Individual Radiation Research Articles

Theranostics: Timing is Everything.

On stage, and in real life, timing is critical for success. Theranostic cancer care epitomizes the central role of timing in the evolution of efficacious molecular targeted radioligand therapy and its incorporation into routine clinical practice of oncology. Nuclear medicine has returned to its therapeutic roots, having been founded as a medical specialty, over three-quarters of a century ago, with radioiodine therapy of thyroid cancer. The very recent oncologist acceptance of 68Ga/177Lu/225Ac-PSMA effectiveness in treating prostate cancer has re-established the role of the physician in nuclear medicine. This article addresses various important issues in respect of timing related to this resurgence. Training of the required new workforce in technical -omics expertise and physicianly virtues is an urgent priority. Precision in radioligand therapy requires definition of individual radiation absorbed dose (Gy) to tumor and to critical normal organs, preferably prospectively. It is time to abandon one-size-fits-all administration of fixed activities (GBq) in arbitrary cycle intervals and duration. The time has also come to design combination sequenced theranostic-immuno-chemotherapeutic approaches to metastatic cancer to address unmet needs, particularly in pancreatic carcinoma; exploiting the potential of new fibroblast activation protein inhibitor radioligands targeting the tumor microenvironment. Public perception of all things "nuclear," including nuclear medicine, has recently recovered from the general opprobrium and radiophobia of the last half-century. Nuclear is the new green. At last, there have arisen propitious circumstances for the future development of theranostics: The timing is right, now.

Personal history of irradiation and risk of breast cancer: A Mendelian randomisation study.

Studies on the relationship between personal history of irradiation and breast cancer have been reported for a long time. Still, epidemiological studies have not been conclusive, and the causal relationship is unclear. To address this issue, we employed Mendelian randomisation (MR) analysis to examine the association between individual radiation exposure history and breast cancer. We used a series of quality control methods to select single nucleotide polymorphism (SNP) closely related to exposure. Meanwhile, several analysis methods were used to analyse the sample data to make the conclusion more reliable. To evaluate the horizontal pleiotropy, heterogeneity and stability of SNPs for breast cancer, the MR-Egger intercept test, Cochran's Q test and 'leave one' sensitivity analysis were used. Finally, the outlier variation determined by the Mendelian Randomisation Pleiotropy RESidual Sum and Outlier test is gradually eliminated to reduce the influence of heterogeneity and horizontal pleiotropy. After implementing rigorous quality control procedures, we carefully chose 102 qualified instrumental variables closely associated with the selected exposure for sensitivity analysis. This was conducted to evaluate the heterogeneity, level multiplicity, and stability of SNPs in the context of personal radiation history and its correlation with breast cancer. The results of the inverse variance weighted method analysis revealed a positive correlation between personal radiation and a heightened risk of breast cancer (odds ratio (OR) = 1.52; 95% confidence interval (CI) = 1.30-1.77). We also validated on another data set; the results were similar (OR = 1.51; 95% CI = 1.27-1.81). Furthermore, the findings from the sensitivity analysis were consistent. At the genetic level, our research demonstrated that personal radiation exposure is associated with an elevated risk of breast cancer. Using genetic data provides evidence and strengthens the causal link that personal radiation causes breast cancer.

A review of criticality dosimetry at the Y-12 National Security Complex and practical importance of dose accuracy in emergency response

A nuclear criticality results in the emission of both neutron and gamma radiation and can produce doses to personnel near the event that exceed 0.1 Gy (10 rad). The primary purpose of nuclear accident dosimetry is to rapidly identify affected personnel in need of prompt medical treatment and to reassure personnel who have been only minimally exposed. While accurate dosimetry is desired, it must be recognized that dose determinations made from whole-body dosimeters or simple triage methods are very rough estimates and contain significant uncertainties. Even when accounting for factors like varying neutron energy spectra, mean photon energies, body orientation within the radiation field, and transient effects on dosimeter response, etc., the end value is a dosimetric quantity defined for very specific radiological conditions and determined within a simple phantom usually at a single depth. Of more importance is the biological response to the radiation, which will vary by person and can be affected by the individual's radiation sensitivity, age, gender, mass, and underlying health conditions. The overall biological, person-specific response to a given dose cannot be precisely determined except by patient symptom observation and individual biological dosimetry (e.g. chromosome analysis, lymphocyte ratios, etc.). This work describes and discusses the criticality accident dosimetry program at the Y-12 National Security Complex, a United States Department of Energy National Nuclear Security Administration facility. The primary goals of the Y-12 accident dosimetry program are, among others, the rapid identification of significantly exposed persons, prompt routing of exposed workers for medical evaluation and treatment, and the ultimate processing of dosimeters to assign doses to personnel.

Practical guidance on the assessment of radiation risks for diagnostic radiological examinations.

Patient doses cannot be limited; instead, radiological examinations should be justified and optimized to ensure the necessary diagnostic or therapeutic effect with the lowest patient dose achievable. Assessment of the radiation risks from patient exposure is important part of the justification process. Hence, medical staff within the framework of their professional activities should possess necessary information on the data on radiation risk from different types of radiological procedures. An approach has been developed that allows considering age and gender dependences of the risk coefficients of radiogenic cancer and the age and gender distribution of patients for various radiological examinations to assess the individual radiation risk for patient and collective risk for population from medical exposure. The approach is based on a new expanded use of the effective dose concept proposed in ICRP Publication 147 and demonstrated using the medical exposure in the Russian Federation as the example. For 30 radiological examinations that compose about 80% of the collective dose from medical exposure of the public in the Russian Federation radiation risk was assessed based on calculated age and gender specific risk coefficients per unit effective dose. For the rest of the examinations a simplified approach was used to assess the risk, which was based on using an age and gender specific risk coefficient determined for one of 4 anatomical regions (head, neck, chest and abdomen) or for uniform irradiation of the whole body. The proposed approach allows significantly improving the assessment of the radiation risk while continuing to use the effective dose as a dosimetric quantity within the framework of the state program in the Russian Federation. As a result the collective risk from medical examinations in the Russian Federation in 2022 was lower by the factor of 3 compared to the previous assessment based on the effective dose with the nominal risk coefficient.

Biology of Exfoliation of Plasma Membrane-Derived Vesicles and the Radiation Response: Historical Background, Applications in Biodosimetry and Cell-Free Therapeutics, and Quantal Mechanisms for Their Release and Function with Implications for Space Travel.

This historical review of extracellular vesicles in the setting of exposure to ionizing radiation (IR) traces our understanding of how vesicles were initially examined and reported in the literature in the late 1970s (for secreted exosomes) and early 1980s (for plasma membrane-derived, exfoliated vesicles) to where we are now and where we may be headed in the next decade. An emphasis is placed on biophysical properties of extracellular vesicles, energy consumption and the role of vesiculation as an essential component of membrane turnover. The impact of intercellular signal trafficking by vesicle surface and intra-vesicular lipids, proteins, nucleic acids and metabolites is reviewed in the context of biomarkers for estimating individual radiation dose after exposure to radiation, pathogenesis of disease and development of cell-free therapeutics. Since vesicles express both growth stimulatory and inhibitory molecules, a hypothesis is proposed to consider superposition in a shared space and entanglement of molecules by energy sources that are external to human cells. Implications of this approach for travel in deep space are briefly discussed in the context of clinical disorders that have been observed after space travel.

High-Capacity Multiple-Input Multiple-Output Communication for Internet-of-Things Applications Using 3D Steering Nolen Beamforming Array

In this paper, a novel 2D Nolen beamforming phased array with 3D scanning capability to achieve high channel capacity is presented for multiple-input multiple-output (MIMO) Internet-of-Things (IoT) applications. The proposed 2D beamforming phased array is designed by stacking a fundamental building block consisting of a 3 × 3 tunable Nolen matrix, which applies a small number of phase shifters with a small tunning range and reduces the complexity of the beam-steering control mechanism. Each 3 × 3 tunable Nolen matrix can achieve a full 360° range of progressive phase delay by exciting all three input ports, and nine individual radiation beams can be generated and continuously steered on azimuth and elevation planes by stacking up three tunable Nolen matrix in horizontal and three in vertical to maximize signal-to-noise ratio (SNR) in the corresponding spatial directions. To validate the proposed design, the simulations have been conducted on the circuit network and assessed in a fading channel environment. The simulation results agree well with the theoretical analysis, which demonstrates the capability of the proposed 2D Nolen beamforming phased array to realize high channel capacity in MIMO-enabled IoT communications.

Roadmap of Graphite Moderator and Graphite-Matrix TRISO Fuel Management Options

Most high-temperature reactors use graphite as a moderator and structural material. This includes high-temperature gas-cooled reactors with helium cooling and TRi-structural ISOtropic (TRISO) fuel particles embedded in graphite, as well as fluoride salt–cooled high-temperature reactors with clean salt coolant and TRISO fuel particles embedded in graphite and thermal spectrum molten salt reactors with a graphite moderator and fuel dissolved in the salt. The largest volume radioactive waste stream from these reactors is the irradiated graphite. We describe herein a roadmap for management of these graphite wastes that contain radioactive 14C, tritium, and other radionuclides. There may be some graphite wastes with sufficiently low radioactivity levels that can be treated as nonradioactive waste and managed like other graphite waste. Management options for the graphite include (1) direct disposal, (2) recycled back to the reactor or other nuclear applications, and (3) oxidizing the graphite with release as an effluent or underground sequestration of the carbon dioxide. Cosequestration of this carbon dioxide with carbon dioxide from industrial, biological, and cement production processes can isotopically dilute the 14C before sequestration to eliminate the possibility of exceeding individual radiation exposure limits. We also describe options for processing graphite-matrix TRISO fuel, including separating the bulk graphite to reduce the volumes of used fuel for disposal or processing to recover fissile materials. The inventories of radioactive isotopes in different carbon wastes vary by many orders of magnitude; thus, there is no single economic option for the management of all graphite waste.

Specific emitter identification based on multiple sequence feature learning.

The specific emitter identification is widely used in electronic countermeasures, spectrum control, wireless network security and other civil and military fields. In response to the problems that the traditional specific emitter identification algorithm relies on a priori knowledge and has poor generalizability, and the existing specific emitter identification algorithm based on deep learning has poor feature selection and the adopted feature extraction network is not targeted, etc., the specific emitter identification algorithm based on multi-sequence feature learning is proposed. Firstly, multiple sequence features of the emitted signal of the communication radiation source are extracted, and these features are combined into multiple sequence features. Secondly, the multiple sequence fusion convolutional network is constructed to fuse and deeply extract the multiple sequence features and complete the classification of individual communication radiation sources through the classifier of neural network. The selected sequence features of this algorithm contain more and more essential RFF information, while the targeted design of the multi-sequence feature fusion learning network can effectively extract the essential RFF information. The results show that the algorithm can significantly improve the performance of SEI compared with the benchmark algorithm, with a recognition rate gain of about 17%.

Radiation Dose-Volume-Response Relationships for Adverse Events in Childhood Cancer Survivors: Introduction to the Scientific Issues in PENTEC

At its very core, radiation oncology involves a trade-off between the benefits and risks of exposing tumors and normal tissue to relatively high doses of ionizing radiation. This trade-off is particularly critical in childhood cancer survivors (CCS), in whom both benefits and risks can be hugely consequential due to the long life expectancy if the primary cancer is controlled. Estimating the normal tissue-related risks of a specific radiation therapy plan in an individual patient relies on predictive mathematical modeling of empirical data on adverse events. The Pediatric Normal-Tissue Effects in the Clinic (PENTEC) collaborative network was formed to summarize and, when possible, to synthesize dose-volume-response relationships for a range of adverse events incident in CCS based on the literature. Normal-tissue clinical radiation biology in children is particularly challenging for many reasons: (1) Childhood malignancies are relatively uncommon-constituting approximately 1% of new incident cancers in the United States-and biologically heterogeneous, leading to many small series in the literature and large variability within and between series. This creates challenges in synthesizing data across series. (2) CCS are at an elevated risk for a range of adverse health events that are not specific to radiation therapy. Thus, excess relative or absolute risk compared with a reference population becomes the appropriate metric. (3) Various study designs and quantities to express risk are found in the literature, and these are summarized. (4) Adverse effects in CCS often occur 30, 50, or more years after therapy. This limits the information content of series with even very extended follow-up, and lifetime risk estimates are typically extrapolations that become dependent on the mathematical model used. (5) The long latent period means that retrospective dosimetry is required, as individual computed tomography-based radiation therapy plans gradually became available after 1980. (6) Many individual patient-level factors affect outcomes, including age at exposure, attained age, lifestyle exposures, health behaviors, other treatment modalities, dose, fractionation, and dose distribution. (7) Prospective databases with individual patient-level data and radiation dosimetry are being built and will facilitate advances in dose-volume-response modeling. We discuss these challenges and attempts to overcome them in the setting of PENTEC.

Spectroscopic and dosimetric comparison of tooth enamel separation methods for EPR retrospective dosimetry

Precise estimation of individual radiation dose utilizing biomaterials (fingernail, bone, and tooth) is very challenging due to their complex sample processing. Despite, tooth enamel, the most mineralized tissue of tooth is used for this purpose due to its high radiation sensitivity and ability to produce radiation induced long lived CO2− radicals. However, human teeth are not always available, and invasive nature of sample collection adds to the complexity making dose estimation difficult. In such cases, animal teeth (goat, cow, and moose) can be used as a substitute for human teeth due to comparable enamel sensitivity. Moreover, separation of enamel from dentine is a crucial step towards accurate dose estimation from irradiated teeth. In this work, Indian goat teeth were used as it was readily available to us and the comparison of goat enamel sensitivity to radiation was found to be within ∼7.4 % that of human. The enamel samples were separated following two chemical methods; (1) density separation using sodium polytungstate, (2) alkaline denaturation using NaOH and the quality was compared based on their purity and radiation sensitivity. Combined results of spectroscopic characterization using X-ray diffraction (XRD), Fourier transform infrared (FTIR), and Raman analysis authenticated the crystallinity and purity of the separated enamel samples. The radiation sensitivity of separated enamel samples was compared by electron paramagnetic resonance (EPR) analysis as a part of dosimetric characterization. The suitability of both the samples for retrospective dosimetry and epidemiological studies was checked by validating the dose estimated from separated enamel samples with standard alanine/EPR dosimeter.

Doses to the right coronary artery and the left anterior descending coronary artery and death from ischemic heart disease after breast cancer radiotherapy: a case-control study in a population-based cohort.

Doses to the coronary arteries in breast cancer (BC) radiotherapy (RT) have been suggested to be a risk predictor of long-term cardiac toxicity after BC treatment. We investigated the dose-risk relationships between near maximum doses (Dmax) to the right coronary artery (RCA) and left anterior descending coronary artery (LAD) and ischemic heart disease (IHD) mortality after BC RT. In a cohort of 2,813 women diagnosed with BC between 1958 and 1992 with a follow-up of at least 10 years, we identified 134 cases of death due to IHD 10-19 years after BC diagnosis. For each case, one control was selected within the cohort matched for age at diagnosis. 3D-volume and 3D-dose reconstructions were obtained from individual RT charts. We estimated the Dmax to the RCA and the LAD and the mean heart dose (MHD). We performed conditional logistic regression analysis comparing piecewise spline transformation and simple linear modeling for best fit. There was a linear dose-risk relationship for both the Dmax to the RCA (odds ratio [OR]/Gray [Gy] 1.03 [1.01-1.05]) and the LAD (OR/Gy 1.04 [1.02-1.06]) in a multivariable model. For MHD there was a linear dose-risk relationship (1,14 OR/Gy [1.08-1.19]. For all relationships, simple linear modelling was superior to spline transformations. Doses to both the RCA and LAD are independent risk predictors of long-term cardiotoxicity after RT for BC In addition to the LAD, the RCA should be regarded as an organ at risk in RT planning.

Using the genomic adjusted radiation dose (GARD) to personalize the radiation dose in nasopharyngeal cancer

BackgroundLocally advanced nasopharyngeal cancer (NPC) patients undergoing radiotherapy are at risk of treatment failure, particularly locoregional recurrence. To optimize the individual radiation dose, we hypothesize that the genomic adjusted radiation dose (GARD) can be used to correlate with locoregional control. MethodsA total of 92 patients with American Joint Committee on Cancer / International Union Against Cancer stage III to stage IVB recruited in a randomized phase III trial were assessed (NPC-0501) (NCT00379262). Patients were treated with concurrent chemo-radiotherapy plus (neo) adjuvant chemotherapy. The primary endpoint is locoregional failure free rate (LRFFR). ResultsDespite the homogenous physical radiation dose prescribed (Median: 70 Gy, range 66–76 Gy), there was a wide range of GARD values (median: 50.7, range 31.1–67.8) in this cohort. In multivariable analysis, a GARD threshold (GARDT) of 45 was independently associated with LRFFR (p = 0.008). By evaluating the physical dose required to achieve the GARDT (RxRSI), three distinct clinical subgroups were identified: (1) radiosensitive tumors that RxRSI at dose < 66 Gy (N = 59, 64.1 %) (b) moderately radiosensitive tumors that RxRSI dose within the current standard of care range (66–74 Gy) (N = 20, 21.7 %), (c) radioresistant tumors that need a significant dose escalation above the current standard of care (>74 Gy) (N = 13, 14.1 %). ConclusionGARD is independently associated with locoregional control in radiotherapy-treated NPC patients from a Phase 3 clinical trial. GARD may be a potential framework to personalize radiotherapy dose for NPC patients.

Specific emitter identification based on ensemble domain adversarial neural network in multi-domain environments

Specific emitter identification is pivotal in both military and civilian sectors for discerning the unique hardware distinctions inherent to various launchers, it can be used to implement security in wireless communications. Recently, a large number of deep learning-based methods for specific emitter identification have been proposed, achieving good performance. However, these methods are trained based on a large amount of data and the data are independently and identically distributed. In actual complex environments, it is very difficult to obtain reliable labeled data. Aiming at the problems of difficulty in data collection and annotation, and the large difference in distribution between training data and test data, a method for individual radiation source identification based on ensemble domain adversarial neural network was proposed. Specifically, a domain adversarial neural network is designed and a Transformer encoder module is added to make the features obey Gaussian distribution and achieve better feature alignment. Ensemble classifiers are then used to enhance the generalization and reliability of the model. In addition, three real and complex migration environments, Alpine–Montane Channel, Plain-Hillock Channel, and Urban-Dense Channel, were constructed, and experiments were conducted on WiFi dataset. The simulation results show that the proposed method exhibits superior performance compared to the other six methods, with an accuracy improvement of about 3%.

Robotic Assistance in Percutaneous Liver Ablation Therapies: A Systematic Review and Meta-Analysis.

The aim of this systematic review and meta-analysis is to identify current robotic assistance systems for percutaneous liver ablations, compare approaches, and determine how to achieve standardization of procedural concepts for optimized ablation outcomes. Image-guided surgical approaches are increasingly common. Assistance by navigation and robotic systems allows to optimize procedural accuracy, with the aim to consistently obtain adequate ablation volumes. Several databases (PubMed/MEDLINE, ProQuest, Science Direct, Research Rabbit, and IEEE Xplore) were systematically searched for robotic preclinical and clinical percutaneous liver ablation studies, and relevant original manuscripts were included according to the Preferred Reporting items for Systematic Reviews and Meta-Analyses guidelines. The endpoints were the type of device, insertion technique (freehand or robotic), planning, execution, and confirmation of the procedure. A meta-analysis was performed, including comparative studies of freehand and robotic techniques in terms of radiation dose, accuracy, and Euclidean error. The inclusion criteria were met by 33/755 studies. There were 24 robotic devices reported for percutaneous liver surgery. The most used were the MAXIO robot (8/33; 24.2%), Zerobot, and AcuBot (each 2/33, 6.1%). The most common tracking system was optical (25/33, 75.8%). In the meta-analysis, the robotic approach was superior to the freehand technique in terms of individual radiation (0.5582, 95% confidence interval [CI] = 0.0167-1.0996, dose-length product range 79-2216 mGy.cm), accuracy (0.6260, 95% CI = 0.1423-1.1097), and Euclidean error (0.8189, 95% CI = -0.1020 to 1.7399). Robotic assistance in percutaneous ablation for liver tumors achieves superior results and reduces errors compared with manual applicator insertion. Standardization of concepts and reporting is necessary and suggested to facilitate the comparison of the different parameters used to measure liver ablation results. The increasing use of image-guided surgery has encouraged robotic assistance for percutaneous liver ablations. This systematic review analyzed 33 studies and identified 24 robotic devices, with optical tracking prevailing. The meta-analysis favored robotic assessment, showing increased accuracy and reduced errors compared with freehand technique, emphasizing the need for conceptual standardization.

Sustainable synthesis of levulinic acid using waste derived silica-alumina-hydroxyapatite supported nano ZrO2 photo-acidic catalyst under synergistic UV-FIR irradiations

A novel nano-photocatalyst has been prepared using hydroxyapatite (HAp) derived from waste fish scale and fly ash-derived aluminosilicate (SiO2-Al2O3) grafted with zirconium oxide (ZrO2) active sites by innovative photo-hydrothermal protocol. The physiochemical properties of the prepared photocatalyst have been characterized by different analyses like TGA, XRD, FTIR, XPS, UV–VIS–NIR, BET, NH3-TPD, HRTEM, and DLS. The optimal catalyst has a zirconium loading of 20 wt% and has a low bandgap energy of 2.15 eV as confirmed by UV–VIS–NIR spectroscopy. The optimal catalyst also depicted a high acidity of 1.52 mmol NH3/g and a specific surface area of 62.872 m²/g. Owing to the high acidity, specific surface area, and low band gap energy the photocatalyst has led to achieving an elevated yield of 76.6% levulinic acid (LA) from glucose in hybrid irradiation reactor (HIR) deploying UV and FIR radiations at appreciably low temperature and reaction time of 115 ℃ and 2 h respectively. Under the same reaction conditions, the conventionally heated reactor (CHR) gave a very low yield of 23.7%. Individual radiation effects on LA yield evinced the synergistic advantageous effect of the hybrid irradiation technique. The catalyst reusability and regenerative study confirmed the high stability of the prepared catalyst. Also, a comparative LCA study has been conducted between HIR and CHR systems which revealed that HIR was more environmentally sustainable than CHR. HIR -based process demonstrated a reduction in 59% global warming potential, 70.66% forest resource scarcity, and 65% lower terrestrial ecotoxicity while being 120% more energy efficient than CHR-based reaction making HIR more environmentally sustainable as well as economically feasible.

Establishment of dose monitoring system for dentistry

Along with the advancement of dental x-ray equipment, the use of diagnostic radiation has been rapidly increasing. Accordingly, concerns about radiation exposure are increasing. In particular, imaging examinations inthe dental field have a low individual radiation exposure. However, the frequency of the examinations is high.Also, due to the abundant usage of dental CBCT, concerns has been widely spread across the users and the nation. In response to this, there has been a need to establish a dose monitoring system for dental x-ray equipment.Therefore, the purpose of this study was to establish of a national dose monitoring system for imaging examinations in the dentistry. For the system establishment, the structure of intraoral, panoramic radiography and CBCT system was surveyed and the integrated data collection plan was prepared. Based on this, dose monitoring system, which can be utilized for nation-wide, was established and a pilot operation was conducted. In orderto continuously expand the system in the future, system supplements should be confirmed through gatheringexpert opinions.

Radiation Dose Does Not Affect the Predictive Value of Thyroid Biopsy for Diagnosing Papillary Thyroid Cancer in a Belarusian Cohort Exposed to Chernobyl Fallout

Introduction: The Chernobyl nuclear accident exposed residents of contaminated territories to substantial quantities of radioiodines and was followed by an increase in thyroid cancer, primarily papillary thyroid cancer (PTC), among exposed children and adolescents. Although thyroid biopsy is an essential component of screening programs following accidental exposure to radioiodines, it is unknown whether the predictive value of biopsy is affected by different levels of environmental exposure. Methods: A cohort of 11,732 Belarusians aged ≤18 years at the time of the Chernobyl accident with individual thyroid radiation dose estimates was screened at least once 11–22 years later. Paired cytologic conclusions and histopathologic diagnoses were possible for 258 thyroid nodules from 238 cohort members. Cytologic conclusions were divided into five reporting categories, with all follicular lesion aspirates combined into a single indeterminate category. Standard performance indicators, risk of malignancy (ROM), and odds ratios for a correct cytologic conclusion were calculated, both overall and according to quintile of thyroid radiation dose. Results: The arithmetic mean thyroid dose estimate for the study group was 1.73 Gy (range: 0.00–23.64 Gy). The final histopathologic diagnosis was cancer for 136 of 258 biopsies (52.7%; 135 papillary and 1 follicular). The overall ROM was 96.7% for cytologies definite for PTC, 83.7% for suspicious for PTC, 33.0% for indeterminate, 8.1% for benign, and 31.0% for non-diagnostic. The ROM showed little change according to level of radiation exposure. Overall, there was no association between thyroid radiation dose and the odds ratio for a correct cytologic conclusion (p = 0.24). When analyzed according to dose quintile, the odds ratio for a correct conclusion increased two-fold at 0.10–0.29 Gy compared to a dose of 0.00–0.09 Gy and decreased at doses of 0.3–24 Gy (p value for linear trend = 0.99). Conclusions: At radiation doses received by a cohort of young Belarusians exposed to radioiodines by the Chernobyl accident, the predictive value of thyroid biopsy for diagnosing PTC was not significantly affected by level of radiation exposure.

Результаты контроля радона в жилых домах вблизи разработки Шкурлатовского месторождения гранита

The presence of acting granite quarrying near the residential area may cause increase in indoor radon concentration. The paper presents results of estimating the level of radiation and carcinogenic danger for residents living near the acting Shkurlatov granite deposit. To assess average annual equivalent equilibrium volume activity (EEVA), Bq/m3, and the average annual individual effective radiation doses from radon isotopes presented in the indoor air, mSv/year, the data of the unified system for individual doses monitoring from 2017 through 2022 were used. Results of voluntary in-situ examination and 42 measures of radon volume activity in 17 residential buildings the closest to the granite quarry, were carried out in 2023. The above measures were used for calculation of EEVA of radon isotopes (Bq/m3) and the average annual individual effective radiation dose to the residents inhalated indoor radon (mSv/year). According to the data on radon monitoring in the dwellings situated near the Shkurlatov granite deposit the EEVA in wooden houses varied from 9.2 to 35.5 Bq/m3, EEVA in stone houses varied from 9.4 to 41.4 Bq/m3, average values are 21.22.0 and 21.91.8. The quoted values do not differ from the monitoring data in the Pavlovsk district of the Voronezh Region. Statistic data on malignant neoplasms incidence from 2017 through 2022 were investigated. As for the incidence of trachea, bronchus and lung cancer, no statistically significant difference between average multiyear cancer incidence in the area close to the Shkurlatov granite deposit in Pavlovsk district, Voronezh region, and in the more favorable district. The comparison was based on annual radiation doses due to radon isotopes inhalation. The results of the study suggest that radon at the registered indoor concentration does not affect cancer incidence among people living near the Shkurlatov granite deposit.

Efeito agudo da cinesioterapia e da eletroestimulação neuromotora sobre a variação térmica de indivíduos com insuficiência venosa crônica

Abstract Introduction: Chronic venous insufficiency (CVI) is a change in the venous system that can be caused by dysfunction in the triceps surae muscles. Objective: To evaluate the acute effect of neuromuscular electrical stimulation and kinesio-therapy on ankle joint flexibility, infrared radiation and triceps surae strength in individuals with CVI. Methods: We conducted a comparative study, in which ankle flexibility, dorsiflexion and plantar flexion strength and thermal variations of the calf were evaluated. An electrical stimulation session (1 kHz Aussie current with burst = 2 ms) was performed on the right lower limb (EG - electrostimulation group) and kinesio-therapy on the lower limb left (KG - kinesiotherapy group), with stretching and metabolic exercises involving the ankle. Results: Nineteen female patients were evaluated. Analysis of ankle flexibility did not demonstrate significant changes. In the assessment of muscle strength, there was no difference between groups, and in the intragroup assessment, only KG showed an increase for dorsiflexion (before treatment: 11.6 ± 3.5; 24 h after: 13.5 ± 3.0; p = 0.02), and for plantar flexion (before: 11.8 ± 6.3; 24 h later: 14.4 ± 5.06; p = 0.04). Regarding thermography, there was no intragroup difference, while in the intergroup assessment, KG showed an increase in temperature immediately and 24 h later (0.44 ± 0.68, p = 0.01 and 0.25 ± 0.83, p = 0.07, respectively). When analyzing the correlation between dorsiflexion and plantar flexion strength of both lower limbs with total range of motion of the right and left ankle, a positive correlation was observed only between the plantar flexion strength immediately after and 24 h later with range of motion and ankle in KG (r = 0.49, p = 0.03 and r = 0.51, p = 0.03, respectively). Conclusion: There were no significant differences between kinesiotherapy and electrotherapy when analyzing joint flexibility and muscle strength, but kinesiotherapy was superior in increasing calf temperature before and after 24 h of intervention.

Review of Radiation Dose Metric Tracking for Patients: Ethical Implications of the “Do Not Disclose” Standard

Medical diagnostic imaging tests that produce ionizing radiation now deploy technology that captures an individual patient’s cumulative radiation dose. This raises the question of whether there is an imperative for regional health authorities to disclose this information to physicians who may then engage their patients in decisions about whether the potential harms are worth the benefits of subsequent diagnostic imaging. Currently, the advice of the professional bodies providing standards of practice for medical diagnostic imaging is to withhold this information from physicians. Their concern is that cumulative dose information is difficult to evaluate in terms of risk to individual patients; it is not easily applicable to clinical decision making about the appropriateness of a subsequent imaging exam; and referring clinicians will feel compelled to offer a patient a less efficacious non-ionizing test, which could negatively affect patient care. We present a critical analysis of several assumptions underlying the stance of non-disclosure. Working at the intersection of medical physics, medical anthropology, and clinical ethics, we offer an alternative framing of the discourse of risk that has shaped the recent scholarly debate on disclosure of individual cumulative radiation dose. We posit that a persuasive argument can be made against the stance of the professional bodies and for a policy of disclosure – provided that such a policy prioritizes patient-centred shared decision making, radiologists as risk-interpretation experts, and the authority of the prescribing physician.