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Previous studies showed that replacing conventional flattened beams (FF) with flattening filter-free (FFF) beams improves the therapeutic ratio in lung stereotactic body radiation therapy (SBRT), but these findings could have been impacted by dose calculation uncertainties caused by the heterogeneity of the thoracic anatomy and by respiratory motion, which were particularly high for target coverage. In this study, we minimised such uncertainties by calculating doses using high-spatial-resolution Monte Carlo and four-dimensional computed tomography (4DCT) images. We aimed to evaluate more reliably the benefits of using FFF beams for lung SBRT.
Materials and methods:
For a cohort of 15 patients with early-stage lung cancer that we investigated in a previous treatment planning study, we recalculated dose distributions with Monte Carlo using 4DCT images. This included 15 FF and 15 FFF treatment plans.
Compared to Monte Carlo, the treatment planning system (TPS) over-predicted doses in low-dose regions of the planning target volume (PTV). For most patients, replacing FF beams with FFF beams improved target coverage, tumour control, and uncomplicated tumour control probabilities.
Monte Carlo tends to reveal deficiencies in target coverage compared to coverage predicted by the TPS. Our data support previously reported benefits of using FFF beams for lung SBRT.
The aim of this study was to investigate the extent to which lung stereotactic body radiotherapy (SBRT) treatment plans can be improved by replacing conventional flattening filter (FF) beams with flattening filter-free (FFF) beams.
Materials and methods:
We selected 15 patients who had received SBRT with conventional 6-MV photon beams for early-stage lung cancer. We imported the patients’ treatment plans into the Eclipse 13·6 treatment planning system, in which we configured the AAA dose calculation model using representative beam data for a TrueBeam accelerator operated in 6-MV FFF mode. We then created new treatment plans by replacing the conventional FF beams in the original plans with FFF beams.
The FFF plans had better target coverage than the original FF plans did. For the planning target volume, FFF plans significantly improved the D98, D95, D90, homogeneity index and uncomplicated tumour control probability. In most cases, the doses to organs at risk were lower in FFF plans. FFF plans significantly reduced the mean lung dose, V10, V20, V30, and normal tissue complication probability for the total lung and improved the dosimetric indices for the ipsilateral lung. For most patients, FFF beams achieved lower maximum doses to the oesophagus, heart and the spinal cord, and a lower chest wall V30.
Compared with FF beams, FFF beams achieved lower doses to organs at risk, especially the lung, without compromising tumour coverage; in fact, FFF beams improved coverage in most cases. Thus, replacing FF beams with FFF beams can achieve a better therapeutic ratio.
Electric-powered disposable unmanned aerial vehicles (UAVs) have wide applications due to their advantages in terms of long time flight and load capacity. Thus, improving their endurance has become an important task to enhance the performance of these UAVs. To achieve this, we investigated a battery dumping strategy which splits the battery into several packs that are used and dumped in sequence to reduce the dead weight. The Peukert effect is also considered. In this paper, the sensitivity analysis method was employed to analyse the endurance benefits for different battery weight ratios, Peukert constants and capacities, quantitatively. The results show that the endurance benefits are significantly affected by all three parameters. For ideal batteries, the endurance can be improved by 20% and 28% respectively when employing a double-pack or triple-pack battery strategy (for a battery weight ratio of 0.4), but these benefits will fall rapidly if the Peukert constant exceeds 1.0 or the battery weight declines. Besides, the endurance will be 10% longer if the lift coefficient rather than the velocity remains constant after the battery packs are dumped at a Peukert constant of 1.2.
This paper presents the filter design in the student design competition of EuMW 2019. This contest motivates students for the design and implementation of a dual-band bandpass filter able to get outstanding performance, where different implementation technologies, such as microstrip, coplanar, multilayer microstrip, substrate integrated waveguide, and some others can be effectively employed. Filters are evaluated by considering a figure of merit (FoM) defined by the insertion loss level, selectivity, spurious-free response, and size. To this end, three viable dual-band bandpass filters with different feeding technologies, resonators, and design topologies are investigated for the optimal FoM.
To assess the Framingham risk score as a prognostic tool for idiopathic sudden sensorineural hearing loss patients.
Medical records were reviewed for unilateral idiopathic sudden sensorineural hearing loss patients between January 2010 and October 2017. The 10-year risk of developing cardiovascular disease was calculated. Patients were subdivided into groups: group 1 – Framingham risk score of less than 10 per cent (n = 28); group 2 – score of 10 to less than 20 per cent (n = 6); and group 3 – score of 20 per cent or higher (n = 5).
Initial pure tone average and Framingham risk score were not significantly associated (p = 0.32). Thirteen patients in group 1 recovered completely (46.4 per cent), but none in groups 2 and 3 showed complete recovery. Initial pure tone average and Framingham risk score were significantly associated in multivariable linear regression analysis (R2 = 0.36). The regression coefficient was 0.33 (p = 0.003) for initial pure tone average and −0.67 (p = 0.005) for Framingham risk score.
Framingham risk score may be useful in predicting outcomes for idiopathic sudden sensorineural hearing loss patients, as those with a higher score showed poorer hearing recovery.
Tourette's syndrome (TS) is a childhood-onset neuro- psychiatric disorder characterised by multiple motor and vocal tics lasting more than one year. An immune-mediated mechanism involving molecular mimicry has been proposed for PANDAS (Paediatric autoimmune neuropsychiatric disorders associated with streptococcal infection). PANDAS may offer a new way to explore the pathogens of GTS. IL-1Ra86bp,IL-1βexon5 gene Polymorphism and Cognitive Function are studied in 86 Children with Tourette's Syndrome.
In the present study, we genotyped a large multiplex sample of GTS affected children for polymorphisms in IL-1Ra86bp,IL-1βexon5 genes. Associations were tested by the transmission disequilibrium test (TDT). 86 Han Chinese children with GTS were tested using a set of neuropsychological test(Stroop test, trail making test, verbal fluency test, modified Wisconsin Card sorting test) and compared with 51 healthy control group to understand the relationship between cognitive deficits and genetics.
No evidence for transmission disequilibrium was found for polymorphisms of IL-1 Ra86bp,IL-1 βexon5 gene in this GTS sample. The frequency of 410bp/240bp genotype and 240bp allele in combined ADHD were significantly different from GTS alone. Compared with normal children, The GTS group showed impairment on almost all psychological measures. No evidence show significantly difference among IL-1Ra86bp, IL-1βexon5 gene Polymorphism and Cognitive Function.
For the GTS+ADHD group, the 240bp allele of IL-1Ra gene Polymorphism perhaps is another risk factor.GTS patient has memory, attention and executive function defect, these defects may have something to do with the prefrontal dopamine disfunction.
Impaired executive function has been proposed as a trait marker for adult bipolar disorder. However, similar impairments in children bipolar disorder have not been yet documented. Here,we assessed executive function in 21 children and adolescents with bipolar disorder.
21 children and adolescents with bipolar disorder and 21 demographically matched healthy participants completed a standardized WCST test.
The operation result in children with bipolar disorder did not differ from that in controls. Severity of mood symptomatology was not associated with WCST performance in any bipolar subtype.
Findings suggest that executive function in children bipolar disorder are not similar to those seen in the adult form of the illness. Compares with the adult, the children bipolar disorder possibly may have different pathogenesis.
This study aimed to evaluate various associated risks between internet addiction (IA) and Attention deficit/Hyperactivity disorder (ADHD) children and adolescents by comparing ADHD group with and without IA problem.
78 ADHD children and their parents were performed designed general demographic questionnaire and standardized measurement including Chen IA Scale (CIAS), Swanson, Nolan, and Pelham, Version IV ADHD questionnaire (SNAP-IV), Child Behavior Checklist (CBCL), Adult ADHD self Rating Scale (ASRS), Symptom Check List (SCL-90) and were then divided into ADHD with IA or without IA group according to IA cutting point. Various associated risks included the BMI value, general demographic data, subtype, comorbidity, childhood common behavior problem, parental ADHD diagnosis, parental symptom, nail biting, and media exposure problem.
ADHD youth with IA problem was highly associated with overweight and playing computer game more than one hour. Stepwise logistic regression revealed that father of these ADHD children in this group were significantly younger, and children self having withdrawn tendency.
Father's younger age, overweight and withdrawal tendency on ADHD youth is risks associated with internet addiction problem and the presence of playing computer game more than one hour on ADHD child is at greater risk for developing internet addiction.
The presence of comorbid anxiety disorders (AD) and bipolar II disorders (BP-II) compounds disability complicates treatment, worsens prognosis, and has been understudied. The genes involved in metabolizing dopamine and encoding dopamine receptors, such as aldehyde dehydrogenase 2 (ALDH2) and dopamine D2 receptor (DRD2) genes, may be important to the pathogenesis of BP-II comorbid with AD. We aimed to clarify ALDH2 and DRD2 genes for predisposition to BP-II comorbid with and without AD. The sample consisted of 335 subjects BP-II without AD, 127 subjects BP-II with AD and 348 healthy subjects as normal control. The genotypes of the ALDH2 and DRD2 Taq-IA polymorphisms were determined using polymerase chain reactions plus restriction fragment length polymorphism analysis. Logistic regression analysis showed a statistically significant association between DRD2 Taq-I A1/A2 genotype and BP-II with AD (OR = 2.231, P = 0.021). Moreover, a significant interaction of the DRD2 Taq-I A1/A1 and the ALDH2*1*1 genotypes in BP-II without AD was revealed (OR = 5.623, P = 0.001) compared with normal control. Our findings support the hypothesis that a unique genetic distinction between BP-II with and without AD, and suggest a novel association between DRD2 Taq-I A1/A2 genotype and BP-II with AD. Our study also provides further evidence that the ALDH2 and DRD2 genes interact in BP-II, particularly BP-II without AD.
In the Philippines, morbidity control of soil-transmitted helminth (STH) infections is done through mass drug administration (MDA) of anthelmintics to school-age children (SAC). In 2013, the Philippines was devastated by the deadliest cyclone ever recorded, Typhoon Haiyan. The study aimed to understand the impact of Typhoon Haiyan on the MDA of anthelmintics to SAC in the provinces of Capiz and Iloilo in the Philippines from the perspectives of local health and education officials.
The study was conducted in the municipalities of Panay and Pilar in Capiz and the municipalities of Estancia and Sara in Iloilo, areas that were devastated by Typhoon Haiyan. Qualitative, semi-structured key informant interviews were conducted with 16 total participants, which included officials of the Department of Health, Department of Education, and concerned local government units. All interviews were transcribed verbatim and coded in an open, iterative manner. Codes were reviewed to identify patterns and themes.
Participants described the following themes: (1) their perception that the typhoon had no effect on the MDA program or on resources necessary to complete the program; (2) the program’s simple design allowed for 1-time administration to a pre-assembled population; (3) the program allowed a sense of community cohesiveness; (4) the program served as a vehicle for altruism, particularly regarding helping needy children, in this time of calamity.
Our informants perceived that the MDA program in Region VI was not affected by Typhoon Haiyan. They attributed the resilience to the program’s simple procedure, attitudes of altruism, program importance, and community cohesiveness. Despite Typhoon Haiyan’s mass destruction of infrastructure and livelihood leading to incredible challenges, mobilization of the community allowed for the continuation and successful implementation of the MDA program. The experience of Region VI may serve as a model for other low- and middle-income countries prone to natural disasters.
Types of sugar-sweetened beverages (SSB) can differ greatly between countries, with greater consumption of sweetened tea in Asia. This study aimed to understand changes in SSB consumption by adolescents in Taiwan over 18 years and their association with demographic characteristics and clinical outcome. This study used survey data from the 1993–1996 and 2010–2011 Nutrition and Health Surveys in Taiwan. Participants were high school students aged 13 to 18 years. Data were weighted and analysed using SUDAAN 11.0 and SAS 9.4. Participants were asked about intake frequencies of SSB and were grouped into four different SSB intake groups based on the combination of high or low frequency (including moderate frequency) of intake of sweetened tea and soda/sports/energy drinks. Results indicated over 99 % of teens reported having at least one SSB in the past week. Smoking status was significantly associated with SSB intake types with high tea intake (high tea and low soda (HL) group, OR 7·56, P < 0·001; high tea and high soda (HH) group, OR 9·96, P < 0·001). After adjustment for potential confounders, adolescents in the low tea and high soda (LH) group (β = 0·05, P = 0·034) had significantly higher mean serum uric acid values. In conclusion, sugary tea remains the SSB of choice for Taiwanese adolescents. Those with a frequent intake of soda/sports/energy drinks had a higher chance of being hyperuricaemic.
The influence of combined corrosion and vibration to the anti-loosening performance of a precision locknut used in a machine tool is investigated. Firstly, the locknut was submerged in 5% NaCl solution according to ASTM B895 standard for corrosion testing. The locknuts, after submerged in 1-hr, 2-hr and 4-hr periods, respectively, were then installed on the rotating spindle in a vertical dynamic impact tester for performing anti-loosening test. The initial installed pretension was 9800 N and the spindle was rotating in a constant speed of 1000 rpm. Turmogrease Li 802 EP lubricant was used on the contact surface between spindle thread and locknut. The set screws on the locknut were tightened sequentially and evenly in three-stage of torque: 1.96 N-m, 3.92 N-m and 5.88 N-m. Its real-time pretension variation with the periodic transverse impact and its final loosening torque were measured. Accordingly, the axial force ratio and anti-loosening torque ratio were calculated and discussed. It was found that corrosion treatment had similar influence on both the axial force ratio and the anti-loosening torque ratio. More corrosion on the locknut with longer submersion in NaCl solution deteriorated its anti-loosening characteristics. The result could serve as the reference for evaluating the fastening performance of precision locknut and guide the design and manufacturing for the application improvement.
Tracheophilus cymbius (Trematoda: Cyclocoelidae) is a common tracheal fluke of waterfowl, causing serious loss in the poultry industry. However, taxonomic identification of T. cymbius remains controversial and confused. Mitochondrial (mt) genomes can provide genetic markers for the identification of closely related species. We determined the mt genome of T. cymbius and reconstructed phylogenies with other trematodes. The T. cymbius mt genome is 13,760 bp in size, and contains 12 protein-coding genes (cox 1–3, nad 1–6, nad 4L, cyt b and atp 6), 22 transfer RNA (tRNA) genes, two ribosomal RNA genes and one non-coding region. All are transcribed in the same direction. The A + T content is 62.82%. ATG and TAG are the most common initiation and termination codons, respectively. Phylogenetic analyses of concatenated nucleotide sequences show T. cymbius grouping in suborder Echinostomata, and clustering together, with high statistical support, as a sister taxon with Echinochasmus japonicus (Echinochasmidae), the two forming a distinct branch rooted to the ancestor of all Echinostomatidae and Fasciolidae species. This is the first report of the T. cymbius mt genome, and the first reported mt genome within the family Cyclocoelidae. These data will provide a significant resource of molecular markers for studying the taxonomy, population genetics and systematics of trematodes.
Optical properties of infrared-bright (IR-bright) dust-obscured galaxies (DOGs) are reported. DOGs are faint in optical but very bright in mid-IR, which are powered by active star formation (SF) or active galactic nucleus (AGN), or both. The DOGs is a candidate population that are evolving from a gas-rich merger to a quasar. By combining three catalogs of optical (Subaru Hyper Suprime-Cam), near-IR (VIKING), and mid-IR (ALLWISE), we have discovered 571 IR-bright DOGs. Using their spectral energy distributions, we classified the selected DOGs into the SF-dominated DOGs and the AGN-dominated DOGs. We found that the SF-dominated DOGs show a redder optical color than the AGN-dominated DOGs. Interestingly, some DOGs shows extremely blue color in optical (blue-excess DOGs: bluDOGs). A possible origin for this blue excess is either the leaked AGN light or stellar UV light from nuclear starbursts. The BluDOGs may be in the transition phase from obscured AGNs to unobscured AGNs.
Abnormal effort-based decision-making represents a potential mechanism underlying motivational deficits (amotivation) in psychotic disorders. Previous research identified effort allocation impairment in chronic schizophrenia and focused mostly on physical effort modality. No study has investigated cognitive effort allocation in first-episode psychosis (FEP).
Cognitive effort allocation was examined in 40 FEP patients and 44 demographically-matched healthy controls, using Cognitive Effort-Discounting (COGED) paradigm which quantified participants’ willingness to expend cognitive effort in terms of explicit, continuous discounting of monetary rewards based on parametrically-varied cognitive demands (levels N of N-back task). Relationship between reward-discounting and amotivation was investigated. Group differences in reward-magnitude and effort-cost sensitivity, and differential associations of these sensitivity indices with amotivation were explored.
Patients displayed significantly greater reward-discounting than controls. In particular, such discounting was most pronounced in patients with high levels of amotivation even when N-back performance and reward base amount were taken into consideration. Moreover, patients exhibited reduced reward-benefit sensitivity and effort-cost sensitivity relative to controls, and that decreased sensitivity to reward-benefit but not effort-cost was correlated with diminished motivation. Reward-discounting and sensitivity indices were generally unrelated to other symptom dimensions, antipsychotic dose and cognitive deficits.
This study provides the first evidence of cognitive effort-based decision-making impairment in FEP, and indicates that decreased effort expenditure is associated with amotivation. Our findings further suggest that abnormal effort allocation and amotivation might primarily be related to blunted reward valuation. Prospective research is required to clarify the utility of effort-based measures in predicting amotivation and functional outcome in FEP.
Consumption of sugar-sweetened beverages (SSB) by infants and young children are less explored in Asian populations. The Growing Up in Singapore Towards healthy Outcomes cohort study examined associations between SSB intake at 18 months and 5 years of age, with adiposity measures at 6 years of age. We studied Singaporean infants/children with SSB intake assessed by FFQ at 18 months of age (n 555) and 5 years of age (n 767). The median for SSB intakes is 28 (interquartile range 5·5–98) ml at 18 months of age and 111 (interquartile range 57–198) ml at 5 years of age. Association between SSB intake (100 ml/d increments and tertile categories) and adiposity measures (BMI standard deviation scores (sd units), sum of skinfolds (SSF)) and overweight/obesity status were examined using multivariable linear and Poisson regression models, respectively. After adjusting for confounders and additionally for energy intake, SSB intake at age 18 months were not significantly associated with later adiposity measures and overweight/obesity outcomes. In contrast, at age 5 years, SSB intake when modelled as 100 ml/d increments were associated with higher BMI by 0·09 (95 % CI 0·02, 0·16) sd units, higher SSF thickness by 0·68 (95 % CI 0·06, 1·44) mm and increased risk of overweight/obesity by 1·2 (95 % CI 1·07, 1·23) times at age 6 years. Trends were consistent with SSB intake modelled as categorical tertiles. In summary, SSB intake in young childhood is associated with higher risks of adiposity and overweight/obesity. Public health policies working to reduce SSB consumption need to focus on prevention programmes targeted at young children.
Better understanding of interplay among symptoms, cognition and functioning in first-episode psychosis (FEP) is crucial to promoting functional recovery. Network analysis is a promising data-driven approach to elucidating complex interactions among psychopathological variables in psychosis, but has not been applied in FEP.
This study employed network analysis to examine inter-relationships among a wide array of variables encompassing psychopathology, premorbid and onset characteristics, cognition, subjective quality-of-life and psychosocial functioning in 323 adult FEP patients in Hong Kong. Graphical Least Absolute Shrinkage and Selection Operator (LASSO) combined with extended Bayesian information criterion (BIC) model selection was used for network construction. Importance of individual nodes in a generated network was quantified by centrality analyses.
Our results showed that amotivation played the most central role and had the strongest associations with other variables in the network, as indexed by node strength. Amotivation and diminished expression displayed differential relationships with other nodes, supporting the validity of two-factor negative symptom structure. Psychosocial functioning was most strongly connected with amotivation and was weakly linked to several other variables. Within cognitive domain, digit span demonstrated the highest centrality and was connected with most of the other cognitive variables. Exploratory analysis revealed no significant gender differences in network structure and global strength.
Our results suggest the pivotal role of amotivation in psychopathology network of FEP and indicate its critical association with psychosocial functioning. Further research is required to verify the clinical significance of diminished motivation on functional outcome in the early course of psychotic illness.