A randomized trial evaluating a novel hydrogel packing system compared to standard packing during image-guided high-dose rate brachytherapy boost for cervical cancer.

INTRODUCTION: The purpose of this prospective randomized trial was to compare the use of a novel vaginal hydrogel packing system (BrachyGel) to standard vaginal packing (VP) during high dose rate (HDR) brachytherapy (BT) for locally advanced cervical cancer (LACC). METHODS: This cross-over study included LACC patients receiving HDR BT boost (intracavitary +/- interstitial). All patients received alternating gauze or BrachyGel VP on Arms A and B. Patients, physicians, and physicists evaluated BT characteristics via a 4-point Likert scale. Adverse events (AEs) were prospectively collected and scored per CTCAE. RESULTS: The 20 patients enrolled. The mean bladder D2cc difference between gauze and BrachyGel in Arm A was 0.117 Gray (Gy) and in Arm B 0.013 Gy. The mean difference in rectum D2cc in Arm A and Arm B was -0.189 Gy and -0.191 Gy, respectively. The mean dose to 90% of the high-risk clinical target volume (HR-CTV) for gauze compared to BrachyGel was -0.032 Gy (95% CI: 0.472, 0.409). Patient-reported discomfort was similar with BrachyGel and gauze ("mild/moderate" 70.0% vs 74.0%, respectively). The clarity of VP was similar between BrachyGel and gauze (86.8% vs 89.7%, respectively). The completeness of VP was more frequently "excellent/good" with BrachyGel (79.0%) compared to gauze (56.4%). The ease of packing was more frequently "extremely easy" with BrachyGel (21.2% vs 0%). No serious AEs were reported. CONCLUSION: This randomized trial found no clinically significant difference in OAR or HR-CTV dosimetry between BrachyGel and standard VP. BrachyGel performed well compared to gauze for the patient and physician use experience.

Functional Characterization of Core and Unique Calcite-Dissolving Bacteria Communities from Peanut Fields.

Calcium deficiency is a leading cause of reduced peanut (Arachis hypogaea) seed quality and has been linked to increased disease susceptibility, specifically to soilborne fungal pathogens. Sufficient calcium at flowering time is critical to ensure proper pod development. Calcite-dissolving bacteria (CDB) isolated from farming fields can dissolve calcite (CaCO3) on plates and increase soluble calcium levels in soil. However, the phylogenetic diversity and geographic distribution of CDB is unclear. Here, we surveyed soil samples from 15 peanut-producing fields in three regions in southern Georgia, representing distinct soil compositions. We isolated CDB through differentiating media and identified 52 CDB strains. CDB abundance was not associated with any of the soil characteristics we evaluated. Three core genera, represented by 43 strains, were found in all three regions. Paenibacillus was the most common CDB found in all regions, making up 30 of the 52 identified strains. Six genera, represented by eight strains, are unique to one region. Members of the core and unique communities showed comparable solubilization indexes on plates. We conclude that a diversified phylogenetic population of CDB is present in Georgia peanut fields. Despite the phylogenetic diversity, as a population, they exhibit comparable functions in solubilizing calcite on plates.