A study on the correlation between plan complexity and gamma index analysis in patient specific quality assurance of volumetric modulated arc therapy

Aim

To evaluate the new Octavius 4D system for patient specific quality assurance and to study the correlation between plan complexity and gamma index analysis in patient specific quality assurance of VMAT using the Octavius 4D system.

Background

McNiven (2010) proposed a study to evaluate the utility of a complexity metric, the Modulation Complexity Score, to evaluate the relationship of the metric with deliverability in IMRT.

Materials and methods

Evaluation of the Octavius 4D system was carried out by gamma evaluation of user defined MLC created patterns and AAPM TG 119 benchmark plans. The relationship between plan complexity expressed as Modulation Complexity Score (MCS) and the gamma index analysis was established by a planar and volumetric gamma analysis of 106 clinically approved VMAT patient plans of different sites.

Results

Average volumetric 3D global gamma evaluation (3 mm/3%) results for the evaluation plans was 97.41% for 6 MV X-rays and 98.30% for 15 MV X-rays. Average MCS values for the head and neck, pelvic and thoracic plans were 0.2224, 0.3615 and 0.1874. Average volumetric 3D global gamma analysis (3 mm/3%) results for the head and neck, pelvic and thoracic VMAT plans were 95.45%, 97.51% and 96.98%, respectively. Out of 90 correlation analyses between the MCS and gamma passing rate, only 3 had the r value greater than 0.5.

Conclusions

The Octavius 4D system is a suitable device for patient specific pretreatment QA. Global and local gamma analysis results showed a weak correlation with the MCS.     

A novel selectable marker based on Aspergillus niger arginase expression

Selectable markers are valuable tools in transforming asexual fungi like Aspergillus niger. An arginase (agaA) expression vector and a suitable arginase-disrupted host would define a novel nutritional marker/selection for transformation. The development of such a marker was successfully achieved in two steps. The single genomic copy of A. niger arginase gene was disrupted by homologous integration of the bar marker. The agaA disruptant was subsequently complemented by transforming it with agaA expression vectors. Both citA and trpC promoters were able to drive the expression of arginase cDNA. Such agaA+ transformants displayed arginase expression pattern distinct from that of the parent strain. The results are also consistent with a single catabolic route for arginine in this fungus. A simple yet novel arginine-based selection for filamentous fungal transformation is thus described.     

Occurrence of Antibiotic Resistance Genes and Bacterial Markers in a Tropical River Receiving Hospital and Urban Wastewaters

The occurrence of emerging biological contaminants including antibiotic resistance genes (ARGs) and Faecal Indicator Bacteria (FIB) is still little investigated in developing countries under tropical conditions. In this study, the total bacterial load, the abundance of FIB (E. coli and Enterococcus spp. (ENT)), Pseudomonas spp. and ARGs (bla_TEM, bla_CTX-M, bla_SHV, bla_NDM and aadA) were quantified using quantitative PCR in the total DNA extracted from the sediments recovered from hospital outlet pipes (HOP) and the Cauvery River Basin (CRB), Tiruchirappalli, Tamil Nadu, India. The abundance of bacterial marker genes were 120, 104 and 89 fold higher for the E. coli, Enterococcus spp. and Pseudomonas spp., respectively at HOP when compared with CRB. The ARGs aadA and bla_TEM were most frequently detected in higher concentration than other ARGs at all the sampling sites. The ARGs bla_SHV and bla_NDM were identified in CRB sediments contaminated by hospital and urban wastewaters. The ARGs abundance strongly correlated (r ≥ 0.36, p < 0.05, n = 45) with total bacterial load and E. coli in the sediments, indicating a common origin and extant source of contamination. Tropical aquatic ecosystems receiving wastewaters can act as reservoir of ARGs, which could potentially be transferred to susceptible bacterial pathogens at these sites.     

Management of postharvest disease of mango anthracnose incited by Colletotrichum gleosporioides

Abstract

Among the seven fungal (Gliocladium virens, Trichoderma hamatum, T. harzianum, T. koningii, T. longibrachiatum, T. pseudokoningii and T. viride) and two bacterial (Bacillus subtilis and Pseudomonas fluorescens) antagonists screened against C. gloeosporioides under in vitro conditions, T. harzianum exhibited maximum inhibition followed by Pseudomonas fluorescens at 5 days after incubation. These fungal and bacterial antagonists were selected for application to fruits infected with pathogens. Fruits inoculated with C. gloeosporioides were dipped in spore/cell suspensions of fungal/bacterial antagonists and kept for different durations. The fungal antagonists T. harzianum and P. fluorescens were effective in checking the spread of pathogens on fruits compared with the pathogen-inoculated control.     

Estradiol treatment and its interaction with the cholinergic system: effects on cognitive function in healthy young women

The steroid hormone estradiol has been shown to modulate cognitive function in both animals and humans, and although the exact mechanisms associated with these effects are unknown, interactions with the cholinergic system have been proposed. We examined the neurocognitive effects of short-term estradiol treatment and its interaction with the cholinergic system using the muscarinic receptor antagonist scopolamine in healthy young women. Thirty-four participants (Mean age ± SD = 22.4 ± 4.4) completed baseline cognitive assessment and then received either 100 μg/day transdermal estradiol or transdermal placebo for 31 days. On days 28 and 31 of treatment, further cognitive assessment was performed pre- and 90 min post-scopolamine (0.4 mg) or placebo (saline) injection, under a randomized double-blind placebo-controlled design. Short-term estradiol treatment significantly enhanced spatial working memory with a trend for improvement in long-term verbal learning and memory. Overall, estradiol treatment did not protect against or attenuate the scopolamine-induced impairments in the cognitive domains assessed. Findings suggest that estrogen has minimal effects on cholinergic-mediated cognitive processes following short-term treatment. Effects of estradiol treatment may be dependent on age, dose of estradiol, integrity of cholinergic innervation and baseline endogenous estrogen levels, which may in part explain the inconsistent findings in the literature.     

Adaptive volumetric modulated arc treatment planning for esophageal cancers using cone beam computed tomography

PurposeTo assess the potential of cone beam CT (CBCT) derived adaptive RapidArc treatment for esophageal cancers in reducing the dose to organs at risk (OAR).Methods and materialsTen patients with esophageal cancer were CT scanned in free breathing pattern. The PTV is generated by adding a 3D margin of 1 cm to the CTV as per ICRU 62 recommendations. The double arc RapidArc plan (Clin_RA) was generated for the PTV. Patients were setup using kV orthogonal images and kV-CBCT scan was acquired daily during first week of therapy, then weekly. These images were exported to the Eclipse TPS. The adaptive CTV which includes tumor and involved nodes was delineated in each CBCT image set for the length of the PTV. The composite CTV from first week CBCT was generated using Boolean union operator and 5 mm margin was added circumferentially to generate adaptive PTV (PTV1). Adaptive RapidArc plan (Adap_RA) was generated. NTCP and DVH of the OARs of the two plans were compared. Similarly, PTV2 was generated from weekly CBCT. PTV2 was evaluated for the coverage of 95% isodose of Adap_RA plan.ResultsThe PTV1 and PTV2 volumes covered by 95% isodose in adaptive plans were 93.51 ± 1.17% and 94.59 ± 1.43% respectively. The lung V_10Gy, V_20Gy and mean dose in Adap_RA plan was reduced by 17.43% (p = 0.0012), 34.64% (p = 0.0019) and 16.50% (p = 0.0002) respectively compared to Clin_RA. The Adap_RA plan reduces the heart D_35% and mean dose by 17.35% (p = 0.0011) and 17.16% (p = 0.0012). No significant reduction in spinal cord and liver doses were observed. NTCP for the lung (0.42% vs. 0.08%) and heart (1.39% vs. 0.090%) was reduced significantly in adaptive plans.ConclusionThe adaptive re-planning strategy based on the first week CBCT dataset significantly reduces the doses and NTCP to OARs.     

Concerns with oral health care services for adults with cognitive and intellectual disabilities

It is of interest to document data on oral health care services for adults with cognitive and intellectual disabilities. Hence, a study protocol was registered at the International Prospective Register of Systematic Reviews (PROSPERO) with registration number: CRD42020150759. We used PubMed, Science Direct, LILACS and SCIELO to collect data from known literature using keywords containing MESH (Medical Subject Headings) terms. The risk of bias rating for the collected data was calculated using the Newcastle-Ottawa assessment Scale. The AHRQ (Agency for Healthcare, Research and Quality) was used for classifying the level of evidence in the collected data. Analysis of available data shows that there is a lack of dentists with adequate skills to treat people with disabilities resulting in high cost for dental treatment. Thus, we conclude that inconvenient location of dental clinic, lack of dentists willing to treat people with disabilities and attitude of dental staff towards people with learning disabilities were considered as barriers and challenges faced for dental health service utilization in this context.