Pivotal role of families in doctor–patient communication in oncology: a qualitative study of patients, their relatives and cancer clinicians

Families are a unique source of support for many cancer patients. Most advanced communication skills training for oncologists are patient centred and do not cover interactions with family members. The current study used in-depth qualitative interviews of patients, relatives and cancer clinicians with thematic analysis to explore the role of family members in the communication process. Forty-one participants included 10 cancer patients, 10 relatives ensuring proportionate representation of both gender and primary cancer site and 21 doctors representing both medical and surgical oncology. Nineteen of 20 patients and relatives wanted an "open and honest" discussion with their doctors. All patients, relatives and doctors preferred involvement of the family at most stages of cancer treatment. Five themes were identified in relation to communication with family members. The participants highlighted the "importance of family for physical and psychological care," they emphasised the need to "balance patient autonomy and relatives desire to be protective" using varied "negotiating strategies" that are influenced by "socioeconomic circumstances of both patient and family." The doctor-patient-relative communication process was not static with preferences changing over time. The data suggests that communication skills training of cancer clinicians should incorporate modules on better communication with relatives

Predictive approach for simultaneous biosorption of hexavalent chromium and pentachlorophenol degradation by Bacillus cereus RMLAU1

Chromium and pentachlorophenol are the major environmental pollutants emanating from tannery effluent. Indigenous Bacillus cereus isolate was employed for biosorption and PCP degradation studies under varied environmental conditions such as pH, temperature, contact time, presence of other heavy metals, initial biosorbent and Cr6+ concentrations. Best results for Cr6+ biosorption (% removal) by living and dead biomass at 2.0 g l-1 were found to be 35.2 mg Cr g-1 dry wt (63%) at pH 5.0, and 42.5 mg Cr g-1 dry wt (70.5%) at pH 4.0, respectively at 35ºC (150 rpm) during 120 min at an initial concentration of 200 mg Cr6+ l-1 and 500 mg PCP l-1. Among various factors, pH had profound effect on Cr6+ biosorption and PCP degradation. Maximum 7.5 % (w/v) PCP degradation ensued in 2 h only by live cells in the presence of 0.4 % (w/v) cometabolite glucose. Presumably, this is the first report on simultaneous biosorption of chromium and pentachlorophenol remediation by native Bacillus cereus isolate from tannery effluent. Statistical regressional analysis suitably validated the experimental findings. This strain would be helpful in eco-friendly simultaneous bioremediation allied with a predictive computational approach.Key words: Bacillus cereus, Biosorption, Chromium, Heavy metals, Pentachlorophenol

Dose calculations in high-dose rate brachytherapy planning for cancer treatment

This article provides the overview of current literature regarding the application of high-dose rate planning and optimization techniques. A summary of commonly used optimization technique known as heuristics method (stochastic and deterministic) is also provided

Antibiotic Sensitivity Pattern of Bacterial Isolates from the Intensive Care Unit of a Tertiary Care Hospital in India

Purpose: To undertake an audit of the antimicrobial (AM) sensitivity pattern of bacterial isolates in the intensive care units (ICU) of a tertiary hospital of Bhavnagar, India.Methods: Retrospective analysis of the indoor case papers of ICUs from January 2010 to 31st March 2011 was carried out at Department of Pharmacology, Govt. Medical College and Sir Takhtsinhji General Hospital, Bhavnagar, India. Information collected include demographic data of the patient, admission unit, duration of hospital stay, diagnosis, type of infection, empirical treatment, indication of the use of the antimicrobials (AMs). Others include collected specimen, causative agent, sensitivitypattern, and treatment changes based on the sensitivity pattern in a case record form. AM sensitivity testing was performed by the modified Kirby Baur method as recommended by clinical and laboratory standard institute (CLSI). Internal and external quality control were maintained for culture and sensitivity method.Results: The most commonly isolated organisms were Klebsiella pneumoniae (28.6 %) and Pseudomonas aeruginosa (16.3 %). Lower respiratory tract infection (LRTI) was the most common infection. Imipenem, meropenem and levofloxacin were the most effective antimicrobials for Gramnegative isolates (GNIs) while vancomycin ciprofloxacin, and gentamicin were the most efficacious antimicrobials for Gram-positive isolates (GPIs). Widespread resistance to third generationcephalosporins and cloxacillin was noted for GNIs and GPIs, respectively. Meropenem (100 %) > levofloxacin (100 %) > sparfloxacin (94.4 %) > gentamicin (83.3 %) was the rank order of antimicrobial activity against LRTI.Conclusion: GNIs were the predominant cause of infection in ICUs. Third generation cephalosporinsresistant GNIs were the predominant resistant organisms. The study showed that fluoroquinolones and aminoglycosides could be used as first line AMs for the effective management of LRTI in a hospital setting.Keywords: Antibiotic sensitivity, Bacterial resistance, Intensive care unit, Tertiary hospita

Performance of the CMS Cathode Strip Chambers with Cosmic Rays

The Cathode Strip Chambers (CSCs) constitute the primary muon tracking device in the CMS endcaps. Their performance has been evaluated using data taken during a cosmic ray run in fall 2008. Measured noise levels are low, with the number of noisy channels well below 1%. Coordinate resolution was measured for all types of chambers, and fall in the range 47 microns to 243 microns. The efficiencies for local charged track triggers, for hit and for segments reconstruction were measured, and are above 99%. The timing resolution per layer is approximately 5 ns

Mesenchymal-epithelial signalling in tumour microenvironment: role of high-mobility group Box 1.

Glucose deprivation, hypoxia and acidosis are characteristic features of the central core of most solid tumours. Myofibroblasts are stromal cells present in many such solid tumours, including those of the colon, and are known to be involved in all stages of tumour progression. HMGB1 is a nuclear protein with an important role in nucleosome stabilisation and gene transcription; it is also released from immune cells and is involved in the inflammatory process. We report that the microenvironmental condition of glucose deprivation is responsible for the active release of HMGB1 from various types of cancer cell lines (HT-29, MCF-7 and A549) under normoxic conditions. Recombinant HMGB1 (10 ng/ml) triggered proliferation in myofibroblast cells via activation of PI3K and MEK1/2. Conditioned medium collected from glucose-deprived HT-29 colon cancer cells stimulated the migration and invasion of colonic myofibroblasts, and these processes were significantly inhibited by immunoneutralising antibodies to HMGB1, RAGE and TLR4, together with specific inhibitors of PI3K and MEK1/2. Our data suggest that HMGB1 released from cancer cells under glucose deprivation is involved in stimulating colonic myofibroblast migration and invasion and that this occurs through the activation of RAGE and TLR4, resulting in the activation of the MAPK and PI3K signalling pathways. Thus, HMGB1 might be released by cancer cells in areas of low glucose in solid tumours with the resulting activation of myofibroblasts and is a potential therapeutic target to inhibit solid tumour growth

Human antibodies targeting Zika virus NS1 provide protection against disease in a mouse model.

Zika virus is a mosquito-borne flavivirus closely related to dengue virus that can cause severe disease in humans, including microcephaly in newborns and Guillain-Barré syndrome in adults. Specific treatments and vaccines for Zika virus are not currently available. Here, we isolate and characterize four monoclonal antibodies (mAbs) from an infected patient that target the non-structural protein NS1. We show that while these antibodies are non-neutralizing, NS1-specific mAbs can engage FcγR without inducing antibody dependent enhancement (ADE) of infection in vitro. Moreover, we demonstrate that mAb AA12 has protective efficacy against lethal challenges of African and Asian lineage strains of Zika virus in Stat2-/- mice. Protection is Fc-dependent, as a mutated antibody unable to activate known Fc effector functions or complement is not protective in vivo. This study highlights the importance of the ZIKV NS1 protein as a potential vaccine antigen

Performance of CMS muon reconstruction in pp collision events at sqrt(s) = 7 TeV

The performance of muon reconstruction, identification, and triggering in CMS has been studied using 40 inverse picobarns of data collected in pp collisions at sqrt(s) = 7 TeV at the LHC in 2010. A few benchmark sets of selection criteria covering a wide range of physics analysis needs have been examined. For all considered selections, the efficiency to reconstruct and identify a muon with a transverse momentum pT larger than a few GeV is above 95% over the whole region of pseudorapidity covered by the CMS muon system, abs(eta) < 2.4, while the probability to misidentify a hadron as a muon is well below 1%. The efficiency to trigger on single muons with pT above a few GeV is higher than 90% over the full eta range, and typically substantially better. The overall momentum scale is measured to a precision of 0.2% with muons from Z decays. The transverse momentum resolution varies from 1% to 6% depending on pseudorapidity for muons with pT below 100 GeV and, using cosmic rays, it is shown to be better than 10% in the central region up to pT = 1 TeV. Observed distributions of all quantities are well reproduced by the Monte Carlo simulation.Comment: Replaced with published version. Added journal reference and DO

Performance of CMS muon reconstruction in pp collision events at sqrt(s) = 7 TeV

The performance of muon reconstruction, identification, and triggering in CMS has been studied using 40 inverse picobarns of data collected in pp collisions at sqrt(s) = 7 TeV at the LHC in 2010. A few benchmark sets of selection criteria covering a wide range of physics analysis needs have been examined. For all considered selections, the efficiency to reconstruct and identify a muon with a transverse momentum pT larger than a few GeV is above 95% over the whole region of pseudorapidity covered by the CMS muon system, abs(eta) < 2.4, while the probability to misidentify a hadron as a muon is well below 1%. The efficiency to trigger on single muons with pT above a few GeV is higher than 90% over the full eta range, and typically substantially better. The overall momentum scale is measured to a precision of 0.2% with muons from Z decays. The transverse momentum resolution varies from 1% to 6% depending on pseudorapidity for muons with pT below 100 GeV and, using cosmic rays, it is shown to be better than 10% in the central region up to pT = 1 TeV. Observed distributions of all quantities are well reproduced by the Monte Carlo simulation.Comment: Replaced with published version. Added journal reference and DO

Nanoscale optical nonreciprocity with nonlinear metasurfaces.

Optical nonreciprocity is manifested as a difference in the transmission of light for the opposite directions of excitation. Nonreciprocal optics is traditionally realized with relatively bulky components such as optical isolators based on the Faraday rotation, hindering the miniaturization and integration of optical systems. Here we demonstrate free-space nonreciprocal transmission through a metasurface comprised of a two-dimensional array of nanoresonators made of silicon hybridized with vanadium dioxide (VO2). This effect arises from the magneto-electric coupling between Mie modes supported by the resonator. Nonreciprocal response of the nanoresonators occurs without the need for external bias; instead, reciprocity is broken by the incident light triggering the VO2 phase transition for only one direction of incidence. Nonreciprocal transmission is broadband covering over 100 nm in the telecommunication range in the vicinity of λ = 1.5 µm. Each nanoresonator unit cell occupies only ~0.1 λ3 in volume, with the metasurface thickness measuring about half-a-micron. Our self-biased nanoresonators exhibit nonreciprocity down to very low levels of intensity on the order of 150 W/cm2 or a µW per nanoresonator. We estimate picosecond-scale transmission fall times and sub-microsecond scale transmission rise. Our demonstration brings low-power, broadband and bias-free optical nonreciprocity to the nanoscale