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Adaptive ultra-hypofractionated whole-pelvic radiotherapy in high-risk and very high-risk prostate cancer on 1.5-Tesla MR-Linac:Estimated delivered dose and early toxicity results

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Chronic Diseases and Translational Medicine 2024年第1期10卷 51-61页

作者： Linrui Gao Ran Wei Shirui Qin Yuan Tian Wenlong Xia Yongwen Song Shulian Wang Hui Fang Yu Tang Hao Jing Yueping Liu Yuan Tang Shunan Qi Bo Chen Yexiong Li Nianzeng Xing Ningning Lu Department of Radiation Oncology National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina GCP center/Clinical Research center National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina Department of Urology State Key Laboratory of Molecular OncologyNational Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina

Background: Magnetic resonance(MR)-guided ultra-hypofractionated radiotherapy with whole-pelvic irradiation(UHF-WPRT)is a novel approach to radiotherapy for patients with high-risk(HR)and very high-risk(VHR)prostate cancer(Pca).However,the inherent complexity of adaptive UHF-WPRT might inevitably result in longer on-couch time.We aimed to estimate the delivered dose,study the feasibility and safety of adaptive UHF-WPRT on a 1.5-Tesla MR-Linac.Methods: Ten patients with clinical stage T3a-4N0-1M0-1c Pca,who consecutively received UHF-WPRT,were enrolled prospectively.The contours of the target and organ-at-risks on the position verification-MR(PV-MR),beam-on 3D-MR(Bn-MR),and post-MR(after radiotherapy delivery)were derived from the pre-MR data by deformable image registration.The physician then manually adjusted them,and dose recalculation was performed accordingly.GraphPad Prism 9(GraphPad Prism Software Inc.)was utilized for conducting statistical analyses.Results: In total,we collected 188 MR scans(50 pre-MR,50 PV-MR,44 Bn-MR,and 44 post-MR scans).With median 59 min,the mean prostate clinical target volume(CTV)-V_(100%)was 98.59%±2.74%,and the mean pelvic CTVp-V_(100%)relative percentages of all scans was 99.60%±1.18%.The median V29 gy change in the rectal wall was−2%(−18%to 20%).With a median follow-up of 9 months,no patient had acute Common Terminology Criteria for Adverse Events(CTcaE)grade 2 or more severe genitourinary(GU)or gastrointestinal(GI)toxicities(0%).Conclusion: UHF-RT to the prostate and the whole pelvis with concomitant boost to positive nodes using an Adapt-To-Shape(ATS)workflow was technically feasible for patients with HR and VHR Pca,presenting only mild GU and GI toxicities.The estimated target dose during the beam-on phase was clinically acceptable based on the 3D-MR-based dosimetry analysis.Clinical trial registration Chinese Clinical Trial Registry ChiCTR2000033382.

关键词： dosimetry hypofractionation magnetic resonance imaging prostate cancer radiation dose radiotherapy

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Pre-operative visceral adipose tissue radiodensity is a potentially novel prognostic biomarker for early endoscopic post-operative recurrence in Crohn’s disease

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World Journal of Gastrointestinal Surgery 2024年第3期16卷 740-750页

作者： Phillip Gu Shishir Dube Norman Gellada So Yung Choi Susan Win Yoo Jin Lee Shaohong Yang Talin Haritunians Gil Y Melmed Eric A Vasiliauskas Niru Bonthala Gaurav Syal Andres J Yarur David Ziring Shervin Rabizadeh Phillip Fleshner Cindy Kallman Suzanne Devkota Stephan R Targan Dalin Li Dermot PB McGovern Department of Medicine Cedars-Sinai Medical CenterLos AngelesCA 90048United States Department of Imaging Cedars-Sinai Medical CenterLos AngelesCA 90048United States Department of Biostatistics Shared Resource Cedars-Sinai Medical CenterLos AngelesCA 90048United States Department of Internal Medicine Keimyung University School of MedicineDaegu 42601South Korea Department of Medicine University of California at Los AngelesLos AngelesCA 90095United States Department of Medicine University of California at San DiegoSan DiegoCA 92093United States Department of Pediatrics Cedars-Sinai Medical CenterLos AngelesCA 90048United States Department of Surgery Cedars-Sinai Medical CenterLos AngelesCA 90048United States

BACKGROUND Evidence suggests inflammatory mesenteric fat is involved in post-operative recurrence(POR)of Crohn’s disease(CD).However,its prognostic value is INTRODUCTION Crohn’s disease(CD)is a debilitating chronic immune-mediated inflammatory disease(IMID)of the gastrointestinal tract that is increasing in incidence and prevalence globally[1].CD patients often undergo surgery for disease-related complic-ations and/or medically refractory disease.Unfortunately,surgery is not curative,and many patients develop post-operative recurrence(POR)of CD with a significant proportion eventually requiring additional surgeries.With advances in early detection and therapeutics,the contemporary 10-year risk of surgery has improved from 50%to 26%,but the risk of recurrent surgery has remained unchanged at 30%,suggesting a need to improve post-operative management strategies[2].Presently,there are two accepted strategies to mitigate POR,but each have potential limitations.Firstly,patients start early post-operative pharmacologic prophylaxis within 4-6 wk after surgery.This strategy can potentially overtreat a subset of patient who may not develop long-term disease recurrence off therapy.Consequently,these patients are at risk of medication-related adverse events and the direct and indirect costs associated with therapy with little or no benefit[3].The second strategy is performing early colonoscopy within 6-12 months after surgery and escalating therapy based on FOOTNOTES Author contributions:Gu P is the guarantor of the article and was involved in concept and design,data collection,statistical analysis,drafting of manuscript,and final approval of manuscript;Dube S and Choi SY were involved in statistical analysis,drafting of the manuscript,and final approval of manuscript;Gellada N,Win S,Lee YJ and Yang S were involved in the data collection,drafting of the manuscript,and final approval of manuscript;Haritunians T and Li D were involved in data analysis and interpretation,drafting of manuscript and final approval of manuscript;

关键词： Crohn’s disease Surgery Visceral adipose tissue Mesenteric adipose tissue Creeping fat Computed tomography

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A preliminary study on rectal dose reduction associated with hyaluronic acid implantation in brachytherapy for prostate cancer

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Asian Journal of Urology 2024年第2期11卷 286-293页

作者： Tairo Kashihara Yuka Urago Hiroyuki Okamoto Mihiro Takemori Hiroki Nakayama Shohei Mikasa Tetsu Nakaichi Kotaro Iijima Takahito Chiba Junichi Kuwahara Satoshi Nakamura Weishan Chang Yoshiyuki Matsui Hiroshi Igaki Department of Radiation Oncology National Cancer Center Hospital5-1-1 TsukijiChuo-kuTokyoJapan Radiation Safety and Quality Assurance Division National Cancer Center Hospital5-1-1 TsukijiChuo-kuTokyoJapan Department of Radiological Sciences Graduate School of Human Health SciencesTokyo Metropolitan University7-2-10 Higashi-OguArakawa-kuTokyoJapan Department of Radiological Technology National Cancer Center Hospital5-1-1 TsukijiChuo-kuTokyoJapan Department of Urological Oncology National Cancer Center Hospital5-1-1 TsukijiChuo-kuTokyoJapan

Objectives: Hydrogel spacer (HS) was developed to reduce rectal toxicities caused by radiotherapy, but has been reported to cause major adverse events. Our institute has attempted to introduce a hyaluronic acid (HA) as an alternative spacer. This study aimed to compare rectal doses and geometric distributions between the HS and HA implantation in prostate cancer.Methods: HS and HA were inserted in 20 and 18 patients undergoing high-dose brachytherapy, respectively. The rectum spacer volumes injected were 10 mL and 22 mL, respectively. In the treatment planning system, 13.5 gy was administered with common catheter positions. The rectal dose indices were assessed between the spacer groups for dosimetry evaluation. Distances between the prostate and rectum and configurations of the spacers were compared.Results: The mean doses irradiated to 0.1 and 2 mL of the rectum were 10.45 gy and 6.71 gy for HS, and 6.73 gy and 4.90 gy for HA (pcal configuration comparisons revealed that HA has a higher ability to expand the space than HS.Conclusion: The rectal dose reduction ability of HA is significantly greater than that of HS, suggesting its potential as a new spacer.

关键词： Brachytherapy Hyaluronicacid Hydrogel Prostaticneoplasm Radiotherapy

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老年心脏病学杂志:英文版 2023年第8期20卷 555-566页

作者： Alexander Schmitt Kathrin Weidner Jonas Rusnak Marinela Ruka Sascha Egner-Walter Kambis Mashayekhi Péter Tajti Mohamed Ayoub Ibrahim Akin Michael Behnes Tobias Schupp Department of cardiology AngiologyHaemostaseology and Medical Intensive CareUniversity Medical Centre Mannh-eimMedical Faculty MannheimHeidelberg UniversityMannheimGermany European center for AngioScience(EcaS) German Center for Cardiovascular Research(DZHK)partner site Heidelberg/MannheimMannheimGermany Depar-tment of Internal Medicine and cardiology Mediclin Heart Centre LahrLahrGermany gottsegen györgy national ca-rdiovascular center BudapestHungary Division of cardiology and Angiology Heart Center University of Bochum-Bad OeynhausenBad OeynhausenGermany

BACKGROUND As a result of improved and novel treatment strategies,the spectrum of patients with cardiovascular disease is consistently changing.Overall,those patients are typically older and characterized by increased burden with comorbidities.Limited data on the prognostic impact of age in cardiogenic shock(CS)is available.Therefore,this study investigates the prognostic impact of age in patients with CS.METHODS From 2019 to 2021,consecutive patients with CS of any cause were included.The prognostic value of age(i.e.,60-80 years and>80 years)was investigated for 30-day all-cause mortality.Spearman’s correlations,Kaplan-Meier analyses,as well as multivariable Cox proportional regression analyses were performed for statistics.Subsequent risk assessment was performed based on the presence or absence of CS related to acute myocardial infarction(AMI).RESULTS 223 CS patients were included with a median age of 77 years(interquartile range:69-82 years).No significant difference in 30-day all-cause mortality was observed for both age-groups(54.6%vs.63.4%,log-rank P=0.169;HR=1.273,95%CI:0.886-1.831,P=0.192).In contrast,when analyzing subgroups stratified by CS-etiology,AMI-related CS patients of the group>80 years showed an increased risk of 30-day all-cause mortality(78.1%vs.60.0%,log-rank P=0.032;HR=1.635,95%CI:1.000-2.673,P=0.050),which was still evident after multivariable adjustment(HR=2.072,95%CI:1.174-3.656,P=0.012).CONCLUSIONS Age was not associated with 30-day all-cause mortality in patients with CS of mixed etiology.However,increasing age was shown to be a significant predictor of increased mortality-risk in the subgroup of patients presenting with AMI-CS.

关键词： patients etiology mortality

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Long-term outcomes after endoscopic removal of malignant colorectal polyps:Results from a 10-year cohort

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World Journal of Gastrointestinal Endoscopy 2024年第4期16卷 193-205页

作者： Anna Fábián Renáta Bor Béla Vasas Mónika Szűcs Tibor Tóth Zsófia Bősze Kata Judit Szántó Péter Bacsur Anita Bálint Bernadett Farkas Klaudia Farkas Ágnes Milassin Mariann Rutka Tamás Resál Tamás Molnár Zoltán Szepes Department of Internal Medicine University of SzegedSzent-Györgyi Albert Medical SchoolSzeged 6725Hungary Department of Pathology University of SzegedSzent-Györgyi Albert Medical SchoolSzeged 6725Hungary Department of Medical Physics and Medical Informatics University of SzegedSzent-Györgyi Albert Medical SchoolSzeged 6720Hungary USZ Translational Colorectal Research Group Hungarian Centre of Excellence for Molecular MedicineSzeged 6725Hungary

BACKGROUND Choosing an optimal post-polypectomy management strategy of malignant colorectal polyps is challenging,and evidence regarding a surveillance-only strategy is limited.AIM To evaluate long-term outcomes after endoscopic removal of malignant colorectal polyps.METHODS A single-center retrospective cohort study was conducted to evaluate outcomes after endoscopic removal of malignant colorectal polyps between 2010 and 2020.Residual disease rate and nodal metastases after secondary surgery and local and distant recurrence rate for those with at least 1 year of follow-up were invest-igated.Event rates for categorical variables and means for continuous variables with 95%confidence intervals were calculated,and Fisher’s exact test and Mann-Whitney test were performed.Potential risk factors of adverse outcomes were RESULTS In total,135 lesions(mean size:22.1 mm;location:42%rectal)from 129 patients(mean age:67.7 years;56%male)were enrolled.The proportion of pedunculated and non-pedunculated lesions was similar,with en bloc resection in 82%and 47%of lesions,respectively.Tumor differentiation,distance from resection margins,depth of submucosal invasion,lymphovascular invasion,and budding were reported at 89.6%,45.2%,58.5%,31.9%,and 25.2%,respectively.Residual tumor was found in 10 patients,and nodal metastasis was found in 4 of 41 patients who underwent secondary surgical resection.Univariate analysis identified piecemeal resection as a risk factor for residual malignancy(odds ratio:1.74;P=0.042).At least 1 year of follow-up was available for 117 lesions from 111 patients(mean follow-up period:5.59 years).Overall,54%,30%,30%,11%,and 16%of patients presented at the 1-year,3-year,5-year,7-year,and 9-10-year surveillance examinations.Adverse outcomes occurred in 9.0%(local recurrence and dissemination in 4 patients and 9 patients,respectively),with no difference between patients undergoing secondary surgery and surveillance only.CONCLUSION Reporting of histological features and adherence to surveillance colonoscopy nee

关键词： Malignant colorectal polyps T1 tumor Endoscopic removal Outcomes Long-term Surveillance

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Estimating wheat spike-leaf composite indicator(SLI)dynamics by coupling spectral indices and machine learning

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The Crop Journal 2024年第3期12卷 927-937页

作者： Haiyu Tao Ruiheng Zhou Yining Tang Wanyu Li Xia Yao Tao Cheng Yan Zhu Weixing cao Yongchao Tian national Engineering and Technology center for Information Agriculture Key Laboratory of Crop System Analysis and Decision MakingMinistry of Agriculture and Rural AffairsJiangsu Key Laboratory for Information AgricultureNanjing Agricultural UniversityNanjing 210095JiangsuChina

The contribution of spike photosynthesis to grain yield(gy)has been overlooked in the accurate spectral prediction of yield.Thus,it’s essential to construct and estimate a yield-related phenotypic trait considering spike photosynthesis.Based on field and spectral reflectance data from 19 wheat cultivars under two nitrogen fertilization conditions in two years,our objectives were to(i)construct a yield-related phenotypic trait(spike–leaf composite indicator,SLI)accounting for the contribution of the spike to photosynthesis,(ii)develop a novel spectral index(enhanced triangle vegetation index,ETVI3)sensitive to SLI,and(iii)establish and evaluate SLI estimation models by integrating spectral indices and machine learning algorithms.The results showed that SLI was sensitive to nitrogen fertilizer and wheat cultivar variation as well as a better predictor of yield than the leaf area index.ETVI3 maintained a strong correlation with SLI throughout the growth stage,whereas the correlations of other spectral indices with SLI were poor after spike emergence.Integrating spectral indices and machine learning algorithms improved the estimation accuracy of SLI,with the most accurate estimates of SLI showing coefficient of determination,root mean square error(RMSE),and relative RMSE values of 0.71,0.047,and 26.93%,respectively.These results provide new insights into the role of fruiting organs for the accurate spectral prediction of gy.This high-throughput SLI estimation approach can be applied for wheat yield prediction at whole growth stages and may be assisted with agronomical practices and variety selection.

关键词： Wheat spike photosynthesis Yield-related phenotypic trait Spectral indices Machine learning Estimation

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A new insight into LPSO phase transformation and mechanical properties uniformity of large-scale Mg-Gd-Y-Zn-Zr alloy prepared by multi-pass friction stir processing

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Journal of Magnesium and Alloys 2024年第5期12卷 2041-2056页

作者： Xiaohu Guan Wen Wang Ting Zhang Pai Peng Qiang Liu Peng Han Ke Qiao Jun cai Liqiang Wang Kuaishe Wang School of Metallurgical Engineering National and Local Joint Engineering Research Center for Functional Materials Processing Xi'an University of Architecture and Technology Xi'an Rare Metal Materials Institute Co.Ltd State Key Laboratory of Metal Matrix Composites School of Material Science and Engineering Shanghai Jiao Tong University

A large-scale fine-grained Mg-Gd-Y-Zn-Zr alloy plate with high strength and ductility was successfully prepared by multi-pass friction stir processing(MFSP) technology in this work. The structure of grains and long period stacking ordered(LPSO) phase were characterized,and the mechanical properties uniformity was investigated. Moreover, a quantitative relationship between the microstructure and tensile yield strength was established. The results showed that the grains in the processed zone(PZ) and interfacial zone(IZ) were refined from 50 μm to 3 μm and 4 μm, respectively, and numerous original LPSO phases were broken. In IZ, some block-shaped 18R LPSO phases were transformed into needle-like 14H LPSO phases due to stacking faults and the short-range diffusion of solute atoms. The severe shear deformation in the form of kinetic energy caused profuse stacking fault to be generated and move rapidly, greatly increasing the transformation rate of LPSO phase. After MFSP, the ultimate tensile strength, yield strength and elongation to failure of the large-scale plate were 367 MPa, 305 MPa and 18.0% respectively. Grain refinement and LPSO phase strengthening were the major strengthening mechanisms for the MFSP sample.In particularly, the strength of IZ was comparable to that of PZ because the strength contribution of the 14H LPSO phase offsets the lack of grain refinement strengthening in IZ. This result opposes the widely accepted notion that IZ is a weak region in MFSP-prepared large-scale fine-grained plate.

关键词： Friction stir processing Multi-pass Mg-Gd-Y-Zn-Zr alloy LPSO phase transformation Mechanical properties

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The effect of secondary phase on corrosion behaviors of the titanium–zirconium–molybdenum alloy

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Tungsten 2024年第2期6卷 342-354页

作者： Song-Wei Ge Ping Hu Jie Deng Shi-Lei Li Hai-Rui Xing Jia-Yu Han Xing-Jiang Hua Li Wang Jun-Zhou Yang Bo Jin Wen Zhang Kuai-She Wang School of Metallurgy Engineering Xi’an University of Architecture and TechnologyXi’an 710055China national and Local Joint Engineering Research center for Functional Materials Processing Xi’an University of Architecture and TechnologyXi’an 710055China Western Xinxing Rare and Precious Metals Co. Ltd.Shangluo 726000China Northwest Institute for Non-Ferrous Metal Research Xi’an 710016China

As the range of applications for molybdenum and its alloys has expanded,the corrosive environment for molybdenum alloys has become more demanding.In the past,the content of doping elements has been studied to investigate their infl uence on the corrosion performance of titanium–zirconium–molybdenum(TZM)alloys.In this paper,it is considered that the second phase in the alloy is the main factor aff ecting the corrosion performance of TZM alloys.By comparing the corrosion behavior of molybdenum metal and TZM alloy,the eff ect of the secondary phase on corrosion behaviors of TZM alloy has been investigated.The results show that the second phase reduces the corrosion resistance of the TZM alloy.The potential of the second phase is 73.7 mV higher than that of the Mo matrix,which contributes to the formation of microscopic electric couples.Under the action of microscopic electric couples,pitting corrosion is preferentially formed at the interface between the second phase and the matrix,which accelerates the corrosion of the matrix.This paper provides a theoretical basis for the application of TZM alloys in corrosive environments.

关键词： Secondary phase Electrochemical corrosion Titanium–zirconium–molybdenum(TZM) Galvanic corrosion Corrosion resistance

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Analysis and Optimization of Transient Mode Switching Behavior for Power Split Hybrid Electric Vehicle with Clutch Collaboration

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Automotive Innovation 2024年第1期7卷 150-165页

作者： Dehua Shi Sheng Liu Yujie Shen Shaohua Wang Chaochun Yuan Long Chen Automotive Engineering Research Institute Jiangsu UniversityZhenjiang 212013China Jiangsu Province Engineering Research center of Electric Drive System and Intelligent Control for Alternative Vehicles Zhenjiang 212013China

The power split hybrid electric vehicle(HEV)adopts a power coupling configuration featuring dual planetary gearsets and multiple clutches,enabling diverse operational modes through clutch engagement and disengagement.The multi-clutch configuration usually involves the collaboration of two clutches during the transient mode switching process,thereby substantially elevating control complexity.This study focuses on power split HEVs that integrate multi-clutch mechanisms and investigates how different clutch collaboration manners impact the characteristics of transient mode switching.The powertrain model for the power-split HEV is established utilizing matrix-based methodologies.Through the formulation of clutch torque curves and clutch collaboration models,this research systematically explores the effects of clutch engagement timing and the duration of clutch slipping state on transient mode switching behaviors.Building upon this analysis,an optimization problem for control parameters pertaining to the two collaborative clutches is formulated.The simulated annealing algorithm is employed to optimize these control parameters.Simulation results demonstrate that the clutch collaboration manners have a great influence on the transient mode switching performance.Compared with the pre-calibrated benchmark and the optimal solution derived by the genetic algorithm,the maximal longitudinal jerk and clutch slipping work during the transient mode switching process is reduced obviously with the optimal control parameters derived by the simulated annealing algorithm.The study provides valuable insights for the dynamic coordinated control of the power-split HEVs featuring complex clutch collaboration mechanisms.

关键词： Power split hybrid electric vehicle Transient mode switching Clutch collaboration Simulated annealing Powertrain model

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Isomeric fluorescence sensors for wide range detection of ionizing radiations

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Defence Technology（防务技术） 2024年第4期34卷 247-257页

作者： Jimin Han Tianyu Yang Li Yang Yuanjian Li State Key Laboratory of Explosion Science and Technology of China Beijing Institute of TechnologyBeijing 100081China Chongqing Innovation center Beijing Institute of TechnologyChongqing 401120China

In order to achieve a wider range of ionizing radiations detection,novel fluorescence sensing materials have been developed that utilize the fluorescence enhancement phenomenon caused by the intramolecular photoinduced electron transfer(PET)effect.Two perylene diimide isomers PDI-P and PDI-B were designed and synthesized,and their molecular structures were characterized by high-resolution Fourier transform mass spectrometry(HRMS),nuclear magnetic resonance hydrogen and carbon spectroscopy(~1H and~(13)C NMR).The interaction between ionizing radiation and fluorescent molecules was simulated by HCl titration.The results show that combining PDIs and HCl can improve fluorescence through the retro-PET process.Despite the similarities in chemical structures,the fluorescent enhancement multiple of PDI-B with aromatic amine as electron donor is much higher than that of PDI-P with alkyl amine.In the direct irradiation experiments of ionizing radiation,the emission enhancement multiples of PDI-P and PDI-B are 2.01 and 45.4,respectively.Furthermore,density functional theory(DFT)and time-dependent density functional theory(TDDFT)calculations indicate that the HOMO and HOMO-1 energy ranges of PDI-P and PDI-B are 0.54 e V and 1.13 e V,respectively.A wider energy range has a stronger driving force on electrons,which is conducive to fluorescence quenching.Both femtosecond transient absorption spectroscopy(fs-TAS)and transient fluorescence spectroscopy(TFS)tests show that PDI-B has shorter charge separation lifetime and higher electron transfer rate constant.Although both isomers can significantly reduce LOD during PET process,PDI-B with aromatic amine has a wider detection range of 0.118—240 gy due to its larger emission enhancement,which is a leap of three orders of magnitude.It breaks through the detection range of gamma radiation reported in existing studies,and provides theoretical support for the further study of sensitive and effective new materials for ionizing radiation detection.

关键词： Perylene imide Intramolecular PET Ionizing radiation detection Fluorescence sensor Isomers

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