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The spiral FLAIR technique demonstrated better delineation of the trigeminal nerve REZ, improved tissue contrast of the brain stem, and minimized flow artifacts, compared to steady-state free precession (SSFP) MRI. Spiral FLAIR also improved fluid suppression, SNR, and artifacts, which contributed to better delineation of the trigeminal nerve REZ compared to conventional Cartesian FLAIR. The measured mean (± standard deviation) distance between spiral FLAIR and CT images is 0.98 ± 0.56mm, comparable to 0.40 ± 0.26mm in 3T T1 spoiled gradient echo (T1-SPGR), 0.59 ± 0.25mm in 3T SSFP, 0.66 ± 0.38mm in 1.5T T1-SPGR, and 0.61 ± 0.25mm in 1.5T Cartesian FLAIR.

A spiral FLAIR technique with improved image quality and good geometric accuracy provides a potential alternative for treatment planning in SRS for TN patients.

A spiral FLAIR technique with improved image quality and good geometric accuracy provides a potential alternative for treatment planning in SRS for TN patients.

Radioembolization with

Y microspheres is a treatment approach for liver cancer. Currently, employed dosimetric calculations exhibit low accuracy, lacking consideration of individual patient, and tissue characteristics.

The purpose of the present study was to employ deep learning (DL) algorithms to differentiate patterns of pretreatment distribution of

Tc-macroaggregated albumin on SPECT/CT and post-treatment distribution of

Y microspheres on PET/CT and to accurately predict how the

Y-microspheres will be distributed in the liver tissue by radioembolization therapy.

Data for 19 patients with liver cancer (10 with hepatocellular carcinoma, 5 with intrahepatic cholangiocarcinoma, 4 with liver metastases) who underwent radioembolization with

Y microspheres were used for the DL training. We developed a 3D voxel-based variation of the Pix2Pix model, which is a special type of conditional GANs designed to perform image-to-image translation. SPECT and CT scans along with the clinical target volum rapid and accurate 3D dosimetry method will render it clinically suitable and could improve patient-specific pretreatment planning.

The proposed deep-learning-based pretreatment planning method for liver radioembolization accurately predicted 90 Y microsphere biodistribution. Its combination with a rapid and accurate 3D dosimetry method will render it clinically suitable and could improve patient-specific pretreatment planning.

The RefleXion™ X1 is a novel radiotherapy system that is designed for image-guided radiotherapy, and eventually, biology-guided radiotherapy (BgRT). BgRT is a treatment paradigm that tracks tumor motion using real-time positron emission signals. This study reports the small-field measurement results and the validation of a Monte Carlo (MC) model of the first clinical RefleXion unit.

The RefleXion linear accelerator (linac) produces a 6 MV flattening filter free (FFF) photon beam and consists of a binary multileaf collimator (MLC) system with 64 leaves and two pairs of y-jaws. The maximum clinical field size achievable is 400×20 mm

. The y-jaws provide either a 10 or 20mm opening at source-to-axis distance (SAD) of 850mm. The width of each MLC leaf at SAD is 6.25mm. Percentage depth doses (PDDs) and relative beam profiles were acquired using an Edge diode detector in a water tank for field sizes from 12.5×10 to 100×20 mm

. Beam profiles were also measured using films. Output factors of fields ranging frofiles among different depths is within 1.72%. By taking the W2 measurements as the ground truth, the output correction factors k for Edge detector ranging from 0.958 to 1 were reported. For the MC model validation, the simulated PDD10 agreed within 0.6% to the diode measurement. The MC-simulated output factor differed from the W2 results by 2.3% on average (std=3.7%), while the MC simulated beam penumbra differed from the diode results by 0.67mm on average (std=0.42mm). The MC FWHM agreed with the diode results to within 1.40% on average. The averaged beam profile consistency calculated between the diode and MC profiles among different depths is less than 1.29%.

This study represents the first small-field dosimetry of a clinical RefleXion system. A complete and accurate MC model of the RefleXion linac has been validated.

This study represents the first small-field dosimetry of a clinical RefleXion system. A complete and accurate MC model of the RefleXion linac has been validated.Dermatofibrosarcoma protuberans (DFSP) is a mesenchymal neoplasm that is usually located in the dermis or subcutis and is locally aggressive. CDK and cancer Rarely, these lesions may undergo fibrosarcomatous transformation, which is thought to increase their metastatic potential. DFSP is classically associated with a 17;22 translocation (or ring chromosome thereof) resulting in fusion of the COL1A1 and PDGFB genes. However, variant fusions involving PDGFD have been recently reported. Herein, we present two morphologically diverse cases of DFSP with PDGFD rearrangement. Case 1 is a 68-year-old female with a left dorsal foot lesion. Morphologically, the lesion is unusual as it is a well-circumscribed, hypercellular, subcutaneous nodule with uniform CD34-positive spindle cells arranged in a herringbone pattern without storiform arrangement or "honeycombing" fat entrapment. It was diagnosed as pure fibrosarcomatous DFSP. Case 2 is a 37-year-old male with a right supra-auricular lesion. Morphologically, the lesion displays classic DFSP features including bland CD34-positive spindle cells with storiform growth, fat entrapment, and infiltrative borders. Both lesions were negative for COL1A1-PDGFB fusion but positive for PDGFD rearrangement by fluorescence in situ hybridization (FISH) analysis. FISH testing for PDGFD rearrangement should be performed in cases where there is a high suspicion for DFSP but initial studies for COL1A1-PDGFB are negative.During the COVID-19 pandemic, parents face unprecedented challenges linked to social isolation, uncertainty about the future, and financial, employment, and school-related stress. Individuals who planned to separate and divorce before the pandemic now find their lives on hold. In this exploratory study of 14 women who completed an online survey of open- and closed-ended questions regarding the divorce process and parenting challenges during COVID-19, we were guided by family stress and resilience theory and a directed qualitative content analysis approach to generate a collective story of their experiences, which included four themes (a) pile-up of tensions, challenges, and stressors, (b) living in limbo during the pandemic, (c) finding creative strategies and solutions to navigating parenting and relational dissolution, while still living together, and (d) reaching the breaking point. We conclude with implications for professionals seeking to support individuals, couples, and families during a time of unprecedented transition and uncertainty.

Although climate change and agricultural practices have non-negligible impacts on crop yields, their quantitative contributions to soybean yields remain unclear. First-order difference multiple regression was used to determine the respective contributions of climate change and agricultural practice to changes in soybean yields at station level from 1981 to 2010 in northeast China.

From 1981 to 2010, the soybean yields at 87% of the stations were increasing with an average 41.18 kg ha year

change trend in northeast China. The individual impacts of climate change and agricultural practice on soybean yield were -0.33% to 0.58% year

and -3.3% to 7.89% year

, respectively. The sensitivity of the soybean yield to climatic factors was related to latitude, and yields at high-latitude stations were positively correlated with temperature but negatively correlated with accumulated sunshine hours. Climate change contributed -24% to 38% to the trend in soybean yield, and the temperature had the greatest effect of all the climatic factors.

The contribution of agricultural practices was greater than that of climate change, counteracting the adverse effects of climate change and even affecting the direction of soybean yield changes. In adaptive decision making, priority should be given to management measures that have less impact on the environment, such as breeding new varieties adapted to specific latitudes, thus promoting the sustainable production of soybeans. © 2021 Society of Chemical Industry.

The contribution of agricultural practices was greater than that of climate change, counteracting the adverse effects of climate change and even affecting the direction of soybean yield changes. In adaptive decision making, priority should be given to management measures that have less impact on the environment, such as breeding new varieties adapted to specific latitudes, thus promoting the sustainable production of soybeans. © 2021 Society of Chemical Industry.The neurons in the rostral ventromedial medulla (RVM) play a major role in pain modulation. We have previously shown that early-life noxious bladder stimuli in rats resulted in an overall spinal GABAergic disinhibition and a long-lasting bladder/colon sensitization when tested in adulthood. However, the neuromolecular alterations within RVM neurons in the pathophysiology of early life bladder inflammation have not been elucidated. In this study, we have identified and characterized RVM neurons that are synaptically linked to the bladder and colon and examined the effect of neonatal bladder inflammation on molecular expressions of these neurons. A transient bladder inflammation was induced by intravesicular instillation of protamine sulfate and zymosan during postnatal days 14 through 16 (P14-16) followed by pseudorabies virus PRV-152 and PRV-614 injections into the bladder and colon, respectively, on postnatal day P60. Tissues were examined 96 hours post-inoculation for serotonergic, GABAergic, and enkephalinergic expressions using In situ Hybridization and/or Immunohistochemistry techniques. The results revealed that >50% of RVM neurons that are synaptically connected to the bladder (i.e., PRV-152+) were GABAergic, 40% enkephalinergic, and about 14% expressing serotonergic marker TpH2. Neonatal cystitis resulted in a significant increase in converging neurons in RVM receiving dual synaptic inputs from the bladder and colon. In addition, neonatal cystitis significantly downregulated GABA transporter VGAT with a concomitant increase in TpH2 expression in bladder-linked RVM neurons suggesting an alteration in supraspinal signaling. These alterations of synaptic connectivity and GABAergic/serotonergic expressions in RVM neurons may contribute to bladder pain modulation and cross-organ visceral sensitivity. This article is protected by copyright. All rights reserved.

We introduced an output factor (cGy/MU) prediction model for wobbling proton beams over the full range of proton energy, scatterer thickness, and the width of spread-out Bragg peak (SOBP).

From December 2015 to August 2020, 1990 wobbling proton fields were used to treat patients, where 1714 fields had a diameter smaller than 11cm and 276 had a diameter between 11 and 16cm, which were designated as small and middle wobbling radius cases, respectively. The output factor is defined as the ratio of proton absorbed dose at mid-depth of SOBP to monitor unit (MU). It depends dominantly on proton energy, scatterer thickness, and the width of SOBP. We established the prediction model using the polynomial fitting function and determined its coefficients for the small and middle wobbling radius cases. We evaluated the accuracy of our prediction model by calculating the difference between predicted and measured output factors.

For the small wobbling radius cases, the mean value of the output factor difference was 0.