The effect and stability of MVCT images on adaptive TomoTherapy.

Use of helical TomoTherapy-based MVCT imaging for adaptive planning is becoming increasingly popular. Treatment planning and dose calculations based on MVCT require an image value to electron density calibration to remain stable over the course of treatment time. In this work, we have studied the dosimetric impact on TomoTherapy treatment plans due to variation in image value to density table (IVDT) curve as a function of target degradation. We also have investigated the reproducibility and stability of the TomoTherapy MVCT image quality over time. Multiple scans of the TomoTherapy "Cheese" phantom were performed over a period of five months. Over this period, a difference of 4.7% in the HU values was observed in high-density regions while there was no significant variation in the image values for the low densities of the IVDT curve. Changes in the IVDT curves before and after target replacement were measured. Two clinical treatment sites, pelvis and prostate, were selected to study the dosimetric impact of this variation. Dose was recalculated on the MVCTs with the planned fluence using IVDT curves acquired before and after target change. For the cases studied, target replacement resulted in an overall difference of less than 5%, which can be significant for hypo-fractionated cases. Hence, it is recommended to measure the IVDT curves on a monthly basis and after any major repairs/replacements

ROLE OF KSHARSUTRA IN THE TREATMENT OF RECURRENT PILONIDAL SINUSES

Pilonidal sinus is a disease that most commonly arises in the hair follicles of the natal cleft of the sacrococcygeal area. Incidence is reportedly 26 per 1000 population, affecting males twice as often as females and predominantly young adults of working age. Pilonidal sinus usually presents as an abscess or a chronically discharging, painful sinus tract. Irrespective of the mode of presentation the painful nature of the condition causes significant morbidity, often with a protracted loss of normal activity. The ideal therapy would be a quick cure that allowed patients to return rapidly to normal activity, with minimal morbidity and a low risk of complications. As recurrence rate after surgery is very high almost 50 % and 30 % after surgery, this needs to see another treatment modalities. Ksharasutra has proved its efficacy in the treatment of fistula-in-ano since many decades. So here we have considered Ksharsutra for the treatment of recurrent pilonidal sinus especially in the recurrence after surgery. In this study very good results were found with post treatment follow up. In this study of 34 patients, all had achieved complete healing within 4 weeks to 8 weeks, mean is 6 weeks of operation. Follow-up of 30 patients was available for 12–24 months in which no patients had recurrence

Palliation of advanced/metastatic carcinoma esophagus with radiotherapy

Background: Esophageal carcinoma carries an overall poor prognosis. Most patients present with lo¬cally advanced, unresectable or metastatic disease. The main objective in advanced disease is the palliation of dysphagia. Treatment options include surgery (bypass, resection), laser, stent placement, external beam radiotherapy (EBRT), brachytherapy and systemic chemotherapy. We have focused on our experience with EBRT followed by brachytherapy.Methods: From January 2013 to December 2014, 29 patients of advanced/metastatic esophageal cancer were treated by HDR Brachytherapy following EBRT. All patients received 2# of 5Gy HDR brachytherapy. EBRT was 40Gy/20# (18 patients) and 36Gy/12# (11 patients). Disease remission and relief of dysphagia along with toxicity assessment were carried out at 1, 3 and 6 months after completion of treatment.Results: Evaluation at 1 month after brachytherapy showed complete remission (CR) of the disease in 6 patients, partial remission (PR) in 17 patients and no remission (NR) in 6. Overall improvement in swallowing status was seen in 22(75.86%) patients. 7 patients showed no improvement and 1 reported worsening of dysphagia score at 1 month after ILRT. The improvement in swallowing was maintained by 55.17% of patients at 6 months. Strictures had developed in 5 patients, ulceration in 3 patients and fistula in 1.Conclusions: A combination of EBRT and HDR brachytherapy affords effective palliation in advanced esophageal cancer with acceptable toxicity.

Exploring Cognitive States: Methods for Detecting Physiological Temporal Fingerprints

Cognitive state detection and its relationship to observable physiologically telemetry has been utilized for many human-machine and human-cybernetic applications. This paper aims at understanding and addressing if there are unique psychophysiological patterns over time, a physiological temporal fingerprint, that is associated with specific cognitive states. This preliminary work involves commercial airline pilots completing experimental benchmark task inductions of three cognitive states: 1) Channelized Attention (CA); 2) High Workload (HW); and 3) Low Workload (LW). We approach this objective by modeling these "fingerprints" through the use of Hidden Markov Models and Entropy analysis to evaluate if the transitions over time are complex or rhythmic/predictable by nature. Our results indicate that cognitive states do have unique complexity of physiological sequences that are statistically different from other cognitive states. More specifically, CA has a significantly higher temporal psychophysiological complexity than HW and LW in EEG and ECG telemetry signals. With regards to respiration telemetry, CA has a lower temporal psychophysiological complexity than HW and LW. Through our preliminary work, addressing this unique underpinning can inform whether these underlying dynamics can be utilized to understand how humans transition between cognitive states and for improved detection of cognitive states

Forecasting minimum temperature during winter and maximum temperature during summer at Delhi

A knowledge of minimum temperature during winter and maximum temperature during summer is a very useful for individuals, as well as for organisations whose workers and machines have to operate in the open, e.g. the armed forces, railways, roadways, tourism, etc. Accurate forecasts of minimum temperature during winter help in the prediction of cold-wave conditions and those of maximum temperature during summer help in the prediction of heat-wave conditions over northern India. Models for forecasting the minimum temperature during December and the maximum temperature during May at Delhi have been developed using surface and upper-air meteorological data from 1984-89. The results of testing the models on independent data from recent years (1994-95) are presented. The results are encouraging and more than 80% of the forecasts are correct within ±2°C. Possible reasons for large deviations are also investigated

Forecasting of thunderstorms in the pre-monsoon season at Delhi

Accurate prediction of thunderstorms during the pre-monsoon season (April-June) in India is essential for human activities such as construction, aviation and agriculture. Two objective forecasting methods are developed using data from May and June for 1985-89. The developed methods are tested with independent data sets of the recent years, namely May and June for the years 1994 and 1995. The first method is based on a graphical technique. Fifteen different types of stability index are used in combinations of different pairs. It is found that Showalter index versus Totals total index and Jefferson's modified index versus George index can cluster cases of occurrence of thunderstorms mixed with a few cases of non-occurrence along a zone. The zones are demarcated and further sub-zones are created for clarity. The probability of occurrence/non-occurrence of thunderstorms in each sub-zone is then calculated. The second approach uses a multiple regression method to predict the occurrence/nonoccurrence of thunderstorms. A total of 274 potential predictors are subjected to stepwise screening and nine significant predictors are selected to formulate a multiple regression equation that gives the forecast in probabilistic terms. Out of the two methods tested, it is found that the multiple regression method gives consistently better results with developmental as well as independent data sets; it is a potential method for operational use

Protein fold recognition using HMM–HMM alignment and dynamic programming

Detecting three dimensional structures of protein sequences is a challenging task in biological sciences. For this purpose, protein fold recognition has been utilized as an intermediate step which helps in classifying a novel protein sequence into one of its folds. The process of protein fold recognition encompasses feature extraction of protein sequences and feature identification through suitable classi- fiers. Several feature extractors are developed to retrieve useful information from protein sequences. These features are generally extracted by constituting protein’s sequential, physicochemical and evolutionary properties. The performance in terms of recognition accuracy has also been gradually improved over the last decade. However, it is yet to reach a well reasonable and accepted level. In this work, we first applied HMM–HMM alignment of protein sequence from HHblits to extract profile HMM (PHMM) matrix. Then we computed the distance between respective PHMM matrices using kernalized dynamic programming. We have recorded significant improvement in fold recognition over the state-of-the-art feature extractors. The improvement of recognition accuracy is in the range of 2.7–11.6% when experimented on three benchmark datasets from Structural Classification of Proteins

Assimilation of IRS-P4 (MSMR) meteorological data in the NCMRWF global data assimilation system

Oceansat-1 was successfully launched by India in 1999, with two payloads, namely Multi-frequency Scanning Microwave Radiometer (MSMR) and Ocean Color Monitor (OCM) to study the biological and physical parameters of the ocean. The MSMR sensor is configured as an eight-channel radiometer using four frequencies with dual polarization. The MSMR data at 75 km resolution from the Oceansat-I have been assimilated in the National Centre for Medium Range Weather Forecasting (NCMRWF) data assimilation forecast system. The operational analysis and forecast system at NCMRWF is based on a T80L18 global spectral model and Spectral Statistical Interpolation (SSI) scheme for data analysis. The impact of the MSMR data is seen globally, however it is significant over the oceanic region where conventional data are rare. The dry-nature of the control analyses have been removed by utilizing the MSMR data. Therefore, the total precipitable water data from MSMR has been identified as a very crucial parameter in this study. The impact of surface wind speed from MSMR is to increase easterlies over the tropical Indian Ocean. Shifting of the positions of westerly troughs and ridges in the south Indian Ocean has contributed to reduction of temperature to around 30‡S