 fractions and is kept the same for all techniques. The target body, non-target body, OARs and total body dose are compared.
ID is lowest in the RapidArc plan for every patient in comparison to Helical and Direct-IMRT. The ID for Body-PTV was found slightly higher in the RapidArc plan in comparison to 3DCRT plans. But there is better normal tissue sparing for most of the OARs in RapidArc plans if it compares with 3DCRT plans.
RapidArc is a better alternative for the treatment of CSI. It provides better target coverage and better OARs sparing from any other treatment techniques.
Shock–shock interaction structures and a newly discovered dynamic instability in granular streams resulting from such interactions are presented. Shock waves are generated by placing two similar triangular wedges in a gravity-driven granular stream. When the shock waves interact, grains collapse near the centre region of the wedges and a slow-moving concentrated diamond-shaped streak of grains is formed that grows as the inclination of the channel is increased. The diamond streak, under certain geometric conditions, is found to become unstable and start oscillating in the direction transverse to the mainstream. When the wedges are placed too close to each other, the granular flux of the incoming stream is unable to pass through the small gap, resulting in the formation of a single bow shock enveloping both the wedges. Experiments are performed for a wide range of flow speeds, wedge angles and wedge separations to investigate the interaction zone. We discuss a possible mechanism for the formation of the central streak and the associated dynamic instability observed for specific physical parameters.
Genetic diversity is a valuable asset for crop improvement. In this study, a total of 50 rice genotypes were screened for salinity tolerance at the reproductive stage using gravel-based hydroponics, soil, controlled mini-field and field methods. Different morpho-agronomic, physiological markers and tolerance indices were used to classify tolerant and susceptible genotypes. Our results showed high genetic variability in response of rice genotypes to salinity using different screening methods. The significant effect (P < 0.01) of salinity include increased Na+ sequestration in the flag leaf, increased unfilled grains (except for the field method) and reduced pollen fertility, total yield, panicle length and the average number of filled grains per panicle. Plant height (except for the soil method) and K+ ion concentration in the flag leaf were not significantly affected by salinity (P > 0.05). Genetic diversity analysis indicated that the germplasm evaluated exhibits moderate diversity (PIC
= 0.2085). Cluster analysis using single nucleotide polymorphisms showed that the genetic make-up of rice germplasm somehow did not necessarily indicate their over-all tolerance or susceptibility to salinity. This study proved that the controlled mini-field method is the most advantageous among the screening methods while geometric mean productivity, stress tolerance index and yield index are the tolerance indices that can be classified as better predictors of salinity tolerance considering the yield potentials of the genotypes. The genotypes Nona Bokra and Mushkan 41 can be used for breeding in the future through low Na+:K+ ratio while Damodar and Bhura Rata 4-10 for breeding salt-tolerant cultivars with higher yield potentials.
In this paper, two different radiating structures fed with modified L-probe, are reported using a circuit theory concept. The proposed antennas are operating in wireless local area network (WLAN) and universal mobile telecommunications system (UMTS) frequency bands. In the first design, an E-shaped patch is studied to increase the bandwidth. It is observed that the bandwidth is directly proportional to notch dimensions. In the second design, E-shaped patch is modified to reduce the antenna size up to 30% with high bandwidth. In the first design, measured bandwidth and gain achieved are 32.68% (1.92–2.67 GHz) and 8.43 dBi while in second design it is 34.19% (1.94–2.74 GHz) and 8.39 dBi, respectively. Radiation patterns for both the antennas are symmetrical and broadside in nature. The proposed antennas are fabricated and measured results compare well with the theoretical and simulated results.
Maturing oocytes have diverse developmental potential and good quality oocytes exhibit a better ability to attain physiological milestones in a time-dependent manner. This situation necessitates the confirmation of oocyte developmental status more precisely under an in vitro embryo production (IVEP) regime. The aim of this study was to explain timely events in germinal vesicle breakdown (GVBD), an important milestone of oocyte nuclear maturation, to delineate the developmental capacity of Bubalus bubalis oocytes. In addition, the expression profile of genes responsible for GVBD was assessed in order to understand the molecular context responsible for GVBD. The chronology of GVBD events at different time intervals during in vitro maturation (IVM) suggests that the rate at which oocytes undergo GVBD was strikingly different in the brilliant cresyl blue (BCB)+ and BCB− groups. The expression of AKT and CDC25B genes for BCB+ oocytes was maximum at 8 h of IVM, and CCNB (cyclin B) peaked at around 10 h, which suggested that GVBD was finished after 10 h in BCB+ oocytes, whereas the expression of AKT and CDC25B was found to peak at around 12–14 h of IVM. This difference consequently delays the GVBD event by 2–4 h in BCB− oocytes. Poor abundance of gene transcripts was mainly implicated in delay and lower rate of GVBD in BCB− oocytes which in turn strongly affected the translational ability of oocytes to blastocysts. The findings of this study support the idea that there is a propensity in sub-optimal grade oocytes for delayed GVBD that compromises the developmental ability of low grade buffalo oocytes. The study highlights the very small, but importantly vital and separate, time window of the GVBD event during which the competence levels of buffalo oocytes are altered along with their translational ability to develop into the prospective embryos.
The National Iodine and Salt Intake Survey (NISI) 2014–2015 was undertaken to estimate household iodised salt coverage at national and sub-national levels in India.
Cross-sectional survey with multistage stratified random sampling.
India was divided into six geographic zones (South, West, Central, North, East and North-East) and each zone was further stratified into rural and urban areas to yield twelve distinct survey strata.
The target respondent from each household was selected as per predefined priority; wife of the household head, followed by women of reproductive age, followed by any adult available during the visit.
Households (n 5717) were surveyed and salt samples (n 5682) were analysed. Household coverage of iodised salt (iodine≥5 ppm) was 91·7 (95 % CI 91·0, 92·7) %. Adequately iodised salt (iodine≥15 ppm) was consumed in 77·5 (95 % CI 76·4, 78·6) % of households. Significant differences in coverage were seen across six geographic regions, with North and North-East zones on the verge of achieving the universal salt iodisation target of >90 % coverage. Coverage of households with adequately iodised salt (adjusted OR; 95 % CI) was significantly less in rural households (0·55; 0·47, 0·64), lower/backward castes (0·84; 0·72, 0·98), deprived households (0·72; 0·61, 0·85) as assessed by multidimensional poverty index, households with non-diverse diet (0·73; 0·62, 0·86) and households using non-packaged salt (0·48; 0·39, 0·59) and non-refined salt (0·17; 0·15, 0·20).
India is within striking reach of achieving universal salt iodisation. However, significant differentials by rural/urban, zonal and socio-economic indicators exist, warranting accelerated efforts and targeted interventions for high-risk groups.
A nonlinear mathematical model for innovation diffusion is proposed. The system of ordinary differential equations incorporates variable external influences (the cumulative density of marketing efforts), variable internal influences (the cumulative density of word of mouth) and a logistically growing human population (the variable potential consumers). The change in population density is due to various demographic processes such as intrinsic growth rate, emigration, death rate etc. Thus the problem involves two dynamic variables viz. a non-adopter population density and an adopter population density. The model is analysed qualitatively using the stability theory of differential equations, with the help of the corresponding characteristic equation of the system. The interior equilibrium point can be stable for all time delays to a critical value, beyond which the system becomes unstable and a Hopf bifurcation occurs at a second critical value. Employing normal form theory and a centre manifold theorem applicable to functional differential equations, we derive some explicit formulas determining the stability, the direction and other properties of the bifurcating periodic solutions. Our numerical simulations show that the system behaviour can become extremely complicated as the time delay increases, with a stable interior equilibrium point leading to a limit cycle with one local maximum and minimum per cycle (Hopf bifurcation), then limit cycles with more local maxima and minima per cycle, and finally chaotic solutions.
Balance between adipocyte and osteoblast differentiation is the key link of disease progression in obesity and osteoporosis. We have previously reported that formononetin (FNT), an isoflavone extracted from Butea monosperma, stimulates osteoblast formation and protects against postmenopausal bone loss. The inverse relationship between osteoblasts and adipocytes prompted us to analyse the effect of FNT on adipogenesis and in vivo bone loss, triggered by high-fat diet (HFD)-induced obesity. The anti-obesity effect and mechanism of action of FNT was determined in 3T3-L1 cells and HFD-induced obese male mice. Our findings show that FNT suppresses the adipogenic differentiation of 3T3-L1 fibroblasts, through down-regulation of key adipogenic markers such as PPARγ, CCAAT/enhancer-binding protein alpha (C/EBPα) and sterol regulatory element-binding protein (SREBP) and inhibits intracellular TAG accumulation. Increased intracellular reactive oxygen species levels and AMP-activated protein kinase (AMPK) activation accompanied by stabilisation of β-catenin were attributed to the anti-adipogenic action of FNT. In vivo, 12 weeks of FNT treatment inhibited the development of obesity in mice by attenuating HFD-induced body weight gain and visceral fat accumulation. The anti-obesity effect of FNT results from increased energy expenditure. FNT also protects against HFD-induced dyslipidaemia and rescues deterioration of trabecular bone volume by increasing bone formation and decreasing bone resorbtion caused by HFD. FNT’s rescuing action against obesity-induced osteoporosis commenced at the level of progenitors, as bone marrow progenitor cells, obtained from the HFD mice group supplemented with FNT, showed increased osteogenic and decreased adipogenic potentials. Our findings suggest that FNT inhibits adipogenesis through AMPK/β-catenin signal transduction pathways and protects against HFD-induced obesity and bone loss.
Human lymphatic filariasis (LF) is a major cause of disability globally. The success of global elimination programmes for LF depends upon effectiveness of tools for diagnosis and treatment. In this study on stage-specific antigen detection in brugian filariasis, L3, adult worm (AW) and microfilarial antigenaemia were detected in around 90–95% of microfilariae carriers (MF group), 50–70% of adenolymphangitis (ADL) patients, 10–25% of chronic pathology (CP) patients and 10–15% of endemic normal (EN) controls. The sensitivity of the circulating filarial antigen (CFA) detection in serum samples from MF group was up to 95%. In sera from ADL patients, unexpectedly, less antigen reactivity was observed. In CP group all the CFA positive individuals were from CP grade I and II only and none from grade III or IV, suggesting that with chronicity the AWs lose fecundity and start to disintegrate and die. Amongst EN subject, 10–15% had CFA indicating that few of them harbour filarial AWs, thus they might not be truly immune as has been conventionally believed. The specificity for antigen detection was 100% when tested with sera from various other protozoan and non-filarial helminthic infections.
To observe the impact of internal mammary node irradiation (IMNI) on disease-free survival (DFS) and overall survival (OS) in postmastectomy women with breast cancer.
Materials and methods
Between 1978 and 1996, 153 women with stage II–III breast cancer were treated with postmastectomy radiation therapy (RT) with IMNI. Their clinical, pathological and treatment characteristics were matched with 166 patients without IMNI. The RT dose was 35 Gy to the chest wall and 40 Gy to the supraclavicular fossa and IMN in 15 fractions over 3 weeks with photons. All patients were planned with two-dimensional technique. Adjuvant chemotherapy was administered to 41% and endocrine therapy to 52% of the patients. Symptomatic patients were further assessed for late pulmonary and late cardiac effects.
The median follow-up period was 203 months (range, 182–224), and the median age was 44 years (range 20–73 years). The IMNI group had significantly more right-sided and inner/central quadrant tumours. Other characteristics were comparable between both the groups. DFS at 15 years with and without IMNI was 64 and 49%, respectively (p=0·0001). On multivariate analysis, IMNI was an independent, positive predictor of DFS [hazard ratio (HR), 2·89; p=0·0001]. Benefit of IMNI on DFS was more apparent in inner/central tumours [HR, 1·48; 95% confidence interval (CI), 1·02–2·88], N2–N3 patients (HR, 1·44; 95% CI, 1·09–2·10) and in those who received chemotherapy (HR, 1·70; 95% CI, 1·07–2·71). OS at 15 years with and without IMNI was 68 and 54%, respectively (p=0·0001). Late pulmonary toxicity was 1·5 versus 1% with and without IMNI, respectively. Late cardiac toxicity was 2·6 versus 1·8% with and without IMNI, respectively.
IMNI significantly improved DFS and OS in postmastectomy breast cancer patients. Benefit of IMNI was seen in patients with central/inner tumours and N2–N3 disease. Late cardiopulmonary toxicities were comparable between the two groups.
To measure compliance with National Institute for Health and Care Excellence (NICE) recommendations in two adult attention-deficit hyperactivity disorder (ADHD) clinics and to guide further service development. We audited the case notes of 150 patients referred to adult ADHD clinics in East Anglia in 2010–2011 against NICE standards using an adapted version of the ADHD audit support tool.
We found good compliance with NICE standards for diagnosis, assessment and pharmacological treatment of adult ADHD. There was a failure in smooth transitional arrangements from child and adolescent mental health to adult ADHD services. Comprehensive treatment programmes addressing psychological, behavioural, educational and occupational needs were not well developed. Deficiencies were observed in conducting recommended physical examinations. Substance use was prevalent in almost half of ADHD patients.
Greater attention is needed in delivering better transitional arrangements and comprehensive treatment programmes for adult ADHD. More structured training with emphasis on ADHD-specific psychological interventions, physical examination and treatment of complex cases, especially with comorbid substance misuse, should be offered to clinicians.
Female genital cutting (FGC) is widely practised in Kenya. However, its prevalence has declined over the last two decades (38.0% in 1998 KDHS, 32.2% in 2003 KDHS and 27.1% in 2008–09 KDHS), implying changes in behaviours and attitudes of Kenyans towards FGC. This study provides an overview of changing attitudes of women towards FGC in Kenya. An extensive literature review was undertaken and 2008–09 Kenya Demographic and Health Survey data were used to focus on the present scenario. Analyses were based on a national sample of 2284 circumcised women. About 68% of these women wanted to discontinue FGC, and attitudes towards discontinuation were found to vary with women's background characteristics. Surprisingly, 92.5% of circumcised women of the North-Eastern province still wished to continue FGC, and for Muslims the percentage was 72.2%. About 36% of circumcised women responded that their daughters were already circumcised. Only 13% of circumcised mothers intended their daughters to be circumcised in the future. The study shows that the attitude of Kenyan women, irrespective of their circumcision status, has been changing gradually towards the discontinuation of circumcision of their daughters.
Skin contamination is one of the most likely risks after accidental or occupational radiological accidents. Using scintigraphy, we assessed a topical lotion for its decontamination efficacy (DE) after exposure with short-lived medical radioisotopes technetium Tc 99m (99mTc) and thallium 201Tl (201Tl).
Using 99mTc (300 ± 5 μCi/100 μl) and 201Tl (100 ± 5 μCi/100 μl), the thoracoabdominal region (shaved skin) of Sprague Dawley rats and human tissue equivalent were contaminated and then decontaminated using cotton swabs soaked in formulated lotion at different time intervals. Static counts were recorded and calculated for DE. Histologic examination was performed on the animal model.
The DE of the formulation for 99mTc and 201Tl was 85% ± 5 and 88% ± 2, respectively. The prepared formulation effectively removed the radionuclides from the tissue surface.
The formulated lotion assisted in the effective removal of radiocontaminants by decontaminating the radionuclides. Moreover, minimal and easily manageable radioactive waste was generated by this process. Further investigation regarding the infusion of formulated lotion into ready-to-use skin wipes for self-decontamination may be useful for mass casualty scenarios. (Disaster Med Public Health Preparedness. 2014;0:-)
To establish a laboratory iodization quality assurance system to support small-scale salt production facilities in India and to assess the level of agreement for the internal quality assurance (IQA) and external quality assurance (EQA) protocols.
Operational research. The IQA and EQA programme was established in the year 2008. Agreement between field laboratories and the reference laboratory for estimation of iodine content of salt from 2008 to 2011 was assessed. Agreement was assessed using the χ2 test, kappa statistics and the Bland–Altman plot.
Small-scale salt producers in the states of Andhra Pradesh, Gujarat, Rajasthan, Tamil Nadu, Odisha and Karnataka; ‘field laboratories’ supporting the small-scale salt producers; and the ‘reference laboratory’ of the Regional Office (South Asia) of the International Council for the Control of Iodine Deficiency Disorders.
Three hundred small-scale salt producers in the states of Andhra Pradesh, Gujarat, Rajasthan, Tamil Nadu, Odisha and Karnataka and seventeen ‘field laboratories’.
A total of 6573 salt samples for IQA and 347 salt samples for EQA were exchanged between field and reference laboratories during 2008–2012. Out of the total salt sample exchanges, 527 were from Andhra Pradesh and Odisha, 2343 from Gujarat, 2016 from Rajasthan and 1677 from Tamil Nadu and Karnataka. The overall between-laboratory agreement was for 61·6 % for IQA and 64·8 % for EQA. The mean difference between iodine content estimation of field laboratories and the reference laboratory was 0·3 ppm (sd 8·2 ppm) for IQA and –0·3 ppm (sd 3·5 ppm) for EQA.
Our study successfully documents implementation of a laboratory iodization quality assurance protocol in laboratories supporting small-scale salt production facilities in India.
Records of past climate changes have been preserved variously on the earth's surface. Sand dunes are one such prominent imprint, and it is suggested that their presence is an indicator of periods of transition from arid to less arid phases. We report inland sand dunes from Andhra Pradesh (SE India) spread over an area of ~ 500 km2, ~ 75 km inland from the east coast. The dune sands are examined to understand their provenance, transportation, timing of sand aggradation and their relationship to past climates. The dune distribution, grain morphology and the grain-size studies on sands suggest an aeolian origin. Physiography of the study area, heavy mineral assemblage, and abundance of quartz in the parent rocks indicate that the dune sands are largely derived from first-order streams emanating from hills in the region and from weathering of the Nellore schist belt. It appears that the geomorphology and wind direction pattern both facilitated and restricted the dune aggradation and preservation to a limited area. OSL dating of 47 dune samples ranged from the present to ~ 50 ka, thereby suggesting a long duration of sand-dune aggradation and/or reworking history.
We present our results on spatio-temporal evolution of laser plasma produced shockwaves (SWs) and hot core plasma (HCP) created by focused second harmonic (532 nm, 7 ns) of Nd-YAG laser in quiescent atmospheric air at f/#10 focusing geometry. Time resolved shadowgraphs imaged with the help of an ICCD camera with 1.5 ns temporal resolution revealed the presence of two co-existing sources simultaneously generating SWs. Each of the two sources independently led to a spherical SW following Sedov-Taylor theory along the laser propagation direction with a maximum velocity of 7.4 km/s and pressure of 57 MPa. While the interaction of SWs from the two sources led to a planar SW in the direction normal to the laser propagation direction. The SW detaches from the HCP and starts expanding into the ambient air at around 3 µs indicating the onset of asymmetric expansion of the HCP along the z-axis. The asymmetric expansion is observed till 10 µs beyond which the SW leaves the field of view followed by a deformation of the irradiated region in the XY-plane due to the penetration of surrounding colder air in to the HCP. The deformation in the XY-plane lasts till 600 µs. The dynamics of rapidly expanding HCP is observed to be analogous to that of cavitation bubble dynamics in fluids.
Radioactive contamination can occur as a result of accidental or intentional release of radioactive materials (RM) into the environment. RM may deposit on clothing, skin, or hair. Decontamination of contaminated persons should be done as soon as possible to minimize the deleterious health effects of radiation. The goal of this study was to evaluate the decontamination efficiency (for residual contaminant) of the active components of “Shudhika,” an indigenously developed skin decontamination kit. The study kit is for external radioactive decontamination of intact skin.
Decontamination efficiency was evaluated on the skin surface of rabbit (n = 6) and human volunteers (n = 13). 99mTc sodium pertechnetate (200-250 μCi) was used as the radio-contaminant. Skin surface area (5 × 5 cm2) of thoracic abdominal region of the rabbit and the forearm and the palm of human volunteers were used for the study. Decontamination was performed by using cotton swabs soaked with chemical decontamination agents of the kit.
Decontamination efficiency (% of the contaminant removed) was calculated for each component of the study. Overall effectiveness of the kit was calculated to be 85% ± 5% in animal and 92% ± 3% in human skin surfaces. Running water and liquid soap with water was able to decontaminate volunteers' hand and animal skin up to 70% ± 5%. Chemical decontamination agents were applied only for trace residues (30% ± 5%). Efficiency of all the kit components was found up to be 20% ± 3% (animal) and 28% ± 2 (human), respectively. Residual contamination after final decontamination attempt for both the models was observed to be 12% ± 3% and 5% ± 2%. After 24 and 48 hours of the decontamination procedure, skin was found to be normal (no redness, erythema and edema were observed).
Decontaminants of the study kit were effective in removal of localized radioactive skin contamination when water is ineffective for further decontamination. By using the chemical decontaminants of the study kit, the use of water and radioactive waste generation could be reduced. Cross-contamination could also be avoided. During radiologic emergencies where water may be radioactively contaminated, the study kit could be used.
Rana S, Dutta M, Soni NL, Chopra MK, Kumar V, Goel R, Bhatnagar A, Sultana S, Sharma RK. Decontamination of human and rabbit skin experimentally contaminated with 99mTc radionuclide using the active components of “Shudika”—a skin decontamination kit. Prehosp Disaster Med. 2012;27(2):1-5.
Glacier outlines are mapped for the upper Bhagirathi and Saraswati/Alaknanda basins of the Garhwal Himalaya using Corona and Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER) satellite images acquired in 1968 and 2006, respectively. A subset of glaciers was also mapped using Landsat TM images acquired in 1990. Glacier area decreased from 599.9 ± 15.6 km2 (1968) to 572.5 ± 18.0 km2 (2006), a loss of 4.6 ± 2.8%. Glaciers in the Saraswati/Alaknanda basin and upper Bhagirathi basin lost 18.4 ± 9.0 km2 (5.7 ± 2.7%) and 9.0 ± 7.7 km2 (3.3 ± 2.8%), respectively, from 1968 to 2006. Garhwal Himalayan glacier retreat rates are lower than previously reported. More recently (1990–2006), recession rates have increased. The number of glaciers in the study region increased from 82 in 1968 to 88 in 2006 due to fragmentation of glaciers. Smaller glaciers (<1 km2) lost 19.4 ± 2.5% (0.51 ± 0.07% a−1) of their ice, significantly more than for larger glaciers (>50 km2) which lost 2.8 ± 2.7% (0.074 ± 0.071 % a−1). From 1968 to 2006, the debris-covered glacier area increased by 17.8 ± 3.1% (0.46 ± 0.08% a−1) in the Saraswati/Alaknanda basin and 11.8 ± 3.0% (0.31 ± 0.08% a−1) in the upper Bhagirathi basin. Climate records from Mukhim (∼1900 m a.s.l.) and Bhojbasa (∼3780 m a.s.l.) meteorological stations were used to analyze climate conditions and trends, but the data are too limited to make firm conclusions regarding glacier–climate interactions.