Mean HI Research Articles

Assessment of heavy metal(oid) pollution and related health risks in agricultural soils surrounding a coal gangue dump from an abandoned coal mine in Chongqing, Southwest China

The coal gangue dump may introduce heavy metal(oid)s (HMs) into surrounding agricultural soils, posing potential health risks to nearby communities. This study evaluated heavy metal(oid) pollution in agricultural soils adjacent to a gangue dump at an abandoned coal mine in Chongqing, Southwest China. The concentrations of HMs (As, Cd, Cr, Cu, Ni, Pb, and Zn) were quantified using ICP-MS, and the contamination status was assessed using the Geoaccumulation Index (Igeo), Contamination Factor (CF), Pollution Load Index (PLI), and Potential Ecological Risk Index (RI). Heavy metal(oid) contamination was detected in soils across a depth of 0–30 cm, particularly pronounced in the topsoil layer (0–10 cm and 10–20 cm depths). Cu emerged as the predominant contaminant across all examined depths, with average Igeo values of 1.20, 1.21, and 1.16 for the 0–10 cm, 10–20 cm, and 20–30 cm depths, respectively, indicating moderate contamination. The CF for Cu was 3.55, 3.55, and 3.50 for these respective depths, classifying it as considerable contamination. The PLI values ranged from 1.61 to 2.50, with a mean value of 2.12, indicating overall contamination. The ecological risk assessment indicated that the soil's ecological risk was low at all depths. Cd was the major contributor to the RI, accounting for 48%, 47%, and 42% at 0–10 cm, 10–20 cm, and 20–30 cm depths, respectively. Health risk assessments revealed significant non-carcinogenic risks to children (mean HI = 1.30) and unacceptable carcinogenic risks to both adults and children (mean TCR = 3.26 × 10–4 and 1.53 × 10–3, respectively). This study underscores the critical need for comprehensive risk assessments using multiple indicators to prioritize remediation efforts for HMs, providing a scientific basis for effective environmental management and public health protection in the Three Gorges Reservoir Area.

Al and MCPD in grain products in Gansu province, China and risk assessment

ABSTRACT This study conducted a dietary exposure assessment of chloropropanols and aluminium, after quantifying their content in food. The mean dietary exposure to Al from total grain products was found to be 6.4E–04 mg/kg bw/week, not exceeding the provisional tolerable weekly intake (PTWI). The results showed that the mean dietary exposure of 3-monochloro-1,2-propanediol (3-MCPD) from grain products was higher than the tolerable daily intake (TDI). Deterministic evaluations showed that the mean HQ of 1.5 to Al from fried dough twist was higher than 1. However, the HI values to Al were lower than 1 and the Monte Carlo simulation (MCS) showed that the HQ was greater than 1 at the 99% exposure level. Deterministic and probabilistic methods indicated that HQ values of 3-MCPD from grain products were above 1, whereas the mean HI value was 0.62.

Protective effectiveness of two vaccination schemes against the prevalent Egyptian strain of Newcastle disease virus genotype VII.

Despite the strict preventive immunization used in Egypt, Newcastle disease remained a prospective risk to the commercial and backyard chicken industries. The severe economic losses caused by the Newcastle disease virus (NDV) highlight the importance of the trials for the improvement and development of vaccines and vaccination programs. In the present study, we evaluated the effectiveness of two vaccination schemes for protection against the velogenic NDV (vNDV) challenge. Four groups (A-D) of commercial broiler chickens were used. Two groups (G-A and G-B) were vaccinated with priming live HB1 GII simultaneously with inactivated GVII vaccines at 5 days of age, then boosted with live LaSota GII vaccine in group A and live recombinant NDV GVII vaccine in group B on day 16. Groups A to C were challenged with NDV/Chicken/Egypt/ALEX/ZU-NM99/2019 strain (106 Embryo infective dose 50/0.1 ml) at 28 days of age. Two vaccination schemes achieved 93.3% clinical protection against NDV with body gain enhancement; whereas, 80% of the unvaccinated-challenged birds died. On day 28, the mean HI antibody titers were 4.3 ± 0.33 and 5.3 ± 0.33 log2 in groups A and B, respectively. As well as both programs remarkably reduced virus shedding. The two vaccination schemes displayed close protection efficacy against the vNDV challenge. Therefore, using the combination of a live attenuated vaccine with an inactivated genetically matched strain vaccine and then boosting it with one of the available live vaccines could be considered one of the most effective programs against current field vNDV infection in Egypt.

Dosimetric comparison between RapidArc and HyperArc in hippocampal-sparing whole-brain radiotherapy with a simultaneous integrated boost

The HyperArc technique is known for generating high-quality radiosurgical treatment plans for intracranial lesions or hippocampal-sparing whole-brain radiotherapy (WBRT). However, there is no reported feasibility of using the HyperArc technique in hippocampal-sparing WBRT with a simultaneous integrated boost (SIB). This study aimed to compare dosimetric parameters of 2 commercially-available volumetric-modulated arc radiotherapy techniques, HyperArc and RapidArc, when using hippocampal-sparing WBRT with a SIB to treat brain metastases.Treatment plans using HyperArc and RapidArc techniques were generated retrospectively for 19 previously treated patients (1 to 3 brain metastases). The planning target volumes for the whole brain (excluding the hippocampal avoidance region; PTVWB) and metastases (PTVmet) were prescribed 25 and 45 Gy, respectively, in 10 fractions. Each plan included homogeneous and inhomogeneous delivery to the PTVmet. Dosimetric parameters for the target (conformity index [CI], homogeneity index [HI], target coverage [D95%]), and nontarget organs at risk were compared for the HyperArc and RapidArc plans.For homogeneous delivery, dosimetric parameters, including mean CI, HI, and target coverage in PTVWB and PTVmet, were superior for HyperArc than RapidArc plans (all p < 0.01). The PTVWB and PTVmet target coverage for HyperArc plans was significantly greater than for RapidArc plans (96.17% vs 93.38%, p < 0.01; 94.02% vs 92.21%, p < 0.01, respectively). HyperArc plans had significantly lower mean hippocampal Dmax and Dmin values than RapidArc plans (Dmax: 15.53 Gy vs, 16.71 Gy, p < 0.01; Dmin: 8.33 Gy vs 8.93 Gy, p < 0.01, respectively). Similarly, inhomogeneous delivery of hyperArc produced a superior target and lower hippocampal dosimetric parameters than RapidArc, except for the HI of PTVmet (all p < 0.01).HyperArc generated superior conformity and target coverage with lower hippocampal doses than RapidArc. HyperArc could be an attractive technique for hippocampal-sparing WBRT with an SIB.

A Booster with a Genotype-Matched Inactivated Newcastle Disease Virus (NDV) Vaccine Candidate Provides Better Protection against a Virulent Genotype XIII.2 Virus.

Newcastle disease (ND) is endemic in Bangladesh. Locally produced or imported live Newcastle disease virus (NDV) vaccines based on lentogenic virus strains, locally produced live vaccines of the mesogenic Mukteswar strain, as well as imported inactivated vaccines of lentogenic strains, are being used in Bangladesh under different vaccination regimens. Despite these vaccinations, frequent outbreaks of ND are being reported in Bangladesh. Here we compared the efficacy of booster immunization with three different vaccines in chickens that had been primed with two doses of live LaSota vaccine. A total of 30 birds (Group A) were primed with two doses of live LaSota virus (genotype II) vaccine at days 7 and 28, while 20 birds (Group B) remained unvaccinated. At day 60, birds of Group A were divided into three sub-groups, which received booster immunizations with three different vaccines; A1: live LaSota vaccine, A2: inactivated LaSota vaccine, and A3: inactivated genotype XIII.2 vaccine (BD-C161/2010 strain from Bangladesh). Two weeks after booster vaccination (at day 74), all vaccinated birds (A1-A3) and half of the unvaccinated birds (B1) were challenged with a genotype XIII.2 virulent NDV (BD-C161/2010). A moderate antibody response was observed after the primary vaccination, which substantially increased after the booster vaccination in all groups. The mean HI titers induced by the inactivated LaSota vaccine (8.0 log2/5.0 log2 with LaSota/BD-C161/2010 HI antigen) and the inactivated BD-C161/2010 vaccine (6.7 log2/6.2 log2 with LaSota/BD-C161/2010 HI antigen) were significantly higher than those induced by the LaSota live booster vaccine (3.6 log2/2.6 log2 with LaSota/BD-C161/2010 HI antigen). Despite the differences in the antibody titers, all chickens (A1-A3) survived the virulent NDV challenge, while all the unvaccinated challenged birds died. Among the vaccinated groups, however, 50% of the chickens in Group A1 (live LaSota booster immunization) shed virus at 5- and 7-days post challenge (dpc), while 20% and 10% of the chickens in Group A2 (inactivated LaSota booster immunization) shed virus at 3 and 5 dpc, respectively, and only one chicken (10%) in Group A3 shed virus at 5 dpc. In conclusion, the genotype-matched inactivated NDV booster vaccine offers complete clinical protection and a significant reduction in virus shedding.

Effects of Escherichia coli strain Nissle 1917 on immune responses of Japanese quails (Coturnix japonica) to Newcastle disease vaccines.

The development of proper immune responses to Newcastle disease (ND) vaccines is important in controlling the disease. Escherichia coli strain Nissle 1917 (EcN) is involved in regulating the immune system. The current study evaluated the effects of EcN on immune responses to ND live vaccines in Japanese quails. A total of 150 one-day-old quails were divided into three equal groups. Groups A and B received 107 and 106 CFU/ml/day of EcN, respectively, sprayed on their diets, while group C received 1 ml/day of PBS. All birds were vaccinated with B1 and Lasota vaccines at 10 and 20 days of age, respectively. Serum samples were collected in order to assay the levels of IgA and certain cytokines, including IL4, IFN-α, and IFN-γ, as well as antibody titers to NDV by HI and ELISA methods. No significant difference (P>0.05) was observed in serum IgA and IFN-α levels among the groups. However, concentrations of IFN-γ and IL-4 in 42-day-old chicks in group A were significantly (P<0.05) higher than in both other groups. After 15 days of the second vaccination, the mean HI titer following NDV was significantly higher in group A than group C. Groups B and C showed significantly lower HI titer than group A after 22 days of the second vaccination. Mean ELISA titer to NDV was significantly (P<0.05) higher in group A than in groups B and C after 22 days of the second vaccination. It seems that the spraying of 107 CFU/ml/day of EcN on quail diets enhances the immune response to NDV vaccines by increasing serum levels of IFN-γ and IL-4.

Differentiation of various salivary gland tumours using diffusion-weighted MRI and dynamic contrast-enhanced MRI.

To determine the role of functional magnetic resonance imaging techniques (diffusion-weighted magnetic resonance imaging [DW-MRI] and dynamic contrast-enhanced magnetic resonance imaging [DCE-MRI]) in the differentiation of various salivary gland tumours. In this prospective study, we evaluated 32 patients with salivary gland tumours using functional MRI. Diffusion parameters (mean apparent diffusion coefficient [ADC], normalized ADC and homogeneity index [HI]),semiquantitative DCE parameters (time signal intensity curves [TICs]) and quantitative DCE parameters (Kep, Ktrans and Ve) were analysed. Diagnostic efficiencies of all these parameters were determined to differentiate benign and malignant tumours as well as to characterize 3 major subgroups of salivary gland tumours, namely pleomorphic adenoma, Warthin tumour, and malignant tumours. Mean ADC, normalized ADC and HI were insignificant in differentiating benign and malignant tumours but were significant in differentiating pleomorphic adenomas, Warthin tumours, and malignant tumours. Mean ADC was the best parameter in predicting both pleomorphic adenomas and Warthin tumours (AUC: 0.95 and 0.89, respectively). Amongst DCE parameters, only TIC pattern could differentiate between benign and malignant tumours, with an accuracy of 93.75% (AUC: 0.94). The quantitative perfusion parameters aided greatly in characterizing pleomorphic adenomas, Warthin tumours and malignant tumours. For predicting pleomorphic adenomas, the accuracy of Kep and Ktrans was 96.77% (AUC: 0.98) and 93.55% (AUC: 0.95), respectively and for predicting Warthin tumours, the accuracy of both Kep and Ktrans was 96.77% (AUC: 0.97). DCE parameters (particularly TIC, Kep and Ktrans) had higher accuracy in characterizing various tumour subgroups (pleomorphic adenomas, Warthin tumours, and malignant tumours) than DWI parameters. Hence, dynamic contrast-enhanced imaging adds immense value with only a minimum time penalty to the examination.

Evaluation of Efficacy of Oil Adjuvanted H5N6 Inactivated Vaccine against Highly Pathogenic H5N6 and H5N1 Influenza Viruses Infected Chickens.

Over the last 20 years, circulating highly pathogenic (HP) Asian H5 subtype avian influenza viruses have caused global pandemics in poultry and sporadic infections in humans. Vaccines are a desirable solution to prevent viral infections in poultry and reduce transmission to humans. Herein, we investigated the efficacy of an oil-adjuvanted inactivated H5N6 vaccine against highly pathogenic H5N6 and H5N1 influenza virus infections in chickens. The polybasic amino acid cleavage site depleted HA gene and NA gene of A/Waterfowl/Korea/S57/2016 (clade 2.3.4.4) (H5N6) was assembled with the rest of the A/PR/8/34 (H1N1) genes to construct the vaccine virus. The vaccine virus was propagated in fertilized eggs, partially purified using a tangential flow filtration (TFF) system, and inactivated using formalin. The chickens were intramuscularly immunized with 384 HA, 192HA, and 96HA units of oil-adjuvanted inactivated H5N6 vaccine. Antibody titer, survival rate, and lung pathology were evaluated against the homologous H5N6: A/waterfowl/Korea/S57/2016 (clade 2.3.4.4) and heterologous H5N1: A/Hong Kong/213/2003 (clade 1) viruses 12 and 4 weeks post-vaccination (p.v.), respectively. Data were statistically analyzed using the Mann-Whitney U test. The 384HA (n = 10) and 192HA (n = 5) antigen-immunized chickens showed 100% survival after lethal infections with homologous H5N6, and no virus shedding was observed from tracheal and cloacal routes. All chickens that received the 384HA vaccine survived the challenge of heterologous H5N1 after 4 weeks of immunization. The chickens that received the 384HA vaccine showed mean HI titers of 60 and 240 after 12 and 4 weeks of vaccination, respectively, against HP H5N6, whereas a mean HI titer of 80 was observed in sera collected 4 weeks after vaccination against HP H5N1. Our findings indicate that one dose of 384HA oil-adjuvanted inactivated H5N6 vaccine can induce a long-lasting immune response against both homologous H5N6 and heterologous H5N1 infections in chickens.

Climate variability and Aedes vector indices in the southern Philippines: An empirical analysis.

BackgroundVector surveillance is an essential public health tool to aid in the prediction and prevention of mosquito borne diseases. This study compared spatial and temporal trends of vector surveillance indices for Aedes vectors in the southern Philippines, and assessed potential links between vector indices and climate factors.MethodsWe analysed routinely collected larval and pupal surveillance data from residential areas of 14 cities and 51 municipalities during 2013–2018 (House, Container, Breteau and Pupal Indices), and used linear regression to explore potential relationships between vector indices and climate variables (minimum temperature, maximum temperature and precipitation).ResultsWe found substantial spatial and temporal variation in monthly Aedes vector indices between cities during the study period, and no seasonal trend apparent. The House (HI), Container (CI) and Breteau (BI) Indices remained at comparable levels across most surveys (mean HI = 15, mean CI = 16, mean BI = 24), while the Pupal Productivity Index (PPI) was relatively lower in most months (usually below 5) except for two main peak periods (mean = 49 overall). A small proportion of locations recorded high values across all entomological indices in multiple surveys. Each of the vector indices were significantly correlated with one or more climate variables when matched to data from the same month or the previous 1 or 2 months, although the effect sizes were small. Significant associations were identified between minimum temperature and HI, CI and BI in the same month (R2 = 0.038, p = 0.007; R2 = 0.029, p = 0.018; and R2 = 0.034, p = 0.011, respectively), maximum temperature and PPI with a 2-month lag (R2 = 0.031, p = 0.032), and precipitation and HI in the same month (R2 = 0.023, p = 0.04).ConclusionsOur findings indicated that larval and pupal surveillance indices were highly variable, were regularly above the threshold for triggering vector control responses, and that vector indices based on household surveys were weakly yet significantly correlated with city-level climate variables. We suggest that more detailed spatial and temporal analyses of entomological, climate, socio-environmental and Aedes-borne disease incidence data are necessary to ascertain the most effective use of entomological indices in guiding vector control responses, and reduction of human disease risk.

Health risk assessment associated with heavy metals through fractioned dust from coal and chromite mines in Pakistan.

Heavy metals exposure through dust emissions pose a health risk to workers in coal and chromite mines. The processes involved in mining are noteworthy for the generation of heavy metal-contaminated dust which causes human health implications, especially to the workers that are mainly exposed to such toxins. This study determined pollution levels in coal and chromite mines and calculated the health risk of workers being exposed to heavy metal-contaminated dust. We used fractioned dust with particle sizes < 75, 75-106, and 107-150µm to assess the pollution levels, anthropogenic impacts, geo-accumulation index, and enrichment factor for selected coal and chromite mines. Through a probabilistic approach, Monte Carlo simulations were used to determine health risks. The findings revealed that the smallest size dust fraction (< 75μm) contained the highest metal concentrations. Ingestion was considered a prominent exposure route contributing to health risk. In the dust fraction (< 75μm), chromite mines exhibited the highest Cr (340.6mg/kg) and lowest Cd (8.4mg/kg) concentrations. In coal mines, Mn (284.9mg/kg) and Cd (2.1mg/kg) were measured highest and lowest, respectively. Pollution assessment revealed dust to be moderately polluted. Health risk assessment showed that Cr in chromite mines exhibited a mean HI value of 1.16E + 00 that was higher than the safe level (HI > 1) having the potential to cause significant health risk to workers. In coal mines, the estimated total HI was 6E-1. Sensitivity analysis revealed concentration and exposure time to be the most influential parameters contributing to risk. Therefore, governmental and nongovernmental organizations must develop dust pollution control guidelines and mitigation measures to safeguard the health of mineworkers by limiting heavy metal exposure.

A dosimetric comparative analysis of Brainlab elements and Eclipse RapidArc for spine SBRT treatment planning

Purpose. This is a dosimetric study comparing stereotactic body radiotherapy (SBRT) plans of spine tumors using Brainlab Elements Spine planning module against Eclipse RapidArc plans. Dose conformity, dose gradient, dose fall-off, and patient-specific quality assurance (QA) metrics were evaluated. Methods:Twenty patients were immobilized in supine position using half Vac-Lok. A prescription dose of 16 Gy in a single fraction was planned for Varian TrueBeam. Conformal arc plans were generated with Pencil beam (PB), MonteCarlo (MC) in Elements, and RapidArc with Acuros XB algorithm in Eclipse using identical treatment geometry. Results. Eclipse, Elements PB, and Elements MC generated dosimetrically conformal plans having Inverse Paddick Conformity Index (IPCI) <1.3. All plans satisfied the dose constraints to target and OARs. Elements PB had a sharper gradient than Elements MC with average GI of 3.67(95% CI: 3.52–3.82) and 4.06 (95% CI: 3.93–4.20) respectively. Eclipse plans were more homogeneous with mean HI = 1.22 (95% CI: 1.20–1.23) that is lower than others. Average maximum clinical target volume (CTV) doses were higher in Elements MC with 22.31 Gy (95% CI: 21.87–22.74), while PB plans have 21.15 Gy (95% CI: 20.36–21.96), respectively. Elements MC and PB plans had lower average dose to 0.35 c.c. of spinal cord (D0.35cc) of 7.60 Gy (95% CI: 7.18–8.02) and 8.42 Gy (95% CI: 7.83–9.01). All plans had >95% points passing the gamma QA criteria at 3%/2 mm. Conclusion. All treatment plans achieved clinically acceptable target coverage >95% and meet spinal cord dose limits. Smart optimization in Brainlab Elements spine module produced dosimetrically superior plans by better spinal cord sparing.

VMAT treatment plan acceptability and quality assurance study for prostate cancer in radiotherapy

AbstractAim:The aim of this work was to study the acceptability of plans prepared for prostate patients treated by volumetric modulated arc therapy (VMAT) with the vision to evaluate the quality of plans and test pre-treatment quality assurance (QA).Material methods:VMAT plans of 35 patients, planned on the Eclipse Treatment Planning System (Aria 15), were included in the study. Plan acceptability was checked using statistical analysis, which includes homogeneity index, radical and median homogeneity index, coverage and uniformity index. Dose–volume histograms (DVH) of the plans were also studied to check prescribed dose (PD), Dmax, Dmin, D5 and D95. Portal dosimetry was also done by gamma analysis using 3%/3 mm criterion. SD and mean SD error were also calculated and analysed.Results:Statistical analysis showed a mean HI of 1·054, coverage 0·959, UI 1·055, mDHI 0·962 and rDHI 0·866. SD of HI, coverage, UI, mDHI and rDHI was 0·019, 0·019, 0·014, 0·013 and 0·030, respectively. From the DVHs, mean of D5, D95, Dmin and Dmax was calculated at 6,252·9, 5,757·4, 6,413·3 and 5,657·7 cGy, respectively, with a prescribed dose of 6,000 cGy. According to gamma analysis, area gamma &lt; 1 was 99·12% with a tolerance limit of 95%, maximum gamma was 1·466 with a tolerance limit of 3·5, average gamma was 0·388 with a tolerance limit of 0·5, area gamma &gt; 1·2 was 0·242% with a tolerance limit of 0·5%, maximum dose difference was 0·6 with a tolerance limit of 1·0 and average dose difference was 0·029 with a tolerance limit of 0·2.Conclusion:All three computations showed the results to be within acceptable limits. VMAT possesses a unique feature of delivering the whole treatment with only two rotations of the gantry. VMAT has an improved efficiency of delivery for equivalent dosimetric quality.

Three Dimensional Printed Individual Template Based 192ir High-Dose Rate Interstitial Brachytherapy for Central Recurrent Gynecologic Cancer: A Phase II Clinical Trial

To evaluate the feasibility, safety, and accuracy of three-dimensional (3D)-printed individual template (3D-PIT) based with HDR interstitial brachytherapy (HDR-IB) for pelvic central recurrent gynecologic cancer (CR-GYN). 32 patients diagnosed CR-GYN in our institution were received 192Ir HDR-IB. 3D-PIT technique was carried out for all these patients in our center. They underwent procedure that firstly simulation; then preplan; thirdly 3D template design and printing and fourthly interstitial 192Ir HDR brachytherapy operation. There are two types of individual 3D-PIT designed. Type I: transvaginal template/applicator, and Type II: transvaginal combined transperineal template. The prescription dose to GTV was 10-36Gy, 5-6Gy/fraction, 2-6f. Dose parameters were D90, D100, V100, conformal index, external index and homogeneity index of the target volume, and the dose received by 2cm3 of normal tissue of organs at risk (rectum, bladder, and intestine) were recorded. We compared the dose parameters of the treatment plan with the preplan. The short-term efficacy was evaluated by RECIST v1.1, and the adverse event was evaluated by CTCAE V4.0. In total 32 patients, 205 needles were inserted for 153 applications, The mean V100, D100, and D90 per fraction were 88.9%±9.8%,3.45Gy±0.54Gy, and 5.79 Gy±0.32Gy respectively; the mean D2cc of rectum, bladder and colon per fraction were 3.14Gy±0.23Gy, 3.76Gy±0.72Gy and 2.47Gy±0.34Gy respectively. The mean CI, EI, and HI were 0.59±0.12, 0.31±0.16, and 0.47±0.22. Dosimetry parameters comparison between preplan and treatment plan of 20/32 patients with Type II 3D-PIT based HDR-IB show that there were no statistically significant (P > 0.05) difference in GTV volume, V100, D100, D90, CI and HI. Treatment plan EI was lower than preplan, and the difference was statistically significant (P = 0.022). Median follow up time was 10 months (3–28 months). No severe complications of procedures occurred. Grade 3 or 4 late toxicities (fistula ) were observed in 3 patients (9%). The local response rate (CR + PR) was 84.4% (27/32) one month later completion of treatment. In addition, the median TTP was 15.4 months (95% CI 11.3- 19.6ms), 1 year and 2 year local control rate were 51.7% and 51.7%. 3D-PIT based with CT-simulator for HDR-IB for central r-GYN has good dosimetry parameters consistently, was clinically feasible and efficient, and complications did not increased significantly.

Patterns of organic carbon enrichment in a lacustrine system across the K-T boundary: Insight from a multi-proxy analysis of the Yacoraite Formation, Salta rift basin, Argentina

In this study, an integrated approach was applied using available sedimentary, geochronology, geochemical and isotopic datasets to better understand the complex interactions between production, destruction, and dilution processes that characterize the organic-rich sediments dynamic across the K-T boundary in a lacustrine system. This approach was tested here on the Late Cretaceous to Early Cenozoic Yacoraite Formation, a typical lacustrine source rock from the Salta rift Basin (NW Argentina). The Yacoraite Formation corresponds to a mixed carbonate-siliciclastic lacustrine sedimentary system, deposited during the sag phase (post-rift). We demonstrated here that new ashes U-Pb dating tie the K-T boundary during the deposition of the Yacoraite Formation.The Yacoraite Formation recorded major climate changes that can be documented in terms of catchment dynamic, erosion processes, carbonate accumulation trends, lacustrine dynamic and source rock quality. The pattern of organic carbon enrichment in the Yacoraite Formation illustrates how a biological pump came across a major climatic change. The background organic matter correspond to Type I dominated by algal growth (mean HI 600–800 mgHC/gTOC, TOC0 1–2 wt%). The K-T boundary was the climax of a climate change initiated ca. 0.3 Myr before and induced a major change in the catchment weathering processes, which temporally corresponds to the accumulation of poor quality source rock intervals (TOC0 ≤ 0.2 wt% and HI < 50 mgHC/gTOC) in these series. The K-T boundary is highlighted by the main negative anomaly in δ13C of the carbonate deposits of the Yacoraite Formation. It was followed by a major pulse in paleoproductivity, itself followed by a major pulse in TOC0 (10–15 wt%) under anoxia conditions. In ca. 0.2 Myr the lacustrine dynamic and its related organic‑carbon enrichment resumed to their initial setting, just prior to the preluding K-T boundary climate change. Results suggest that the Yacoraite Formation can be considered as a world-class example to illustrate how the K-T boundary is recorded in lacustrine sediments.

Low-intensity pulsed ultrasound enhances callus consolidation in distraction osteogenesis of the tibia by the technique of lengthening over the nail procedure

BackgroundLow-intensity pulsed ultrasound (LIPUS) has been widely accepted in promoting the fracture healing process. However, there have been limited clinical trials focused on the efficacy of LIPUS during distraction osteogenesis (DO) by the technique of lengthening over the nail procedure. The purpose of the current study was to evaluate the efficacy of LIPUS during DO.MethodsWe retrospectively evaluated 30 patients (60 segments) who underwent simultaneous bilateral tibial lengthening over the nail. The patients were grouped into the LIPUS group and the control group based on LIPUS stimulation. The two patient groups were compared for demographic data (sex, age at operation, preoperative height, BMI, and smoking history), qualitative assessments of the callus (callus shape and type), external fixation index, and four cortical healing indexes.ResultsFifteen patients (30 segments) were classified as the LIPUS group, and another 15 patients (30 segments) were classified as the control group. No significant differences were found in the assessed demographic data between the groups. LIPUS stimulated a more cylindrical, more homogenous, and denser type of callus formation at the end of the distraction phase. The two groups exhibited equivalent outcomes in terms of external fixation index (p = 0.579). However, significant differences were found in healing indexes of the anterior and medial cortices (p < 0.001 and p = 0.002, respectively). The healing indexes of those cortices in the LIPUS group (mean of 36.6 days/cm and 32.5 days/cm, respectively) reflected their significantly faster healing compared to the control group (mean HI of 57.5 days/cm and 44.2 days/cm, respectively). There were no LIPUS-related complications.ConclusionsLIPUS is a noninvasive and effective adjuvant therapy to enhance callus maturation during DO. It enhances callus consolidation and may have a positive effect on the appropriate callus shape and type.

Extreme spheres: counts-in-cells for 21cm intensity mapping

Intensity mapping surveys will provide access to a coarse view of the cosmic large-scale structure in unprecedented large volumes at high redshifts. Given the large fractions of the sky that can be efficiently scanned using emission from cosmic neutral hydrogen (HI), intensity mapping is ideally suited to probe a wide range of density environments and hence to constrain cosmology and fundamental physics. To efficiently extract information from 21cm intensities beyond average, one needs non-Gaussian statistics that capture large deviations from mean HI density. Counts-in-cells statistics are ideally suited for this purpose, as the statistics of matter densities in spheres can be predicted accurately on scales where their variance is below unity. We use a large state-of-the-art magneto-hydrodynamic simulation from the IllustrisTNG project to determine the relation between neutral hydrogen and matter densities in cells. We demonstrate how our theoretical knowledge about the matter PDF for a given cosmology can be used to extract a parametrisation-independent HI bias function from a measured neutral hydrogen PDF. When combining the predicted matter PDFs with a simple bias fit to the simulation, we obtain a prediction for neutral hydrogen PDFs at a few percent accuracy at scale R=5 Mpc/h from redshift z=5 to z=1. Furthermore, we find a density-dependent HI clustering signal that is consistent with theoretical expectations and could allow for joint constraints of HI bias and the amplitude of matter fluctuations or the growth of structure.

Inoculum effect of methicillin-susceptible Staphylococcus aureus against broad-spectrum beta-lactam antibiotics.

Scarce information concerning the inoculum effect (InE) of methicillin-susceptible Staphylococcus aureus (MSSA) against broad-spectrum β-lactam antibiotics is available. We investigated the InE of MSSA against ceftriaxone, cefepime, meropenem, ampicillin/sulbactam and piperacillin/tazobactam. The bacteraemic MSSA isolates were collected at ten Korean general hospitals from Sep 2013 to Mar 2015. The InE was defined if MICs of antibiotics at high inoculum (HI, ~5 × 107CFU/ml) increased beyond the susceptible range compared to those at standard inoculum (SI, ~5 × 105CFU/ml). All isolates were sequenced for blaZ gene typing. Among 302 MSSA isolates, 254 (84.1%) were positive for blaZ; types A, B, C and D were 13.6%, 26.8%, 43.4% and 0.3%, respectively. Mean HI MICs of all tested antibiotics were significantly increased and increases in HI MIC of piperacillin/tazobactam (HI, 48.14 ± 4.08 vs. SI, 2.04 ± 0.08mg/L, p < 0.001) and ampicillin/sulbactam (HI, 24.15 ± 1.27 vs. SI, 2.79 ± 0.11mg/L, p < 0.001) were most prominent. No MSSA isolates exhibited meropenem InE, and few isolates exhibited cefepime (0.3%) and ceftriaxone (2.3%) InE, whereas 43.0% and 65.9% of MSSA isolates exhibited piperacillin/tazobactam and ampicillin/sulbactam InE, respectively. About 93% of type C blaZ versus 45% of non-type C exhibited ampicillin/sulbactam InE (p < 0.001) and 88% of type C blaZ versus 9% of non-type C exhibited piperacillin/tazobactam InE (p < 0.001). A large proportion of MSSA clinical isolates, especially those positive for type C blaZ, showed marked ampicillin/sulbactam InE and piperacillin/tazobactam.

Dosimetric comparison of Volumetric Modulated Arc Therapy and Three-Dimensional Conformal Radiotherapy during Post Mastectomy left chest wall Irradiation

Aims: To dosimetrically evaluate the Volumetric Modulated Arc Therapy (VMAT) technique and compare it with Three-Dimensional Conformal Radiotherapy (3D-CRT) for postmastectomy breast cancer therapy. Methods and Material: Ten consecutively treated left sided breast cancer patients were selected for this study. VMAT plans were generated from each of the patients planning CT and compared with 3D-CRT plans. Statistical analysis used: Two tailed paired t test Results: The VMAT technique provided statistically significant homogenous and conformal dose distribution with mean HI of (0.1±0.02) and mean CI of (1.1±0.06) when compared mean HI of (0.3±0.02) and mean CI of (1.7±0.2) in the 3D-CRT technique. VMAT plans showed reduced V30 of the heart (10±4.54) when compared to 3D-CRT plans (15.1±8.53). Except V30, VMAT plans resulted in higher doses to heart. The mean doses received by left lung was (17.50±6.27) and was significantly higher than that of 3D-CRT plans (10.20±3.72). VMAT plans also gave higher doses to the contralateral lung and the opposite breast. Conclusions: VMAT plans in post mastectomy breast cancers provide more homogenous and conformal plans as compared to 3DCRT plans but higher doses to normal tissues.

Efficient Interplay Effect Mitigation for Proton Pencil Beam Scanning by Spot-Adapted Layered Repainting Evenly Spread out Over the Full Breathing Cycle

To develop and implement a practical repainting method for efficient interplay effect mitigation in proton pencil beam scanning (PBS). A new flexible repainting scheme with spot-adapted numbers of repainting evenly spread out over the whole breathing cycle (assumed to be 4 seconds) was developed. Twelve fields from 5 thoracic and upper abdominal PBS plans were delivered 3 times using the new repainting scheme to an ion chamber array on a motion stage. One time was static and 2 used 4-second, 3-cm peak-to-peak sinusoidal motion with delivery started at maximum inhalation and maximum exhalation. For comparison, all dose measurements were repeated with no repainting and with 8 repaintings. For each motion experiment, the 3%/3-mm gamma pass rate was calculated using the motion-convolved static dose as the reference. Simulations were first validated with the experiments and then used to extend the study to 0- to 5-cm motion magnitude, 2- to 6-second motion periods, patient-measured liver tumor motion, and 1- to 6-fraction treatments. The effect of the proposed method was evaluated for the 5 clinical cases using 4-dimensional (4D) dose reconstruction in the planning 4D computed tomography scan. The target homogeneity index, HI = (D2 - D98)/Dmean, of a single-fraction delivery is reported, where D2 and D98 is the dose delivered to 2% and 98% of the target, respectively, and Dmean is the mean dose. The gamma pass rates were 59.6% ± 9.7% with no repainting, 76.5% ± 10.8% with 8 repaintings, and 92.4% ± 3.8% with the new repainting scheme. Simulations reproduced the experimental gamma pass rates with a 1.3% root-mean-square error and demonstrated largely improved gamma pass rates with the new repainting scheme for all investigated motion scenarios. One- and two-fraction deliveries with the new repainting scheme had gamma pass rates similar to those of 3-4 and 6-fraction deliveries with 8 repaintings. The mean HI for the 5 clinical cases was 14.2% with no repainting, 13.7% with 8 repaintings, 12.0% with the new repainting scheme, and 11.6% for the 4D dose without interplay effects. A novel repainting strategy for efficient interplay effect mitigation was proposed, implemented, and shown to outperform conventional repainting in experiments, simulations, and dose reconstructions. This strategy could allow for safe and more optimal clinical delivery of thoracic and abdominal proton PBS and better facilitate hypofractionated and stereotactic treatments.

Effects of a multidisciplinary weight loss intervention in overweight and obese children and adolescents: 11 years of experience.

AimsTo evaluate the effects of an outpatient multidisciplinary weight loss intervention in reducing body mass index (BMI) in children and adolescents suffering overweight and obesity, changes in A Body Shape Index (ABSI, waist circumference normalized to height and weight) and Hip Index (HI, normalized hip circumference) during treatment and correlation between the ABSI and HI with change in BMI z score.MethodsWe analyze anthropometric data from pediatric patients affected by overweight and obesity aged 2 to 18 years old who entered our multidisciplinary weight loss intervention, which included medical, psychological and nutritional sessions, from January 1st 2006 to December 31st 2016. Lifestyle modification counselling was delivered. Follow-up visits were planned every month for 3 months and subsequently every 2–4 months. BMI, ABSI, and HI were converted to z scores using age and sex specific population normals.Results864 patients entered our intervention. 453 patients (208 males), mean age 11.2 ±3.1 years, 392 with obesity (86%, z-BMI 2.90 ±0.80 SD) and 61 patients with overweight (z-BMI 1.73±0.21 SD) attended at least 1 follow-up visit. The mean number of visits was 3.5 (± 1.8 SD) in overweight subjects and 3.9 (±2.2 SD) in ones with obesity. At the last attended follow-up visit (at 16 ± 12 months SD) we observed a reduction in mean z-BMI in patients with obesity (to 2.52 ±0.71 SD) and patients with overweight (to 1.46 ±0.5 SD). Most patients (80.8%) reduced their BMI z scores. Mean ABSI and HI z scores showed no significant change. 78/392 patients (19.8%) recovered from obese to overweight, 5/392 (1.2%) from obese to normal weight. The recovery rate from overweight to normal weight was 13.1%. In a multivariate model, initial BMI z score and number of follow-up visits were significant predictors of weight change, while age, sex, ABSI, and HI were not significant predictors.ConclusionsPatients affected by overweight and obesity involved in a multidisciplinary weight loss intervention reduced their mean BMI z score, while ABSI and HI were stable. Weight loss was not predicted by initial ABSI or HI. More visits predict more weight loss, but dropout rates are high. The great majority of patients leave the weight management program before having normalized their BMI.