Contextual Challenges in the Implementation of the Alliance for Maternal and Newborn Health Improvement, Prospective Cohort Study, an Experience from Rural Pakistan

Introduction: Improving maternal and newborn survival needs robust data on patterns of morbidity and mortality from well-characterized cohorts. It is equally important for researchers to document and understand the contextual challenges of data collection and how they are addressed. Methods: This was a prospective cohort study implemented from December 2012 to August 2014 in Matiari, Pakistan. A total of 11,315 pregnancies were enrolled. Participants were approached at home for sequential data collection through the standard pretested structured questionnaires. Some indicators were sourced through health facility records. Information on field challenges gathered through field diaries and minutes of meetings with field staff. Results: Inaccurate reporting of last menstrual period (LMP) dates caused difficulties in the planning and completion of antenatal data collection visits at scheduled gestational weeks. We documented ultrasound reports wherever available, relied on quickening technique, and implemented a seasonal event calendar to help mothers’ recall their LMP. Health system coordinators of public sector and private healthcare providers were individually approached for maximum data collection. But an unregulated private health system with poor record maintenance and health care providers’ reluctance for cooperation posed a greater challenge in data collection. Conclusions: Within a broader understanding of the health systems and socio-cultural environment, temporal and spatial feasibility of data collection should be considered thoroughly at the early stages of study designing, planning, resource allocation, and implementation. Pre-defined regular and need-based meetings with each tier of data collection teams and study managers help to reinvigorate field execution plans and optimize both quantity and quality of study data.

Clinical and Dosimetric Implications of Air Gaps between Bolus and Skin Surface during Radiation Therapy

Purpose: The main objective of the study was to evaluate the effect of air gaps of 0 - 5.0 cm between bolus and skin for 1.0 cm Superflab bolus on surface dose (DSurf) and depth of maximum dose (dmax) in solid water and Rando? phantoms. Methods: In this work, the effects of bolus to surface distance on DSurf and variation in dmax were analyzed in a solid water phantom and in an anthropomorphic Rando? phantom for different field sizes, using Gafchromic? EBT films and farmer chamber. Results: For field sizes of 5 × 5 cm2 the DSurf is significantly affected by increasing air gaps greater than 5 mm. For field sizes larger than 10 × 10 cm2, DSurf is nearly the same for air gaps of 0 - 5.0 cm. For small fields and 6 MV photon beam, dmax increases with increasing air gap, while for 10 MV beam and smaller field sizes (i.e. 5 × 5 and 10 × 10 cm2) the dmax first decreases and then increases with the air gaps. For both 3DCRT and IMRT plans on Rando?, DSurf reduction is more prominent with increasing air gaps. Conclusion: For field sizes larger than 10 × 10 cm2 DSurf is largely unaffected by air gaps. However, smaller air gap results in shallower dmax for both 6 MV and 10 MV photon beams at all fields sizes. Special consideration should be taken to reduce air gaps between bolus and skin for field sizes smaller than 10 × 10 cm2 or when surface contour variations are greater or when the bolus covers small area and at the border of the field.

Analytical and Numerical Approaches to Squeezing Flow and Heat Transfer between Two Parallel Disks with Velocity Slip and Temperature Jump

Analytic and numerical techniques are presented to analyze the influence of temperature and wall slip conditions on the unsteady flow and heat transfer via viscous fluid squeezed between two parallel disks in the presence of an applied magnetic field.The governing partial differential equations for momentum and heat transfer are reduced to a system of coupled nonlinear ordinary differential equations using similarity transformations.The homotopy analysis method(HAM)is then utilized to find explicit series solution of the resulting problem.The convergence of the obtained solution is carefully analyzed.To check the reliability of the method the same problem is also solved by using the shooting method and an excellent agreement is observed between the two sets of results.Influence of various parameters of practical importance on the velocity and temperature profiles is studied and portrayed graphically.Values of skin friction coefficient and local Nusselt number are tabulated by assigning different values to various emerging parameters.

Variation in patient dose due to differences in calibration and dosimetry protocols

For precise and accurate patient dose delivery,the dosimetry system must be calibrated properly according to the recommendations of standard dosimetry protocols such as TG-51 and TRS-398. However, the dosimetry protocol followed by a calibration laboratory is usually different from the protocols that are followed by different clinics, which may result in variations in the patient dose.Our prime objective in this study was to investigate the effect of the two protocols on dosimetry measurements.Dose measurements were performed for a Co-60 teletherapy unit and a high-energy Varian linear accelerator with 6 and 15 MV photon and 6, 9, 12, and 15 MeV electron beams, following the recommendations and procedures of the AAPM TG-51 and IAEA TRS-398 dosimetry protocols. The dosimetry systems used for this study were calibrated in a Co-60 radiation beam at the Secondary Standard Dosimetry Laboratory(SSDL) PINSTECH,Pakistan, following the IAEA TRS-398 protocol. The ratio of the measured absorbed doses to water in clinical setting,D_w(TG-51/TRS-398), was 0.999 and 0.997 for 6 and15 MV photon beams,whereas these ratios were 1.013,1.009, 1.003, and 1.000 for 6, 9, 12, and 15 MeV electron beams, respectively. This difference in the absorbed dosesto-water D_w ratio may be attributed mainly due to beam quality(K_Q) and ion recombination correction factor.

Mechanism of tobacco osmotin gene in plant responses to biotic and abiotic stress tolerance:A brief history

Plants are recurrently exposed to myriads of biotic and abiotic stresses leading to several biochemical and physiological variations that cause severe impacts on plant growth and survival.To overcome these challenges,plants activate two primary defense mechanisms,such as structural response(cell wall strengthening and waxy epidermal cuticle development)and metabolic changes,including the synthesis of anti-microbial compounds and proteins,especially the pathogenesis-related(PR)proteins.PR proteins are members of a super large family of defense proteins that exhibit antimicrobial activities.Their over-expression in plants provides tolerance to many abiotic and biotic stresses.PR proteins have been classified into 17 families,including PR-5–also called thaumatin-like proteins(TLPs)that involve osmotin and osmotin-like proteins(OLPs).Osmotin was first identified in tobacco(Nicotiana tabacum var.Wisconsin 38),and then its homolog proteins(OLPs)were reported from the whole plant kingdom.Osmotin and OLPs are ubiquitous in all fruits and vegetables.Their expression has been detected in various plant tissues and organs.The phylogenetic tree studies revealed that the osmotin group originated from spermatophytes.Moreover,the atomic structure of OLP has shown similarity to thaumatin and TLPs from monocot and eudicot species,which determines a strong evolutionary pressure in flowering plants for conserving thaumatin fold.This is associated with the role of these proteins against pathogens as defense molecules and to induce stress tolerance to plants against several biotic and abiotic factors.In this review,we have briefly described the development history of osmotin,including its function and mechanism to induce biotic and abiotic stress tolerance to plants.

(L^p, L^q)-Boundedness of Hausdorff Operators with Power Weight on Euclidean Spaces

In this paper, we prove the （L^p, L^q）-boundedness of （fractional） Hausdorff operators with power weight on Euclidean spaces. As special cases, we can obtain some well known results about Hardy operators.

Poincaré-MacMillan Equations of Motion for a Nonlinear Nonholonomic Dynamical System

MacMillan's equations are extended to Poincaré's formalism,and MacMillan's equations for nonlinear nonholonomic systems are obtained in terms of Poincaréparameters.The equivalence of the results obtained here with other forms of equations of motion is demonstrated.An illustrative example of the theory is provided as well.

Symmetries,optimal system,exact and soliton solutions of(3+1)-dimensional Gardner-KP equation

In this research article,the(3+1)-dimensional nonlinear Gardner-Kadomtsov-Petviashvili(Gardner-KP)equation which depicts the nonlinear modulation of periodic waves,is analyzed through the Lie group-theoretic technique.Considering the Lie invariance condition,we find the symmetry generators.The pro-posed model yields eight-dimensional Lie algebra.Moreover,an optimal system of sub-algebras is com-puted,and similarity reductions are made.The considered nonlinear partial differential equation is re-duced into ordinary differential equations(ODEs)by utilizing the similarity transformation method(STM),which has the benefit of yielding a large number of accurate traveling wave solutions.These ODEs are further solved to get closed-form solutions of the Gardner-KP equation in some cases,while in other cases,we use the new auxiliary equation method to get its soliton solutions.The evolution profiles of the obtained solutions are examined graphically under the appropriate selection of arbitrary parameters.