Anisotropic diffusion of Fe ions in Fricke-XO-Pluronic F-127 and Fricke-XO-gelatine 3D radiotherapy dosimeters.

A new radiochromic dosimeter was examined with Raman spectroscopy and an optical approach for assessment of 3D dose distribution integrity. The acronym of the dosimeter is Fricke-XO-Pluronic F-127, where XO denotes xylenol orange; Pluronic F-127 is a copolymer matrix of poly(ethylene oxide)-block-poly(propylene oxide)-block-poly(ethylene oxide), and the dosimeter contains the components of a Fricke dosimetric solution. Two dosimeter samples in cuvettes were partially irradiated such that a radiation dose was absorbed at the bottom of the cuvettes. After irradiation, one sample was stored upside down such that the irradiated part was at the top and another one was stored with the irradiated part at the bottom. Two diffusion coefficients of ferric ion complexes with XO ([XO-Fe]+3) were calculated. They were compared with those for similar dosimeter, however with gelatine matrix instead of Pluronic F-127. The results obtained indicate an impact of the gravitational force on the diffusion of [XO-Fe]+3ions over time after irradiation and thus a possibility of severely undermining the integrity of a dose distribution in irradiated dosimeter. The conclusions drawn suggest the necessity of examination of different 3D Fricke dosimeter compositions for anisotropic diffusion of ferric ions.

An attenuated total reflection (ATR) and Raman spectroscopic investigation into the effects of chloroquine on Plasmodium falciparum-infected red blood cells.

Attenuated Total Reflection Fourier Transform Infrared (ATR-FTIR) and Raman spectroscopy were used to compare chloroquine (CQ)-treated and untreated cultured Plasmodium falciparum-infected human red blood cells (iRBCs). The studies were carried out in parallel from the same starting cultures using both spectroscopic techniques, in duplicate. ATR FTIR spectra showed modifications in the heme vibrational bands as well as increases in the CH2/CH3 stretching bands in the 3100-2800 cm(-1) region of CQ-treated iRBCs consistent with an increase in lipid content. Other changes consisted of secondary structural variations including shifts in the amide I and II modes, along with changes in RNA and carbohydrate bands. Raman microspectroscopy of single red blood cells using 532 nm revealed subtle changes in the positions and intensity of ν37 of the core size region marker band and ν4 in the pyrrole ring-stretching region between untreated and CQ-treated iRBCs. Similar patterns in the corresponding relations were also observed in the non-fundamental (overtone region) between the control and treated cells. These differences were consistent with higher levels of oxygenated hemoglobin (oxyHb) in the treated cells as shown in a Principle Component Analysis (PCA) loadings plot. The results obtained demonstrate that vibrational spectroscopic techniques can provide insight into the effect of quinolines on iRBCs and thus may assist understanding the sensitivity and resistance of new and existing anti-malarial drugs.

Clostridium difficile the hospital plague.

Clostridium difficile infection (CDI) has become one of the major public health threats in the last two decades. An increase has been observed not only in the rate of CDI, but also in its severity and mortality. Symptoms caused by this pathogen are accompanied by intense local and systemic inflammation. We confirmed that Raman microspectroscopy can help us in understanding CDI pathogenesis. A single erythrocyte of patients with CDI shows a difference, approximately 10 times, in the intensity of the Raman spectra at the beginning of hospitalization and after one week of treatment. The intensity level is an indicator of the spread of the inflammation within the cell, confirmed by standard laboratory tests. Many of the observed bands with enormously enhanced intensity, e.g. 1587, 1344, 1253, 1118 and 664 cm(-1), come from the symmetric vibration of the pyrrole ring. Heme variation of recovered cells in the acute CDI state between the first and the seventh day of treatment seems to show increased levels of oxygenated hemoglobin. Intense inflammation alters the conformation of the protein which is reflected in the significant changes in the amide I, II and III bands. There is an observed shift and a significant intensity increase of 1253 and 970 cm(-1) amide III and skeletal protein backbone CC stretching vibration bands, respectively. Principal Component Analysis (PCA) was used to find the variance in the data collected on the first and seventh day. PC2 loading in the 1645-1500 cm(-1) range shows an increase of heme, Tyr, Trp, or Phe vibrations because of changes in the protein microenvironment due to their exposure. Positive maxima at 1621, 1563 and 1550 in the PC2 loading originated from the ring vibrations. These observations indicate that Clostridium difficile toxins induce cytopathogenicity by altering cellular proteins.

New functionality of chalcogenide glasses for radiation sensing of nuclear wastes.

Data about gamma radiation induced effects in Ge40Se60 chalcogenide thin films and radiation induced silver diffusion within these are presented. Blanket films and devices were created to study the structural changes, diffusion products, and device performance. Raman spectroscopy, X-ray diffraction, current vs. voltage (I-V) and impedance measurements expound the behavior of Ge40Se60 glass and silver diffusion within this glass under radiation. Raman study shows that there is a decrease in the area ratio between edge shared and corner shared structural units revealing structural reorganization occurring in the glasses as a result of gamma radiation. X-ray diffraction studies revealed that with sufficiently radiation dose it is also possible to create Ag2Se in selenium-depleted systems. Oxidation of the Ge enriched chalcogenide backbone is confirmed through the electrical performance of the sensing elements based on these films. Combination of these structural and diffusion products influences the device performance. The I-V behavior is characterized by increase in current and then stabilization as a function of radiation dose. Additionally, device modeling is also presented using Silvaco software and analytical methods to shed light on the device behavior. This type of sensor design and material characterizations facilitate in improving the radiation sensing capabilities of silver containing chalcogenide glass thin films.

Raman micro-spectroscopy tracing human lymphocyte activation.

The activation of lymphocytes occurs when they are exposed to viruses or other foreign antigens. The aim of this work was to verify if Raman spectroscopy can be used to screen the activation of lymphocytes during viral infection. There are distinct peaks that reveal differences between activated and intact cells. The most important marker of the lymphocyte activation process is the prominent 521 cm(-1) disulfide band which marks the immunoglobulin formation. The up shift of the S-S mode from the broad band centered at 510 cm(-1) of human normal immunoglobulin to a single band at 521 cm(-1) of human B cells indicates a selection of the optimal geometry of the disulphide bridges to bind to a foreign antigen. Polarization data is used to detect the structural alteration between domain fragments. Differences in other band intensities may be due to different protein compositions in both the investigated forms. B cell activation causes the change of the intracellular cytoplasm composition due to the secretion of immunoglobulins during the fighting of the infection.

Low voltage cycling of programmable metallization cell memory devices.

Future nanoscale memory technologies must ultimately be able to operate at power supply voltages in the order of 0.6 V or less. We have demonstrated in this work that it is possible to utilize symmetric program-erase (P-E) cycling for Ag/Ag-Ge-S/W programmable metallization cell devices at voltages below 0.6 V and still maintain an OFF/ON resistance ratio well in excess or 10 over a wide range of program and erase currents (0.27, 1.6, 55 and 220 µA) as set by a series resistance. The distributions of resistance values for 10(4) P-E cycles indicate that the margins between the highest on- and lowest off-state resistances are sufficient for unambiguous differentiation in all but the lowest current case in which there is some overlap. In addition, there is no substantial change in switching speed for up to 1.5 × 10(6) P-E operations, the maximum number of cycles attempted in this study.

Dosimetric characterization of CyberKnife radiosurgical photon beams using polymer gels.

Dose distributions registered in water equivalent, polymer gel dosimeters were used to measure the output factors and off-axis profiles of the radiosurgical photon beams employed for CyberKnife radiosurgery. Corresponding measurements were also performed using a shielded silicon diode commonly employed for CyberKnife commissioning, the PinPoint ion chamber, and Gafchromic EBT films, for reasons of comparison. Polymer gel results of this work for the output factors of the 5, 7.5, and 10 mm diameter beams are (0.702 +/- 0.029), (0.872 +/- 0.039), and (0.929 +/- 0.041), respectively. Comparison of polymer gel and diode measurements shows that the latter overestimate output factors of the two small beams (5% for the 5 mm beam and 3% for the 7.5 mm beams). This is attributed to the nonwater equivalence of the high atomic number silicon material of the diode detector. On the other hand, the PinPoint chamber is found to underestimate output factors up to 10% for the 5 mm beam due to volume averaging effects. Polymer gel and EBT film output factor results are found in close agreement for all beam sizes, emphasizing the importance of water equivalence and fine detector sensitive volume for small field dosimetry. Relative off-axis profile results are in good agreement for all dosimeters used in this work, with noticeable differences observed only in the PinPoint estimate of the 80%-20% penumbra width, which is relatively overestimated.

Polymer gel dosimetry close to an 125I interstitial brachytherapy seed.

Despite its advantages, the polymer gel-magnetic resonance imaging (MRI) method has not, as yet, been successfully employed in dosimetry of low energy/low dose rate photon-emitting brachytherapy sources such as 125I or 103Pd interstitial seeds. In the present work, two commercially available 125I seed sources, each of approximately 0.5 U, were positioned at two different locations of a polymer gel filled vial. The gel vial was MR scanned with the sources in place 19 and 36 days after seed implantation. Calibration curves were acquired from the coupling of MRI measurements with accurate Monte Carlo dose calculations obtained simulating the exact experimental setup geometry and materials. The obtained gel response data imply that while linearity of response is sustained, sensitivity (calibration curve slope) is significantly increased (approximately 60%) compared to its typical value for the 192Ir (or 60Co and 6 MV LINAC) photon energies. Water equivalence and relative energy response corrections of the gel cannot account for more than 3-4% of this increase, which, therefore, has to be mainly attributed to physicochemical processes related to the low dose rate of the sources and the associated prolonged irradiation time. The calibration data obtained from one 125I source were used to provide absolute dosimetry results for the other 125I source, which were found to agree with corresponding Monte Carlo calculations within experimental uncertainties. It is therefore suggested that, regardless of the underlying factors accounting for the gel dose response to 125I irradiations, polymer gel dosimetry of new 125I or 103Pd sources should be carried out as originally proposed by Heard and Ibbot (2004 J. Phys.: Conf. Ser. 3 221-3), i.e., by irradiating the same gel sample with the new low dose rate source, as well as with a well-characterized low dose rate source which will provide the dose calibration curve for the same irradiation conditions.

Relative output factor measurements of a 5 mm diameter radiosurgical photon beam using polymer gel dosimetry.

Besides the fine spatial resolution inherent in polymer gel-magnetic resonance imaging (MRI) dosimetry, the method also features the potential for multiple measurements of varying sensitive volume in a single experiment by integrating results in MRI voxels of finite dimensions (i.e., in plane resolution by slice thickness). This work exploits this feature of polymer gel dosimetry to propose an experimental technique for relative output factor (OF) measurements of small radiosurgical beams. Two gel vials were irradiated with a 5 and 30 mm diameter 6 MV radiosurgery beam and MR scanned with the same slice thickness and three different in plane resolutions. Using this experimental data set, 5 mm OF measurements with the PinPoint ion chamber are simulated by integrating results over a sensitive volume equal to that of the chamber. Results are found in agreement within experimental uncertainties with actual PinPoint measurements verifying the validity of the proposed experimental procedure. The polymer gel data set is subsequently utilized for OF measurements of the 5 mm beam with varying sensitive volume to discuss the magnitude of detector volume averaging effects. Seeking to correct for volume averaging, results are extrapolated to zero sensitive volume yielding a 5 mm OF measurement of (0.66+/-5%). This result compares reasonably with corresponding ionometric and radiographic film measurements of this work and corresponding, limited, data in the literature. Overall, results suggest that polymer gel dosimetry coupled with the proposed experimental procedure helps overcome not only tissue-equivalence and beam perturbation implications but also volume averaging and positioning uncertainties which constitute the main drawback in small radiosurgical beam dosimetry.

Three-dimensional dose verification of the clinical application of gamma knife stereotactic radiosurgery using polymer gel and MRI.

This work seeks to verify multi-shot clinical applications of stereotactic radiosurgery with a Leksell Gamma Knife model C unit employing a polymer gel-MRI based experimental procedure, which has already been shown to be capable of verifying the precision and accuracy of dose delivery in single-shot gamma knife applications. The treatment plan studied in the present work resembles a clinical treatment case of pituitary adenoma using four 8 mm and one 14 mm collimator helmet shots to deliver a prescription dose of 15 Gy to the 50% isodose line (30 Gy maximum dose). For the experimental dose verification of the treatment plan, the same criteria as those used in the clinical treatment planning evaluation were employed. These included comparison of measured and GammaPlan calculated data, in terms of percentage isodose contours on axial, coronal and sagittal planes, as well as 3D plan evaluation criteria such as dose-volume histograms for the target volume, target coverage and conformity indices. Measured percentage isodose contours compared favourably with calculated ones despite individual point fluctuations at low dose contours (e.g., 20%) mainly due to the effect of T2 measurement uncertainty on dose resolution. Dose-volume histogram data were also found in a good agreement while the experimental results for the percentage target coverage and conformity index were 94% and 1.17 relative to corresponding GammaPlan calculations of 96% and 1.12, respectively. Overall, polymer gel results verified the planned dose distribution within experimental uncertainties and uncertainty related to the digitization process of selected GammaPlan output data.

Dose verification of single shot gamma knife applications using VIPAR polymer gel and MRI.

This work describes an experimental procedure with potential to assess the overall accuracy associated with gamma knife clinical applications, from patient imaging and dosimetry planning to patient positioning and dose delivery using the automated positioning system of a Leksell Gamma Knife model C. The VIPAR polymer gel-MRI dosimetry method is employed due to its inherent three-dimensional feature and linear dose response over the range of gamma knife applications. Different polymer gel vials were irradiated with single shot gamma knife treatment plans using each of the four available collimator helmets to deliver a maximum dose of 30 Gy. Percentage relative dose results are presented not only in the form of one-dimensional profiles but also planar isocontours and isosurfaces in three dimensions. Experimental results are compared with corresponding Gammaplan treatment planning system calculations as well as acceptance test radiochromic film measurements. A good agreement, within the experimental uncertainty, is observed between measured and expected dose distributions. This experimental uncertainty is of the order of one imaging pixel in the MRI gel readout session (<1 mm) and allows for the verification of single shot gamma knife applications in terms of acceptance specifications for precision in beam alignment and accuracy. Averaging net R(2) results in the dose plateau of the 4 mm and 18 mm collimator irradiated gel vials, which were MR scanned in the same session, provides a crude estimate of the 4 mm output factor which agrees within errors with the default value of 0.870.

Polymer gel water equivalence and relative energy response with emphasis on low photon energy dosimetry in brachytherapy.

The water equivalence and stable relative energy response of polymer gel dosimeters are usually taken for granted in the relatively high x-ray energy range of external beam radiotherapy based on qualitative indices such as mass and electron density and effective atomic number. However, these favourable dosimetric characteristics are questionable in the energy range of interest to brachytherapy especially in the case of lower energy photon sources such as 103Pd and 125I that are currently utilized. In this work, six representative polymer gel formulations as well as the most commonly used experimental set-up of a LiF TLD detector-solid water phantom are discussed on the basis of mass attenuation and energy absorption coefficients calculated in the energy range of 10 keV-10 MeV with regard to their water equivalence as a phantom and detector material. The discussion is also supported by Monte Carlo simulation results. It is found that water equivalence of polymer gel dosimeters is sustained for photon energies down to about 60 keV and no corrections are needed for polymer gel dosimetry of 169Yb or 192Ir sources. For 125I and 103Pd sources, however, a correction that is source-distance dependent is required. Appropriate Monte Carlo results show that at the dosimetric reference distance of 1 cm from a source, these corrections are of the order of 3% for 125I and 2% for 103Pd. These have to be compared with corresponding corrections of up to 35% for 125I and 103Pd and up to 15% even for the 169Yb energies for the experimental set-up of the LiF TLD detector-solid water phantom.

3D dose verification in 192Ir HDR prostate monotherapy using polymer gels and MRI.

VIPAR polymer gels and 3D MRI techniques were evaluated for their ability to provide experimental verification of 3D dose distributions in a simulation of a 192Ir prostate monotherapy clinical application. A real clinical treatment plan was utilized, generated by post-irradiation, CT based calculations derived from Plato BPS and Swift treatment planning systems. The simulated treatment plan involved the use of 10 catheters and 39 source positions within a glass vessel of appropriate dimensions, homogeneously filled with the VIPAR gel. 3D high resolution MR scanning of the gel produced T2 relaxation time maps, from which 3D dose distributions were derived via an appropriate calibration procedure. Results were compared to corresponding dose distributions obtained from the Plato and Swift treatment planning systems. Quantitative comparison, on a point by point basis, was based on user adopted acceptance criteria of 5% dose-difference and 3 mm distance-to-agreement. Significant deviations between experimental and calculated dose distributions were found for doses lower than 50% due to the reduced dose resolution of the method in the low dose, low dose gradient region. Measurement errors were observed at 1.0-1.5 mm around each catheter due to MR imaging susceptibility artifacts. For most remaining points the acceptance criteria were fulfilled. Systematic offsets of the order of 1-2 mm, observed between measured and corresponding calculated isocontours at specific segments, are attributed to the 1 mm uncertainty in catheter reconstruction and 1 mm uncertainty in the alignment of the MR and CT imaging planes.

'Boil it, cook it, peel it or forget it': does this rule prevent travellers' diarrhoea?

A total of 688 out of 2240 air charter passengers in flight to Kenya, West Africa or Sri Lanka/Maldives volunteered to participate in a follow-up study investigating the influence of various food and beverage items on the incidence of travellers' diarrhoea. Within the first three days of their stay abroad, 98% accepted food or beverages whose avoidance is traditionally recommended. The incidence of diarrhoea, which was 19.5%, was proportionate to the number of dietary mistakes committed. The most dangerous items were those whose avoidance was traditionally recommended.

[Preventive measures against travel diarrhea]. / Vorbeugende Massnahmen gegen Reisediarrhöe.

The rules of exposition prophylaxis for traveler's diarrhea are strictly adhered to by only 2% of tourists in developing countries even though the benefits have been well documented. Vacationers generally prefer to take various types of drug prophylaxis despite the fact that a protective effect has only been proven for chemotherapeutic agents and for subsalicylate bismuth. Since their use is strictly limited, therapeutic self-medication becomes even more important. Glucose-electrolyte-solutions may initially increase the number of bowel movements and antidiarrheal agents tend to prolong illness in dysenteric patients. Chemotherapeutic agents are indicated only in select cases.