Long-term effects of radiation exposure on health

Effects of low-dose radiation produced during radiofrequency ablation guided by 3D mapping on mitochondrial apoptosis in diabetic cardiomyocytes

BACKGROUND

Three-dimensional (3D) mapping has been widely used in the clinical radiofrequency ablation of arrhythmia; however, the dose of intraoperative radiation exposure has not been determined. Moreover, whether a single instance of intraoperative radiation exposure has an effect on myocardial tissue or exacerbates diabetic heart injury remains uncertain.

METHODS AND RESULTS

In this study, we evaluated the dose of intraoperative radiation generated during radiofrequency ablation via 3D mapping. ELISA, Western blot, flow cytometry, and oxygen consumption rate detection were used to identify the effects of the intraoperative radiation dose on cardiomyocyte apoptosis via the mitochondrial pathway and its specific mechanism. These results indicated that the exposure radiation used in radiofrequency ablation guided by 3D mapping for all types of arrhythmia was low-dose radiation (LDR; the doses were all less than 200 mGy). Although LDR (50, 100 and 200 mGy) had no significant effect on the mitochondrial apoptosis of normal cardiomyocytes, the 200 mGy radiation dose reduced the mitochondrial apoptosis of cardiomyocytes subjected to high glucose and high lipid (HG/HL) treatment. Mechanistically, an LDR of 200 mGy improved the expression of IL-10, reversed the accumulation of IL-6, ROS, disruption of Δψm, and the impairment of mitochondrial function caused by HG/HL. Additionally, 200 mGy radiation promoted the expression of Bcl-xl while reducing the expression of Bax in cardiomyocytes treated with HG/HL.

CONCLUSION

In summary, this study demonstrated that the exposure radiation dose used in radiofrequency ablation guided by 3D mapping was low-dose radiation (LDR), which had no effect on the mitochondrial apoptosis pathway in normal cardiomyocytes and even had a protective effect on cardiomyocytes treated with HG/HL via increased IL-10 levels and the suppression of IL-6, ROS, and mitochondrial damage induced by HG/HL.

Nanotechnology meets radiobiology: Fullerenols and Metallofullerenols as nano-shields in radiotherapy

Despite significant advances in the development of radioprotective measures, the clinical application of radioprotectors and radiomitigators remains limited due to insufficient efficacy and high toxicity of most agents. Additionally, in oncological radiotherapy, these compounds may interfere with the therapeutic effectiveness. Recent progress in nanotechnology highlights fullerenols (FulOHs) and metallofullerenols (Me@FulOHs) as promising candidates for next-generation radioprotectors. These nanostructures possess unique antioxidant properties, demonstrating greater efficacy in rediucing oxidative stress compared to conventional agents. Moreover, their potential to minimize pro-oxidative risks depends on the precise identification of cellular environments and irradiation conditions that optimize their radioprotective effects. In parallel, Me@FulOHs serve as powerful theranostic tools in oncology. Their strong imaging signals enable high-resolution PET and MRI, facilitating early detection and accurate localization of pathogenic alterations. This dual functionality positions Me@FulOHs as key components in advanced radiotherapy. By integrating these nanomaterials with modern theranostic approaches, it is possible to enhance the precision of treatment while minimizing side effects, addressing a critical need in contemporary oncology. This review emphasizes the importance of systematic evaluation of context-dependent effects of Me@FulOHs, particularly in pre- and post-irradiation scenarios, to optimize their clinical relevance. The dual role of Me@FulOHs as both radioprotectors and diagnostic agents distinguishes them from traditional compounds, paving the way for innovative practical applications. Their use in radiotherapy represents a significant step toward the development of safer and more effective strategies in radiation protection and cancer treatment. We also review ionizing radiation effects, classifications, cancer radiotherapy applications, and countermeasures.

Long term effects of gamma radiation on inflammatory and apoptotic biomarkers in nuclear medicine staff

BACKGROUND

Gamma radiation at low doses might have potential health effects in long-term exposure. The current study was aimed to search cell death pathway and inflammatory biomarkers in nuclear medicine workers with long-term exposure to gamma radiation.

MATERIAL AND METHODS

Fifty cases with a history of 10 years' exposure to gamma radiation and 30 normal individuals were included in the current study. Blood samples were collected and then analyzed for gene expression of apoptotic markers, pro-inflammatory factor TNF-a, and antioxidant enzymes using Real Time PCR (RT-PCR) in both groups. Protein expressions were examined by Western blot and trace elements were analyzed using atomic absorption spectrometry.

RESULT

In exposed group, the expression of pro-apoptotic markers (CASP 8, CASP 3, Casp 9, and BAX genes), the pro-inflammatory factor TNF and antioxidant enzymes such as SOD, CAT, and GPX was increased in comparison with control group (P < 0.05). However, Bcl2 expression was decreased in exposed group. In addition, there was a significant and inverse correlation between serum levels of zinc and selenium in the exposed subjects compared to the control group (P < 0.05).

CONCLUSION

Our results revealed the potential role of low and chronic doses of gamma radiation in triggering apoptosis and inflammatory responses. However, more studies are needed to consolidate our findings.

Implementing tin-prefiltration in routine clinical CT scans of the lower extremity: impact on radiation dose

OBJECTIVES

Several studies have demonstrated the potential of tin-prefiltration to reduce radiation dose while maintaining diagnostic image quality for musculoskeletal imaging. Still, no study has reported data on the impact of tin-prefiltration on radiation dose reduction for clinical routine scanning.

MATERIALS AND METHODS

Retrospective inclusion of 300 clinically indicated CT scans of the pelvis, knee, and ankle before January 2020 (without tin filter) and after December 2020 (with tin filter). For each joint, 50 examinations with tin-prefiltration and 50 examinations without tin-prefiltration were selected. Dose parameters were extracted, calculated, and compared. Subjective and quantitative parameters for image quality were assessed.

RESULTS

The CTDIvol, DLP, and effective dose were reduced significantly in all tin-prefiltered examinations compared to the non-tin-prefiltered examinations (p < 0.001): CTDIvol was 65% lower in the pelvis, 73% lower in the knee, and 54% lower in the ankle. This reduced the effective dose of 61%, 71%, and 60%, respectively. In absolute numbers, the reduction of the median effective dose delivered in a single CT scan of the pelvis was - 2.29 mSv, - 0.15 mSv for the knee, and - 0.03 mSv for the ankle. No difference in diagnostic image quality, depiction of bone anatomy and soft tissues, and image artifacts was observed (p > 0.05). Subjective and objective image noise was higher in tin-prefiltered pelvis CT (p < 0.001).

CONCLUSION

The implementation of tin-prefiltration in clinical routine scan protocols significantly reduced the effective radiation dose for unenhanced CT scans of the lower extremities between 60 and 70%.

A Smart Semi-Implantable Device Integrating Microchannel-Enhanced Sampling and Multiplex Biochemical Testing for Deep Wound Monitoring and Pathogen Identification

Monitoring deep wounds is challenging but necessary for high-quality medical treatment. Current methodologies for deep wound monitoring are typically limited to indirect clinical symptoms or costly non-real-time imaging diagnosis. Herein, a smart system is proposed that enables in situ monitoring of deep wounds' status through a semi-implantable device composed of 2 seamlessly connected functional components: 1) the well-designed, microchannel-structured sampling needles that efficiently and conveniently collect samples from deep wound anatomical locations, and 2) the multiplex biochemical testing compartment that facilitates the immediate and persistent detection of multiple biochemical indicators based on a color image processing software accessible to a conventional smartphone. With the 3 representative preclinical deep wound models, the study demonstrates the device's potential to monitor wound infection, inflammation, healing progress, and reduce inflammation when applied to deep skin injury, surgical implantation, and postoperative intestinal leakage. The device's capability to rapidly and accurately identify pathogenic bacteria is also demonstrated both in vitro and in vivo, potentially facilitating precise intervention in infected wounds. Coupled with the device's favorable biocompatibility and cost-effectiveness, this intelligent system emerges as a promising tool for safe and effective management of complicated deep wounds.

Effects of Low Dose Neutron-Gamma Field on Cell Cycle and Damage of Human Lymphocytes

Purpose: The aim is to investigate the response of peripheral blood lymphocytes to a low-dose neutron-gamma field. Methods: The human peripheral blood was exposed to low-dose neutron-gamma radiation ex vivo. Flow cytometry was utilized to evaluate the changes in cell cycle and protein levels of p21, CDK2, and γH2AX. qPCR analysis was conducted to investigate the mRNA transcription of p21 and CDK2. The chromosomes aberration and micronucleus rate in peripheral blood lymphocytes were observed by microscope. Results: Within the radiation dose range of 0-5976 μGy, compared to the "0" dose group, there was an increase in the proportion of cells in G1 phase and a decrease in the proportion of cells in G2 phase. Additionally, there was an upregulation of p21 and γH2AX protein expression, a downregulation of CDK2 protein expression, and an increase in transcription levels of p21 and CDK2 mRNA. Furthermore, there was an elevation in the rate of chromosome aberrations in peripheral blood lymphocytes; however, no significant change of micronuclei rate was observed. Conclusions: The response of human lymphocytes to low dose neutron gamma irradiation can be reflected by the changes of cell cycle, chromosome aberration and RPS18 expression.

When to Radiate and When to Stop? Timing Radiographic Surveillance During Nonoperative Treatment of Pediatric Diaphyseal Clavicle Fractures

INTRODUCTION

Conservative management of most pediatric clavicle fractures is standard. Despite a predictable nonoperative course, evidence about the timeliness of healing is lacking. The goal of this study was to identify when radiographic signs of healing should be expected during routine conservative management of closed pediatric diaphyseal clavicle fractures.

METHODS

Patients 18 years or younger with an acute diaphyseal clavicle fracture treated at a large academic multispecialty orthopaedic practice over 5 years were retrospectively reviewed. Patients who completed nonoperative management until radiographic and clinical evidence of union were included and categorized into 3 age groups: infants and toddlers (0 to 2 y old), school-aged children (3 to 9 y old), and adolescents (10 to 18 y old). Radiographic healing was analyzed within each 2- to 4-week interval.

RESULTS

Among 390 patients, 303 met inclusion criteria. Overall shortening and displacement averaged 0.3±0.6 centimeters and 42.6%±43.0%, respectively. Follow-up averaged 50±24 days with an orthopaedic physician and 16.3±14.8 months for a well-child check. No clinically relevant or statistically significant improvements in the number of cortices bridged were observed in infants/toddlers after 4 weeks (average 20.4±4.3 d from injury), in school-aged children after 8 weeks (average 39.7±7.9 d from injury), or in adolescents after 12 weeks (average 66.4±8.1 d from injury).

CONCLUSIONS

This study provides an age-dependent timeline during which adequate radiographic healing should be expected in nonoperatively managed pediatric diaphyseal clavicle fractures. Radiographic protocols can be purposefully timed to visualize sufficient healing in infants and toddlers by 4 weeks, school-aged children by 8 weeks, and adolescents by 12 weeks.

LEVEL OF EVIDENCE

Level III.

Management Considerations for Tooth Extraction in a 70-Year-Old Survivor of the Hydrogen Bomb Test on the Lucky Dragon No. 5

The Lucky Dragon No. 5 (Daigo Fukuryu Maru) was a Japanese tuna trawler exposed to radioactive fallout from the Castle Bravo hydrogen bomb test conducted by the United States on March 1, 1954, at Bikini Atoll in the Marshall Islands. All 23 crew members suffered acute radiation sickness as a result of the exposure. In this paper, we present a case of the management of one of the Lucky Dragon No. 5 crew members who underwent tooth extraction 70 years after the nuclear test. Due to the patient's systemic exposure to radiation, various complications were anticipated following tooth extraction. However, systemic complications, post-extraction bleeding, local infection, and wound healing failure were not observed. This article highlights the importance of careful systemic and local management during the perioperative period when treating radiation-exposed individuals, as well as the ongoing nuclear threat and the crucial role of oral surgeons in managing radiation-induced health issues and preparing for nuclear emergencies.

Nervonic acid alleviates radiation-induced early phase lung inflammation by targeting macrophages activation in mice

Background

Patients receiving chest radiation therapy, or exposed to high radiation levels due to accidental nuclear leakage are at risk of radiation-induced lung injury (RILI). In innate immunity, macrophages not only exhibit certain radiation tolerance but also play an important regulatory role in the whole pathological process. Nervonic acid (NA), a long-chain unsaturated fatty acid found in nerve tissue, plays a pivotal role in maintaining normal tissue growth and repair. However, the influence of NA on RILI progression has yet to be examined.

Aim

This study aimed to assess the role of macrophage subtypes in RILI and whether NA can alleviate RILI. Specifically, whether NA can alleviate RILI by targeting macrophages and reducing the levels of inflammatory mediators in mouse models was assessed.

Methods

Mice RILI model was employed with 13 Gy whole thoracic radiation with or without administration of NA. Various assays were performed to evaluate lung tissue histological changes, cytokine expression, IκB-α expression and the number and proportion of macrophages.

Results

Radiation can lead to the release of inflammatory mediators, thereby exacerbating RILI. The specific radiation dose and duration of exposure can lead to different dynamic changes in the number of subpopulations of lung macrophages. NA can affect the changes of macrophages after irradiation and reduce inflammatory responses to alleviate RILI.

Conclusion

Macrophages play a significant role in the integrated pathological process of lung injury after irradiation which shows a dynamic change with different times. NA can protect lung tissues against the toxic effects of ionizing radiation and is a new potential functional component for targeting macrophages.

New insights in tobacco radiotoxicity: on the research of 210Po in modern heated tobacco product-radioactivity, distribution, and dose assessment

The purpose of the study was to assess the radiological risk to users and the environment related to the Glo system used to heat tobacco. The concentration of 210Po, radioactivity per cartridge, and radiation dose assessment were evaluated. For comparison purposes, to present the exposure scale, the same analyses were also performed for several traditional cigarettes. The tests were carried out on an alpha spectrometer equipped with a PIPS detector. After examining 60 samples, the concentration of 210Po was found in tobacco that was a filling of Neo cartridges and in traditional cigarettes. 210Po concentrations [in mBq∙g-1] in heated tobacco were higher than in unheated. After heating, a little release of polonium (mBq per cartridge) was observed. The research was also done taking into account the flavor of the Neo cartridges and cartridges from different packages. The 210Po concentrations in heated Neo cartridges were greater than 30 mBq∙g-1 and in traditional cigarettes up to 50 mBq∙g-1. The estimated annual effective dose for Neo cartridges was lower than that for traditional smoking. However, it cannot be concluded that the use of Neo cartridges is healthier and does not affect the environment. What is disturbing is the increase in the number of cartridges used daily, resulting in the creation of waste containing 210Po and, of course, a higher effective dose received by the user.

Molecular Insights into Radiation Effects and Protective Mechanisms: A Focus on Cellular Damage and Radioprotectors

Ionizing radiation has been a critical tool in various fields, such as medicine, agriculture, and energy production, since its discovery in 1895. While its applications-particularly in cancer treatment and diagnostics-offer significant benefits, ionizing radiation also poses risks due to its potential to cause molecular and cellular damage. This damage can occur through the direct ionization of biological macromolecules, such as deoxyribonucleic acid (DNA), or indirectly through the radiolysis of water, which generates reactive oxygen species (ROS) that further damage cellular components. Radioprotectors, compounds that protect against radiation-induced damage, have been extensively researched since World War II. These agents work by enhancing DNA repair, scavenging free radicals, and boosting antioxidant defenses, thereby protecting healthy tissues. Furthermore, some radioprotective agents also stimulate DNA repair mechanisms even after radiation exposure, aiding in recovery from radiation-induced damage. This article explores the molecular mechanisms of radiation-induced damage, focusing on both direct and indirect effects on DNA, and discusses the role of radioprotectors, their mechanisms of action, and recent advancements in the field. The findings underscore the importance of developing effective radioprotective strategies, particularly in medical and industrial settings, where radiation exposure is prevalent.

Cascade Fluorescence Modulation in Photochromic Microcapsules

Certain derivatives of terarylene are able to undergo a highly efficient oxidative cycloreversion cascade effect, a ring opening reaction with quantum yields above unity, resulting in a colored-to-colorless transition in solution. In the presence of chloroform, high-energy UV and X-rays can trigger this phenomenon, potentially acting as a visual detection system for ionizing radiation. However, chloroform is sensitive to different irradiation wavelengths without distinction, making it difficult to adapt to a reusable device. Chlorobenzene was chosen as an alternative halogenated solvent, as it offers wavelength selectivity between photocyclization and cascade effect cycloreversion. Nile Red was also incorporated into the system with the aim of improving the sensitivity of the visual detection via fluorescence photoswitching. Finally, microencapsulation of both terarylene and Nile Red was targeted to obtain both the cascade effect and photoswitching in a single system. In microcapsules made from a Pickering emulsion, this terarylene-Nile Red system showed high fatigue resistance to repeated photocyclization and cycloreversion irradiation, giving access to repeated ON/OFF fluorescence photoswitching. The cascade effect was also successfully demonstrated along with fluorescence recovery, showing the versatility of the two phenomena in different media.

The use of intraoral ultrasound in the evaluation of the benign lesions in pediatric patients

Ultrasonography (US) or diagnostic sonography is a radiographic technique that uses sound waves with frequencies higher than 20 kHz to demonstrate soft tissues such as muscles, internal organs, joints, and tendons. The US has various applications in dentistry such as cervical lymph node examination, salivary gland examination, periodontal examination, maxillofacial fracture examination, temporomandibular joint examination, and orofacial swelling examination. One of the most important advantages of the US is it does not produce any ionizing radiation. Since the US does not produce any ionizing radiation, it is a favorable technique especially for the patients who are susceptible to ionizing radiation such as pregnant patients and pediatric patients. In this article, we presented benign tumor lesions that were examined with the US in children and conducted a review of the literature.

Low-dose radiation promotes high-fat diet-induced atherosclerosis by activating cGAS signal pathway

BACKGROUND

Atherosclerosis (AS) is the most prevalent cardiovascular disease, with an exceptionally high burden. High-fat diet (HFD) is a popular diet behavior, whereas low-dose radiation (LDR) is an environmental physical factor. There is evidence to suggest that an HFD may exacerbate the onset of atherosclerosis. Whether the combination effect of HFD and LDR would have potential on atherosclerosis development remains incompletely unclear.

METHODS

In this study, ApoE-/- mice were used as atherosclerosis model animals to investigate the combination effects of HFD and LDR (10 × 0.01Gy, or 20 × 0.01Gy) on vascular lesions. Doppler ultrasound imaging, H&E staining, oil red O staining, western blotting, and immunohistochemistry (IHC) were used to assess the pro-atherosclerotic effects. LC-MS was used to detect the non-targeted lipidomic.

RESULTS

Long-term exposure of low-dose radiation at an accumulated dose of 0.2Gy significantly increased the occurrence of vascular stiffness and the aortic lesion in ApoE-/- mice. The synergistic effect of HFD and LDR was observed in the development of atherosclerosis, which might be linked to both the dysbiosis of lipid metabolism and the stimulation of the inflammatory signaling system. Moreover, LDR but not HFD can activate the cGAS-STING signaling through increasing the yield of cytosolic mitochondrial DNAs as well as the expression of cGAS protein. The activation of cGAS-STING signal triggers the release of IFN-α/-β, which functions as an inflammatory amplifier in the formation of atherosclerotic plaque.

CONCLUSION

The current study offers fresh insights into the risks and mechanism that underlie the development of atherosclerosis by LDR, and there is a combination effect of LDR and HFD with the involvement of cGAS-STING signal pathway.

Spatial disparities in cause-specific mortality in Ukraine: A district-level analysis, 2006-19

Turbulent socio-economic development, recent political challenges, and remarkable regional diversity with deep historical roots make Ukraine an important case study for understanding mortality trends in Eastern Europe. In this paper, we provide the first comprehensive, spatially detailed analysis of cause-specific mortality trends and patterns in Ukraine, focusing on the period 2006-19. We rely on official mortality data and use various demographic and spatial analysis techniques. Our results suggest a notable attenuation of the long-standing West-East and West-South-East mortality gradients. Cardiovascular mortality at older ages largely explains the gap between the vanguard (lowest mortality) and laggard (highest mortality) areas, especially for females and in the most recent period. By contrast, the impact of mortality from external causes has greatly diminished over time. Hotspot analyses reveal strong and persistent clustering of mortality from suicide, HIV, and lung cancer. Further research should focus on in-depth assessment of the mechanisms causing the observed patterns.

Expected role of photodynamic therapy to relieve skin damage in nuclear or radiological emergency: Review

Nuclear and radiological accidents can occur due to poor management, in transportation, radiation therapy and nuclear wards in hospitals, leading to extreme radiation exposure and serious consequences for human health. Additionally, in many of previous radiological accidents, skin damage was observed in patients and survivors due to the high radiation exposure. However, as part of a medical countermeasures in a nuclear/radiological emergency, it is critical to plan for the treatment of radiation-induced skin damage. Hence, the new, non-invasive technology of photodynamic therapy (PDT) is projected to be more effectively used for treating skin damage caused by high-dose radiation. PDT plays an important role in treating, repairing skin damage and promoting wound healing as evidenced by research. This review, highlighted and recommended potential impacts of PDT to repair and decrease radiation-induced skin tissue damage. Moreover, we have suggested some photosensitizer (PS) agent as radio-mitigator drugs to decrease radiobiological effects.

Midterm outcomes of endovascular repair for abdominal aortic aneurysm using the cuff-first technique to prevent type II endoleaks

OBJECTIVE

The aim of this study was to evaluate the initial and midterm outcomes of endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA) using the cuff-first technique (CFT) to prevent type II endoleak (T2EL).

METHODS

CFT involves deploying an aortic cuff inside the AAA to cover the ostium of the aortic side branch vessels before deploying the main body. We performed a retrospective review of all patients undergoing EVAR with CFT or side branch embolization (SBE) for AAAs at The Jikei University Hospital between 2016 and 2022. Primary endpoint was the rate of aneurysm sac shrinkage. Secondary endpoints were procedure time, radiation exposure, technical and clinical success rates, occurrence of T2EL, and freedom from reintervention or aneurysm-related death.

RESULTS

Of 406 patients who underwent EVAR for AAAs, CFT was utilized in 56 (CFT group) and SBE in 35 (SBE group); all 91 patients were included in this study. There were no differences in patient demographics between groups, but there were differences in patency rate of the inferior mesenteric artery and absent intraluminal thrombus. The technical success rate per target vessel in the CFT and SBE group was 97.8% and 91.8%, and the clinical success rate was 91.0% and 100%, respectively. The median procedure time was shorter for CFT than for SBE: CFT, 10 (interquartile range [IQR], 6-14) minutes vs SBE, 25 (IQR, 18.5-45) minutes; P < .05), and median radiation exposure was lower for CFT than for SBE (CFT, 1455 (IQR, 840-2634) mGy vs SBE, 2353 (IQR, 1552-3586) mGy; P < .05). During the median follow-up of 25 months (IQR, 12.5-47 months), sac shrinkage occurred at similar rates in both groups (CFT, 37.5% vs SBE, 40.0%; P = .812), and there were no differences in freedom from reintervention (CFT, 96.2% and 91.4% at 12 and 36 months vs SBE, 100% and 89.5% at 12 and 36 months; log-rank P = .761) and freedom from aneurysm-related death (100% at 36 months in both groups; log-rank P = .440). The odds ratio of CFT vs SBE for sac regression was calculated by adjusting for inferior mesenteric artery patency and absent intraluminal thrombus, resulting in no statistical significance (odds ratio, 1.231; 95% confidence interval, 0.486-3.122).

CONCLUSIONS

CFT is feasible with a shorter procedure time and lower radiation exposure than SBE and comparable mid-term outcomes, including sac shrinkage rate, compared with SBE. We believe that CFT, if anatomically suitable, is an alternative to SBE for the prevention of T2EL during EVAR.

Artificial Intelligence and Deep Learning in Revolutionizing Brain Tumor Diagnosis and Treatment: A Narrative Review

The emergence of artificial intelligence (AI) in the medical field holds promise in improving medical management, particularly in personalized strategies for the diagnosis and treatment of brain tumors. However, integrating AI into clinical practice has proven to be a challenge. Deep learning (DL) is very convenient for extracting relevant information from large amounts of data that has increased in medical history and imaging records, which shortens diagnosis time, that would otherwise overwhelm manual methods. In addition, DL aids in automated tumor segmentation, classification, and diagnosis. DL models such as the Brain Tumor Classification Model and the Inception-Resnet V2, or hybrid techniques that enhance these functions and combine DL networks with support vector machine and k-nearest neighbors, identify tumor phenotypes and brain metastases, allowing real-time decision-making and enhancing preoperative planning. AI algorithms and DL development facilitate radiological diagnostics such as computed tomography, positron emission tomography scans, and magnetic resonance imaging (MRI) by integrating two-dimensional and three-dimensional MRI using DenseNet and 3D convolutional neural network architectures, which enable precise tumor delineation. DL offers benefits in neuro-interventional procedures, and the shift toward computer-assisted interventions acknowledges the need for more accurate and efficient image analysis methods. Further research is needed to realize the potential impact of DL in improving these outcomes.

Cumulative Dose from Recurrent CT Scans: Exploring the DNA Damage Response in Human Non-Transformed Cells

Recurrent computed tomography (CT) examination has become a common diagnostic procedure for several diseases and injuries. Though each singular CT scan exposes individuals at low doses of low linear energy transfer (LET) radiation, the cumulative dose received from recurrent CT scans poses an increasing concern for potential health risks. Here, we evaluated the biological effects of recurrent CT scans on the DNA damage response (DDR) in human fibroblasts and retinal pigment epithelial cells maintained in culture for five months and subjected to four CT scans, one every four weeks. DDR kinetics and eventual accumulation of persistent-radiation-induced foci (P-RIF) were assessed by combined immunofluorescence for γH2AX and 53BP1, i.e., γH2AX/53BP1 foci. We found that CT scan repetitions significantly increased both the number and size of γH2AX/53BP1 foci. In particular, after the third CT scan, we observed the appearance of giant foci that might result from the overlapping of individual small foci and that do not associate with irreversible growth arrest, as shown by DNA replication in the foci-carrying cells. Whether these giant foci represent coalescence of unrepaired DNA damage as reported following single exposition to high doses of high LET radiation is still unclear. However, morphologically, these giant foci resemble the recently described compartmentalization of damaged DNA that should facilitate the repair of DNA double-strand breaks but also increase the risk of chromosomal translocations. Overall, these results indicate that for a correct evaluation of the damage following recurrent CT examinations, it is necessary to consider the size and composition of the foci in addition to their number.

Proteomic analysis of plasma at the preterminal stage of rhesus nonhuman primates exposed to a lethal total-body dose of gamma-radiation

The identification and validation of radiation biomarkers is critical for assessing the radiation dose received in exposed individuals and for developing radiation medical countermeasures that can be used to treat acute radiation syndrome (ARS). Additionally, a fundamental understanding of the effects of radiation injury could further aid in the identification and development of therapeutic targets for mitigating radiation damage. In this study, blood samples were collected from fourteen male nonhuman primates (NHPs) that were exposed to 7.2 Gy ionizing radiation at various time points (seven days prior to irradiation; 1, 13, and 25 days post-irradiation; and immediately prior to the euthanasia of moribund (preterminal) animals). Plasma was isolated from these samples and was analyzed using a liquid chromatography tandem mass spectrometry approach in an effort to determine the effects of radiation on plasma proteomic profiles. The primary objective was to determine if the radiation-induced expression of specific proteins could serve as an early predictor for health decline leading to a preterminal phenotype. Our results suggest that radiation induced a complex temporal response in which some features exhibit upregulation while others trend downward. These statistically significantly altered features varied from pre-irradiation levels by as much as tenfold. Specifically, we found the expression of integrin alpha and thrombospondin correlated in peripheral blood with the preterminal stage. The differential expression of these proteins implicates dysregulation of biological processes such as hemostasis, inflammation, and immune response that could be leveraged for mitigating radiation-induced adverse effects.

DNA repair in tumor radioresistance: insights from fruit flies genetics

BACKGROUND

Radiation therapy (RT) is a key anti-cancer treatment that involves using ionizing radiation to kill tumor cells. However, this therapy can lead to short- and long-term adverse effects due to radiation exposure of surrounding normal tissue. The type of DNA damage inflicted by radiation therapy determines its effectiveness. High levels of genotoxic damage can lead to cell cycle arrest, senescence, and cell death, but many tumors can cope with this damage by activating protective mechanisms. Intrinsic and acquired radioresistance are major causes of tumor recurrence, and understanding these mechanisms is crucial for cancer therapy. The mechanisms behind radioresistance involve processes like hypoxia response, cell proliferation, DNA repair, apoptosis inhibition, and autophagy.

CONCLUSION

Here we briefly review the role of genetic and epigenetic factors involved in the modulation of DNA repair and DNA damage response that promote radioresistance. In addition, leveraging our recent results on the effects of low dose rate (LDR) of ionizing radiation on Drosophila melanogaster we discuss how this model organism can be instrumental in the identification of conserved factors involved in the tumor resistance to RT.

Radiation and male reproductive system: Damage and protection

Male fertility has been declining in recent decades, and a growing body of research points to environmental and lifestyle factors as the cause. The widespread use of radiation technology may result in more people affected by male infertility, as it is well established that radiation can cause reproductive impairment in men. This article provides a review of radiation-induced damage to male reproduction, and the effects of damage mechanisms and pharmacotherapy. It is hoped that this review will contribute to the understanding of the effects of radiation on male reproduction, and provide information for research into drugs that can protect the reproductive health of males.

X-ray radiation damage cycle of solvated inorganic ions

X-ray-induced damage is one of the key topics in radiation chemistry. Substantial damage is attributed to low-energy electrons and radicals emerging from direct inner-shell photoionization or produced by subsequent processes. We apply multi-electron coincidence spectroscopy to X-ray-irradiated aqueous solutions of inorganic ions to investigate the production of low-energy electrons (LEEs) in a predicted cascade of intermolecular charge- and energy-transfer processes, namely electron-transfer-mediated decay (ETMD) and interatomic/intermolecular Coulombic decay (ICD). An advanced coincidence technique allows us to identify several LEE-producing steps during the decay of 1s vacancies in solvated Mg2+ ions, which escaped observation in previous non-coincident experiments. We provide strong evidence for the predicted recovering of the ion's initial state. In natural environments the recovering of the ion's initial state is expected to cause inorganic ions to be radiation-damage hot spots, repeatedly producing destructive particles under continuous irradiation.

Low to moderate dose 137Cs (γ) radiation promotes M2 type macrophage skewing and reduces atherosclerotic plaque CD68+ cell content in ApoE(-/-) mice

The effects of low doses of ionizing radiation on atherosclerosis remain uncertain, particularly as regards the generation of pro- or anti-inflammatory responses, and the time scale at which such effects can occur following irradiation. To explore these phenomena, we exposed atheroprone ApoE(-/-) mice to a single dose of 0, 0.05, 0.5 or 1 Gy of 137Cs (γ) administered at a 10.35 mGy min-1 dose rate and evaluated short-term (1-10 days) and long-term consequences (100 days). Bone marrow-derived macrophages were derived from mice 1 day after exposure. Irradiation was associated with a significant skewing of M0 and M2 polarized macrophages towards the M2 phenotype, as demonstrated by an increased mRNA expression of Retnla, Arg1, and Chil3 in cells from mice exposed to 0.5 or 1 Gy compared with non-irradiated animals. Minimal effects were noted in M1 cells or M1 marker mRNA. Concurrently, we observed a reduced secretion of IL-1β but enhanced IL-10 release from M0 and M2 macrophages. Effects of irradiation on circulating monocytes were most marked at day 10 post-exposure, when the 1 Gy dose was associated with enhanced numbers of both Ly6CHigh and Ly6Low cells. By day 100, levels of circulating monocytes in irradiated and non-irradiated mice were equivalent, but anti-inflammatory Ly6CLow monocytes were significantly increased in the spleen of mice exposed to 0.05 or 1 Gy. Long term exposures did not affect atherosclerotic plaque size or lipid content, as determined by Oil red O staining, whatever the dose applied. Similarly, irradiation did not affect atherosclerotic plaque collagen or smooth muscle cell content. However, we found that lesion CD68+ cell content tended to decrease with rising doses of radioactivity exposure, culminating in a significant reduction of plaque macrophage content at 1 Gy. Taken together, our results show that short- and long-term exposures to low to moderate doses of ionizing radiation drive an anti-inflammatory response, skewing bone marrow-derived macrophages towards an IL-10-secreting M2 phenotype and decreasing plaque macrophage content. These results suggest a low-grade athero-protective effect of low and moderate doses of ionizing radiation.

Comprehensive Analysis of Contaminants in Powdered Milk Samples Using an HPGe for γ Radiation

Aims: This study aimed to assess the activity concentrations and cancer risk assessments of 232Th and 40K in powdered milk samples collected from various suppliers in Pakistan, considering the increasing concern about cancer risks associated with environmental radiological effects related to food consumption. Subjects and Methods: Specific activity concentrations were determined using a high-resolution, high-purity germanium γ-spectroscopy system. Results: The specific activity levels of 40K and 232Th in the analyzed powdered milk samples were found to be 230.86 and 6.87 Bq/kg, respectively, well within the safe limits recommended by the United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR). The hazard index (0.074 Bq/kg) and radium equivalent (27.58 Bq/kg) were calculated as indicators of radiation hazard, along with absorbed dose (26.26 nGy/h), annual effective dose (0.13 nGy/h), and excess lifetime cancer risk (0.45). These parameters provide insights into the potential health risks associated with powdered milk consumption. Conclusions: The findings collectively affirm the radiological safety of the analyzed powdered milk samples, providing valuable insights into the potential health risks associated with their consumption.

Radiation hazards of the Ukraine nuclear power plants: how can international blood and marrow stem cell transplant societies help?

Any conflict in countries that process nuclear power plants raises concerns of the potential radiation injuries to the people in that region and beyond such as the current conflict in Ukraine. International healthcare organizations and societies should prepare for the potential scenarios of nuclear incidents. The Worldwide Network for Blood and Marrow Transplantation (WBMT) and its members, have recent experience preparing for this type of events such as the Fukushima incident in 2011. In this article, we discuss the risks of radiation exposure, current guidelines, and scientific evidence on hematopoietic support, including the role of hematopoietic stem cell transplant (HCT) for those exposed to nuclear radiation, and the role that the WBMT and other global BMT societies can play in triaging and managing people suffering from radiation injuries.

A comprehensive review of dose limits, triage systems and measurement tools for consequence management of nuclear and radiological emergencies

During a radiological or nuclear emergency, occupational workers, members of the public, and emergency responders may be exposed to radionuclides, whether external or internal, through inhalation, ingestion, or wounds. In the case of internalized radiation exposure, prompt assessment of contamination is necessary to inform subsequent medical interventions. This review assembles the constituent considerations for managing nuclear and radiological incidents, focused on a parallel analysis of the evolution of radiation dose limits - notably in the emergency preparedness and response realm - alongside a discussion of triage systems and in vivo radionuclide detection tools. The review maps the development of international and national standards and regulations concerning radiation dose limits, illuminating how past incidents and accumulated knowledge have informed present emergency preparedness and response practices, specifically for internalized radiation. Additionally, the objectives and levels of radiation triage systems are explored in-depth, along with a global survey of practices and protocols. Finally, this review also focuses on in vivo detection systems and their capacities for radionuclide identification, prioritizing internalized gamma-emitting isotopes due to their broader relevance. Collectively, this study comprehensively addresses the intricacies of triage management following radiation emergencies, emphasizing the imperative for enhanced standardization and continued research in this critical domain.

A cohort analysis of residential radon exposure and melanoma incidence in Switzerland

Radon is a radioactive noble gas found in Earth's crust. It accumulates in buildings, and accounts for approximately half the ionizing radiation dose received by humans. The skin is considerably exposed to ionizing radiation from radon. We aimed to evaluate the association between residential radon exposure and melanoma and squamous cell carcinoma incidence. The study included 1.3 million adults (20 years and older) from the Swiss National Cohort who were residents of the cantons of Vaud, Neuchâtel, Valais, Geneva, Fribourg, and Ticino at the study baseline (December 04, 2000). Cases of primary tumours of skin (melanoma and squamous cell carcinoma) were identified using data from cantonal cancer registries. Long-term residential radon and ambient solar ultraviolet radiation exposures were assigned to each individual's address at baseline. Cox proportional hazard models with age as time scale, adjusted for canton, socioeconomic position, demographic data available in the census, and outdoor occupation were applied. Total and age specific effects were calculated, in the full population and in non-movers, and potential effect modifiers were tested. In total 4937 incident cases of melanoma occurred during an average 8.9 years of follow-up. Across all ages, no increased risk of malignant melanoma or squamous cell carcinoma incidence in relation to residential radon was found. An association was only observed for melanoma incidence in the youngest age group of 20-29 year olds (1.68 [95% CI: 1.29, 2.19] 100 Bq/m3 radon). This association was mainly in women, and in those with low socio-economic position. Residential radon exposure might be a relevant risk factor for melanoma, especially for young adults. However, the results must be interpreted with caution as this finding is based on a relatively small number of melanoma cases. Accumulation of radon is preventable, and measures to reduce exposure and communicate the risks remain important to convey to the public.

Conserved mechanisms of self-renewal and pluripotency in mouse and human ESCs regulated by simulated microgravity using a 3D clinostat

Embryonic stem cells (ESCs) exhibit unique attributes of boundless self-renewal and pluripotency, making them invaluable for fundamental investigations and clinical endeavors. Previous examinations of microgravity effects on ESC self-renewal and differentiation have predominantly maintained a descriptive nature, constrained by limited experimental opportunities and techniques. In this investigation, we present compelling evidence derived from murine and human ESCs, demonstrating that simulated microgravity (SMG)-induced stress significantly impacts self-renewal and pluripotency through a previously unidentified conserved mechanism. Specifically, SMG induces the upregulation of heat shock protein genes, subsequently enhancing the expression of core pluripotency factors and activating the Wnt and/or LIF/STAT3 signaling pathways, thereby fostering ESC self-renewal. Notably, heightened Wnt pathway activity, facilitated by Tbx3 upregulation, prompts mesoendodermal differentiation in both murine and human ESCs under SMG conditions. Recognizing potential disparities between terrestrial SMG simulations and authentic microgravity, forthcoming space flight experiments are imperative to validate the impact of reduced gravity on ESC self-renewal and differentiation mechanisms.

Occupational exposure to radiation among health workers: Genome integrity and predictors of exposure

The current study aimed to investigate genomic instabilities in healthcare workers who may experience varying levels of radiation exposure through various radiological procedures. It also sought to determine if factors related to the work environment and dosimeter reading could effectively explain the observed genomic instabilities. Utilizing the cytokinesis-block micronucleus assay (CBMN) on peripheral blood lymphocytes, we assessed a spectrum of genomic aberrations, including nucleoplasmic bridge (NPB), nuclear budding (NBUD), micronucleus (MN) formation, and total DNA damage (TDD). The study uncovered a statistically significant increase in the occurrence of distinct DNA anomalies among radiology workers (with a significance level of P < 0.0001 for all measurements). Notably, parameters such as total working hours, average work duration, and time spent in projection radiography exhibited significant correlations with MN and TDD levels in these workers. The dosimeter readings demonstrated a positive correlation with the frequency of NPB and NBUD, indicating a substantial association between radiation exposure and these two genomic anomalies. Our multivariable models identified the time spent in projection radiography as a promising parameter for explaining the overall genomic instability observed in these professionals. Thus, while dosimeters alone may not fully explain elevated total DNA damage, intrinsic work environment factors hold potential in indicating exposure levels for these individuals, providing a complementary approach to monitoring.

Patients' Radiation Exposure During Endovascular Abdominal Aortic Aneurysm Repair

BACKGROUND

To investigate associations between patient characteristics, intraprocedural complexity factors, and radiation exposure to patients during endovascular abdominal aortic aneurysm repair (EVAR).

METHODS

Elective standard EVAR procedures between January 2015 and December 2020 were retrospectively analyzed. Patient characteristics and intraprocedural data (i.e., type of device, endograft configuration, additional procedures, and contralateral gate cannulation time [CGCT]) were collected. Dose area product (DAP) and fluoroscopy time were considered as measurements of radiation exposure. Furthermore, effective dose (ED) and doses to internal organs were calculated using PCXMC 2.0 software. Descriptive statistics, univariable, and multivariable linear regression were applied to investigate predictors of increased radiation exposure.

RESULTS

The 99 patients were mostly male (90.9%) with a mean age of 74 ± 7 years. EVAR indications were most frequently abdominal aortic aneurysm (93.9%), penetrating aortic ulceration (2.0%), focal dissection (2.0%), or subacute rupture of infrarenal abdominal aortic aneurysm (2.0%). Median fluoroscopy time was 19.6 minutes (interquartile range [IQR], 14.1-29.4) and median DAP was 86,311 mGy cm2 (IQR, 60,160-130,385). Median ED was 23.2 mSv (IQR, 17.0-34.8) for 93 patients (93.9%). DAP and ED were positively correlated with body mass index (BMI) and CGCT. Kidneys, small intestine, active bone marrow, colon, and stomach were the organs that received the highest equivalent doses during EVAR. Higher DAP and ED values were observed using the Excluder endograft, other bi- and tri-modular endografts, and EVAR with ≥2 additional procedures. Multivariable linear regression analysis revealed that BMI, ≥2 additional procedures during EVAR, and CGCT were independent positive predictors of DAP and ED levels after accounting for endograft type.

CONCLUSIONS

Patient-related and procedure-related factors such as BMI, ≥2 additional procedures during EVAR, and CGCT resulted predictors of radiation exposure for patients undergoing EVAR, as quantified by higher DAP and ED levels. The main intraprocedural factor that increased radiation exposure was CGCT. These data can be of importance for better managing radiation exposure during EVAR.

Layered metal sulfides with MaSbc- framework (M = Sb, In, Sn) as ion exchangers for the removal of Cs(Ⅰ) and Sr(Ⅱ) from radioactive effluents: a review

Nuclear power has emerged as a pivotal contributor to the global electricity supply owing to its high efficiency and low-carbon characteristics. However, the rapid expansion of the nuclear industry has resulted in the production of a significant amount of hazardous effluents that contain various radionuclides, such as 137Cs and 90Sr. Effectively removing 137Cs and 90Sr from radioactive effluents prior to discharge is a critical challenge. Layered metal sulfides exhibit significant potential as ion exchangers for the efficient uptake of Cs+ and Sr2+ from aqueous solutions owing to their open and exchangeable frameworks and the distinctive properties of their soft S2- ligands. This review provides a detailed account of layered metal sulfides with MaSb c- frameworks (M = Sb, In, Sn), including their synthesis methods, structural characteristics, and Cs+ and Sr2+ removal efficiencies. Furthermore, we highlight the advantages of layered metal sulfides, such as their relatively high ion exchange capacities, broad active pH ranges, and structural stability against acid and radiation, through a comparative evaluation with other conventional ion exchangers. Finally, we discuss the challenges regarding the practical application of layered metal sulfides in radionuclide scavenging.

Association of low-dose ionising radiation with site-specific solid cancers: Chinese medical X-ray workers cohort study, 1950-1995

BACKGROUND

The dose-response relationship between cancers and protracted low-dose rate exposure to ionising radiation is still uncertain. This study aims to estimate quantified relationships between low-dose radiation exposures and site-specific solid cancers among Chinese medical X-ray workers.

METHODS

This cohort study included 27 011 individuals who were employed at major hospitals in 24 provinces in China from 1950 to 1980 and had been exposed to X-ray equipment, and a control group of 25 782 physicians who were not exposed to X-ray equipment. Person-years of follow-up were calculated from the year of employment to the date of the first diagnosis of cancer or the end of follow-up, whichever occurred first. All cancers were obtained from medical records during 1950-1995. This study used Poisson regression models to estimate the excess relative risk (ERR) and excess absolute risk (EAR) for incidence of site-specific solid cancers associated with cumulative dose.

RESULTS

1643 solid cancers were developed, the most common being lung, liver and stomach cancer. Among X-ray workers, the average cumulative colon dose was 0.084 Gy. We found a positive relationship between cumulative organ-specific dose and liver (ERR/Gy=1.48; 95% CI 0.40 to 2.83), oesophagus (ERR/Gy=18.1; 95% CI 6.25 to 39.1), thyroid (ERR/Gy=2.96; 95% CI 0.44 to 8.18) and non-melanoma skin cancers (ERR/Gy=7.96; 95% CI 2.13 to 23.12). We found no significant relationship between cumulative organ-specific doses and other cancers. Moreover, the results showed a statistically significant EAR for liver, stomach, breast cancer (female), thyroid and non-melanoma skin cancers.

CONCLUSIONS

These findings provided more useful insights into the risks of site-specific cancers from protracted low-dose rate exposure to ionising radiation.

Plasma D-dimer levels are a biomarker for in-hospital complications and long-term mortality in patients with traumatic brain injury

Introduction

Traumatic brain injury (TBI) is a major health concern worldwide. D-dimer levels, commonly used in the diagnosis and treatment of neurological diseases, may be associated with adverse events in patients with TBI. However, the relationship between D-dimer levels, TBI-related in-hospital complications, and long-term mortality in patients with TBI has not been investigated. Here, examined whether elevated D-dimer levels facilitate the prediction of in-hospital complications and mortality in patients with TBI.

Methods

Overall, 1,338 patients with TBI admitted to our institute between January 2016 and June 2022 were retrospectively examined. D-dimer levels were assessed within 24 h of admission, and propensity score matching was used to adjust for baseline characteristics.

Results

Among the in-hospital complications, high D-dimer levels were associated with electrolyte metabolism disorders, pulmonary infections, and intensive care unit admission (p < 0.05). Compared with patients with low (0.00-1.54 mg/L) D-dimer levels, the odds of long-term mortality were significantly higher in all other patients, including those with D-dimer levels between 1.55 mg/L and 6.35 mg/L (adjusted hazard ratio [aHR] 1.655, 95% CI 0.9632.843), 6.36 mg/L and 19.99 mg/L (aHR 2.38, 95% CI 1.416-4.000), and >20 mg/L (aHR 3.635, 95% CI 2.195-6.018; p < 0.001). D-dimer levels were positively correlated with the risk of death when the D-dimer level reached 6.82 mg/L.

Conclusion

Overall, elevated D-dimer levels at admission were associated with adverse outcomes and may predict poor prognosis in patients with TBI. Our findings will aid in the acute diagnosis, classification, and management of TBI.

The burden of radiation exposure in children requiring percutaneous nephrolithotomy

BACKGROUND

Children undergoing investigation and management for complex upper tract urolithiasis often require multimodal imaging. The significance of related radiation exposure in stone care pathways has received little attention in the published literature.

STUDY DESIGN

Medical records of paediatric patients undergoing percutaneous nephrolithotomy were retrospectively analysed to ascertain the modalities used and determine extent of radiation exposure occurring during each care pathway. Radiation dose simulation and calculation was performed a priori. The cumulative effective dose (mSv) and cumulative organ dose (mGy) for radiosensitive organs was calculated.

RESULTS

A total of 140 imaging studies were included from the care pathways of 15 children with complex upper tract urolithiasis. Median follow-up was 9.6 years (range: 6.7-16.8 years). The average number of imaging studies with ionising radiation per patient was nine, with a cumulative effective dose of 18.3 mSv across all modalities. The most common modalities were: mobile fluoroscopy (43%), x-ray (24%), and computed tomography (18%). The cumulative effective dose per study type was greatest for CT (4.09 mSv), followed by fixed and mobile fluoroscopy (2.79 mSv and 1.82 mSv, respectively).

CONCLUSION

There is high general awareness of radiation exposure involved in CT scanning with resultant caution in employing this modality in paediatric patients. However, the significant radiation exposure relating to fluoroscopy (whether fixed or mobile) is less well documented in children. We recommend implementing steps to minimise radiation exposure by optimisation and avoidance of certain modalities where possible. Paediatrics urologists must employ strategies to minimise radiation exposure in children with urolithiasis, given the significant exposures encountered.

Nuclear bomb and public health

Since the nuclear bomb attack against Hiroshima and Nagasaki in 1945, the world has advanced in nuclear technology. Today, a nuclear bomb could target a large-scale attack, at a longer range, and with much greater destructive force. People are increasingly concerned about the potential destructive humanitarian outcomes. We discuss actual conditions detonation of an atomic bomb would create, radiation injuries, and diseases. We also address concerns about functionality of medical care systems and other systems that support medical systems (i.e., transport, energy, supply chain, etc. systems) following a massive nuclear attack and whether citizens able to survive this.

Assessment of radiation level and potential risk to public living around major hospitals in central and western Bangladesh

Human beings are continuously bathed in radiation coming from natural and artificial sources. Although the use of radiation in medical applications is beneficial to patients, it also contributes significantly to the health hazard for radiation workers and the public if radiation-generating equipment and radioactive sources are not handled properly. 96% dose contributed from medical uses of ionizing radiation in the US population among man-made sources as per NCRP Report No. 160. There is no extensive study conducted on the large hospitals in Bangladesh following the In-Situ method. We used a real-time digital portable radiation monitor with Garmin eTrex Global Positioning System at 320 monitoring points for radiation monitoring and positioning around the ten largest hospitals in central & western Bangladesh from September to November 2021. The mean radiation dose rates around Bangabandhu Sheikh Mujib Medical University, Dhaka Medical College Hospital, Evercare Hospital, Khulna Medical College Hospital, Mitford Hospital, National Institute of Cancer Research Hospital, Popular Hospital, Rajshahi Medical College Hospital, Shaheed Suhrawardy Medical College Hospital, and Square Hospitals were measured as 0.145 ± 0.012 μSv/h, 0.135 ± 0.009 μSv/h, 0.148 ± 0.008 μSv/h, 0.139 ± 0.01 μSv/h, 0.133 ± 0.007 μSv/h, 0.153 ± 0.011 μSv/h, 0.144 ± 0.012 μSv/h, 0.137 ± 0.008 μSv/h, 0.145 ± 0.01 μSv/h, and 0.153 ± 0.009 μSv/h, respectively. The mean excess lifetime cancer risk (ELCR) of the public who lives nearby the hospital's boundary was estimated at 1.05 × 10-3, 0.983 × 10-3, 1.071 × 10-3, 1.004 × 10-3, 0.964 × 10-3, 1.084 × 10-3, 1.043 × 10-3,0.996 × 10-3, 1.051 × 10-3 & 1.112 × 10-3 respectively. ELCR in most of the locations around the ten largest hospitals in central & western Bangladesh is higher than the global average value. Radiation monitoring is significant for minimizing the public's radiation risk and keeping hospital environments as radiation-free as possible.

Candidate biomarkers and persistent transcriptional responses after low and high dose ionizing radiation at high dose rate

PURPOSE

Development of an integrated time and dose model to explore the dynamics of gene expression alterations and identify biomarkers for biodosimetry following low- and high-dose irradiations at high dose rate.

MATERIAL AND METHODS

We utilized multiple transcriptome datasets (GSE8917, GSE43151, and GSE23515) from Gene Expression Omnibus (GEO) for identifying candidate biological dosimeters. A linear mixed-effects model with random intercept was used to explore the dose-time dynamics of transcriptional responses and to functionally characterize the time- and dose-dependent changes in gene expression.

RESULTS

We identified genes that are correlated with dose and time and discovered two clusters of genes that are either positively or negatively correlated with both dose and time based on the parameters of the model. Genes in these two clusters may have persistent transcriptional alterations. Twelve potential transcriptional markers for dosimetry-ARHGEF3, BAX, BBC3, CCDC109B, DCP1B, DDB2, F11R, GADD45A, GSS, PLK3, TNFRSF10B, and XPC were identified. Of these genes, BAX, GSS, and TNFRSF10B are positively associated with both dose and time course, have a persistent transcriptional response, and might be better biological dosimeters.

CONCLUSIONS

With the proposed approach, we may identify candidate biomarkers that change monotonically in relation to dose, have a persistent transcriptional response, and are reliable over a wide dose range.

Brownfield land and health: A systematic review of the literature

BACKGROUND

Brownfield land is vacant or derelict land that was previously used for industrial or commercial purposes. Brownfield land is increasingly being targeted for housing development, however, depending on the previous use and remediation activity, it might pose potential risks to the health of residents on or in the vicinity of redeveloped sites. This systematic review of the literature synthesises the empirical evidence on the associations between brownfield land and health.

METHODS

We systematically searched EMBASE, MEDLINE, Global Health, Web of Science, Scopus and GreenFile using a study protocol registered on PROSPERO (CRD42022286826). The search strategy combined the keywords "brownfield" and its interchangeable terms such as "previously developed land", and any health outcomes such as "respiratory diseases" and "mortality". Publications identified from the search were screened for eligibility by two authors, and data were extracted from the selected articles. Study quality was assessed based on the Newcastle-Ottawa Scale.

RESULTS

Of the 1,987 records retrieved, 6 studies met the inclusion criteria; 3 ecological studies, 2 cross-sectional studies, and 1 longitudinal study. There was considerable heterogeneity in the exposure metrics and health outcomes assessed. All studies found significant positive associations between brownfield land proximity or density with at least one health relevant outcome, including poorer self-reported general health, increased mortality rates, increased birth defects, increased serum metal levels, and accelerated immune ageing.

CONCLUSIONS

Brownfield land may negatively affect the health of nearby residents. The epidemiological evidence on health effects associated with brownfield land in local communities, however, remains inconclusive and limited. Further studies are required to build the evidence base to inform future housing policies and urban planning.

Accelerated subsequent lung cancer after post-operative radiotherapy for breast cancer

BACKGROUND

Post-operative whole breast radiotherapy for breast cancer (BC) may increase the risk of subsequent lung cancer (LC). The impact of radiotherapy intensification (boost) has not been specifically explored in this context. We investigated the role of radiation modalities on the development of subsequent LC among our patients treated by radiotherapy for localized BC.

METHODS

All patients with a diagnosis of LC between 2000 and 2020 with a history of prior localized BC treated by surgery and post-operative radiotherapy were retrospectively reviewed. Primary endpoint was time to first diagnosis of LC after BC treatment with radiotherapy (RT).

RESULTS

From 98 patients who developed subsequent LC after primary BC treated with post-operative RT, 38% of patients (n = 37) received an additional RT boost, and 46% (n = 45) received hormonal treatment post radiation. A total of 61% (n = 60) were smokers. With regards to LC characteristics, adenocarcinoma was the most frequent histology (68%, n = 66); 36% (n = 35) harbored at least 1 molecular alteration, 57% (n = 20) of them being amenable to targeted therapy. Median time to first diagnosis of LC was 6 years [1.7-28.4 yrs] in the whole cohort. In the subgroup of patients treated with boost this time was reduced to 4 years [1.8-20.8 years] compared to 8 years for patients without boost [1.7-28.4 yrs] (p = 0.007). Boost, smoking usage, endocrine therapy, and age <50 yrs old at BC radiation remained independent factors associated with shorter time to first diagnosis of LC after BC treatment.

DISCUSSION

We report for the first time the potential impact of boost -part of BC radiation treatment- for BC on the risk of subsequent LC. The impact of low dose radiation on lung parenchyma could explain this phenomenon, but the underlying physiopathology is still under investigation. This work highlights the need for clinicians to identify patients at risk of developing faster subsequent thoracic malignancy after BC radiation, for implementing personalized surveillance.

Biological dosimetry dose-response curves for residents living near nuclear power plants in South Korea

The purpose of this study was to establish the dose-response curves for biological dosimetry of the Dong Nam Institute of Radiological and Medical Sciences to monitor radiation exposure of local residents in the vicinity of the nuclear power plant. The blood samples of five healthy volunteers were irradiated with gamma ray, and each sample was divided equally for analysis of chromosomal aberrations by Giemsa staining and three-color fluorescence in situ hybridization painting of the triplet (chromosomes #1, #2, and #4). The results of chromosomal aberrations followed the Poisson distribution in all individual and averaged data which include inter-individual variation in radiation susceptibility. Cytogenetics Dose Estimate Software version 5.2 was used to fit the dose-response curve and to determine the coefficients of linear-quadratic equations. The goodness of fit of the curves and statistical significance of fitted α and β-coefficients were confirmed in both Giemsa-based dicentric analysis and FISH-based translocation analysis. The coefficients calculated from the five-donor average data were almost identical in both of the analyses. We also present the results that the dose-response curve for dicentric chromosomes plus fragments could be more effective for dose estimation following low-dose radiation accidents.

Multi-Layered Composites of Natural Rubber (NR) and Bismuth Oxide (Bi2O3) with Enhanced X-ray Shielding and Mechanical Properties

Due to rapid increases in the utilization of radiation and nuclear technologies, effective and suitable radiation-shielding materials have become one of the most sought-after options to protect users and the public from excessive exposure to the radiation. However, most radiation-shielding materials have greatly reduced mechanical properties after the addition of fillers, resulting in their limited useability and shortened lifetime. Therefore, this work aimed to alleviate such drawbacks/limitations by exploring a possible method to simultaneously enhance both the X-ray shielding and mechanical properties of bismuth oxide (Bi₂O₃)/natural rubber (NR) composites through multi-layered structures, with varying (1-5) layers and a total combined thickness of 10 mm. To correctly determine the effects of the multi-layered structures on the properties of NR composites, the formulation and layer configuration for all multi-layered samples were tailored such that their theoretical X-ray shielding properties were equal to those of a single-layered sample that contained 200 phr Bi₂O₃. The results indicated that the multi-layered Bi₂O₃/NR composites with neat NR sheets on both outer layers (sample-D, sample-F, sample-H, and sample-I) had noticeably higher tensile strength and elongation at break than those of the other designs. Furthermore, all multi-layered samples (sample-B to sample-I), regardless of the layer structure, had enhanced X-ray shielding properties compared to those with a single layer (sample-A), as shown by their higher values of the linear attenuation coefficient (µ) and lead equivalence (Pb_eq) and the lower value of the half-value layer (HVL) in the former. This work also determined the effects of thermal aging on relevant properties for all samples, with the results revealing that all the thermal-aged composites had higher values for the tensile modulus but lower values for the swelling percentage, tensile strength, and elongation at break, compared with the non-aged composites. Hence, based on the overall outcomes from this work, it could be concluded that the worrisome decreases in mechanical properties of the common single-layered NR composites after the addition of Bi₂O₃ could be prevented/reduced by introducing appropriate multi-layered structures, which would not only widen potential applications but also prolong the lifetime of the composites.

High-LET-Radiation-Induced Persistent DNA Damage Response Signaling and Gastrointestinal Cancer Development

Ionizing radiation (IR) dose, dose rate, and linear energy transfer (LET) determine cellular DNA damage quality and quantity. High-LET heavy ions are prevalent in the deep space environment and can deposit a much greater fraction of total energy in a shorter distance within a cell, causing extensive DNA damage relative to the same dose of low-LET photon radiation. Based on the DNA damage tolerance of a cell, cellular responses are initiated for recovery, cell death, senescence, or proliferation, which are determined through a concerted action of signaling networks classified as DNA damage response (DDR) signaling. The IR-induced DDR initiates cell cycle arrest to repair damaged DNA. When DNA damage is beyond the cellular repair capacity, the DDR for cell death is initiated. An alternative DDR-associated anti-proliferative pathway is the onset of cellular senescence with persistent cell cycle arrest, which is primarily a defense mechanism against oncogenesis. Ongoing DNA damage accumulation below the cell death threshold but above the senescence threshold, along with persistent SASP signaling after chronic exposure to space radiation, pose an increased risk of tumorigenesis in the proliferative gastrointestinal (GI) epithelium, where a subset of IR-induced senescent cells can acquire a senescence-associated secretory phenotype (SASP) and potentially drive oncogenic signaling in nearby bystander cells. Moreover, DDR alterations could result in both somatic gene mutations as well as activation of the pro-inflammatory, pro-oncogenic SASP signaling known to accelerate adenoma-to-carcinoma progression during radiation-induced GI cancer development. In this review, we describe the complex interplay between persistent DNA damage, DDR, cellular senescence, and SASP-associated pro-inflammatory oncogenic signaling in the context of GI carcinogenesis.

Impact of Disasters on Older Adult Cancer Outcomes: A Scoping Review

PURPOSE

There is an urgent need to address the growing global cancer burden in the context of complex disaster events, which both disrupt access to oncology care and facilitate carcinogenic exposures. Older adults (65 years and older) are a growing population with multifaceted care needs, making them especially vulnerable to disasters. The objective of this scoping review is to characterize the state of the literature concerning older adult cancer-related outcomes and oncologic care after a disaster event.

METHODS

A search was conducted in PubMed and Web of Science. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for scoping reviews, articles were extracted and screened for inclusion. Eligible articles were summarized using descriptive and thematic analyses.

RESULTS

Thirty-five studies met all criteria for full-text review. The majority focused on technological disasters (60%, n = 21), followed by climate-amplified disasters (28.6%, n = 10) and geophysical disasters (11.4%, n = 4). Thematic analysis classified the current evidence into three major categories: (1) studies concerned with carcinogenic exposure and cancer incidence related to the disaster event, (2) studies examining changes in access to cancer care and cancer treatment disruptions as a result of the disaster event, and (3) studies exploring the psychosocial experiences of patients with cancer affected by a disaster event. Few studies focused on older adults specifically, and most of the current evidence focuses on disasters in the United States or Japan.

CONCLUSION

Older adult cancer outcomes after a disaster event are understudied. Current evidence suggests that disasters worsen cancer-related outcomes among older adults by disrupting continuity of care and access to timely treatment. There is a need for prospective longitudinal studies following older adult populations postdisaster and studies focused on disasters in low- and middle-income country contexts.

Diagnostic accuracy of Doppler twinkling artifact for identifying urolithiasis: a systematic review and meta-analysis

OBJECTIVE

The goal of this study was to perform a comprehensive meta-analysis to assess the overall diagnostic value of Doppler twinkling for the diagnosis of urolithiasis.

METHODS

We systematically searched the PubMed, EMBASE, and Cochrane Library databases from inception through May 31, 2021. Studies including patients with urolithiasis who underwent color flow Doppler sampling to highlight the twinkling artifact and computed tomography were included. Diagnostic test meta-analysis was performed with a bivariate model. We used summary receiver operating characteristic curves to summarize the overall diagnostic performance. The weighted sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio were calculated.

RESULTS

Sixteen studies involving 4572 patients were included in the systematic review and meta-analysis. The weighted sensitivity was 0.86 (95% confidence interval [CI] 0.72-0.94), specificity 0.92 (95% CI 0.75-0.98), positive likelihood ratio 11.3, negative likelihood ratio 0.2, and diagnostic odds ratio 75.5.

CONCLUSION

The Doppler twinkling artifact has good diagnostic value for the diagnosis of urolithiasis and should be used as a complementary tool in the diagnosis of urolithiasis.

Effects of Gamma Radiation on Single- and Multicomponent Organic Crystalline Materials

Exploration of highly ionizing radiation damage to organic materials has mainly been limited to polymers and single-component organic crystals due to their use in coatings and scintillation detection. Additional efforts are needed to create new tunable organic systems with stability in highly ionizing radiation to rationally design novel materials with controllable chemical and physical properties. Cocrystals are a promising class of compounds in this area because of the ability to rationally design bonding and molecular interactions that could lead to novel material properties. However, currently it is unclear if cocrystals exposed to radiation will maintain crystallinity, stability, and physical properties. Herein, we report the effects of γ radiation on both single-component- and multicrystalline organic materials. After irradiation with 11 kGy dose both single- (trans-stilbene, trans-1,2-bis(4-pyridyl)ethylene (4,4'-bpe), 1,n-diiodotetrafluorobenzene (1,n-C₆I₂F₄ ), 1,n-dibromotetrafluorobenzene (1,n-C₆Br₂F₄ ), 1,n-dihydroxybenzene (1,n-C₆H₆O₂ ) (where n = 1, 2, or 3)), and multicomponent materials (4,4'-bpe)·(1,n-C₆I₂F₄ ), (4,4'-bpe)·(1,n-C₆Br₂F₄ ), and (4,4'-bpe)·(1,n-C₆H₆O₂ ) were analyzed and compared to their preirradiated forms. Radiation damage was evaluated via single-crystal- and powder-X-ray diffraction, Raman spectroscopy, differential scanning calorimetry, and solid-state fluorimetry. Single-crystal X-ray diffraction analysis indicated minimal changes in the lattice postirradiation, but additional crystallinity changes for bulk materials were observed via powder X-ray diffraction. Overall, cocrystalline forms with 4,4'-bpe were more stable than the related single-component systems and were related to the relative stability of the individual conformers to γ radiation. Fluorescence signals were maintained for trans-stilbene and 4,4'-bpe, but quenching of the signal was observed for the cocrystalline forms to varying degrees. Three of the single components, 1,2-diiodotetrafluorobenzene (1,2-C₆I₂F₄ ), 1,4-diiodotetrafluorobenzene (1,4-C₆I₂F₄ ), and 1,4-dibromotetrafluorobenzene (1,4-C₆Br₂F₄ ), also underwent sublimation within an hour of exposure to air postirradiation. Further analysis using differential scanning calorimetry (DSC) and Raman spectroscopy attributed this phenomenon to removal of impurities adsorbed to the crystal surface during irradiation.