IMRT, VMAT and Proton Therapy for Prostate Cancer Treatment

Dear Editor,Recently, I read an article entitled "Literature Review on IMRT and VMAT for Prostate Cancer" published by American Journal of Cancer Review in its Volume 2, Issue 1[1]. Authors have done excellent work in reviewing two radiation treatment techniques for prostate cancer, and the article also highlights various factors which can have direct or indirect impact on the dosimetric results. Prostate cancer is the most frequently diagnosed cancer among men in the world. Different types of treatment options are currently available to manage the prostate cancer, and radiation therapy is one of them. Due to advancement in computing power and technology, it is now possible to generate very conformal dose plans for the prostate cancer. Although VMAT provides slight advantage over the IMRT,  the superiority of the VMAT over the IMRT is still a debating topic due to lack of clinical evidence [1].In the review article [1], authors have focused solely on the IMRT and VMAT, which use photon radiation beams to deliver the radiation dose. However, there are other radiotherapy techniques, which can produce comparable results to that of IMRT and VMAT. The primary purpose of this letter is to provide brief update on the most advanced radiotherapy technique in the form of proton therapy for the prostate cancer. Proton therapy can produce excellent dose distribution because protons have finite range and sharp distal fall-off at the end of proton beam path [2]. Several studies [3-10] have shown that proton therapy is capable of producing excellent dosimetric results in terms of rectal and bladder sparing. For example, Vargas et al. [3] demonstrated that proton therapy is better at sparing rectum and bladder when compared to photon therapy. Trofimov et al. [4] showed that the angled lateral proton fields can further reduce the rectal dose. Rana et al. [5] showed that the combination of lateral and oblique fields in proton therapy provides dosimetric advantage over the VMAT for prostate cancer involving a metallic hip prosthesis. Chera et al.[6] showed that proton therapy reduced the dose to the bladder, rectum, small bowel, and pelvis when compared to the IMRT. In another study by Rana et al. [7], it was shown that the proton therapy produced lower values for the rectum and bladder doses for the similar target volume coverage when compared to the VMAT. Hence, literature review indicates that the advanced proton therapy technique has the potential of lowering rectal and bladder toxicities in prostate cancer patients when compared to the photon therapy such as IMRT and VMAT

Effect of Mycorrhiza on Vegetative Growth of Mandarin’s (Citrus reticulata Blanco) Seedlings

Citrus is among the top fruits which are cultivated around the world, and among citrus, Mandarin (Citrus reticulata Blanco) comes first and belongs to the family Rutaceae. A field experiment was conducted in Gorkha, Nepal, from April 2021 to July 2022, to study the effect of different doses of Mycorrhiza in the vegetative growth seedlings. The experiment was set up in a Randomized Complete Block Design (RCBD) with five treatments and four replications. The treatments were named T1: Control, T2: 3g/seedling, T3: 6g/seedling, T4: 9g/seedling, and T5: 11g/seedling, respectively. Eighteen months old seedlings of local Mandarin were uprooted and transplanted in finely pulverized and prepared seedbeds, and Mycorrhiza was added subsequently. Data was collected for plant height, number of leaves, and stem diameter. Data analysis was done through Microsoft- Excel, RStudio, and Analysis of Variance (ANOVA). Results of the study showed that plants treated with 9g of Mycorrhiza produced the highest number of measured parameters compared to plants treated with other doses. Control treatment (0g) produces the least number of plant leaves, Height, and stem diameter, and it can be concluded that a mycorrhizal dose of 9g is the best for the vegetative growth of Mandarin

A luminal non-coding RNA-based genomic classifier confirms favourable outcomes in patients with clinically organ-confined bladder cancer treated with radical cystectomy

Objective:To further evaluate a genomic classifier (GC) in a cohort of patients undergoing radical cystectomy (RC), as long non-coding RNA (lncRNA)-based genomic profiling has suggested utility in identifying a distinct tumour subgroup corresponding to a favourable prognosis in patients with bladder cancer.Patients and Methods:Transcriptome-wide expression profiling using Decipher Bladder was performed on transurethral resection of bladder tumour samples from a cohort of patients with high-grade, clinically organ-confined (cTa-T2N0M0) urothelial carcinoma (UC) who subsequently underwent RC without any neoadjuvant therapy (n = 226). The lncRNA-based luminal favourable status was determined using a previously developed GC. The primary endpoint was overall survival (OS) after RC. Secondary endpoints included cancer-specific mortality and upstaging at RC.Results:In the study, 134 patients were clinical non-muscle-invasive bladder cancer (cTa/Tis/T1) and 92 patients were cT2. We identified 60 patients with luminal favourable subtype, all of which showed robust gene expression patterns associated with less aggressive bladder cancer biology. On multivariate analysis, patients with the luminal favourable subtype (vs without) were significantly associated with lower odds of upstaging to pathological (p)T3+ disease (odds ratio [OR] 0.32, 95% confidence interval [CI] 0.12-0.82; P = 0.02), any upstaging (OR 0.41, 95% CI 0.20-0.83; P = 0.01), and any upstaging and/or pN+ (OR 0.50, 95% CI 0.25-1.00; P = 0.05). Luminal favourable bladder cancer was significantly associated with better OS (hazard ratio 0.33, 95% CI 0.15-0.74; P = 0.007).Conclusions:This study validates the performance of the GC for identifying UCs with a luminal favourable subtype, harbouring less aggressive tumour biology

Inferring the coronal flaring patterns in AGN from reverberation maps

The relativistically broadened iron K-alpha line at 6.4 keV observed in the Seyfert 1 galaxy MCG-6-30-15 has provided a probe of the strong-gravity environment near a black hole, in particular suggesting that it is rapidly spinning. An important variable in such analyses is the geometry of the illuminating source. We present a new technique which constrains this geometry based on the spectral line shape, based on a model of discrete, point-like flaring regions in the X-ray corona. We apply it to simulated reverberation maps and give examples of successful reconstructions of complex coronal flaring patterns. For time-averaged spectral lines the problem is highly degenerate, and so its inversion more challenging. We quantify this degeneracy and give a measure of the spatial accuracy of the method in this case, before checking that it is consistent with the existing picture of MCG-6-30-15 by applying it to recent data from XMM-Newton.Comment: Submitted to MNRAS. A version with higher-resolution figures is available for download at http://www.mrao.cam.ac.uk/~rg200 as are colour versions of some figure

Identification of Clinical Immunological Determinants in Asymptomatic VL and Post Kala-azar Dermal Leishmaniasis Patients

Background: Visceral Leishmaniasis (VL) caused by protozoa belonging to the genus Leishmania, usually have anthroponotic mode of transmission and is issue of great public health importance in Indian subcontinent. Asymptomatic cases of VL and PKDL are subject of keen interest to find their role in the transmission of VL in epidemic areas. We evaluated the immunological cytokine determinants expressed in most clinical suspects of asymptomatic VL and PKDL (IL-10, IFN-γ, and TNF-α). Methods: Eighty-four participants were included at RMRIMS, Patna, India in 2016-17 out of which 64 asymptomatic individual positive for rK-39, without sign and symptoms of VL; 15 PKDL patient’s with past history of VL and 5 endemic healthy subjects were recruited from VL endemic areas. DAT and quantitative assessment of plasma cytokines was determined from the blood samples collected in a plain and sodium-EDTA vacutainer respectively from the subjects. Results: The mean level of IL-10 in DATposLOW of asymptomatic VL and PKDL was significantly higher than endemic healthy (P<0.05). The cytokine polarization index (IFN-γ versus IL-10) was significantly low in PKDL cases compared with asymptomatic VL cases in DATposLOW titre (P<0.05). This index was low again but statistically not significant in PKDL than in asymptomatic VL when TNF-α was considered against IL-10. The ratio of IFN-γ: IL-10 and TNF-α: IL-10 was observed decreased both in asymptomatic VL and PKDL cases than in healthy from endemic areas. Conclusion: Collectively we surmise from our data that asymptomatic VL can also play an important role like PKDL in transmission of VL

\u3cem\u3eThe Undefeated\u3c/em\u3e: Conceptualizing Pundonor

Considers the story a tribute to the honor of matador Manuel García López “Maera.

The Problem of Moral Agency: Prospects of the Sociological Approach in the Context of the “Moral Dyad” Theory

In the context of developing a new sociology of morality, the article examines such phenomena as moral agency and moral patiency, understood as an actor’s attributed ability to be seen as a subject or object of morally relevant actions. The authors analyze the concept of the “moral dyad” as the most popular general approach that addresses various aspects of attributing moral agency and patiency through mind ascription. We also examine the four key principles of the moral dyad concept: causing harm as a prerequisite for the moral relevance of the action, the inseparable link between mind ascription and moral agency/patiency, the phenomenon of moral typecasting, and the principle of the moral scheme’s completion being a necessity. Based on the criticisms of these basic principles, we consider the prospects for further research in the field of studying these moral qualities of actors of various types. For this purpose, we identify and discuss three key problems of the concept of the “moral dyad”, which, as we argue, should be addressed from a sociological perspective: explaining the moral status of actors in the case of pro-social actions, as well as the moral status of collective (groups, corporations, states, institutions) and non-human (robots, computer algorithms) actors. In conclusion we suggest that focusing on these problems in the context of actual social interactions can become one of the key research areas within the framework of the new sociology of morality.</jats:p