Virtual Reality Prototype of a Linear Accelerator Simulator for Oncological Radiotherapy Training

Learning to operate medical equipment is one of the essential skills for providing efficient treatment to patients. One of the current problems faced by many medical institutions is the lack or shortage of specialized infrastructure for medical practitioners to conduct hands-on training. Medical equipment is mostly used for patients, limiting training time drastically. Virtual simulation can help alleviate this problem by providing the virtual embodiment of the medical facility in an affordable manner. This paper reports the current results of an ongoing project aimed at providing virtual reality-based technical training on various medical equipment to radiophysicist trainees. In particular, we introduce a virtual reality (VR) prototype of a linear accelerator simulator for oncological radiotherapy training. The paper discusses the main challenges and features of the VR prototype, including the system design and implementation. A key factor for trainees’ access and usability is the user interface, particularly tailored in our prototype to provide a powerful and versatile yet friendly user interaction

The Dark Matter halo of the Milky Way, AD 2013

We derive the mass model of the Milky Way (MW) using a cored dark matter (DM) halo profile and recent data. The method used consists in fitting a spherically symmetric model of the Galaxy with a Burkert DM halo profile to available data: MW terminal velocities in the region inside the solar circle, circular velocity as recently estimated from maser star forming regions at intermediate radii, and velocity dispersions of stellar halo tracers for the outermost Galactic region. The latter are reproduced by integrating the Jeans equation for every modeled mass distribution, and by allowing for different velocity anisotropies for different tracer populations. For comparison we also consider a Navarro-Frenk-White profile. We find that the cored profile is the preferred one, with a shallow central density of rho_H~4x10^7M_s/kpc^3 and a large core radius R_H~10 kpc, as observed in external spirals and in agreement with the mass model underlying the Universal Rotation Curve of spirals. We describe also the derived model uncertainties, which are crucially driven by the poorly constrained velocity dispersion anisotropies of halo tracers. The emerging cored DM distribution has implications for the DM annihilation angular profile, which is much less boosted in the Galactic center direction with respect to the case of the standard \Lambda CDM, NFW profile. Using the derived uncertainties we discuss finally the limitations and prospects to discriminate between cored and cusped DM profile with a possible observed diffuse DM annihilation signal. The present mass model aims to characterize the present-day description of the distribution of matter in our Galaxy, which is needed to frame current crucial issues of Cosmology, Astrophysics and Elementary Particles

Degradabilidade in situ de híbridos de milho e de capim-elefante colhidos em quatro estádios de maturidade

Dentre as forragens, a silagem de milho é amplamente utilizada pelos fazendeiros que visam explorar o máximo do potencial genético dos animais. No entanto, outros volumosos tropicais como o capim-elefante (Pennisetum purpureum) são mais produtivos e, portanto, mais baratos do que a silagem de milho. Nosso objetivo foi comparar a degradabilidade in situ do capim-elefante com a degradabilidade de híbridos de milho, colhidos em quatro estágios de maturidade. O experimento seguiu um delineamento de blocos ao acaso com sub-parcelas. Dois híbridos de milho: AG5011 e ZN8392 foram colhidos com 25, 30, 35 e 40% matéria seca (MS) na planta toda e separados na fração colmo + bainha + folhas e espigas. Capim elefante foi colhido 30, 40, 50 e 60 dias após o corte de nivelamento. As amostras secas e trituradas foram incubadas no rúmen por 0, 6, 12, 24, 48 e 72 h para cálculo da cinética da degradação ruminal da MS e da fibra em detergente neutro (FDN). O avanço da maturidade aumentou os teores de FDN e fibra em detergente ácido (FDA) do capim elefante e reduziu a degradabilidade da MS. Entretanto, a maturidade teve pouco efeito sobre os teores de fibra e a degradabilidade da MS da fração planta dos híbridos de milho. O capim elefante apresentou maior degradabilidade da FDN do que híbridos de milho, e não houve efeito da maturidade sobre a degradabilidade da FDN das duas espécies. A degradabilidade da fibra de capim-elefante não é pior do que a de híbridos de milho e, portanto a escolha da forragem deve ser feita com base em análises econômicas ao invés de assumir um menor potencial de produção em dietas a base de capim elefanteAmong tropical forages, corn silage is largely used by farmers trying to explore the maximum genetic potential from the animals. However, other tropical forages, such as elephant-grass (Pennisetum purpureum), are more productive and therefore cheaper to use than corn silage. Our objective was to compare the in situ degradability of elephant-grass with that from corn hybrids, all harvested at four stages of maturity. The experimental design followed a randomized block design with nested subplots. Two corn hybrids: AG5011, ZN8392 were harvested with 25, 30, 35, and 40% dry matter (DM) in the whole plant, and separated in stem + leaf sheath + leaf blade (stover), and cobs. Elephant-grass was harvested with 30, 40, 50 and 60 days after a leveling cut. Dried and ground samples were incubated in nylon bags inside the rumen for 0, 6, 12, 24, 48 and 72 h to estimate the kinetics of ruminal DM and neutral detergent fiber (NDF) degradation. The advance of maturity increased the NDF and acid detergent fiber (ADF) content in elephant-grass, and reduced its DM degradability. However, maturity had little or no effect on fiber content and DM degradability of corn stover. Elephant-grass had a higher NDF degradability than corn stover, and there was no effect of maturity on NDF degradability of either elephant-grass or corn stover. Fiber degradability of elephant-grass was not worse than that of corn stover, and therefore the choice of forage should be made on economical analysis rather than assuming an intrinsic low production potential for elephant-grass based diet

In situ degradability of corn stover and elephant-grass harvested at four stages of maturity

Among tropical forages, corn silage is largely used by farmers trying to explore the maximum genetic potential from the animals. However, other tropical forages, such as elephant-grass (Pennisetum purpureum), are more productive and therefore cheaper to use than corn silage. Our objective was to compare the in situ degradability of elephant-grass with that from corn hybrids, all harvested at four stages of maturity. The experimental design followed a randomized block design with nested subplots. Two corn hybrids: AG5011, ZN8392 were harvested with 25, 30, 35, and 40% dry matter (DM) in the whole plant, and separated in stem + leaf sheath + leaf blade (stover), and cobs. Elephant-grass was harvested with 30, 40, 50 and 60 days after a leveling cut. Dried and ground samples were incubated in nylon bags inside the rumen for 0, 6, 12, 24, 48 and 72 h to estimate the kinetics of ruminal DM and neutral detergent fiber (NDF) degradation. The advance of maturity increased the NDF and acid detergent fiber (ADF) content in elephant-grass, and reduced its DM degradability. However, maturity had little or no effect on fiber content and DM degradability of corn stover. Elephant-grass had a higher NDF degradability than corn stover, and there was no effect of maturity on NDF degradability of either elephant-grass or corn stover. Fiber degradability of elephant-grass was not worse than that of corn stover, and therefore the choice of forage should be made on economical analysis rather than assuming an intrinsic low production potential for elephant-grass based diets.Dentre as forragens, a silagem de milho é amplamente utilizada pelos fazendeiros que visam explorar o máximo do potencial genético dos animais. No entanto, outros volumosos tropicais como o capim-elefante (Pennisetum purpureum) são mais produtivos e, portanto, mais baratos do que a silagem de milho. Nosso objetivo foi comparar a degradabilidade in situ do capim-elefante com a degradabilidade de híbridos de milho, colhidos em quatro estágios de maturidade. O experimento seguiu um delineamento de blocos ao acaso com sub-parcelas. Dois híbridos de milho: AG5011 e ZN8392 foram colhidos com 25, 30, 35 e 40% matéria seca (MS) na planta toda e separados na fração colmo + bainha + folhas e espigas. Capim elefante foi colhido 30, 40, 50 e 60 dias após o corte de nivelamento. As amostras secas e trituradas foram incubadas no rúmen por 0, 6, 12, 24, 48 e 72 h para cálculo da cinética da degradação ruminal da MS e da fibra em detergente neutro (FDN). O avanço da maturidade aumentou os teores de FDN e fibra em detergente ácido (FDA) do capim elefante e reduziu a degradabilidade da MS. Entretanto, a maturidade teve pouco efeito sobre os teores de fibra e a degradabilidade da MS da fração planta dos híbridos de milho. O capim elefante apresentou maior degradabilidade da FDN do que híbridos de milho, e não houve efeito da maturidade sobre a degradabilidade da FDN das duas espécies. A degradabilidade da fibra de capim-elefante não é pior do que a de híbridos de milho e, portanto a escolha da forragem deve ser feita com base em análises econômicas ao invés de assumir um menor potencial de produção em dietas a base de capim elefante

Anemia prevalence in women of reproductive age in low- and middle-income countries between 2000 and 2018

Anemia is a globally widespread condition in women and is associated with reduced economic productivity and increased mortality worldwide. Here we map annual 2000–2018 geospatial estimates of anemia prevalence in women of reproductive age (15–49 years) across 82 low- and middle-income countries (LMICs), stratify anemia by severity and aggregate results to policy-relevant administrative and national levels. Additionally, we provide subnational disparity analyses to provide a comprehensive overview of anemia prevalence inequalities within these countries and predict progress toward the World Health Organization’s Global Nutrition Target (WHO GNT) to reduce anemia by half by 2030. Our results demonstrate widespread moderate improvements in overall anemia prevalence but identify only three LMICs with a high probability of achieving the WHO GNT by 2030 at a national scale, and no LMIC is expected to achieve the target in all their subnational administrative units. Our maps show where large within-country disparities occur, as well as areas likely to fall short of the WHO GNT, offering precision public health tools so that adequate resource allocation and subsequent interventions can be targeted to the most vulnerable populations.Peer reviewe

Observation of a sudden cessation of a very-high-energy gamma-ray flare in PKS 1510-089 with H.E.S.S. and MAGIC in May 2016

The flat spectrum radio quasar (FSRQ) PKS 1510-089 is known for its complex multiwavelength behavior, and is one of only a few FSRQs detected at very high energy (VHE, E >100 GeV) -rays. VHE -ray observations with H.E.S.S. and MAGIC during late May and early June 2016 resulted in the detection of an unprecedented flare, which reveals for the first time VHE -ray intranight variability in this source. While a common variability timescale of 1.5 hr is found, there is a significant deviation near the end of the flare with a timescale of ∼ 20 min marking the cessation of the event. The peak flux is nearly two orders of magnitude above the low-level emission. For the first time, curvature is detected in the VHE -ray spectrum of PKS 1510-089, which is fully explained through absorption by the extragalactic background light. Optical R-band observations with ATOM reveal a counterpart of the -ray flare, even though the detailed flux evolution differs from the VHE lightcurve. Interestingly, a steep flux decrease is observed at the same time as the cessation of the VHE flare. In the high energy (HE, E >100 MeV) -ray band only a moderate flux increase is observed with Fermi-LAT, while the HE -ray spectrum significantly hardens up to a photon index of 1.6. A search for broad-line region (BLR) absorption features in the -ray spectrum indicates that the emission region is located outside of the BLR. Radio VLBI observations reveal a fast moving knot interacting with a standing jet feature around the time of the flare. As the standing feature is located ∼ 50 pc from the black hole, the emission region of the flare may have been located at a significant distance from the black hole. If this correlation is indeed true, VHE rays have been produced far down the jet where turbulent plasma crosses a standing shock.Accepted manuscrip

Global age-sex-specific fertility, mortality, healthy life expectancy (HALE), and population estimates in 204 countries and territories, 1950–2019: a comprehensive demographic analysis for the Global Burden of Disease Study 2019

Background: Accurate and up-to-date assessment of demographic metrics is crucial for understanding a wide range of social, economic, and public health issues that affect populations worldwide. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 produced updated and comprehensive demographic assessments of the key indicators of fertility, mortality, migration, and population for 204 countries and territories and selected subnational locations from 1950 to 2019. Methods: 8078 country-years of vital registration and sample registration data, 938 surveys, 349 censuses, and 238 other sources were identified and used to estimate age-specific fertility. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate age-specific fertility rates for 5-year age groups between ages 15 and 49 years. With extensions to age groups 10–14 and 50–54 years, the total fertility rate (TFR) was then aggregated using the estimated age-specific fertility between ages 10 and 54 years. 7417 sources were used for under-5 mortality estimation and 7355 for adult mortality. ST-GPR was used to synthesise data sources after correction for known biases. Adult mortality was measured as the probability of death between ages 15 and 60 years based on vital registration, sample registration, and sibling histories, and was also estimated using ST-GPR. HIV-free life tables were then estimated using estimates of under-5 and adult mortality rates using a relational model life table system created for GBD, which closely tracks observed age-specific mortality rates from complete vital registration when available. Independent estimates of HIV-specific mortality generated by an epidemiological analysis of HIV prevalence surveys and antenatal clinic serosurveillance and other sources were incorporated into the estimates in countries with large epidemics. Annual and single-year age estimates of net migration and population for each country and territory were generated using a Bayesian hierarchical cohort component model that analysed estimated age-specific fertility and mortality rates along with 1250 censuses and 747 population registry years. We classified location-years into seven categories on the basis of the natural rate of increase in population (calculated by subtracting the crude death rate from the crude birth rate) and the net migration rate. We computed healthy life expectancy (HALE) using years lived with disability (YLDs) per capita, life tables, and standard demographic methods. Uncertainty was propagated throughout the demographic estimation process, including fertility, mortality, and population, with 1000 draw-level estimates produced for each metric. Findings: The global TFR decreased from 2•72 (95% uncertainty interval [UI] 2•66–2•79) in 2000 to 2•31 (2•17–2•46) in 2019. Global annual livebirths increased from 134•5 million (131•5–137•8) in 2000 to a peak of 139•6 million (133•0–146•9) in 2016. Global livebirths then declined to 135•3 million (127•2–144•1) in 2019. Of the 204 countries and territories included in this study, in 2019, 102 had a TFR lower than 2•1, which is considered a good approximation of replacement-level fertility. All countries in sub-Saharan Africa had TFRs above replacement level in 2019 and accounted for 27•1% (95% UI 26•4–27•8) of global livebirths. Global life expectancy at birth increased from 67•2 years (95% UI 66•8–67•6) in 2000 to 73•5 years (72•8–74•3) in 2019. The total number of deaths increased from 50•7 million (49•5–51•9) in 2000 to 56•5 million (53•7–59•2) in 2019. Under-5 deaths declined from 9•6 million (9•1–10•3) in 2000 to 5•0 million (4•3–6•0) in 2019. Global population increased by 25•7%, from 6•2 billion (6•0–6•3) in 2000 to 7•7 billion (7•5–8•0) in 2019. In 2019, 34 countries had negative natural rates of increase; in 17 of these, the population declined because immigration was not sufficient to counteract the negative rate of decline. Globally, HALE increased from 58•6 years (56•1–60•8) in 2000 to 63•5 years (60•8–66•1) in 2019. HALE increased in 202 of 204 countries and territories between 2000 and 2019. Interpretation: Over the past 20 years, fertility rates have been dropping steadily and life expectancy has been increasing, with few exceptions. Much of this change follows historical patterns linking social and economic determinants, such as those captured by the GBD Socio-demographic Index, with demographic outcomes. More recently, several countries have experienced a combination of low fertility and stagnating improvement in mortality rates, pushing more populations into the late stages of the demographic transition. Tracking demographic change and the emergence of new patterns will be essential for global health monitoring. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licens