OBJECTIVE: Brachytherapy has been indicated as an alternative option for treating cystic craniopharyngiomas (CPs). The potential benefits of brachytherapy for CPs have not yet been clarified. The purpose of this work was to conduct a meta-analysis to analyze the long-term efficacy and adverse reactions profile of brachytherapy for CPs.
METHODS: The relevant databases were searched to collect the clinical trials on brachytherapy in patients with CPs. Included studies were limited to publications in full manuscript form with at least 5-year median follow-up, and adequate reporting of treatment outcomes and adverse reactions data. Stata 12.0 was used for data analysis.
RESULTS: According to the inclusion and exclusion criteria, a total of 6 clinical trials involving 266 patients with CPs were included in this meta-analysis. The minimum average follow-up was 5 years. The results of the meta-analysis showed that 1-year, 2-3 years and 5 years progression free survival rates (PFS) are 75% (95%CI: 66-84%), 62% (95%CI: 52-72%) and 57% (95%CI: 22-92%), respectively. At the last follow-up, less than 16% of patients with visual outcomes worser than baseline in all included studies. While, for endocrine outcomes, less than 32% of patients worser than baseline level.
CONCLUSIONS: In general, based on the above results, brachytherapy should be considered as a good choice for the treatment of CP.

Craniopharyngioma (CP) treatment, including surgery and radiotherapy, can have short- and long-term vascular side effects. Hypothalamic damage is related to morbid obesity and may increase the lifelong risk of experiencing vascular events in CP patients. This review summarized the available evidence regarding vascular complications in adamantinomatous or papillary CP patients, whatever their age at diagnosis. Three databases (Medline, CINAHL, Web of Science) were searched (06/2023) to retrieve eligible articles. The search was limited to peer-reviewed articles. Titles, abstracts, and full texts were screened by two independent reviewers, and data were extracted using a self-developed grid. Seventy-two studies were included in this review; the majority were case reports. Reported vascular sequela that occurred due to surgery were fusiform dilation of the carotid artery, stroke, vasospasm, hemorrhage, and aneurysm. Related conditions that emerged due to radiotherapy included Moyamoya syndrome and cavernoma. Cardiovascular morbidity and mortality often lead to hypothalamic obesity and metabolic syndrome in CP patients. Vascular damage is a rare complication of CP treatment. Surgical strategies should protect the surrounding hypothalamic and vascular structures. Patients receiving radiotherapy, particularly at a young age, should undergo magnetic resonance angiography monitoring to identify possible neurovascular sequela during post-treatment care.

BACKGROUND: High-dose-rate brachytherapy (HDR-BT) plays an important role in the treatment of locally recurrent prostate cancer after definitive treatment. The objective of this study is to summarize the efficacy and toxicity of HDR-BT in these patients.
METHODS: We performed a systematic review of PubMed and EMBASE from inception to July 2023. The primary endpoint was relapse-free survival (RFS) in different subgroups, and the secondary endpoint was gastrointestinal (GI) and genitourinary (GU) toxicity. A semi-automated tool (WebPlotDigitizer) and a new Shiny application combined with R software (R: a language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria; https://www.R-project.org/ ) helped to reconstruct survival curves.
RESULTS: Twenty-six studies met the inclusion criteria for quantitative analysis, including 1447 patients. A total of 761 patients from 13 studies were included in survival reconstruction, and the median RFS time was 61.2 months (57.6-72.0 months). The estimated 2‑, 3‑, and 5‑year rates were 75.9% (95% confidence interval [CI] 72.8 ~ 79.2%), 66.7% (95% CI 63.0 ~ 70.5%), and 52.3% (95% CI 47.5 ~ 57.4%), respectively. Whole-gland irradiation with multiple fractions (≥ 2 F) resulted in better RFS compared with focal gland irradiation with fewer fractions (1 F mostly; hazard ratio [HR]: 0.60, 95% CI 0.47-0.77, p < 0.0001). According to the different median time from primary treatment to salvage therapy (TRS) and median age at recurrence, short median TRS (56-67.2 months vs. 70-120 months; HR 0.52, 95% CI 0.68-0.40; p < 0.0001) and younger median age (60-70 years vs. 71-75 years; HR 0.58, 95% CI 0.46-0.74; p < 0.0001) were positive factors for RFS. The cumulative incidences estimated for grade ≥ 3 acute and late GU toxicities were 1% (95% CI 0 ~ 1%) and 5% (95% CI 4 ~ 7%), respectively. Three patients (3/992) experienced grade ≥ 3 late GI toxicity, and no cases of grade ≥ 3 acute GI toxicity were reported.
CONCLUSIONS: HDR-BT has a high safety profile and good RFS benefit for salvage treatment of radiorecurrent prostate cancer. In terms of RFS, whole-gland irradiation with multiple fractions seems to be better than focal gland irradiation with fewer fractions, while short TRS and younger age are good prognostic factors. In view of the low level of evidence in the included studies and the large heterogeneity of each study, these conclusions still need to be confirmed by randomized controlled trials.

Immunotherapy has revolutionized the treatment of several cancers, including melanoma and lung cancer. However, for colorectal cancer, it is ineffective for 95% of patients with microsatellite-stable disease. Recent evidence suggests that the liver\'s immune microenvironment plays a pivotal role in limiting the effectiveness of immunotherapy. There is also evidence to show that targeting liver metastases with locoregional therapies, such as surgery or irradiation, could potentiate immunotherapy for these patients. This review presents evidence from preclinical studies regarding the underlying mechanisms and from clinical studies that support this approach. Furthermore, we outline potential directions for future clinical trials. This innovative strategy could potentially establish immunotherapy as an effective treatment for MS-stable colorectal cancer patients, which are currently considered resistant.

UNASSIGNED: To evaluate the impact various levels of irradiation have on bone-patellar tendon-bone (BTB) allograft load-to-failure.
UNASSIGNED: Pubmed, Google Scholar and Embase were searched for studies reporting load-to-failure measurements of BTB allografts following gamma or eBeam irradiation. All systematic reviews, editorials, as well as studies that utilized animal models and/or other graft sources (achilles, hamstring, quadriceps) were excluded. Meta-analysis was performed to compare the impact of low dose (19 ≤ kGy), intermediate (20-49 kGy) and high dose (>50 kGy) gamma and eBeam radiation on load-to-failure.
UNASSIGNED: Twelve studies, containing a total of 429 BTB allografts (159 controls, 270 irradiated), were identified. Load-to-failure of BTB allograft was significantly decreased at intermediate (20-49 kGy) doses of radiation, while low (≤19 kGy) and high (>50 kGy) doses did not significantly change load-to-failure.
UNASSIGNED: Intermediate doses of radiation may negatively impact the biomechanical integrity of BTB allograft in vitro. Future studies are required to examine clinical outcomes at varying irradiation levels.

BACKGROUND: Severe idiopathic arthrofibrosis after total knee arthroplasty (TKA) is a challenging problem to treat. Low-dose irradiation may decrease fibro-osseous proliferation, while rotating-hinge (RH) revision allows for distal femur shortening and collateral ligament sacrifice. This study reports the clinical outcomes and implant survivorship in patients treated with low-dose irradiation and RH revision for severe idiopathic arthrofibrosis following TKA.
METHODS: A retrospective review was performed on 60 consecutive patients. Patients who had greater than 80° arc of knee motion or less than 15° flexion contracture were excluded. Mean follow-up was 6 years (range, 2 to 14). Kaplan-Meier survivorship analyses were performed, and logistic regressions were used to determine associations between preoperative patient characteristics and clinical outcomes.
RESULTS: Median flexion contracture and median terminal flexion at presentation were 20 and 70°, respectively; at final follow-up, 59 of 60 patients (98%) had ≤10° flexion contracture and 49 of 60 patients (82%) had ≥90° of flexion. The 10-year survivorship free from reoperation for any reason, revision for any reason, and revision for aseptic loosening were 63, 87, and 97%, respectively. There were 27% percent of patients who underwent a manipulation under anesthesia postoperatively, which was the most common reason for return to the operating room. A greater number of prior surgeries was significantly associated with worse range of motion at the final follow-up (P = .004). There were no known radiation-associated complications.
CONCLUSIONS: Patients with severe idiopathic arthrofibrosis following TKA treated with low-dose irradiation and RH revision maintained a gain in knee range of motion of 60° with reliable flexion contracture correction at a mean 6-year follow-up. A manipulation under anesthesia was common in the postoperative period. Survivorship free from revision for aseptic loosening was excellent at 10 years.

After the Fukushima nuclear accident, the development of new accident-tolerant fuel cladding materials has become a research hotspot around the world. Due to its outstanding corrosion resistance, radiation resistance, and creep properties at elevated temperatures, the oxide dispersion strengthened (ODS) FeCrAl alloy, as one of the most promising candidate materials for accident-tolerant fuel cladding, has been extensively studied during the past decade. Recent research on chemical composition design as well as its effects on the microstructure and mechanical properties has been reviewed in this paper. In particular, the reasonable/optimized content of Cr is explained from the aspects of oxidation resistance, radiation resistance, and thermal stability. The essential role of the Al element in oxidation resistance, high-temperature stability, and workability was reviewed in detail. The roles of oxide-forming elements, i.e., Y (Y2O3), Ti, and Zr, and the solid solution strengthening element, i.e., W, were discussed. Additionally, their reasonable contents were summarized. Typical types of oxide, i.e., Y-Ti-O, Y-Al-O, and Y-Zr-O, and their formation mechanisms were also discussed in this paper. All aspects mentioned above provide an important reference for understanding the effects of composition design parameters on the properties of nuclear-level ODS FeCrAl alloy.

Magnetic tunnel junctions (MTJs) have been widely utilized in sensitive sensors, magnetic memory, and logic gates due to their tunneling magnetoresistance. Moreover, these MTJ devices have promising potential for renewable energy generation and storage. Compared with Si-based devices, MTJs are more tolerant to electromagnetic radiation. In this review, we summarize the functionalities of MgO-based MTJ devices under different electromagnetic irradiation environments, with a focus on gamma-ray radiation. We explore the effects of these radiation exposures on the MgO tunnel barriers, magnetic layers, and interfaces to understand the origin of their tolerance. This review enhances our knowledge of the radiation tolerance of MgO-based MTJs, improves the design of these MgO-based MTJ devices with better tolerances, and provides information to minimize the risks of irradiation under various irradiation environments. This review starts with an introduction to MTJs and irradiation backgrounds, followed by the fundamental properties of MTJ materials, such as the MgO barrier and magnetic layers. Then, we review and discuss the MTJ materials and devices\' radiation tolerances under different irradiation environments, including high-energy cosmic radiation, gamma-ray radiation, and lower-energy electromagnetic radiation (X-ray, UV-vis, infrared, microwave, and radiofrequency electromagnetic radiation). In conclusion, we summarize the radiation effects based on the published literature, which might benefit material design and protection.

The bell pepper (Capsicum annuum L.) is a commercially important horticultural crop grown in tropical and sub-tropical areas across the world. Despite this importance, it is a perishable vegetable with a limited shelf life and high disease susceptibility. Bell pepper output has expanded significantly in recent years. However, this crop is still experiencing close to 40% postharvest losses annually. Chemical fumigation for postharvest disease control of bell pepper has been shown to be efficient against fungal infections, but environmental impact and consumption hazards limit its full use. Recently, non-chemical techniques including biological and botanical methods, non-destructive technologies and Artificial intelligence have been demonstrated to be effective as postharvest management of bell pepper. The paper provides exciting information on recent and emerging techniques for curtailing these losses in bell pepper, alongside their mechanism and existing benefits. The current limitations of these techniques as well as recommendations for potential applications are also addressed.

By their unique compositions and microstructures, recently developed high-entropy materials (HEMs) exhibit outstanding properties and performance above the threshold of traditional materials. Wear- and erosion-resistant materials are of significant interest for different applications, such as industrial devices, aerospace materials, and military equipment, related to their capability to tolerate heavy loads during sliding, rolling, or impact events. The high-entropy effect and crystal lattice distortion are attributed to higher hardness and yield stress, promoting increased wear and erosion resistance in HEMs. In addition, HEMs have higher defect formation/migration energies that inhibit the formation of defect clusters, making them resistant to structural damage after radiation. Hence, they are sought after in the nuclear and aerospace industries. The concept of high-entropy, applied to protective materials, has enhanced the properties and performance of HEMs. Therefore, they are viable candidates for today\'s demanding protective materials for wear, erosion, and irradiation applications.