Spreading and Capillary Imbibition of Viscous Oil Lens into an Open-Cell Porous Structure.

Oil pollution in the ocean is becoming more and more of a serious issue, which increases interest in both ways for combating its cause and methods for observing and monitoring how oil spreads. A promising approach based on an optical method with empirical relations for selected viscous oil-water systems is presented. Based on a modified melamine sponge (MMS), the microscopic spreading and oil capillary penetration phenomenon of the porous structure were investigated. The objective of this study is 2-fold: (i) to present a more thorough experimental description of the spreading of viscous oil lens on the water surface and capillary action of oil lens into MMS porous structure; and (ii) to provide a theoretical description that helps to explain some of the observed behavior. With knowledge of δ∞2=-2SρW/gρO(ρW-ρO), we can determine the spreading coefficient S. It needs to be pointed out that the oil lens floating on the water surface does satisfy Neumann's rule as the spreading coefficient of the air-oil-water system is negative (- 9.8 mN/m), indicating the ability to form a stable oil lens with thickness δO = 3.04 mm and radius RL = 38.64 mm after 60 min of spreading test. Furthermore, to better understand the capillary phenomena from a mechanical approach, an oil lens in contact with the surface of the MMS porous structure, by in-depth visualization, is properly defined as the balance of forces acting. Finally, as an illustration of this method, we utilized this approach to obtain the equilibrium height of the capillary rise and take it into account in terms of effective material thickness.

The lignin-degrading abilities of Gelatoporia subvermispora gat1 and pex1 mutants generated via CRISPR/Cas9.

White-rot fungi efficiently degrade wood lignin; however, the mechanisms involved remain largely unknown. Recently, a forward genetics approach to identify several genes in Pleurotus ostreatus (Agaricales) in which mutations cause defects in wood lignin degradation was used. For example, pex1 encodes a peroxisome biogenesis factor and gat1 encodes a putative Agaricomycetes-specific DNA-binding transcription factor. In this study, we examined the effects of single-gene mutations in pex1 or gat1 on wood lignin degradation in another white-rot fungus, Gelatoporia (Ceriporiopsis) subvermispora (Polyporales), to investigate conserved and derived degradation mechanisms in white-rot fungi. G. subvermispora pex1 and gat1 single-gene mutant strains were generated from a monokaryotic wild-type strain, FP-90031-Sp/1, using plasmid-based CRISPR/Cas9. As in P. ostreatus, Gsgat1 mutants were nearly unable to degrade lignin sourced from beech wood sawdust medium (BWS), while Gspex1 mutants exhibited a delay in lignin degradation. We also found that the transcripts of lignin-modifying enzyme-encoding genes, mnp4, mnp5, mnp6, mnp7, and mnp11, which predominantly accumulate in FP-90031-Sp/1 cultured with BWS, were greatly downregulated in Gsgat1 mutants. Taken together, the results suggest that Gat1 may be a conserved regulator of the ligninolytic system of white-rot fungi and that the contribution of peroxisomes to the ligninolytic system may differ among species.

Urethral stricture following endoscopic prostate surgery: a systematic review and meta-analysis of prospective, randomized trials.

INTRODUCTION AND OBJECTIVES: This systematic review aims to evaluate the incidence and influencing factors of urethral stricture (US) in relation to different BPH endoscopic techniques. MATERIALS AND METHODS: We performed a systematic literature review using MEDLINE, EMBASE, and Cochrane Central Controlled Register of Trials. The incidence of US was estimated through comparative studies between different endoscopic techniques. Patients were assigned into groups according to the type of surgery (enucleation, ablation and resection group). Incidences of US were pooled using the Cochran-Mantel-Haenszel Method with the random effect model and reported as Risk Ratio (RR), 95% Confidence Intervals (CI), and p-values. RESULTS: A total of 80 studies were included for meta-analysis. The pooled incidence of US was 1.7% after enucleation, 2.1% after ablation, 3.8% after monopolar (M)-TURP and 2.1% after bipolar (B)-TURP. The incidence of US was significantly lower after Enucleation than after TURP (RR 0.58 95% CI 0.39-0.84, p = 0.004). US incidence was lower for Ablation procedures than TURP, but the difference did not reach significance (RR 0.79 95% CI 0.61-1.3, p = 0.08). However, this was significant in the subgroup of M-TURP studies (RR 0.67, 95% CI, 0.49-0.91, p = 0.01). Sub-analysis showed that the risk of US was significantly lower after Enucleation than after TURP within 12 months after surgery (RR 0.51 95% CI 0.33-0.81, p = 0.004). CONCLUSION: The study shows an increased incidence of US after TURP compared to enucleation and ablation procedures. The main factors related to increased US incidence are the use of monopolar energy, instrument caliber and duration of postoperative catheterization.

Distribution and ecological risk assessment of phthalic acid esters in surface sediments of three rivers in Northern Vietnam.

Pollution status and distribution characteristics of ten typical phthalic acid esters (PAEs) were investigated in 36 sediment samples collected from three rivers in Northern Vietnam from June to October 2020. The total concentrations of PAEs in sediment samples collected from the To Lich River (n = 9), the Nhue River (n = 12), and the Day River (n = 15) were in ranges of 11,000-125,000 ng/g-dwt (mean/median: 50,000/42,200 ng/g-dwt), 2140-89,900 ng/g-dwt (mean/median: 29,300/20,700 ng/g-dwt), and 1140-43,100 ng/g-dwt (mean/median: 13,800/10,400 ng/g-dwt), respectively. Among ten PAEs studied, di-(2-ethylhexyl) phthalate (DEHP) was found at the highest levels in all samples meanwhile dimethyl phthalate (DMP), diethyl phthalate (DEP), and dipropyl phthalate (DPP) were detected at low frequency and concentration. Significant correlations have existed between the median-chain (C4-C7) PAE pairs in sediment samples. Due to the high accumulation in the sediments, the median-chain PAEs had a higher ecological risk than the short-chain (C1-C3) PAEs. These contaminants may present a longstanding influence on organisms and ecosystems.

CRISPR/Cas9 using a transient transformation system in Ceriporiopsis subvermispora.

Ceriporiopsis subvermispora is a white-rot fungus with great potential for industrial and biotechnological applications, such as the pretreatment of lignocellulose in biorefineries, as it decomposes the lignin in the plant cell wall without causing severe cellulose degradation. A genetic transformation system was recently developed; however, gene-targeting experiments to disrupt or modify the gene(s) of interest remain challenging, and this is a bottleneck for further molecular genetic studies and breeding of C. subvermispora. Herein, we report efficient clustered regularly interspaced short palindromic repeat (CRISPR)/CRISPR-associated protein 9 (Cas9)-assisted gene mutagenesis in this fungus. Two plasmids expressing Cas9 together with a different pyrG-targeting single-guide RNA were separately introduced into the monokaryotic C. subvermispora strain FP-90031-Sp/1, which frequently generated strains that exhibited resistance to 5-fluoroorotic acid and uridine/uracil auxotrophy. Southern blot analyses and genomic polymerase chain reaction followed by DNA sequencing of some mutants revealed that they were pyrG mutants. We also observed that hygromycin resistance of the pyrG mutants was frequently lost after repeated subcultivations, indicating that a maker-free genome editing occurred successfully. It is also suggested that a gene mutation(s) can be introduced via a transient expression of Cas9 and a single-guide RNA; this feature, together with high-frequency gene targeting using the CRISPR/Cas9 system, would be helpful for studies on lignocellulose-degrading systems in C. subvermispora. KEY POINTS: • Efficient plasmid-based CRISPR/Cas9 was established in C. subvermispora. • The mutations can be introduced via a transient expression of Cas9 and sgRNA. • A maker-free CRISPR/Cas9 is established in this fungus.

Full-duplex transmission of multi-Gb/s subcarrier multiplexing and 5G NR signals in 39 GHz band over fiber and space.

We propose a stable full-duplex transmission of millimeter-wave signals over a hybrid single-mode fiber (SMF) and free-space optics (FSO) link for the fifth-generation (5G) radio access networks to accelerate the Industry 4.0 transformation. For the downlink (DL), we transmit 39 GHz subcarrier multiplexing (SCM) signals using variable quadrature amplitude modulation (QAM) allocations for multi-user services. As a proof of operation, we experimentally demonstrate the transmission of 3 Gb/s SCM signals (1 Gb/s per user) over a hybrid system consisting of a 10 km SMF and 1.2 m FSO link. For the uplink (UL), satisfactory performance for the transmission of 2.4 Gb/s 5G new radio (NR) signal at 37 GHz over the hybrid system is experimentally confirmed for the first time, to the best of our knowledge. The measured error vector magnitudes for both DL and UL signals using 4/16/64-QAM formats are well below the third generation partnership project (3GPP) requirements. We also further evaluate by simulation the full-duplex transmission over the system in terms of received optical and RF powers and bit error rate performance. A wireless radio distance of approximately 200 m, which is sufficient for 5G small-cell networks, is estimated for both DL and UL direction under the heavy rain condition, based on the available data from Spain. Furthermore, simulation for the DL direction is conducted to verify the superior performance of the system using variable QAM allocation over uniform QAM allocation. Using a variable modulation allocation, up to five users (2 Gb/s per user) can be transmitted over a hybrid 10 km SMF and 150 m FSO link.

vNOTES Hysterectomy, Adnexectomy, and Uterosacral Ligament Suspension: A Walk-Through Guide.

OBJECTIVE: To provide a stepwise guide to performing vNOTES hysterectomy, adnexectomy, and vault suspension, using 2 access platform methods. DESIGN: Narrated surgical video based on 2 cases of vNOTES for abnormal uterine bleeding and endometrial intraepithelial neoplasia. SETTING: A single tertiary-care academic center. INTERVENTIONS: Step-by-step walk-through is shown to demonstrate the successful completion of a hysterectomy, adnexectomy, and vault suspension. Use of a traditional glove platform and that of an advanced access system, the GelPOINT Access System (Applied Medical), are illustrated. The surgical steps are summarized as follows: (1) colpotomy and abdominal entry, (2) transection of the uterosacral ligaments, (3) placement of an access platform, (4) upper abdominal survey, (5) transection of the uterine and cornual pedicles, (6) identification of the ureters, (7) bilateral salpingo-oophorectomy, (8) uterosacral ligament suspension, (9) cystoscopy, and (10) vaginal vault closure and tying of the suspension sutures. CONCLUSION: This video demonstrates the steps to safely reproduce a vNOTES hysterectomy, adnexectomy, and uterosacral ligament suspension with 2 access techniques. vNOTES offers scar-free surgery, improved access to high pedicles and surgical fields, and a favorable recovery profile, making it an attractive surgical route in appropriate candidates.

Outpatient hysteroscopy is effective for uterine cavity evaluation following failed office-based endometrial biopsy.

BACKGROUND: Failure to obtain an office-based endometrial biopsy for abnormal uterine bleeding is not uncommon. Although operating room-based procedures are traditionally considered the gold standard assessment tool in these circumstances, outpatient hysteroscopy is a less invasive, more cost-effective, and safer alternative. However, there is no contemporary Canadian literature on the effectiveness of an outpatient approach for this specific population. OBJECTIVE: We aim to evaluate the effectiveness and outcomes of outpatient hysteroscopy for uterine cavity evaluation for patients who have failed an in-office endometrial biopsy attempt. METHODS: We conducted a retrospective cohort study of all patients referred to an academic outpatient hysteroscopy unit between January 2015 and January 2018, who underwent an outpatient hysteroscopy following failed endometrial biopsy. Data were collected from electronic medical records. RESULTS: Of the 407 consecutive patients who underwent an outpatient hysteroscopic procedure, 68 met inclusion criteria. Postmenopausal bleeding was the most common indication for initial biopsy, and most failures were attributed to cervical stenosis. Outpatient hysteroscopies were successfully completed in 96% of cases (n = 65/68). Failure resulted from either anxiety and discomfort (n = 2), or severe intrauterine adhesions (n = 1). Overall, 10% of patients subsequently required an operating room-based hysteroscopy, either to complete a myomectomy or polypectomy, or to allow general anesthesia. Outpatient hysteroscopy identified endometrial hyperplasia and cancer in 4.5% and 3% of patients, respectively. CONCLUSION: Outpatient hysteroscopy following unsuccessful office endometrial biopsy attempts appears to be a feasible, safe, and cost-effective investigation strategy that may prevent the need for an operating room-based procedure in 90% of cases.

SARS-CoV-2 coronavirus in water and wastewater: A critical review about presence and concern.

The presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in water and wastewater has recently been reported. According to the updated literature, the stools and masks of the patients diagnosed with coronavirus disease (COVID-19) were considered as the primary route of coronavirus transmission into water and wastewater. Most coronavirus types which attack human (possible for SARS-CoV-2) are often inactivated rapidly in water (i.e., the survival of human coronavirus 229E in water being 7 day at 23 °C). However, the survival period of coronavirus in water environments strongly depends on temperature, property of water, concentration of suspended solids and organic matter, solution pH, and dose of disinfectant used. The World Health Organization has stated that the current disinfection process of drinking water could effectively inactivate most of the bacterial and viral communities present in water, especially SARS-CoV-2 (more sensitive to disinfectant like free chlorine). A recent study confirmed that SARS-CoV-2 RNA was detected in inflow wastewater (but not detected in outflow one). Although the existence of SARS-CoV-2 in water influents has been confirmed, an important question is whether it can survive or infect after the disinfection process of drinking water. To date, only one study confirmed that the infectivity of SARS-CoV-2 in water for people was null based on the absence of cytopathic effect (CPE) in infectivity tests. Therefore, further studies should focus on the survival of SARS-CoV-2 in water and wastewater under different operational conditions (i.e., temperature and water matrix) and whether the transmission from COVID-19-contaminated water to human is an emerging concern. Although paper-based devices have been suggested for detecting the traces of SARS-CoV-2 in water, the protocols and appropriate devices should be developed soon. Wastewater and sewage workers should follow the procedures for safety precaution against SARS-CoV-2 exposure.

Correction to: A 14-bp stretch plays a critical role in regulating gene expression from ß1-tubulin promoters of basidiomycetes.

The original publication of this paper unfortunately contained three errors in Figs. 2B and 3. In Fig. 2B, the TSS site must be counted as "+ 1" instead of "- 1". And we indicated wrong sequences in Fig. 3: the construct "Control" has a missing one "A" in the BCE sequence, and the reverse direction of BCE sequence in the construct "BCEr" must be "GCGGAGTTTCAATT", not "CGCCTCAAGTTAA". For the reasons stated herein, the authors wish to notify the readers that Figs. 2B and 3 must be interpreted as the followings.

A 14-bp stretch plays a critical role in regulating gene expression from ß1-tubulin promoters of basidiomycetes.

Cis-acting elements play a vital role in regulation of transcription initiation. Several cis-acting elements have been identified in filamentous fungi; however, the fundamental requirements for basic promoter function in basidiomycetes are obscure. In this study, core elements in ß1-tubulin promoters of basidiomycetes were functionally characterized. Using transient transformation in Ceriporiopsis subvermispora as a promoter assay, we found that a 14-bp region (ß1-tubulin core promoter element, BCE), as well as CT-rich stretch, in the ß1-tubulin promoter of the species played a critical role in the expression of a recombinant hph as a reporter gene. In addition, in silico analysis revealed other members of basidiomycetes also harboured the BCE motif as well as CT-rich stretch in the ß1-tubulin promoter region, suggesting their functional conservation among the species of basidiomycetes. To confirm the function of BCE, we investigated the effects of BCE motif deletion in the Pleurotus ostreatus ß1-tubulin promoter on expression levels of a recombinant luminous shrimp luciferase reporter gene, which was targeted into the Pofcy1 locus. Intriguingly, luciferase activity was abolished when the BCE motif was deleted in the ß1-tubulin promoter, strongly demonstrating its essential function in transcription from this promoter on the chromosome. This study clearly demonstrates the crucial role of the BCE as well as the CT-rich stretch regions in the ß1-tubulin promoter among basidiomycetes and provides new insights into the fundamental mechanism of transcription initiation in this group.

Gold nanorod/molybdenum sulfide core-shell nanostructures synthesized by a photo-induced reduction process.

Coupling of plasmonic nanostructures and semiconductors gives promising hybrid nanostructures that can be used in different applications such as photosensing and energy conversion. In this report, we describe an approach for fabricating a new hybrid material by coupling a gold nanorod (Au NR) core and amorphous molybdenum sulfide (MoSx) shell. The Au NR/MoSx core-shell structure is achieved by exploiting the hot electrons generated in the plasmonic excitation of Au NRs to drive the reduction of [MoS4]2-, which is pre-adsorbed on the Au NR surface, producing a thin MoSx layer. This approach allows us to control the thickness of the MoSx coating layer on the Au NR surface. The resultant Au NR/MoSx hybrid is characterized by absorption spectroscopy, scanning electron microscopy, transmission electron microscopy, energy-dispersive x-ray spectroscopy elemental mapping, x-ray diffraction and x-ray photoelectron spectroscopy.

M-QAM signal transmission at the photonically generated K-band over thermal-induced turbulent FSO links with different turbulence distributions.

We present a theoretical and experimental study on the impact of different thermal-induced free-space turbulence distributions on the M-quadrature amplitude modulation (M-QAM) signal transmission in radio frequency K-band over hybrid optical links of standard single mode fiber (SSMF) and free-space optics (FSO). Frequency multiplication using an external intensity modulator biased at the null transmission point has been employed to photonically generate radio signals at a frequency of 25 GHz , included for the frequency bands for fifth-generation (5G) mobile networks. Moreover, extensive simulations have been performed for 10Gb/s with 4-, 16-, and 64-QAM over 5 km of SSMF and 500 m long FSO channels under scenarios with different turbulence levels and distributions. Proof-of-concept experiments have been conducted for 20 MHz with 4- and 64-QAM over 5 km of SSMF and 2 m long FSO channels under turbulence conditions. Both theoretical and experimental systems have been analyzed in terms of error vector magnitude (EVM) performance showing feasible transmission over the hybrid links in the received optical power range. Non-uniform turbulence distributions are shown to have a different impact on M-QAM modulation formats, i.e., turbulence distributions with higher strength in the middle of the FSO link reveal a 1.9 dB penalty when using 64-QAM signals compared to a 1.3 dB penalty using 4-QAM signals, whereas higher penalties have been measured when 4-QAM format is transmitted over turbulence distributions with larger magnitude in the second half of the FSO link. The results have been validated by theoretical predictions and lead to practical consequences on future networks' deployment.

Antimicrobial residues, non-typhoidal Salmonella, Vibrio spp. and associated microbiological hazards in retail shrimps purchased in Ho Chi Minh city (Vietnam).

We investigated antimicrobial residues, non-typhoidal Salmonella (NTS), Vibrio spp. and their associated antimicrobial resistance (AMR), in shrimps locally purchased in Ho Chi Minh City (Vietnam). In addition, we investigated the relationship between AMR in NTS, Vibrio spp. and antimicrobial residue in the same sample. A total of 40 samples of shrimp heads/shells from different retail sources was cultured using ISO 6579-1:2017 (NTS) and ISO/TS 21872-1:2007 (Vibrio spp.). Phenotypic antimicrobial susceptibility was investigated using Vitek (NTS, 34 antimicrobials) and disk diffusion (Vibrio spp., 12 antimicrobials). A total of 9 (22.5%) samples contained antimicrobial residue, including tetracyclines, fluoroquinolones, sulfonamides and macrolides (in 7.5%, 7.5%, 2.5% and 2.5% of samples, respectively). Shrimp samples from supermarkets had a higher prevalence of antimicrobial residue than those purchased in street markets (50% vs. 13.3%) (p = 0.049). A total of 30 (75%) samples were contaminated with NTS. All samples contained Vibrio spp., with V. parahaemolyticus being most common (87.5% samples). A total of 58.9% NTS isolates were multidrug resistant. With regards to the highest priority, critically important antimicrobials, the highest resistance corresponded to quinolones (14.4-47.8%), followed by 3rd and 4th generation cephalosporins (3.3-7.8%). Vibrio spp. isolates were characterised by their high resistance against ampicillin (82.7%) and 3rd generation cephalosporins (8.3-16.5%). Extended Spectrum Beta-Lactamase (ESBL) activity was detected in 28.1% V. parahaemolyticus isolates. Half of ESBL-positive V. parahaemolyticus strains harboured bla CTX-M1. We found an association between the presence of residues and the number of resistances for NTS (p = 0.075) and Vibrio spp. isolates (p = 0.093) from the same sample. These findings suggest that the presence of residues may contribute to the selection of AMR in foodborne pathogens in shrimps. Authorities should strengthen policies aiming at restricting inappropriate antimicrobial usage in shrimp farming, and step up monitoring of antimicrobial residues and food-borne pathogens at retail in Vietnam.

Using a 'vector rotation' technique and 'parallel geometry' utility to calculate the equivalent dose rate from a patient undergoing nuclear medicine procedures.

A dose calculation for a person who has been in contact with a patient undergoing Nuclear medicine procedures can be performed by using Merged Phantom Tool (MPT). In this study, we are upgrading the MPT to help users easily merge phantoms at any axis and with any angle using the "vector rotation" technique. The segmented structure information of the contact's phantom is also included in the calculation using the GEANT4 "parallel geometry" utility. The calculation is applied to a case of a male cancer patient lying on a bed who has used I-131, and a caregiver standing beside the patient. The equivalent dose to the thyroid of the caregiver is calculated at 0.3, 0.5, 0.8 and 1m away from the patient, as the caregiver is standing near the patient's abdomen, chest and neck area. The results show that the dose to the thyroid of the contact greatly depends on his standing position and that there are clear differences between the results calculated with the point source and those calculated with the patient source. In summary, using activity distributions in the patient's body as well as the right communication circumstance helps to calculate the optimal dose for people who have been in contact with patients.

M-QAM transmission over hybrid microwave photonic links at the K-band.

Two experimental configurations of a hybrid K-band (25 GHz) microwave photonic link (MPL) are investigated for seamless broadband wireless access networks. Experimental configurations consist of optical fiber, free-space optics (FSO) and radio frequency (RF) wireless channels. We analyze in detail the effects of channel impairments, namely fiber chromatic dispersion, atmospheric turbulence and multipath-induced fading on the transmission performance. In the first configuration, transmission of the 64-quadrature amplitude modulation (QAM) signal with 5, 20 and 50 MHz bandwidths over 5 km standard single-mode fiber (SSMF), 2 m turbulent FSO and 3 m RF wireless channels is investigated. We show that, for QAM with a high bandwidth, the link performance is being affected more by atmospheric turbulence. In the second configuration, the 20 MHz 4/16/64-QAM signals over a 50 km SSMF and 40 m FSO/RF wireless links are successfully transmitted with the measured error vector magnitude (EVM) values of 12, 9 and 7.9%, respectively. It is shown that, for all transmitted microwave vector signals, the bit error rate is lower than the hard-decision forward-error-correction limit of 3.8×10-3. Moreover, an extended FSO link span of 500 m for 25 GHz hybrid MPL with 16-QAM at 10 Gb/s under the weak and strong turbulence regimes is evaluated via simulation analysis to mimic a practical outdoor system.

Development of a loop-mediated isothermal amplification assay for Vibrio cholerae O1 and O139.

A loop-mediated isothermal amplification assay was developed. It was designed for recognizing Vibrio cholerae O1/O139, where atpA, rfbN, and wfbR genes were adopted. The assay specifically detected the target with sensitivities of 5-67 copies per reaction in 1 h. The assay will aid rapid detection of the cholera bacterium.

Effect of Hospital Choice on the Risk of Caesarean Delivery.

OBJECTIVE: This study aimed to evaluate the variation in Caesarean delivery rate (CDR) among hospitals across the United States, its effect on maternal and neonatal outcomes, and whether differences in pregnancy and hospital characteristics can explain the higher CDRs seen in certain hospitals. METHODS: This retrospective population-based cohort study was conducted using the 2014 Healthcare and Utilization Project Nationwide Inpatient Sample. The investigators identified all hospitals with birth admissions and compared hospitals with high CDRs with hospitals with low/mid CDRs, in terms of hospital characteristics, maternal characteristics, and maternal and neonatal outcomes. Regression analyses within multiple hospital and patient characteristic strata were used to evaluate the adjusted independent effect of the hospital on the risk of Caesarean delivery (Canadian Task Force Classification II-2). RESULTS: In this study population, 96% of U.S. hospitals had a CDR above 20%, and 5% had a CDR >40%. High-CDR hospitals (>40%) were more often privately owned, non-teaching hospitals with an older patient population. When adjusting for baseline obstetrical and hospital characteristics, high-CDR hospitals remained independently associated with an elevated risk of Caesarean delivery. These findings persisted in stratified analyses of each hospital and patient-level characteristic. Obstetrical and neonatal outcomes were comparable in all hospitals irrespective of CDR. CONCLUSION: Hospital characteristics and case mix do not account for the significant variation in CDRs across U.S. hospitals. Individual hospitals are in themselves independent risk factors for Caesarean delivery. Choosing to give birth in a certain hospital may put women at an increased risk of having a Caesarean delivery, without maternal or neonatal benefit.

Dosimetric and Monte Carlo verification of jaws-only IMRT plans calculated by the Collapsed Cone Convolution algorithm for head and neck cancers.

AIM: The aim of this study is to verify the Prowess Panther jaws-only intensity modulated radiation therapy (JO-IMRT) treatment planning (TP) by comparing the TP dose distributions for head-and-neck (H&N) cancer with the ones simulated by Monte Carlo (MC). BACKGROUND: To date, dose distributions planned using JO-IMRT for H&N patients were found superior to the corresponding three-dimensional conformal radiotherapy (3D-CRT) plans. Dosimetry of the JO-IMRT plans were also experimentally verified using an ionization chamber, MapCHECK 2, and Octavius 4D and good agreements were shown. MATERIALS AND METHODS: Dose distributions of 15 JO-IMRT plans of nasopharyngeal patients were recalculated using the EGSnrc Monte Carlo code. The clinical photon beams were simulated using the BEAMnrc. The absorbed dose to patients treated by fixed-field IMRT was computed using the DOSXYZnrc. The simulated dose distributions were then compared with the ones calculated by the Collapsed Cone Convolution (CCC) algorithm on the TPS, using the relative dose error comparison and the gamma index using global methods implemented in PTW-VeriSoft with 3%/3 mm, 2%/2 mm, 1%/1 mm criteria. RESULTS: There is a good agreement between the MC and TPS dose. The average gamma passing rates were 93.3 ± 3.1%, 92.8 ± 3.2%, 92.4 ± 3.4% based on the 3%/3 mm, 2%/2 mm, 1%/1 mm criteria, respectively. CONCLUSIONS: According to the results, it is concluded that the CCC algorithm was adequate for most of the IMRT H&N cases where the target was not immediately adjacent to the critical structures.