A case of endometrial carcinoma with age related hyperkyphosis treated with definitive radiotherapy

This report describes a simple brachytherapy procedure in a patient with endometrial cancer with age related hyperkyphosis.  Sixty-eight year-old postmenopausal woman with age related hyperkyphosis presented with endometrial carcinoma, and the patient was not operated on due to associated pelvic deformity. The patient received whole pelvic radiation followed by uterovaginal brachytherapy. Patient was supported with soft pillows to support her exaggerated anterior concavity during brachytherapy procedure and execution. The brachytherapy dose was 6 Gy per fraction per week for 3 weeks using image guidance. This is probably the first reported case of endometrial cancer with age related hyperkyphosis. In spite of the associated skeletal problems, a simple brachytherapy procedure is possible and provides good result.

Grand Challenges in global eye health: a global prioritisation process using Delphi method

Background: We undertook a Grand Challenges in Global Eye Health prioritisation exercise to identify the key issues that must be addressed to improve eye health in the context of an ageing population, to eliminate persistent inequities in health-care access, and to mitigate widespread resource limitations. Methods: Drawing on methods used in previous Grand Challenges studies, we used a multi-step recruitment strategy to assemble a diverse panel of individuals from a range of disciplines relevant to global eye health from all regions globally to participate in a three-round, online, Delphi-like, prioritisation process to nominate and rank challenges in global eye health. Through this process, we developed both global and regional priority lists. Findings: Between Sept 1 and Dec 12, 2019, 470 individuals complete round 1 of the process, of whom 336 completed all three rounds (round 2 between Feb 26 and March 18, 2020, and round 3 between April 2 and April 25, 2020) 156 (46%) of 336 were women, 180 (54%) were men. The proportion of participants who worked in each region ranged from 104 (31%) in sub-Saharan Africa to 21 (6%) in central Europe, eastern Europe, and in central Asia. Of 85 unique challenges identified after round 1, 16 challenges were prioritised at the global level; six focused on detection and treatment of conditions (cataract, refractive error, glaucoma, diabetic retinopathy, services for children and screening for early detection), two focused on addressing shortages in human resource capacity, five on other health service and policy factors (including strengthening policies, integration, health information systems, and budget allocation), and three on improving access to care and promoting equity. Interpretation: This list of Grand Challenges serves as a starting point for immediate action by funders to guide investment in research and innovation in eye health. It challenges researchers, clinicians, and policy makers to build collaborations to address specific challenges. Funding: The Queen Elizabeth Diamond Jubilee Trust, Moorfields Eye Charity, National Institute for Health Research Moorfields Biomedical Research Centre, Wellcome Trust, Sightsavers, The Fred Hollows Foundation, The Seva Foundation, British Council for the Prevention of Blindness, and Christian Blind Mission. Translations: For the French, Spanish, Chinese, Portuguese, Arabic and Persian translations of the abstract see Supplementary Materials section

Grand Challenges in global eye health: a global prioritisation process using Delphi method

Background We undertook a Grand Challenges in Global Eye Health prioritisation exercise to identify the key issues that must be addressed to improve eye health in the context of an ageing population, to eliminate persistent inequities in health-care access, and to mitigate widespread resource limitations. Methods Drawing on methods used in previous Grand Challenges studies, we used a multi-step recruitment strategy to assemble a diverse panel of individuals from a range of disciplines relevant to global eye health from all regions globally to participate in a three-round, online, Delphi-like, prioritisation process to nominate and rank challenges in global eye health. Through this process, we developed both global and regional priority lists. Findings Between Sept 1 and Dec 12, 2019, 470 individuals complete round 1 of the process, of whom 336 completed all three rounds (round 2 between Feb 26 and March 18, 2020, and round 3 between April 2 and April 25, 2020) 156 (46%) of 336 were women, 180 (54%) were men. The proportion of participants who worked in each region ranged from 104 (31%) in sub-Saharan Africa to 21 (6%) in central Europe, eastern Europe, and in central Asia. Of 85 unique challenges identified after round 1, 16 challenges were prioritised at the global level; six focused on detection and treatment of conditions (cataract, refractive error, glaucoma, diabetic retinopathy, services for children and screening for early detection), two focused on addressing shortages in human resource capacity, five on other health service and policy factors (including strengthening policies, integration, health information systems, and budget allocation), and three on improving access to care and promoting equity. Interpretation This list of Grand Challenges serves as a starting point for immediate action by funders to guide investment in research and innovation in eye health. It challenges researchers, clinicians, and policy makers to build collaborations to address specific challenge

Nations within a nation: variations in epidemiological transition across the states of India, 1990–2016 in the Global Burden of Disease Study

18% of the world's population lives in India, and many states of India have populations similar to those of large countries. Action to effectively improve population health in India requires availability of reliable and comprehensive state-level estimates of disease burden and risk factors over time. Such comprehensive estimates have not been available so far for all major diseases and risk factors. Thus, we aimed to estimate the disease burden and risk factors in every state of India as part of the Global Burden of Disease (GBD) Study 2016

Fatigue properties of sand cast, stircast and extruded Al-7Si-0.3 Mg alloy with trace additions of Be and Mn

Studies the fatigue behaviour of Al-7Si-0.3 Mg sand cast alloys at varying iron levels and with beryllium and manganese trace additions and when the alloy is stircast and extruded. From the stress (S)-number of cycles to failure (N)-(S-N) curves it is observed that the presence of higher amount of iron (0.76%) in sand cast alloys leads to a shorter fatigue life. Beryllium and manganese additions to a higher iron containing alloy (0.76%) show better fatigue properties than low (0.29%) and high (0.76%) iron containing sand cast alloys, thus countering the detrimental effect of iron. The better fatigue life of beryllium and manganese added high iron alloy is due to the presence of (Be,Mn)-Fe phases only inside α-Al dendrites. The fatigue life of stircast and extruded low iron (0.44%) alloy is superior to sand cast low (0.29%) iron alloys. Observation of fractured surfaces reveals that porosity/inclusions is the high stress concentrating point where the crack originates (stage-I) and then propagates (stage-II) depending on the presence of the second phases. In the case of low iron alloys (sand and extruded stircast) a crack propagates along eutectic silicon, while in the high iron alloys a crack propagates through the brittle β-phase. In beryllium and manganese added alloys, even though a crack nucleates on the (Be,Mn)-Fe phase, it will be arrested as it approaches α-Al dendrites and hence, the crack has to propagate along silicon particles. The fractured surface of the stircast and extruded alloys has revealed fine fatigue fracture with striation as compared to sand cast alloys. This aspect of crack nucleation and propagation is explained schematically

Design-based performance evaluation of two-winding capacitor self-excited single-phase induction generator

A comprehensive and general analytical method supported by computer software for design of single-phase self-excited induction generator (SEIG) has been presented to analyse and evaluate the system performance under any operating condition. The steady-state and transient behaviours of a single-phase two-winding SEIG have been analysed. The experimental results on a specially designed SEIG validate the theoretical model and the suggested method to incorporate magnetic nonlinearity. Effects of different design parameters are studied and a method to choose the right combination of machine parameters is presented to ensure the most appropriate design of the system for the required stand-alone application

Biomimetic synthesis of superparamagnetic iron oxide particles in proteins

Matrix-mediated in situ synthesis of monodispersed magnetite and maghemite nanoparticles (2-16 nm) was carried out using the cavities present in gels of globular proteins such as egg white and bovine serum albumin. Under stringent conditions, spatial-charge-distribution-assisted molecular recognition of proteins for inorganic ions led to the site- and polymorph-specific synthesis of superparamagnetic iron oxide particles. A transformation from magnetite to maghemite as a nucleating phase could be observed by partially denaturing the egg white protein, signifying the delicate role of quaternary structure of proteins under different reaction conditions, in determining the size and shape of the polymorph