Investigation of dosimetric effect of beam current fluctuations in synchrotron-based proton PBS continuous scanning.

OBJECTIVE: In proton pencil beam scanning (PBS) continuous delivery, the beam is continuously delivered without interruptions between spots. For synchrotron-based systems, the extracted beam current exhibits a spill structure, and recent publications on beam current measurements have demonstrated significant fluctuations around the nominal values. These fluctuations potentially lead to dose deviations from those calculated assuming a stable beam current. This study investigated the dosimetric implications of such beam current fluctuations during proton PBS continuous scanning. Approach: Using representative clinical proton PBS plans, we performed simulations to mimic a worst-case clinical delivery environment with beam current varies from 50% to 250% of the nominal values. The simulations used the beam delivery parameters optimized for the best beam delivery efficiency of the upcoming particle therapy system at Mayo Clinic Florida. We reconstructed the simulated delivered dose distributions and evaluated the dosimetric impact of beam current fluctuations. Main results: Despite significant beam current fluctuations resulting in deviations at each spot level, the overall dose distributions were nearly identical to those assuming a stable beam current. The 1mm/1% Gamma passing rate was 100% for all plans. Less than 0.2% root mean square error (RMSE) was observed in the PTV DVH. Minimal differences were observed in all dosimetric evaluation metrics. Significance: Our findings demonstrate that with our beam delivery system and clinical planning practice, while significant beam current fluctuations may result in large local move MU deviations at each spot level, the overall impact on the dose distribution is minimal. .

A photothermal assisted zinc-air battery cathode based on pyroelectric and photocatalytic effect.

Zinc-air battery as one of the new generations of battery system, its theoretical specific energy is as high as 1086 Wh kg-1, specific capacity up to 820 mAh/g, and zinc has the advantages of environmental friendliness, resource abundance, low cost and good safety, so it has attracted much attention. However, due to its slow reaction kinetic process, zinc-air battery will produce a large charging overpotential usually up to 2 V, it is far beyond the theoretical voltage of 1.65 V, so reducing the overpotential of zinc-air batteries is extremely necessary, and the most common way to solve this problem is to use excellent catalyst cathode to improve the oxygen reduction and oxygen evolution kinetics of zinc-air batteries. So we developed a new photothermal assisted zinc-air battery system with Hollow carbon nanosphere@poly (vinylidene fluoride-trifluoroethylene-chlorofluoroethylene)@CdS(HCN@PVTC@CdS) photocathode, the pyroelectric and photocatalysis effect can effectively promote the reaction kinetics and reduce the reaction overpotential. With the pyroelectric and photocatalysis synergistic effect, the zinc-air has displayed a high discharge potential of 1.33 V and a low charging potential of 1.5 V with good cycle stability. This multi-assist technology with built-in electric and light fields paves the way for the development of high-performance zinc-air batteries and other energy storage systems.

Rich oxygen vacancy and amorphous/crystalline ruthenium-doped CoCu -layered double hydroxide electrocatalysts for enhanced oxygen evolution reactions.

Reinforcing the development of efficient and robust electrocatalysts is pivotal in addressing the challenges associated with oxygen evolution reactions (OER) in water splitting technology. Here, an amorphous/crystalline low-ruthenium-doped bimetallic layered double hydroxide (LDH) electrocatalyst (a/c-CoCu + Rux-LDH/NF) with massive oxygen vacancy on nickel foam was fabricated via ion-exchange and chemical etching, facilitating efficient OER. Among the various catalyst materials tested, the a/c-CoCu + Ru10-LDH/NF exhibits remarkable performance in the OER when employed in an alkaline electrolyte containing 1 M KOH. Achieving a minimal overpotential at 10 mA cm-2 of 214 mV, exhibiting a low Tafel slope value of 64.3 mV dec-1 and exceptional durability lasting for over 100 h. Theoretical calculations demonstrate that the electron structure and d-band center of CoCu-LDH can be effectively regulated through the utilization of a strategy possessing abundant oxygen vacancies and a Ru-doped crystalline/amorphous heterostructure. It will lead to optimized adsorption free energy of reactants and reduced energy barriers for OER. The construction strategy proposed in this paper for catalysts with amorphous/crystalline heterointerfaces offer a novel opportunity to achieve highly efficient OER.

Impact of proton PBS machine operating parameters on the effectiveness of layer rescanning for interplay effect mitigation in lung SBRT treatment.

BACKGROUND: Rescanning is a common technique used in proton pencil beam scanning to mitigate the interplay effect. Advances in machine operating parameters across different generations of particle therapy systems have led to improvements in beam delivery time (BDT). However, the potential impact of these improvements on the effectiveness of rescanning remains an underexplored area in the existing research. METHODS: We systematically investigated the impact of proton machine operating parameters on the effectiveness of layer rescanning in mitigating interplay effect during lung SBRT treatment, using the CIRS phantom. Focused on the Hitachi synchrotron particle therapy system, we explored machine operating parameters from our institution's current (2015) and upcoming systems (2025A and 2025B). Accumulated dynamic 4D dose were reconstructed to assess the interplay effect and layer rescanning effectiveness. RESULTS: Achieving target coverage and dose homogeneity within 2% deviation required 6, 6, and 20 times layer rescanning for the 2015, 2025A, and 2025B machine parameters, respectively. Beyond this point, further increasing the number of layer rescanning did not further improve the dose distribution. BDTs without rescanning were 50.4, 24.4, and 11.4 s for 2015, 2025A, and 2025B, respectively. However, after incorporating proper number of layer rescanning (six for 2015 and 2025A, 20 for 2025B), BDTs increased to 67.0, 39.6, and 42.3 s for 2015, 2025A, and 2025B machine parameters. Our data also demonstrated the potential problem of false negative and false positive if the randomness of the respiratory phase at which the beam is initiated is not considered in the evaluation of interplay effect. CONCLUSION: The effectiveness of layer rescanning for mitigating interplay effect is affected by machine operating parameters. Therefore, past clinical experiences may not be applicable to modern machines.

DNA metabarcoding reveals the seasonal variation of dietary composition of Taihangshan macaque (Macaca mulatta tcheliensis), Jiyuan, north China.

Dietary analysis in wildlife is fundamental for understanding their flexible response to seasonal changes and developing effective conservation management measures. Taihangshan macaque (Macaca mulatta tcheliensis) is the northernmost population of rhesus macaque, currently only distributed in the southern Mt. Taihangshan area. This area belongs to a semi-arid region resulting in limited plant food availability for Taihangshan macaques, with seasonal variation. Herein, we used a chloroplast trnL DNA metabarcoding approach to identify the plant diet diversity and composition from 100 fecal samples of Taihangshan macaque in four seasons (spring, summer, autumn, and winter) from 2020 to 2021. The results revealed that (1) a total of 48 distinct families, 88 genera, and 52 species within the 105 food items that were consumed by Taihangshan macaques throughout the year; (2) the diversity of food items exhibited significant differences across the four seasons; (3) Rosaceae, Rhamnaceae, Fagaceae, and Poaceae are the preferential food items for Taihangshan macaques and have different relative abundances, fluctuating with seasonal variation. DNA metabarcoding can expand our understanding of the repertoire of food items consumed by Taihangshan macaques by detecting some consumed food items in this population that were not yet discovered using traditional methods. Therefore, the integrative results from traditional methods and DNA metabarcoding can provide a fundamental understanding of dietary composition to guide the conservation management of Taihangshan macaques.

Rethinking Sweetener Discovering: Multiparameter Modeling of Molecular Docking Results between the T1R2-T1R3 Receptor and Compounds with Different Tastes.

Molecular docking has been widely applied in the discovery of new sweeteners, yet the interpretation of computational results sometimes remains difficult. Here, the interaction between the T1R2-T1R3 sweet taste receptor and 66 tasting compounds, including 26 sweet, 19 bitter, and 21 sour substances was investigated by batch molecular docking processes. Statistical analysis of the docking results generated two novel methods of interpreting taste properties. Quantitative correlation between relative sweetness (RS) and docking results created a multiparameter model to predict sweetness intensity, whose correlation coefficient r = 0.74 is much higher than r = 0.17 for the linear correlation model between sweetness and binding energy. The improved correlation indicated that docking results besides binding energy contain undiscovered information about the ligand-protein interaction. Qualitative discriminant analysis of different tasting molecules generated an uncorrelated linear discriminant analysis (UDLA) model, which achieved an overall 93.1% accuracy in discriminating the taste of molecules, with specific accuracy for verifying sweet, bitter, and sour compounds reaching 88.0%, 92.1%, and 100%. These unprecedented models provide a unique perspective for interpreting computational results and may inspire future research on sweetener discovery.

Iron-decorated covalent organic framework as efficient catalyst for activating peroxydisulfate to degrade 2,4-dichlorophenol: Performance and mechanism insight.

Herein, a novel two-dimensional double-pore covalent organic framework (JLNU-305) was synthesized using N,N,N',N'-tetrakis(4-aminophenyl)-1,4-phenylenediamine (TAPD) and 2,2'-bipyridine-5,5'-dicarboxaldehyde (BPDA). The extended π-π conjugated structure and nitrogen-riched pyridine in JLNU-305 (JLNU = Jilin Normal University) provide abundant binding sites for Fe doping. The obtained JLNU-305-Fe exhibited high and recycled catalytic efficiency for peroxydisulfate (PDS) activation to completely degrade 10 mg/L 2,4-dichlorophenol (2,4-DCP) within 8 min. The JLNU-305-Fe/PDS system showed excellent catalytic activity and cyclic stability. The capture experiments and electron paramagnetic resonance (ESR) analysis indicated that the catalytic behavior of JLNU-305-Fe/PDS is contributed to the synergistic effect between free radicals and non-free radicals. It is the first time to activate PDS for covalent organic frameworks (COFs) being used to degrade 2,4-DCP, which has a great potential for development and practical application in related water environment remediation.

Enhanced Photocatalytic Properties of All-Organic IDT-COOH/O-CN S-Scheme Heterojunctions Through π-π Interaction and Internal Electric Field.

Herein, we present a distinct methodology for the in situ electrostatic assembly method for synthesizing a conjugated (IDT-COOH)/oxygen-doped g-C3N4 (O-CN) S-scheme heterojunction. The electron delocalization effect due to π-π interactions between O-CN and self-assembled IDT-COOH favors interfacial charge separation. The self-assembled IDT-COOH/O-CN exhibits a broadened visible absorption to generate more charge carriers. The internal electric field between the IDT-COOH and the O-CN interface provides a directional charge-transfer channel to increase the utilization of photoinduced charge carriers. Moreover, the active species (•O2-, h+, and 1O2) produced by IDT-COOH/O-CN under visible light play important roles in photocatalytic disinfection. The optimum 40% IDT-COOH/O-CN can kill 7-log of methicillin-resistant Staphylococcus aureus (MRSA) cells in 2 h and remove 88% tetracycline (TC) in 5 h, while O-CN only inactivates 1-log of MRSA cells and degrades 40% TC. This work contributes to a promising method to fabricate all-organic g-C3N4-based S-scheme heterojunction photocatalysts with a wide range of optical responses and enhanced exciton dissociation.

Comparison of the effects of stepwise intracranial decompression and decompressive craniectomy in the treatment of severe traumatic brain injury: A randomized controlled trial.

BACKGROUND: To compare the effects of stepwise intracranial decompression (SID) and decompressive craniectomy (DC) on severe traumatic brain injury. METHODS: This prospective randomized study was conducted at The Third Affiliated Hospital of Soochow University. Ninety two patients were divided into 2 groups according to the random number table method. The study group received SID, whereas the control group received DC. The surgical time and intraoperative bleeding of the 2 groups of patients were recorded, neurological function and glasgow coma score before and after treatment in both groups, incidence of complications, prognostic situation, and levels of brain oxygen metabolism indicators before and after treatment. RESULTS: Among the 92 patients who agreed, 46 were assigned to the study and control groups, and 6 patients were excluded. Finally, 86 patients were analyzed, including 43 in the study group and 43 in the control group. After treatment, the glasgow coma score scores of the 2 groups increased compared to before treatment; the study group had a higher score, The National Institutes of Health Stroke Scale score decreased compared to before treatment, and the study group had a lower score (P < .05). The incidence of complications in the study group (4.65%) was significantly lower than that in the control group (18.60%) (P < .05). The good prognosis rate of the research group (41.86%) was significantly higher than that of the control group (16.28%) (P < .05). CONCLUSION: Compared with DC, using SID to treat severe traumatic brain injury can shorten surgical time and reduce intraoperative bleeding, more effectively improve patients neurological function and consciousness state, reduce the incidence of complications, and regulate brain oxygen metabolism status, which is beneficial for improving prognosis and ensuring a good outcome of the disease.

Ultralow ruthenium modification of cobalt metal-organic frameworks for enhanced efficient bifunctional water splitting.

Hydrogen economy has emerged as a promising alternative to the current hydrocarbon economy. It involves harvesting renewable energy to split water into hydrogen and oxygen and then further utilising clean hydrogen fuel for various applications. The rational exploration of advanced non-precious metal bifunctional electrocatalysts for the oxygen evolution reaction (OER) and hydrogen evolution reaction (HER) is critical for efficient water splitting. Herein, an ultralow Ru-modified cobalt metal-organic framework (CoRu0.06-MOF/NF) two-dimensional nanosheet array bifunctional catalyst was fabricated through a strategy under mild experimental conditions. The obtained CoRu0.06-MOF/NF exhibited excellent bifunctional electrocatalytic activity and stability in alkaline media, with low overpotentials of 37 and 181 mV and significant durability for more than 95 and 110 h toward the HER and OER at 10 mA cm-2, respectively. The experimental results showed that the two-dimensional nanoarray structure had a large specific surface area and abundant exposed active sites. Additionally, ultralow Ru modification optimized the electronic structure and improved the conductivity of the cobalt metal-organic frameworks, thereby reducing the energy barrier of the rate-limiting step and accelerating the water splitting reaction.

Investigation of scan path optimization in improving proton pencil beam scanning continuous delivery.

Objective. To investigate the impact of scan path optimization on the dose accuracy and beam delivery time (BDT) of proton pencil beam scanning in the dose-driven continuous scanning (DDCS).Approach. A diverse set of six clinical plans, representing various spot patterns and treatment sites, was used to evaluate the effectiveness of scan time optimization and scan length optimization. The DDCS dose discrepancy and BDT with optimized scan paths was compared to the default serpentine scan path.Main results. Both scan time optimization and scan path optimization were able to reduce the DDCS dose discrepancy compared to the default serpentine scan path. All plans, except for the layer repainting lung plan, achieved a 2%/2 mm gamma pass rate of over 99% and less than 1% PTV DVH root mean square error (RMSE) through scan path optimization. In the case of the layer repainting lung plan, when compared to the default serpentine scan path, the 2%/2 mm gamma pass rate showed improvements from 91.3% to 93.1% and 95.8%, while the PTV DVH RMSE decreased from 2.1% to 1.7% and 1.1% for scan time optimization and scan length optimization, respectively. Although scan time optimization resulted in shorter total scan times for all plans compared to the default scan path and scan length optimization tended to have longer total scan times. However, due to the short total scan times and their minimal contribution to the total BDT, the impact of scan path optimization on the total BDT was practically negligible.Significance. Both scan time optimization and scan length optimization proved to be effective in minimizing DDCS dose discrepancy. No definitive winner can be determined between these two optimization approaches. Both scan time and scan length optimization had minimal effect on the total BDT.

Selecting Optimal Proton Pencil Beam Scanning Plan Parameters to Reduce Dose Discrepancy between Discrete Spot Plan and Continuous Scanning: A Proof-of-Concept Study.

Pencil beam scanning delivered with continuous scanning has several advantages over conventional discrete spot scanning. Such advantages include improved beam delivery efficiency and reduced beam delivery time. However, a move dose is delivered between consecutive spots with continuous scanning, and current treatment planning systems do not take this into account. Therefore, continuous scanning and discrete spot plans have an inherent dose discrepancy. Using the operating parameters of the state-of-the-art particle therapy system, we conducted a proof-of-concept study in which we systematically generated 28 plans for cubic targets with different combinations of plan parameters and simulated the dose discrepancies between continuous scanning and a planned one. A nomograph to guide the selection of plan parameters was developed to reduce the dose discrepancy. The effectiveness of the nomograph was evaluated with two clinical cases (one prostate and one liver). Plans with parameters guided by the nomograph decreased dose discrepancy than those used standard plan parameters. Specifically, the 2%/2 mm gamma passing rate increased from 96.3% to 100% for the prostate case and from 97.8% to 99.7% for the liver case. The CTV DVH root mean square error decreased from 2.2% to 0.2% for the prostate case and from 1.8% to 0.9% for the liver case. The decreased dose discrepancy may allow the relaxing of the delivery constraint for some cases, leading to greater benefits in continuous scanning. Further investigation is warranted.

Investigation of total skin helical tomotherapy using a 3D-printed total skin bolus.

OBJECTIVE: To investigate the effectiveness of using a 3D-printed total skin bolus in total skin helical tomotherapy for the treatment of mycosis fungoides. MATERIALS AND METHODS: A 65-year-old female patient with a 3-year history of mycosis fungoides underwent treatment using an in-house desktop fused deposition modelling printer to create a total skin bolus made of a 5-mm-thick flexible material, which increased the skin dose through dose building. The patient's scan was segmented into upper and lower sections, with the division line placed 10 cm above the patella. The prescription was to deliver 24 Gy over 24 fractions, given 5 times per week. The plan parameters consisted of a field width of 5 cm, pitch of 0.287 and modulation factor of 3. The complete block was placed 4 cm away from the planned target region to reduce the area of the internal organs at risk, especially the bone marrow. Dose delivery accuracy was verified using point dose verification with a "Cheese" phantom (Gammex RMI, Middleton, WI), 3D plane dose verification with ArcCHECK (Model 1220, Sun Nuclear, Melbourne, FL), and multipoint film dose verification. Megavoltage computed tomography guidance was also utilized to ensure the accuracy of the setup and treatment. RESULTS: A 5-mm-thick 3D-printed suit was used as a bolus to achieve a target volume coverage of 95% of the prescribed dose. The conformity index and homogeneity index of the lower segment were slightly better than those of the upper segment. As the distance from the skin increased, the dose to the bone marrow gradually decreased, and the dose to other organs at risk remained within clinical requirements. The point dose verification deviation was less than 1%, the 3D plane dose verification was greater than 90%, and the multipoint film dose verification was less than 3%, all of which confirmed the accuracy of the delivered dose. The total treatment time was approximately 1.5 h, which included 0.5 h of wearing the 3D-printed suit and 1 h with the beam on. Patients only experienced mild fatigue, nausea or vomiting, low-grade fever, and grade III bone marrow suppression. CONCLUSION: The use of a 3D-printed suit for total skin helical tomotherapy can result in a uniform dose distribution, short treatment time, simple implementation process, good clinical outcomes, and low toxicity. This study presents an alternative treatment approach that can potentially yield improved clinical outcomes for mycosis fungoides.

Incidence of Rib Fracture following Treatment with Proton Therapy for Breast Cancer.

Purpose: To determine the rib fracture rate in a cohort of patients with breast cancer treated with proton therapy. Patient and Methods: From a prospective database, we identified 225 patients treated with proton therapy between 2012 and 2020 (223 women; 2 men). Clinical and dosimetric data were extracted, the cumulative incidence method assessed rib fracture rate, and Fine-Gray tests assessed prognostic significance of select variables. In-field rib fracture was defined as a fracture that occurred in a rib located within the 10% isodose line. Out-of-field rib fracture was defined as a fracture occurring in a rib location outside of the 10% isodose line. Results: Of the patients, 74% had left-sided breast cancer; 5%, bilateral; and 21%, right-sided. Dual-energy x-ray absorptiometry scans showed normality in 20%, osteopenia in 34%, and osteoporosis in 6% (test not performed in 40%). Additionally, 57% received an aromatase inhibitor. Target volumes were breast ± internal mammary nodes (IMNs) (16%), breast and comprehensive regional lymphatics (32%), chest wall ± IMNs (1%), and chest wall/comprehensive regional lymphatics (51%). Passive-scattered proton therapy was used for 41% of patients, 58% underwent pencil-beam scanning (PBS), and 1% underwent a combination (passive scattering/PBS), with 85% of patients receiving a boost. Median follow-up was 3.1 years, with 97% having >12-month follow-up. The 3-year cumulative in-field rib fracture incidence was 3.7%. Eight patients developed in-field rib fractures (1 symptomatic, 7 imaging identified) for a 0.4% symptomatic rib fracture rate. Median time from radiation completion to rib fracture identification was 1.8 years (fractures were identified within 2.2 years for 7 of 8 patients). No variables were associated with rib fracture on univariate analysis. Three fractures developed outside the radiation field (0.9% cumulative incidence of out-of-field rib fracture). Conclusion: In this series of patients with breast cancer treated with proton therapy, the 3-year rib fracture rates remain low (in-field 3.7%; symptomatic 0.4%). As in photon therapy, the asymptomatic rate may be underestimated owing to a lack of routine surveillance imaging. However, patients experiencing symptomatic rib fractures after proton therapy for breast cancer are rare.

A molecularly imprinted fiber array solid-phase microextraction strategy for simultaneous detection of multiple estrogens.

A kind of selective enrichment material based on a homemade molecularly imprinted polymer (MIP) fiber array with high adsorption capacity was developed for the accurate analysis of estrogens in food samples. Here, the MIP with 17ß-estradiol as the template was obtained by in situ polymerization. The chemical composition, morphologies, surface area, and pore size of the polymer were characterized by Fourier transform infrared spectroscopy, scanning electron microscopy, and Brunauer-Emmett-Teller theory. The extraction time, desorption solvent, desorption time, ionic strength, and the pH of solution were investigated to ascertain the best extraction conditions. Under the optimal extraction conditions, three fiber coatings of 17ß-estradiol MIP and commercial polyacrylate (PA) were bound to a homemade handle to assemble the fiber array, respectively. The findings showed that the three-fiber array of the MIP significantly improved the extraction capacity by 145 times compared to PA. The MIP fiber array showed high adsorption capacity for the template molecule 17ß-estradiol and its structural analogues estrone, bisphenol F, bisphenol B, and bisphenol A, with enrichment factors of 99.60-133.16. A molecularly imprinted polymer solid-phase microextraction fiber array (MIP-SPME fiber array) coupled with high-performance liquid chromatography-diode array detection was used for the analysis and detection of the five estrogens in milk and yogurt samples. Satisfactory recoveries were achieved ranging from 74.75-119.41% with <9.42% relative standard deviations. The developed method for the simultaneous determination of trace estrogens in food samples exhibited a limit of detection of 0.33 µg L-1. The MIP-SPME fiber array provided an available strategy for improving the selectivity and adsorption capacity of SPME for trace target component analysis in complex matrices and increasing the sensitivity of the analytical method.

Self-assembled A-D-A type indacenodithiophene-based small conjugated molecule/TiO2 for enhancing the photocatalytic activity.

Herein, A-D-A type indacenodithiophene-based small conjugated molecule IDT-COOH and IDT-COOH/TiO2 photocatalysts with stable non-covalent bonding have been successfully synthesized via in situ electrostatic assembly. The self-assembled three-dimensional π-conjugation structure IDT-COOH with high crystallinity not only broadens the visible absorption to produce more photogenerated carriers but also provides directional charge-transfer channels to accelerate the charge mobility. Thus, 7 log inactivation of S. aureus in 2 h and 92.5% decomposition of TC in 4 h under visible light exposure are achieved for optimized 30% IDT-COOH/TiO2. The dynamic constants (k) of S. aureus disinfection and TC degradation for 30% IDT-COOH/TiO2 are 3.69 and 2.45 times compared to those of self-assembled IDT-COOH, respectively. The notable inactivation performance is among the best reported for conjugated semiconductor/TiO2 photocatalysts for photocatalytic sterilization. ˙O2-, e- and ˙OH are the primary reactive species in the photocatalytic process. The strong interfacial interaction between TiO2 and IDT-COOH is in favour of rapid charge transfer, which leads to enhanced photocatalytic performance. This work offers a feasible method to fabricate TiO2-based photocatalytic agents with a wide visible light response and improved exciton dissociation.

Technical note: Delivery benefit and dosimetric implication of synchrotron-based proton pencil beam scanning using continuous scanning mode.

BACKGROUND: Discrete spot scanning (DSS) is the commonly used method for proton pencil beam scanning (PBS). There is lack of data on the dose-driven continuous scanning (DDCS). PURPOSE: To investigate delivery benefits and dosimetric implications of DDCS versus DSS for PBS systems. METHODS: The irradiation duty factor, beam delivery time (BDT), and dose deviation were simulated for eight treatment plans in prostate, head and neck, liver, and lung, with both conventional fractionation and hypofractionation schemes. DDCS results were compared with those of DSS. RESULTS: The DDCS irradiation duty factor (range, 11%-41%) was appreciably improved compared to DSS delivery (range, 4%-14%), within which, hypofractionation schemes had greater improvement than conventional fractionation. With decreasing stop ratio constraints, the DDCS BDT reduction was greater, but dose deviation also increased. With stop ratio constraints of 2, 1, 0.5, and 0, DDCS BDT reduction reached to 6%, 10%, 12%, and 15%, respectively, and dose deviation reached to 0.6%, 1.7%, 3.0%, and 5.2% root mean square error in PTV DVH, respectively. The 3%/2-mm gamma passing rate was greater than 99% with stop ratio constraints of 2 and 1, and greater than 95% with a stop ratio of 0.5. When the stop ratio constraint was removed, five of the eight treatment plans had a 3%/2-mm gamma passing rate greater than 95%, and the other three plans had a 3%/2-mm gamma passing rate between 90% and 95%. CONCLUSIONS: The irradiation duty factor was considerably improved with DDCS. Smaller stop ratio constraints led to shorter BDTs, but with the cost of larger dose deviations. Our finding suggested that a stop ratio of 1 constraint seems to yield acceptable DDCS dose deviation.

Effects of High-flux Hemodialysis With Narrative Care on Clinical Efficacy and Prognostic Quality of Life of Patients With Chronic Renal Failure.

Context: Chronic renal failure (CRF) is the outcome of the continuous progression of various chronic kidney diseases. Effective treatment of a wide range of diseases may require decreasing patients' negative emotions and enhancing their disease resilience. Narrative care focuses on patients' inner awareness, feelings, and experience of a disease, stimulating positive energy in the face of it. Objective: The study intended to investigate the effects of using narrative care during high flux hemodialysis (HFHD) on clinical outcomes and prognosis of quality of life (QoL) for patients with chronic renal failure (CRF), to provide a reliable theoretical reference for future clinical treatment. Design: The research team performed a randomized controlled trial. Setting: The study took place at the Blood Purification Center at the Affiliated Hospital of Medical School at Ningbo University in Ningbo, Zhejiang, China. Participants: Participants were 78 patients with CRF who received treat with HFHD at the hospital between January 2021 and August 2022. Intervention: The research team divided participants into two groups using the random number table method, with 39 participants in each group: (1) and intervention group who received narrative nursing care and (2) a control group who receive the usual care. Outcome Measures: The research team: (1) evaluated the clinical efficacy for both groups; (2) at baseline and postintervention, measured participants' blood creatinine (SCr) and blood urea nitrogen (BUN) using blood sampling; (3) counted adverse effects; (4) investigated participants' nursing satisfaction postintervention; (5) at baseline and postintervention, assessed psychology and QoL using the Self-Assessment Scale for Anxiety (SAS), the Self-Assessment Scale for Depression (SDS), and the General Quality of Life Inventory (GQOLI-74) scale. Results: No statistically significant differences existed between the groups in terms of efficacy or renal function postintervention (P > .05). The incidence of adverse reactions was significantly lower in the intervention group than in the control group postintervention (P = .033), and the group's nursing satisfaction was significantly higher (P = .042). In addition, participants' SAS and SDS scores decreased significantly in the intervention group postintervention (P < .05), while no change occurred for the control group (P > .05). Finally, the GQOLI-74 scores were all significantly higher in the intervention group than in the control group. Conclusions: Narrative care can effectively enhance the safety of HFHD treatment in CRF patients and reduce patients' negative emotions postintervention, which is important for improving their QoL.

Ferric ion substitution renders cadmium metal-organic framework derivatives for modulated Li storage based on local oxidation active centers.

In this work, a novel anionic Cd-MOF ([(CH3)2NH2]n[Cd(HL)DMF]n·2nH2O·nDMF, H4L = 1,2,4,5-tetrakis[(4-carboxy)phenoxymethyl]benzene) was synthesized for the first time. As a precursor, it was utilized to obtain Fe@Cd-MOF crystals via the substitution of Fe3+ ions due to a negatively charged framework and free-coordinated carboxyl group. Fe3O4/Fe-embedded carbon-based materials (Fe@Cd-MOFD) were further constructed by deriving Fe@Cd-MOF at high temperatures. The derived Fe@Cd-MOFD showed a structure resembling a central city with metal redox centers embedded into a carbon matrix. The introduced Fe3+ ions formed a local nano-sized metal oxide upon annealing, and these derived carbon materials offered high electronic conductivity. These pushed Fe@Cd-MOFD to remarkable electrochemical performance with an initial discharge capacity of 1703.8 mA h g-1. This work offers new insights into the fabrication of novel MOF-derived iron oxide hybrids for lithium storage.

Advancing n-π* electron transition of carbon nitride via distorted structure and nitrogen heterocycle for efficient photodegradation: Performance, mechanism and toxicity insight.

To adequately utilize solar energy for water pollution remediation, tailoring graphite carbon nitride (CN) with sufficient active sites exposure, visible-light harvest and eminent charge separation/migration/recombination efficiency, has long been pursuing. Herein, a pyrazine doped distorted architecture CN with advancing n-π* electron transition was tailored via one-pot thermal-melting assemble following thermal-induce copolymerization of pyrazine-2,3-dicarboxylic acid and urea. Various characterizations verify the successful construction of distorted porous thin wall CN. The nitrogen adsorption-desorption, photoelectric and band structure analysis manifest that the optimized 20-PACN sample possesses propelled visible-light capture ability with wavelength above 500 nm, more active sites exposure with high specific surface area and hybrid electron structure with distinctly improved charge separation/migration/recombination efficiency. More importantly, 10 mg of 20-PACN can photodegradation 97 % of tetracycline (91 % of rhodamine B or 91 % of methylene blue) within 100 min, which is 7.1 times of bulk counterparts. ESR and quenching tests confirm that apart from h+, ⋅O2- and 1O2 significantly assist to the photodegradation reaction, which profit from upshifted CB and the appearance of intermediate state. The mass spectrum, toxicity prediction and on-line infrared spectroscopy explicated intermediates, routes and toxicity, as well as real-time monitor the variation of functional groups during photodegradation reaction. At last, combined the above test characterization and density functional theory analysis, a potential propelled mechanism of photodegradation was proposed.