bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of the relationship between γ-H2AX biomarker levels and dose received after radiation exposure in abdominal–pelvic and chest CT scans
Authors: Fardid Reza , Janipour Sara , Haddadi Golamhassan , Mahdavi Maziyar , Sharifzadeh Sedigheh , Lotfi Mehrzad , Rostamyari Maliheh 
Published: September 2023

ABSTRACT

Background:
As one of the most informative diagnostic radiation instruments, computed tomography (CT) has seen considerable improvement since its implementation in the 1970s; however, the possibility of low-dose radiation risk after CT procedures is still challenging and little is known about the biological effects of CT exposure on patients. As a result, this research aimed to look at the biological and cytogenetic effects of low-dose abdominal–pelvic and chest CT scans on adults, focusing on the number of γ-H2AX foci formation.

Materials and Methods:
Blood tests were taken before and 10 min after CT exams on patients aged 25–55 who were undergoing abdominal–pelvic and chest CT exams with very low-ionizing radiation exposure (TLD doses of 15.67–63.45 mGy). Blood lymphocytes that had been isolated, fixed, and stained were dyed with γ-H2AX antibodies. Finally, the percentage of phosphorylation of histone H2AX as an indicator of double-strand breaks was determined using a cytometry technique.

Results:
Our findings showed that after CT examination, the mean value of γ-H2AX foci in patients increased (P < 0.0001). A statistically significant correlation between dose radiation and the number of γ-H2AX foci was also found (P = 0.047, r = 0.4731). The current study also found a pattern of elevated γ-H2AX foci in patients over 40 years of age relative to younger patients.

Conclusion:
A Significant activation of γ-H2AX foci was found in lymphocytes of peripheral blood samples of patients after CT compared to before CT scan. This increase in γ-H2AX foci levels in blood cells may be a useful quantitative biomarker of low-level radiation exposure in humans.
Measurement of Ambient Dose Equivalent in Compact Proton Therapy using In-house Neutron Moderator-based Poly Allyl Diglycol Carbonate
Authors: Tawonwong Tanawat , Suriyapee Sivalee , Dachviriyakij Tanapol , Pungkun Vithit , Ruangchan Sirinya , Sanghangthum Taweap 
Published: September 2023

Purpose:
The high-energy proton produces the unwanted dose contribution from the secondary neutron. The main purpose of this study is to report the validation results of in-house neutron moderator based on poly allyl diglycol carbonate (CR-39) detector, Chulalongkorn University Neutron Moderator (CUMOD) through the ambient dose equivalent, H*(10) measurement.

Materials and Methods:
The Particle and Heavy Ion Transport code System (PHITS) Monte Carlo code was used to simulate the neutron response function. The CUMOD was calibrated with 241AmBe source calibrator in the range of 100–1000 μSv. The variation of neutron fields was generated employing different proton treatment plans covering most of the clinical scenarios. The ambient dose equivalents, H*(10), evaluated employing CUMOD were compared to those obtained with WENDI-II dosimeter.

Results:
The linear relationship between CUMOD and WENDI-II responses showed an R
2 value close to 1. The H*(10) per Gy delivered dose was in the range of 22–105 μSv for a 10 cm × 10 cm field.

Conclusion:
The in-house CUMOD neutron moderator can expand the neutron detection dose range of CR-39 detector for ambient dose equivalent. The advantage of CUMODs is its capability to evaluate H*(10) in various positions simultaneously.
Dosimetric Comparision of Coplanar versus Noncoplanar Volumetric Modulated Arc Therapy for Treatment of Bilateral Breast Cancers
Authors: Bharati Avinav , Rath Satyajeet , Khurana Rohini , Rastogi Madhup , Mandal Susama R. , Gandhi Ajeet Kumar , Hadi Rahat , Srivastava Anoop K. , Mishra Surendra Prasad 
Published: September 2023

Introduction:
The purpose of this study was to compare the dosimetric parameters of volumetric modulated arc therapy (VMAT) treatment plans using coplanar and noncoplanar beams in patients with bilateral breast cancer/s (BBCs) in terms of organ at risk sparing and target volume coverage. The hypothesis was to test whether VMAT with noncoplanar beams can result in lesser dose delivery to critical organs such as heart and lung, which will result in lesser overall toxicity.

Materials and Methods:
Data of nine BBC cases treated at our hospital were retrieved. Computed tomography simulation data of these cases was used to generate noncoplanar VMAT plans and the parameters were compared with standard VMAT coplanar plans. Contouring was done using radiation therapy oncology group guidelines. Forty-five Gray in 25 fractions was planned followed by 10 Gy in five fractions boost in breast conservation cases.

Results:
No significant difference in planning target volume (PTV) coverage was found for the right breast/chestwall (P = 0.940), left breast/chestwall (P = 0.872), and in the total PTV (P = 0.929). Noncoplanar beams resulted in better cardiac sparing in terms of Dmean heart. The difference in mean dose was >1 Gy (8.80 ± 0.28 − 7.28 ± 0.33, P < 0.001). The Dmean, V20 and V30 values for total lung slightly favor noncoplanar beams, although there was no statistically significant difference. The average monitor units (MUs) were similar for coplanar plans (1515 MU) and noncoplanar plans (1455 MU), but the overall treatment time was higher in noncoplanar plans due to more complex setup and beam arrangement. For noncoplanar VMAT plans, the mean conformity index was slightly better although the homogeneity indices were similar.

Conclusion:
VMAT plans with noncoplanar beam arrangements had significant dosimetric advantages in terms of sparing of critical organs, that is Dmean of heart doses with almost equivalent lung doses and equally good target coverage. Larger studies with clinical implications need to be considered to validate this data.
Investigation of TG-43 Dosimetric Parameters for 192Ir Brachytherapy Source Using GATE Monte Carlo Code
Authors: Joya Musa , Nedaie Hassan Ali , Geraily Ghazale , Rezaei Hadi , Bromand Awaz , Ghorbani Mahdi , Sheikhzadeh Peyman 
Published: September 2023

Purpose:
According to the revised Task Group number 43 recommendations, a brachytherapy source must be validated against a similar or identical source before its clinical application. The purpose of this investigation is to verify the dosimetric data of the high dose rate (HDR) BEBIG 192Ir source (Ir2.A85-2).

Materials and Methods:
The HDR 192Ir encapsulated seed was simulated and its main dosimetric data were calculated using Geant4 Application for Tomographic Emission (GATE) simulation code. Cubic cells were used for the calculation of dose rate constant and radial dose function while for anisotropy function ring cells were used. DoseActors were simulated and attached to the respective cells to obtain the required data.

Results:
The dose rate constant was obtained as 1.098 ± 0.003 cGy.h − 1.U − 1, differing by 1.0% from the reference value reported by Granero et al. Similarly, the calculated values for radial dose and anisotropy functions presented good agreement with the results obtained by Granero et al.

Conclusion:
The results of this study suggest that the GATE Monte Carlo code is a valid toolkit for benchmarking brachytherapy sources and can be used for brachytherapy simulation-based studies and verification of brachytherapy treatment planning systems.
A Simplified Approach for Determination of Inflection Points of Flattening Filter-Free Photon Beam Using In-House Developed Software and Derivation of Reference Levels
Authors: Sharma Smriti , Dixit D. K. , Sharma S. D. , Sharma Amit , Sahani G. , Upreti Ritu Raj , Kinhikar R. A. , Sharma P. K. Dash 
Published: September 2023

Aim:
This article aimed to present the salient features of the in-house developed Java program for the determination of inflection point and dosimetric parameters of flattening filter-free (FFF) photon beam. Reference levels for the dosimetric parameters of the FFF photon beams were also presented.

Materials and Methods:
Beam profiles of 6 MV FFF and 10 MV FFF photon beams for a collimator setting of 20 cm × 20 cm measured at 10 cm depth in an isocentric setup acquired from various institutions were analyzed using an in-house developed Java program and manual method. The values of reference dose value (RDV), field size, penumbra, and degree of un-flatness (defined as the lateral separation between 90% [X90%], 75% [X75%], and 60% [X60%] dose points on the profile) were calculated and compared. The reference values of field size, penumbra, and degree of un-flatness were also determined for Varian and Elekta medical electron linear accelerators (LINACs).

Results:
The maximum differences for RDV determined using the Java method and manual method are 2.4% and 2.7% for 6 and 10 MV FFF photon beams, respectively. The maximum difference between the values of field size, penumbra, and degree of un-flatness determined using Java and manual methods is within 1.3 mm. The reference values of field size and penumbra for Varian LINACs are 19.94 ± 0.10 cm and 0.83 ± 0.08 cm (6 MV FFF) and 19.95 ± 0.10 cm and 0.83 ± 0.08 cm (10 MV FFF). Similarly, the reference values of field size and penumbra for Elekta LINACs are 20.02 ± 0.09 cm and 0.94 ± 0.12 cm (6 MV FFF) and 20.03 ± 0.11 cm and 0.97 ± 0.16 cm (10 MV FFF).

Conclusions:
A software program was developed in Java for analyzing the beam profiles of FFF photon beams. The results of Java-derived values of dosimetric parameters of FFF photon beams were found in good agreement with the values determined using the manual method. The reference values of these parameters were also derived and quoted using a large cohort of the data.
Dosimetric Characteristics of Radiophotoluminescent Glass Dosimeters for Proton Beams
Authors: Oonsiri Sornjarod , Kingkaew Sakda , Vimolnoch Mananchaya , Chatchumnan Nichakan , Oonsiri Puntiwa 
Published: September 2023

Purpose:
The purpose of the study was to investigate the dosimetric characteristics of radiophotoluminescent glass dosimeters (RGDs) for pencil beam scanning proton therapy. The RGD’s end-to-end testing of intensity-modulated proton therapy (IMPT) plans was also evaluated.

Materials and Methods:
The dosimetric characteristics of the GD-302M type glass dosimeter were studied in terms of uniformity, short-term and long-term reproducibility, stability of the magazine position readout, dose linearity in the range from 0.2 to 20 Gy, energy response in 70–220 MeV, and fading effect. The reference conditions of the spot scanning beam from the Varian ProBeam Compact system were operation at 160 MeV, a 2 cm water-equivalent depth in a solid water phantom, a 10 cm × 10 cm field size at the isocenter, and 2 Gy dose delivery. End-to-end testing of IMPT plans for the head, abdomen, and pelvis was verified using the Alderson Rando phantom. The overall uncertainty analysis was confirmed in this study.

Results:
The relative response of RGDs for the uniformity test was within 0.95–1.05. The percentages of the coefficients of variation for short-term and long-term reproducibility were 1.16% and 1.50%, respectively. The dose ACE glass dosimetry reader FGD-1000 showed a stable magazine position readout. The dose was found to be linear with R
2 = 0.9988. The energy response relative to 160 MeV was approximately within 4.0%. The fading effect was within 2.4%. For the end-to-end test, the difference between the treatment plan and RGD measurement was within 1.0%. The overall uncertainty of the RGD measurement for the proton beam was 4.6%, which covered all energy ranges in this study.

Conclusion:
The experimental study indicates that the RGDs have the potential to be used in the dosimetry of therapeutic proton beams, including end-to-end dosimetry.
Efficacy of Pathyadi Churna and Trikatu Churna in the management of Amavata (rheumatoid arthritis)
Authors: Makhija Deepa , Borkar Preeti Sujit , Desai Priti , Singh Renu , Singhal Richa 
Published: September 2023

BACKGROUND:
Rheumatoid arthritis (RA) is a chronic, progressive, systemic autoimmune disease primarily affecting the synovial joints. Clinical symptoms of RA are similar to Amavata- a disease mentioned in Ayurveda. As per the Ayurveda classical texts, the formation and deposition of Ama (biotoxin) play a significant role in the pathogenesis of Amavata (RA). Hence, Deepana (appetite stimulant) & Ama-pachana (interventions that digest the biotoxins) can be first line of treatment for managing RA. Being Deepana and Pachana, Pathyadi Churna and Trikatu Churna can mitigate the Ama, prevent its genesis in the body, and thereby break down the pathogenesis of RA. Both formulations have anti-inflammatory and analgesic action which is supportive while treating RA. The present study will compare the efficacy of Pathyadi Churna and Trikatu Churna in managing RA.

MATERIALS AND METHODS:
It will be a randomized, parallel-group comparative trial with a sample size of 110 participants. Patients of any gender aged 18 to 65 years diagnosed with Rheumatoid arthritis based on American College of Rheumatology (ACR) 2010 criteria and presenting with Sama clinical features of Amavata will be enrolled in the study. Participants will be divided randomly into two groups. In group I, Pathyadi Churna, and Group II, Trikatu Churna will be administered in 3 gm and 1 gm, respectively, twice daily after food with lukewarm water for four weeks. The efficacy of the study interventions will be assessed through the changes in Disease Activity Score 28 (DAS28) and Ayurvedic disease-specific parameters from baseline.

CONCLUSION:
The study will help generate evidence regarding the efficacy of Pathyadi Churna and Trikatu Churna in managing RA.
An observational study to assess the demographic status and health-seeking behavior of SC women and children in Bhubaneswar Block of Odisha
Authors: Binitha P. , Ratha Kshirod K. , Das Banamali , Ota Sarada , Gavali Kishor A. , Rao Mrithyunjaya M. 
Published: September 2023

BACKGROUND:
The Scheduled Castes (SC) population of Odisha constitutes 17.3% of the total population of the state and is one of the most vulnerable groups with regard to health care due to the non-availability of affordable and quality health services. Reproductive health literacy is relatively poorer in adolescents and women, which impacts their reproductive health.

OBJECTIVE:
The core objectives of the study were to determine the socioeconomic status, living conditions, educational status, dietetic habits, lifestyles, and healthcare-seeking behavior of SC women and children, promote awareness regarding lifestyle and health, and also provide healthcare services at their doorsteps.

MATERIALS AND METHODS:
The study was conducted from January to December 2019 in the SC population-dominated areas of the Khurdha district of Odisha. The requisite information was documented by door-to-door visits from respondents who provided their consent for participation in the study, through a structured format. Awareness was created to the respondents through distribution of Information, Education, and Communication materials and public lectures. Ayurveda healthcare services were provided as per the initial screening, presence of risk factors, and presenting complaints, if any. The data gathered were analyzed through descriptive statistical assessment, i.e., measures of frequency and position of the data.

RESULTS:
A total of 5041 people were surveyed, including females and children only. Among these, 2758 were women of reproductive age and 2283 were children. Of the 2283 children, 1186 were male and 1097 were female. The causes of gynecological diseases in SC women are poor living conditions, environmental factors, poor hygiene, improper care during menstrual cycles, a faulty lifestyle, and a low socioeconomic status. The health indices were found to have improved due to the implementation of various women-centric welfare schemes by the government and institutional delivery.

CONCLUSION:
The Reproductive and Child Health program is pivotal for improving the health outcomes of the deprived and unreached segment of the SC women’s population. Supplementation of comprehensive and holistic health care through Ayurveda advocacy is sustainable and can improve health outcomes and reduce mortality and morbidity.
Therapeutic evaluation of Rasnadi Gutika and Chandrakala Lepa in Janusandhigata Vata (osteoarthritis knee)
Authors: Das Banamali , Singh Sanjay K. , Meher Sudhanshu K. , Srivastav Alok K. , Ota Sarada , Rana Rakesh , Singhl Richa , Sharma Bhagwan S. , Khanduri Shruti , Kumar Adarsh , Rao Meda M. , Srikanth Narayanam 
Published: September 2023

BACKGROUND:

Sandhivata [osteoarthritis (OA)] is one of the Vata Vyadhi, which causes much suffering for a prolonged period. The cause of Sandhivata in Ayurveda is attributed to improper diet, lifestyle, and old age, leading to aggravation of Vata, and is associated with slow and steady decline in tissue quality and function. The disease specific symptoms of Sandhigata vata are very similar to that of OA. Treatment in OA is targeted for reviving joint function through halting the disease pathogenesis and promotion of joint health and vitality.

OBJECTIVE:
The objective of this study was to assess the clinical efficacy of Rasnadi Gutika (RG) and Chandrakala Lepa (CKL) in the management of Janusandhigata Vata [osteoarthritis knee (OA knee)].

MATERIALS AND METHODS:
The study was conducted at two peripheral institutes of the Central Council for Research in Ayurvedic Sciences, viz., Central Ayurveda Research Institute, Bhubaneswar, Odisha and Regional Ayurveda Research Institute, Lucknow, Uttar Pradesh. A total of 120 patients between the age of 40 and 75 years suffering from primary OA knee joint were treated with RG and CKL. The duration of the therapy was 12 weeks, and follow-up was done on the 14th, 28th, 42nd, 56th, 70th, and 84th days. RG was administered orally in the dose of 1 g twice daily with lukewarm water, and CKL 10 g was applied locally twice daily for 12 weeks. Parameters such as chief complaints of the disease, viz., joint pain on movement, joint pain at rest, restricted joint, crepitus, swollen joint, stiffness, and bony enlargement; total WOMAC score; and quality of life through WHO QOL BREF score were assessed before and after the administration of therapy.

RESULTS:
The WOMAC score, the key outcome measure, showed statistically significant improvement (P = 0.001) on the 84th day of follow-up. Improvement was noted in all areas, including pain, stiffness, and physical functioning. The physical health, physiological and social relationships, and environmental areas of the WHO QOL BREF score for quality of life were also significantly influenced (P = 0.0001). No adverse drug reactions or adverse events were reported during the trial period.

CONCLUSION:
Oral administration of RG and external application of CKL are effective for the management of OA knee. However, further clinical study with sufficient sample size may be required to revalidate this study’s findings.
Clinical evaluation of the efficacy of Shadbindu Taila and Chitraka Haritaki in the management of chronic rhinosinusitis
Authors: Mata Shweta , Singh Harbans , Makhija Deepa , Yadav Babita , Singhal Richa , Chandrasekhara Rao Bhogavalli , Shivshankar Rajput , Gupta Bharti , Srikanth Narayanam 
Published: September 2023

BACKGROUND:
The disease Pinasa (chronic rhinosinusitis disease) is a chronic nasal disease, which affects nasal canal and paranasal sinuses and the symptoms of this disease are similar to that of chronic rhinosinusitis. In Ayurvedic classics, the internal administration of Chitraka Haritaki Avaleha (CHA) and nasal instillation of Shadbindu Taila (SBT) are mentioned for the management of Pinasa. In view of the literary indication, the present work was carried out with the objective to evaluate the clinical efficacy and safety of CHA and SBT in the management of chronic rhinosinusitis.

MATERIALS AND METHODS:
A multicenter, single-arm, open-label clinical trial was proposed for the assessment of therapeutic efficacy of oral administration of CHA and nasal instillation of SBT. A total of 60 patients with chronic rhinosinusitis from Central Ayurveda Research Institute (CARI), New Delhi and CARI, Patiala were enrolled in this study. SBT Nasya (nasal drop to be given for three sittings, 7 days in each, with the interval of 7 days between each sitting) and CHA (6 g, twice daily after food) in the form of Avaleha (semisolid confection) were given to all participants for 42 days and the follow-up period was 28 days. The primary outcome was to assess change in SNOT (Sino-Nasal Outcome Test) scores. The secondary outcome was to assess change in RSDI (Rhinosinusitis Disability Index) scores and change in Lund-Mackay scores of computed tomography (CT) scan of paranasal sinuses.

CONCLUSION:
The effect of CHA and SBT nasal drop in treatment of Pinasa with special reference to chronic rhinosinusitis may provide an evidence-based complementary therapeutic approach for the management of the said condition.
A multi-center collaborative double-blind study on clinical evaluation of AYUSH-SL in patients receiving mass drug administration for management of chronic filarial lymphedema—study protocol
Authors: Tripathi Santanu K. , Singh Renu , Bhuyan Gurucharan , Mitra Achintya , Sharma Lalita , Murlikrishna Chagam R. , Ratha Kshirod K. , Dhoke Sujata , Gupta Bharti , Kumar Adarsh , Srikanth Narayanam 
Published: September 2023

BACKGROUND:
Lymphatic filariasis (LF) is caused by Wuchereria bancrofti, Brugia malayi, or B. timori, the parasitic nematodes that are transmitted through mosquitoes. The World Health Organization has recommended mass drug administration (MDA) as preventive chemotherapy strategy. In Ayurveda, LF has been narrated under the heading Shlipada, and the literature also includes detailed therapeutic measures. AYUSH-SL is a formulation prepared based on the classical information of herbs used in treating LF.

MATERIALS AND METHODS:
This is a multi-center, prospective, parallel-group, placebo-controlled, double blind interventional study. A total of 180 participants are planned to be recruited, and the duration of the study will be 2.5 years. Diagnosed cases of filariasis (as evidenced by a positive immune-chromatographic card test or enzyme-linked immunosorbent assay or microfilariae (MF) test report) of either sex within the age group of 18–65 years present with features of filarial lymphedema of Grade I and Grade II (lower limbs) will be included in the trial. The study group will be treated with MDA and AYUSH-SL tablet. The control group will receive MDA and a matching placebo. The duration of the therapy will be of 12 weeks, and a last follow-up will be done at the 24th week.

OUTCOME MEASURES:
The primary outcome measure is reduction of edema computed for analysis by percentage reduction from the baseline at 4th, 12th, and 24th week. The secondary outcome measures include improvement in quality of life (QoL), which will be assessed using the Lymphatic Filariasis Specific QoL Questionnaire, and prevention of recurrence of acute episodes, which will be assessed by probing the presence and severity of episodes in the past 4 weeks.

DISCUSSION:
The deformities and disability due to filarial lymphedema vanquish physically as well as mentally leading to hardships in normal life. Management of filarial lymphedema is required for preventing disease progression and episodes of adenolymphangitis. The study is expected to provide evidence on the coded Ayurveda drug AYUSH-SL in the management of chronic filarial lymphedema.