OBJECTIVE: The main objective of this study was to assess inter- and intrafraction errors for two patient immobilisation devices in the context of lung stereotactic body radiation therapy: a vacuum cushion and a simple arm support.
METHODS: Twenty patients who were treated with lung stereotactic body radiation therapy in supine position with arms above their head were included in the study. Ten patients were setup in a vacuum cushion (Bluebag™, Elekta) and ten other patients with a simple arm support (Posirest™, Civco). A pretreatment four-dimensional cone-beam computed tomography and a post-treatment three-dimensional cone-beam computed tomography were acquired to compare positioning and immobilisation accuracy. Based on a rigid registration with the planning computed tomography on the spine at the target level, translational and rotational errors were reported.
RESULTS: The median number of fractions per treatment was 5 (range: 3-10). Mean interfraction errors based on 112 four-dimensional cone-beam computed tomographies were similar for both setups with deviations less than or equal to 1.3mm in lateral and vertical direction and 1.2° in roll and yaw. For longitudinal translational errors, mean interfraction errors were 0.7mm with vacuum cushion and -3.9mm with arm support. Based on 111 three-dimensional cone-beam computed tomographies, mean lateral, longitudinal and vertical intrafraction errors were -0.1mm, -0.2mm and 0.0mm respectively (SD: 1.0, 1.2 and 1.0mm respectively) for the patients setup with vacuum cushion, and mean vertical, longitudinal and lateral intrafraction errors were -0.3mm, -0.7mm and 0.1mm respectively (SD: 2.3, 1.8 and 1.4mm respectively) for the patients setup with arm support. Intrafraction errors means were not statistically different between both positions but standard deviations were statistically larger with arm support.
CONCLUSIONS: The results of our study showed similar inter and intrafraction mean deviations between both positioning but a large variability in intrafraction observed with arm support suggested a more accurate immobilization with vacuum cushion.

In conservative treatment for proximal humerus fractures (PHFs), the immobilization position of the affected arm should not be determined uniformly. The aim of this study is to investigate the optimal immobilization position for conservative treatment of different types of PHFs. We hypothesized that the optimal position minimizing the deforming force in PHFs depends on the fracture components involved. PHF models involving either the surgical neck (SN) or greater tuberosity (GT) were created using 12 fresh-frozen cadaveric shoulders. In the SN model, the deforming forces on the pectoralis major muscle were measured in full adduction by increasing external rotation. In the GT model, the deforming force of the supraspinatus muscle was measured in neutral rotation by decreasing abduction, and the deforming force of the infraspinatus muscle was measured in full adduction by increasing internal rotation, respectively. In the SN model, the deforming force of the pectoralis major muscle increased significantly with external rotation from full internal rotation to neutral rotation (P = 0.006), indicating that the arm should be placed in full internal rotation. In the GT model, the deforming force of the supraspinatus muscle increased significantly with adduction from 45° of abduction to full adduction (P = 0.006); the deforming force of the infraspinatus muscle increased significantly with internal rotation from neutral rotation to full internal rotation (P = 0.006). These findings should be considered when placing the arm in abduction and neutral rotation so as to minimize the deforming force by either the supra or infraspinatus muscle. In conservative treatment for PHFs, the affected arm should be placed in a position that minimizes the deforming force on the fracture components involved.

OBJECTIVE: To compare patient discomfort and immobilisation performance of open-face and closed immobilization masks in cranial radiotherapy.
METHODS: This was a single-center randomized self-controlled clinical trial. At CT simulation, an open-face and closed mask was made for each patient and treatment plans with identical dose prescription were generated for each mask. Patients were randomised to start treatment with an open-face or closed mask. Masks were switched halfway through the treatment course; every patient was their own control. Patients self-reported discomfort, anxiety and pain using the visual analogue scale (VAS). Inter- and intrafraction set-up variability was measured with planar kV imaging and a surface guided radiotherapy (SGRT) system for the open-face masks.
RESULTS: 30 patients with primary or metastatic brain tumors were randomized - 29 completed radiotherapy to a median total dose of 54 Gy (range 30-60 Gy). Mean discomfort VAS score was significantly lower with open-face masks (0.5, standard deviation 1.0) vs. closed masks (3.3, standard deviation 2.9), P < 0.0001. Anxiety and pain VAS scores were significantly lower with open-face masks (P < 0.0001). Closed masks caused more discomfort in infraorbital (P < 0.001) and maxillary (P = 0.02) areas. Two patients and 27 patients preferred closed or open-face masks, respectively. Interfraction longitudinal shifts and roll and yaw rotations were significantly smaller and lateral shifts were significantly larger with closed masks in combination with the laser system (P < 0.05) compared to open masks in combination with a SGRT system. Intrafraction variability did not differ between the masks.
CONCLUSIONS: Open-face masks are associated with decreased patient discomfort without compromising patient positioning and immobilisation accuracy.

UNASSIGNED: The Dual Shell Encompass Fibreplast™ System (DS-Encompass) by CQ Medical™ is validated for frameless immobilization in stereotactic brain radiotherapy. An alternative mask model has been proposed with the rear shell replaced by a Moldcare® cushion (M-Encompass). To validate the use of this model in our cranial stereotactic workflow method including HyperArc™, we performed a prospective randomized study comparing inter-and intrafractional motion and patients comfort between both masks.
UNASSIGNED: A prospective randomized study between DS-Encompass and M-Encompass was conducted involving 60 participants. Stratification between DS-Encompass and M-Encompass was carried out based on the fractionation scheme. Treatment plans were created with HyperArc™. During treatment, surface guidance was used for patient positioning and monitoring. A pre-treatment cone-beam CT (CBCT) was acquired to correct interfractional motion and a post-treatment CBCT was acquired to quantify the intrafractional motion. Patients reported comfort was analyzed with a Likert-scale at the end of the treatment. Unpaired t-tests were conducted to determine the level of significance.
UNASSIGNED: No significant difference in interfractional translations is present. A significant difference is revealed in roll-axis rotation, where DS-Encompass allows for smaller deviations. Since interfractional motion can be corrected through daily CBCT-scans and 6D-couch corrections, they are clinically irrelevant. Intrafractional motion does not differ significantly and remains below 0.5 mm and 0.5° for both systems. There is no statistical difference in patient-reported comfort.
UNASSIGNED: We conclude that Encompass with Moldcare offers a safe alternative to Duall Shell Encompass for non-coplanar stereotactic brain radiotherapy. There is no significant difference in intrafractional motion nor difference in comfort levels.

The effluents from pulp and paper manufacturing industries contain high concentrations of phenol, which when discharged directly into surface water streams, increases the biological oxygen demand (BOD) and chemical oxygen demand (COD). In this study, two dominant bacteria SP-4 and SP-8 were isolated from the effluent emanating with a pulp and paper industry. The selected phenol-degrading isolates were identified as Staphylococcus sp. and Staphylococcus sciuri respectively by using nucleotide sequence alignment and phylogenetic analysis of 16 S rRNA regions of the genome. The two isolates used for the biodegradation process effectively degraded phenol concentration of pulp and paper industry effluent upto 1600 and 1800 mg/L resepctively. The individual isolates and consortium were immobilized using activated carbon, wood dust, and coal ash. Additionally, the effluent was treated using a bio-filter tower packed column immobilized with bacterial cells at a constant flow rate of 5 mL/min. The present study showed that the developed immobilized microbial consortium can effectively degrade 99% of the phenol present in pulp and paper industry effluents, resulting in a significant reduction in BOD and COD of the system. This study can be well implemented on real-scale systems as the bio-filter towers packed with immobilized bacterial consortium can effectively treat phenol concentrations up to 1800 mg/L. The study can be implemented for bioremediation processes in phenolic wastewater-contaminated sites.

暂无摘要。

BACKGROUND: Arthroscopic rotator cuff repair with biceps rerouting (ABR) has emerged as a reliable option for treating large posterosuperior rotator cuff tears (RCTs). This study aims to compare functional and structural outcomes of early vs. delayed motion rehabilitation protocols following ABR.
METHODS: A total of 101 patients with semirigid, large, posterosuperior RCTs undergoing ABR were randomized into 2 groups: group I (early motion) with 53 patients (34 females, 19 males) and group II (delayed motion) with 48 patients (31 females, 17 males). In group I, the mean age was 63.9 years (range, 46-79), and in group II, it was 65.4 years (range, 43-78). The mean follow-up periods for group I and group II were 16.2 and 15.5 months, respectively. Preoperative and postoperative assessments were conducted at 3, 6, and 12 months, with structural integrity assessed with magnetic resonance imaging at a minimum follow-up of 12 months. Statistical analyses were performed to compare outcomes between the 2 groups.
RESULTS: Both groups demonstrated significant improvements in visual analog scale score (group I: 4.0-1.6, group II: 3.7-1.4, P = .501), University of California-Los Angeles shoulder score (group I: 21.5-31.4, group II: 22.4-30.6, P = .331), and acromiohumeral interval (group I: 8.2 mm-9.1 mm, group II: 8.6 mm-9.5 mm, P = .412), with no statistically or clinically meaningful differences. Active range of movements (ROM) were not significantly different between groups, except for active forward flexion at 3 months (group I: 140.1°, group II: 119.2°, P = .006), that was not shown to be translated clinically into differences in function or healing between the groups in this study. Notably, retear rates were similar between groups (group I: 22.6%, group II: 20.8%, P = .826).
CONCLUSIONS: This study\'s findings reveal no clinically discernible differences in active range of motion at 1-year follow-up between patients who underwent ABR for semirigid, large, posterosuperior RCTs and were assigned to either early or delayed motion protocols. Notably, the early motion group demonstrated a plateau in maximum range of movement improvement as early as 3 months postsurgery. Based on these results, implementing an early motion protocol is recommended as an effective approach in the postoperative rehabilitation following ABR.

Soil heavy metal pollution is an important issue that affects human health and ecological well-being. In-situ thermal treatment techniques, such as self-sustaining smoldering combustion (SSS), have been widely studied for the treatment of organic pollutants. However, the lack of fuel in heavy metal-contaminated soil has hindered its application. In this study, we used corn straw as fuel to investigate the feasibility of SSS remediation for copper and lead in heavy metal-contaminated soil, as well as to explore the remediation mechanism. The results of the study showed that SSS increased soil pH, electrical conductivity (EC), total phosphorus (TP), total potassium (TK), rapidly available phosphorus (AP), and available potassium (AK), while decreasing total nitrogen (TN), alkali-hydrolyzed nitrogen (AN), and cation exchange capacity (CEC). The oxidation state of copper (Cu) increased from 10% to 21%-40%, and the residual state of lead (Pb) increased from 18% to 51%-73%. The Toxicity characteristic leaching procedure (TCLP) of Cu decreased by a maximum of 81.08%, and the extracted state of Diethylenetriaminepentaacetic acid (DTPA) decreased by 67.63%; the TCLP of Pb decreased by a maximum of 81.87%, and DTPA decreased by a maximum of 85.68%. The study indicates that SSS using corn straw as fuel successfully achieved remediation of heavy metal-contaminated soil. However, SSS does not reduce the content of copper and lead; it only changes their forms in the soil. The main reasons for the fixation of copper and lead during the SSS process are the adsorption of biochar, complexation with -OH functional groups, binding with π electrons, and the formation of crystalline compounds. This research provides a reference for the application of SSS in heavy metal-contaminated soil and has potential practical implications.

In the presented study, a variety of hybrid and single nanomaterials of various origins were tested as novel platforms for horseradish peroxidase immobilization. A thorough characterization was performed to establish the suitability of the support materials for immobilization, as well as the activity and stability retention of the biocatalysts, which were analyzed and discussed. The physicochemical characterization of the obtained systems proved successful enzyme deposition on all the presented materials. The immobilization of horseradish peroxidase on all the tested supports occurred with an efficiency above 70%. However, for multi-walled carbon nanotubes and hybrids made of chitosan, magnetic nanoparticles, and selenium ions, it reached up to 90%. For these materials, the immobilization yield exceeded 80%, resulting in high amounts of immobilized enzymes. The produced system showed the same optimal pH and temperature conditions as free enzymes; however, over a wider range of conditions, the immobilized enzymes showed activity of over 50%. Finally, a reusability study and storage stability tests showed that horseradish peroxidase immobilized on a hybrid made of chitosan, magnetic nanoparticles, and selenium ions retained around 80% of its initial activity after 10 repeated catalytic cycles and after 20 days of storage. Of all the tested materials, the most favorable for immobilization was the above-mentioned chitosan-based hybrid material. The selenium additive present in the discussed material gives it supplementary properties that increase the immobilization yield of the enzyme and improve enzyme stability. The obtained results confirm the applicability of these nanomaterials as useful platforms for enzyme immobilization in the contemplation of the structural stability of an enzyme and the high catalytic activity of fabricated biocatalysts.

Cadmium (Cd) accumulates in the vegetative tissues of rice and wheat crops, posing a serious threat in the food chain. A long-term field experiment was conducted to investigate the effects of rice husk biochar (RHB), farm manure (FM), press mud (PrM), and poultry manure (PM) on the growth, yield, and economics of wheat and rice crops grown with sewage water. The results showed that RHB increased wheat plant height (27%, 66%, 70%), spike-length (33%, 99%, 56%), straw yield (21%, 51%, 49%), and grain yield (42%, 63%, 65%) in year-1, year-2, and year-3, than respective controls. For rice crop, RHB showed the maximum increase in plant height (64%, 92%, 96%), spike length (55%, 95%, 90%), straw yield (34%, 53%, 55%), and grain yield (46%, 66%, 69%) each year (2019-2021), compared to their respective controls. The Cd immobilization was increased by the application of RHB while other treatments followed FM > PrM > PM > control in each year of wheat and rice crops. For year-1, benefit-cost ratio remained maximum with the application of FM while for the 2nd and 3rd years in sequence, RHB proved more economical than other treatments and consistently produced wheat and rice with lower Cd concentration than FM, PrM, and PM in grains. This long-term experiment suggested that the application of organic amendments consistently increased biomass of rice and wheat and decreased the Cd concentration in tissues. The RHB remained more effective compared with FM, PrM, and PM in terms of yield, low Cd accumulation and economics of rice and wheat crops.