Independent isomeric yield ratios of fission products in the epi-cadmium neutron induced fission of 233U

The independent isomeric yield ratios (IR) of 128,130,132Sb, 131,133Te, 132,134,136I, 135Xe and 138Cs have been measured in the epi-cadmium neutron induced fission of 233U by using an off-line gamma-ray spectrometric technique. The average neutron energy of the epi-cadmium reactor neutron spectrum is 1.9 MeV. The root mean square fragment angular momenta (JRMS) were deduced from the IR values by using spin dependent statistical model analysis. The IR and JRMS values of considered fission products in the epi-cadmium neutron induced fission of 233U were compared with the literature data in the thermal neutron induced fission of 233U to examine the influence of excitation energy on nuclear structure effect.

Charge distribution studies in the epi-cadmium neutron induced fission of 238Pu

Studies on charge distribution have been carried out in the epi-cadmium neutron induced fission of 238Pu for the first time. Experimentally fractional cumulative yields (FCY) and independent yields (IY) of various fission products have been measured by using an off-line γ-ray spectrometric technique. From the FCY values, the charge distribution parameters such as the isobaric width parameter (σZ), most probable charge (ZP) and the charge polarization (ΔΖEXPT) as a function of fragment mass were obtained. On the other hand, from the measured IY values, isotopic width parameter (σA), the most probable mass (AP) and the elemental yields (YZ) of Sn, Sb, Te, I, Xe, Cs, Ba, La, Ce and Pr were determined by using a non-linear fit. From the YZ values, the proton even-odd effect (δp) was obtained for the first time. The isobaric and isotopic charge distribution parameters in the 238Pu(nf, f) reaction were compared with the similar data in the thermal neutron induced fission of 238Pu and other actinides to examine the role of excitation energy.

Activation cross section for the (n,2n) and (n,p) reactions on 103Rh, 48Ti and 52Cr from reaction threshold up to 25 MeV energy region

Activation and off-line γ-ray spectrometric methods were used to measure the ground and isomeric state (n,2n) reaction cross section for 103Rh at two different neutron energies. The standard 27Al (n,α)24Na reference reaction was used to normalise neutron flux. The proton beam from the 14UD BARC-TIFR Pelletron facility in Mumbai, India, was utilised to create high-energy quasi-monoenergetic neutrons via the 7Li (p,n) reaction. Statistical model calculations including the level density, pre-equilibrium and optical potential model were performed using the TALYS (ver. 1.95) and EMPIRE (ver. 3.2.3) reaction codes. In addition, because of considerable discrepancies in measured data, the literature (n,p) reaction cross section of 52Cr and 48Ti targets were examined theoretically in the present work. The measured cross sections are discussed and compared with the latest evaluated data of the FENDL-3.2b, CENDL-3.2, TENDL-2019, JENDL-5.0, and ENDF/B-VIII.0 libraries, and experimental data based on the EXFOR compilation. The theoretical investigation of the (n,2n) reaction cross section was performed for the ground and isomeric state for the first time from reaction threshold to 25 MeV energies. The experimental data corresponding to the ground, isomeric state and isomeric ratio were reproduced consistently by the theoretical calculations. The present experimental results are good with certain literature data and theoretical values.

Clinical Profile and Treatment Outcomes of Patients with Malaria Complicated by Acute Kidney Injury

As Odisha is an endemic region for malaria with many acute kidney injury (AKI) cases, this study evaluated the clinical profile and treatment outcomes of patients with malaria complicated by AKI. This prospective observational study was conducted between December 2015 and September 2017. Detailed histories and clinical examinations were recorded. On admission, tests for routine hematology, plasma glucose, liver function, renal function, serum electrolytes, thick smears, thin smears, and malarial parasites were performed. Of the 958 AKI malarial patients admitted, 202 (82.6 % males) were included in the study, with a mean age of 38.37 years. In total, 86.14%, 3.46%, and 10.39% of patients had Plasmodium falciparum, Plasmodium vivax, and mixed malaria, respectively. Headache and decreased urination (83.66% each) were the most common symptoms after fever (100%). Anuria and oliguria were reported in 5.95% and 67.82% of patients, respectively, whereas 26.23% reported a urine output of >400 mL/24 h. All patients had raised serum creatinine and urea levels, and >60% had anemia, proteinuria, and/or hyponatremia. Multiple organ dysfunction syndrome was observed in 62.87% of patients. Acute tubular necrosis was seen in 60% of renal biopsy specimens (n = 15). Of the 75.75% of patients requiring dialysis, 82.12% and 17.88% of patients required hemodialysis and peritoneal dialysis, respectively, during which 11 patients died. AKI, a serious complication of P. falciparum or P. vivax malaria, is a life-threatening condition. Fever, anemia, oligo/anuria, hepatic involvement, cerebral malaria, high serum creatinine and urea, and disseminated intravascular coagulation were the main predictors of mortality in our study.

Erythropoietic protoporphyria: time to prodrome, the warning signal to exit sun exposure without pain-a patient-reported outcome efficacy measure

PURPOSE

Patients with erythropoietic protoporphyria (EPP), a severe painful photodermatosis, experience prodromal sensations when exposed to sunlight, which are the "warning signals" to exit the sun, as prolonged exposure causes an excruciatingly painful phototoxic attack. The unique prodromal cutaneous sensations are reversible and differ from the severe burning pain attack lasting 2-7 days. Previously, afamelanotide treatment was studied using time to pain or time outside as primary outcome measures. Since patients have an ingrained fear of sunlight, these measures did not capture the full treatment effect. We retrospectively characterized and evaluated time to prodrome (TTP) as a safer, patient-reported outcome (PRO) measure in afamelanotide-treated patients.

METHODS

Structured interviews recorded TTP before and during afamelanotide treatment in retrospective US and Dutch cohort studies.

RESULTS

Thirty-one US and 58 Dutch EPP patients participated. Before afamelanotide treatment, 54.8% US and 39.7% Dutch patients reported TTP onset <10 minutes in direct sunlight. In both studies, patients' TTP's were significantly longer during afamelanotide treatment (p < 0.0001). All US patients' TTP increased; no TTP was <10 minutes. Among Dutch patients 81% improved; only 10.3% reported TTPs < 10 minutes.

CONCLUSION

EPP patients reported substantial improvements in TTP during afamelanotide treatment. TTP could provide a safer, PRO-based efficacy endpoint for assessing future EPP treatments.

Combined cancer patient-reported symptom and health utility tool for routine clinical implementation: a real-world comparison of the ESAS and EQ-5D in multiple cancer sites

Background

We assessed whether the presence and severity of common cancer symptoms are associated with the health utility score (hus) generated from the EQ-5D (EuroQol Research Foundation, Rotterdam, Netherlands) in patients with cancer and evaluated whether it is possible pragmatically to integrate routine hus and symptom evaluation in our cancer population.

Methods

Adult outpatients at Princess Margaret Cancer Centre with any cancer were surveyed cross-sectionally using the Edmonton Symptom Assessment System (esas) and the EQ-5D-3L, and results were compared using Spearman correlation coefficients and regression analyses.

Results

Of 764 patients analyzed, 27% had incurable disease. We observed mild-to-moderate correlations between each esas symptom score and the hus (Spearman coefficients: -0.204 to -0.416; p < 0.0001 for each comparison), with the strongest associations being those for pain (R = -0.416), tiredness (R = -0.387), and depression (R =-0.354). Multivariable analyses identified pain and depression as highly associated (both p < 0.0001) and tiredness as associated (p = 0.03) with the hus. The ability of the esas to predict the hus was low, at 0.25. However, by mapping esas pain, anxiety, and depression scores to the corresponding EQ-5D questions, we could derive the hus using partial esas data, with Spearman correlations of 0.83-0.91 in comparisons with direct EQ-5D measurement of the hus.

Conclusions

The hus derived from the EQ-5D-3L is associated with all major cancer symptoms as captured by the esas. The esas scores alone could not predict EQ-5D scores with high accuracy. However, esas-derived questions assessing the same domains as the EQ-5D-3L questions could be mapped to their corresponding EQ-5D questions to generate the hus, with high correlation to the directly measured hus. That finding suggests a potential approach to integrating routine symptom and hus evaluations after confirmatory studies.

Measurement of neutron induced 86Sr(n, 2n)85Sr reaction cross sections at different neutron energies

The cross-sections for ⁸⁶Sr (n, 2n)⁸⁵Sr reaction are measured at neutron energies 19.44 ± 1.02 MeV and 16.81 ± 0.85 MeV wherein there is scarcity of data. The standard neutron activation analysis technique and offline gamma ray spectroscopy have been employed for measurement and analysis of the data. The results are compared with experimental data available in EXFOR database, JEFF-3.3, JENDL-4.0, TENDL-2017 and ENDF/B-VIII.0 evaluated data. The theoretical prediction was incorporated using nuclear modular codes TALYS 1.8 and EMPIRE 3.2.2. A detailed comparative study of experimental results with the theoretical models and various major evaluations has been presented.

Health utility scores from EQ-5D and health-related quality of life in patients with esophageal cancer: a real-world cross-sectional study

Esophageal cancer and its treatment can cause serious morbidity/toxicity. These effects on health-related quality of life (HRQOL) can be measured using disease-specific scales such as FACT-E, generic scales such as EQ-5D-3L, or through symptoms. In a two-year cross-sectional study, we compared HRQOL across esophageal cancer patients treated in an ambulatory clinic and across multiple disease states, among patients with all stages of esophageal cancer. Consenting patients completed FACT-E, EQ-5D, a visual analog scale, and patient reported (PR)-ECOG. Symptom complexes were constructed from FACT-E domains. Responses were categorized by disease state: pre-, during, and post-treatment, surveillance, progression, and palliative chemotherapy. Spearman correlation and multivariable linear regression characterized these associations. In total, 199 patients completed 317 questionnaires. Mean FACT-E and subscale scores dropped from baseline through treatment and recovered during post-treatment surveillance (P < 0.001); EQ-5D health utility scores (HUS) displayed a similar pattern but with smaller differences (P = 0.07), and with evidence of ceiling effect. Among patients with stage II/III esophageal cancer, mean EQ-5D HUS varied across disease states (P < 0.001), along with FACT-E and subscales (P < 0.001). Among patients with advanced disease, there was no significant difference between baseline and on-treatment total scores, but improved esophageal cancer-specific scales were noted (P = 0.003). Strong correlation was observed between EQ-5D and FACT-E (R = 0.73), along with physical and functional subscales. In addition, the association between FACT-E and EQ-5D HUS was maintained in a multivariable model (P < 0.001). We interpret these results to suggest that in a real-world clinic setting, FACT-E, EQ-5D HUS, and symptoms were strongly correlated. Most HRQOL and symptom parameters suggested that patients had worse HRQOL and symptoms during curative therapy, but recovered well afterwards. In contrast, palliative chemotherapy had a neutral to positive impact on HRQOL/symptoms when compared to their baseline pre-treatment state.

Measurement of 232Th and 238U neutron capture cross-sections in the energy range 5-17 MeV

The neutron capture cross sections of ²³²Th and ²³⁸U at the average neutron energies of 5.08 ± 0.17, 8.96 ± 0.77, 12.47 ± 0.83, and 16.63 ± 0.95 MeV have been measured by using the activation technique and off-line γ-ray spectroscopy. The ²³²Th and ²³⁸U were irradiated with neutrons produced from the ⁷Li(p, n) reaction using the proton energies of 7, 11, 15 and 18.8 MeV from the 14UD BARC-TIFR Pelletron facility in Mumbai, India. Detailed covariance analysis was also performed to evaluate the uncertainties in the measured cross-sections. The excitation function of the ²³²Th(n, γ) and ²³⁸U(n, γ) reactions were calculated using the theoretical model code TALYS-1.9. The experimental and theoretical results from the present work were compared with the ENDF/B-VII-1 and JENDL-4.0 nuclear data libraries and were found to be in good agreement.

Neutron capture cross-sections for 159Tb isotope in the energy range of 5 to 17 MeV

The neutron capture cross-sections have been measured for the ¹⁵⁹Tb(n, γ)¹⁶⁰Tb reaction at the spectrum average peak neutron energies of 5.08 ± 0.165, 12.47 ± 0.825, and 16.63 ± 0.95 MeV respectively. The experiment has been carried out using the standard neutron activation technique and off-line γ-ray spectrometry. The present measurement has been done for the energies where very few measured results are available in the data library. The results have been compared with ENDF/B-VII.1 and JENDL-4.0 data libraries. The present results have also been supported by theoretical predictions of nuclear model code TALYS 1.9. Detailed covariance analysis was carried out to find the uncertainty and the correlations among the measured cross-sections.

Spectrum average cross section measurement of 183W (n, p)183Ta and 184W (n, p)184Ta reaction cross section in 252Cf(sf) neutron field

Neutron induced nuclear reactions are of prime importance for both fusion and fission nuclear reactor technology. Present work describes the first time measurement of spectrum average cross section of nuclear reactions ¹⁸³W(n,p)¹⁸³Ta and ¹⁸⁴W(n,p)¹⁸⁴Ta using ²⁵²Cf spontaneous fission neutron source. Standard neutron activation analysis (NAA) technique was used. The neutron spectra were calculated using Monte Carlo N Particle Code (MCNP). The effects of self-shielding and back scattering were taken into account by optimizing the detector modeling. These effects along with efficiency of detector were corrected for volume sample in the actual source-detector geometry. The measured data were compared with the previously measured data available in Exchange Format (EXFOR) data base and evaluated data using EMPIRE - 3.2.2.

Socioeconomic status and lifestyle behaviours in cancer survivors: smoking and physical activity

PURPOSE

Smoking cessation and increased physical activity (pa) have been linked to better outcomes in cancer survivors. We assessed whether socioeconomic factors influence changes in those behaviours after a cancer diagnosis.

METHODS

As part of a cross-sectional study, a diverse group of cancer survivors at the Princess Margaret Cancer Centre (Toronto, ON), completed a questionnaire about past and current lifestyle behaviours and perceptions about the importance of those behaviours with respect to their health. The influence of socioeconomic indicators on smoking status and physical inactivity at 1 year before and after diagnosis were assessed using multivariable logistic regression with adjustment for clinico-demographic factors.

RESULTS

Of 1222 participants, 1192 completed the smoking component. Of those respondents, 15% smoked before diagnosis, and 43% of those smokers continued to smoke after. The proportion of survivors who continued to smoke increased with lower education level (p = 0.03). Of the 1106 participants answering pa questions, 39% reported being physically inactive before diagnosis, of whom 82% remained inactive afterward. Survivors with a lower education level were most likely to remain inactive after diagnosis (p = 0.003). Lower education level, household income, and occupation were associated with the perception that pa had no effect or could worsen fatigue and quality of life (p ≤ 0.0001).

CONCLUSIONS

In cancer survivors, education level was a major modifier of smoking and pa behaviours. Lower socioeconomic status was associated with incorrect perceptions about pa. Targeting at-risk survivors by education level should be evaluated as a strategy in cancer survivorship programs.