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The myQA SRS (IBA) is a new to market 2D complementary metal oxide semiconductor detector array with an active area 140 × 120 mm2 and 0.4 mm resolution, making it a potential real-time dosimetry alternative to radiochromic film for stereotactic plan verification. Characterisation of the device was completed to assess performance. The dosimetric properties of the device were assessed for 6FF and 6FFF beams from a Varian TrueBeam STx with high definition multileaf collimator. Clinical suitability of the device for Patient Specific Quality Assurance was verified using ten SRS/SBRT plans, compared against other detectors, as well as multi leaf collimator (MLC) tests including picket fence and chair. Gamma analysis was performed using myQA software with criteria of 4%/1 mm. The device demonstrated compliance with recommended specifications for basic tests. After the required warm-up period, the maximum deviation in detector signal from initial readings was 0.2%. Short-term and long-term reproducibility was 0.1% (6FF) and 1.0% (6FFF), respectively. Dose linearity was within 0.3% (6FF) and 0.7% (6FFF) and dose-rate dependence within 1.7% (6FF) and 2.9% (6FFF) and were verified with a Farmer type ionization chamber (PTW 30013). Angular dependence was quantified for coplanar and non-coplanar situations. Output factors and beam profiles measured on the device showed agreement within 1% of baseline RAZOR diode (IBA) and CC04 ionisation chamber (IBA) measurements for field sizes 1 × 1 to 10 × 10 cm2. The minimum gamma (4%/1 mm) pass rates for MLC-pattern tests were 96.5% and 98.1% for the myQA SRS and film, respectively. The average gamma (4%/1 mm) pass rates for SBRT and SRS plans were 98.8% and 99.8% respectively. This work represents one of the first studies performed on the commissioning and performance characterisation of this novel device, demonstrating its accuracy and reliability, making it highly useful as a film alternative in stereotactic treatment plan verification. [ABSTRACT FROM AUTHOR]

Antimicrobial drug resistance has made the treatment of microbial infections quite challenging. A Gram-positive, anaerobic, spore-forming, and toxin-producing bacillus, Clostridioides difficile infection causes diarrhea-related deaths globally. The available drugs like vancomycin and metronidazole are becoming less effective against this infection. We have designed this study to identify genes responsible for antimicrobial resistance and have a better understanding of the mutations and their impact on the antimicrobial resistance activity. The Whole Genome Sequencing data of 11 C. difficile clinical isolates was analyzed to determine novel genes playing a significant role in antimicrobial resistance mechanisms. Comparative structure analysis of wild and mutant structures of proteins and their functions provided insight into the impact of the identified mutations on antimicrobial resistance. We identified 8 genes common in all the isolates that play a vital role in drug resistance through antibiotic efflux, ribosomal protection, and antibiotic inactivation. Variations in the functional domains of tetA(P), tetM, and ermB genes were found to be the most promising novel drug targets. Our findings suggest that these novel gene mutations would be beneficial in designing new drugs to combat C. difficile infection. [ABSTRACT FROM AUTHOR]

Background: Nutritional status assessment in children with nephrotic syndrome (NS) is critical for identifying patients who are at risk of protein-energy wasting (PEW) and for determining their nutritional needs and monitoring nutritional intervention outcomes. Methods: In a case–control study, we enrolled 40 children (age range: 2–16 years) with NS and 40 apparently healthy children (age and sex-matched) as a control group. Anthropometric data, as well as demographic, clinical, and laboratory data, were collected. A dietary intake assessment using a 3-day food intake record was done, and the quadriceps rectus femoris thickness (QRFT) and quadriceps vastus intermedius thickness (QVIT) were assessed using B-mode ultrasound and compared between both groups. Results: Children with NS had lower QRFT and QVIT measurements than control groups (p < 0.001). Inadequacy in protein intake occurred in 62.5% and 27.5% of the NS and control groups, respectively (p = 0.002). The thickness of the rectus and vastus muscles by ultrasound was significantly associated with the percentage of protein intake (p < 0.001). The ROC curve revealed that the best cutoff value of QRFT for the prediction of the patient at risk of malnutrition was ≤ 1.195 with an area under curve of 0.907, with p < 0.001. Conclusion: In children with NS, skeletal muscle ultrasound is a simple and easy-to-use bedside technique for the identification of patients at risk of malnutrition. [ABSTRACT FROM AUTHOR]

Verifying the accuracy of the dose calculation algorithm is considered one of the most critical steps in radiotherapy treatment for delivering an accurate dose to the patient. This work aimed to evaluate the dosimetric performance of the treatment planning system (TPS) algorithms; the AAA (v. 15.6), AXB (v. 15.6) and eMC (v. 15.6) following the AAPM medical physics practice guideline 5.a (MPPG 5.a) validation tests package in a Varian iX Linear Accelerator (Linac). A series of tests were developed based on the MPPG 5.a. on a Varian's Eclipse TPS (v. 15.6) (Varian Medical Systems). First, the basic photon and electron tests were validated by comparing the TPS calculated dose with the measurements. Next, for heterogeneity tests, we verified the Computed Tomography number to electron density (CT-to-ED) curve by comparing it with the baseline values, and TPS calculated point doses beyond heterogeneous media were compared to the measurements. Finally, for IMRT/VMAT dose validation tests, clinical reference plans were re-calculated on ArcCheck's virtual phantom (Sun Nuclear Corporation, Melbourne, FL, USA) and exported to the Linac for delivery using the ArcCheck dosimetry system. All validation tests were evaluated following the MPPG 5.a recommended tolerances. In basic dose validation tests, the TPS calculated depth dose profiles agreed well with the measurements, with a minimum gamma passing rate of 95% at 2%/2 mm criteria. However, disagreements are seen in the build-up and penumbra region. Results for most point doses in homogeneous water phantoms were within the MPPG 5.a tolerance. For the heterogeneity tests, the CT-to-ED curve was established, and calculated point doses were all within 3% of the measurements for heterogeneous media for both photon algorithms at three energies. These results are within the MPPG5.a the recommended tolerance of 3%. Moreover, for electron beams, the differences between the calculated and measured point doses averaged 5% and 7%, but were just within the MPPG 5.a tolerance of 7%. For IMRT and VMAT validation tests using a gamma criteria of a 2%/2 mm, IMRT plans showed maximum and minimum passing rates of 98.2% and 97.4%, respectively. Whereas VMAT plans showed maximum and minimum passing rates of 100% and 94.3%, respectively. We conclude that the dosimetric accuracy of the Eclipse TPS (v15.6) algorithm is adequate for clinical use. The MPPG 5.a tests are valuable for evaluating dose calculation accuracy and are very useful for TPS upgrade checks, commissioning tests, and routine TPS QA. [ABSTRACT FROM AUTHOR]

To obtain dose distributions more physically representative to the patient anatomy in brachytherapy, calculation algorithms that can account for heterogeneity are required. The current standard AAPM Task Group No 43 (TG-43) dose calculation formalism has some clinically relevant dosimetric limitations. Lack of tissue heterogeneity and scattered dose corrections are the major weaknesses of the TG-43 formalism and could lead to systematic dose errors in target volumes and organs at risk. Over the last decade, model-based dose calculation algorithms (MBDCAs) have been clinically offered as complementary algorithms beyond the TG43 formalism for high dose rate (HDR) brachytherapy treatment planning. These algorithms provide enhanced dose calculation accuracy by using the information in the patient's computed tomography images, which allows modeling the patient's geometry, material compositions, and the treatment applicator. Several researchers have investigated the implementation of MBDCAs in HDR brachytherapy for dose optimization, but moving toward using them as primary algorithms for dose calculations is still lagging. Therefore, an overview of up-to-date research is needed to familiarize clinicians with the current status of the MBDCAs for different cancers in HDR brachytherapy. In this paper, we review the MBDCAs for HDR brachytherapy from a dosimetric perspective. Treatment sites covered include breast, gynecological, lung, head and neck, esophagus, liver, prostate, and skin cancers. Moreover, we discuss the current status of implementation of MBDCAs and the challenges. [ABSTRACT FROM AUTHOR]

A systematic study of the effect of substitution on the thermodynamic stability of the 1∶1 complexes which the UO ion forms in aqueous media with salicylic acid and ten monosubstituted salicylic acids has been carried out using a new spectrophotometric method. The new features of the method as well as a thermodynamic treatment for the effect of substitution is discussed. [ABSTRACT FROM AUTHOR]

New synthetic routes to 1-triacontanol and 1-bromotriacontane, and the novel ligands 4,4′-diuntriacontanyl-2,2′-bipy-ridine, 4-untriacontanyl-4'-methyl-2,2'-bipyridine and 4,4′-ditricosyl-2,2′-bipyridine are reported, as well as the preparation of the novel ruthenium(II) salts, [Ru(bipy)(bipy-4-R-4′-R′)]Cl (bipy = 2,2'-bipyridine; R = R' = CH or CH; R = CH, R' = Me). [ABSTRACT FROM AUTHOR]