Evaluating ChatGPT to test its robustness as an interactive information database of radiation oncology and to assess its responses to common queries from radiotherapy patients: A single institution investigation.

PURPOSE: Commercial vendors have created artificial intelligence (AI) tools for use in all aspects of life and medicine, including radiation oncology. AI innovations will likely disrupt workflows in the field of radiation oncology. However, limited data exist on using AI-based chatbots about the quality of radiation oncology information. This study aims to assess the accuracy of ChatGPT, an AI-based chatbot, in answering patients' questions during their first visit to the radiation oncology outpatient department and test knowledge of ChatGPT in radiation oncology. MATERIAL AND METHODS: Expert opinion was formulated using a set of ten standard questions of patients encountered in outpatient department practice. A blinded expert opinion was taken for the ten questions on common queries of patients in outpatient department visits, and the same questions were evaluated on ChatGPT version 3.5 (ChatGPT 3.5). The answers by expert and ChatGPT were independently evaluated for accuracy by three scientific reviewers. Additionally, a comparison was made for the extent of similarity of answers between ChatGPT and experts by a response scoring for each answer. Word count and Flesch-Kincaid readability score and grade were done for the responses obtained from expert and ChatGPT. A comparison of the answers of ChatGPT and expert was done with a Likert scale. As a second component of the study, we tested the technical knowledge of ChatGPT. Ten multiple choice questions were framed with increasing order of difficulty - basic, intermediate and advanced, and the responses were evaluated on ChatGPT. Statistical testing was done using SPSS version 27. RESULTS: After expert review, the accuracy of expert opinion was 100%, and ChatGPT's was 80% (8/10) for regular questions encountered in outpatient department visits. A noticeable difference was observed in word count and readability of answers from expert opinion or ChatGPT. Of the ten multiple-choice questions for assessment of radiation oncology database, ChatGPT had an accuracy rate of 90% (9 out of 10). One answer to a basic-level question was incorrect, whereas all answers to intermediate and difficult-level questions were correct. CONCLUSION: ChatGPT provides reasonably accurate information about routine questions encountered in the first outpatient department visit of the patient and also demonstrated a sound knowledge of the subject. The result of our study can inform the future development of educational tools in radiation oncology and may have implications in other medical fields. This is the first study that provides essential insight into the potentially positive capabilities of two components of ChatGPT: firstly, ChatGPT's response to common queries of patients at OPD visits, and secondly, the assessment of the radiation oncology knowledge base of ChatGPT.

Assessing the effects of bladder decellularization protocols on extracellular matrix (ECM) structure, mechanics, and biology.

INTRODUCTION: Acellular matrices have historically been applied as biologic scaffolds in surgery, wound care, and tissue engineering, albeit with inconsistent outcomes. One aspect that varies widely between products is the selection of decellularization protocol, yet few studies assess comparative effectiveness of these protocols in preserving mechanics, and protein content. This study characterizes bladder acellular matrix (BAM) using two different detergent and enzymatic protocols, evaluating effects on nuclei and DNA removal (≥90%), structure, tensile properties, and maintenance of extracellular matrix proteins. METHODS: Porcine bladders were decellularized with 0.5% Sodium Dodecyl Sulfate (SDS) or 0.25% Trypsin-hypotonic-Triton X-100 hypertonic (TT)-based agitation protocols, followed by DNase/RNase agents. Characterization of BAM included decellularization efficacy (DAPI, DNA quantification), structure (histology and scanning electron microscopy), tensile testing (Instron 345C-1 mechanical tester), and protein presence and diversity (mass spectrometry). SDS and TT data was directly compared to the same native bladder using two-tailed paired t-tests. Native, TT, and SDS cohorts for tensile testing were compared using one-way ANOVA; Tukey's post-hoc tests for among group differences. RESULTS: Effective nuclei removal was achieved by SDS- and TT-based protocols. However, target DNA removal was achieved with SDS but not TT. SDS more effectively maintained qualitative tissue architecture compared to TT. The tensile modulus of the TT cohort increased, and stretchability decreased after decellularization in both SDS and TT. UTS was unaffected by either protocol. Higher overall diversity and quantity of core matrisome and matrisome-associated proteins was maintained in the SDS vs TT cohort post-decellularization. CONCLUSION: The results indicated that detergent selection affects multiple aspects of the resultant BAM biologic product. In the selected protocols, SDS was superior to TT efficacy, and maintenance of gross tissue architecture as well as maintenance of ECM proteins. Decellularization increased scaffold resistance to deformation in both cohorts. Future studies applying biologic scaffolds must consider the processing method and agents used to ensure that materials selected are optimized for characteristics that will facilitate effective translational use.

Performance evaluation of Monaco radiotherapy treatment planning system using CIRS Thorax Phantom: Dosimetric assessment of flattened and non-flattened photon beams.

Aim: The present study was undertaken to evaluate the performance of different algorithms for flattening filter-free (FFF) and flattened (FF) photon beams in three different in-homogeneities. Materials and Method: Computed tomography (CT) image sets of the CIRS phantom maintained in the SAD setup by placing the ionization chamber in the lung, bone, and tissue regions, respectively, were acquired. The treatment planning system (TPS) calculated and the ionization chamber measured the doses at the center of the chamber (in the three mediums) were recorded for the flattened and non-flattened photon beams. Results: The results were reported for photon energies of 6 MV, 10 MV, 15 MV, 6 FFF, and 10 FFF of field sizes 5 × 5 cm2, 10 × 10 cm2, and 15 × 15 cm2. In the bone inhomogeneity, the pencil beam algorithm predicted that the maximum dose variation was 4.88% of measured chamber dose in 10-MV photon energy for the field size 10 × 10 cm2. In water inhomogeneity, both the collapsed cone and Monte Carlo algorithm predicted that the maximum dose variation was ± 3% of measured chamber dose in 10-MV photon energy for the field size 10 × 10 cm2 and in 10-MV FFF photon energy for the field size 5 × 5 cm2, whereas in lung inhomogeneity, the pencil beam algorithm predicted that the highest dose variation was - 6.9% of measured chamber dose in 10-MV FFF photon energy for the field size 5 × 5 cm2. Conclusion: FF and FFF beams performed differently in lung, water, and bone mediums. The assessment of algorithms was conducted using the anthropomorphic phantom; therefore, these findings may help in the selection of appropriate algorithms for particular clinical settings in radiation delivery.

Gamma Index Analysis as a Patient-Specific Quality Assurance Tool for High-Precision Radiotherapy: A Clinical Perspective of Single Institute Experience.

Purpose Patient-specific quality assurance (QA) by gamma (γ) analysis is an important component of high-precision radiotherapy. It is important to standardize institute-specific protocol. In this study, we describe our institutional experience of patient-specific QA for high-precision radiotherapy from a clinical perspective. Methods The planning data of 56 patients treated with intensity-modulated radiotherapy (IMRT)/volumetric modulated arc therapy (VMAT) were included. γ index analysis was done using Octavius 4D IMRT QA phantom (PTW, Freiburg, Germany) using 3 mm/3% criteria. Local, global, and volumetric gammas were calculated and compared. The relationship of γ index in the transverse, coronal, and sagittal direction and anatomical region of treatment was explored. Results Global three-dimensional (3D) γ indices in the coronal, sagittal, and transverse axes were 96.73 ± 2.35, 95.66 ± 3.01, and 93.36 ± 4.87 (p < 0.05). The average local two-dimensional (2D) γ index was 78.23 ± 5.44 and the global γ index was 92.41 ± 2.41 (p < 0.005). The average local 3D γ index was 84.99 ± 4.24 and the global 3D γ index was 95.25 ± 1.72 (p < 0.005, paired t-test). The average local volumetric γ index was 84.29 ± 4.73 and the global volumetric γ index was 95.96 ± 2.08 (p < 0.005). 3D global gamma index was significantly different in different anatomical regions (p < 0.05). Conclusion Our study shows that γ index analysis is a useful parameter for routine clinical IMRT QA. The choice of type of γ index depends on the context of use and degree of stringency in measurement. Average 2D and 3D global γ were different in anatomical regions. The average 3D γ index was significantly different in axes. No difference was observed with techniques of IMRT/VMAT. Localization of failed points in CT anatomy can be advantageous for clinical decision-making.

Dosimetric Study Comparing 3D Conformal Radiotherapy (3D-CRT), Intensity Modulated Radiotherapy (IMRT) and Volumetric Modulated Arc Therapy (VMAT) in Hypofractionated One-Week Radiotherapy Regimen in Breast Cancer.

Introduction Recently, the one-week hypofractionated radiotherapy regimen (26 Gy in 5 fractions) for adjuvant breast radiotherapy has been shown to be non-inferior to other hypofractionated regimens (15-16 fractions). The aim of the present dosimetric study is to compare Intensity Modulated Radiotherapy (IMRT), Volumetric Modulated Arc Therapy (VMAT) and 3D Conformal Radiotherapy (3D-CRT) for a one-week hypofractionated radiotherapy regimen (26 Gy in 5 fractions) for adjuvant breast radiotherapy. Methods A total of 30 patients with histologically proven invasive carcinoma of the breast after breast conservation surgery (BCS) or modified radical mastectomy (MRM) were considered for in silico planning study. The dose prescription used was 26 Gy in 5 fractions as used in the FAST Forward protocol. Targets were contoured according to standard guidelines. The heart, ipsilateral lung, and contralateral breast were contoured as organs at risk. Results Planning Target Volume (PTV) coverage: For IMRT, VMAT and 3D-CRT, respectively, the volumes that received at least 95% of the prescription dose (V95) were 95.7 ± 2.12, 92.47 ± 3.83, 90.87 ± 5.13; mean PTV doses (Dmean) were 26.1 ± 0.6, 25.7 ± 0.7, and 28 ± 4.39 (3D-CRT has higher Dmean compared to other techniques). Maximum PTV doses (Dmax) were 28.23 ± 0.72, 28.73 ± 0.64, and 29.8 ± 1.03. IMRT had a better V95 coverage and conformity index.  Organs At Risk (OARs): The volumes that received at least 25% of the prescription dose (V25) of the heart were 3.41 ± 4.7, 1.8 ± 2.02 and 4.3 ± 6.98 in IMRT, VMAT and 3D-CRT, respectively. The volumetric (V25) comparison of heart dose in left-sided breast cancer was significantly different between VMAT and 3D-CRT (p=0.04, Wilcoxon signed-rank test). The volume that received at least 5% of the prescription dose (V5 ) was less than 25% in the 3D-CRT plan (12.55). For the ipsilateral lung, the V25 parameters were 19.53 ± 10.96, 23.93 ± 13.58 and 20.5 ± 12.32 in IMRT, VMAT and 3D-CRT, respectively. Conclusion From this study, we can conclude that IMRT and VMAT techniques are feasible and can achieve better dosimetric goals for target and OARs though minimizing the area achieving low dose remains to be a dosimetric concern for VMAT.

Piezosurgery Versus Conventional Method Alveoloplasty: A Comparative Study.

Purpose: The conventional alveoloplasty approach which uses manual equipment results in more resorption of the underlying alveolar ridge that makes denture prosthesis unstable. The goal of this study was to compare results of piezosurgery alveoloplasty to those of conventional alveoloplasty. Materials and Methods: This was an in-vivo comparative study consisting of ten edentulous individuals who needed alveoloplasty due to bilateral bony projection. On one side, a conventional alveoloplasty was performed with a bone rongeur and bone file, whereas the contralateral side was treated with a piezosurgery unit. The clinical parameters were analyzed using SPSS version 21 software including operating time, postoperative pain evaluation on day 3 and a healing on day 7. Results: There was a statistically significant difference between the two groups in terms of outcome variables such as operating time, pain and healing. The Conventional group has a lower mean of operating time, a higher mean rank of VAS and a lower mean rank of healing index compared to the piezosurgery group. Conclusion: Piezosurgery alveoloplasty not only lowers postoperative patient discomfort but also preserves alveolar bone integrity by not disrupting soft and hard tissue architecture thus allowing faster tissue healing and easier prosthesis replacement in the future.

Beam steered graphene-based Yagi-Uda array antenna with a transverse magnetic to hybrid mode conversion approach.

This work presents the existence of the mode conversion technique in a graphene-based Yagi-Uda array antenna. It comprises four arrays whose strands are placed on a silicon dioxide substrate, and are eventually connected with the graphene ring. All four driven elements of the Yagi-Uda array antenna are excited through the 50Ω silver nanostrip feedline. The proposed antenna offers mode conversion due to variation of the chemical potential of graphene. It controls conversion of the TM32δ to HEM21δ mode of the antenna. This is attributed to the change in the biasing voltage of graphene. This in turn shifts the radiation pattern from the end-fire to the broadside direction, which effectively confirms the beam reconfigurability. This antenna provides a high directivity of 12.21 dBi at 4.55 THz center frequency. The proposed antenna is designed and analyzed by using CST Microwave Studio, which is based on the finite difference time domain scheme. The beam steered graphene-based antenna has been utilized for several terahertz communication systems.

First Leptophobic Dark Matter Search from the Coherent-CAPTAIN-Mills Liquid Argon Detector.

We report the first results of a search for leptophobic dark matter (DM) from the Coherent-CAPTAIN-Mills (CCM) liquid argon (LAr) detector. An engineering run with 120 photomultiplier tubes (PMTs) and 17.9×10^{20} protons on target (POT) was performed in fall 2019 to study the characteristics of the CCM detector. The operation of this 10-ton detector was strictly light based with a threshold of 50 keV and used coherent elastic scattering off argon nuclei to detect DM. Despite only 1.5 months of accumulated luminosity, contaminated LAr, and nonoptimized shielding, CCM's first engineering run has already achieved sensitivity to previously unexplored parameter space of light dark matter models with a baryonic vector portal. With an expected background of 115 005 events, we observe 115 005+16.5 events which is compatible with background expectations. For a benchmark mediator-to-DM mass ratio of m_{V_{B}}/m_{χ}=2.1, DM masses within the range 9 MeV≲m_{χ}≲50 MeV are excluded at 90% C. L. in the leptophobic model after applying the Feldman-Cousins test statistic. CCM's upgraded run with 200 PMTs, filtered LAr, improved shielding, and 10 times more POT will be able to exclude the remaining thermal relic density parameter space of this model, as well as probe new parameter space of other leptophobic DM models.

Evaluating impact of medium variation on dose calculated through planning system in a low cost in-house phantom.

Purpose: In radiotherapy, accuracy in dose estimation of dose calculation methods is critical. The influence of deformity on radiation dose calculations derived by planning system is evaluated in present study. The goal of study was to create a low-cost inhomogeneous phantom for measuring absorbed dose using an Ionisation chamber and Gafchromic film, which was validated using treatment planning system (TPS) dose outcome.Methods:and Materials: The central axis dose calculations were computed using Pencil Beam Convolution algorithm (PBC), Collapsed Cone Convolution (CCC) and Monte Carlo (MC) algorithm in the Monaco treatment planning system using an In-house phantom (20 × 20 × 20cm3) made up of acrylic sheet containing water and inhomogeneous material wooden powder equivalent to lung. Phantom was scanned in Computed Tomography (CT) scanner and image set was sent to the planning workstation. The depth dose evaluations were performed using ionization chamber and Gafchromic film with same beam settings and monitor units in every setup. Following that, the calculated doses obtained from TPS and measured depth doses were compared.Results: The results was reported for photon energies 6MV, 10MV, 15MV, 6FFF and 10FFF at varying field sizes of 4 × 4 cm2, 5 × 5 cm2, 10 × 10 cm2, and 15 × 15 cm2. MC maximum dose variation predicted was 2.06% in 15MV of measured chamber dose and -2.06% of measured gafchromic film dose in 6MVFFF. CCC maximum dose variation predicted was 2.68% of measured chamber dose in 6MV and 3.31% of measured gafchromic film dose in 6MV whereas PB maximum dose variation predicted was -5.94% in 15MV of measured chamber dose and -11.6% of measured gafchromic film dose in 6MVFFF.Conclusion: Low-cost in-house phantoms can be utilised to assess point and planar doses during patient-specific quality assurance in centres that don't have accessibility to phantoms due to the high cost of commercially available tools.

Effect of nation-wide lock-down due to Covid-19 over industrial pollution in Delhi, India.

In India, very first infection due to Covid-19 was reported by end of January 2020 and, the same has been increased with the span of time. In order to fight the increasing risk among the citizens of nation, the complete lock-down was declared on March 25, 2020 for initially 21 days and thereafter it has been subsequently increased up to its present 4th phase, which would be remain continue until May 31, 2020. First two phases of lock-down were imposed without any relaxation, however, there were gradual relaxation implemented in third and fourth lock-down phases. Air pollution depends on emission of the pollutants from vehicles and industries, as well as dust from construction activities. Due to lock-down, operations concerning these activities were completely shut down. The effect of lock-down on PM2.5, PM10, NO2, SO2, CO and AQI level was studied and comparison of PM2.5, PM10, NO2, SO2, CO and AQI during lock-down with same dates of previous year was also considered.

Investigation of tube voltage dependence on CT number and its effect on dose calculation algorithms using thorax phantom in Monaco treatment planning system for external beam radiation therapy.

Introduction: The accuracy of dose calculation algorithms depends on the electron density and computed tomography (CT) number of medium scanned. Our study aimed to verify the impact of different CT scanning protocols on Hounsfield unit (HU) and effect on dose calculation algorithms. Materials and Methods: CIRS thorax phantom with different density material plugs was scanned at varying tube voltages from CT scanner and HU values were measured in treatment planning system (TPS). Calibration curves of electron density at different tube voltages were plotted and used for dose calculation with different calculation algorithms at varying high energy megavoltage photon energies. Results: Insignificant difference is obtained in electron density curves plotted at different tube voltages. The mean variation in HU values was found at different tube voltages for bone, lung, and water are 896.75 (standard deviation [SD] 122.88), -799.25 (SD 5.74), and -17.5 (SD 0.57), respectively. The estimated P values for change in HU values were 0.089, 0.258, and 0.121 for bone, lung, and water, respectively. Pencil beam (PB) convolution and collapsed cone algorithms show no significant dose difference, i.e., <1% variation and Monte Carlo (MC) shows maximum dose difference up to 1.4%. Conclusion: Third-generation algorithms such as MC shows dependence on varying tube voltages in dose calculation. Calibration curves plotted at different kVp in TPS advised to be chosen wisely to avoid any dosimetric errors in different medium.

Bleomycin sclerotherapy in lymphangiomas of the head and neck region: a prospective study.

Intralesional sclerotherapy for lymphatic malformations (LMs) has become a modality of choice because of the high morbidity and recurrence rates with surgical excision. Traditionally, the macrocystic variant has shown good results with sclerotherapy. This prospective study was performed to evaluate the role of bleomycin sclerotherapy in the management of different radiological variants of LM. A total of 142 patients were included in this study. The lesions were classified as macrocystic, microcystic, or mixed LMs on the basis of ultrasonography. All patients were managed by intralesional injection of bleomycin and were recalled after 4 weeks for evaluation. Colour photographs of the patients were taken before the onset of treatment and at each monthly visit, and were utilized to assess the response. Following the second, third, and fourth doses, the response was better in patients with the macrocystic variant than in those with the other two variants. However, after the completion of six doses, 80.3% of patients with the macrocystic variant, 67.4% with the microcystic variant, and 71.4% with the mixed type had a complete response. There was no difference in the overall response between the three types (P=0.28). Oedema, erythema, and local induration with fever were the most common adverse effects and were more common in younger children.

Development of a biomarker of efficacy in second-line treatment for lymphangioma of the tongue: a pilot study.

Lymphangioma of the tongue is a rare lymphatic malformation, and various authors have reported the successful use of sirolimus for its treatment. However, the safety of sirolimus in children needs further evaluation so that those who do not respond are not necessarily exposed to its potential adverse effects. We hypothesised that assessment of lymphangiogenesis can be used to predict whether the patient will respond to sirolimus, so we organised a prospective study after ethics committee approval had been given. After clinical and histological diagnoses of lymphangioma of the tongue had been confirmed, 16 patients were given sirolimus 0.8mg/day in three divided doses. Clinical response was assessed and compared with lymphatic microvessel density (LMVD), which was calculated immunohistochemically using the monoclonal antibody D2-40 as the lymphatic endothelial marker. Nine patients responded well, five partially, and two failed to respond. Mean (SD) LVD among the good responders was 21.00 (3.74), whereas among non-responders it was 8.00 (4.24). There was a significant difference in mean LVD between good responders, partial responders, and non-responders (p=0.04). Sirolimus is effective in treating children with lymphangioma of the tongue, and lymphangiogenesis is a useful therapeutic predictive marker.

Electron versus Muon Neutrino Induced Cross Sections in Charged Current Quasielastic Processes.

Differences between ν_{e} and ν_{µ} quasielastic cross sections are essential in neutrino oscillation analyses and CP violation searches for experiments such as DUNE and T2HK. The ratio of these is however poorly known experimentally and for certain kinematic regions theoretical models give contradictory answers. We use two independent mean-field based models to investigate this ratio using ^{40}Ar and ^{12}C targets. We demonstrate that a proper treatment of the final nucleon's wave function confirms the dominance of ν_{µ} over ν_{e} induced cross sections at forward lepton scattering.