Langballemeyers7740

Ultra-high dose rate radiation has been reported to produce a more favorable toxicity and tumor control profile compared to conventional dose rates that are used for patient treatment. So far, the so-called FLASH effect has been validated for electron, photon and scattered proton beam, but not yet for proton pencil beam scanning (PBS). Because PBS is the state-of-the-art delivery modality for proton therapy and constitutes a wide and growing installation base, we determined the benefit of FLASH PBS on skin and soft tissue toxicity. Using a pencil beam scanning nozzle and the plateau region of a 250 MeV proton beam, a uniform physical dose of 35 Gy (toxicity study) or 15 Gy (tumor control study) was delivered to the right hind leg of mice at various dose rates Sham, Conventional (Conv, 1 Gy/s), Flash60 (57 Gy/s) and Flash115 (115 Gy/s). Acute radiation effects were quantified by measurements of plasma and skin levels of TGF-β1 and skin toxicity scoring. Delayed irradiation response was defined by hind leg contracture as a surrogate of irradiation-induced skin and soft tissue toxicity and by plasma levels of 13 different cytokines (CXCL1, CXCL10, Eotaxin, IL1-beta, IL-6, MCP-1, Mip1alpha, TNF-alpha, TNF-beta, VEGF, G-CSF, GM-CSF and TGF- β1). Plasma and skin levels of TGF-β1, skin toxicity and leg contracture were all significantly decreased in FLASH compared to Conv groups of mice. FLASH and Conv PBS had similar efficacy with regards to growth control of MOC1 and MOC2 head and neck cancer cells transplanted into syngeneic, immunocompetent mice. These results demonstrate consistent delivery of FLASH PBS radiation from 1 to 115 Gy/s in a clinical gantry. Radiation response following delivery of 35 Gy indicates potential benefits of FLASH versus conventional PBS that are related to skin and soft tissue toxicity.Clinical practice and some scientific evidence seem to suggest that there is some kind of relationship between the components that form the postural chain. For professional dancers, good posture and balance are essential. The aim of the present retrospective study is to evaluate whether gnathological treatment could have an impact on the postural balance and sports performance of professional ballet dancers. Electromyographic (EMG) data and balance tests were recorded before and after six months of treatment with a customized occlusal splint. Twenty athletes were examined during ballet exercises in terms of balance and speed of execution by two experienced clinicians. The results showed statistically significant changes for all EMG tests carried out and the Flamingo Balance Test. It appears that the use of a customized occlusal device improved neuro-muscular coordination and the overall performance of dancers.Central nervous system (CNS) tuberculosis is a rare manifestation of all tuberculosis presentations. The incidence of brain tuberculoma is increasing in developed countries due to HIV infection and immigration from tuberculosis-endemic countries. Symptoms and radiologic findings of CNS tuberculosis can be non-specific and lead to misdiagnosis or mistreatment. Intracranial tuberculoma can present with a seizure, intracranial hypertension, or focal neurologic symptoms. In our case, the diagnosis was challenging between neurosarcoidosis and intracranial tuberculoma due to inconclusive results of stereotactic brain biopsy and clinical presentation. The pathology result of the open brain biopsy revealed non-caseating granuloma. Finally, we were able to diagnose intracranial tuberculoma following acid-fast bacilli culture results of open brain biopsy. This report highlights the importance of including intracranial tuberculoma in the differential diagnosis of cerebral space-occupying lesions, even in patients with negative laboratory findings of tuberculosis.Thirty honey samples from different regions of Estonia were investigated to determine the chemical compositions, physicochemical properties, bioactive compounds, and sensory characteristics of typical honeys from a northern climate. The physicochemical parameters, such as electrical conductivity, moisture content, free acidity, hydroxymethylfurfural, diastase, and invertase activity were measured. The color was measured and expressed by L*-, a*-, and b*-coordinates. Sensory parameters were determined by using "fruity", "floral", "berry-like", "herbal", "woody", "spicy", "sweet", and "animal-like" as the main odor and flavor attributes. The total polyphenol and flavonoid contents were in the range of 26.2-88.7 mg gallic acid equivalents (GAE) per 100 g and 1.9-6.4 mg quercetin equivalents (QE) per 100 g, respectively. The identified polyphenols showed the highest intensities of caffeic acid, coumaric acid, and abscisic acid and its derivatives. The protocatechuic acid intensity was highest in honeys containing traces of honeydew elements and of cinnamic acid and myricetin in heather honey. The water-soluble antioxidant values were 37.8-311.2 mg ascorbic acid equivalents (AAE) per 100 g and the lipid soluble antioxidant values were 14.4-60.7 mg Trolox equivalents (TE) per 100 g. The major amino acid in the analyzed honeys was proline, with variable values depending on the honey's botanical source. Correlations were calculated based on the results obtained. It was revealed that the typical Estonian honey has floral, berry-like, sweet, and rather mild sensory characteristics. Most of the honeys lacked stronger spicy, woody, and animal-like attributes. The typical color of Estonian honey is quite light.Disposition is one of the main tasks in the emergency department. However, there is a lack of objective and reliable disposition criteria, and diagnosis-based risk prediction is not feasible at early time points. The aim was to derive a risk score (TRIAL) based on routinely collected baseline (TRIage level and Age) and Laboratory data-supporting disposition decisions by risk stratification based on mortality. We prospectively included consecutive patients presenting to the emergency department over 18 weeks. Data sets of routinely collected baseline (triage level and age) and laboratory data were used for multivariable logistic regression to develop the TRIAL risk score predicting mortality. Routine laboratory variables and disposition cut-offs were chosen beforehand by expert consensus. Risk stratification was based on low risk (10%) of in-hospital mortality. In total, 8687 data sets were analyzed. Variables identified to develop the TRIAL risk score were triage level (Emergency Severity Index), age, lactate dehydrogenase, creatinine, albumin, bilirubin, and leukocyte count. The area under the ROC curve for in-hospital mortality was 0.93. Stratification according to the TRIAL score showed that 67.5% of all patients were in the low-risk category. Mortality was 0.1% in low-risk, 3.5% in intermediate-risk, and 26.2% in high-risk patients. The TRIAL risk score based on routinely available baseline and laboratory data provides prognostic information for disposition decisions. TRIAL could be used to minimize admission in low-risk and to maximize observation in high-risk patients.Academic success is a complex concept comprising not only good academic performance, but also the development of competencies and the accomplishment made by the ends of learning. Among the motivational and attentional variables likely to influence academic success, extant literature reports the relevance of developing self-regulation and attentional control to foster school success. Still, little is known about how to foster attentional control competencies through training on self-regulated learning strategies. The present study aims are twofold (i) to assess the efficacy of a program targetted to promote self-regulation strategies on attentional control, specifically in selective attention, and (ii) to explore the role of selective attention on arithmetic performance. Participants were 136 fourth grade students, aged from 8 to 11 years old. Of those, 68 were enrolled in a school-based intervention aimed to promote self-regulation. At the end of the intervention, the experimental group showed higher levels of self-regulation and selective attention that were significantly different when compared to the control group. The SR training has influenced positively participants SA with impact on their arithmetic competencies. The findings of this study can provide relevant insight to better understand these variables and to design better in-class practices.In object detection of remote sensing images, anchor-free detectors often suffer from false boxes and sample imbalance, due to the use of single oriented features and the key point-based boxing strategy. This paper presents a simple and effective anchor-free approach-RatioNet with less parameters and higher accuracy for sensing images, which assigns all points in ground-truth boxes as positive samples to alleviate the problem of sample imbalance. In dealing with false boxes from single oriented features, global features of objects is investigated to build a novel regression to predict boxes by predicting width and height of objects and corresponding ratios of l_ratio and t_ratio, which reflect the location of objects. Besides, we introduce ratio-center to assign different weights to pixels, which successfully preserves high-quality boxes and effectively facilitates the performance. On the MS-COCO test-dev set, the proposed RatioNet achieves 49.7% AP.The risk of neuromuscular blockade is certainly minimized by sugammadex in combination with monitoring. However, the effect of sugammadex-aided recovery on patients' satisfaction is unclear. This study compared the Quality of Recovery (QoR)-15 score, which is a patient-reported outcome, in patients undergoing laparoscopic cholecystectomy. Eighty patients were randomly assigned to the neostigmine or sugammadex groups. At the end of surgery, neostigmine or sugammadex was administered, and tracheal extubation was performed after confirmation of a train of four ratio ≥ 0.9. The QoR-15 questionnaire was administered at 1 day before surgery and on post-operative days (POD) 1 and 2. The primary outcome was the QoR-15 score on POD 1. The secondary outcomes were the QoR-15 score on POD 2, modified Aldrete score, length of post-anesthetic care unit stay, post-operative pain, administration of anti-emetics, urinary retention, and length of hospital stay. No significant differences were found in QoR-15 scores on POD 1 (94.4 vs. 95.5, p = 0.87) or 2 (116.3 vs. 122, p = 0.33). Secondary outcomes were also comparable, with the exception of urinary retention (15.8% neostigmine vs. selleck inhibitor 2.6% sugammadex, p = 0.04). This study demonstrated that the quality of recovery was comparable between the neostigmine and sugammadex groups when reversal and tracheal extubation were performed in accordance with the current guidelines.The aim of the study was to objectively evaluate the short-term effect of Arabic coffee and black tea on oral halitosis. This study was a single-center, randomized, double-blind, placebo-controlled, crossover clinical trial on 17 healthy individuals. During the initial visit, pre-treatment breath samples were collected from each subject and analyzed using portable gas chromatography (OralChroma™). Four interventions were evaluated, with Arabic coffee and black tea as the test intervention tools, mouthwash containing a solution (0.05% chlorhexidine, 0.05% cetylpyridinium chloride, and 0.14% zinc lactate (CHX-CPC-Zn)) as a positive control, and drinking water as a negative control. Halitosis was induced by rinsing with 10 mL solution of L-cysteine for 30 s. Twenty minutes later, a breath sample was taken to record the baseline volatile sulfur compounds (VSC) levels (T0). Then, the participants were asked to rinse with 10 mL of a randomly-assigned solution for 30 s. Sixty minutes later, another breath sample was recorded (T1).