Ultrasonography is the recommended first-line investigation for the diagnosis of pediatric nephrolithiasis. Despite higher sensitivity and specificity for this condition, computed tomography is reserved for more complex cases due to its radiation exposure. Despite increasing stone prevalence in the pediatric population, there is a lack of low-dose computed tomography pediatric urolithiasis protocols and descriptions of low-dose protocols are sparse. Herein we report the development and implementation of a low-dose protocol to reduce radiation exposure to this vulnerable population. A novel low-dose computed tomography protocol was designed through multidisciplinary collaboration, literature review, and phantom trials. Patients undergoing computed tomography for urolithiasis assessment were evaluated using the novel low-dose protocol and were compared to a retrospective cohort. Radiation reduction was characterized using descriptive statistics and comparative analysis. Mean (± standard deviation) age for the low-dose group was 12.6 ± 4.2 years (n = 26) compared to 12.4 ± 3.7 years for the standard-dose group (n = 15). The low-dose protocol reduced radiation dose when compared to the standard-dose group by 55.5 % (≥45 kg) (p = 0.02) and 27.8 % (<45 kg) (p = 0.03). The low-dose protocol visualized stones seen on ultrasound with 100 % accuracy (n = 6), and in 61.5 % (n = 16/26) of patients. There was no difference in stone sizes between groups. Reduced-dose computed tomography protocols are effective for assessing urolithiasis while reducing radiation exposure. Implementation of reduced-dose computed tomography protocols in cases of suspected urolithiasis is advised to limit radiation exposure while maintaining diagnostic imaging detail.

Evaluation of exposure characteristics and radiological risks for cyclotron-based 18F radiopharmaceutical production workers in China.

Evidence suggests that ionizing radiation increases the risk of dementia, but data are limited for those chronically exposed to low doses (<100 millisieverts (mSv)). We addressed this gap by investigating associations between cumulative low-dose radiation exposure and dementia mortality among nuclear power plant (NPP) workers. Our study cohort comprised Canadian NPP workers monitored for radiation exposure between 1950 and 2018, with mortality follow-up extending through 2020. Dementia deaths were identified through record linkage to national mortality data and based on underlying or contributing causes of death. Standardized mortality ratios (SMRs) were derived to compare mortality in the workers to the Canadian population. We used Poisson regression and fit linear excess relative risk models to describe the shape of the exposure-response relationship between cumulative radiation (lagged 10 years) and dementia mortality. Among 97,250 NPP workers, there were 1,458,299 person-years of follow-up. The mean whole-body lifetime accumulated exposure at the end of follow-up was 9.8mSv. In total, there were 235 deaths with dementia listed as the underlying cause, and 450 when the definition was expanded to include contributing causes. Relative to the Canadian population, NPP workers had a reduced mortality rate of dementia (SMR = 0.69; 95% CI: 0.63, 0.76). We found some evidence that exposure to ionizing radiation was associated with an increased risk of dementia mortality, but no statistically significant linear dose-response relationship (ERR/100mSv=0.010; 95% CI: -0.227, 0.247). Spline analyses suggested a non-linear dose-response relationship. We found modest evidence that low-dose radiation exposure is associated with increased risks of dementia mortality. These findings should be interpreted cautiously, given that they differ from those found when we modelled dementia as an incident outcome in a cohort that included many of these same workers. Taken together, our findings highlight limitations of using death data to identify etiological risk factors for dementia.

Impact of robotic assistance on early outcomes in adult spinal deformity surgery: A comparative analysis of inpatient and 30-day outcomes.

Melasma is a skin condition characterised by hyperpigmentation patches on facial skin due to increased melanin synthesis. Important aetiological factors for development of melasma include genetic predisposition and Ultraviolet (UV) radiation exposure, resulting in melanocyte overactivity. ‘Vyanga,’ described in Ayurveda under category of ‘Kshudra Roga,’ denotes facial blemishes or patches characteristic to this condition. Many Ayurveda interventions are being used, but extent of their clinical efficacy evidences is scarce. In present review, clinical research articles were retrieved from databases focused on Ayurveda research, viz., AYUSH (Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homeopathy) Research Portal and Digital Helpline for Ayurveda Research Articles (DHARA). A review of 12 such articles exhibited usage of variety of interventions with positive outcomes. It was observed that, along with classically mentioned remedies such as Manjishtha (Rubia cordifolia), a number of rational combinations, such as ‘AYUSH face pack,’ were designed and successfully used. In conclusion, Ayurveda could play a very important role in the management of melasma.

Thermal signatures in breast cancer: Deciphering latent biomarkers through deep learning and explainable AI.

FDG-PET/MR Imaging in the Assessment of Inflammatory and Infectious Disease in Pediatric Patients.

Introduction: Computed Tomography (CT) procedures contribute significantly to medical radiation exposure and therefore necessitate the implementation of optimisation measures that balance diagnostic image quality with patient safety. Body Mass Index (BMI) influences radiation absorption; however, standard CT protocols do not adequately account for patient-specific body dimensions. Aim: To analyse the relationship between BMI categories and radiation dose metrics—volumetric CT Dose Index (CTDIvol), Dose-Length Product (DLP), Effective Dose (ED) and SizeSpecific Dose Estimates (SSDE)—while examining genderbased and protocol-specific differences in adult thoracic and abdominal CT examinations. Materials and Methods: This Cross-sectional study was conducted at the Department of Radiodiagnosis, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pimpri, Pune, India, from April 2025 to July 2025. The study included adult participants (aged 18-70 years) who underwent thoracoabdominal CT examinations 2025 at a tertiary care centre. A total of 200 participants were classified according to the World Health Organisation (WHO) BMI classification as underweight (&lt;18.5 kg/m2 ), normal weight (18.5-24.9 kg/ m2 ), overweight (25.0-29.9 kg/m2 ) and obese (≥30.0 kg/m2 ). Standard acquisition protocols included non contrast and contrast-enhanced abdominal studies, as well as non contrast and contrast-enhanced high-resolution thoracic imaging. Technical parameters (tube voltage, tube current-time product, pitch, slice thickness and field of view) and dosimetry-related data were consistently recorded. Statistical analysis included Pearson’s correlation, Analysis of Variance (ANOVA) and linear regression models. Results: The BMI demonstrated a positive correlation with CTDIvol (r=0.266, p&lt;0.001), DLP (r=0.180, p=0.011) and ED (r=0.168, p=0.017). No significant correlation was observed between BMI and SSDE (r=0.043, p=0.549). Overweight (BMI 25.0-29.9 kg/m2 ) and obese (BMI ≥30.0 kg/m2 ) participants received approximately 30% higher CTDIvol values (mean 14.4 vs. 11.1 mGy, p=0.003) and a 23% higher DLP compared to normal-weight individuals. Gender-related disparities persisted after adjustment for BMI, with male participants exhibiting a 28% higher DLP (647.7 vs. 504.1 mGy•cm, p&lt;0.001). Protocol-specific analysis revealed that contrast-enhanced thoracic CT had the highest radiation dose (mean DLP 746.4 mGy•cm), which was 47% higher than that of high-resolution thoracic protocols. Conclusion: The BMI significantly influences radiation dose in thoracoabdominal CT examinations, supporting the need for BMI-stratified Diagnostic Reference Levels (DRLs). The poor correlation between BMI and SSDE suggests limitations in size calibration for individuals with extreme body habitus. Observed gender-based differences in radiation dose may warrant the development of sex-specific protocol adaptations. Overall, these findings support the personalisation of CT protocols and dose optimisation based on anthropometric parameters and anatomical features, particularly when advanced reconstruction algorithms are employed.

This study aimed to investigate the function of KLF11 in regulating radiosensitivity (RT) in esophageal squamous cell carcinoma (ESCC) and to elucidate the underlying mechanisms. A nude mouse ESCC xenograft model was established by injecting KYSE150 cells into the left dorsal flank. Cell proliferation was assessed using cell counting kit-8 (CCK-8) and colony formation assays, while DNA damage was evaluated via a neutral comet assay. Key gene and protein expression levels were analyzed by reverse transcription-quantitative polymerase chain reaction (RT-qPCR), Western blotting, and immunohistochemistry. Additionally, coimmunoprecipitation and immunofluorescence were employed to validate proteinprotein interactions. KLF11 expression was upregulated in both ESCC and RT-resistant tissues. At the cellular level, KLF11 expression was higher in ESCC cell lines than in the normal esophageal epithelial cell line HET-1A, with the most pronounced upregulation in KYSE150 cells and the least in TE1 cells. Notably, KLF11 knockdown under ionizing radiation exposure suppressed proliferation and colony formation, promoted apoptosis, and increased the expression of the DNA damage marker γ-H2AX as well as overall DNA damage levels in KYSE150 cells. Conversely, KLF11 overexpression in TE1 cells led to the opposite phenotype, suggesting that KLF11 confers RT resistance in ESCC by mitigating DNA damage. Further investigations revealed that KLF11 primarily repairs RT-induced DNA damage through the homologous recombination (HR) pathway rather than through nonhomologous end joining (NHEJ). Additionally, the expression of MDM2, E2F1, and RAD51 was significantly elevated in ESCC and RT-resistant ESCC tissues. Mechanistically, KLF11 promotes MDM2 expression, which inhibits E2F1 ubiquitination, thereby stabilizing E2F1 protein levels and enhancing RAD51-mediated HR repair, ultimately leading to RT resistance in ESCC. This study elucidates the critical role and molecular mechanism through which KLF11 drives radiotherapy resistance in ESCC by regulating the MDM2/E2F1 axis and enhancing HR repair, thereby providing a solid theoretical foundation and potential target for the development of KLF11-targeted radiosensitization therapies for ESCC.

Robot-assisted endoscopic retrograde cholangiopancreatography for biliary stent placement in an in vivo porcine model:a proof-of-concept investigation.

The linear no-threshold hypothesis (commonly known as LNT) has received increasing criticism in recent years. LNT assumes that the damaging effects of ionizing radiation, that is, stochastic effects such as cancer and genetic or teratogenic effects, increase linearly with dose and without a lower dose threshold. However, statistically verified data on the relationship between radiation and effects are only obtained for the range above 100 mSv y -1 , which is why linear extrapolation downward is carried out for the range of low radiation doses, i.e., below 100 mSv y -1 . Today's radiation protection systems are based on this principle. To place radiation protection on a different basis (that is, no longer on the LNT hypothesis), a traffic light model is proposed. It uses natural radiation exposure as a reference but maintains the existing limits and everything in radiation protection that has proven effective. What does change, however, is the lower end of the optimization range, according to the ALARA recommendation. For the justification of today's levels of exceptions, the precautionary principle is applied.

Dihydroartemisinin targets GPX4 to induce autophagy-dependent ferroptosis and reduce radioresistance in triple-negative breast cancer.

In Japan, there are currently no laws concerning ionizing radiation exposure among students during science experiments. The same is true for medical students. However, we consider radiation safety management to be essential. We present findings from a trial of radiation exposure management during clinical training for medical students. Students underwent 30 min of practical training on radiation protection. Regular monitoring of radiation doses was conducted, and if a student’s dose exceeded acceptable levels, interviews were conducted to discuss measures for exposure reduction. Radiation exposure control measures for medical student have been consistently implemented through various approaches, including reinforcing students’ awareness, collaborating with radiation control staff at facilities, promoting awareness of radiation exposure reduction among supervisors and faculty, and enhancing the availability of protective clothing and eyewear at training hospitals.

ABSTRACT Natural radioactive materials present in rocks, soil, water, and air contribute to daily radiation exposure, particularly in indoor environment where people spend approximately 80% of their time. This exposure is further influenced by building materials such as granite, which is commonly used in construction. This study investigated 21 varieties of granite tiles commercially available and commonly used as decorative finishing materials in residential building in Erbil City – Kurdistan region of Iraq. Gamma-ray spectrometry employing a “3 × 3” NaI(Tl) scintillation detector was used to determine the activity concentrations of 226Ra, 232Th, and 40K. The activity of 226Ra was arranged from 12 ± 05 to 163 ± 09 Bq.kg−1 with an average value of 81 ± 16 Bq.kg−1. In contrast, the activity concentration of 232Th varied from 0.7 ± 0.40 Bq.kg−1 to 153 ± 12 Bq.kg−1, with an average of 59 ± 07 Bq.kg−1. For 40K, the average activity concentration ranged from 220 ± 15 Bq.kg−1 to 2177 ± 46 Bq.kg−1 with an average of 1548 ± 39 Bq kg−1. When compared with established global average values, the majority of the analyzed granite tiles exhibited elevated levels of natural radioactivity. To assess the potential radiation hazard effects associated with 226Ra, 232Th, and 40K in granite samples, several radiological hazard indices were calculated.

Fatigue is a prevalent and late effect among childhood cancer survivors (CCSs). Few large studies have comprehensively evaluated its prevalence and determinants. Identifying risk factors for fatigue and severe fatigue (SF) is crucial to improving survivorship care. This study assessed the prevalence of fatigue and SF, as well as demographic, clinical, and treatment-related predictors in the French Childhood Cancer Survivor Study (FCCSS). This cross-sectional analysis included adult 5-year CCSs diagnosed before age 21 (1946-2000) in the FCCSS cohort. Fatigue was measured using the French Multidimensional Fatigue Inventory (MFI-20); SF was defined as a total score > 60. Associations with sex, age, cancer type, treatment, and social deprivation were estimated using multivariable regressions. Analyses were stratified by central nervous system (CNS) vs. non-CNS tumors and compared to general population norms. Among 3170 CCSs, fatigue scores exceeded population norms from age 30, with women affected earlier and more severely. General (10.0 ± 4.2) and physical fatigue (9.6 ± 4.2) were the most pronounced dimensions, increasing with age and peaking at ≥ 50years. Higher fatigue scores were independently associated with female sex, obesity, older age, and CNS tumor history. SF affected 16% of CCSs, more frequently in women (OR = 1.30), obese survivors (OR = 2.40), CNS tumor survivors (OR = 3.27), hematologic tumor survivors (OR = 1.46), and radiotherapy exposure (OR = 1.46). Fatigue remains a common, persistent late effect in CCSs. Female sex, older age, CNS tumors, and radiotherapy were strong predictors, underscoring the needs for targeted screening and long-term management.

Ultrasound in the evaluation and management of pharyngeal dysphagia: A narrative review.

Reject rate analysis focuses traditionally on frequency rather than radiation impact, thus limiting its alignment with radiation protection goals. This study examined reject rates by body part in digital radiography at a Finnish imaging department and introduced an evaluation of their relative contribution to patients' additional radiation exposure by calculating a median effective dose-weighted reject rate. The resulting metric may serve as a practical tool to support optimization of radiation burden. The pelvic region and lumbar spine rejected radiographs contributed the highest additional radiation dose, followed by the chest, where the high examination volume outweighed the low relative rejection rate in population-wide dose impact. Extremities contributed negligibly to additional effective dose irrespective of their reject rates, primarily due to a substantially lower radiation sensitivity. These findings emphasize the value of integrating effective dose metrics into reject analysis to better reflect patient risk and enhance quality assurance.

Fluoroscopically guided jejunal tube placement via percutaneous endoscopic gastrostomy (PEG-J) provides minimally invasive post-pyloric access in children. Limited data exist regarding routine application and procedural risks. To evaluate the safety and technical success of PEG-J in pediatric patients, performed without general anesthesia or sedation. All pediatric cases of fluoroscopically guided PEG-J procedures performed between 2011 and 2025 were included. Fluoroscopic images were reviewed to determine the final position of the tube tip. Technical success, complications, anatomical variants, and tube patency were assessed. Fluoroscopy time and dose area product (DAP) were documented. A total of 126 PEG-J procedures in 60 children (36 males) were analyzed. The technical success rate was 85% (107/126) with final tube tip placement in the jejunum in 88 cases (82%) and in the duodenum in 19 cases (18%). Nineteen procedures (15%) were unsuccessful, including six with documented anatomical causes (steep vertical duodenal entry, n=2; malrotation, hiatus hernia, hooked stomach in superior mesenteric artery syndrome, steep take-off of the jejunum with kinking of the tube at the ligament of Treitz, n=1 each) and 13 without documented reasons. The median fluoroscopy time was 5min 24s (range, 2s-37min), at a frame rate of 0.5 frames per second. The median DAP was 6.1cGy·cm2 (range, 0.08-343cGy·cm2). Fluoroscopically guided PEG-J placement is a safe and effective procedure in pediatric patients, with high technical success and low radiation exposure.

The 1945 atomic bombings in Hiroshima and Nagasaki exposed a large population to radiation, resulting in significant deaths and disabilities. Despite the potential transgenerational effects-defined as the multidimensional impact of atomic bomb exposure (i.e., physical, psychological, and social dimensions) transmitted from survivors to their descendants-research on second-generation survivors remains limited. Therefore, this study explores the lived experiences of Korean second-generation atomic bomb survivors from Hiroshima and Nagasaki. To this end, we interviewed 15 participants who identified themselves as the descendants of atomic bomb survivors and analyzed the obtained data using a descriptive phenomenological approach. We extracted four themes from the data: persistent pain, disability, and loss; uncertainty about the health risks of radiation exposure; family secrets etched into genes; and silenced voices of forgotten victim survivors. The participants reported various physical ailments and disabilities experienced by them and their families. Their awareness of the potential genetic impacts of radiation exposure led to concerns about their health and to possible genetic effects on their children. Nonetheless, they often felt compelled to conceal their fears and anxieties because of the social stigma and trauma experienced by their parents. These findings highlight the need for psychological care and support for this population, as well as the need to develop strategies aimed at health monitoring and counseling.

The Zero-Fluoroscopy (ZF) approach has emerged as an alternative technique for transcatheter ventricular septal defect (VSD) closure, eliminating radiation exposure by relying solely on echocardiographic guidance. This method is particularly beneficial for pediatric patients. However, its efficacy and safety compared to the standard fluoroscopy-guided approach remain uncertain. A systematic review was conducted following PRISMA guidelines. Data were retrieved from four databases. Studies reporting procedural success, complications, or procedural outcomes were included. Meta-analysis was performed using RStudio with a 95% CI, and subgroup comparisons were assessed. A total of 62 studies, including 5,020 patients (mean age 11.11 years), were analyzed. Nine studies utilized the ZF approach. The success rate was 95.5% (91.7-98.3%) for the ZF group and 98.0% (97.1-98.8%) for the fluoroscopy group, with no statistically significant difference (p = 0.08), indicating non-inferiority. The early residual shunt rate was significantly lower in the ZF group (5.5%, 0.1-15.8%) compared to the fluoroscopy group (20.8%, 15.7- 26.4%) (p < 0.05). Other complications, including new-onset conduction block (p = 0.12) and new-onset valvular regurgitation (p = 0.29), showed no significant differences. ZF closure shows similar success and safety to the standard approach, with the added benefit of reduced residual shunt and radiation exposure. ZF is a safe, effective alternative to fluoroscopy-guided VSD closure, particularly suited for reducing radiation risks in pediatric and vulnerable patients.