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Comparison of the integral dose (ID) delivered to organs at risk (OAR), non-target body and target body by using different techniques of craniospinal irradiation (CSI).
Materials and methods:
Ten CSI patients (medulloblastoma) already planned and treated either with linear accelerator three-dimensional conformal radiation therapy (Linac-3DCRT) technique or with linear accelerator RapidArc (Linac-RapidArc) technique by Novalis-Tx Linac machine have been analysed. Retrospectively, these patients are again planned on Radixact-X9 Linac with Helical, Direct-3DCRT and Direct-intensity-modulated radiation therapy (Direct-IMRT) techniques. The dose prescription to planning target volume brain (PTV-Brain) and PTV-Spine is 36 Gy in 20 fractions and is kept the same for all techniques. The target body, non-target body, OARs and total body dose are compared.
Results:
ID is lowest in the RapidArc plan for every patient in comparison to Helical and Direct-IMRT. The ID for Body-PTV was found slightly higher in the RapidArc plan in comparison to 3DCRT plans. But there is better normal tissue sparing for most of the OARs in RapidArc plans if it compares with 3DCRT plans.
Findings:
RapidArc is a better alternative for the treatment of CSI. It provides better target coverage and better OARs sparing from any other treatment techniques.
An analytical study of the small amplitude electron acoustic double layers in a magnetized plasma consisting of superthermal electrons and ions along with cold fluid electrons is discussed. The dispersion relation allows electron acoustic waves with the frequency within electron and ion gyro-frequency in the modelled plasma. In the process of study of the nonlinear structures, the Sagdeev pseudo-potential method for small amplitude regions is employed. The existence domains for the double layers are investigated in terms of the Mach numbers of the structures and the temperature ratios of the species for different ratios of their concentration. The effects of the compositional parameters on the nature and size of the double layers are also explored and it is observed that the plasma can support both compressive and rarefactive double layers depending on the values of those parameters and the Mach numbers.
Background: Continuous video-EEG (cvEEG) monitoring is the standard of care for diagnosis and management of neonatal seizures. However, it is labour-intensive. We aimed to establish consistency in monitoring of newborns utilising NICU nurses. Methods: Neonatal nurses were trained to apply scalp electrodes, troubleshoot technical issues. Guidelines, checklists and visual training modules were developed. A central network system allowed remote access to the cvEEGs by the epileptologist for timely interpretation and feedback. We compared 100 infants with moderate to severe HIE before and after the training program. Results: 192 cvEEGs were performed. Of the 100 infants compared; time to initiate brain monitoring decreased by average of 31.5 hours, in electrographic seizure detection increased(20% compared to 34% a), seizure clinical misdiagnosis decreased (65% compared to 36% ), and Anti-Seizure burden decreased. Conclusions: Training experienced NICU nurses to set-up, start and monitor cvEEG can decrease the time to initiate cvEEG which may lead to better seizure diagnosis and management.
Epidemiological and experimental evidence has supported the concept of using helminths as alternative bio-therapeutic agents in the treatment of type 1 diabetes (T1D). In the current study, two filarial proteins, recombinant Wuchereria bancrofti L2 (rWbL2) and Brugia malayi abundant larval transcript 2 (rBmALT-2) have been investigated, individually and in combination, for their therapeutic potential in streptozotocin (STZ)-induced T1D. The rWbL2 and rBmALT-2 proteins, when administered individually or in combination, have resulted in lowering of the blood glucose levels and reducing the incidence of T1D in mice. In addition, these proteins have led to reduced lymphocytic infiltration and decreased islet damage and inflammation. The curative effect was found to be associated with the suppression of release of tumour necrosis factor-α (TNF-α) and interferon-γ (IFN-γ), and increased production of interleukin (IL)-4, IL-5 and IL-10 cytokines by the splenocytes of the diabetic mice. Insulin-specific IgG1 and antigen-specific IgE antibodies were found to be elevated in the sera of mice treated with rWbL2 and rBmALT-2 proteins. From the findings in this study, it can be envisaged that both of these filarial immunomodulatory proteins have the potential to ameliorate T1D by altering the regulatory immune responses.
Docetaxel, cisplatin plus 5-fluorouracil is an efficacious induction regimen but is more toxic than cisplatin plus 5-fluorouracil. This study aimed to determine whether docetaxel and cisplatin without 5-fluorouracil maintains efficacy while decreasing toxicity.
Methods:
A multicenter non-comparative pilot study of locally advanced squamous cell carcinoma of the head and neck was performed. Patients received primary therapy comprising three cycles of 75 mg/m2 docetaxel and 75 mg/m2 cisplatin followed by concurrent chemoradiotherapy. The primary endpoint was the response rate to the docetaxel and cisplatin induction regimen.
Results:
A total of 26 patients were enrolled: of these, 23 (88.5 per cent) received all three docetaxel and cisplatin cycles. Common grade 3–4 adverse events were febrile neutropenia (19.2 per cent of patients), diarrhoea (19.2 per cent) and non-neutropenic infection (15.4 per cent). The overall response rate to docetaxel and cisplatin induction chemotherapy was 65.4 per cent. A total of 23 patients (88.5 per cent) subsequently received chemoradiotherapy with a median radiotherapy dose of 70 Gy. The response rate to chemoradiotherapy was 73 per cent. At a median follow up of 44 months, the 3-year progression-free survival and overall survival rates were 62 per cent and 69 per cent, respectively.
Conclusion:
Docetaxel and cisplatin induction chemotherapy is a feasible induction regimen with comparable efficacy to docetaxel, cisplatin and 5-fluorouracil induction chemotherapy.
We propose and analyse an alternate approach to a priori error estimates for the semidiscrete Galerkin approximation to a time-dependent parabolic integro-differential equation with nonsmooth initial data. The method is based on energy arguments combined with repeated use of time integration, but without using parabolic-type duality techniques. An optimal $L^2$-error estimate is derived for the semidiscrete approximation when the initial data is in $L^2$. A superconvergence result is obtained and then used to prove a maximum norm estimate for parabolic integro-differential equations defined on a two-dimensional bounded domain.
Systematic lithofacies, palaeocurrent, palaeomorphological and palaeohydrological analyses have provided detailed information about a hitherto unstudied river system of the Siwalik foreland basin of the Himalaya. Three distinct lithofacies associations, each representing a specific depositional setting, have been identified and named as ‘Facies Association A’, ‘Facies Association B’ and ‘Facies Association C’. The ‘Facies Association A’ comprises pebbly sandstone, cross-bedded sandstone, ripple-laminated sandy siltstone and bioturbated mudstone lithofacies and represents deposits of a braided channel. The ‘Facies Association B’ comprises cross-bedded sandstone, bioturbated mudstone, fine sandstone–mudstone alternation and lensoid to prismatic sandstone lithofacies and represents deposits of a channel, natural levee, crevasse-splay and flood plain of a meandering stream. The ‘Facies Association C’ comprises mottled siltstone–mudstone heterolith and fine sandstone lithofacies and represents deposits of the upland interfluve region. The braided stream had a maximum depth of 4.15 m, maximum width of 305 m and maximum discharge of 7045 cumec, whereas the meandering stream had a sinuosity of 1.26, maximum depth of 3.71 m, maximum width of 180 m and maximum discharge of 4070 cumec. The area had a regional radial outward flow pattern, but dominantly towards the SSW. However, the braided river had a bimodal flow pattern due to an active basement-high-induced bend along its course. A comparison of the sediment characters and morphological and hydrological parameters of these streams with those of the modern rivers of the Ganga (Gangetic) basin has enabled us to infer that this river system was located in the medial-distal megafan-interfan setting of the basin.
In view of the mandate from the World Health Organization (WHO) for developing novel drug candidates against human lymphatic filariasis, dihydrofolate reductase (DHFR) inhibitors are explored as potential antifilarial agents. The in vitro biological evaluation of an in-house library of 12 diverse antifolate compounds with 2,4-diaminopyrimidine and 2,4-diamino-s-triazine structural features against Brugia malayi is reported. To confirm the DHFR inhibitory potential of these compounds, reversal studies using folic acid and folinic acid were undertaken. Inhibition of DHFR can induce apoptosis; in this light, preliminary evidence of apoptosis by test compounds was detected using ethidium bromide–acridine orange staining and the poly(adenosine diphosphate-ribose) polymerase (PARP) inhibition assay. Among the evaluated compounds, 3 showed significant activity against both microfilariae and adult worms. The effects of 2 of these compounds were mostly reversed by folic acid, validating DHFR inhibitory activity. Partial reversal of the effect of 2 compounds by folinic acid and non-reversal of the effect of the third compound both by folic and folinic acids are discussed. This study opens new avenues for the discovery of lead molecules by exploiting the folate pathway against one of the major neglected tropical diseases, filariasis.
Detailed facies analysis and morphotectonic investigations of the Malin River's alluvial fan in the western Ganga Plain, India, reveal that the morphology of the fan is largely tectonically controlled whereas the sedimentary processes are mainly climatically controlled. The sedimentation occurred in two distinct evolutionary cycles which are separated by a time gap. The older cycle deposited thick gravelly units up to the distal-fan area, whereas the sediment fill of the younger cycle is gavel-dominated in the proximal-fan area, gravel–sand dominated in the middle-fan area and sand–mud dominated in the distal-fan area. The gravels of the older cycle were emplaced by intense sediment gravity flows during periods of strengthened monsoon and steeper regional gradient. During the younger cycle, the proximal to distal parts of the fan were dominated by different sedimentary processes. This was a time of relatively weaker monsoon and gentler regional slopes, when gravels could travel only up to the middle-fan area. The gravels in the proximal-fan area have mainly been deposited by sediment gravity flows and channel processes; in the middle-fan area channel processes, sheetfloods and sediment gravity flows have been the main sedimentary processes; and in the distal-fan area fluvial processes of channel migration and overbank deposition have been the main sedimentary processes.
InxGa1-xN-based LED structures were grown on digital AlxGa1-xN/GaN DBR substrate to enhance emission extraction. Same LED structure was grown on sapphire substrate as a comparison. LEDs grown on DBR substrate exhibited similar IV characteristics to that grown on sapphire substrate but emission-angle-dependent EL spectra were observed. Also, the resonant vertical cavity modes were observed in EL spectra of LEDs with DBR structure and compared to simulated results. Image processing analysis results show that light extraction of LEDs is enhanced with use of DBR substrate.
Our goal was to investigate auditory and speech perception abilities of children with and without reading disability (RD) and associations between auditory, speech perception, reading, and spelling skills. Participants were 9-year-old, Finnish-speaking children with RD (N = 30) and typically reading children (N = 30). Results showed significant group differences between the groups in phoneme duration discrimination but not in perception of amplitude modulation and rise time. Correlations among rise time discrimination, phoneme duration, and spelling accuracy were found for children with RD. Those children with poor rise time discrimination were also poor in phoneme duration discrimination and in spelling. Results suggest that auditory processing abilities could, at least in some children, affect speech perception skills, which in turn would lead to phonological processing deficits and dyslexia.
We use a one-dimensional quasi-neutral fluid model to study the formation of an electrostatic shock associated with the lower-hybrid mode propagating almost perpendicularly to the magnetic field that exists in the auroral zone of the magnetosphere containing cold downward-streaming electrons, cold upward-streaming ions and beam electrons. We examine the effects of finite electron-beam temperature by describing the beam electrons with fluid equations. We then show how exact time-stationary shock solutions may be found when quasi-neutrality is considered.
Currently, concomitant chemoradiation using cisplatin is one of the standards of care for the management of head and neck cancer, but at the cost of increased acute toxicity. Our aim was to assess whether vinorelbine was less toxic and of at least comparable efficacy, if not better, compared with cisplatin.
Materials and methods:
A total of 72 patients with squamous cell carcinoma in the head and neck region were recruited, 40 in arm A and 32 in arm B. Patients in arm A received 40 mg/m2 cisplatin weekly. Patients in arm B received 6 mg/m2 vinorelbine weekly. Both arms also received 66 Gy of radiation in conventional fractionation.
Results and analysis:
There was no statistically significant difference in response rate or toxicities between the two arms, except for nausea and/or vomiting, which was significantly less frequent in the vinorelbine arm.
Conclusion:
Vinorelbine was as effective as cisplatin in controlling locoregional disease in locally advanced head and neck cancer, but was only marginally less toxic than cisplatin.
Fifteen indigenous nondescript kids (8·2 kg; 8 months initial age), randomly allotted into three equal groups, were used to study the effects of supplementation of extra iodine on their performance when fed a leucaena (Leucaena leucocephala) leaf meal containing diet. Group I (CON) was fed a control concentrate supplement consisting of a conventional protein source whereas the other two groups (LL and LLI) were fed a concentrate containing leucaena leaf meal so as to supply 0·5 of the net crude protein (CP) requirements. Additionally, animals in group LLI were given supplemental iodine (as potassium iodide solution) at 0·25 mg/head/day. Wheat straw was provided ad libitum as the sole source of roughage during the 120 days of the experimental period. A metabolism trial, conducted at the end of the feeding trial, revealed no variation in the dry matter intake (DMI) among the groups. A significant (P<0·01) decline was evident in digestibility of CP in both the leucaena-fed groups (0·463 and 0·482 versus 0·586) whilst that of the other organic components remained unaffected. Animals on the LL diet exhibited lower (P<0·01) nitrogen retention and average daily gain (ADG) in live weight (LW). Blood collected periodically was analysed for the thyroid hormones triiodothyronine (T3) and thyroxine (T4) as well as other biochemical parameters. At the end of the experimental feeding, the cell-mediated immune (CMI) response of the goats was assessed by intra-dermal inoculation of phytohaemagglutinin-P and measuring the change in skin thickness at various post-inoculation hours. The results revealed that the serum concentration of glucose was significantly (P<0·05) higher in the LLI group of animals fed leucaena with iodine. The concentration of cholesterol in serum of LL animals increased significantly (P<0·05) compared to the CON and LLI groups. No variation due to dietary interventions was evident in other indices of metabolic profile. While the concentration of circulating T3 remained unaffected due to dietary intervention, that of T4 reduced significantly (P<0·05) in the LL group. Moreover, the T4 concentration in the LLI group remained similar to that of control indicative of positive impact of iodine supplementation. The immune response revealed that the skin thickness of animals in the LL group was lower (P<0·05) as compared to the control, indicating a compromise of CMI response due to feeding of leucaena leaf meal. Supplementation of iodine appeared to be partially effective in potentiating the response. In conclusion, iodine supplementation could be adopted as a strategic management strategy to ameliorate the negative impacts of feeding leucaena leaf meal in growing kids.
This paper analyzes adiscrete-time multi-server queue in which service capacity of eachserver is a minimum of one and a maximum of b customers. Theinterarrival- and service-times are assumed to be independent andgeometrically distributed. The queue is analyzed under theassumptions of early arrival system and late arrival system withdelayed access. Besides, obtaining state probabilities atarbitrary and outside observer's observation epochs, someperformance measures and waiting-time distribution in the queuehave also been discussed. Finally, it is shown that in limitingcase the results obtained in thispaper tend to the continuous-time counterpart.
The development of light weight hydrogen storage systems with high volumetric and gravimetric hydrogen densities is indeed essential for the on-board fuel cell vehicular applications [1]. Among the different hydrogen storage systems designed and developed so far, Ti- doped sodium aluminum hydrides exhibit potential promise of reversible hydrogen storage capacity (4-5 wt.%) at moderate temperatures [2,3]. However, the poor cyclic stability of these hydrides due to the partial reversibility of the two step reactions necessitates the development of exotic materials or tailoring the known hydride systems. On the other hand, transition metal complex hydrides, TMHx (T = Mg; M = Fe, Co, Ni) have also been identified as potential candidates for hydrogen storage [4-6] and/or analogous to alanates [7]. These hydrides especially Mg2FeH6, have shown excellent cyclic capacities (more than 500 cycles) even without a catalyst [8]. Besides, Mg2FeH6 possesses the highest volumetric and gravimetric hydrogen densities of 150 kg/m3 and 5.6 wt.% respectively [9]. However, at low temperatures, the rate of release of hydrogen and the effective reversible hydrogen capacity seems poor. Recent reports declared that the enhancement in the cycling kinetics and reduction in the operating temperature is very much possible by using a distorted nano-scale Mg structure [10, 11], doping the host lattice with Ti- species and/or lattice substitution [12]. Keeping these facts in view, the present investigation aims to improve the sorption kinetics and thermodynamics of Mg2FeH6, by 1) preparing nano-scale Mg-Fe-H system using mechano-chemical synthesis process, 2) surface localized catalyst (Ti- species) doping and 3) cationic substitution of Na+/Li+ for Mg2+ by incorporating NaH/LiH. The synergistic behavior of the tailored nano-scale transition metal complex for hydrogen storage is outlined.
Highly (111)-oriented and conformal iridium (Ir) films were deposited by a liquid source metalorganic-chemical-vapor-deposition process on various substrates. An oxygen-assisted pyrolysis of (methylcyclopentadienyl) (1,5-cyclooctadiene) Ir precursor at a wide range of substrate temperatures (Tsub) between 300 and 700 °C was used. At a low Tsub of 350 °C, the randomly oriented polycrystalline films exhibited an I111/I200 x-ray intensity ratio of 6. However, the films deposited at Tsub = 700 °C on native SiO2 and amorphous SiO2 surfaces were highly oriented with the I111/I200 ratios of 277 and 186, respectively. The transmission electron microscopy study revealed continuous, dense, and faceted microstructures of Ir films. Also, the step coverage of Ir on TiN (64%) was higher than that on amorphous SiO2 (50%) surfaces.
The problem of scattering of surface water waves obliquely incident on a fixed half immersed circular cylinder is solved approximately by reducing it to the solution of an integral equation and also by the method of multipoles. For different values of the angle of incidence and the wave number the reflection and transmission coefficients obtained by both methods are evaluated numerically and represented graphically to compare the results obtained by the respective methods.
The high rate of twinning in rural areas is suggested to be due to higher coefficient of inbreeding, better physical conditions of mothers on the countryside and higher mean birth order. Family data indicate the frequent role of maternal genotype in DZ twinning.
With the revision of application of terms “endogamous” and “exogamous” the inbreeding levels have been calculated from certain parts of Madhya Pradesh. Higher inbreeding levels in persons with rural background are in conformity with other workers.