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In this work, we studied the broadband temporal and spectral properties of the flat-spectrum radio quasar Ton 599. We collected the long-term data from January 2019 to August 2024 when the source was in a long flaring episode. We used the Bayesian block methodology to identify the various flux states, including three flares. The broadband fractional variability is estimated during two flaring states. The F$_{\text{var}}$ variation with respect to frequency shows a nearly double hump structure similar to broadband SED. The power spectral density shows a pink-noise kind of stochastic variability in the light curve, and we do not see any break in the power spectrum, suggesting a much longer characteristic timescale is involved in gamma-ray variability. The flux distribution is well-fitted with a double log-normal flux distribution, suggesting the variability of non-linear in nature. The gamma-ray, optical, and X-ray emissions were found to be highly correlated with a zero time lag, suggesting a co-spatial origin of their emissions. We used the one-zone leptonic model to reproduce the broadband spectrum in the energy range from the IR to very high-energy gamma rays. The increase in the magnetic field and the Doppler factor were found to be the main causes for high flux states. The XMM-Newton spectra taken during one of the flaring durations exhibit a signature of thermal black body emission from the accretion disc, suggesting a possible disc-jet coupling. This has also been indicated by the gamma-ray flux distribution, which shows the distribution as non-linear in nature, which is mostly seen in galactic X-ray binaries or active galactic nuclei, where the accretion disc dominates the emission.
We show that for $5/6$-th of all primes p, Hilbert’s 10th problem is unsolvable for the ring of integers of $\mathbb {Q}(\zeta _3, \sqrt [3]{p})$. We also show that there is an infinite set S of square-free integers such that Hilbert’s 10th problem is unsolvable over the ring of integers of $\mathbb {Q}(\zeta _3, \sqrt {D}, \sqrt [3]{p})$ for every $D \in S$ and for every prime $p \equiv 2, 5\ \pmod 9$. We use the CM elliptic curves $y^2=x^3-432 D^2$ associated with the cube-sum problem, with D varying in suitable congruence class, in our proof.
Stochastic generators are useful for estimating climate impacts on various sectors. Projecting climate risk in various sectors, e.g. energy systems, requires generators that are accurate (statistical resemblance to ground-truth), reliable (do not produce erroneous examples), and efficient. Leveraging data from the North American Land Data Assimilation System, we introduce TemperatureGAN, a Generative Adversarial Network conditioned on months, regions, and time periods, to generate 2 m above ground atmospheric temperatures at an hourly resolution. We propose evaluation methods and metrics to measure the quality of generated samples. We show that TemperatureGAN produces high-fidelity examples with good spatial representation and temporal dynamics consistent with known diurnal cycles.
Mycetoma is a chronic infection of the skin and the subcutaneous tissue caused by both bacteria and fungi. Eumycetoma, caused by fungus, requires prolonged use of antifungals and/or surgery.
Methods:
In this scenario it has been attempted to treat a case of eumycetoma with an aim to improve the symptoms and to give an antifungal drug free period. Radiotherapy was delivered in two sittings. In the first sitting, 20 Gy in five fractions was given. Because of the excellent response to the radiotherapy, after 9 months, another 15 Gy was delivered in five fractions.
Results:
The symptom-free period extended for another 11 months, making a cumulative effect of 21 months.
Conclusion:
The use of radiotherapy in the salvage of refractory eumycetoma cases should be further explored.
To study the simplified sphericity index (SSI) of planning target volume (PTV) and correlate it with the gradient index (GI) for stereotactic radiosurgery (SRS)/stereotactic radiotherapy (SRT) treatment of brain metastasis.
Materials & Methods:
A collection of fifteen brain metastasis cases previously treated with SRS/SRT by volumetric-modulated arc therapy (VMAT) technique was included in the analysis. All the previous plan data from Monaco 6.2.1.0 TPS were used for re-planning and computation of SSI and GI. Pearson’s correlation analysis was performed by using OriginPro 8.5 software, and the outcomes were tabulated.
Results:
The statistical analysis and linear fitting of data show a negative linear correlation between SSI and GI, taking SSI as the independent variable and GI as the dependent variable. Pearson’s correlation coefficient (r) was found to be -0.91563 with a p-value of 0.0000124 showing strong statistical significance.
Conclusion:
It is observed that the GI of the PTV improves as the SSI increases, that is, when the target volume approaches a perfect sphere. Calculating the SSI of the target before planning may help in predicting the GI which may guide making crucial decisions regarding PTV dose prescription and acceptance criteria for organs-at-risk dose tolerance.
The aim of this study is to understand the path for establishing digital health technologies-health technology assessment (DHT-HTA) in India.
Methods
A rapid review of HTA and DHT frameworks on PubMed (MEDLINE) and Google Scholar was conducted to identify DHT-HTA guidelines, and HTA processes in India. MS-Excel template was created with key domains for assessing DHT in resource-constrained settings based on studies and reports identified. Responses received from seventeen experts with varying expertise in DHT, HTA, clinical, and research were contacted using an online form. Following the principles of qualitative research rooted on grounded theory approach, themes and domains were derived for a framework which was again circulated through participants. Weightage for each theme was assigned based on the frequency of responses and qualifiers were used to interpret results. Inductively derived themes from these responses were clubbed together to identify macro-level systems requirements, and finally pre-requisites for setting up DHT-HTA framework was synthesized.
Results
HT are commonly perceived by experts (64.7 percent participants) as a technology strictly connected to health information. Real-world data (i.e., electronic health data) are recognized as a relevant tool in support of decision-making for clinical and managerial levels. Experts identified some pre-requisites for the establishment of DHT-HTA in the country in terms of infrastructure, contextual factors, training, finance, data security, and scale-up.
Conclusion
Our research not only identified the pre-requisites for the adoption of a DHT-HTA framework for India, but confirmed the need to address DHT-HTA’s acceptability among. Hospitals and health insurance providers.
Across sub-Saharan Africa, South Asia, and the Caribbean, the English-language essay engages with colonialism and postcolonial reality to embody forms of life writing that grapple with the provocative confluences of English education, local context, and migrant desire. While conflicts between colonial legacy, postcolonial liberation, and creative imagination assume urgency with pioneers such as V.S. Naipaul and Chinua Achebe, linguistic limits on ethical and political values emerge as defining concerns for apartheid-riven writers such as Nadine Gordimer and Zoë Wicomb, while the scope and constraints of postcolonial representation energise the essays of Shashi Deshpande and Amit Chaudhuri. The fluid and constantly changeable identity of the postcolonial subject that drives the aspirations of the postcolonial essay finds language in its promiscuous texture and heterogeneous structure, its dalliance with analysis, narrative, and image, and its perpetually wandering and unfinished form.
Intracavitary brachytherapy (ICBT) is essential in managing locally advanced cervical cancer. Brachytherapy as a modality has the advantage of a higher dose to the tumour with a dose fall off at the periphery as per the inverse square law. The dose per fraction is much higher than external beam radiotherapy. So proper application and dosimetry are of paramount importance to reduce late toxicity.
Methods:
A retrospective analysis of 69 patients who underwent three ICBT applications of 7 Gray in each fraction was done. The factors under consideration were the type of pain management (spinal anaesthesia (SA) versus conscious sedation (CS)), the initial size of the disease (bulky and non-bulky) and subsequent fractions (first fraction versus third fraction). The dosimetric parameters analysed were the doses received by points A, B and P and that of the critical organs (bladder, rectum and sigmoid colon).
Results:
The dose received by critical organs was comparable concerning all the factors under consideration. The dose to point P on the left side was significantly lower in the CS group than in the SA group (p-value = 0·031). Also, the dose to point P on the right side was significantly lower in the third fraction compared with the first fraction (p-value = 0·016).
Conclusions:
ICBT under spinal anaesthesia resulted in a higher dose to the pelvic wall. The initial size of the tumour or the subsequent fractions does not significantly affect the dose received by critical organs.
The population of people living with a Fontan circulation are highly heterogenous, including both children and adults, who have complex health issues and comorbidities associated with their unique physiology throughout life. Research focused on nutritional considerations and interventions in the Fontan population is extremely limited beyond childhood. This review article discusses the current literature examining nutritional considerations in the setting of Fontan physiology and provides an overview of the available evidence to support nutritional management strategies and future research directions. Protein-losing enteropathy, growth deficits, bone mineral loss, and malabsorption are well-recognised nutritional concerns within this population, but increased adiposity, altered glucose metabolism, and skeletal muscle deficiency are also more recently identified issues. Emergencing evidence suggets that abnormal body composition is associated with poor circulatory function and health outcomes. Many nutrition-related issues, including the impact of congenital heart disease on nutritional status, factors contributing to altered body composition and comorbidities, as well as the role of the microbiome and metabolomics, remain poodly understood.
To analyse the dosimetric benefit of the hybrid inverse planning optimisation (HIPO) planning method over the graphical optimisation (GrO) planning method for 3D volume-based intravaginal brachytherapy (IVBT) in a mono-centre patient cohort.
Material and methods:
Twenty-five patients surgically staged with endometrial cancer were considered for the study. All the patients had received adjuvant IVBT for three fractions with one-time computed tomography image-based planning. The data on the patient, tumour, plan, and treatment characteristics were retrieved from the database. All the plans were re-optimised with GrO and HIPO techniques for this comparison study. The different dosimetric parameters were compared between the two methods, and the collected data were tabulated and shown graphically. The statistical evaluation was performed with IBM SPSS version 26, and Origin Pro 8.5 was employed for plots.
Results:
HIPO plans show similar target coverage in terms of D 90(%), V 95(%) and conformity index with no significant statistical difference from the GrO plans with an acceptable increase in homogeneity index (0·087 ± 0·062%). It succeeds in achieving a statistically significant reduction of dose to organs at risk such as D0·1 cc, D1·0 cc and D2·0 cc for the bladder (11·59%, 4·8% and 3·99%), rectum (41·33%, 16·9% and 16·05%) and sigmoid (20·97%, 13·53% and 11·21%), respectively, in comparison with GrO optimisation.
Conclusion:
Considering the dosimetric outcome of 3D-based IVBT, it is suggested to adopt inverse optimisation techniques like HIPO over GrO to achieve higher quality treatment plan in terms of adequate target dose and lesser dose to OARs.
Addressing many social challenges requires both structural and behavioral change. The binary of an i- and s-frame obscures how behavioral science can help foster bottom-up collective action. Adopting a community-frame perspective moves toward a more integrative view of how social change emerges, and how it might be promoted by policymakers and publics in service of addressing challenges like climate change.
Objectives: We evaluated the role of 12-hydroxystearic acid (12HSA) in upregulating skin antimicrobial peptides (AMPs) in in vitro and ex vivo assays, and 12HSA provides long-lasting germ protection in vivo through a handwash formulation. Methods: In vitro assays were performed by treating skin cells, maintained in cell-culture media, with 12HSA. After treatment, AMP gene-expression was measured in cells by RT-qPCR, and secreted AMPs in spent cell culture media were analyzed by ELISA. Skin explants were treated with 12HSA, and 3D-living skin equivalent (LSE) models were treated with 12HSA-containing handwash formulations. AMP levels were measured by immunohistochemical staining or RT-qPCR after treatment. In clinical studies, volunteer forearms were washed multiple times with 12HSA-containing handwash in an ethics-approved study in which participants provided informed consent. The washed forearms were challenged with E. coli at different time points after washing. The 12HSA deposition from the formulation was measured using tape strips. Results: Skin cells treated with 12HSA showed increased expression of several AMP genes in vitro, and higher psoriasin AMP secretion was measured in cell-culture media. An enhanced level of LL37 AMP was obtained from the skin epidermis of 12HSA-treated explant skin. AMP genes were also upregulated in the 3D-LSE model treated with a 12HSA-containing handwash formulation. A measurable level of 12HSA was deposited from handwash formulation in the in vivo clinical sample. E. coli recovery from challenged skin was significantly lower at 6 and 10 hours after washing compared to unwashed skin. Conclusions: These data demonstrate that 12HSA boosts skin-AMPs and that a handwash containing 12HSA provides long-lasting germ protection under in vivo test conditions by potentially enhancing skin’s natural immunity. With an emerging understanding of skin’s innate immunity and AMPs, designing cleansing products that strengthen these natural defenses will offer novel approaches to extend hygiene benefits beyond immediate in-wash protection.
This chapter argues that the various forms of fallibility historically identified in the genre of the essay – the tentative, the unfinished, and the imperfect – add up to a freedom from mastery that is peculiarly conducive to the consciousness of the postcolonial subject. The author examines essays by writers such as J. M. Coetzee, Nirad C. Chaudhuri, C. L R. James, Jamaica Kincaid, and Arundhati Roy.
The effect of a chordwise flexible aft-tail of a rigid heaving aerofoil on the dynamical transitions of the trailing-wake is studied here. The two-way coupled fluid–solid dynamics is simulated using an in-house fluid–structure interaction (FSI) platform, comprising a discrete forcing immersed boundary method based incompressible Navier–Stokes solver, weakly coupled with a finite difference method based structural solver. The FSI dynamics is studied in comparison to the corresponding rigid tail configuration. For the latter, mild jet-switching due to quasi-periodic movement of the wake vortices gives way to vigorous jet-switching as the dynamics transitions to a state of intermittency, where the quasi-periodic behaviour gets interspersed with chaotic windows. Introduction of a moderately flexible tail regularises this intermittent dynamics, eliminating jet-switching. The wake exhibits a deflected reverse Kármán pattern with fluctuating angles, governed by quasi-periodicity. With a highly flexible tail (very low rigidity), the wake shows almost a symmetric reverse Kármán street as periodicity is restored. Flexibility of the aft-tail is next controlled by changing its length, and flow is regularised and periodicity retained for moderate rigidity for increased length. Different dynamical states are established through robust nonlinear dynamical tools. The underlying flow-field behaviour, instrumental in suppressing the jet-switching phenomenon, is identified through a detailed investigation of the near-field vortex interactions dictated by the dynamics. A suite of measures has also been derived from the unsteady flow field to quantify the interactions of the key near-field vortices with a view to understanding the mechanism of switching and its subsequent suppression through flexibility.
The present study focuses on identifying dynamical transition boundaries and presents an order-to-chaos map for the unsteady flow field of a flapping foil in the low Reynolds number regime. The effect of an extensive parametric space, covering a large number of kinematic conditions, has been investigated. It is shown that the conventional non-dimensional parameters cannot effectively capture the changes in the flow field due to the variations in the relevant kinematic parameters and are unable to demarcate the dynamical transition boundaries. Two new non-dimensional measures – maximum effective angle of attack and a leading-edge amplitude-based Strouhal number – are proposed here, which can capture the physical effect of the parametric variations on the wake dynamics. The study proposes generalised transition boundaries and an order-to-chaos map through a transitional regime in terms of these two newly proposed parameters. Published data from the existing literature have also been tested to verify the proposed transition model. It is seen that despite the wide variety of the parametric combinations, the dynamical states from both the new and the published data corroborate well the proposed boundaries, giving credibility to the order-to-chaos map.
We report a familial cluster of 24 individuals infected with severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). The index case had a travel history and spent 24 days in the house before being tested and was asymptomatic. Physical overcrowding in the house provided a favourable environment for intra-cluster infection transmission. Restriction of movement of family members due to countrywide lockdown limited the spread in community. Among the infected, only four individuals developed symptoms. The complete genome sequences of SARS-CoV-2 was retrieved using next-generation sequencing from eight clinical samples which demonstrated a 99.99% similarity with reference to Wuhan strain and the phylogenetic analysis demonstrated a distinct cluster, lying in the B.6.6 pangolin lineage.