UK adaptive radiotherapy practices for head and neck cancer patients

Objective: To provide evidence on the extent and manner in which adaptive practices have been employed in the UK and identify the main barriers for the clinical implementation of adaptive radiotherapy (ART) in head and neck (HN) cancer cases. Methods: In December 2019, a Supplementary Material 1, of 23 questions, was sent to all UK radiotherapy centres (67). This covered general information to current ART practices and perceived barriers to implementation. Results: 31 centres responded (46%). 56% responding centres employed ART for between 10 and 20 patients/annum. 96% of respondents were using CBCT either alone or with other modalities for assessing "weight loss" and "shell gap," which were the main reasons for ART. Adaptation usually occurs at week three or four during the radiotherapy treatment. 25 responding centres used an online image-guided radiotherapy (IGRT) approach and 20 used an offline ad hoc ART approach, either with or without protocol level. Nearly 70% of respondents required 2 to 3 days to create an adaptive plan and 95% used 3-5 mm adaptive planning target volume margins. All centres performed pre-treatment QA. "Limited staff resources" and "lack of clinical relevance" were identified as the two main barriers for ART implementation. Conclusion: There is no consensus in adaptive practice for HN cancer patients across the UK. For those centres not employing ART, similar clinical implementation barriers were identified. Advances in knowledge: An insight into contemporary UK practices of ART for HN cancer patients indicating national guidance for ART implementation for HN cancer patients may be required

Identifying specific prefrontal neurons that contribute to autism-associated abnormalities in physiology and social behavior.

Functional imaging and gene expression studies both implicate the medial prefrontal cortex (mPFC), particularly deep-layer projection neurons, as a potential locus for autism pathology. Here, we explored how specific deep-layer prefrontal neurons contribute to abnormal physiology and behavior in mouse models of autism. First, we find that across three etiologically distinct models-in utero valproic acid (VPA) exposure, CNTNAP2 knockout and FMR1 knockout-layer 5 subcortically projecting (SC) neurons consistently exhibit reduced input resistance and action potential firing. To explore how altered SC neuron physiology might impact behavior, we took advantage of the fact that in deep layers of the mPFC, dopamine D2 receptors (D2Rs) are mainly expressed by SC neurons, and used D2-Cre mice to label D2R+ neurons for calcium imaging or optogenetics. We found that social exploration preferentially recruits mPFC D2R+ cells, but that this recruitment is attenuated in VPA-exposed mice. Stimulating mPFC D2R+ neurons disrupts normal social interaction. Conversely, inhibiting these cells enhances social behavior in VPA-exposed mice. Importantly, this effect was not reproduced by nonspecifically inhibiting mPFC neurons in VPA-exposed mice, or by inhibiting D2R+ neurons in wild-type mice. These findings suggest that multiple forms of autism may alter the physiology of specific deep-layer prefrontal neurons that project to subcortical targets. Furthermore, a highly overlapping population-prefrontal D2R+ neurons-plays an important role in both normal and abnormal social behavior, such that targeting these cells can elicit potentially therapeutic effects

Optimisation of heat exchanger network cleaning schedules: incorporating uncertainty in fouling and cleaning model parameters

The optimisation of the cleaning schedule in heat exchanger networks (HENs) subject to fouling is presented in which the impact of parametric uncertainty is considered. This work is based on the realisation that these HEN cleaning scheduling problems are multistage mixed-integer optimal control problems (MIOCPs) in which the controls, i.e. cleaning actions, exhibit bang-bang behaviour as they occur linearly in the system equations. A multiple scenario feasible path MIOCP approach is proposed, whereby many scenarios of the HEN multiperiod problem are stacked, sharing the same control actions. This is implemented on a 10 unit and a 25 unit HEN case studies representing crude oil refinery preheat trains (PHTs). Results show that there is a large difference in financial performance for the deterministic case versus the parametric uncertainty problem and hence it is vital that uncertainty be taken into account during the optimisation of schedules for HEN maintenance problems.This research was supported by the Ministry of Higher Education in the Sultanate of Oman and Petroleum Development Oman (PDO)

Nondestructive Testing Potential of a Magnetoacoustic Storage Correlator (MASC)

A simple magnetoacoustic storage correlator (MASC) was tested as a pulse compressor in an ultrasonic nondestructive testing application. The pulse compression ratio reached was 30. Higher compression ratios are readily available through choice of different device lengths and device operating regime. The system is flexible; it is not limited to any particular type of large time-bandwidth signal. The correlator reference signal is easily programmable and erasable, and can be changed at any time. This system offers real-time correlation signal processing at a repetition rate that is only limited by the temporal length of the large time-bandwidth signal

Emergent excitations in a geometrically frustrated magnet

Frustrated systems are ubiquitous and interesting because their behavior is difficult to predict. Magnetism offers extreme examples in the form of spin lattices where all interactions between spins cannot be simultaneously satisfied. Such geometrical frustration leads to macroscopic degeneracies, and offers the possibility of qualitatively new states of matter whose nature has yet to be fully understood. Here we have discovered how novel composite spin degrees of freedom can emerge from frustrated interactions in the cubic spinel ZnCr2O4. Upon cooling, groups of six spins self-organize into weakly interacting antiferromagnetic loops whose directors, defined as the unique direction along which the spins are aligned parallel or antiparallel, govern all low temperature dynamics. The experimental evidence comes from a measurement of the magnetic form factor by inelastic neutron scattering. While the data bears no resemblance to the atomic form factor for chromium, they are perfectly consistent with the form factor for hexagonal spin loop directors. The hexagon directors are to a first approximation decoupled from each other and hence their reorientations embody the long-sought local zero energy modes for the pyrochlore lattice.Comment: 10 pages, 4 figures upon reques

Live-cell imaging to detect phosphatidylserine externalization in brain endothelial cells exposed to ionizing radiation: Implications for the treatment of brain arteriovenous malformations

© 2016 AANS. Objective Stereotactic radiosurgery (SRS) is an established intervention for brain arteriovenous malformations (AVMs). The processes of AVM vessel occlusion after SRS are poorly understood. To improve SRS efficacy, it is important to understand the cellular response of blood vessels to radiation. The molecular changes on the surface of AVM endothelial cells after irradiation may also be used for vascular targeting. This study investigates radiation-induced externalization of phosphatidylserine (PS) on endothelial cells using live-cell imaging. methods An immortalized cell line generated from mouse brain endothelium, bEnd.3 cells, was cultured and irradiated at different radiation doses using a linear accelerator. PS externalization in the cells was subsequently visualized using polarity-sensitive indicator of viability and apoptosis (pSIVA)-IANBD, a polarity-sensitive probe. Live-cell imaging was used to monitor PS externalization in real time. The effects of radiation on the cell cycle of bEnd.3 cells were also examined by flow cytometry. results Ionizing radiation effects are dose dependent. Reduction in the cell proliferation rate was observed after exposure to 5 Gy radiation, whereas higher radiation doses (15 Gy and 25 Gy) totally inhibited proliferation. In comparison with cells treated with sham radiation, the irradiated cells showed distinct pseudopodial elongation with little or no spreading of the cell body. The percentages of pSIVA-positive cells were significantly higher (p = 0.04) 24 hours after treatment in the cultures that received 25-and 15-Gy doses of radiation. This effect was sustained until the end of the experiment (3 days). Radiation at 5 Gy did not induce significant PS externalization compared with the sham-radiation controls at any time points (p > 0.15). Flow cytometric analysis data indicate that irradiation induced growth arrest of bEnd.3 cells, with cells accumulating in the G2 phase of the cell cycle. coNclusioNs Ionizing radiation causes remarkable cellular changes in endothelial cells. Significant PS externalization is induced by radiation at doses of 15 Gy or higher, concomitant with a block in the cell cycle. Radiation-induced markers/targets may have high discriminating power to be harnessed in vascular targeting for AVM treatment

The validity of using ICD-9 codes and pharmacy records to identify patients with chronic obstructive pulmonary disease

Background: Administrative data is often used to identify patients with chronic obstructive pulmonary disease (COPD), yet the validity of this approach is unclear. We sought to develop a predictive model utilizing administrative data to accurately identify patients with COPD. Methods: Sequential logistic regression models were constructed using 9573 patients with postbronchodilator spirometry at two Veterans Affairs medical centers (2003-2007). COPD was defined as: 1) FEV1/FVC <0.70, and 2) FEV1/FVC < lower limits of normal. Model inputs included age, outpatient or inpatient COPD-related ICD-9 codes, and the number of metered does inhalers (MDI) prescribed over the one year prior to and one year post spirometry. Model performance was assessed using standard criteria. Results: 4564 of 9573 patients (47.7%) had an FEV1/FVC < 0.70. The presence of ≥1 outpatient COPD visit had a sensitivity of 76% and specificity of 67%; the AUC was 0.75 (95% CI 0.74-0.76). Adding the use of albuterol MDI increased the AUC of this model to 0.76 (95% CI 0.75-0.77) while the addition of ipratropium bromide MDI increased the AUC to 0.77 (95% CI 0.76-0.78). The best performing model included: ≥6 albuterol MDI, ≥3 ipratropium MDI, ≥1 outpatient ICD-9 code, ≥1 inpatient ICD-9 code, and age, achieving an AUC of 0.79 (95% CI 0.78-0.80). Conclusion: Commonly used definitions of COPD in observational studies misclassify the majority of patients as having COPD. Using multiple diagnostic codes in combination with pharmacy data improves the ability to accurately identify patients with COPD.Department of Veterans Affairs, Health Services Research and Development (DHA), American Lung Association (CI- 51755-N) awarded to DHA, the American Thoracic Society Fellow Career Development AwardPeer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/84155/1/Cooke - ICD9 validity in COPD.pd

Electrodeposition of CuGaSe2 and CuGaS2 thin films for photovoltaic applications

The final publication is available at Springer via http://dx.doi.org/10.1007/s10008-016-3237-0.Abstract CuGaSe2 and CuGaS2 polycrystalline thin film absorbers were prepared by one-step electrodeposition from an aqueous electrolyte containing CuCl2, GaCl3 and H2SeO3. The pH of the solution was adjusted to 2.3 by adding HCl and KOH. Annealing improved crystallinity of CuGaSe2 and further annealing in sulphur atmosphere was required to obtain CuGaS2 layers. The morphology, topography, chemical composition and crystal structure of the deposited thin films were analysed by scanning electron microscopy, atomic force microscopy, energy dispersive spectroscopy and X-ray diffraction, respectively. X-Ray diffraction showed that the asdeposited CuGaSe2 film exhibited poor crystallinity, but which improved dramatically when the layers were annealed in forming gas atmosphere for 40 min. Subsequent sulphurization of CuGaSe2 films was performed at 400 °C for 10 min in presence of molecular sulphur and under forming gas atmosphere. The effect of sulphurization was the conversion of CuGaSe2 into CuGaS2. The formation of CuGaS2 thin films was evidenced by the shift observed in the X-ray diffraction pattern and by the blue shift of the optical bandgap. The bandgap of CuGaSe2 was found to be 1.66 eV, while for CuGaS2 it raised up to 2.2 eV. A broad intermediate absorption band associated to Cr and centred at 1.63 eV was observed in Cr-doped CuGaS2 films.This work was supported by Ministerio de Economia y Competitividad (ENE2013-46624-C4-4-R) and Generalitat Valenciana (Prometeus 2014/044). One of the authors (S. Ullah) acknowledges the European Union (IDEAS-Call-3, Innovation and Design for Euro-Asian scholars) for its financial support.Ullah, S.; Mollar García, MA.; Marí, B. (2016). Electrodeposition of CuGaSe2 and CuGaS2 thin films for photovoltaic applications. Journal of Solid State Electrochemistry. 20(8):2251-2257. https://doi.org/10.1007/s10008-016-3237-0S22512257208Calixto ME, Sebastian PJ, Bhattacharya RN, Noufi (1999) Sol Energ Mat Sol C 59:75–84Mandati S, Sarada BV, Dey SR, Joshi SV (2015) J Power Sources 273:149–157Jacobsson TJ, Fjällström V, Edoff M, Edvinsson T (2015) Sol Energ Mat Sol C 134:185–193Carrete A, Placidi M, Shavel A, Pérez Rodríguez A, Cabot A (2015) Phys Stat Sol (a) 212:67–71Saji VS, Ik-Ho C, Lee CW (2011) Sol Energy 86:2666–2678Park MG, Ahn SJ, Yun JH, Gwak J, Cho A, Ahn SK, Shin K, Nam D, Cheong H, Yoon K (2012) J Alloy Compd 513:68–74Saji VS, Lee SM, Lee CW (2011) J Korean Electrochem Soc 14:61–70Donglin X, Jangzhuang L, Man X, Xiujian Z (2008) J Non-Cryst Solids 354:1447–1450Araujo J, Ortíz R, López-Rivera A, Ortega JM, Montilla M, Alarcón D (2007) J Solid State Electroch 11(Issue 3):407–412Palacios P, Sanchez K, Conesa JC, Fernandez JJ, Wahnon P (2007) Phys Stat Sol A 203:1395–1401Palacios P, Sanchez K, Conesa JC, Wahnon P (2006) Thin Solid Films 515:6280–6284Lee H, Lee J-H, Hwang Y-H, Kim Y (2014) Curr Appl Phys 14:18–22Kim D, Kwon Y, Lee D, Yoon S, Lee S, Yoo B (2015) J Electrochem Soc 162:D36–D41Hou WW, Bob B, Li S, Yang Y (2009) Thin Solid Films 517:6853–6856Lee J, Lee W, Shrestha NK, Lee DY, Lim I, Kang SH, Nah YC, Lee SH, Yi W, Han SH (2014) Mater Chem Phys 144:49–54Yang JY, Lee D, Huh K, Jung SJ, Lee JW, Lee HC, Baek DH, Kim BJ, Kim D, Nam J, Kim GY, Jo W (2015) RSC Adv 5:40719–407257Sall T, Nafidi A, Marí B, Mollar M, Hartiti B, Fahoume M (2014) J Semicond 35:0630021–0630025Lee JH, Song WC, Yi JS, Joonyang K, Han WD, Hawang J (2003) Thin Solid Films 431-432:349–353Prabukanthan P, Dhanasekaran R (2007) Cryst Growth Des 7:618–623Guillemoles JF, Cowache P, Lusson A, Fezzaa K, Boisivon F, Vedel J, Lincot D (1996) J Appl Phys 79:7293–7302Aguilera I, Palacios P, Wahon P (2010) Sol Energ Mat Sol C 94:1903–1906Palacios P, Aguilera I, Wahnón P, Conesa JC (2008) J Phys Chem C 112:9525–952

Congenital partial arhinia: a case report

Congenital arhinia is an extremely rare anomaly consisting of an absence of external nasal structures and nasal passages. Fewer than 30 cases have been reported. Patients with a familial absence of the nose have been reported, but the effects of genetic and maternal factors are unknown. Midface hypoplasia may accompany arhinia. Accompanying malformations are thought to be caused by an absent or rudimentary nose. A patient with partial congenital arhinia is presented and the embryology and literature review are discussed

Thermal production of axino Dark Matter

We reconsider thermal production of axinos in the early universe, adding: a) missed terms in the axino interaction; b) production via gluon decays kinematically allowed by thermal masses; c) a precise modeling of reheating. We find an axino abunance a few times larger than previous computations.Comment: 6 pages, 2 figures. Final version, to appear on JHE