Quantify the Effect of Air Gap Errors on Skin Dose for Breast Cancer Radiotherapy.

Purpose: Determining the impact of air gap errors on the skin dose in postoperative breast cancer radiotherapy under dynamic intensity-modulated radiation therapy (IMRT) techniques. Methods: This was a retrospective study that involved 55 patients who underwent postoperative radiotherapy following modified radical mastectomy. All plans employed tangential IMRT, with a prescription dose of 50 Gy, and bolus added solely to the chest wall. Simulated air gap depth errors of 2 mm, 3 mm, and 5 mm were introduced at depression or inframammary fold areas on the skin, resulting in the creation of air gaps named Air2, Air3, and Air5. Utilizing a multivariable GEE, the average dose (Dmean) of the local skin was determined to evaluate its relationship with air gap volume and the lateral beam's average angle (AALB). Additionally, an analysis was conducted on the impact of gaps on local skin. Results: When simulating an air gap depth error of 2 mm, the average Dmean in plan2 increased by 0.46 Gy compared to the initial plan (planO) (p < .001). For the 3-mm air gap, the average Dmean of plan3 was 0.51 Gy higher than that of planO (p < .001). When simulating the air gap as 5 mm, the average Dmean of plan5 significantly increased by 0.59 Gy compared to planO (p < .001). The TCP results showed a similar trend to those of Dmean. As the depth of air gap error increases, NTCP values also gradually rise. The linear regression of the multivariable GEE equation indicates that the volume of air gaps and the AALB are strong predictors of Dmean. Conclusion: With small irregular air gap errors simulated in 55 patients, the values of skin's Dmean, TCP, and NTCP increased. A multivariable linear GEE regression model may effectively explain the impact of air gap volume and AALB on the local skin.

SGRT-based stereotactic body radiotherapy for lung cancer setup accuracy and margin of the PTV.

OBJECTIVE: Surface-guided radiation therapy (SGRT, AlignRT) was used to analyze motion during stereotactic body radiotherapy (SBRT) in lung cancer patients and to explore the margin of the planning target volume (PTV). METHODS: The residual errors of the AlignRT were evaluated based on grayscale cone-beam computed tomography registration results before each treatment. AlignRT log file was used to analyze the correlation between the frequency and longest duration of errors larger than 2 mm and lasting longer than 2 s and maximum error with age and treatment duration. The displacement value at the end of treatment, the average displacement value, and the 95% probability density displacement interval were defined as intrafraction errors, and PTV1, PTV2, PTV3 were calculated by Van Herk formula or Z score analysis. Organ dosimetric differences were compared after the experience-based margin was replaced with PTV3. RESULTS: The interfraction residual errors were Vrt0 , 0.06 ± 0.18 cm; Lng0 , -0.03 ± 0.19 cm; Lat0 , 0.02 ± 0.15 cm; Pitch0 , 0.23 ± 0.7°; Roll0 , 0.1 ± 0.69°; Rtn0 , -0.02 ± 0.79°. The frequency, longest duration and maximum error in vertical direction were correlated with treatment duration (r = 0.404, 0.353, 0.283, p < 0.05, respectively). In the longitudinal direction, the frequency was correlated with age and treatment duration (r = 0.376, 0.283, p < 0.05, respectively), maximum error was correlated with age (r = 0.4, P < 0.05). Vertical, longitudinal, lateral margins of PTV1, PTV2, PTV3 were 2 mm, 4 mm, 2 mm; 2 mm, 2 mm, 2 mm, 3 mm, 5 mm, 3 mm, respectively. After replacing the original PTV, mean lung dose (MLD), 2-cm3 chest wall dose (CD), lung V20 decreased by 0.2 Gy, 2.1 Gy, 0.5%, respectively (p < 0.05). CONCLUSION: AlignRT can be used for interfraction setup and monitoring intrafraction motion. It is more reasonable to use upper and lower limits of the 95% probability density interval as an intrafraction error.

Feasibility and dosimetric evaluation of single- and multi-isocentre stereotactic body radiation therapy for multiple liver metastases.

Objectives: Single-isocentre volumetric-modulated arc therapy (VMAT) stereotactic body radiation therapy (SBRT) improves treatment efficiency and patient compliance for patients with multiple liver metastases (MLM). However, the potential increase in dose spillage to normal liver tissue using a single-isocentre technique has not yet been studied. We comprehensively evaluated the quality of single- and multi-isocentre VMAT-SBRT for MLM and propose a RapidPlan-based automatic planning (AP) approach for MLM SBRT. Methods: A total of 30 patients with MLM (two or three lesions) were selected for this retrospective study. We manually replanned all patients treated with MLM SBRT by using the single-isocentre (MUS) and multi-isocentre (MUM) techniques. Then, we randomly selected 20 MUS and MUM plans for training to generate the single-isocentre RapidPlan model (RPS) and the multi-isocentre RapidPlan model (RPM). Finally, we used data from the remaining 10 patients to validate RPS and RPM. Results: Compared with MUS, MUM reduced the mean dose delivered to the right kidney by 0.3 Gy. The mean liver dose (MLD) was 2.3 Gy higher for MUS compared with MUM. However, the monitor units, delivery time, and V20Gy of normal liver (liver-gross tumour volume) for MUM were significantly higher than for MUS. Based on validation, RPS and RPM slightly improved the MLD, V20Gy, normal tissue complications, and dose sparing to the right and left kidneys and spinal cord compared with manual plans (MUS vs RPS and MUM vs RPM), but RPS and RPM significantly increased monitor units and delivery time. Conclusions: The single-isocentre VMAT-SBRT approach could be used for MLM to reduce treatment time and patient comfort at the cost of a small increase in the MLD. Compared with the manual plans, RapidPlan-based plans, especially RPS, have slightly improved quality.

Analysis of China's Population Flow between Urban and Rural Areas and the Reform of Public Health Old-Age Insurance System under the Background of Sustainable Ecological Environment.

The future impact of population development trend on social security is extremely huge and far-reaching, to conform to the law of population mobility to adjust the relevant policies, this study is for the urban and rural flow of the Chinese population, and the public health endowment insurance system analyzes the implementation status of PHEI of China's floating population and the existing problems of labor dispatch and employee endowment insurance system. Questionnaires were distributed to 3000 high-quality migrant workers who participated in the training of high-quality migrant workers in 6 cities in Central China where labor export is concentrated and 1000 fresh graduates from agricultural colleges and universities; through the bivariate t-check model in SPSS software, this study analyzes the needs of landless farmers, agricultural scientific and technological talents, and employed people for the living environment. The results show that from the population outflow and population inflow process there has been certain influence on the sustainable ecological environment; this study puts forward the reform of public health endowment insurance system of floating population, the strategy means in accelerating the rural talent revitalization, for the sustainable development of rural areas that has a significant positive effect.

Logic and Three Wheel Drive Analysis from New Urbanization to URI and Rural Revitalization under the Background of Ecological Environment Sustainability.

In order to explore the new urban-rural relationship (URR), develop urban-rural integration (URI), and realize rural revitalization (RRT), we should break down the barriers between developed cities and backward villages, and gradually realize the flow of production and optimize the combination, promote the coordinated development of rural and urban; this study analyzes the logic and three wheel drive from new urbanization to URI and RRT under the background of ecological environment sustainability, constructs a three wheel transmission model of rural economic development under the mode of URI, collects data through social survey, and analyzes the correlation of data by using the Spearman formula, using the curve estimation formula to analyze the data consistency, and explores the relationship between ecological environment investment and URI and RRT. Through continuous development, the gap between urban and rural areas has been significantly reduced, and major progress has been made in urban planning, construction, and management, and the rate of urban-rural integration has steadily increased, accelerating the pace of urban-rural integration.

High prevalence of serum folate receptor autoantibodies in children with autism spectrum disorders.

BACKGROUND: Supplementation of folic acid by pregnant mothers is thought to lower the risk of autism spectrum disorders (ASDs) in the offspring. Folic acid is taken up by cells via receptors with high affinity for folate and reduced folic acid derivatives. However, this is blocked by the presence of folate receptor autoantibodies (FRAA). Cerebral FRAA have been detected with high frequency in children with ASDs, suggesting the existence of a link between folic acid uptake and disease aetiology. METHODS: We investigated the frequency of FRAA in serum samples from 40 children with ASDs and 42 gender- and age-matched children with typical development (TD). Serum FRAA concentrations were measured by enzyme-linked immunosorbent assay. RESULTS: We found a significant difference in the frequency of serum FRAA in the two study cohorts. Serum FRAA were present in 77.5% (31/40) of children with ASDs compared with 54.8% (23/42) of TD children (p = 0.03746, Fischer's exact test). Thus, serum FRAA are more prevalent in children with ASDs than in TD children. CONCLUSIONS: Our data suggest that children with ASDs may have defects in folic acid absorption that play a role in the onset of ASDs.

Increased stool immunoglobulin A level in children with autism spectrum disorders.

BACKGROUND: There are currently no effective treatments for the core symptoms of autism spectrum disorders (ASDs). However, alleviating gastrointestinal (GI) problems, which are prevalent in ASD patients, can significantly improve the core symptoms of autism. Previous studies have associated GI disorders in ASD patients with abnormal gut microbiota, although few disease-related microorganisms have been identified. Considering that the gut microbiome affects the intestinal immune system and the patient's behavior, and that immunoglobulin A (IgA) is the main antibody secreted by intestinal immune cells, we investigated stool IgA content as a means of understanding the gut immune status of ASD patients. The IgA level in gut can be used as factor to know the Gene x Environment interactions and diagnose of ASDs. METHODS: We enrolled 43 ASD patients and 31 gender- and age-matched healthy children. Stool IgA content was measured by enzyme-linked immunosorbent assay. RESULTS: We found that IgA levels were significantly higher in stool samples from ASD patients than from healthy children (p<0.05, Student's t test). CONCLUSIONS: This finding may suggest the presence of gut immune abnormalities in ASD patients. Further studies with larger patient and control cohorts will be necessary to determine whether stool IgA levels can be used as a biomarker for ASDs.

[Intelligent watch system for health monitoring based on Bluetooth low energy technology].

According to the development status of wearable technology and the demand of intelligent health monitoring, we studied the multi-function integrated smart watches solution and its key technology. First of all, the sensor technology with high integration density, Bluetooth low energy (BLE) and mobile communication technology were integrated and used in develop practice. Secondly, for the hardware design of the system in this paper, we chose the scheme with high integration density and cost-effective computer modules and chips. Thirdly, we used real-time operating system FreeRTOS to develop the friendly graphical interface interacting with touch screen. At last, the high-performance application software which connected with BLE hardware wirelessly and synchronized data was developed based on android system. The function of this system included real-time calendar clock, telephone message, address book management, step-counting, heart rate and sleep quality monitoring and so on. Experiments showed that the collecting data accuracy of various sensors, system data transmission capacity, the overall power consumption satisfy the production standard. Moreover, the system run stably with low power consumption, which could realize intelligent health monitoring effectively.