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Loco‐regional recurrence after radical surgery in esophageal cancer is common. However, there is no universally accepted guideline for managing such loco‐regional recurrences. Even after multiple local recurrences in the mediastinum, a patient can consolidate safely by re‐radiotherapy in the mediastinal region with minimal late morbidity by judicious use of radiotherapy, if there is an acceptable time gap between two radiotherapy periods. Summary of the case with time point of recurrences and treatment received.

Background Metaplastic breast cancer with heterologous mesenchymal differentiation, known earlier as carcinosarcoma, consists of both infiltrating ductal carcinoma cells and mesenchymal cells, and is associated with an aggressive course. The mesenchymal component is rarely endothelial, with only two previously reported cases. The present case is the third among those. Moreover, the disease outcome was good, unlike the usual course of carcinosarcoma. Case presentation A 59-year-old multiparous woman of Indo-aryan ethnicity developed a lump in her left breast and was diagnosed with breast carcinosarcoma having an endothelial component, with the help of histopathological examination and immunohistochemistry. The tumor was surgically removed; then the patient received adjuvant chemotherapy, epirubicin, and cyclophosphamide, followed by adjuvant radiotherapy to the whole breast, followed by tumor bed boost. The patient was clinic-radiologically disease-free even at 26 months post-treatment. Conclusion Surgery followed by adjuvant chemotherapy and radiotherapy gives better outcomes compared with surgery alone, with a doubtful role of neoadjuvant chemotherapy. Targeted therapies can be considered in patients not responding to conventional treatment.

Carcinosarcomas of the salivary gland with osteosarcoma component are very rare, with only 17 cases reported. Despite multiple poor prognostic factors, our patient's outcome was favorable, highlighting the importance of early diagnosis and aggressive treatment in improving prognosis for this aggressive tumor variant.

Oral cavity squamous cell carcinoma (SCC) is conventionally treated with surgery followed by adjuvant radiation therapy. Multiple studies have demonstrated clinical utility of interstitial brachytherapy (BT) alone or external beam radiotherapy (EBRT) with BT boost for T1-T2N0 cancers of lip and buccal mucosa. In case of combined EBRT and BT, dose summation and optimizing doses received by planning target volume (PTV) and organs at risk (OARs) remains challenging.The aim of this study was to generate and evaluate dosimetric parameters of PTV and OARs as a sum of high-dose-rate (HDR)-BT boost and EBRT in early T1-T2N0 cancers of lip and buccal mucosa, using deformable image registration (DIR) software (Velocity ). 2 Gy equivalent dose (EQD ) calculated manually (EQD -D BT + EQD -D EBRT) was compared with that estimated using DIR. An analysis was performed in patients with histopathologically proven T1-T2N0 SCC of lip and buccal mucosa, who underwent interstitial BT boost followed by EBRT. Planning computed tomography (CT) images and respective treatment plans of both BT and EBRT were imported into Velocity software, and DIR was employed to fuse these images for all patients. A synthetic plan incorporating both plans was generated. Dosimetric parameters of both PTV and OAR (mandible) were analyzed. This study included a total of 10 patients (cT1N0: = 6, and cT2N0: = 4), with median age of 57 years (range, 30-69 years) and male : female ratio of 7 : 3. The median dose to PTV using HDR-BT was 21 Gy (range, 20-21 Gy), delivered in 5-6 fractions, 3.5-4 Gy per fraction. The median dose to PTV using EBRT was 44 Gy (range, 40-46 Gy), delivered in 20-23 fractions, 1.8-2 Gy per fraction. DIR software-based dose summation provides accurate dose delivery to target and OARs. If performed prospectively, it can potentially enable optimization of limiting the doses to critical OARs, thus, reducing post-RT morbidity.

Anatomical changes during adjuvant radiotherapy (RT) for post-operative oral cavity squamous cell carcinoma (OCSCC) have greater dosimetric effects with highly conformal techniques, thereby necessitating plan adaptation. We compared conventional adaptive RT (cART) with deformable image registration (DIR)-based ART (dART). Post-operative OCSCC patients receiving adjuvant RT with a ≥ 5 mm change in skin contour on cone beam computed tomography (CBCT) were enrolled. After re-simulation, planning CT (pCT) and extended CBCT were imported into Velocity to generate a synthetic CT (sCT) using DIR. Separate plans were created on the re-simulation CT (rCT) and sCT. The initial plan he was also projected onto the sCT anatomy and compared with the original plan on the pCT. Geometric (volume, Dice similarity coefficient [DSC], mean distance to agreement [MDA]) and dosimetric (mean dose, dose-volume histogram [DVH]) differences were evaluated between rCT- and sCT-based plans. Twenty-five patients were prospectively enrolled. Based on DSC and MDA, DIR showed acceptable geometric accuracy for all structures except the spinal cord (DSC = 0.75). Compared to pCT, most structures had significant volume reduction on sCT, except the low-risk planning target volume (PTV ) (p = 0.14) and the larynx (increased, p = 0.04). Projection of the initial plan onto sCT revealed significant loss in PTV coverage (V p = 0.001; D p = 0.01) and a non-significant loss for the high-risk PTV (PTV ). Organs at risk (OARs) doses increased non-significantly, except for the mandible (p = 0.007). Comparison of rCT and sCT volumes showed a 3.7% increases in PTV (p = 0.009) and 5.7% in PTV (p = 0.049), with non-significant OAR volume increases (2.4%-6.3%) except for the larynx (decreased). DVH comparison showed non-significant dose reductions to the parotids (0.6%), the mandible (0.5%), and the larynx (5.8%), but slight increases for the spinal cord (2.6%) and its planning organ at risk volume (PRV) (3.7%). Target coverage was significantly lower with sCT-based plans (PTV V by 3.2%, D by 3.8%, PTV V by 4.1% and D by 4.3%). dART improved OAR sparing but was compromised in a few target coverage parameters. Further enhancement of DIR accuracy is needed. Currently, DIR is primarily used in ART for dose accumulation to assess the need for plan adaptation.

This study evaluated dosimetry and clinical correlations between intensity modulated radiation therapy (IMRT) boost and image-guided multicatheter interstitial brachytherapy (MIBT) boost, after whole breast hypofractionated radiation post-breast conserving surgery. A mono-institutional randomized prospective controlled trial was conducted in the Department of Radiotherapy and Clinical Oncology at PGIMER, Chandigarh, India, among fifty patients ( = 50) enrolled between September 2018 and January 2020. Each patient received 3D-CRT whole breast radiotherapy (WBRT), 40 Gy in 16 fractions was administered, and delivered within 3.5 weeks. Subsequently, either an IMRT boost ( = 25) with 16 Gy in 8 fractions, or a MIBT boost ( = 25) with 15 Gy in 5 fractions (bid) were delivered. Follow-up visits were scheduled at 6 months, 1 year, 2 years, and 5 years post-treatment to assess toxicity and cosmesis. Cumulative EQD and boost phase EQD doses for dosimetry comparisons were computed. Toxicity was evaluated using RTOG grading, whereas cosmesis was assessed with patient-reported number scores and physician-reported standards based on Harvard criteria. Dosimetry was compared using -tests, toxicity and cosmesis with a likelihood ratio test, and loco-regional recurrence (LRR) was estimated using Fisher's exact test. Progression-free survival (PFS) and overall survival (OS) were analyzed with Kaplan-Meier method and log-rank test. The MIBT group had significantly lower mean cumulative skin and rib D (54.3 Gy and 57.4 Gy) than the IMRT group (62.8 Gy and 64.5 Gy), with a -value of less than 0.001. This also applied to all organs at risk (OARs) EQD doses during the boost phase, with a -value of less than 0.001, except for NTB V and V . Nonetheless, there were no significant differences in the cumulative EQD doses of other OARs, or acute toxicity, late toxicity, patient- and physician-reported cosmesis as well as LRR, PFS, and OS. In left-sided breast cancer, image-guided MIBT outperforms photon boost by reducing the cardiac dose. Despite no statistical significance in cosmesis differences, MIBT exhibited marginally enhanced cosmesis than IMRT boost.

In this article, we demonstrate the solution methodology of start-up electrokinetic flow of non-Newtonian fluids in a microfluidic channel having square cross-section using Spreadsheet analysis tool. In order to incorporate the rheology of the non-Newtonian fluids, we take into consideration the Ostwald-de Waele power law model. By making a comprehensive discussion on the implementation details of the discretized form of the transport equations in Spreadsheet analysis tool, and establishing the analytical solution for a special case of the start-up flow, we compare the results both during initial transience as well as in case of steady-state scenario. Also, to substantiate the efficacy of the proposed spreadsheet analysis in addressing the detailed flow physics of rheological fluids, we verify the results for several cases with the corresponding numerical results. It is found that the solution obtained from the Spreadsheet analysis is in good agreement with the numerical results—a finding supporting spreadsheet analysis's suitability for capturing the fine details of microscale flows. We strongly believe that our analysis study will open up a new research scope in simulating microscale transport process of non-Newtonian fluids in the framework of cost-effective and non-time consuming manner.

The use of molecules bridged between two electrodes as a stable rectifier is an important goal in molecular electronics. Until recently, however, and despite extensive experimental and theoretical work, many aspects of our fundamental understanding and practical challenges have remained unresolved and prevented the realization of such devices. Recent advances in custom-designed molecular systems with rectification ratios exceeding 10 5 have now made these systems potentially competitive with existing silicon-based devices. Here, we provide an overview and critical analysis of recent progress in molecular rectification within single molecules, self-assembled monolayers, molecular multilayers, heterostructures, and metal–organic frameworks and coordination polymers. Examples of conceptually important and best-performing systems are discussed, alongside their rectification mechanisms. We present an outlook for the field, as well as prospects for the commercialization of molecular rectifiers. Molecular rectifiers are an essential component for the construction of molecular electronic devices, which are becoming potentially competitive with existing silicon-based devices. This Review provides an overview of molecular rectification and discusses the outlook for the field as well as prospects for commercialization.

Saline submergence is an important stress for the vast coastal regions of many countries including India. A total of 21 polymorphic simple sequence repeat (SSR) markers distributed across 11 chromosomes of rice were used to study the genetic diversity in a diverse collection of 143 rice accessions from different parts of the world. The polymerase chain reaction profile obtained from 21 SSR markers generated a total of 139 allelic variations. Four genotypes Annakulam Pokkali (IC145150A), Annakulam Pokkali (IC145150B), Pokkali-Ezhikkara-IC324580, and Pokkali-IC324587 showed the higher number of alleles (16) for the miR169j SSR at Chr 9. The population structure analysis divided all the 143 genotypes into three sub-populations and phylogeny analysis revealed three  distinct genetic clusters suggesting how these genotypes were highly diversified and evolutionarily related to each other. We further treated the genotypes under low saline submergence (5 dSm −1 ; 42.92 mM NaCl) and high saline submergence (10 dSm −1 ; 85.83 mM NaCl) at germination stage for 5 days to evaluate the germination percentage. A total of 133 accessions were found to have moderate to high level of tolerance and 10 accessions were susceptible to anaerobic germination under saline-submergence. Our results indicated that Carolina Gold (EC792285) and Pokkali-BJJ/10-2 genotypes are highly tolerant and promising to the saline submergence condition for anaerobic germination. All of the tolerant Pokkali accessions were seen to cluster in the same clade in the phylogenetic tree whereas susceptible accessions grouped in the same cluster. Clear distinction in the pattern of clustering among tolerant and susceptible accessions were visible. Hence, some of the highly tolerant genotypes identified in our study can be used as donors for rice breeding programme. Improved rice ultivars can be developed further by introgression of promising candidate genes associated with saline submergence tolerance in anaerobic condition.

This article deals with the study of a biological feasible two-strain epidemic model considering six compartments with non-monotone incidence and saturated treatment. The model has four types of equilibria, namely disease-free equilibrium, strain-1 endemic equilibrium, strain-2 endemic equilibrium and co-infected endemic equilibrium. We have shown local and global stability of different equilibria in terms of basic reproduction numbers of the system ( R 0 ) and for two strains (namely R 0 ′ and R 0 ′ ′ ). If both R 0 ′ and R 0 ′ ′ are less than unity, then the disease eradicates from the community. It has been also established that global stability of different endemic equilibria depends on values of both R 0 ′ , R 0 ′ ′ and also on strain inhibitory effect reproduction numbers ( R α 1 or/and R α 2 ). We have also verified the principle of exclusive competition, i.e., strain with a higher reproduction number dominates other strains with a lower reproduction number. We have established that the model experiences transcritical bifurcation depending on values of the reproduction numbers. Lastly, we have formulated a time-dependent optimal control problem using Pontryagin’s maximum principle to minimize the number of infected populations and also to reduce the implemented cost for applied treatment control. Numerical simulations are carried out to establish the effect of model parameters on disease spreading as well as the effect of controls.