Effect of leaded glasses and thyroid shielding on cone beam CT radiation dose in an adult female phantom

Objectives:

This study aims to demonstrate the effectiveness of leaded glasses in reducing the lens of eye dose and of lead thyroid collars in reducing the dose to the thyroid gland of an adult female from dental cone beam CT (CBCT). The effect of collimation on the radiation dose in head organs is also examined.

Methods:

Dose measurements were conducted by placing optically stimulated luminescent dosemeters in an anthropomorphic female phantom. Eye lens dose was measured by placing a dosemeter on the anterior surface of the phantom eye location. All exposures were performed on one commercially available dental CBCT machine, using selected collimation and exposure techniques. Each scan technique was performed without any lead shielding and then repeated with lead shielding in place. To calculate the percent reduction from lead shielding, the dose measured with lead shielding was divided by the dose measured without lead shielding. The percent reduction from collimation was calculated by comparing the dose measured with collimation to the dose measured without collimation.

Results:

The dose to the internal eye for one of the scans without leaded glasses or thyroid shield was 0.450 cGy and with glasses and thyroid shield was 0.116 cGy (a 74% reduction). The reduction to the lens of the eye was from 0.396 cGy to 0.153 cGy (a 61% reduction). Without glasses or thyroid shield, the thyroid dose was 0.158 cGy; and when both glasses and shield were used, the thyroid dose was reduced to 0.091 cGy (a 42% reduction).

Conclusions:

Collimation alone reduced the dose to the brain by up to 91%, with a similar reduction in other organs. Based on these data, leaded glasses, thyroid collars and collimation minimize the dose to organs outside the field of view.     

The biomechanics of subscapularis repair in reverse shoulder arthroplasty: The effect of lateralization and insertion site

Functional outcomes of subscapularis (SSc) repair following reverse shoulder arthroplasty (RSA) remains controversial. SSc repair in combination with glenosphere lateralization was reported to yield worse clinical outcomes compared with the non-lateralized glenosphere. The aim of this biomechanical study was to investigate how glenosphere lateralization and different re-insertion sites can affect the biomechanics of the SSc after RSA. Nine patient-specific RSA shoulder models were created from patients' computed tomography scans. Moment arms and SSc length were calculated for abduction, forward flexion, and internal rotation in 20° and 90° abduction for three configurations of glenosphere lateralization (standard/+0, +5, and +10 mm) and three SSc repair sites (native, superior, and inferior) and compared with the native shoulder. When compared with the native shoulder, RSA resulted in large adducting SSc moment arms that were antagonistic to the deltoid. Glenosphere lateralization had no effect on SSc moment arms in any motion. However, lateralization increased SSc tension beyond its anatomic length for +5 and +10 mm of lateralization when attached to its native insertion. A superior SSc repair site created the least adductive moment arm as well as the least amount of SSc lengthening. Increased glenosphere lateralization showed a significant increase in the SSc length, which in combination with its adductive moment arm can be antagonistic to deltoid function. However, a superior SSc repair site may help reduce the adductive SSc moment arm and allow for reduced tension on the repair as its length in that location is less than that of the native SSc. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 38:888-894, 2020     

A phase III trial of recombinant human erythropoietin therapy in nonanemic orthopedic patients subjected to aggressive removal of blood for autologous use: dose, response, toxicity, and efficacy

BACKGROUND: Previous clinical trials have shown that the use of recombinant human erythropoietin (EPO) can facilitate autologous blood donation and reduce allogeneic blood transfusions in autologous blood donors who are anemic at first donation. However, the role of EPO therapy in nonanemic patients remains undefined. To identify this role, a randomized, controlled, multicenter dose-escalation trial was conducted in patients whose initial hematocrit was > 39 percent (0.39). STUDY DESIGN AND METHODS: EPO (150, 300, or 600 units/kg) or placebo was administered intravenously at each of six phlebotomy visits over a 3-week study period. Sixteen (14%) of 116 patients were unable to complete the treatment protocol because of adverse events (n = 11) or for personal reasons (n = 5); 2 patients (1 EPO and 1 placebo) experienced serious adverse events. RESULTS: In 91 evaluable patients, additional red cell production during the study period was 440 +/− 176, 621 +/− 215, 644 +/− 196, and 856 +/− 206 mL (mean +/− SD), respectively, for patients receiving placebo and EPO at 150, 300, and 600 units/kg (p < 0.05 for all EPO groups compared to placebo). However, the percentages of patients in each group who received allogeneic blood did not differ: 2 (9%) of 23 placebo patients and 6 (9%) of 68 EPO patients. CONCLUSION: It is concluded that, while EPO therapy increased preoperative red cell production, no clinical benefit could be demonstrated in autologous blood donors who were not anemic at first blood donation.     

Validity of a theoretical model to examine blood oxygenation dependent optoacoustics

A theoretical model investigating the dependence of optoacoustic (OA) signal on blood oxygen saturation (SO(2)) is discussed. The derivations for the nonbandlimited and bandlimited OA signals from many red blood cells (RBCs) are presented. The OA field generated by many RBCs was obtained by summing the OA field emitted by each RBC approximated as a fluid sphere. A Monte Carlo technique was employed generating the spatial organizations of RBCs in two-dimensional. The RBCs were assumed to have the same SO(2) level in a simulated configuration. The fractional number of oxyhemoglobin molecules, confined in a cell, determined the cellular SO(2) and also defined the blood SO(2). For the nonbandlimited case, the OA signal amplitude decreased and increased linearly with blood SO(2) when illuminated by 700 and 1000 nm radiations, respectively. The power spectra exhibited similar trends over the entire frequency range (MHz to GHz). For the bandlimited case, three acoustic receivers with 2, 10, and 50 MHz as the center frequencies were considered. The linear variations of the OA amplitude with blood SO(2) were also observed for each receiver at those laser sources. The good agreement between simulated and published experimental results validates the model qualitatively.     

Heteroatoms (Si,B, N,and P) doped 2D monolayer MoS2 for NH3 gas detection

2D transition metal dichalcogenide MoS₂ monolayer quantum dots (MoS₂-QD) and their doped boron (B@MoS₂-QD), nitrogen (N@MoS₂-QD), phosphorus (P@MoS₂-QD), and silicon (Si@MoS₂-QD) surfaces have been theoretically investigated using density functional theory (DFT) computation to understand their mechanistic sensing ability, such as conductivity, selectivity, and sensitivity toward NH₃ gas. The results from electronic properties showed that P@MoS₂-QD had the lowest energy gap, which indicated an increase in electrical conductivity and better adsorption behavior. By carrying out comparative adsorption studies using m062-X, ωB97XD, B3LYP, and PBE0 methods at the 6-311G++(d,p) level of theory, the most negative values were observed from ωB97XD for the P@MoS₂-QD surface, signifying the preferred chemisorption surface for NH₃ detection. The mechanistic studies provided in this study also indicate that the P@MoS₂-QD dopant is a promising sensing material for monitoring ammonia gas in the real world. We hope this research work will provide informative knowledge for experimental researchers to realize the potential of MoS₂ dopants, specifically the P@MoS₂-QD surface, as a promising candidate for sensors to detect gas.

2D transition metal dichalcogenide MoS₂ monolayer quantum dots (MoS₂-QD) and their doped boron (B@MoS₂-QD), nitrogen (N@MoS₂-QD), phosphorus (P@MoS₂-QD), and silicon (Si@MoS₂-QD) counterparts are proposed as selective sensors for NH₃ gas.     

新型输送型球囊扩张导管在颅内动脉狭窄治疗中的临床应用研究

目的：探讨新型输送型球囊扩张导管(Fastunnel)在颅内动脉粥样硬化狭窄介入治疗中的应用效果。方法：2021年11月至2022年2月,我们使用新型输送型球囊扩张导管对10例颅内动脉粥样硬化狭窄的患者进行了球囊扩张+支架成形术。收集并分析了患者的基线情况、影像学特点、治疗情况及围手术期情况。结果：男6例,女性4例,平均年龄(62.7±6.7)岁。10例患者均成功接受手术治疗,手术时长为16~65(37.3±18.2)min,治疗过程所受辐射剂量为1381~4901(2643.7±1131.7)mGy,剂量面积乘积(DAP)值为5707~38112(17526.8±10809.5)μGym₂^。围手术期无出血及缺血相关并发症。结论：输送型球囊扩张导管具有较好的安全性,能有效地简化手术步骤、缩短手术时间,对减少患者及医生所受射线剂量。