21 research outputs found
Volumetric Modulated Arc Therapy Improves Outcomes in Definitive Radiochemotherapy for Anal Cancer Whilst Reducing Acute Toxicities and Increasing Treatment Compliance
No full textBackground: Intensity-modulated radiotherapy (IMRT) is the standard of care in chemoradiotherapy (CRT) for anal cancer. Until now, only a limited number of studies have analyzed the results with VMAT (volumetric modulated arc therapy). We conducted a retrospective study on patients treated at our institution. Patients and Methods: We included patients who received curative CRT for anal cancer. We compared VMAT-treated and 3DCRT (3D conformal radiotherapy)-treated patients. We analyzed toxicities (acute: CTCAE criteria; late: LENT/SOMA criteria), treatment compliance, overall survival, cancer-specific survival (CSS), distant control (DC), and locoregional control. Results: A total of 149 patients (3DCRT: n = 87, VMAT: n = 62) were included. The median follow-up was longer in 3DCRT-treated patients (3DCRT: 61.3 months; VMAT: 39.1 months; p < 0.05). VMAT-treated patients had more G3 tumors (3DCRT: 12/87 (13.8%); VMAT: 18/62 (29.0%), p < 0.001). VMAT reduced acute toxicities ≥grade 3 (3DCRT: n = 48/87 (55.2%); VMAT: n = 11/62 (17.7%), p < 0.001). VMAT improved treatment compliance (less interruptions/delays) (3DCRT: 37/87, 42.5%; VMAT: 4/62, 6.5%; p < 0.001), provided a shorter median overall treatment time (3DCRT: 41 days; VMAT: 38 days; p = 0.02), and gave a higher median absolute 5-fluorouracil dose (3DCRT: 13,700 mg; VMAT: 14,400 mg; p = 0.001). Finally, we found improved CSS (p = 0.02; 3DCRT: 81.9% at 3 years; VMAT: 94.1% at 3 years) and DC (p = 0.01; 3DCRT: 89.4% at 3 years; VMAT: 100.0% at 3 years) with VMAT. Summary: Our study is the first to demonstrate improved treatment compliance and outcomes with VMAT for anal cancer. Previous studies have indicated that organs at risk sparing might be more improved with the use of VMAT vs. with conventional IMRT. Future studies should address whether these advantages lead to a further reduction in CRT-associated morbidity
Cryo-EM structure of a helicase loading intermediate containing ORC-Cdc6-Cdt1-MCM2-7 bound to DNA
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Persepsi tentang Film Kupu-Kupu Malam dan Kajian Pendidikan Agama Kristennya
Get PDF“Kupu-kupu Malam” is a beautiful name commonly mentioned by Indonesian citizens for women who work as Commercial Sex Workers. There are various reasons why these women fall into the night world. One of them is faced by Laura, who is played by Michelle Ziudith in the film “Kupu-kupu Malam”. Film is a medium made by humans and is even lifted from the reality of human life. She had to enter the world of prostitution to finance her sister, who was seriously ill because they were orphans and did not have a single family, and the various consequences that she had to face alone for her decision. Starting from having to divide her time to study, working as a “Kupu-kupu Malam”, checking and seeing the development of her sister\u27s health, and accepting the negative stigma and discrimination by society, especially by the man she loves and her family. Talking about night butterfly women among Indonesian people is a sensitive thing, especially if it is done by the closest people because it is an activity that is contrary to the norms of society and the teachings of every religion in Indonesia. The film “Kupu-kupu Malam” premiered on November 25, 2022, and was watched by many young people. They expressed various responses regarding the content and roles played by the film\u27s characters. These responses are what make the author interested in writing it with the study of Christian Religious Education and using a qualitative method approach
Microscopy of bacterial translocation during small bowel obstruction and ischemia in vivo – a new animal model
No full textAbstract Background Existing animal models provide only indirect information about the pathogenesis of infections caused by indigenous gastrointestinal microflora and the kinetics of bacterial translocation. The aim of this study was to develop a novel animal model to assess bacterial translocation and intestinal barrier function in vivo. Methods In anaesthetized male Wistar rats, 0.5 ml of a suspension of green fluorescent protein-transfected E. coli was administered by intraluminal injection in a model of small bowel obstruction. Animals were randomly subjected to non-ischemic or ischemic bowel obstruction. Ischemia was induced by selective clamping of the terminal mesenteric vessels feeding the obstructed bowel loop. Time intervals necessary for translocation of E. coli into the submucosal stroma and the muscularis propria was assessed using intravital microscopy. Results Bacterial translocation into the submucosa and muscularis propria took a mean of 36 ± 8 min and 80 ± 10 min, respectively, in small bowel obstruction. Intestinal ischemia significantly accelerated bacterial translocation into the submucosa (11 ± 5 min, p E. coli were visible in frozen sections of small bowel, mesentery, liver and spleen taken two hours after E. coli administration. Conclusions Intravital microscopy of fluorescent bacteria is a novel approach to study bacterial translocation in vivo. We have applied this technique to define minimal bacterial transit time as a functional parameter of intestinal barrier function.</p
Organising Chemical Reaction Networks in Space and Time with Microfluidics
No full textInformation processing is essential for any lifeform to maintain its organisation despite continuous entropic disturbance. Macromolecules provide the ubiquitous underlying substrate on which nature implements information processing and have also come into focus for technical applications. There are two distinct approaches to the use of molecules for computing. Molecules can be employed to mimic the logic switches of conventional computers or they can be used in a way that exploits the complex functionality offered by a molecular computing substrate. Prerequisite to the latter is a mapping of the versatile means to achieve this. In the present paper we review microfluidic technology as a versatile means to achieve this, show how we use it, and provide proven recipes for its application
Towards simulating the South African fresh fruit export supply chain
No full textThesis (MEng)--Stellenbosch University, 2024.ENGLISH ABSTRACT: Climate change has become one of the, if not the most, pre-eminent environmental issues threatening the human population and natural ecosystems. The extent of greenhouse gases emitted, mainly due to burning fossil fuels, has drastically increased due to the onset of successive industrial revolutions, increasing the likelihood of irreversible consequences. The greenhouse gas emissions of logistics processes and supply chain activities account for the majority of companies' overall greenhouse gas emissions and carbon footprint. Most of these emissions are engendered by logistics activities related to transportation. In particular, global food supply chains face amplified challenges due to their reliance on fossil fuels, exacerbated by volatile fuel prices, heightening vulnerabilities in transportation and distribution components within supply chains This dependence showcases the increasing importance of understanding, quantifying, and better managing carbon emissions related to transport logistics activities within supply chains The carbon emissions from transportation logistics vary among supply chains and can be attributed to various factors. Given the perishable nature of food products especially fresh fruit, the transportation sector can have a significant impact on the food supply chain, as these goods often require long-distance shipment primarily via road, especially so within South Africa (the main case study of this research project). Furthermore, the distribution of fresh fruit necessitates temperature regulation throughout the process, leading to a higher rate of energy and fuel consumption when compared with non-perishable goods. Notable factors and trends contributing to fuel consumption such as the transport mode, vehicle attributes, driver behaviour, environmental factors, and operations ought to be considered when attempting to reduce the environmental impact of transportation activities. There is, however, a trade-off in respect of minimising cost and reducing carbon emissions — managing the financial implications associated with adopting sustainable practices and technologies is widely regarded as a complex endeavour. Within the context of South Africa, the citrus industry is a vital component of the country's In this thesis, an agent-based simulation model of the real-world transportation conditions and decisions within the context of the South African citrus export supply chain is developed towards helping to address the aforementioned challenges This approach incorporates the use of various frameworks and resources to aid in model development. The proposed solution methodology involves data collection and analysis to gather information relating to the current transportation system, including geographical locations of facilities, truck types, and associated costs. An agent- based model is developed, representing key entities such as production regions, packing facilities, cold storage facilities, and the port of export. Each entity is represented by agents with specific attributes and behaviours, including transportation preferences, capacities, and consolidation strategies. Carbon emission calculations are integrated into the model to estimate emissions for different transportation conditions and decisions (referred to as scenarios) considering factors such as fuel consumption, driver behaviour, and truck types, to name a few. Cost reduction simulations are conducted to evaluate financial impacts and identify cost-effective solutions, accounting for fuel costs, and potential savings from consolidation. The agent-based model is formulated in the Any Logic Simulation Software environment enabling valuable visualisation of the physical movement of agents and graphical representations of cost and carbon intensity associated with different scenarios, during which predefined metrics such as carbon emissions, transportation costs, and logistical efficiency are compared. Based on the simulation results, recommendations are generated so as to provide decision support. These recommendations include adopting specific truck types, driver incentives, implementing consolidation practices, and suggesting modifications to the transportation network to achieve sustainability goals while balancing economic considerations. agricultural sector and has a significant economic impact. It is one of the largest citrus exporters globally, supplying fruits to numerous international markets. The South African citrus export supply chain relies heavily on road transportation to move citrus fruits from production regions to packing facilities, cold storage facilities, and export ports posing challenges related to the reduction of carbon emissions and the improvement of cost-effectiveness.AFRIKAANSE OPSOMMING: Klimaatsverandering het een van die, indien nie die mees, vooraaustaande omgewingskwessies geword wat die menslike bevolking en natuurlike ekosisteme bedreig. Die omvang van kweekhuis-gasse wat vrygestel word, hoofsaaklik as gevolg van die verbranding van fossielbraudstowwe, het drasties toegeneem as gevolg van die aanvang van opeenvolgende industriöle revolusies, wat die waarskynlikheid van onomkeerbare gevolge verhoog. Die kweekhuisgasvrystellings van logistieke prosesse en voorsieningskettingaktiwiteite is verantwoordelik vir die meerderheid van maatskappye se algehele kweekhuisgasvrystellings en koolstofvoetspoor. Die meeste van hierdie emissies word veroorsaak deur logistieke aktiwiteite wat met vervoer verband hou. Veral wereldwye voed- selvoorsieningskettings staar groter uitdagings in die gesig as gevolg van hul afhanklikheid van fossielbraudstowwe, vererger deur wisselvallige brandstofpryse, wat kwesbaarhede in vervoer- en verspreidingskomponente binne voorsieningskettings verhoog. Hierdie afhanklikheid toon dietoenemende belangrikheid om koolstofvrystellings wat verband hou met vervoerlogistieke akti- witeite binne voorsieningskettings te verstaan, te kwantifiseer en beter te bestuur. Die koolstofvrystellings van vervoerlogistiek verskil tussen voorsieningskettings en kan aan verskeie faktore toegeskryf word. Gegewe die bederfbare aard van voedselprodukte, veral vars vrugte, kan die vervoersektor 'n beduidende impak op die voedselvoorsieningsketting hé, aangesien hierdie goedere dikwels laugafstandverskeping benodig, hoofsaaklik via pad, veral binne Suid-Afrika (die belaugrikste gevallestudie van hierdie navorsingsprojek). Verder noodsaak die verspreiding van vars vrugte temperatuurregulering deur die hele proses, wat lei tot 'n hoör tempo van en- ergie en brandstofverbruik in vergelyking met nie-bederfbare goedere. Opmerklike faktore en neigings wat bydra tot brandstofverbruik soos die vervoermodus, voertuigkenmerke, bestuur- dergedrag, omgewingsfaktore en bedrywighede — behoort in ag geneem te word wanneer gepoog word om die omgewingsimpak van vervoeraktiwiteite te verminder. Daar is egter 'n afweging ten opsigte van die vermindering van koste en die vermindering van koolstofvrystellings — die bestuur van die finansiöle implikasies wat verba.nd hou met die aanvaar van volhoubare praktyke en tegnologieö word wyd as 'n komplekse poging beskou. Binne die konteks van Suid-Afrika is die sitrusbedryf 'n noodsaaklike komponent van die land se landbousektor en het 'n beduidende ekonomiese impak. Dit is een van die grootste sitrusuit- voerders wéreldwyd, wat vrugte aan talle internasionale markte verskaf. Die Suid-Afrikaause sitrusuitvoervoorsieningsketting maak grootliks staat op padvervoer om sitrusvrugte van pro- duksiestreke na verpakkingsfasiliteite, koelopbergingsfasiliteite en uitvoerhawens te verskuif wat uitdagings inhou wat verband hou met die vermindering van koolstofvrystellings en die verbetering van kostedoeltreffendheid. In hierdie tesis word 'n agent—gebaseerde simulasiemodel van die werklike vervoertoestande en besluite binne die konteks van die Suid-Afrikaanse sitrusuitvoervoorsieningsketting ontwikkel om te help om die voorgenoemde uitdagings aaxm te spreek. Hierdie benadering inkorporeer die gebruik van verskeie raamwerke en hulpbronne om te help met modelontwikkeling. Die voorgestelde oplossingsmetodologie behels data-insameling en -analise om inligting in te samel wat verband hou met die huidige vervoerstelsel, insluitend geografiese liggings van fasiliteite, tipes vragmotors en gepaardgaande koste. 'n Agent—gebaseerde model word ontwikkel wat sleutelentiteite soos produksiestreke, verpakkingsfasiliteite, koelstoorfasiliteite en die uitvoer-hawe verteenwoordig. Elke entiteit word verteenwoordig deur agente met spesifieke eienskappe en gedrag, insluitend vervoervoorkeure, kapasiteite en konsolidasiestrategieö. Koolstofvrystellings- berekeninge word in die model geintegreer om emissies te skat vir verskillende vervoertoestande en besluite (na verwys as scenario's) met inagneming van faktore soos brandstofverbruik, bestu-urdergedrag en vragmotortipes, om 'n paa.r te noem. Kosteverminderingsimulasies word uit-gevoer om finansiöle impakte te evalueer en kostedoeltreffende oplossings te identifiseer, rekening te hou met brandstofkoste en potensiöle besparings deur konsolidasie. Die agent-gebaseerde model is geformuleer in die AnyLogic Simulation Software-omgewing wat waardevolle visualisering van die fisiese beweging van agente en grafiese voorstellings van koste en koolstofintensiteit wat met verskillende scenario's geassosieer word, moontlik maak, waar- tydens voorafbepaalde maatstawwe soos koolstofvrystellings, vervoerkoste en logistieke doeltr- effendheid vergelyk word. Gebaseer op die simulasieresultate, word aanbevelings gegenereer om besluitondersteuning te verskaf. Hierdie aanbevelings sluit in die aanvaarding van spesi- fieke vragmotortipes, bestuurderaansporings, die implementering van konsolidasiepraktyke en die voorstel van wysigings aan die vervoernetwerk om volhoubaarheidsdoelwitte te bereik terwyl ekonomiese oorwegings gebalanseer word. Die voorgestelde agent—gebaseerde model word aan sistematiese verifikasiestappe onderwerp, wat die korrekte funksionering en integrasie van sy subkomponente verseker. Verder ondergaan die model evaluasie onder diverse bedryfstoestande om 'n meer genuanseerde begrip van die kompleksiteite en uitdagings binne bederfbare voorsieningskettings te verkry, terwyl sy toereik-endheid bevestig word. In die besonder word parameterveraudering, sensitiwiteitsontledings, en scenario-ontledings uitgevoer, gevolg deur gesigsvalidasie deur vakgebiedkenners. Die voorgestelde agent—gebaseerde model 16 die grondslag vir talle weö van toekomstige navorsing, insluitend verbeterings en uitbreidings op die huidige model. Sulke opvolgwerk mag die inagneming van 'n wyer reeks faktore wat bydra tot brandstofverbruik behels, sowel as die toepassing van wiskundige modellering om besluitneming te ondersteun ten opsigte van die ligging van fasiliteite (bv. konsolidasie-hubs) en voertuigroetes.Master
