Dear Editor,In a recent Perspective/Viewpoint,Davis et al.[1]outlined strategies aimed at better differentiating an out-of-hospital cardiac arrest(OHCA)from an opioid overdose or poisoning event to improve treatment a...Dear Editor,In a recent Perspective/Viewpoint,Davis et al.[1]outlined strategies aimed at better differentiating an out-of-hospital cardiac arrest(OHCA)from an opioid overdose or poisoning event to improve treatment algorithms and clinical outcomes.We commend the authors on this effort.However,as the opioid crisis continues to evolve,2 of the proposed revisions to the treatment algorithm merit comment and reconsideration.展开更多
According to the NationalHeart,Lung,and Blood Institute(2023),[1]out-of-hospital cardiac arrests(OHCA)claim more than 350,000 lives every year.In parallel,and considering a timeframe starting in 1999,a continuous incr...According to the NationalHeart,Lung,and Blood Institute(2023),[1]out-of-hospital cardiac arrests(OHCA)claim more than 350,000 lives every year.In parallel,and considering a timeframe starting in 1999,a continuous increase in the number of deaths due to opioid overdose or poisoning(OOP)events is found[2](Fig.1).展开更多
Purpose:Non-prosthetic peri-implant fractures are challenging injuries.Multiple factors must be care-fully evaluated for an adequate therapeutic strategy,such as the state of bone healing,the type of implant,the time ...Purpose:Non-prosthetic peri-implant fractures are challenging injuries.Multiple factors must be care-fully evaluated for an adequate therapeutic strategy,such as the state of bone healing,the type of implant,the time and performed personnel of previous surgery,and the stability of fixation.The aim of this study is to propose a rationale for the treatment.Methods:The peri-implant femoral fractures(PIFFs)system,a therapeutic algorithm was developed for the management of all patients presenting a subtype A PIFF,based on the type of the original implant(extra-vs.intra-medulllary),implant length and fracture location.The adequacy and reliability of the proposed algorithm and the fracture healing process were assessed at the last clinical follow-up using the Parker mobility score and radiological assessment,respectively.In addition,all complications were noticed.Continuous variables were expressed as mean and standard deviation,or median and range according to their distribution.Categorical variables were expressed as frequency and percentages.Results:This is a retrospective case series of 33 PIFFs,and the mean post-operative Parker mobility score was(5.60±2.54)points.Five patients(15.1%)achieved complete mobility without aids(9 points)and 1(3.0%)patient was not able to walk.Two other patients(6.1%)were non-ambulatory prior to PPIF.The mean follow-up was(21.51±9.12)months(range 6-48 months).There were 7(21.2%)complications equally distributed between patients managed either with nailing or plating.There were no cases of nonunion or mechanical failure of the original implant.Conclusion:The proposed treatment algorithm shows adequate,reliable and straightforward to assist the orthopaedic trauma surgeon on the difficult decision-making process regarding the management of PIFF occurring in previously healed fractures.In addition,it may become a useful tool to optimize the use of the classification,thus potentially improving the outcomes and minimizing complications.展开更多
Triceps tendon avulsion(TTA)is an uncommon injury,and there are no classifications or treatment guidelines available.This study aims to describe a clinicoradiological classification and treatment algorithm for traumat...Triceps tendon avulsion(TTA)is an uncommon injury,and there are no classifications or treatment guidelines available.This study aims to describe a clinicoradiological classification and treatment algorithm for traumatic TTA in adults.The functional outcome of surgical repair has been evaluated too.;A retrospective analysis of adult patients with traumatic TTA treated in our institution between 2012 and 2017 was done.We only included complete TTA injuries.Children below 15 years,open injuries,associated fractures,and partial TTA were excluded.The data were obtained from hospital records.The intraoperative findings were correlated with the clinicoradiological presentation for classifying TTA.The functional outcome was analyzed using the Mayo Elbow Performance index and Hospital for Special Surgery elbow score.ANOVA test was used to assess the statistical significance.;There were 15 patients included,including 11 males and 4 females.The mean age was(31.5±9.15)years,and the mean follow-up was(22.4±8.4)months.Fall on outstretched hand was the mode of injury.In 6 patients,diagnosis was missed on the initial visit.TTA were classified as Type 1:palpable soft-tissue defect without bony mass;Type 2:palpable soft-tissue defect with a wafer-thin/comminuted bony fragment on X-ray;Type 3:palpable soft-tissue defect with a bony mass and a large bony fragment on X-ray without extension to the articular surface;and Type 4:an olecranon fracture with less than 25%of the articular surface.An algorithm for treatment was recommended,i.e.transosseous suture repair/suture anchor for Type 1,transosseous suture repair for Type 2,and tension band wiring or steel wire sutures for Types 3 and 4.All the patients achieved good to excellent outcome:the mean Mayo Elbow Performance index was 100 and Hospital for Special Surgery score was 98.26±2.60 on final follow-up.;Our clinicoradiological classification and treatment algorithm for TTAs is simple.Surgical treatment results in excellent functions of the elbow.Since it is a single-center study involving a very small number of cases,a multicenter study with a larger number of patients is required for external validation of our classification and treatment recommendations.展开更多
Purpose: To introduce a practical method of using an Electron Density Phantom (EDP) to evaluate different dose calculation algorithms for photon beams in a treatment planning system (TPS) and to commission the Anisotr...Purpose: To introduce a practical method of using an Electron Density Phantom (EDP) to evaluate different dose calculation algorithms for photon beams in a treatment planning system (TPS) and to commission the Anisotropic Analytical Algorithm (AAA) with inhomogeneity correction in Varian Eclipse TPS. Methods and Materials: The same EDP with various tissue-equivalent plugs (water, lung exhale, lung inhale, liver, breast, muscle, adipose, dense bone, trabecular bone) used to calibrate the computed tomography (CT) simulator was adopted to evaluate different dose calculation algorithms in a TPS by measuring the actual dose delivered to the EDP. The treatment plans with a 6-Megavolt (MV) single field of 20 × 20, 10 × 10, and 4 × 4 cm2 field sizes were created based on the CT images of the EDP. A dose of 200 cGy was prescribed to the exhale-lung insert. Dose calculations were performed with AAA with inhomogeneity correction, Pencil Beam Convolution (PBC), and AAA without inhomogeneity correction. The plans were delivered and the actual doses were measured using radiation dosimetry devices MapCheck, EDR2-film, and ionization chamber respectively. Measured doses were compared with the calculated doses from the treatment plans. Results: The calculated dose using the AAA with inhomogeneity correction was most consistent with the measured dose. The dose discrepancy for all types of tissues covered by beam fields is at the level of 2%. The effect of AAA inhomogeneity correction for lung tissues is over 14%. Conclusions: The use of EDP and Map Check to evaluate and commission the dose calculation algorithms in a TPS is practical. In Varian Eclipse TPS, the AAA with inhomogeneity correction should be used for treatment planning especially when lung tissues are involved in a small radiation field.展开更多
Pancreatic fluid collections(PFCs),common sequelae of acute or chronic pancreatitis,are broadly classified as pancreatic pseudocysts or walled-off necrosis according to the revised Atlanta classification.Endoscopic ul...Pancreatic fluid collections(PFCs),common sequelae of acute or chronic pancreatitis,are broadly classified as pancreatic pseudocysts or walled-off necrosis according to the revised Atlanta classification.Endoscopic ultrasound(EUS)-guided drainage is often considered a standard first-line therapy preferable to surgical or interventional radiology approaches for patients with symptomatic PFC.EUS-guided drainage is effective and successful;it has a technical success rate of90%-100%and a clinical success rate of 85%-98%.Recent studies have shown a 5%-30%adverse events(AEs)rate for the procedure.The most common AEs include infection,hemorrhage,perforation and stent migration.Hemorrhage,a severe and sometimes deadly outcome,requires a well-organized and appropriate treatment strategy.However,few studies have reported the integrated management of hemorrhage during EUS-guided drainage of PFC.Establishing a practical therapeutic strategy is an essential and significant step in standardized management.The aim of this review is to describe the current situation of EUS-guided drainage of PFCs,including the etiology and treatment of procedure-related bleeding as well as current problems and future perspectives.We propose a novel and meaningful algorithm for systematically managing hemorrhage events.To our limited knowledge,a multidisciplinary algorithm for managing EUS-guided drainage for PFC-related bleeding has not been previously reported.展开更多
Hepatocellular carcinoma(HCC)is a leading cause of morbidity and mortality worldwide,with rising clinical and economic burden as incidence increases.There are a multitude of evolving treatment options,including locore...Hepatocellular carcinoma(HCC)is a leading cause of morbidity and mortality worldwide,with rising clinical and economic burden as incidence increases.There are a multitude of evolving treatment options,including locoregional therapies which can be used alone,in combination with each other,or in combination with systemic therapy.These treatment options have shown to be effective in achieving remission,controlling tumor progression,improving disease free and overall survival in patients who cannot undergo resection and providing a bridge to transplant by debulking tumor burden to downstage patients.Following locoregional therapy(LRT),it is crucial to provide treatment response assessment to guide management and liver transplant candidacy.Therefore,Liver Imaging Reporting and Data Systems(LI-RADS)Treatment Response Algorithm(TRA)was created to provide a standardized assessment of HCC following LRT.LIRADS TRA provides a step by step approach to evaluate each lesion independently for accurate tumor assessment.In this review,we provide an overview of different locoregional therapies for HCC,describe the expected post treatment imaging appearance following treatment,and review the LI-RADS TRA with guidance for its application in clinical practice.Unique to other publications,we will also review emerging literature supporting the use of LI-RADS for assessment of HCC treatment response after LRT.展开更多
Recently published Medical Physics Practice Guideline 5.a. (MPPG 5.a.) by American Association of Physicists in Medicine (AAPM) sets the minimum requirements for treatment planning system (TPS) dose algorithm commissi...Recently published Medical Physics Practice Guideline 5.a. (MPPG 5.a.) by American Association of Physicists in Medicine (AAPM) sets the minimum requirements for treatment planning system (TPS) dose algorithm commissioning and quality assurance (QA). The guideline recommends some validation tests and tolerances based primarily on published AAPM task group reports and the criteria used by IROC Houston. We performed the commissioning and validation of the dose algorithms for both megavoltage photon and electron beams on three linacs following MPPG 5.a. We designed the validation experiments in an attempt to highlight the evaluation method and tolerance criteria recommended by the guideline. It seems that comparison of dose profiles using in-water scan is an effective technique for basic photon and electron validation. IMRT/VMAT dose calculation is recommended to be tested with some TG-119 and clinical cases, but no consensus of the tolerance exists. Extensive validation tests have provided the better understanding of the accuracy and limitation of a specific dose calculation algorithm. We believe that some tests and evaluation criteria given in the guideline can be further refined.展开更多
Rectal neuroendocrine tumor(rNET)is an indolent malignancy often detected during colonoscopy screening.The incidence of rNET has increased approximately 10-fold over the past 30 years.Most rNETs detected during screen...Rectal neuroendocrine tumor(rNET)is an indolent malignancy often detected during colonoscopy screening.The incidence of rNET has increased approximately 10-fold over the past 30 years.Most rNETs detected during screening endoscopy are small,measuring<10 mm.Current guidelines recommend endoscopic resection for small,well-differentiated rNET using modified endoscopic submucosal resection(mEMR)or endoscopic submucosal dissection.However,the optimal endoscopic treatment method remains uncertain.This paper summarizes the evidence on mEMR with submucosal stretching,mEMR without submucosal stretching,endoscopic submucosal dissection and endoscopic full-thickness resection.Given that rNETs often exhibit submucosal invasion,achieving adequate resection depth is crucial to ensure histological complete resection.mEMR with submucosal stretching appears favorable due to its high rate of histological complete resection,safety and convenience.Risk factors associated with lymph node and distant metastases are also discussed.A treatment algorithm is proposed to facilitate clinical decision-making.展开更多
Aim: This study aims to evaluate the difference between depth data from an intraoral cone and a conventional irradiation tube calculated using a treatment planning system (TPS), and that measured using an intraoral co...Aim: This study aims to evaluate the difference between depth data from an intraoral cone and a conventional irradiation tube calculated using a treatment planning system (TPS), and that measured using an intraoral cone for electron radiotherapy. Background: A TPS is only compatible with conventional irradiation tubes. However, such systems are not suitable for determining dose distributions when a special cone is employed. Materials and Methods: Dose distributions were calculated using the beam data for mounted intraoral cones using a TPS. Then, the dose distribution by field size was calculated for a low-melting-point lead alloy using the beam data for a mounted conventional tube. The calculated data were evaluated against the measured intraoral-cone depth data based on the dose and depth differences. Results: The calculated data for the intraoral cone case did not match the measured data. However, the depth data obtained considering the field size determined for the lead alloy using the conventional tube were close to the measured values for the intraoral cone case. The difference in the depth at which the absorbed dose was 50% of the maximum value of the percentage depth dose was less than ±4 mm for the generalized Gaussian pencil beam convolution algorithm and less than ±1 mm for the electron Monte Carlo algorithm. Conclusion: It was found that the measured and calculated dose distributions were in agreement, especially when then electron Monte Carlo algorithm was used. Thus, the TPS can be employed to determine dose distributions for intraoral cone applications.展开更多
Neuromuscular diseases present profound challenges to individuals and healthcare systems worldwide, profoundly impacting motor functions. This research provides a comprehensive exploration of how artificial intelligen...Neuromuscular diseases present profound challenges to individuals and healthcare systems worldwide, profoundly impacting motor functions. This research provides a comprehensive exploration of how artificial intelligence (AI) technology is revolutionizing rehabilitation for individuals with neuromuscular disorders. Through an extensive review, this paper elucidates a wide array of AI-driven interventions spanning robotic-assisted therapy, virtual reality rehabilitation, and intricately tailored machine learning algorithms. The aim is to delve into the nuanced applications of AI, unlocking its transformative potential in optimizing personalized treatment plans for those grappling with the complexities of neuromuscular diseases. By examining the multifaceted intersection of AI and rehabilitation, this paper not only contributes to our understanding of cutting-edge advancements but also envisions a future where technological innovations play a pivotal role in alleviating the challenges posed by neuromuscular diseases. From employing neural-fuzzy adaptive controllers for precise trajectory tracking amidst uncertainties to utilizing machine learning algorithms for recognizing patient motor intentions and adapting training accordingly, this research encompasses a holistic approach towards harnessing AI for enhanced rehabilitation outcomes. By embracing the synergy between AI and rehabilitation, we pave the way for a future where individuals with neuromuscular disorders can access tailored, effective, and technologically-driven interventions to improve their quality of life and functional independence.展开更多
文摘Dear Editor,In a recent Perspective/Viewpoint,Davis et al.[1]outlined strategies aimed at better differentiating an out-of-hospital cardiac arrest(OHCA)from an opioid overdose or poisoning event to improve treatment algorithms and clinical outcomes.We commend the authors on this effort.However,as the opioid crisis continues to evolve,2 of the proposed revisions to the treatment algorithm merit comment and reconsideration.
文摘According to the NationalHeart,Lung,and Blood Institute(2023),[1]out-of-hospital cardiac arrests(OHCA)claim more than 350,000 lives every year.In parallel,and considering a timeframe starting in 1999,a continuous increase in the number of deaths due to opioid overdose or poisoning(OOP)events is found[2](Fig.1).
文摘Purpose:Non-prosthetic peri-implant fractures are challenging injuries.Multiple factors must be care-fully evaluated for an adequate therapeutic strategy,such as the state of bone healing,the type of implant,the time and performed personnel of previous surgery,and the stability of fixation.The aim of this study is to propose a rationale for the treatment.Methods:The peri-implant femoral fractures(PIFFs)system,a therapeutic algorithm was developed for the management of all patients presenting a subtype A PIFF,based on the type of the original implant(extra-vs.intra-medulllary),implant length and fracture location.The adequacy and reliability of the proposed algorithm and the fracture healing process were assessed at the last clinical follow-up using the Parker mobility score and radiological assessment,respectively.In addition,all complications were noticed.Continuous variables were expressed as mean and standard deviation,or median and range according to their distribution.Categorical variables were expressed as frequency and percentages.Results:This is a retrospective case series of 33 PIFFs,and the mean post-operative Parker mobility score was(5.60±2.54)points.Five patients(15.1%)achieved complete mobility without aids(9 points)and 1(3.0%)patient was not able to walk.Two other patients(6.1%)were non-ambulatory prior to PPIF.The mean follow-up was(21.51±9.12)months(range 6-48 months).There were 7(21.2%)complications equally distributed between patients managed either with nailing or plating.There were no cases of nonunion or mechanical failure of the original implant.Conclusion:The proposed treatment algorithm shows adequate,reliable and straightforward to assist the orthopaedic trauma surgeon on the difficult decision-making process regarding the management of PIFF occurring in previously healed fractures.In addition,it may become a useful tool to optimize the use of the classification,thus potentially improving the outcomes and minimizing complications.
基金This study has been approved by the institutional research committee(GMCKKD/RP2017/IEC/106).
文摘Triceps tendon avulsion(TTA)is an uncommon injury,and there are no classifications or treatment guidelines available.This study aims to describe a clinicoradiological classification and treatment algorithm for traumatic TTA in adults.The functional outcome of surgical repair has been evaluated too.;A retrospective analysis of adult patients with traumatic TTA treated in our institution between 2012 and 2017 was done.We only included complete TTA injuries.Children below 15 years,open injuries,associated fractures,and partial TTA were excluded.The data were obtained from hospital records.The intraoperative findings were correlated with the clinicoradiological presentation for classifying TTA.The functional outcome was analyzed using the Mayo Elbow Performance index and Hospital for Special Surgery elbow score.ANOVA test was used to assess the statistical significance.;There were 15 patients included,including 11 males and 4 females.The mean age was(31.5±9.15)years,and the mean follow-up was(22.4±8.4)months.Fall on outstretched hand was the mode of injury.In 6 patients,diagnosis was missed on the initial visit.TTA were classified as Type 1:palpable soft-tissue defect without bony mass;Type 2:palpable soft-tissue defect with a wafer-thin/comminuted bony fragment on X-ray;Type 3:palpable soft-tissue defect with a bony mass and a large bony fragment on X-ray without extension to the articular surface;and Type 4:an olecranon fracture with less than 25%of the articular surface.An algorithm for treatment was recommended,i.e.transosseous suture repair/suture anchor for Type 1,transosseous suture repair for Type 2,and tension band wiring or steel wire sutures for Types 3 and 4.All the patients achieved good to excellent outcome:the mean Mayo Elbow Performance index was 100 and Hospital for Special Surgery score was 98.26±2.60 on final follow-up.;Our clinicoradiological classification and treatment algorithm for TTAs is simple.Surgical treatment results in excellent functions of the elbow.Since it is a single-center study involving a very small number of cases,a multicenter study with a larger number of patients is required for external validation of our classification and treatment recommendations.
文摘Purpose: To introduce a practical method of using an Electron Density Phantom (EDP) to evaluate different dose calculation algorithms for photon beams in a treatment planning system (TPS) and to commission the Anisotropic Analytical Algorithm (AAA) with inhomogeneity correction in Varian Eclipse TPS. Methods and Materials: The same EDP with various tissue-equivalent plugs (water, lung exhale, lung inhale, liver, breast, muscle, adipose, dense bone, trabecular bone) used to calibrate the computed tomography (CT) simulator was adopted to evaluate different dose calculation algorithms in a TPS by measuring the actual dose delivered to the EDP. The treatment plans with a 6-Megavolt (MV) single field of 20 × 20, 10 × 10, and 4 × 4 cm2 field sizes were created based on the CT images of the EDP. A dose of 200 cGy was prescribed to the exhale-lung insert. Dose calculations were performed with AAA with inhomogeneity correction, Pencil Beam Convolution (PBC), and AAA without inhomogeneity correction. The plans were delivered and the actual doses were measured using radiation dosimetry devices MapCheck, EDR2-film, and ionization chamber respectively. Measured doses were compared with the calculated doses from the treatment plans. Results: The calculated dose using the AAA with inhomogeneity correction was most consistent with the measured dose. The dose discrepancy for all types of tissues covered by beam fields is at the level of 2%. The effect of AAA inhomogeneity correction for lung tissues is over 14%. Conclusions: The use of EDP and Map Check to evaluate and commission the dose calculation algorithms in a TPS is practical. In Varian Eclipse TPS, the AAA with inhomogeneity correction should be used for treatment planning especially when lung tissues are involved in a small radiation field.
文摘Pancreatic fluid collections(PFCs),common sequelae of acute or chronic pancreatitis,are broadly classified as pancreatic pseudocysts or walled-off necrosis according to the revised Atlanta classification.Endoscopic ultrasound(EUS)-guided drainage is often considered a standard first-line therapy preferable to surgical or interventional radiology approaches for patients with symptomatic PFC.EUS-guided drainage is effective and successful;it has a technical success rate of90%-100%and a clinical success rate of 85%-98%.Recent studies have shown a 5%-30%adverse events(AEs)rate for the procedure.The most common AEs include infection,hemorrhage,perforation and stent migration.Hemorrhage,a severe and sometimes deadly outcome,requires a well-organized and appropriate treatment strategy.However,few studies have reported the integrated management of hemorrhage during EUS-guided drainage of PFC.Establishing a practical therapeutic strategy is an essential and significant step in standardized management.The aim of this review is to describe the current situation of EUS-guided drainage of PFCs,including the etiology and treatment of procedure-related bleeding as well as current problems and future perspectives.We propose a novel and meaningful algorithm for systematically managing hemorrhage events.To our limited knowledge,a multidisciplinary algorithm for managing EUS-guided drainage for PFC-related bleeding has not been previously reported.
文摘Hepatocellular carcinoma(HCC)is a leading cause of morbidity and mortality worldwide,with rising clinical and economic burden as incidence increases.There are a multitude of evolving treatment options,including locoregional therapies which can be used alone,in combination with each other,or in combination with systemic therapy.These treatment options have shown to be effective in achieving remission,controlling tumor progression,improving disease free and overall survival in patients who cannot undergo resection and providing a bridge to transplant by debulking tumor burden to downstage patients.Following locoregional therapy(LRT),it is crucial to provide treatment response assessment to guide management and liver transplant candidacy.Therefore,Liver Imaging Reporting and Data Systems(LI-RADS)Treatment Response Algorithm(TRA)was created to provide a standardized assessment of HCC following LRT.LIRADS TRA provides a step by step approach to evaluate each lesion independently for accurate tumor assessment.In this review,we provide an overview of different locoregional therapies for HCC,describe the expected post treatment imaging appearance following treatment,and review the LI-RADS TRA with guidance for its application in clinical practice.Unique to other publications,we will also review emerging literature supporting the use of LI-RADS for assessment of HCC treatment response after LRT.
文摘Recently published Medical Physics Practice Guideline 5.a. (MPPG 5.a.) by American Association of Physicists in Medicine (AAPM) sets the minimum requirements for treatment planning system (TPS) dose algorithm commissioning and quality assurance (QA). The guideline recommends some validation tests and tolerances based primarily on published AAPM task group reports and the criteria used by IROC Houston. We performed the commissioning and validation of the dose algorithms for both megavoltage photon and electron beams on three linacs following MPPG 5.a. We designed the validation experiments in an attempt to highlight the evaluation method and tolerance criteria recommended by the guideline. It seems that comparison of dose profiles using in-water scan is an effective technique for basic photon and electron validation. IMRT/VMAT dose calculation is recommended to be tested with some TG-119 and clinical cases, but no consensus of the tolerance exists. Extensive validation tests have provided the better understanding of the accuracy and limitation of a specific dose calculation algorithm. We believe that some tests and evaluation criteria given in the guideline can be further refined.
基金Supported by Nanchang High-Level Scientific and Technological Innovation Talents‘Double Hundred Plan’Project,China,No.2022-312.
文摘Rectal neuroendocrine tumor(rNET)is an indolent malignancy often detected during colonoscopy screening.The incidence of rNET has increased approximately 10-fold over the past 30 years.Most rNETs detected during screening endoscopy are small,measuring<10 mm.Current guidelines recommend endoscopic resection for small,well-differentiated rNET using modified endoscopic submucosal resection(mEMR)or endoscopic submucosal dissection.However,the optimal endoscopic treatment method remains uncertain.This paper summarizes the evidence on mEMR with submucosal stretching,mEMR without submucosal stretching,endoscopic submucosal dissection and endoscopic full-thickness resection.Given that rNETs often exhibit submucosal invasion,achieving adequate resection depth is crucial to ensure histological complete resection.mEMR with submucosal stretching appears favorable due to its high rate of histological complete resection,safety and convenience.Risk factors associated with lymph node and distant metastases are also discussed.A treatment algorithm is proposed to facilitate clinical decision-making.
文摘Aim: This study aims to evaluate the difference between depth data from an intraoral cone and a conventional irradiation tube calculated using a treatment planning system (TPS), and that measured using an intraoral cone for electron radiotherapy. Background: A TPS is only compatible with conventional irradiation tubes. However, such systems are not suitable for determining dose distributions when a special cone is employed. Materials and Methods: Dose distributions were calculated using the beam data for mounted intraoral cones using a TPS. Then, the dose distribution by field size was calculated for a low-melting-point lead alloy using the beam data for a mounted conventional tube. The calculated data were evaluated against the measured intraoral-cone depth data based on the dose and depth differences. Results: The calculated data for the intraoral cone case did not match the measured data. However, the depth data obtained considering the field size determined for the lead alloy using the conventional tube were close to the measured values for the intraoral cone case. The difference in the depth at which the absorbed dose was 50% of the maximum value of the percentage depth dose was less than ±4 mm for the generalized Gaussian pencil beam convolution algorithm and less than ±1 mm for the electron Monte Carlo algorithm. Conclusion: It was found that the measured and calculated dose distributions were in agreement, especially when then electron Monte Carlo algorithm was used. Thus, the TPS can be employed to determine dose distributions for intraoral cone applications.
文摘Neuromuscular diseases present profound challenges to individuals and healthcare systems worldwide, profoundly impacting motor functions. This research provides a comprehensive exploration of how artificial intelligence (AI) technology is revolutionizing rehabilitation for individuals with neuromuscular disorders. Through an extensive review, this paper elucidates a wide array of AI-driven interventions spanning robotic-assisted therapy, virtual reality rehabilitation, and intricately tailored machine learning algorithms. The aim is to delve into the nuanced applications of AI, unlocking its transformative potential in optimizing personalized treatment plans for those grappling with the complexities of neuromuscular diseases. By examining the multifaceted intersection of AI and rehabilitation, this paper not only contributes to our understanding of cutting-edge advancements but also envisions a future where technological innovations play a pivotal role in alleviating the challenges posed by neuromuscular diseases. From employing neural-fuzzy adaptive controllers for precise trajectory tracking amidst uncertainties to utilizing machine learning algorithms for recognizing patient motor intentions and adapting training accordingly, this research encompasses a holistic approach towards harnessing AI for enhanced rehabilitation outcomes. By embracing the synergy between AI and rehabilitation, we pave the way for a future where individuals with neuromuscular disorders can access tailored, effective, and technologically-driven interventions to improve their quality of life and functional independence.
