Search results for: intensity modulated radiotherapy

Authors: Nadia Warmilee

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This study is s descriptive-analytical research and it aims at studying sound intensity in individuals with antisocial personality disorder and ordinary persons. Data were collected from experimental and control groups by interviews and a field research. Population was all male Iranian with antisocial personality disorder that three of them (a murderer and two individuals with antisocial personality disorder (APD) who have not committed any crimes yet) were selected purposefully. They were compared to three non-affected people. PRAAT software has been used to analyze the data. Results of this study show that there is a significant relationship between dysthymia and sound intensity values. Antisocial personality disorder also affects sound intensity fluctuations. The values of sound intensity are higher in non-affected people than affected one whilst these values are more monotonous. T-test was used to study significance or in significance of sound intensity difference in producing vowels.

Keywords: Acoustics, Sound Intensity, Antisocial Personality Disorder, Psycholinguistics

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Authors: Jeries J. Abou-Hanna, Bradley Storm

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This paper looks to reduce the complexity of determining stress intensity factors while maintaining high levels of accuracy by the use of a linearized layering approach. Many techniques for stress intensity factor determination exist, but they can be limited by conservative results, requiring too many user parameters, or by being too computationally intensive. Multiple notch geometries with various crack lengths were investigated in this study to better understand the effectiveness of the proposed method. By linearizing the average stresses in radial layers around the crack tip, stress intensity factors were found to have error ranging from -10.03% to 8.94% when compared to analytically exact solutions. This approach proved to be a robust and efficient method of accurately determining stress intensity factors.

Keywords: fracture mechanics, finite element method, stress intensity factor, stress linearization

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Authors: A. Fomujong, P. Mobit, A. Ndlovu, R. Teboh

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Purpose: Film’s unique qualities, such as tissue equivalence, high spatial resolution, near energy independence and comparatively less expensive dosimeter, ought to make it the preferred and widely used in radiotherapy centers in low and middle income countries (LMICs). This, however, is not always the case, as other factors that are often maybe taken for granted in advanced radiotherapy centers remain a challenge in LMICs. We explored the unique qualities of film dosimetry that can make it possible for one Institution to benefit from another’s protocols via collaboration. Methods: For simplicity, two Institutions were considered in this work. We used a single batch of films (EBT-XD) and established a calibration protocol, including scan protocols and calibration curves, using the radiotherapy delivery system at Institution A. We then proceeded and performed patient-specific QA for patients treated on system A (PSQA-A-A). Films from the same batch were then sent to a remote center for PSQA on radiotherapy delivery system B. Irradiations were done at Institution B and then returned to Institution A for processing and analysis (PSQA-B-A). The following points were taken into consideration throughout the process (a) A reference film was irradiated to a known dose on the same system irradiating the PSQA film. (b) For calibration, we utilized the one-scan protocol and maintained the same scan orientation of the calibration, PSQA and reference films. Results: Gamma index analysis using a dose threshold of 10% and 3%/2mm criteria showed a gamma passing rate of 99.8% and 100% for the PSQA-A-A and PSQA-B-A, respectively. Conclusion: This work demonstrates that one could use established film dosimetry protocols in one Institution, e.g., an advanced radiotherapy center and apply similar accuracies to irradiations performed at another institution, e.g., a center located in LMIC, which thus encourages collaboration between the two for worldwide patient benefits.

Keywords: collaboration, film dosimetry, LMIC, radiotherapy, calibration

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Authors: Emeshaw Damtew Zebene, Edom Seife, Hagos Tesfay, Gurja Belay

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Background: cancer incidence and mortality has grown rapidly throughout the world. Aging of the population, urbanization, physical inactivity, economic growth followed by smoking and drinking contributed a lot for the increased incidence of cancer all over the globe. Objective: the aim of this study was to assess a one-year trend of cancer patients who underwent curative/radical radiotherapy at radiotherapy center, Tikur Anbessa specialized hospital, Ethiopia. Methodology: We performed a prospective descriptive study of cancer patients treated with LINAC at Tikur Anbessa specialized hospital, Addis Ababa, Ethiopia, from April 2021- March 2022. A standardized questionnaire was used to collect sociodemographic and clinical characteristics of the patients. Descriptive statistics and chi-square results were generated using SPSS version 24. The level of significance was obtained at 0.05. Results: Sixty-four (64) curative/radical patients-44 females and 20 males were analyzed. Majority, 27(42.2%), of the patients age range from 45 to 64, and 45(70%) of them were urban residents where a group of higher gynecologic cancer was observed.78% of the patients were with locally advanced cancer, and 54(84.4%) of them had no awareness about cancer. Generally, head & neck cancer were found the most prevalent cancer 20(31.3%), and the leading cause of cancer among women was cervical cancer 17(38.6%), where about half 7(15.9%) of them were HIV positive. Conclusion: Our finding revealed that most of curative/radical patients presented at a locally advanced stage of the disease. Hence, maintaining the already available teletherapy machines and installing additional radiotherapy centers may help in treating the patients at the early stage of the disease. Since almost all of our study participants did not have information about cancer, awareness raising mechanisms should be done. Additionally, understanding differences in cancer incidence between urban and rural is important. Key words: Cancer, Curative/radical, Radiotherapy, Tikur Anbessa Specialized Hospital

Keywords: cancer, curative/radical, radiotherapy, tkur anbessa specialized hospital

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Authors: Jemini Vyas, Oluwatobi Adeyoe, Jenny Branagan, Chandran Tanabalan, Aakash Pai

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Introduction: Radical prostatectomy and radiotherapy are both viable options for the treatment of localised prostate cancer. Over the years medicine has evolved towards a patient-centred approach. Patient decision-making is not motivated by clinical outcomes alone. Geographical location and ease of access to treating clinician are contributory factors. With the development of robotic surgery, prostatectomy has been centralised into tertiary centres. This has impacted on the distances that patients and their families are expected to travel. Methods: A single centre retrospective study was undertaken over a five-year period. All patients with localised prostate cancer, undergoing radical radiotherapy or prostatectomy were collected pre-centralisation. This was compared to the total number undergoing these treatments post centralisation. Results: Pre-centralisation, both radiotherapy and prostatectomy groups had to travel a median of less than five miles for treatment. Post-centralisation of pelvic surgery, prostatectomy patients had to travel a median of more than 40 miles, whilst travel distance for the radiotherapy group was unchanged. In the post centralisation cohort, there was a 63% decline in the number of patients undergoing radical prostatectomy per month from a mean of 5.1 to 1.9. The radical radiotherapy group had a concurrent 41% increase in patient numbers with a mean increase from 13.3 to 18.8 patients per month. Conclusion: Choice of radical treatment in localised prostate cancer is based on multiple factors. This study infers that local availability can influence choice of radical treatment. It is imperative that efforts are made to maintain accessibility to all viable options for prostate cancer patients, so that patient choice is not compromised.

Keywords: prostate, prostatectomy, radiotherapy, centralisation

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Authors: Li Hoon Lim, Nur Farhanah Said, Katie Simmons, Eric Pei Ping Pang, Sharon Mei Mei Wong

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Background and Purpose: Research regarding the sexual impact of breast cancer treatment on Asian women is both sensitive and scarce. This study aims to assess and evaluate the sexual health needs and concerns of breast cancer radiotherapy patients. It is hoped that awareness will be increased and an appropriate intervention can be developed to address the needs of future breast cancer patients. Methods: 110 consecutive unselected breast cancer patients were recruited prospectively. Questionnaires were administered once for patient undergoing radiotherapy to the breast. This study employed an anonymous questionnaire; any breast radiotherapy patient who can read English can voluntarily receive and complete the survey. The questionnaire consisted of items addressing demographics, potential informational needs, and educational preferences. Results: Patients’ interest to address sexual concerns decreases with age (p=0.024). Coherently, sexual concerns of patients are reported to decrease with age (p=0.015) where 70% of all respondents below age 50 [age 20-29 (60%); 30-39 (56.3%); 40-49(55.1%)] have started to have sexual concerns regarding their treatment effects on their sexual health. Patients who underwent breast conservation surgery (42.2%) and reconstruction surgery (83.3%) were more likely to have concerns about sexual health versus patients who underwent mastectomy (36.7%) (p=0.032). 74.2% of patients with sexual concern regardless of age would initiate conversation with their healthcare providers (p < 0.001). Conclusions: The results showed a staggering interest of female patients wanting information on this area which would not only boost their confidence and body image but also address concerns of the effect of breast radiotherapy on sexual health during their treatment.

Keywords: breast cancer, breast radiotherapy, sexual health, sexual impact

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Authors: Monika Rezacova

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Radiation-induced breast changes are a consequence of radiotherapy toxicity over the breast tissues either related to targeted breast cancer treatment or other thoracic malignancies (eg. lung cancer). This study has created an overview of different changes and their pathophysiology. The main conditions included were skin thickening, interstitial oedema, fat necrosis, dystrophic calcifications, skin retractions, glandular atrophy, breast fibrosis and radiation induced breast cancer. This study has performed focused literature search through multiple databases including pubmed, medline and embase. The study has reviewed English as well as non English publications. As a result of the literature the study provides comprehensive overview of radiation-induced breast changes and their pathophysiology with small focus on new development and prevention.

Keywords: radiotherapy toxicity, breast tissue changes, breast cancer treatment, radiation-induced breast changes

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Authors: Nourhan G. Sahly, Ahmed Moustafa, Mohamed S. Zaghloul, Tamer Z. Salem

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The gut microbiome plays important roles in the human body that includes but not limited to digestion, immunity, homeostasis and response to some drugs such as chemotherapy and immunotherapy. Its role has also been linked to radiotherapy and associated gastrointestinal injuries, where the microbial dysbiosis could be the driving force for dose determination or the complete suspension of the treatment protocol. Linking the gut microbiota alterations to different cancer treatment protocols is not easy especially in humans. However, enormous effort was exerted to understand this complex relationship. In the current study, we described the gut microbiota dysbiosis in pediatric sarcoma patients, in the pelvic region, with regards to radiotherapy and antibiotics. Fecal samples were collected as a source of microbial DNA for which the gene encoding for V3-V5 regions of 16S rRNA was sequenced. Two of the three patients understudy had experienced an increase in alpha diversity post exposure to 50.4 Gy. Although phylum Firmicutes overall relative abundance has generally decreased, six of its taxa increased in all patients. Our results may indicate the possibility of radiosensitivity or enrichment of the antibiotic resistance of the elevated taxa. Further studies are needed to describe the extent of radiosensitivity with regards to antibiotic resistance.

Keywords: combined radiotherapy and chemotherapy, gut microbiome, pediatric cancer, radiosensitivity

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Authors: Loredana G. Marcu, David Marcu, Sanda M. Filip

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Advanced head and neck cancers are aggressive tumours, which require aggressive treatment. Treatment efficiency is often hindered by cancer cell repopulation during radiotherapy, which is due to various mechanisms triggered by the loss of tumour cells and involves both stem and differentiated cells. The aim of the current paper is to present in silico simulations of radiotherapy schedules on a virtual head and neck tumour grown with biologically realistic kinetic parameters. Using the linear quadratic formalism of cell survival after radiotherapy, altered fractionation schedules employing various treatment breaks for normal tissue recovery are simulated and repopulation mechanism implemented in order to evaluate the impact of various cancer cell contribution on tumour behaviour during irradiation. The model has shown that the timing of treatment breaks is an important factor influencing tumour control in rapidly proliferating tissues such as squamous cell carcinomas of the head and neck. Furthermore, not only stem cells but also differentiated cells, via the mechanism of abortive division, can contribute to malignant cell repopulation during treatment.

Keywords: radiation, tumour repopulation, squamous cell carcinoma, stem cell

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Authors: D. Makuteniene

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Agriculture, as one of the human activities, emits a significant amount of greenhouse gas emission and undoubtedly has an impact on climate change. The main gaseous products of agricultural greenhouse gases are carbon dioxide, methane, and nitroxadoxide. The sources and emission of these gases depend on land use, soil, crops, manure, livestock, and energy consumption. One of the indicators showing the agricultural impact on climate change is an intensity of GHG emission and its dynamics. This study analyzed the determinants of an intensity of greenhouse gas emission in Lithuanian agriculture using data decomposition. The research revealed that, although greenhouse gas emission increased during the research period, however, agricultural net value added grew more rapidly, which contributed to a reduction of intensity of greenhouse gas emission in Lithuania between 2000 and 2015. It was identified that during the research period intensity of greenhouse gas emission was mostly increased by the change of the use of nitrogen in agriculture, as compared to the change of the area of agricultural land, and by the change of the number of full-time employees, as compared to the change of net value added. Conversely, the change of energy consumption in agriculture, as compared to the change of the use of nitrogen in agriculture, had a bigger impact in decreasing intensity of greenhouse gas emission.

Keywords: agriculture, determinants of intensity, greenhouse gas emission, intensity

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Authors: Ahmed Arkoazi, Hussein Znad, Ranjeet Utikar

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The synergistic impact and optimization of gas flow rate, concentration of CO₂, and light intensity on CO₂ biofixation rate were investigated using wastewater as a medium to cultivate Chlorella vulgaris under different conditions (gas flow rate 1-8 L/min), CO₂ concentration (0.03-7%), and light intensity (150-400 µmol/m².s)). Response Surface Methodology and Box-Behnken experimental Design were applied to find optimum values for gas flow rate, CO₂ concentration, and light intensity. The optimum values of the three independent variables (gas flow rate, concentration of CO₂, and light intensity) and desirability were 7.5 L/min, 3.5%, and 400 µmol/m².s, and 0.904, respectively. The highest amount of biomass produced and CO₂ biofixation rate at optimum conditions were 5.7 g/L, 1.23 gL^-1d^-1, respectively. The synergistic effect between gas flow rate and concentration of CO₂, and between gas flow rate and light intensity was significant on the three responses, while the effect between CO₂ concentration and light intensity was less significant on CO₂ biofixation rate. The results of this study could be highly helpful when using microalgae for CO₂ biofixation in wastewater treatment.

Keywords: bubble column reactor, gas holdup, hydrodynamics, sparger

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Authors: Pradeep Lamichhane, Nima Pourali, E. V. Rebrov, Volker Hessel

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Nitrogen fixation is critical for plants for the biosynthesis of protein and nucleic acid. Most of our atmosphere is nitrogen, yet plants cannot directly absorb it from the air, and natural nitrogen fixation is insufficient to meet the demands. This experiment used a fast-modulated surface-confined atmospheric pressure plasma created by a 6 kV (peak-peak) sinusoidal power source with a repetition frequency of 68 kHz to fix nitrogen. Plasmas have been proposed for excitation of nitrogen gas, which quickly oxidised to NOX. With different N2/O2 input ratios, the rate of NOX generation was investigated. The rate of NOX production was shown to be optimal for mixtures of 60–70% O2 with N2. To boost NOX production in plasma, metal oxide catalysts based on TiO2 were coated over the dielectric layer of a reactor. These results demonstrate that nitrogen activation was more advantageous in surface-confined plasma sources because micro-discharges formed on the sharp edges of the electrodes, which is a primary function attributed to NOX synthesis and is further enhanced by metal oxide catalysts. The energy-efficient and sustainable NOX synthesis described in this study will offer a fresh perspective for ongoing research on green nitrogen fixation techniques.

Keywords: nitrogen fixation, fast-modulated, surface-confined, sustainable

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Authors: Bonaventure Naab Dery, Abdul Muntaka Samad

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During the past two decades, huge population growth has been recorded in developing countries. Thisled to an increase in the demand for transport services for human and merchandises. The study sought to examine the effect of freight transport intensity on firm performance. Among others, this study sought to examine the link between freight transport intensity and firm performance; the link between operational capability and firm performance, and the mediating role of operational capability on the relationship between freight transport intensity and firm performance. The study used a descriptive research design and a quantitative research approach. Questionnaireswereusedfor the data collection through snowball sampling and purposive sampling. SPSS and Mplus are being used to analyze the data. It is anticipated that, when the data is analyzed, it would validate the hypotheses that have been proposed by the researchers. Base on the findings, relevant recommendations would be made for managerial implications and future studies.

Keywords: freight transport intensity, freight economy transport intensity, freight efficiency transport intensity, operational capability, firm performance

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Authors: Abhishek Kumar, Nilam

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As we know that, time delay exists almost in every biological phenomenon. Therefore, in the present study, we propose a susceptible–infected–recovered (SIR) epidemic model along with time delay, modulated incidence rate of infection, and Holling Type II nonlinear treatment rate. The present model aims to provide a strategy to control the spread of epidemics. In the mathematical study of the model, it has been shown that the model has two equilibriums which are named as disease-free equilibrium (DFE) and endemic equilibrium (EE). Further, stability analysis of the model is discussed. To prove the stability of the model at DFE, we derived basic reproduction number, denoted by (R₀). With the help of basic reproduction number (R₀), we showed that the model is locally asymptotically stable at DFE when the basic reproduction number (R₀) less than unity and unstable when the basic reproduction number (R₀) is greater than unity. Furthermore, stability analysis of the model at endemic equilibrium has also been discussed. Finally, numerical simulations have been done using MATLAB 2012b to exemplify the theoretical results.

Keywords: time delayed SIR epidemic model, modulated incidence rate, Holling type II nonlinear treatment rate, stability

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Authors: Der Chyan Lin

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Since the early introduction by Ormondroyd and Den Hartog, vibration absorber (VA) has become one of the most commonly used vibration mitigation strategies. The strategy is most effective for a primary plant subjected to a single frequency excitation. For continuous systems, notable advances in vibration absorption in the multi-frequency system were made. However, the efficacy of the VA strategy for systems under multi-frequency excitation is not well understood. For example, for an N degrees-of-freedom (DOF) primary-absorber system, there are N 'peak' frequencies of large amplitude vibration per every new excitation frequency. In general, the usable range for vibration absorption can be greatly reduced as a result. Frequency modulated harmonic excitation is a commonly seen multi-frequency excitation example: f(t) = cos(ϖ(t)t) where ϖ(t)=ω(1+α sin⁡(δt)). It is known that f(t) has a series expansion given by the Bessel function of the first kind, which implies an infinity of forcing frequencies in the frequency modulated harmonic excitation. For an SDOF system of natural frequency ωₙ subjected to f(t), it can be shown that amplitude peaks emerge at ω₍ₚ,ₖ₎=(ωₙ ± 2kδ)/(α ∓ 1),k∈Z; i.e., there is an infinity of resonant frequencies ω₍ₚ,ₖ₎, k∈Z, making the use of VA strategy ineffective. In this work, we propose an absorber frequency placement strategy for SDOF vibration systems subjected to frequency-modulated excitation. An SDOF linear mass-spring system coupled to lateral absorber systems is used to demonstrate the ideas. Although the mechanical components are linear, the governing equations for the coupled system are nonlinear. We show using N identical absorbers, for N ≫ 1, that (a) there is a cluster of N+1 natural frequencies around every natural absorber frequency, and (b) the absorber frequencies can be moved away from the plant's resonance frequency (ω₀) as N increases. Moreover, we also show the bandwidth of the VA performance increases with N. The derivations of the clustering and bandwidth widening effect will be given, and the superiority of the proposed strategy will be demonstrated via numerical experiments.

Keywords: Bessel function, bandwidth, frequency modulated excitation, vibration absorber

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Authors: Behzad Sinaei, Shahryar Sane, Behzad Kazemi Haki

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Children with different malignancies usually experience potential neurologic complications when treated with radiation therapy, especially if under frequent anesthesia. The aim of this study was to evaluate the neurologic problems associated with anesthesia in pediatrics treated with radiotherapy under anesthesia. The study was a cross-sectional experiment that consisted of 133 pediatric patients with different malignancies who needed anesthesia for performing radiotherapy and were referred to Omid Charity Hospital and Imam Khomeini University Hospital from 2014 to 2020 by the census. P-values less than 0.05 were considered statistically significant (P-value < 0.05). Anesthesia complications in this study were slight and insignificant. Some were due to the effects of the tumor on other important organs or either previous radiation therapy or chemotherapy. For safe anesthesia, considering the effects of tumors on body organs and the neurological complications they cause can greatly help reduce anesthesia complications in pediatrics under radiation therapy.

Keywords: anesthesia, neurologic complications, pediatrics, radiotherapy

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Authors: Jamal Takhchi

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The understanding of vibration propagation in complex structures such as automotive body in white remains a challenging issue in car design regarding NVH performances. The current analysis is limited to the low frequency range where modal concepts are dominant. Higher frequencies, between 200 and 1000 Hz, will become critical With the rise of electrification. EVs annoying sounds are mostly whines created by either Gears or e-motors between 300 Hz and 2 kHz. Structural intensity analysis was Experienced a few years ago on finite element models. The application was promising but limited by the fact that the propagating 3D intensity vector field is masked by a rotational Intensity field. This rotational field should be filtered using a differential operator. The expression of this operator in the framework of finite element modeling is not yet known. The aim of the proposed work is to implement this operator in the current dynamic solver (NASTRAN) of Stellantis and develop the Expected methodology for the mid-frequency structural analysis of electrified vehicles.

Keywords: structural intensity, NVH, body in white, irrotatational intensity

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Authors: Zhuang He, Andrei Kotousov

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All current experimental methods for determination of stress intensity factors are based on the assumption that the state of stress near the crack tip is plane stress. Therefore, these methods rely on strain and displacement measurements made outside the near crack tip region affected by the three-dimensional effects or by process zone. In this paper, we develop and validate an experimental procedure for the evaluation of stress intensity factors from the measurements of the out-of-plane displacements in the surface area controlled by 3D effects. The evaluation of stress intensity factors is possible when the process zone is sufficiently small, and the displacement field generated by the 3D effects is fully encapsulated by K-dominance region.

Keywords: digital image correlation, stress intensity factors, three-dimensional effects, transverse displacement

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Authors: Ahmad Shanei, Milad Baradaran-Ghahfarokhi

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This study aimed to investigate testicular dose (TD) and the associated risk of heritable disease from common pelvis radiotherapy of male patients in Iran. In this work, the relation between TD and changes in beam energy, pelvis size, source to skin distance (SSD) and beam directions (anterior or posterior) were also evaluated. The values of TDs were measured on 67 randomly selected male patients during common pelvis radiotherapy using 1.17 and 1.33 MeV, Theratron Cobalt-60 unit at SSD of 80 cm and 9 MV, Neptun 10 PC and 18 MV, GE Saturne 20 at SSD of 100 cm at Seyed-Al Shohada Hospital, Isfahan, Iran. Results showed that the maximum TD was up to 12% of the tumor dose. Considering the risk factor for radiation-induced heritable disorders of 0.1% per Sv, an excess risk of hereditary disorders of 72 per 10000 births was conservatively calculated. There was a significant difference in the measured TD using different treatment machines and energies (P < 0.001). The TD at 100 cm SSD were much less than that for 80 cm SSD (P <0.001). The Pearson Correlation test showed that, as expected, there was a strong correlation between TD and patient’s pelvis size (r = 0.275, P <0.001). Using the student’s t-tests, it was found that, there was not a significant difference between TD and beam direction (P = 0.231). Iranian male patients undergoing pelvic radiotherapy have the potential of receiving a TD of more than 1 Gy which might result in temporary azoospermia. The risk for induction of hereditary disorders in future generations should be considered as low but not negligible in comparison with the correspondent nominal risk.

Keywords: pelvis radiotherapy, testicular dose, infertility, hereditary effects

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Authors: A. Bekbaev, M. Dzhamanbaev, R. Abitaeva, A. Karbozova, G. Nabyeva

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In this paper, the regression dependence of dancing intensity from wind speed and length of span was established due to the statistic data obtained from multi-year observations on line wires dancing accumulated by power systems of Kazakhstan and the Russian Federation. The lower and upper limitations of the equations parameters were estimated, as well as the adequacy of the regression model. The constructed model will be used in research of dancing phenomena for the development of methods and means of protection against dancing and for zoning plan of the territories of line wire dancing.

Keywords: power lines, line wire dancing, dancing intensity, regression equation, dancing area intensity

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Authors: Kangkang Wu, Kaizhi Wang, Zhijun Yuan

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This paper deals with a mini radar system aimed at detecting small targets at the low latitude. The radar operates at Ku-band in the frequency modulated continuous wave (FMCW) mode with two receiving channels. The radar system has the characteristics of compactness, mobility, and low power consumption. This paper focuses on the implementation of the radar system, and the Block least mean square (Block LMS) algorithm is applied to minimize the fortuitous distortion. It is validated from a series of experiments that the track of the unmanned aerial vehicle (UAV) can be easily distinguished with the radar system.

Keywords: unmanned aerial vehicle (UAV), interference, Block Least Mean Square (Block LMS) Algorithm, Frequency Modulated Continuous Wave (FMCW)

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Authors: Taleb Lotfi, Benarbia Maheidine, Allam Hamza, Boutira Fatima, Boukerche Abdelbaki

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Introduction and purpose of the study: This is a retrospective single-center study with an analytical aim to determine the prognostic factors for relapse in patients treated with radiotherapy after total laryngectomy with lymph node dissection for laryngeal cancer at the Emir Abdelkader cancer center in Oran (Algeria). Material and methods: During the study period from January 2014 to December 2018, eighty-nine patients (n=89) with squamous cell carcinoma of the larynx were treated with postoperative radiotherapy. Relapse-free survival was studied in the univariate analysis according to pre-treatment criteria using Kaplan-Meier survival curves. We performed a univariate analysis to identify relapse factors. Statistically significant factors have been studied in the multifactorial analysis according to the Cox model. Results and statistical analysis: The average age was 62.7 years (40-86 years). It was a squamous cell carcinoma in all cases. Postoperatively, the tumor was classified as pT3 and pT4 in 93.3% of patients. Histological lymph node involvement was found in 36 cases (40.4%), with capsule rupture in 39% of cases, while the limits of surgical excision were microscopically infiltrated in 11 patients (12.3%). Chemotherapy concomitant with radiotherapy was used in 67.4% of patients. With a median follow-up of 57 months (23 to 104 months), the probabilities of relapse-free survival and five-year overall survival are 71.2% and 72.4%, respectively. The factors correlated with a high risk of relapse were locally advanced tumor stage pT4 (p=0.001), tumor site in case of subglottic extension (p=0.0003), infiltrated surgical limits R1 (p=0.001), l lymph node involvement (p=0.002), particularly in the event of lymph node capsular rupture (p=0.0003) as well as the time between surgery and adjuvant radiotherapy (p=0.001). However, in the subgroup analysis, the major prognostic factors for disease-free survival were subglottic tumor extension (p=0.001) and time from surgery to adjuvant radiotherapy (p=0.005). Conclusion: Combined surgery and postoperative radiation therapy are effective treatment modalities in the management of laryngeal cancer. Close cooperation of the entire cervicofacial oncology team is essential, expressed during a multidisciplinary consultation meeting, with the need to respect the time between surgery and radiotherapy.

Keywords: laryngeal cancer, laryngectomy, postoperative radiotherapy, survival

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Authors: Auj-E Taqaddas

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The use of proton beam therapy is increasing globally. It seems to offer dosimetric advantages, especially in paediatric central nervous system (CNS) and brain tumours. A short E-survey was conducted to assess the clinical, technical, and educational resources and strategies employed in the state of the art proton beam therapy (PBT) centres in the USA to determine the current status of proton beam therapy. The study also aimed at finding out which PBT skills are in demand as well as what improvements are needed to ensure efficient treatment planning, delivery, and dosimetry. The study resulted in identifying areas for future research and development and in identifying cancers for which PBT is most suitable compared to other modalities to facilitate the implementation and use of PBT in clinical settings for cancer treatment.

Keywords: cancer, intensity modulated proton therapy, proton beam therapy, single field uniform scanning

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Authors: Pooja Seth, Shruti Aggarwal

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Thermoluminescence dosimetry (TLD) is one of the most effective methods for the assessment of dose during diagnostic radiology and radiotherapy applications. In these applications monitoring of absorbed dose is essential to prevent patient from undue exposure and to evaluate the risks that may arise due to exposure. LiF based thermoluminescence (TL) dosimeters are promising materials for the estimation, calibration and monitoring of dose due to their favourable dosimetric characteristics like tissue-equivalence, high sensitivity, energy independence and dose linearity. As the TL efficiency of a phosphor strongly depends on the preparation route, it is interesting to investigate the TL properties of LiF based phosphor in nanocrystalline form. LiF doped with magnesium (Mg), copper (Cu), sodium (Na) and silicon (Si) in nanocrystalline form has been prepared using chemical co-precipitation method. Cubical shape LiF nanostructures are formed. TL dosimetry properties have been investigated by exposing it to gamma rays. TL glow curve structure of nanocrystalline form consists of a single peak at 419 K as compared to the multiple peaks observed in microcrystalline form. A consistent glow curve structure with maximum TL intensity at annealing temperature of 573 K and linear dose response from 0.1 to 1000 Gy is observed which is advantageous for radiotherapy application. Good reusability, low fading (5 % over a month) and negligible residual signal (0.0019%) are observed. As per photoluminescence measurements, wide emission band at 360 nm - 550 nm is observed in an undoped LiF. However, an intense peak at 488 nm is observed in doped LiF nanophosphor. The phosphor also exhibits the intense optically stimulated luminescence. Nanocrystalline LiF: Mg, Cu, Na, Si phosphor prepared by co-precipitation method showed simple glow curve structure, linear dose response, reproducibility, negligible residual signal, good thermal stability and low fading. The LiF: Mg, Cu, Na, Si phosphor in nanocrystalline form has tremendous potential in diagnostic radiology, radiotherapy and high energy radiation application.

Keywords: thermoluminescence, nanophosphor, optically stimulated luminescence, co-precipitation method

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Authors: D. F. Carvalho, A. O. Uscamayta, J. C. Guerrero, H. F. Oliveira, P. M. Azevedo-Marques

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The creation of vector contours slices (ROIs) on body silhouettes in oncologic patients is an important step during the radiotherapy planning in clinic and hospitals to ensure the accuracy of oncologic treatment. The radiotherapy planning of patients is performed by complex softwares focused on analysis of tumor regions, protection of organs at risk (OARs) and calculation of radiation doses for anomalies (tumors). These softwares are supplied for a few manufacturers and run over sophisticated workstations with vector processing presenting a cost of approximately twenty thousand dollars. The Brazilian project SIPRAD (Radiotherapy Planning System) presents a proposal adapted to the emerging countries reality that generally does not have the monetary conditions to acquire some radiotherapy planning workstations, resulting in waiting queues for new patients treatment. The SIPRAD project is composed by a set of integrated and interoperabilities softwares that are able to execute all stages of radiotherapy planning on simple personal computers (PCs) in replace to the workstations. The goal of this work is to present an image processing technique, computationally feasible, that is able to perform an automatic contour delineation in patient body silhouettes (SIPRAD-Body). The SIPRAD-Body technique is performed in tomography slices under grayscale images, extending their use with a greedy algorithm in three dimensions. SIPRAD-Body creates an irregular polyhedron with the Canny Edge adapted algorithm without the use of preprocessing filters, as contrast and brightness. In addition, comparing the technique SIPRAD-Body with existing current solutions is reached a contours similarity at least 78%. For this comparison is used four criteria: contour area, contour length, difference between the mass centers and Jaccard index technique. SIPRAD-Body was tested in a set of oncologic exams provided by the Clinical Hospital of the University of Sao Paulo (HCRP-USP). The exams were applied in patients with different conditions of ethnology, ages, tumor severities and body regions. Even in case of services that have already workstations, it is possible to have SIPRAD working together PCs because of the interoperability of communication between both systems through the DICOM protocol that provides an increase of workflow. Therefore, the conclusion is that SIPRAD-Body technique is feasible because of its degree of similarity in both new radiotherapy planning services and existing services.

Keywords: radiotherapy, image processing, DICOM RT, Treatment Planning System (TPS)

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Authors: Takhchi Jamal, Ouisse Morvan, Sadoulet-Reboul Emeline, Bouhaddi Noureddine, Gagliardini Laurent, Bornet Frederic, Lakrad Faouzi

Abstract:

Structural intensity is a technique that can be used to indicate both the magnitude and direction of power flow through a structure from the excitation source to the dissipation sink. However, current analysis is limited to the low frequency range. At medium and high frequencies, a rotational component appear in the field, masking the energy flow and make its understanding difficult or impossible. The objective of this work is to implement a methodology to filter out the rotational components of the structural intensity field in order to fully understand the energy flow in complex structures. The approach is based on the Helmholtz decomposition. It allows to decompose the structural intensity field into rotational, irrotational, and harmonic components. Only the irrotational component is needed to describe the net power flow from a source to a dissipative zone in the structure. The methodology has been applied on academic structures, and it allows a good analysis of the energy transfer paths.

Keywords: structural intensity, power flow, helmholt decomposition, irrotational intensity

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Authors: Taleb L., Benarbia M., Boutira F. M., Allam H., Boukerche A.

Abstract:

Introduction and purpose of the study: Meningiomas are the most common non-glial intracranial tumors in adults, accounting for approximately 30% of all central nervous system tumors. The aim of our study is to determine the epidemiological, clinical, therapeutic, and evolutionary characteristics of a cohort of patients with intracranial meningioma treated with radiotherapy at the Emir Abdelkader Cancer Center in Oran. Material and methods: This is a retrospective study of 44 patients during the period from 2014 to 2020. The overall survival and relapse-free survival curves were calculated using the Kaplan-Meier method. Results and statistical analysis: The median age of the patients was 49 years [21-76 years] with a clear female predominance (sex ratio=2.4). The average diagnostic delay was seven months [2 to 24 months], the circumstances of the discovery of which were dominated by headaches in 54.5% of cases (n=24), visual disturbances in 40.9% (n=18), and motor disorders in 15.9% (n=7). The seat of the tumor was essentially at the level of the base of the skull in 52.3% of patients (n=23), including 29.5% (n=13) at the level of the cavernous sinus, 27.3% (n=12) at the parasagittal level and 20.5% (n=9) at the convexity. The diagnosis was confirmed surgically in 36 patients (81.8%) whose anatomopathological study returned in favor of grades I, II, and III in respectively 40.9%, 29.5%, and 11.4% of the cases. Radiotherapy was indicated postoperatively in 45.5% of patients (n=20), exclusive in 27.3% (n=12) and after tumor recurrence in 27.3% of cases (n=18). The irradiation doses delivered were as follows: 50 Gy (20.5%), 54 Gy (65.9%), and 60 Gy (13.6%). With a median follow-up of 69 months, the probabilities of relapse-free survival and overall survival at three years are 93.2% and 95.4%, respectively, whereas they are 71.2% and 80.7% at five years. Conclusion: Meningiomas are common primary brain tumors. Most often benign but can also progress aggressively. Their treatment is essentially surgical, but radiotherapy retains its place in specific situations, allowing good tumor control and overall survival.

Keywords: diagnosis, meningioma, surgery, radiotherapy, survival

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Authors: R. M. Chandler, A. J. Stringer

Abstract:

In adults, short bursts of high-intensity exercise (intensities between 80-95% of maximum heart rates) increase cardiovascular and metabolic function without the time investment of traditional aerobic training. Similar improvements in various health indices are also becoming increasingly evident in children in countries other than the United States. In the United States, physical education programs have become shorter in length and fewer in frequency. With this in the background, it is imperative that health and physical educators delivered well-organized and focused fitness programs that can be tolerated across many different somatotypes. Perhaps the least effective lag-time in a US physical education (PE) class is the first 10 minutes, a time during which children warm up. Replacing a traditional PE warmup with a 10 min high-intensity excise protocol is a time-efficient method to impact health, leaving as much time for other PE material such as skill development, motor behavior development as possible. This supplemented 10 min high-intensity exercise increases cardiovascular function as well as induces favorable body composition changes in as little as six weeks with further enhancement throughout a semester of activity. The supplemental high-intensity exercise did not detract from the PE lesson outcomes.

Keywords: cardiovascular fitness, high intensity interval training, high intensity exercise, pediatric

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Authors: Yao Song, Danni Cheng, Jianjun Ren

Abstract:

Objectives: We aimed to explore the prognostic effects of absolute values and dynamic changes of common hematological indices on oropharynx squamous cell carcinoma (OPSCC) patients treated with radiation. Methods and materials: The absolute values of white blood cell (WBC), absolute neutrophil count (ANC), absolute lymphocyte count (ALC), hemoglobin (Hb), platelet (Plt), albumin (Alb), neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) at baseline (within 45 days before radiation), 1-, 3-, 6- and 12-months after the start of radiotherapy were retrospectively collected. Locally-estimated smoothing scatterplots were used to describe the smooth trajectory of each index. A mixed-effect model with a random slope was fitted to describe the changing rate and trend of indices over time. Cox proportional hazard analysis was conducted to assess the correlation between hematological indices and treatment outcomes. Results: Of the enrolled 85 OPSCC patients, inflammatory indices, such as WBC and ALC, dropped rapidly during acute treatment and gradually recovered, while NLR and PLR increased at first three months and subsequently declined within 3-12 months. Higher absolute value or increasing trend of nutritional indices (Alb and Hb) was associated with better prognosis (all p<0.05). In contrast, patients with higher absolute value or upward trend of inflammatory indices (WBC, ANC, Plt, PLR and NLR) had worse survival (all p<0.05). Conclusions: The absolute values and dynamic changes of hematological indices were valuable prognostic factors for OPSCC patients who underwent radiotherapy.

Keywords: hematological indices, oropharyngeal cancer, radiotherapy, NLR, PLR

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Authors: Calvince Okome Odeny

Abstract:

There is a current action to increase radiotherapy services in Kenya. The National government of Kenya, in collaboration with the county governments, has embarked on building radiotherapy centers in all 47 regions of the country. As these new centers are established in Kenya, it has to be ensured that minimum radiation safety standards are in place prior to operation. For full implementation of this, it is imperative that more Research and training for regulators are done on radiation protection, and safety and national regulatory infrastructure is geared towards ensuring radiation protection and safety in all aspects of the use of external radiotherapy practices. The present work aims at reviewing the level of protection and safety for patients and staff during external beam radiotherapy using Linac in Kenya and provides relevant guidance to improve protection and safety. A retrospective evaluation was done to verify whether those occupationally exposed workers and patients are adequately protected from the harmful effect of radiation exposure during the treatment procedures using Linac. The project was experimental Research, also including an analysis of resource documents obtained from the literature and international organizations. The critical findings of the work revealed that the key elements of protection of occupationally exposed workers and patients include a comprehensive quality Management system governing all planned activities from siting, safety, and design of the Facility, construction, acceptance testing, commissioning, operation, and decommissioning of the Facility; Government empowering the Regulatory Authority to license Medical Linear facilities and to enforce the applicable regulations to ensure adequate protection; A comprehensive Radiation Protection and Safety program must be established to ensure adequate safety and protection of workers and patients during treatment planning and treatment delivery of patients and categories of staff associated with the Facility must be well educated and trained to perform professionally with a commitment to sound safety culture. Relevant recommendations from the findings are shared with the Medical Linear Accelerator facilities and the regulatory authority to provide guidance and continuous improvement of protection and safety to improve regulatory oversight.

Keywords: oncology, radiotherapy, protection, staff

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