Interrater Reliability in Toxicity Identification: Limitations of Current Standards.

PurposeThe National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) v5.0 is the standard for oncology toxicity encoding and grading, despite limited validation. We assessed interrater reliability (IRR) in multireviewer toxicity identification.Methods and materialsTwo reviewers independently reviewed 100 randomly selected notes for weekly on-treatment visits during radiation therapy from the electronic health record. Discrepancies were adjudicated by a third reviewer for consensus. Term harmonization was performed to account for overlapping symptoms in CTCAE. IRR was assessed based on unweighted and weighted Cohen's kappa coefficients.ResultsBetween reviewers, the unweighted kappa was 0.68 (95% confidence interval, 0.65-0.71) and the weighted kappa was 0.59 (0.22-1.00). IRR was consistent between symptoms noted as present or absent with a kappa of 0.6 (0.66-0.71) and 0.6 (0.65-0.69), respectively.ConclusionsSignificant discordance suggests toxicity identification, particularly retrospectively, is a complex and error-prone task. Strategies to minimize IRR, including training and simplification of the CTCAE criteria, should be considered in trial design and future terminologies

Occurrence, Distribution and Seasonality of Watermolds in Selected Forest Ecosystems of Central Himalaya

Occurrence, Distribution and Seasonality of Watermolds in Selected Forest Ecosystems of Central Himalay

Bulk Current Injection Testing of Cable Noise Reduction Techniques, 50 kHz to 400 MHz

This paper presents empirical results of cable noise reduction techniques as demonstrated using bulk current injection (BCI) techniques with radiated fields from 50 kHz - 400 MHz. It is a follow up to the two-part paper series presented at the Asia Pacific EMC Conference that focused on TEM cell signal injection. This paper discusses the effects of cable types, shield connections, and chassis connections on cable noise. For each topic, well established theories are compared with data from a real-world physical system

THE STUDY OF NUTRITIONAL REQUIREMENTS IN SECOND TRIMESTER W.S.R. GARBHINI PARICHARYA ACCORDING TO SUSHRUTACHARYA

It is the need of an hour to have healthy pregnancies in Indian population as the normal nutritional requirements in maternal periods of women in India are not getting fulfilled, so as the malnourished and birth defective children are born. Out of three trimesters of pregnancy in second trimester nutrition need are higher than estimated nutrition requirement for non pregnant women which is less in first trimester. As per the modern science there are lot many nutritional deficiencies occurring in second trimester which causes serious health hazards in mother as well in fetus. The main deficiencies in second trimester of pregnancy are protein, folic acid, calcium, iron, vitamin D, thiamine, vitamin A.Ancient Ayurveda prescribes some set of guidelines which can help make this time more easy for the women. Ayurveda has given proper regimens of diet and life style in during different stages of pregnancy. This paper talks about second trimester of pregnancy because in this all organ starts to appear according to Ayurvedic Samhitas and modern aspects also. It is given in Mansanumasik Garbhini Paricharya which is mentioned in Ayurvedic Samhita, the regime for the pregnant women. It is similar to the modern science diet to the pregnant women. Therefore this is a small effort to find out the exact concept of Garbhini Paricharya given by Aacharya sushruta is nutritionally a complete supplement for Garbhini

STUDY OF MARMAS IN LOWER EXTREMITY WITH SPECIAL REFERENCE TO URVI MARMA

Marma (vital point) science is one element of Ayurveda gifted by Acharyas. It is not much developed in modern science. Marma are vital point on body surface having importance regarding traumatic effect. Marma is vital point where injury occur can lead to disability, dysfunctioning or even termination of life. Every aspect of Marma like definition, signs symptoms of Marma injury was thoroughly explained by Acharya Sushrut. Not only the Marma but also the Marma Viddha Lakashana (after effect injury) was documented by Acharya Sushrut. These Lakshanas (symptoms) shows similarity with the sign & symptoms occur due to the trauma at that site. It is an need of an hour to find out the exact structure present at Marma site so as to prevent disability or deformity effect after injury. Here we are studying Urvi Marma, which lies in the middle of the thigh as given in Samhita Granthas. As per modern anatomy in the middle region of thigh, there is structure of adductor canal. Adductor canal contains femoral artery, femoral vein, which are major blood vessels of lower limb. Urvi Marma which has been described as Sira Marma (vascular vital point) & Vaikalyakara Marma (deformity) by Acharyas. The present study is done to trace the exact location of Urvi Marma according to modern anatomy, so that actual structure present at that site can be known which helps to elaborate Vidha lakashana (injury effect) of Urvi Marma.&nbsp

CCL11 (eotaxin‐1): A new diagnostic serum marker for prostate cancer

BACKGROUND The recent recommendation of the U.S. Preventive Services Task Force against PSA‐based screening for prostate cancer was based, in part, on the lack of demonstrated diagnostic utility of serum PSA values in the low, but detectable range to successfully predict prostate cancer. Though controversial, this recommendation reinforced the critical need to develop, validate, and determine the utility of other serum and/or urine transcript and protein markers as diagnostic markers for PCa. The studies described here were intended to determine whether inflammatory cytokines might augment serum PSA as a diagnostic marker for prostate cancer. METHODS Multiplex ELISA assays were performed to quantify CCL1, CCL2, CCL5, CCL8, CCL11, CCL17, CXCL1, CXCL5, CXCL8, CXCL10, CXCL12, and IL‐6 protein levels in the serum of 272 men demonstrating serum PSA values of <10 ng/ml and undergoing a 12 core diagnostic needle biopsy for detection of prostate cancer. Logistic regression was used to identify the associations between specific chemokines and prostate cancer status adjusted for prostate volume, and baseline PSA. RESULTS Serum levels for CCL1 (I‐309) were significantly elevated among all men with enlarged prostates ( P  < 0.04). Serum levels for CCL11 (Eotaxin‐1) were significantly elevated among men with prostate cancer regardless of prostate size ( P  < 0.01). The remaining 10 cytokines examined in this study did not exhibit significant correlations with either prostate volume or cancer status. CONCLUSIONS Serum CCL11 values may provide a useful diagnostic tool to help distinguish between prostatic enlargement and prostate cancer among men demonstrating low, but detectable, serum PSA values. Prostate 73: 573–581, 2013. © 2012 Wiley Periodicals, Inc.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/97458/1/22597_ftp.pd

STUDY OF IMPORTANCE OF KAKSHADHARA MARMA W. S. R TO ERBS PALSY

Ayurveda is one of the most reliable and complete medical science. The union of Mamsa, Sira, Snayu Asthi and Sandhi are called as Marma. Acharya Sushruta stated every aspect of Marma like definition, signs and symptoms of Marma injury. Total number of Marma as described in Samhitas are 107 in number. Marma science is one of the special aspects deeply elaborated by Ayurveda. Marma are several vital points on the body having importance regarding traumatic effect. These vital points when exposed to trauma generate the symptoms from pain to fatal effect. These points should be protected from injury. Detail knowledge of Marma is important from surgical point of view. Acharya Sushruta explain the Marma viddha lakshana in detail. Human body when expose to trauma shows various signs and symptoms depending on severity and type of trauma. when the trauma to the Kakshadhara Marma causes “Erbs Palsyâ€. Erbs palsy is the paralysis of the arm caused by injury to the upper trunk (c5-c6) of the brachial plexus. There are other ancient Indian sciences also in which the vital points of human body are described. The main aim of this study is to understand the kakshadhra Marma, its location in human body, its applied aspect and to find out any similarity with the vital points explain in Ayurved classics.

Assessment of Potential Geoheritage Sites, Promotion of Geotourism and Geoconservation of Kachchh District, India

Investigation of new geoheritage sites, their conservation and promotion for tourism development have become a recent trend in the tourism sector. The Indian subcontinent exhibits a wide range of geological and geomorphological features, many with global significance. The Kachchh district of Gujarat is blessed with such geological and geomorphological elements, ranging in age from Mesozoic to Recent. This study describes some geologically rich sites and their potential to be ranked as geoheritage sites. To analyze the potential, we carried out four assessments: scientific value, educational value, touristic value, and the degradational risk. A total of 18 geodiversity sites have been considered for this assessment, all of them with unique significance. The authors appeal to the government of India for the conservation of these geodiversity sites through this paper, as we identify that all of them are at risk of degradation. We also provide some suggestions for the promotion of geotourism, some of which the government may adopt

Quenching across quantum critical points in periodic systems: dependence of scaling laws on periodicity

We study the quenching dynamics of a many-body system in one dimension described by a Hamiltonian that has spatial periodicity. Specifically, we consider a spin-1/2 chain with equal xx and yy couplings and subject to a periodically varying magnetic field in the z direction or, equivalently, a tight-binding model of spinless fermions with a periodic local chemical potential, having period 2q, where q is a natural number. For a linear quench of the magnetic field strength (or potential strength) at rate 1/\tau across a quantum critical point, we find that the density of defects thereby produced scales as 1/\tau^{q/(q+1)}, deviating from the 1/\sqrt{\tau} scaling that is ubiquitous to a range of systems. We analyze this behavior by mapping the low-energy physics of the system to a set of fermionic two-level systems labeled by the lattice momentum k undergoing a non-linear quench as well as by performing numerical simulations. We also find that if the magnetic field is a superposition of different periods, the power law depends only on the smallest period for very large values of \tau although it may exhibit a cross-over at intermediate values of \tau. Finally, for the case where a zz coupling is also present in the spin chain, or equivalently, where interactions are present in the fermionic system, we argue that the power associated with the scaling law depends on a combination of q and interaction strength.Comment: 13 pages including 11 figure