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Enewetak Atoll underwent 43 historical nuclear tests from 1948 to 1958, including the first hydrogen bomb test, resulting in a substantial nuclear material fallout contaminating the Atoll and the lagoon waters. The radionuclide fallout material deposited in lagoon sediments and soil on the islands will remain for decades to come. With intensifying climate and extreme weather events, the possibility of redistribution of deposited radionuclide material has become a great concern. This study uses a numerical modeling approach to estimate the potential elevated radionuclide concentrations that can be distributed during storm events under current and future climates. We simulated three historical storm scenarios that are most likely to impact Atoll’s environment and remobilize the radionuclide-bound sediments. WRF-ARW was used to reconstruct these storm scenarios under current year (2015) and future year (2090) climates. Storm-induced ocean hydrodynamics conditions were generated using FVCOM. FVCOM-ICM was externally coupled to simulate the fate and transport of radionuclides. Given that the 239Pu is the largest fraction of the radionuclide inventory of the lagoon and Atoll islands, the model results show the highest average incremental 239Pu concentration that an island may be exposed to is 3.25E-4 Bq/m3 (becquerel per cubic meters), which is an increase of 84 times the average baseline/existing 239Pu concentration without the storm conditions. The overall increase in 239Pu average over all the islands of Atoll is about 20 folds relative to the baseline concentration. Despite the high relative increase ratios, a comprehensive exposure assessment is required to investigate the exposure risk. Further, due to the limitations of the study and uncertainties/biases in the historical data used, further research supported by field surveys to better characterize the current contamination level may be needed to make more accurate predictions. [ABSTRACT FROM AUTHOR]

Purpose: Cervical cancer is a significant global health burden, with advancements in treatment modalities improving outcomes. However, vaginal toxicities following definitive chemoradiation remain a concern, impacting patients' quality of life. The aim of this systematic review and meta-analysis was to estimate the incidence of vaginal toxicities, explore associated factors, and assess the relationship with radiation dose in intact cervical cancer patients undergoing radical chemoradiation. Material and methods: A systematic search of PubMed, Google Scholar, and Cochrane databases was conducted. Studies reporting on vaginal toxicities post-radical chemoradiation in intact cervical cancer patients were included. Data extraction and analysis were performed according to PRISMA guidelines. Results: Twenty-four studies with various designs were included. The meta-analysis revealed a pooled estimate of 39% (95% CI: 21-56%) for overall vaginal toxicities among cervical cancer patients following definitive chemoradiation. Vaginal stenosis was the most commonly reported toxicity, with a median incidence of 61.5% (range, 20-77.8%) across the studies. Severe toxicities (grade = 3) were reported at rates of 12.74% (CTCAE v. 4.0), 0.98% (CTCAE v. 3.0), 10.41% (RTOG/EORTC), and 0% (LENT-SOMA). Factors, such as age, initial vaginal involvement, and radiation dose were associated with increased toxicity risk. Significant heterogeneity was observed in study populations and methodologies. Conclusions: Vaginal toxicities are common following definitive chemoradiation in intact cervical cancer patients, with vaginal stenosis being predominant. Standardization of toxicity scoring methods and radiotherapy dose reporting parameters is crucial for accurate comparison and interpretation of findings. Future research should focus on optimizing treatment strategies to minimize vaginal toxicities while maximizing efficacy and patient outcomes. [ABSTRACT FROM AUTHOR]