1
|
Abouzahr F, Cesar JP, Crespo P, Gajda M, Hu Z, Klein K, Kuo AS, Majewski S, Mawlawi O, Morozov A, Ojha A, Poenisch F, Proga M, Sahoo N, Seco J, Takaoka T, Tavernier S, Titt U, Wang X, Zhu XR, Lang K. The first probe of a FLASH proton beam by PET. Phys Med Biol 2023; 68:235004. [PMID: 37918021 DOI: 10.1088/1361-6560/ad0901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 11/02/2023] [Indexed: 11/04/2023]
Abstract
The recently observed FLASH effect related to high doses delivered with high rates has the potential to revolutionize radiation cancer therapy if promising results are confirmed and an underlying mechanism understood. Comprehensive measurements are essential to elucidate the phenomenon. We report the first-ever demonstration of measurements of successive in-spill and post-spill emissions of gammas arising from irradiations by a FLASH proton beam. A small positron emission tomography (PET) system was exposed in an ocular beam of the Proton Therapy Center at MD Anderson Cancer Center to view phantoms irradiated by 3.5 × 1010protons with a kinetic energy of 75.8 MeV delivered in 101.5 ms-long spills yielding a dose rate of 164 Gy s-1. Most in-spill events were due to prompt gammas. Reconstructed post-spill tomographic events, recorded for up to 20 min, yielded quantitative imaging and dosimetric information. These findings open a new and novel modality for imaging and monitoring of FLASH proton therapy exploiting in-spill prompt gamma imaging followed by post-spill PET imaging.
Collapse
Affiliation(s)
- F Abouzahr
- Department of Physics, University of Texas at Austin, Austin, TX 78712, United States of America
| | - J P Cesar
- Department of Physics, University of Texas at Austin, Austin, TX 78712, United States of America
| | - P Crespo
- Laboratório de Instrumentação e Física Experimental de Partículas, 3004-516 Coimbra, Portugal
- Departamento de Física, Universidade de Coimbra, 3004-516 Coimbra, Portugal
| | - M Gajda
- Department of Physics, University of Texas at Austin, Austin, TX 78712, United States of America
| | - Z Hu
- Department of Radiation Physics, MD Anderson Cancer Center, University of Texas, Houston, TX 77030, United States of America
| | - K Klein
- Department of Physics, University of Texas at Austin, Austin, TX 78712, United States of America
| | - A S Kuo
- Department of Physics, University of Texas at Austin, Austin, TX 78712, United States of America
| | - S Majewski
- Department of Physics, University of Texas at Austin, Austin, TX 78712, United States of America
- Biomedical Engineering, University of California Davis, CA 96616, United States of America
| | - O Mawlawi
- Department of Imaging Physics, MD Anderson Cancer Center, University of Texas, Houston, TX, 77054, United States of America
| | - A Morozov
- Laboratório de Instrumentação e Física Experimental de Partículas, 3004-516 Coimbra, Portugal
| | - A Ojha
- Department of Physics, University of Texas at Austin, Austin, TX 78712, United States of America
| | - F Poenisch
- Proton Therapy Center, MD Anderson Cancer Center, University of Texas, Houston, TX 77054, United States of America
| | - M Proga
- Department of Physics, University of Texas at Austin, Austin, TX 78712, United States of America
| | - N Sahoo
- Proton Therapy Center, MD Anderson Cancer Center, University of Texas, Houston, TX 77054, United States of America
| | - J Seco
- Div. of Biomed. Physics in Rad. Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Physics and Astronomy, University of Heidelberg, Heidelberg, Germany
| | - T Takaoka
- Particle Therapy Division, Hitachi America Ltd, Houston, TX 77054, United States of America
| | - S Tavernier
- PETsys Electronics, SA, 2740-257 Taguspark, Portugal
| | - U Titt
- Department of Radiation Physics, MD Anderson Cancer Center, University of Texas, Houston, TX 77030, United States of America
| | - X Wang
- Proton Therapy Center, MD Anderson Cancer Center, University of Texas, Houston, TX 77054, United States of America
| | - X R Zhu
- Proton Therapy Center, MD Anderson Cancer Center, University of Texas, Houston, TX 77054, United States of America
| | - K Lang
- Department of Physics, University of Texas at Austin, Austin, TX 78712, United States of America
| |
Collapse
|
2
|
Datta SS, Fraser L, Burnell M, Nasreen S, Ghosh M, Ojha A, Saha T, Mukhopadhyay A, Lanceley A, Menon U. Association of adult attachment with delays in accessing specialist care in women with ovarian cancer. J Psychosoc Oncol 2022; 40:491-505. [PMID: 35112658 DOI: 10.1080/07347332.2022.2025510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Advanced stage at diagnosis and delayed presentation are common in ovarian cancer (OC). The objective of the current study was to explore the association of adult attachment pattern with delays in accessing specialist oncology care in patients with OC. METHODS A cross-sectional structured interview study of patients with OC presenting to an Indian cancer center was undertaken. Consenting patients completed Experiences of Close Relationships-Relationship Style questionnaire (ECR-RS) and Medical Outcome Survey-Social Support Survey (MOS-SSS). Multivariate linear regression with "time to presentation to cancer specialist" as the dependent variable was undertaken. RESULTS In all, 132 of 155 (85%) patients with OC who were invited were interviewed. An increased ECR-RS attachment anxiety score (P = .01) and being part of a multigenerational extended household (P = .04) were both independently associated with delay in presentation to a cancer specialist. There was no association between delay in presentation and social support. CONCLUSIONS Among patients with OC, adult attachment may contribute to delays in presentation. It may be important for the cancer symptom awareness efforts in primary care to include educating physicians on recognizing and interacting with patients with insecure attachment styles. The association of delays in presentation for women with OC living in multigenerational extended households needs more indepth exploration. Supplemental data for this article is available online at https://doi.org/10.1080/07347332.2022.2025510 .
Collapse
Affiliation(s)
- Soumitra Shankar Datta
- Department of Palliative Care and Psycho-oncology, Tata Medical Centre, Kolkata, India.,MRC Clinical Trials Unit, Institute of Clinical Trials & Methodology, University College London, London, UK
| | - Lindsay Fraser
- MRC Clinical Trials Unit, Institute of Clinical Trials & Methodology, University College London, London, UK
| | - Matthew Burnell
- MRC Clinical Trials Unit, Institute of Clinical Trials & Methodology, University College London, London, UK
| | - Shazia Nasreen
- Department of Palliative Care and Psycho-oncology, Tata Medical Centre, Kolkata, India
| | - Manisha Ghosh
- Department of Palliative Care and Psycho-oncology, Tata Medical Centre, Kolkata, India
| | - Aparupa Ojha
- Department of Palliative Care and Psycho-oncology, Tata Medical Centre, Kolkata, India
| | - Tania Saha
- Department of Palliative Care and Psycho-oncology, Tata Medical Centre, Kolkata, India
| | - Asima Mukhopadhyay
- Department of Gynaecological Oncology, Tata Medical Centre, Kolkata, India
| | - Anne Lanceley
- UCL EGA Institute for Women's Health, University College London, London, UK
| | - Usha Menon
- MRC Clinical Trials Unit, Institute of Clinical Trials & Methodology, University College London, London, UK
| |
Collapse
|
3
|
Abstract
Paediatric psycho-oncology is an evolving speciality and is increasingly being recognised as an essential component in children's cancer care. Modern paediatric oncology services aspire to integrate physical care with psycho-social care and build capacity within clinical teams to address the emotional needs of parents and children side by side with other aspects of medical care. This article discusses the unique challenges of paediatric psycho-oncology and common situations where psychological assessment and management of children and young people with cancer become especially important. The authors propose a tiered structure of training. Providing empathic evidence-based psycho-social care is 'everyone's business' in paediatric oncology and not merely that of mental health professionals. However, there are times when a more specialist intervention by a paediatric liaison psychiatrist and/or a clinical psychologist is needed for optimum outcome. Learning interviewing techniques suitable for children and adolescents should be a core part of the training in paediatric psycho-oncology. Professionals should be encouraged to reflect on their own emotional wellbeing, which in turn will provide a stable foundation of emotionally matured care to children, young people and their families.
Collapse
Affiliation(s)
- Soumitra Shankar Datta
- Department of Palliative Care and Psycho-oncology, Tata Medical Centre, Kolkata 700160, India
- EGA UCL Institute for Women’s Health, University College London, London WC1E 6BT, UK
| | - Tania Saha
- Department of Palliative Care and Psycho-oncology, Tata Medical Centre, Kolkata 700160, India
| | - Aparupa Ojha
- Department of Palliative Care and Psycho-oncology, Tata Medical Centre, Kolkata 700160, India
| | - Anirban Das
- Department of Paediatric Oncology, Tata Medical Centre, Kolkata 700160,, India
| | - Rhea Daruvala
- Department of Paediatric Haematology, Oncology and Bone Marrow Transplant, Mazumdar Shaw Cancer Centre, Narayana Health City, Bangalore 560099, India
| | | | - Rimpa Achari
- Department of Radiation Oncology, Tata Medical Centre, Kolkata 700160, India
| |
Collapse
|
4
|
Ojha A, Gupta YK. Study of commonly used organophosphate pesticides that induced oxidative stress and apoptosis in peripheral blood lymphocytes of rats. Hum Exp Toxicol 2016; 36:1158-1168. [DOI: 10.1177/0960327116680273] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
In a previous study, we have found that organophosphate (OP) pesticides such as chlorpyrifos (CPF), methyl parathion (MPT), and malathion (MLT) significantly induced genotoxicity in peripheral blood lymphocytes of rats. To explore the mechanism of OP-induced genotoxicity, we measured the formation of DNA interstrand cross-links (DICs) and apoptosis in peripheral blood lymphocytes of rats. Peripheral blood lymphocytes of rats were treated with CPF, MPT, and MLT individually and in combination at concentrations of 0.1 and 0.25 LC50 for 2, 4, 8, and 12 h at 37°C. Lipid peroxidation (LPO) was measured as a biomarker of oxidative stress. Apoptosis induced by CPF, MPT, and MLT individually and in combination was determined by measuring the intracellular level of active caspase-3 and caspase-9 by spectrofluorimetry. We found significant dose- and time-dependent increases in LPO, DICs formation and increase of intracellular active caspase-3 and caspase-9 in exposed peripheral blood lymphocytes of rats. These findings suggest that the studied pesticides have potential to induce oxidative stress, cause DNA adduct formation, and cause failure of adduct repair, which leads to apoptosis that is partially mediated by activation of intracellular caspase-3 and caspase-9.
Collapse
Affiliation(s)
- A Ojha
- Department of Pharmacology, All India Institute of Medical Sciences, New Delhi, India
| | - YK Gupta
- Department of Pharmacology, All India Institute of Medical Sciences, New Delhi, India
| |
Collapse
|
5
|
Kc S, Khanal L, Ojha A, Karn D. Diseases in Disaster: Post-Earthquake Dermatoses, Nepal 2015. Kathmandu Univ Med J (KUMJ) 2016; 14:279-281. [PMID: 28814694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Nepal experienced a devastating earthquake measuring 7.8 Richter scale on 25th April 2015. Although the heightened effects were secondary to trauma, the indirect effects were also of prime importance. We came across different dermatoses, directly or indirectly secondary to earthquake. We here present an audit of the cutaneous effects following four months of the major shock presenting to a tertiary care center of central Nepal. A total of 7326 patients presented to the dermatology department over a period of four months following the major shock. Among them a total of 3833 patients (52.32%) had direct or indirect dermatoses following earthquake.
Collapse
Affiliation(s)
- S Kc
- Department of Dermatology, Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Kavre, Nepal
| | - L Khanal
- Department of Dermatology, Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Kavre, Nepal
| | - A Ojha
- Department of Dermatology, Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Kavre, Nepal
| | - D Karn
- Department of Dermatology, Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Kavre, Nepal
| |
Collapse
|
6
|
Abstract
Chlorpyrifos (CPF), methyl parathion (MPT), and malathion (MLT) are among the most extensively used organophosphate (OP) pesticides in India. DNA protein cross-links (DPC) and DNA strand breaks are toxic lesions associated with the mechanism(s) of toxicity of carcinogenic compounds. In the present study, we examined the hypothesis that individual and interactive genotoxic effects of CPF, MPT, and MLT are involved in the formation of DPC and DNA strand break. The DNA strand break was measured by comet assay and expressed as DNA damage index, while DPC estimation was carried out by fluorescence emission assay. The results showed that exposure of rat lymphocytes with CPF, MPT, and MLT caused significantly marked increase in DNA damage and DPC formation in time-dependent manner. MPT caused the highest damage, and these pesticides do not potentiate the toxicity of each other.
Collapse
Affiliation(s)
- A Ojha
- Department of Pharmacology, All India Institute of Medical Sciences, New Delhi, India
| | - Y K Gupta
- Department of Pharmacology, All India Institute of Medical Sciences, New Delhi, India
| |
Collapse
|
7
|
Ojha A, Gupta YK. Evaluation of genotoxic potential of commonly used organophosphate pesticides in peripheral blood lymphocytes of rats. Hum Exp Toxicol 2014; 34:390-400. [DOI: 10.1177/0960327114537534] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Chlorpyrifos (CPF), methyl parathion (MPT), and malathion (MLT) are among the most extensively used organophosphate (OP) pesticides in India. DNA protein cross-links (DPC) and DNA strand breaks are toxic lesions associated with the mechanism(s) of toxicity of carcinogenic compounds. In the present study, we examined the hypothesis that individual and interactive genotoxic effects of CPF, MPT, and MLT are involved in the formation of DPC and DNA strand break. The DNA strand break was measured by comet assay and expressed as DNA damage index, while DPC estimation was carried out by fluorescence emission assay. The results showed that exposure of rat lymphocytes with CPF, MPT, and MLT caused significantly marked increase in DNA damage and DPC formation in time-dependent manner. MPT caused the highest damage, and these pesticides do not potentiate the toxicity of each other.
Collapse
Affiliation(s)
- A Ojha
- Department of Pharmacology, All India Institute of Medical Sciences, New Delhi, India
| | - YK Gupta
- Department of Pharmacology, All India Institute of Medical Sciences, New Delhi, India
| |
Collapse
|
8
|
Manandhar SR, Ojha A, Manandhar DS, Shrestha B, Shrestha D, Saville N, Costello AM, Osrin D. Causes of stillbirths and neonatal deaths in Dhanusha district, Nepal: a verbal autopsy study. Kathmandu Univ Med J (KUMJ) 2011; 8:62-72. [PMID: 21209510 DOI: 10.3126/kumj.v8i1.3224] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Perinatal (stillbirths and first week neonatal deaths) and neonatal (deaths in the first 4 weeks) mortality rates remain high in developing countries like Nepal. As most births and deaths occur in the community, an option to ascertain causes of death is to conduct verbal autopsy. OBJECTIVE The objective of this study was to classify and review the causes of stillbirths and neonatal deaths in Dhanusha district, Nepal. MATERIALS AND METHODS Births and neonatal deaths were identified prospectively in 60 village development committees of Dhanusha district. Families were interviewed at six weeks after delivery, using a structured questionnaire. Cause of death was assigned independently by two pediatricians according to a predefined algorithm; disagreement was resolved in discussion with a consultant neonatologist. RESULTS There were 25,982 deliveries in the 2 years from September 2006 to August 2008. Verbal autopsies were available for 601/813 stillbirths and 671/954 neonatal deaths. The perinatal mortality rate was 60 per 1000 births and the neonatal mortality rate 38 per 1000 live births. 84% of stillbirths were fresh and obstetric complications were the leading cause (67%). The three leading causes of neonatal death were birth asphyxia (37%), severe infection (30%) and prematurity or low birth weight (15%). Most infants were delivered at home (65%), 28% by relatives. Half of women received an injection (presumably an oxytocic) during home delivery to augment labour. Description of symptoms commensurate with birth asphyxia was commoner in the group of infants who died (41%) than in the surviving group (14%). CONCLUSION The current high rates of stillbirth and neonatal death in Dhanusha suggest that the quality of care provided during pregnancy and delivery remains sub-optimal. The high rates of stillbirth and asphyxial mortality imply that, while efforts to improve hygiene need to continue, intrapartum care is a priority. A second area for consideration is the need to reduce the uncontrolled use of oxytocic for augmentation of labour.
Collapse
Affiliation(s)
- S R Manandhar
- Department of Paediatrics, Kathmandu Medical College, Sinamangal, Nepal.
| | | | | | | | | | | | | | | |
Collapse
|
9
|
Pathak M, Deshpande A, Mirashe PK, Sorte RB, Ojha A. Ambient air quality monitoring during the H1N1 influence period in Pune (India). J Environ Sci Eng 2010; 52:291-298. [PMID: 22312797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Ambient air quality in an urban area is directly linked with activity level in the city including transport, business and industrial activities. Maharashtra Pollution Control Board (MPCB) has established an ambient air quality network in the city including state-of-the-art continuous air quality monitoring stations which indicate short duration air quality variations for criteria and non-criteria pollutants. The influence of H1N1 outbreak in Pune hitting its worst pandemic condition, led the civic authorities to implement stringent isolation measures including closure of schools, colleges, business malls, cinema halls, etc. Additionally, the fear of such a pandemic brought the city to a stand still. It was therefore necessary to assess the impacts of such activity level on ambient air quality in the city. It has been observed that such events have positive impacts on air quality of the city. There was a decrease in PM concentration almost to the tune of 30 to 40% if the impacts of precipitation, i.e. seasonal variations, are taken into account. Similarly, the non criteria pollutants too showed a marked but unusual decrease in their concentrations in this ever growing city. The influence of these in turn led to lowered concentrations of secondary pollutants, i.e. O3. Overall, the ambient air quality of Pune was found to be improved during the study period.
Collapse
Affiliation(s)
- M Pathak
- Maharashtra Pollution Control Board, Mumbai-400 022, India
| | | | | | | | | |
Collapse
|
10
|
Ojha A, Das B, Mondal S, Maiti M. A solid transportation problem for an item with fixed charge, vechicle cost and price discounted varying charge using genetic algorithm. Appl Soft Comput 2010. [DOI: 10.1016/j.asoc.2009.06.016] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
11
|
Ojha A, Das B, Mondal S, Maiti M. An entropy based solid transportation problem for general fuzzy costs and time with fuzzy equality. ACTA ACUST UNITED AC 2009. [DOI: 10.1016/j.mcm.2009.04.010] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
12
|
Parsey R, Ojha A, Ogden R, Erlandsson K, Kumar D, Landgrebe M, Heertum R, Mann J. Metabolite considerations in the in vivo quantification of serotonin transporters using [11C] DASB and positron emission tomography in humans. Neuroimage 2006. [DOI: 10.1016/j.neuroimage.2006.04.163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
|
13
|
Abstract
We highlight one medical center's experiences with primary malignancies of the small bowel. During a 27-year period, 79 patients were treated for small bowel tumors. Of these, 15 (20%) were lost to follow-up; thus, 64 patients were reviewed retrospectively with emphasis on histological distribution and their topography, perioperative complications, overall survival, and prognostic factors. In our 64-patient series, 33 (51.6%) presented with adenocarcinoma; 10 (15.5%), lymphoma; 8 (12.1%), leiomyosarcoma; 5 (7.6%), neurogenic tumor; 2 (3%), unclassified carcinoma; 5 (7.6%), other types of sarcoma; and 1 patient presented with synchronous adenocarcinoma and lymphoma. Of all patients, 30 (46.9%) were curatively treated, whereas 34 (53.1%) underwent palliative procedures. Hospital lethality was 9.4% and mainly occurred in patients operated on under emergency circumstances. Reoperation rate was 29.7%. The observation period lasted at least five years or until death; three patients were alive less than five years postoperatively. Cumulative five-year survival rate was 22.5% in the adenocarcinoma group, 33.3% in the lymphoma group, 33.3% in the leiomyosarcoma group, and 22.2% in patients with other tumors. The uncharacteristic symptoms presented by patients suffering from small intestinal malignancies make early diagnosis difficult. Therefore, especially in patients with long-standing bowel diseases, malignancy should be considered. Early diagnosis and surgical treatment lead to a good prognosis as shown by our study.
Collapse
Affiliation(s)
- A Ojha
- University Clinic of Surgery, University of Vienna, Austria
| | | | | | | | | |
Collapse
|
14
|
Affiliation(s)
- A Ojha
- B.V. Patel Pharmaceutical Education and Research Development Centre, Thaltej, Gujarat, India
| | | |
Collapse
|
15
|
Bist H, Sarin V, Ojha A, Jain Y. The planar vibrations of chlorobenzene in the ground state from an analysis of 2699 Å electronic band system. ACTA ACUST UNITED AC 1970. [DOI: 10.1016/0584-8539(70)80281-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|