Quantitative Analysis of Radiation-Associated Parenchymal Lung Change

Radiation-induced lung damage (RILD) is a common consequence of thoracic radiotherapy (RT). We present here a novel classification of the parenchymal features of RILD. We developed a deep learning algorithm (DLA) to automate the delineation of 5 classes of parenchymal texture of increasing density. 200 scans were used to train and validate the network and the remaining 30 scans were used as a hold-out test set. The DLA automatically labelled the data with Dice Scores of 0.98, 0.43, 0.26, 0.47 and 0.92 for the 5 respective classes. Qualitative evaluation showed that the automated labels were acceptable in over 80% of cases for all tissue classes, and achieved similar ratings to the manual labels. Lung registration was performed and the effect of radiation dose on each tissue class and correlation with respiratory outcomes was assessed. The change in volume of each tissue class over time generated by manual and automated segmentation was calculated. The 5 parenchymal classes showed distinct temporal patterns We quantified the volumetric change in textures after radiotherapy and correlate these with radiotherapy dose and respiratory outcomes. The effect of local dose on tissue class revealed a strong dose-dependent relationship We have developed a novel classification of parenchymal changes associated with RILD that show a convincing dose relationship. The tissue classes are related to both global and local dose metrics, and have a distinct evolution over time. Although less strong, there is a relationship between the radiological texture changes we can measure and respiratory outcomes, particularly the MRC score which directly represents a patient’s functional status. We have demonstrated the potential of using our approach to analyse and understand the morphological and functional evolution of RILD in greater detail than previously possible

Magnetohydrodynamic Simulations of Hypersonic Flow over a Cylinder Using Axial- and Transverse-Oriented Magnetic Dipoles

Numerical simulations of magnetohydrodynamic (MHD) hypersonic flow over a cylinder are presented for axial- and transverse-oriented dipoles with different strengths. ANSYS CFX is used to carry out calculations for steady, laminar flows at a Mach number of 6.1, with a model for electrical conductivity as a function of temperature and pressure. The low magnetic Reynolds number (≪1) calculated based on the velocity and length scales in this problem justifies the quasistatic approximation, which assumes negligible effect of velocity on magnetic fields. Therefore, the governing equations employed in the simulations are the compressible Navier-Stokes and the energy equations with MHD-related source terms such as Lorentz force and Joule dissipation. The results demonstrate the ability of the magnetic field to affect the flowfield around the cylinder, which results in an increase in shock stand-off distance and reduction in overall temperature. Also, it is observed that there is a noticeable decrease in drag with the addition of the magnetic field

Nonoscillatory Central Schemes for Hyperbolic Systems of Conservation Laws in Three-Space Dimensions

We extend a family of high-resolution, semidiscrete central schemes for hyperbolic systems of conservation laws to three-space dimensions. Details of the schemes, their implementation, and properties are presented together with results from several prototypical applications of hyperbolic conservation laws including a nonlinear scalar equation, the Euler equations of gas dynamics, and the ideal magnetohydrodynamic equations. Parallel scaling analysis and grid-independent results including contours and isosurfaces of density and velocity and magnetic field vectors are shown in this study, confirming the ability of these types of solvers to approximate the solutions of hyperbolic equations efficiently and accurately

Evaluation of eddy viscosity-based models in decaying rotating stratified turbulence

The results of large eddy simulation (LES) using three sub-grid scale models, namely: constant coefficient Smagorinsky, dynamic Smagorinsky, and a dynamic Clark model, for rotating stratified turbulence in the absence of forcing using large-scale isotropic initial condition, are reported here. The LES results are compared to in-house direct numerical simulation (DNS) for establishing grid-independence requirements. Three cases with varying ratios of Brunt-Vaisala frequency to the inertial wave frequency, N / f, have been chosen to evaluate the performance of LES models. The Reynolds number and N / f are chosen as (a) Case 1: Re = 3704, N / f = 5, (b) Case 2: Re = 6667, N / f = 40, and, (c) Case 3: Re = 6667, N / f = 138. This framework is used to illustrate the relative magnitudes of the stratification and rotation which is observed in geophysical flows. Various quantities including turbulent kinetic energy (tke), turbulent potential energy (tpe), total dissipation, potential and total energy spectra, and their fluxes, are analyzed to understand the predictive capability of the various LES models. Results show that all the SGS model predictions are very similar, with the classical Smagorinsky model displaying the highest deviation compared to DNS. The effect of an increase in the value of N / f is also seen in the results of LES with an increase in the oscillations observed in the evolution of tke and tpe and a reduction in dissipation. The spectral analysis shows that the dynamic Clark and Smagorinsky models predict the large-scale physics (\kappa < 10), while the small scales (10 < \kappa < 64) energy is under-predicted.Comment: 12 pages, 10 figure

The Indian medical education explosion and its relationship to economic and social development

This article does not have an abstract

Rehabilitation for cognitive impairments after cerebral malaria in African children: strategies and limitations

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/72221/1/j.1365-3156.2006.01685.x.pd

Pre-transplant reduction of isohaemagglutinin titres by donor group plasma infusion does not reduce the incidence of pure red cell aplasia in major ABO-mismatched transplants

Major ABO incompatibility in stem cell transplant recipients has been associated with pure red cell aplasia (PRCA). Reduction of incompatible isohaemagglutinin titres pre-transplant by various methods has been thought to reduce the incidence of PRCA. Our data suggest that pre-transplant reduction of incompatible isohaemagglutinin titres by donor group plasma infusion does not reduce the incidence of PRCA. We also failed to find any relationship between pre-transplant ABO isohaemagglutinin titre and the risk of developing PRCA

Magnetohydrodynamic Simulations of Hypersonic Flow over a Cylinder Using Axial- and Transverse-Oriented Magnetic Dipoles

Numerical simulations of magnetohydrodynamic (MHD) hypersonic flow over a cylinder are presented for axial- and transverse-oriented dipoles with different strengths. ANSYS CFX is used to carry out calculations for steady, laminar flows at a Mach number of 6.1, with a model for electrical conductivity as a function of temperature and pressure. The low magnetic Reynolds number (≪1) calculated based on the velocity and length scales in this problem justifies the quasistatic approximation, which assumes negligible effect of velocity on magnetic fields. Therefore, the governing equations employed in the simulations are the compressible Navier-Stokes and the energy equations with MHD-related source terms such as Lorentz force and Joule dissipation. The results demonstrate the ability of the magnetic field to affect the flowfield around the cylinder, which results in an increase in shock stand-off distance and reduction in overall temperature. Also, it is observed that there is a noticeable decrease in drag with the addition of the magnetic field

Investigation of the evolution of radiation-induced lung damage using serial CT imaging and pulmonary function tests

Background and purpose: Radiation-induced lung damage (RILD) is a common consequence of lung cancer radiotherapy (RT) with unclear evolution over time. We quantify radiological RILD longitudinally and correlate it with dosimetry and respiratory morbidity. Materials and methods: CTs were available pre-RT and at 3, 6, 12 and 24-months post-RT for forty-five subjects enrolled in a phase 1/2 clinical trial of isotoxic, dose-escalated chemoradiotherapy for locally advanced non-small cell lung cancer. Fifteen CT-based measures of parenchymal, pleural and lung volume change, and anatomical distortions, were calculated. Respiratory morbidity was assessed with the Medical Research Council (MRC) dyspnoea score and spirometric pulmonary function tests (PFTs): FVC, FEV1, FEV1/FVC and DLCO. Results: FEV1, FEV1/FVC and MRC scores progressively declined post-RT; FVC decreased by 6-months before partially recovering. Radiologically, an early phase (3–6 months) of acute inflammation was characterised by reversible parenchymal change and non-progressive anatomical distortion. A phase of chronic scarring followed (6–24 months) with irreversible parenchymal change, progressive volume loss and anatomical distortion. Post-RT increase in contralateral lung volume was common. Normal lung volume shrinkage correlated longitudinally with mean lung dose (r = 0.30–0.40, p = 0.01–0.04). Radiological findings allowed separation of patients with predominant acute versus chronic RILD; subjects with predominantly chronic RILD had poorer pre-RT lung function. Conclusions: CT-based measures enable detailed quantification of the longitudinal evolution of RILD. The majority of patients developed progressive lung damage, even when the early phase was absent or mild. Pre-RT lung function and RT dosimetry may allow to identify subjects at increased risk of RILD