Haemophilia A (HA), defined by factor VIII (FVIII) levels ≤40 IU/dL, is a chronic condition with consequences beyond bleeding complications. Jan Astermark (Professor of Clinical Coagulation Medicine, Senior Consultant, and Head of Department of Translational Medicine, Lund University; and Department of Haematology, Oncology and Radiation Physics, Skåne University Hospital, Malmö, Sweden) outlined the burden of HA on the quality of life (QoL) of patients, including bleeding, joint damage, pain, psychosocial wellbeing, and physical activity. He shared real-world evidence showing that current prophylactic regimens with FVIII or non-factor therapy (NFT) are not sufficient to eliminate all types of bleeds and that many challenges remain. Astermark presented several analyses highlighting that FVIII levels in the non-haemophilia range may be necessary to prevent residual bleeding. These analyses have informed recent treatment goals that transcend historical targets of converting severe HA (SHA) into moderate or mild forms and aim towards normalised haemostasis to eliminate bleeds. Maria Elisa Mancuso (Senior Consultant in Haematology, Centre for Thrombosis and Haemorrhagic Diseases, IRCCS Humanitas Research Hospital and Humanitas University, Milan, Italy) presented a patient case to illustrate the challenges that people with HA (PwHA) face over their lives and the evolution of treatment strategies to address unmet needs. Christoph Königs (Head of Clinical and Molecular Haemostasis at the Department of Paediatrics and Adolescent Medicine, Clinical and Molecular Haemostasis, Goethe University, University Hospital, Frankfurt, Germany) emphasised the unique challenges faced by children with HA and their caregivers, including restrictions in daily activities, regular evaluations for subclinical and evident bleeds, long-term joint protection, delayed inhibitor development, self-injection skills, and suboptimal adherence. He discussed how standard and extended half-life (SHL, EHL) therapies have improved care in children with HA but highlighted how prophylaxis with existing therapies is not sufficient to eliminate evident and subclinical bleeds. He concluded by sharing data on novel therapies that offer the potential to maintain FVIII levels in the non-haemophilia range (≥40 IU/dL) to help address these unmet needs. Robert Klamroth (Head of the Department of Internal Medicine, Vascular Medicine and Haematology, and Director of Haemophilia Treatment Centre, at Vivantes Klinikum Friedrichshain, Berlin, Germany) focused on the evolving challenges of HA in adulthood, including surgery and the need for anticoagulant or antiplatelet therapy for the management of comorbidities. Recent clinical data were shown to demonstrate how high sustained FVIII levels could minimise bleeding risk and improve joint health, surgical management, and overall QoL in adults with HA. In the panel discussion, two patient cases were reviewed to consider unmet needs in people with mild HA and in elderly people with HA, and the panel summarised how sustaining FVIII levels in the non-haemophilia range could help address these needs. The panel concluded by reviewing the evolution of treatment strategies and the importance of targeting normalised haemostasis in a new era of protection in HA.

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• Pub. Date : 2025
• Page : pp.25-32
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Background: There is a need to develop concrete data in India about the number of people who need to switch to second-line HIV drugs and widespread emergence of drug resistance threatens the sustainability of the national programme. This study was conducted to study on Socio-Demographic and Clinical Profile of Patients on Second Line Anti-Retroviral Therapy Registered at ART Centre in Surat City. Methodology: The present study was a Cross-sectional study conducted at the ART centre of Gujarat, which are providing free second line ART. The study was conducted by pretested semi-structured questionnaire. The information regarding socio-demography and clinical variables, treatment and sexual activity were taken by oral interview of patients. While information regarding laboratory profile, adherence and treatment history were taken from patient treatment cards. Results: Most common reason for switch to second line ART was virological failure (84.2%). Mean duration of first line ART treatment was 30.15 (S.D. 25.350) months. All patients were given ritonavir boosted PI. Majority (66.7%) were given Atazinavir-ritonavir boosted PI and around 30% had history of substitution within second line ART. Conclusion: On the basis of our findings, we conclude that early detection of first-line treatment failure and improve availability/affordability of second-line regimens should become priorities in National Programme. First line ART patients with history of tuberculosis following ART initiation, treatment interruptions, treatment from private facility, belonging to nuclear family and lower social-economic class should be watched for ART failure.

• Book : 15(02)
• Pub. Date : 2025
• Page : pp.164-169
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Purpose: comprehensive search for filtration sites on protective hydraulic structures using sensing techniques. Materials and methods. The results of a long-term study of the hydraulic structure section – a dam, which is a protective obstacle to water leakage from the ash disposal area of Chita TPP-1 are presented. Radiometers with frequencies of 34 and 13 GHz were installed on a ground carrier. As a result, when crossing the reservoir, route records of the radio brightness temperature of the ice cover, characterizing the power of thermal radiation, which recorded the areas of the outlet of water passing through the embankment, were obtained. To confirm the water leakage sites, a geoelectric section along the profile along the dam section, using the Skala-48 electrical prospecting station, was made. Results. Water filtration through this structure was detected using remote sensing techniques of the object. Satellite images in the visible range were analyzed at the initial moment of the reservoir ice cover formation, which is located near the dam, where the warm water leakage in the form of dark areas of ice was recorded. The rest of the water area of the reservoir ice cover is presented as a whitish area of ice in the images. This is due to the freshly fallen snow frozen into the ice cover, which was captured in it at the time of its formation. In addition, studies of the ice cover's own thermal radiation in the microwave range were carried out. Conclusions. The study confirmed the supposed location of water leakage through the dam. Three years after the study with the help of satellite images, it was shown that water leakage in this place ceased. In addition, the area of the water surface of the man-made reservoir near the dam was reduced by 4.1 times over ten years (2013–2024), while the amount of precipitation in the region increased.

• Book : 15(1)
• Pub. Date : 2025
• Page : pp.155-172
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Reduction quality is associated with fracture prognosis. Displaced subcapital femoral neck fracture has highest possibility of avascular necrosis of femoral head and non-union among the femoral neck fractures, which commonly necessitate revisions or hip replacement. This study introduces for the first time of using hip arthroscope to directly visualize and assist the reduction of displaced subcapital femoral neck fracture when closed reduction is unsatisfactory. Due to the minimally invasive advantage of arthroscopic assistance, radiation exposure or intraoperative bleeding can be reduced, open reduction is avoided so that the blood supply of femoral head can be preserved. Through direct visualization, the complete removal of hematoma and fracture debris can be achieved, which is not possible with closed reduction, and can potentially reduce the risk of non-union during bone healing.

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• Pub. Date : 2025
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• Book : ()
• Pub. Date : 2025
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• Book : ()
• Pub. Date : 2025
• Page :
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Goal: This study evaluates the feasibility and outcome of a personalized MRI-based liver SBRT treatment planning platform with the SPION contrast agent Ferumoxytol® (Sandoz Inc.; Princeton, NJ, USA) to maintain a superior real-time visualization of liver tumors and volumes of functional hepatic parenchyma for radiotherapy planning throughout multi-fractionated liver SBRT with online plan adaptations on an Elekta Unity 1.5 T MR-Linac (Elekta; Stockholm, Sweden). Materials and Methods: Patients underwent SPION-enhanced MRI on the Elekta Unity MR-Linac for improved tumor and functional hepatic parenchyma visualization. An automated contouring algorithm was applied for the delineation and subsequent guided avoidance of functional liver parenchyma volumes (FLVs) on the SPION-enhanced MR-Linac. Radiation dose constraints were adapted exclusively to FLV. Local control, toxicity, and survival were assessed with at least 6-month radiographic follow-up. Pre- and post-transplant outcomes were analyzed in the subset of patients with HCC and hepatic cirrhosis who completed SBRT as a bridge to liver transplant. Model of End-Stage Liver Disease (MELD-Na) was used to score hepatic function before and after SBRT. Results: With a median follow-up of 23 months (range: 3–40 months), 23 HCC patients (26 lesions treated) and 9 patients (14 lesions treated) with hepatic metastases received SBRT (mean dose: 48 Gy, range: 36–54 Gy) in 1–5 fractions. Nearly all patients in this study had pe-existing liver conditions, including hepatic cirrhosis (23), prior TACE (7), prior SBRT (18), or history of hepatic resection (2). Compared to the non-contrast images, SPIONs improved tumor visibility on post-SPION images on the background of negatively enhancing functionally active hepatic parenchyma. Prolonged SPION-contrast retention within hepatic parenchyma enabled per-fraction treatment adaptation throughout the entire multi-fraction treatment course. FLV loss (53%, p < 0.0001) was observed in cirrhotic patients, but functional and anatomic liver volumes remained consistent in non-cirrhotic patients. Mean dose to FLV was maintained within the liver threshold tolerance to radiation in all patients after the optimization of Step-and-Shoot Intensity-Modulated Radiotherapy (SS-IMRT) on the SPION-enhanced MRI-Linac. No radiation-induced liver disease was observed within 6 months post-SBRT, and the MELD-Na score in cirrhotic patients was not significantly elevated at 3-month intervals after SBRT completion. Conclusions: SPION Ferumoxytol® administered intravenously as an alternative MRI contrast agent on the day of SBRT planning produces a long-lasting contrast effect between tumors and functional hepatic parenchyma for precision targeting and guided avoidance during the entire course of liver SBRT, enabling fast and accurate online plan adaptation on the 1.5 T Elekta Unity MR-Linac. This approach demonstrates a safe and effective bridging therapy for patients with hepatic cirrhosis, leading to low toxicity and favorable transplant outcomes.

• Book : 17(7)
• Pub. Date : 2025
• Page : pp.1088-1088
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Ion-exchange resins (IERs) are used for the decontamination of effluents from chemical impurities and radioisotopes in the primary and secondary cooling circuits of pressured water reactors. Cementation in OPC matrices (CA, cement and fly ash) has been the preferred alternative for the conditioning of spent IERs (SIERs). Due to the progressive supply shortage of ash in the international market, the technical feasibility of other alternative cementitious formulations (CAS, cement, ash and slag, and CS, cement and slag) to confine this waste has been assessed. In this study, aspects such as the maximum waste loading, physic-chemical characteristics of the wasteforms, or their radionuclide retention capacity were evaluated. The maximum SIERs surrogates admitted for each formulation was 7.5 % wt./wt. resin/binder (12 % volume). For all wasteforms, boron released from SIERs surrogates seemed to interact with calcium compounds of the raw materials, retarding the reaction kinetics and setting, especially in the CS sample, and delaying the formation of the gel and the portlandite. No formation of boron compound but substitution of silicon tetrahedral by boron tetrahedral in the gel structure. CAS wasteforms sample with immobilised resin, independently of the SIERs surrogates content, exhibited an improved performance compared to the CA formulation currently in use.

• Book : 57(5)
• Pub. Date : 2025
• Page : pp.1-42
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This article is written as a continuation of the previous issues by the theme “Focal zone model”. Work carried out in a frame of investigation directed to elaboration of automated determination of the core events depth. As a base tool, a modified algorithm of location was used, supplemented with the simplex method of minimization. Early studies showed that the method built on the basis of an over determined mathematical task solution, that determined a point, doesn’t take into account the main aspect – the effect bias to the environment determined by volume and distribution of movements inside the focal zone. Criteria of received solution is minimum of Root Mean Square residuals (RMS). In solution of the formulated task depth phases pP were used. The detailed investigation showed that it is possible to consider that radiation from source of P waves is a continuation on initial stage of a source activity. The same can be said for pP phases registration. This give us the ability to construct an algorithm using the maximum of the seismic energy radiation as a criterion of the final solutions.

• Book : 7(1)
• Pub. Date : 2025
• Page : pp.58-73
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In-situ radiation monitoring is important in evaluating nuclear incidents, facilitating the prevention and management of accidents. Conventional in-situ detectors comprise a single detection module. However, the limited geometric adaptability of single-detector systems renders the surveillance of contaminated regions at inaccessible sites or with unconventional shapes challenging. Moreover, the narrow detection area of the conventional detectors necessitates repeated measurements to encompass accident sites comprehensively. This study introduces a transformable in-situ gamma monitoring (TRIGAM) system for 1D and 2D scanning and high-resolution imaging. The TRIGAM system incorporates eight detectors, each linked to an extendable and rotatable arm, enabling the modification of the system's shape through adjustments in the distance and angles between detectors to suit specific user applications. Compared to single-detector systems, the TRIGAM system enables faster monitoring over large areas and enhanced sensitivity at sites with unconventional geometries by adjusting geometric configuration. Moreover, TRIGAM enables 2D imaging with 5.72 degrees image resolution using Compton camera technique imaging. For source localization in 3D imaging, 8 % and 12 % position error was observed with a source distance of 1 m and 5 m when using 3D imaging and triangulation technique, respectively. In summary, the TRIGAM offers a highly adaptable solution for in-situ radiation monitoring.

• Book : 57(6)
• Pub. Date : 2025
• Page :
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