Individualized vaginal applicator for stage IIb primary vaginal adenocarcinoma:A case report

BACKGROUND Primary vaginal cancer is rare and most vaginal tumors are metastatic,often arising from adjacent gynecologic structures.Primary vaginal cancers are also more common among postmenopausal women and most of these are squamous cell carcinomas,with adenocarcinomas being relatively rare.Vaginal bleeding is the most common clinical manifestation of vaginal adenocarcinoma.About 70%of vaginal adenocarcinomas are stage I lesions at the time of diagnosis,for which radical surgery is recommended.However,more advanced vaginal cancers are not amenable to radical surgical treatment and have poor clinical outcomes.Optimal treatments modes are still being explored.Here,we report a rare case of stage IIb primary vaginal adenocarcinoma for which an individually designed vaginal applicator for after-loading radiotherapy was used to achieve good tumor control.CASE SUMMARY A 62-year-old woman presented to our clinic after 3 months of abnormal postmenopausal vaginal bleeding.Gynecological examination,computed tomography(CT),and positron emission tomography-CT showed a large mass(about 5 cm)on the anterior vaginal wall.Colposcopy biopsy confirmed adenocarcinoma of vaginal origin.After three cycles of carboplatin plus paclitaxel chemotherapy,the lesion partially shrunk.The patient then received external irradiation of 45 gray(gy)in 25 fractions,which further reduced the vaginal lesion,followed by after-loading radiotherapy of 30 gy in 5 fractions with an individually designed vaginal applicator.Three months later,magnetic resonance imaging showed a slight thickening CONCLUSION Primary vaginal adenocarcinoma is rare,and prognosis is poor in most vaginal cancers of locally advanced stages,which cannot be treated with radical surgery.Better tumor control can be achieved with an individualized vaginal applicator that allows administration of a higher radical dose to the tumor area while protecting normal tissues.

Dosimetric Comparison of Fixed and Flexible Geometry ICRT Applicators in Patients Treated for Carcinoma Cervix

In intracavitary radiotherapy (ICRT) for cancer cervix, applicator geometry has the potential to impact the doses to organs at risk (OARs) and the coverage of the target volume. At our centre two Varian made Fletcher-style applicator sets, namely defined (fixed) geometry and flexible geometry, are used for ICRT. In the present work, the two types of applicators were compared dosimetrically as per the recommendations of the International Commission on Radiation Units and Measurements (ICRU-38) while delivering high dose rate brachytherapy. Twenty four patients who underwent ICRT were considered for this study. Radiographic method was used for treatment planning on Abacus planning system. ICRU-38 recommended parameters were estimated and compared. Flexible geometry applicator showed 8.8% and 16% higher bladder and rectum point doses as compared to the fixed geometry one but the difference was statistically not significant. The thickness of the pear-shaped isodose volume was larger for the flexible geometry implant also indicating towards higher doses to OARs. The higher bladder and rectum point doses in the case of flexible applicator will need to be validated by a larger data set.

Pseudo Central-Catheter Method for Asymmetrical Vaginal Prescription with Multi-Channel Cylindrical Applicators in Image-Guided High Dose-Rate Brachytherapy

Multi-channel cylindrical applicators for high dose-rate (HDR) brachytherapy are utilized mainly for special gynecology cases often involving image-guidance high dose-rate (IG-HDR or IGBT) brachytherapy. In these cases, doses are prescribed to partial vaginal wall/depth where the disease is indicated by an MRI study scanned on the same day. These novel IG-HDR procedures are logistical challenges comparing to typical HDR out-patient treatments due to the complexity of planning for asymmetrical prescriptions as well as the extension of the whole procedure. Indeed the main advantages of HDR over LDR brachytherapy would be significantly weaken unless the IG-HDR procedures become more efficient in time, thus timely treatment planning becomes crucial. Based on our clinical experience, we propose the pseudo central-catheter method to reduce errors, to minimize uncertainty and to ensure efficiency. In this method, the central hollow path of the multi-channel cylindrical applicator is digitized into a pseudo catheter similar to other active catheters, and the asymmetrical prescription points could be generated corresponding to the pseudo dwelling points in the pseudo central-catheter. The pseudo dwelling points are later deleted after generating the prescription point arrays. This method is robust with minimal chance of errors or uncertainties, and demonstrates high efficiency with much less chance of uncertainty, which is significant for IG-HDR brachytherapy procedures utilizing multi-channel applicators.

Analysis of 80 Cases of Nasopharyngeal Carcinoma Treated by Intracavitary Brachytherapy Using A New-Type Applicator

OBJECTIVE To evaluate the results and complications associated with nasopharyngeal carcinoma （NPC） treated with combined external-beam radiotherapy （EBR） and intracavitary brachytherapy （IB） using a new-type applicator. METHODS Eighty patients with untreated NPC were divided into two groups based on therapy methods. An experimental group was treated with EBR plus IB and a control group was treated only with EBR. IB was given to the patients of the experimental group when the external radiotherapy dose amounted to more than 60～65 Gy. The total dose of IB was 6～20 Gy and the total dose of EBR of the control group was 70～75 Gy. RESULTS Follow-up was conducted for 97.5% of the patients with re- suits as follows： the overall response rates （ORR） for the experimental and the control groups were 92.5% and 75.3% respectively （P〈0.05）; the 3 and 5-year survival rates for the experimental group were 87.5% and 74.2% and for the control group, 65.0% and 55.6% （P〈0.05）; for the experimental group, the 3 and 5-year disease-free survival rates were 72.5% and 64.5% and for the control group, 60.0% and 52.8% （P〉0.05）.Some complications following radiotherapy showed a significant difference. CONCLUSION External irradiation plus intracavitary brachytherapy using a new-type applicator may improve the ORR and survival rates, reduce radiation complications and increase the quality of life.

Comparison of Three Single-Nozzle Operator-Carried Spray Applicators for Whitefly (<i>Bemisia tabaci</i>) Management on Squash

Whiteflies cause problems in vegetable production on a global scale. The primary worldwide whitefly pest is Bemisia tabaci (Gennadius). Insecticides are commonly used to mitigate the whitefly problem in vegetable crops. In limited-resource crop production, operator-carried spray applicators are commonly used for pesticide treatments. Three single-nozzle operator-carried spray applicators were assessed for their efficacies for whitefly (B. tabaci) control on summer squash (Cucurbita pepo L.) in Egypt. Each knapsack spray equipment was evaluated with five biorational and conventional insecticides. Counts of whitefly nymphs (first, second, third and fourth instars) on leaf samples were taken on 3, 9, 15 and 21 days after treatments with the insecticides. Nymphal mortality varied about 10% among the three spray equipment treatments. The Economy Micro Ulva sprayer resulted in significantly more nymphal mortality as compared with the Arimitsu sprayer and the CZP-3 sprayer, respectively. All insecticides greatly suppressed the whitefly populations;mean mortality ranged from 73% to 95% for all nymphs combined by day for a given treatment. These results provide pest management practitioners with performance assessment of the three operator-carried pesticide applicators for whitefly management with selected foliar insecticides.

Active substance applicator to remove the disturbances in the fluid flow

The paper presents the construction of an automatic applicator of active substance that removes causes of the disturbances in the fluid flow in a system that is under the control. In a particular case, it can be applied to the removal of disturbances in the blood flow in vessels caused by a thrombus formation (e.g. post-operative or due to dialysis treatment). The presented applicator automatically releases the active substance into the system while detecting in real time the abnormal fluid flow. It allows mixing the active substance (e.g. anticoagulant drug) with the controlled medium outside the substance container (e.g. serum) while offering the possibility of the repeated usage.

Design and Development of a Prilled Urea Applicator

A prilled urea applicator was designed and developed to increase fertilizer use efficiency. The developed applicator’s aims to place Urea continuously at the subsurface of soil between two rows of plants. A line-to-line distance of 20 cm, depth of prilled urea placement of 5 - 7 cm, and field operating condition at 1 - 1.5 cm standing water (for softening the field) was the designed hypothesis. At the laboratory and farm level, test the developed applicator. The applicator consists of a rectangular frame, two skids and furrow opener, two cylindrical hoppers, and a drive wheel connected with a metering device. The designed applicator was fabricated using PVC, except the push handled (mild steel). The metering device consists of twelve spikes and is made of a metallic plate to apply the Urea uniformly. The applicator has a furrow opener and closer options. The effective field capacity was 0.13 ha/h with a speed of 1.22 km/h and field efficiency of 98%. Due to the continuous falling mechanism, there is no missing option but found the over-falling urea for both hoppers was found 5.35%. The average depth of urea placement was 6.38 cm. The machine was user-friendly to push, and the mean pushing force was 63.89 N. The weight of the applicator was 9 kg. So, it is natural to carry from one field to another field. The applicator is also convenient to handle, operate and manage.

MICROSTRIP APPLICATOR FOR TREATMENT OF PROSTATITIS AND HYPERTROPHY OF PROSTATE VIA RECTUM

The paper introduces a microstrip applicator for treatment or prostatitisand kypertrophy or prostate via rectum. The principle or the applicator, the theoreticalcalculation or near field distribution of the applicator covered with a lossy dielectric, theperformance or the impedance matching and the heating pattern or the applicator andthe clinical results are reported.

MICROSTRIP APPLICATOR FOR TREATMENT OF CERVICAL EROSION AND CERVICAL CONDYLOMA ACUMINATUM

This Paper introduces a microstrip applicator for treatment of cervical erosion and cervical condyloma acuminatum with microwave tissue coagulationmethod. The principle of the applicator,the theoretical calculation of near field distribution of the applicator covered with a lossy dielectric, the experimental resultsfor its performance of the impedance matching and for microwave leakage energyare reported. Finally,the therapeutic method and effects are presented.

Structural design and parameter determination for fluted-roller fertilizer applicator

The instability of the motion layer of fertilizer particle influences the precision and the accuracy of the amount of fertilizer application in the working process of fluted-roller fertilizer applicator.The characteristics of the motion layer were investigated,and a systematic scheme was proposed for designing the structures of fertilizer-filling cavity,fertilizer-filling surface and fertilizer-delivery cavity.The key parameters of the structure were studied by discrete element method.It was figured out that to ensure the smooth operation of fertilizer applicator,the fertilizer-filling angle was 105°,fertilizer-contact angle should be large than 100°,and the fertilizer-resistance angle should be smaller than 35°.Moreover,the stability of fertilizer motion morphology was investigated to verify the design.The results showed that when the roll rotational speed was larger than 120 deg/s,compared with the conventional design the CV of the amount of fertilizer application was reduced from 1.5%-3.5%to 0.5%-1.0%,and the accuracy of the fertilizer discharge was improved with the square of the correlation coefficient between the amount of fertilizer application and the roll rotational speed was larger than 0.999.It was deduced from the results that the precision and accuracy of the amount of fertilizer application are improved via eliminating the driving layer and enhancing the stable filling and conveying of the forced layer.

Development of a variable rate applicator for uniform fertilizer spreading

Environmental impact and economic concerns have driven a variable rate technology(VRT).Spinner spreaders were mainly used for granular fertilizer application since they are simple in design,inexpensive,and can cover large areas.However,the spreader was not adequate for VRT because uniformity changes drastically while varying application rates.Thus,the purpose of this study was to develop a variable rate applicator with uniform spreading patterns.A commercial spreader was modified with a controller and electric actuators for controlling fertilizer discharge directions and amounts.Database was established to determine the optimum discharge direction according to the fertilizer application amount.The uniformity of spreading patterns in accordance with the spread amount per set unit area was evaluated by the statistical coefficient of variation(CV)lower than 15%is assumed to prevent damage to the crop.Test results showed that CVs were 8%,9%,and 8%,respectively,for a tractor in race track mode(adjacent passes in same direction of travel)at 200 kg/hm^(2),300 kg/hm^(2),and 400 kg/hm^(2).This indicates that the fertilizer was spread uniformly,while the coefficient of variation was 12%at 200 kg/hm^(2) in back and forth mode(adjacent passes in the opposite direction of travel).Overall,the results suggest that the race track mode is suitable for operation of a tractor to ensure uniform spreading of fertilizer when applying at variable rates.The future goal is to establish a system for automatic variable rate application according to location in connection with soil analysis and geographic information systems.

Outcomes of intermediate-risk to high-risk stage I endometrial cancer: 10-year clinical experiences of using in-house multi-channel applicators in a single center

Background: There are only very few reports on clinical outcomes using multi-channel applicators (MCA) for patients with endometrial cancer (EC) in China. We aimed to evaluate the clinical experience of treating intermediate-risk (IR) to high-risk (HR) stage I EC using in-house made multi-channel applicators (IH-MCA) in a single institution. Methods: Three hundred and ninety patients with stage I IR to HR EC were treated with hysterectomy and adjuvant radiotherapy from 2003 to 2015. All patients received post-operative vaginal cuff brachytherapy (VBT) alone or as a boost after external beam radiotherapy (EBRT). The prescriptions were 500 cGy per fraction for a total of 5 to 6 fractions with brachytherapy alone or 400 to 600 cGy per fraction for 2 to 3 fractions if it was combined with EBRT. Two types of applicators including a traditional rigid IH-MCA and a recent model custom-made with 3 dimension printing technology were used for treatment. The Kaplan-Meier method was used to calculate survival rate. Results: Follow-up rate was 92.8% and the median follow-up time was 48 months (range 4–172 months). The 5-year overall survival (OS), progression-free survival, local recurrence, and distant metastasis rates for all patients were 96.3%, 92.1%, 2.9%, and 4.8% respectively. Two patients had isolated relapse in vagina outside the irradiated volume. The univariate and multivariate analysis showed that age and grade were the prognostic factors correlated with OS (hazard ratio: 0.368, 95% confidence interval [CI]: 0.131–1.035, P = 0.048;hazard ratio: 0.576, 95% CI: 0.347–0.958, P = 0.026,). Conclusions: For patients with IR to HR stage I EC, adjuvant VBT alone or in combination with EBRT using IH-MCA led to excellent survival and recurrence rates. Age and grade were the prognostic factors correlated with OS.

Advances in ethnopharmacology,phytochemistry and pharmacology of Erigerontis Herba and its Chinese medicine prescriptions

Erigerontis Herba(EH),the dried whole plant of Erigeron breviscapus,is well-known for circulating blood,activating meridians to alleviate pain,expelling wind,and clearing away cold.It has been extensively utilized in southern China for the treatment of stroke hemiplegia,chest stuffiness and pains,rheumatic arthralgia,headache,and toothache.This review focuses on the botany,ethnopharmacology,phytochemistry,pharmacology and toxicity of EH and its related prescriptions to offer new insights for prospective research of EH.Relevant information about EH was retrieved from ancient records and books,PubMed,China National Knowledge Infrastructure,Chinese Pharmacopoeia,Web of Science,Doctoral and Master’s Theses,and various electronic databases.EH is a member of Compositae family and is mainly grown in southern China.Traditional Chinese medicine records that EH has the effects of circulating blood and removing blood stasis,expelling wind,and removing cold,as well as relieving rigidity of muscle and relieving pain.By now,nearly 200 ingredients have been characterized from EH,including flavonoids,caffeoyls,aromatic acids,coumarins,pentacyclic terpenoids,volatile oil and other compounds.EH extracts,EH related prescriptions(Dengzhan Xixin injection,Dengzhan Shengmai capsules,etc.)or compounds(scutellarin,scutellarein,etc.)possessed obvious therapeutic effects of ischemic stroke,cerebral hemorrhage,myocardial infarction,Alzheimer’s disease,diabetes and its complications,gastric cancer,bone,and joint degenerative diseases.Scutellarin,the major active compound of EH,has been used as a quality marker.And no obvious toxicity of EH has been reported.According to its traditional applications,ethnopharmacology,phytochemistry,pharmacology,and toxicity,EH was applied as a valuable herb for clinical application in food and medicine fields.While several compounds have been shown to possess diverse biological activities,the underlying mechanisms of their actions remain elusive.To fully exploit the medicinal potential of EH,further studies on understanding the effective material basis and mechanisms are warranted.

Design and experimental study of the fertilizer applicator with vertical spiral fluted rollers

To improve the uniformity and accuracy of fertilizing amount for fertilizer applicators with spiral fluted roller,this paper experimentally studied the influence of major structural parameters on the fertilizing performance.Through two sets of orthogonal tests,it is found that the helix angle and installation angle of spiral fluted rollers are the main factors,which affect the uniformity of fertilizer discharge and the linear relationship between fertilizing amount and opening,respectively.Based on these findings,the experiment and analysis were carried out to determine the optimal helix angle and installation angle for the spiral fluted roller The experimental results of fertilizing performance show that:when the helix angle is 45°,it able to achieve satisfactory uniformity of fertilizer discharge and linear relationship between fertilizing amount and rotational speed;when the installation angle is 40°,it enhances the accuracy of fertilizer discharge with good linear relationship between fertilizing amount and opening.Compared with the fertilizing performance of traditional fertilizer applicators with horizontally installed straight fluted roller,in the aspect of uniformity,the optimized fertilizer applicators reduce the variation coefficient of fertilizing amount within 0.2 s at low speed(10-30 r/min)from 5.1%-52.5%to 4.2%-14.7%;in the aspect of accuracy;and increase the correlation coefficient square R2 between fertilizing amount and opening from 0.93-0.97 to no less than 0.996,and the regression intercept in the fitting equation is reduced from larger than 10.0 to less than 1.0.

Remnant fertilizer monitoring system for maize fertilizer applicators

A remnant fertilizer monitoring system utilizing three-dimensional(3D)reconstruction was proposed to detect the amount of remaining fertilizer in the applicator’s tank.Bench tests were carried out to compare the performance of four algorithms to estimate the remnant fertilizer amount:fertilizer remnant monitoring biharmonic spline algorithm(V4),natural nearest-neighbor algorithm(Natural),linear algorithm(Linear),cubic algorithm(Cubic).The average relative error for remnant fertilizer monitoring is 7.33%for the Linear algorithm,7.30%for the Natural algorithm,5.18%for the Cubic algorithm,and 4.30%for the V4 algorithm.Field tests are conducted at three fertilization rates to compare the performances of the V4 and Cubic algorithms.The average relative error for discharged fertilizer monitoring is 8.64%for the Cubic algorithm,which is 1.91%lower than that of the V4 algorithm.The results show that the Cubic algorithm has the best performance for remnant fertilizer monitoring.The average relative error of remnant fertilizer monitoring is 2.42%for the Cubic algorithm,which is 0.43%lower than that of the V4 algorithm.The response time of the remnant fertilizer monitoring system is 0.26 s.The results demonstrate that the proposed remnant fertilizer monitoring system is highly accurate and suitable for real-time applications.

The evolution of robotics:research and application progress of dental implant robotic systems

The use of robots to augment human capabilities and assist in work has long been an aspiration.Robotics has been developing since the 1960s when the first industrial robot was introduced.As technology has advanced,robotic-assisted surgery has shown numerous advantages,including more precision,efficiency,minimal invasiveness,and safety than is possible with conventional techniques,which are research hotspots and cutting-edge trends.This article reviewed the history of medical robot development and seminal research papers about current research progress.Taking the autonomous dental implant robotic system as an example,the advantages and prospects of medical robotic systems would be discussed which would provide a reference for future research.

Drilling-based measuring method for the c-φ parameter of rock and its field application

The technology of drilling tests makes it possible to obtain the strength parameter of rock accurately in situ. In this paper, a new rock cutting analysis model that considers the influence of the rock crushing zone(RCZ) is built. The formula for an ultimate cutting force is established based on the limit equilibrium principle. The relationship between digital drilling parameters(DDP) and the c-φ parameter(DDP-cφ formula, where c refers to the cohesion and φ refers to the internal friction angle) is derived, and the response of drilling parameters and cutting ratio to the strength parameters is analyzed. The drillingbased measuring method for the c-φ parameter of rock is constructed. The laboratory verification test is then completed, and the difference in results between the drilling test and the compression test is less than 6%. On this basis, in-situ rock drilling tests in a traffic tunnel and a coal mine roadway are carried out, and the strength parameters of the surrounding rock are effectively tested. The average difference ratio of the results is less than 11%, which verifies the effectiveness of the proposed method for obtaining the strength parameters based on digital drilling. This study provides methodological support for field testing of rock strength parameters.

先进压缩空气储能系统的基础研究与应用进展

Decarbonization of the electric power sector is essential for sustainable development.Low-carbon generation technologies,such as solar and wind energy,can replace the CO_(2)-emitting energy sources(coal and natural gas plants).As a sustainable engineering practice,long-duration energy storage technologies must be employed to manage imbalances in the variable renewable energy supply and electricity demand.Compressed air energy storage(CAES)is an effective solution for balancing this mismatch and therefore is suitable for use in future electrical systems to achieve a high penetration of renewable energy generation.This study introduces recent progress in CAES,mainly advanced CAES,which is a clean energy technology that eliminates the use of fossil fuels,compared with two commercial CAES plants at Huntorf and McIntosh which are conventional ones utilizing fossil fuels.Advanced CAES include adiabatic CAES,isothermal CAES,liquid air energy storage,supercritical CAES,underwater CAES,and CAES coupled with other technologies.The principles and configurations of these advanced CAES technologies are briefly discussed and a comprehensive review of the state-of-the-art technologies is presented,including theoretical studies,experiments,demonstrations,and applications.The comparison and discussion of these CAES technologies are summarized with a focus on technical maturity,power sizing,storage capacity,operation pressure,round-trip efficiency,efficiency of the components,operation duration,and investment cost.Potential application trends were compiled.This paper presents a comprehensive reference for developing novel CAES systems and makes recommendations for future research and development to facilitate their application in several areas,ranging from fundamentals to applications.

Potential industrial applications of photo/electrocatalysis: Recent progress and future challenges

Nowadays,the rapid development of the social economy inevitably leads to global energy and environmental crisis.For this reason,more and more scholars focus on the development of photocatalysis and/or electrocatalysis technology for the advantage in the sustainable production of high-value-added products,and the high efficiency in pollutants remediation.Although there is plenty of outstanding research has been put forward continuously,most of them focuses on catalysis performance and reaction mechanisms in laboratory conditions.Realizing industrial application of photo/electrocatalytic processes is still a challenge that needs to be overcome by social demand.In this regard,this review comprehensively summarized several explorations in thefield of photo/electrocatalytic reduction towards potential industrial applications in recent years.Special attention is paid to the successful attempts and the current status of photo/electrocatalytic water splitting,carbon dioxide conversion,resource utilization from waste,etc.,by using advanced reactors.The key problems and challenges of photo/electrocatalysis in future industrial practice are also discussed,and the possible development directions are also pointed out from the industry view.

MXene-Based Elastomer Mimetic StretchableSensors: Design, Properties, and Applications

Flexible sensors based on MXene-polymer composites are highly prospective for next-generation wearable electronics used in human-machine interfaces.One of the motivating factors behind the progress of flexible sensors is the steady arrival of new conductive materials.MXenes,a new family of 2D nanomaterials,have been draw-ing attention since the last decade due to their high electronic conduc-tivity,processability,mechanical robustness and chemical tunability.In this review,we encompass the fabrication of MXene-based polymeric nanocomposites,their structure-property relationship,and applications in the flexible sensor domain.Moreover,our discussion is not only lim-ited to sensor design,their mechanism,and various modes of sensing platform,but also their future perspective and market throughout the world.With our article,we intend to fortify the bond between flexible matrices and MXenes thus promoting the swift advancement of flexible MXene-sensors for wearable technologies.