Nowadays intimacy or intimate relationship is very familiar and widely used term all over the world. The term ‘Intimacy’ generally denotes a close interpersonal relationship or feeling of being in a ...close personal association and belonging together from both physical and mental point of view. It also denotes very close and effective connection with one another which may exist for whole life or may not. This article has been prepared on the basis of secondary sources and it tries to explore how this intimacy or intimate relationship has been gradually transforming from pre-modern society to modern society and from modern society to post-modern society for over the eras. This article also tries to explore the impact of transformed intimacy or intimate relationship, especially in the developing countries, like Bangladesh. Intimate relationship plays very significant role in the overall life style of any human being. This relationship includes feelings of liking, romance, sexuality or sexual relationship, emotional or personal support between mates. But the role of sexuality or sexual relationship is gradually increasing in intimacy, not only in the western countries but also in the developing countries. Nowadays people are involved with many kinds of premarital and extramarital relationships and they try to avoid the risk of reproduction. This tendency creates many problems in the developing countries, as most of the people of such developing countries are poor and illiterate. They are not aware about the dangerous impact of unsafe physical or sexual relationship. So the people of developing countries like Bangladesh are very vulnerable in the aspect of erosion of values and spreading different types of sexually transmitted diseases.
Background:
Escherichia coli
is a major extended-spectrum β-lactamase (ESBL)–producing organism responsible for the rapid spread of antimicrobial resistance (AMR) that has compromised our ability to ...treat infections. Baseline data on population structure, virulence, and resistance mechanisms in
E. coli
lineages from developing countries such as Bangladesh are lacking.
Methods:
Whole-genome sequencing was performed for 46 ESBL–
E. coli
isolates cultured from patient samples at the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)-Dhaka. Sequence data were analyzed to glean details of AMR, virulence, and phylogenetic and molecular markers of
E. coli
lineages.
Results:
Genome comparison revealed presence of all major high-risk clones including sequence type 131 (ST131) (46%), ST405 (13%), ST648 (7%), ST410 (4.3%), ST38 (2%), ST73 (2%), and ST1193 (2%). The predominant ESBL gene and plasmid combination were
bla
CTX
–
M
–
15
and FII-FIA-FIB detected in diverse
E. coli
phylogroups and STs. The
bla
NDM
–
5
(9%) gene was present in prominent
E. coli
STs. One (2%)
mcr-1–
positive ST1011
E. coli
, coharboring
bla
CTXM
–
55
gene, was detected. The extraintestinal pathogenic
E. coli
genotype was associated with specific
E. coli
lineages. The single nucleotide polymorphism (SNP)-based genome phylogeny largely showed correlation with phylogroups, serogroups, and
fimH
types. Majority of these isolates were susceptible to amikacin (93%), imipenem (93%), and nitrofurantoin (83%).
Conclusion:
Our study reveals a high diversity of
E. coli
lineages among ESBL-producing
E. coli
from Dhaka. This study suggests ongoing circulation of ST131 and all major non-ST131 high-risk clones that are strongly associated with cephalosporin resistance and virulence genes. These findings warrant prospective monitoring of high-risk clones, which would otherwise worsen the AMR crises.
Purpose: To report case‐study and experience of the first Robotic Intensity Modulated Radiation Therapy (RIMRT) for Accelerated Partial Breast Irradiation (APBI) using the CyberKnife® Robotic ...Radiosurgery System. Method and Materials: RIMRT with CyberKnife® for APBI has some unique advantages over conventional APBI. Brachytherapy techniques are invasive and can cause short term problems such as discomfort, wound care and risk of infection and bleeding. These risks are eliminated by highly accurate, non‐invasive CyberKnife procedure. Respiratory motion compensation and the sub‐millimeter targeting accuracy of CyberKnife eliminate target position uncertainty in the conventional 3‐D Conformai APBI, thereby reducing the need for expanded PTV. But CyberKnife procedures are challenging. Fiducial may migrate, making the target localization difficult. It may be challenging to reproduce treatment setup or fiducial localization due to patient setup or breast location with respect to the body contour. In this study we report our experience with the first RIMRT case with CyberKnife in our clinic. A set of five fiducials were inserted around the tumor. Two sets of CT images were acquired one week apart to evaluate fiducial migration. Prior to treatment, patient underwent tracking simulation to assess fiducial visibility in live images and tracking and breathing model quality. Breast immobilization was avoided in order to assess reproducibility. Results: The patient received 47.5 Gy in 10 fractions. No fiducial migration was observed. Excellent fiducial image quality was observed throughout the treatment. No effect of breast location with respect to the body contour was observed on the image quality; the treatment setup was easily reproducible. Conclusion: In the 3‐month follow‐up, patient stated pleasure with the cosmesis and outcome of the RIMRT. 3‐month follow‐up MRI indicates decrease in size and change in enhancement characteristics of the lesion. RIMRT with CyberKnife promises to be a new, non‐invasive and highly accurate technique for APBI.
Purpose: To validate Accuray Monte Carlo treatment plans in various heterogeneous phantom systems. Materials and Methods: Monte Carlo Dose Calculation algorithm is considered to be the gold standard ...as compared to the ray tracing algorithm especially in rapidly changing heterogeneous density structures as well as in obliquely incident beams and superficial targets. Three anthropomorphic phantoms loaded with radiochromic EBT films were used for the validation of the dose predicted by Monte Carlo calculations algorithm. Plans performed in MultiPlan (MP 3.1) system simulated lesions in head phantom, lung phantom and a breast phantom. The lung phantom was custom fitted to accommodate small stereotactic A16 chamber for absolute dose verification. Using fixed cones, plans were first obtained and optimized then, calculated in Monte Carlo using the same beam orientation and weighting with %0.5 calculation uncertainty. Six exposed EBT films crossing the target at various axes were used for relative and absolute dose comparison with the calculated dose. Results: FilmQA statistical analysis performed with 3% dose difference index and 1mm distance to agreement (DTA) criteria revealed an average pixel passing (Mean,SD) of 83(11)% and 94(10)% respectively with an average pass of gamma index 88(4)%. Consideration of small target volume and high dose gradient within the evaluated region, the high DTA is indicative of good dose prediction. Both film dosimetry and chamber dose value predictions were in agreement to within <2%. Conclusion: Both EBT film and small stereotactic chamber measurements confirmed Accuray Multiplan Monte Carlo algorithm to be highly accurate for heterogeneous and shallow skin depth dose prediction. This technique can be used to validate Accuray treatment plans.
Purpose: To compare between two national protocols, the Virtual HDR and homogeneous plans for prostate treatment using the CyberKnife® Robotic Radiosurgery System and the MultiPlan® Treatment ...Planning System, effect of dose homogeneity on organs at risk (OAR) and to evaluate the effect of tissue inhomogeneity on the dose using Monte Carlo calculations. Method and Materials: The unique robotic delivery capability of CyberKnife makes it possible to treat prostates with HDR‐like dose plans as well as with homogeneous dose plans. At the CyberKnife Centers of San Diego, low risk and select intermediate risk prostate cancer patients are treated with Virtual HDR dose protocol. Fifteen patients were selected randomly and were replanned following the guidelines of the homogeneous prostate protocol. The introduction of Iris variable aperture collimators together with Sequential Optimization algorithm enables both the Virtual HDR and homogeneous planning with excellent OAR sparring and treatment delivery in reasonably short time. The PTV DVHs as well as those for OARs such as bladder, urethra and rectum are compared. Plans, calculated with Ray Trace algorithm, were later recalculated using Monte Carlo algorithm to evaluate the effect of tissue inhomogeneities on dose. Results: 1) Virtual HDR dose distribution spares the OARs better than the homogeneous dose distributions. 2) The number of beams for heterogeneous plans was 190–200 with the total monitor units around 80000 in 4 fractions. In comparison, the homogeneous plans required 130–180 beams with the total monitor units around 45000 in 5 fractions. 3) A typical Virtual HDR plan takes about an hour to deliver using Iris collimator. A typical homogeneous plan is estimated to take about 40 minutes. 4) The Monte Carlo calculations show no significant effect on the dose in the PTV, however in the OARs, Monte Carlo predicts lower or equivalent dose compared to the Ray Trace calculations.
The cAMP pathway in Schizosaccharomyces pombe is the major nutrient sensing pathway to initiate sexual development when opposite mating type cells exist. We identified moc1-moc4 as genes that ...overcome a partially sterile S. pombe strain due to an elevation of cAMP. When we compared the strength of inducing ability of sexual development in the same S. pombe strain, Moc1 had highest, Moc2 had lowest, and both Moc3 and Moc4 had intermediate effects. Moc1/Sds23 and Moc2/Ded1 are known to be a potential regulator of M-phase progression and an essential RNA helicase, respectively. While Moc4 was found to be identical with a Zn-finger protein Zfs1, Moc3 (SPAC821.07c) was a novel protein containing a Zn-finger (Zn(2)-Cys(6)) motif. Deletion mutant of the moc3 gene was constructed and its disruptant was found to be lower in mating efficiency and formed aberrant asci. In addition, unexpectedly, a moc3 disruptant was sensitive to CaCl₂ and DNA damaging agents such as MMS and UV. Those phenotypes were opposite to the phenotypes observed in a zfs1 disruptant, and quite different from the ones in a moc1 disruptant. Moc3 localized in the nucleus as observed for Zfs1. Moc3 bound with Moc4/Zfs1 weakly in the two hybrid system, but no other combination of Moc(s) bound each other in the same analysis. Thus, Moc3 is not only involved in sexual development, but also in ascus formation and DNA integrity in an independent manner with Moc1 and Moc2 in S. pombe.
Purpose: To validate the Monte Carlo dose calculation algorithm for the CyberKnife® Robotic Radiosurgery System (Accuray Inc.) in the MultiPlan® Treatment Planning System. Method and Materials: Dose ...was measured in heterogeneous phantoms for clinically relevant dosimetry situations and compared with Monte Carlo dose calculations. The validation tests involve dose measurements in slab phantoms for single beams as well as multiple beams delivered on phantoms such as a modified Accuray ball cube and the RPC thorax‐lung phantom. Depth doses as well as dose distributions at the inhomogeneity boundaries were measured. Single beam tests were performed for four collimator sizes (5, 10, 30, and 60 mm). Measurements were performed primarily with EBT films and complemented with MOSFETs at inhomogeneity interfaces. Results: 1) EBT film and MOSFET measurements at the tissue inhomogeneities show excellent agreements in all phantoms and for all collimators in both orthogonal and oblique incidences. 2) The Monte Carlo depth dose calculations in heterogeneous phantoms show excellent agreements with measurements. For example, the depth doses in water‐lung‐water phantom show a drop in the lung region that was predicted very well by the Monte Carlo calculation. 3) The treatment plans delivered to the heterogeneous ball cube and RPC thorax‐lung phantom show excellent agreements between radiochromic film measurements and Monte Carlo calculations. Conclusion: The tests and phantoms collectively cover a wide range of tissue types (including air and lung, water, and bone‐equivalent materials), angles of incidence of beams to tissue interfaces, collimator sizes, and single and multiple beam situations. A total of 91 tests were performed and in 83 (91%) of these tests, 90% or more pixels pass γ(2% dose difference, 2 mm distance‐to‐agreement) condition.
Purpose: The CyberKnife® Robotic Radiosurgery System (Accuray, Inc.) was developed with twelve fixed secondary collimators which deliver circular beams from 5 to 60 mm in diameter at 800 mm SAD. The ...effective beam diameters vary as actual SADs can range from approximately 650 to 1000 mm depending on the particular treatment. Accuray recently developed the Iris™ Variable Aperture Collimator to improve the ability to use multiple field sizes in a treatment. Tests were performed to compare the beam properties of the Iris Collimator with the fixed collimators. Method and Materials: The Iris Collimator consists of two stacked banks of rotationally offset hexagonal apertures. The resulting beam has a 12‐sided shape and a field size that can be varied between 5 and 60 mm at 800 mm SAD. The standard (non‐Monte Carlo) CyberKnife dose calculation algorithm assumes a circularly symmetric beam model. Beam data acquired with stereotactic diodes was processed to generate average dose profiles that are representative of equivalent circular beams for the Iris Collimator. These beam profiles were uploaded to the treatment planning system and the calculated dose distributions were compared with radiochromic film measurements. Results: Gamma histogram film analyses and water phantom measurements show that Iris Collimator beams are substantially equivalent to fixed circular collimator beams with respect to beam quality, collimator transmission and transverse profiles. Maximum leakage dose through the Iris Collimator <0.2%, RMS deviation of the 50% isodose curve from circularity <2%, and the average profile 20–80% penumbra is typically a fraction of a millimeter wider than that of equivalent fixed circular collimator. Conclusion: The beam properties of the 12‐sided Iris™ Collimator are sufficiently similar to those of the fixed circular collimators that the same beam modeling approach and standard dose calculation algorithm used for fixed collimators can be used with the Iris Collimator.
Inclusive transverse momentum spectra of eta mesons have been measured within p(T)=2-10 GeV/c at midrapidity by the PHENIX experiment in Au+Au collisions at root s(NN) = 200 GeV. In central Au+Au the ...eta yields are significantly suppressed compared to peripheral Au+Au, d+Au, and p+p yields scaled by the corresponding number of nucleon-nucleon collisions. The magnitude, centrality, and p(T) dependence of the suppression is common, within errors, for eta and pi(0). The ratio of eta to pi(0) spectra at high p(T) amounts to 0.40 < R-eta/pi(0)< 0.48 for the three systems, in agreement with the world average measured in hadronic and nuclear reactions and, at large scaled momentum, in e(+)e(-) collisions.
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