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Antibiotic therapy must be carried out consistently and according to the guidelines. Viruses are the dominant cause of upper respiratory tract infections (URTIs) in children, as has been shown in many previous studies. Unnecessary antibiotic therapy should be avoided so that it does not affect patients' health and lead to the development of resistant bacterial strains. Here we report a national survey conducted in a group of 4,389 children to assess the impact of selected behavioral and environmental factors on antibiotic therapy in patients with URTIs. We found that selected environmental factors influenced the type of treatment. The place of residence, having siblings, an absence of vaccinations, the presence of allergies, and attendance at educational institutions were conducive to antibiotic therapy. These factors also influenced the frequency of hospitalization of children and their absence from nurseries, kindergartens, and schools, as well as the absence of their guardians from work., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Ślęzak, Dembiński, Konefał, Dąbrowski, Mazur, Peregud-Pogorzelska, Wawrykow, Konefał and Peregud-Pogorzelski.)

Purpose: The field of online monitoring of the beam range is one of the most researched topics in proton therapy over the last decade. The development of detectors that can be used for beam range verification under clinical conditions is a challenging task. One promising possible solution are modalities that record prompt-gamma radiation produced by the interactions of the proton beam with the target tissue. A good understanding of the energy spectra of the prompt gammas and the yields in certain energy regions is crucial for a successful design of a prompt-gamma detector. Monte-Carlo simulations are an important tool in development and testing of detector concepts, thus the proper modelling of the prompt-gamma emission in those simulations are of vital importance. In this paper, we confront a number of GEANT4 simulations of prompt-gamma emission, performed with different versions of the package and different physics lists, with experimental data obtained from a phantom irradiation with proton beams of four different energies in the range 70-230 MeV., Methods: The comparison is made on different levels: features of the prompt-gamma energy spectrum, gamma emission depth profiles for discrete transitions and the width of the distal fall-off in those profiles., Results: The best agreement between the measurements and the simulations is found for the GEANT4 version 10.4.2 and the reference physics list QGSP_BIC_HP., Conclusions: Modifications to prompt-gamma emission modelling in higher versions of the software increase the discrepancy between the simulation results and the experimental data., (Copyright © 2021 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.)

This study provides the first insight into the problem of the induced radioactivity of the construction materials of the new-generation cardiac implantable electronic devices (CIEDs). Its aim was to identify nuclear reactions and the resulting radioisotopes induced in the CIEDs by high-energy X-ray therapeutic beams generated by medical linear accelerators. The presented results allow to verify the rightness of choice of materials for investigated CIEDs. Such analysis is currently available only for the older types of the CIEDs, but not for those of the new generation. Gamma spectrometry measurements have been performed using a high-purity germanium detector (HPGe). The identification and activities of the generated radioisotopes were obtained from the measured spectra of gamma - rays from decays of the produced unstable radioisotopes. 21 radioisotopes originating from 24 nuclear reactions were identified. For all considered models of CIEDs the highest activities are from the tin isomer 117m Sn. The induced activities were relatively small, not exceeding 3.1 Bq per a 1 Gy X-ray dose to a target volume., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Aim: This work is focused on the Monte Carlo microdosimetric calculations taking into account the influence of the AuNPs' shape, size and mass concentration on the radiation dose enhancement for the high-energy 6 MV and 18 MV X-ray therapeutic beams from a medical linac., Background: Due to a high atomic number and the photoelectric effect, gold nanoparticles can significantly enhance doses of ionizing radiation. However, this enhancement depends upon several parameters, such as, inter alia, nanoparticles' shape etc., Method: The simulated system was composed of the therapeutic beam, a water phantom with the target volume (with and without AuNPs) located at the depth of the maximum dose, i.e. at 1.5 cm for the 6 MV beam and at 3.5 cm for the 18 MV one. In the study the GEANT4 code was used because it makes it possible to get a very short step of simulation which is required in case of simulating the radiation interactions with nanostructures., Results: The dependence between the dose increase and the mass concentration of gold was determined and described by a simple mathematical formula for three different shapes of gold nanoparticles - two nanorods of different sizes and a flat 2D structure. The dose increase with the saturation occurring with the increasing mass concentration of gold was observed., Conclusions: It was found that relatively large cylindrical gold nanoparticles can limit the increase of the dose absorbed in the target volume much more than the large 2D gold nanostructure., (© 2020 Greater Poland Cancer Centre. Published by Elsevier B.V. All rights reserved.)

Purpose: During radiotherapy, leakage from the machine head and collimator expose patients to out-of-field irradiation doses, which may cause secondary cancers. To quantify the risks of secondary cancers due to out-of-field doses, it is first necessary to measure these doses. Since most dosimeters are energy-dependent, it is essential to first determine the type of photon energy spectrum in the out-of-field area. The aim of this study was to determine the mean photon energy values for the out-of-field photon energy spectrum for a 6 MV photon beam using the GEANT 4-Monte Carlo method., Material and Methods: A specially-designed large water phantom was simulated with a static field at gantry 0°. The source-to-surface distance was 92cm for an open field size of 10×10cm2. The photon energy spectra were calculated at five unique positions (at depths of 0.5, 1.6, 4, 6, 8, and 10cm) along the central beam axis and at six different off-axis distances., Results: Monte Carlo simulations showed that mean radiation energy levels drop rapidly beyond the edge of the 6 MV photon beam field: at a distance of 10cm, the mean energy level is close to 0.3MeV versus 1.5MeV at the central beam axis. In some cases, the energy level actually increased even as the distance from the field edge increased: at a depth of 1.6cm and 15cm off-axis, the mean energy level was 0.205MeV versus 0.252MeV at 20cm off-axis., Conclusion: The out-of-field energy spectra and dose distribution data obtained in this study with Monte Carlo methods can be used to calibrate dosimeters to measure out-of-field radiation from 6MV photons., (Copyright © 2017 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.)

We present the results of an investigation of the prompt-gamma emission from an interaction of a proton beam with phantom materials. Measurements were conducted with a novel setup allowing the precise selection of the investigated depth in the phantom, featuring three different materials composed of carbon, oxygen and hydrogen. We studied two beam energies of 70.54 and 130.87MeV and two detection angles: 90° and 120°. The results are presented in form of profiles of the prompt-gamma yield as a function of depth. In the analysis we focused on the transitions with the largest cross sections: 12 C 4.44→g.s. and 16 O 6.13→g.s. . We compare the profiles obtained under various irradiation conditions, with emphasis on the shape of the distal fall-off. The results are also compared to calculations including different cross-section models. They are in agreement with the model exploiting published cross-section data, but the comparison with the Talys model shows discrepancies., (Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.)

The detailed analysis of nuclear reactions occurring in materials of the door is presented for the typical construction of an entrance door to a room with a slowed down neutron field. The changes in the construction of the door were determined to reduce effectively the level of neutron and gamma radiation in the vicinity of the door in a room adjoining the neutron field room. Optimisation of the door construction was performed with the use of Monte Carlo calculations (GEANT4). The construction proposed in this paper bases on the commonly used inexpensive protective materials such as borax (13.4 cm), lead (4 cm) and stainless steel (0.1 and 0.5 cm on the side of the neutron field room and of the adjoining room, respectively). The improved construction of the door, worked out in the presented studies, can be an effective protection against neutrons with energies up to 1 MeV., (© The Author 2013. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)

Aim: The aim of the investigation was to determine the undesirable dose coming from neutrons produced in reactions (p,n) in irradiated tissues represented by water., Background: Production of neutrons in the system of beam collimators and in irradiated tissues is the undesirable phenomenon related to the application of protons in radiotherapy. It makes that proton beams are contaminated by neutrons and patients receive the undesirable neutron dose., Materials and Methods: The investigation was based on the Monte Carlo simulations (GEANT4 code). The calculations were performed for five energies of protons: 50 MeV, 55 MeV, 60 MeV, 65 MeV and 75 MeV. The neutron doses were calculated on the basis of the neutron fluence and neutron energy spectra derived from simulations and by means of the neutron fluence-dose conversion coefficients taken from the ICRP dosimetry protocol no. 74 for the antero-posterior irradiation geometry., Results: The obtained neutron doses are much less than the proton ones. They do not exceed 0.1%, 0.4%, 0.5%, 0.6% and 0.7% of the total dose at a given depth for the primary protons with energy of 50 MeV, 55 MeV, 60 MeV, 65 MeV and 70 MeV, respectively., Conclusions: The neutron production takes place mainly along the central axis of the beam. The maximum neutron dose appears at about a half of the depth of the maximum proton dose (Bragg peak), i.e. in the volume of a healthy tissue. The doses of neutrons produced in the irradiated medium (water) are about two orders of magnitude less than the proton doses for the considered range of energy of protons.

Aim: The goal of this work was to assess the additional dose from secondary neutrons and γ-rays generated during total body irradiation (TBI) using a medical linac X-ray beam., Background: Nuclear reactions that occur in the accelerator construction during emission of high-energy beams in teleradiotherapy are the source of secondary radiation. Induced activity is dependent on the half-lives of the generated radionuclides, whereas neutron flux accompanies the treatment process only., Materials and Methods: The TBI procedure using a 18 MV beam (Clinac 2100) was considered. Lateral and anterior-posterior/posterior-anterior fractions were investigated during delivery of 2 Gy of therapeutic dose. Neutron and photon flux densities were measured using neutron activation analysis (NAA) and semiconductor spectrometry. The secondary dose was estimated applying the fluence-to-dose conversion coefficients., Results: The main contribution to the secondary dose is associated with fast neutrons. The main sources of γ-radiation are the following: (56)Mn in the stainless steel and (187)W of the collimation system as well as positron emitters, activated via (n,γ) and (γ,n) processes, respectively. In addition to 12 Gy of therapeutic dose, the patient could receive 57.43 mSv in the studied conditions, including 4.63 μSv from activated radionuclides., Conclusion: Neutron dose is mainly influenced by the time of beam emission. However, it is moderated by long source-surface distances (SSD) and application of plexiglass plates covering the patient body during treatment. Secondary radiation gives the whole body a dose, which should be taken into consideration especially when one fraction of irradiation does not cover the whole body at once.

Qualitative and quantitative analysis of radionuclides originating inside a medical linear accelerator during emission of high-energy therapeutic photon beams (15, 18, and 20 MV) is presented. The semiconductor spectrometry method allowed to obtain the fluence rate of photons with defined energy and hence, to quantify the dose at the chosen points in the vicinity of linac, contribution of particular radionuclides and its evolution in time. Typically used materials: copper, tungsten, lead, tantalum and their admixtures: antimony, manganese or bromine, are activated the most., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

Background: High-energy photon and electron therapeutic beams generated in medical linear accelerators can cause the electronuclear and photonuclear reactions in which neutrons with a broad energy spectrum are produced. A low-energy component of this neutron radiation induces simple capture reactions from which various radioisotopes originate and in which the radioactivity of a linac head and various objects in the treatment room appear., Aim: The aim of this paper is to present the results of the thermal/resonance neutron fluence measurements during therapeutic beam emission and exemplary spectra of gamma radiation emitted by medical linac components activated in neutron reactions for four X-ray beams and for four electron beams generated by various manufacturers' accelerators installed in typical concrete bunkers in Polish oncological centers., Materials and Methods: The measurements of neutron fluence were performed with the use of the induced activity method, whereas the spectra of gamma radiation from decays of the resulting radioisotopes were measured by means of a portable high-purity germanium detector set for field spectroscopy., Results: The fluence of thermal neutrons as well as resonance neutrons connected with the emission of a 20 MV X-ray beam is ∼10(6) neutrons/cm(2) per 1 Gy of a dose in water at a reference depth. It is about one order of magnitude greater than that for the 15 MV X-ray beams and about two orders of magnitude greater than for the 18-22 MeV electron beams regardless of the type of an accelerator., Conclusion: The thermal as well as resonance neutron fluence depends strongly on the type and the nominal potential of a therapeutic beam. It is greater for X-ray beams than for electrons. The accelerator accessories and other large objects should not be stored in a treatment room during high-energy therapeutic beam emission to avoid their activation caused by thermal and resonance neutrons. Half-lives of the radioisotopes originating from the simple capture reaction (n,γ) (from minutes to hours) are long enough to accumulate radioactivity of components of the accelerator head. The radiation emitted by induced radioisotopes causes the additional doses to staff operating the accelerators.

Dependence between therapeutic dose and activity induced in mammal bones is discussed. This activity leads to gamma ray emission registered by HPGe detector and scintilation probe. Presented results are focused on activation which occurs during emission of 15 and 20 MV photon beams. The purpose is to describe how therapeutic conditions (dose, time of irradiation) influence the induced radioactivity. Preliminary studies of decay rate, calculation of half-life and identification of isotopes involved in this dynamic process are given., (Copyright 2009 Elsevier Ltd. All rights reserved.)

High-energy therapeutic beams used in the radiotherapy induce photonuclear and electronuclear reactions which are accompanied by generation of undesirable radioisotopes and neutrons inside the treatment room. These neutrons at thermal and resonance energies induce nuclear reactions through the whole accelerator bunker. In consequence various radioisotopes emitting high-energy photons appear. In this paper the correlation between radioactivity induced inside the treatment room and the undesirable thermal and resonance neutron radiation generated by the therapeutic accelerator X-rays was studied. The thermal and resonance neutron fluence determined in chosen places inside the bunkers was 1.0x10(5)-3.4x10(5)cm(-2)Gy(-1) and 1.0x10(5)-1.6x10(6)cm(-2)Gy(-1) at thermal energies (<0.1eV) and 3.9x10(4)-1.3x10(5)cm(-2)Gy(-1) and 1.0x10(5)-1.1x10(6)cm(-2)Gy(-1) at epithermal energies (0.1eV-10keV), for the 15MV and 20MV beams, respectively. The gamma energy spectra measured inside the accelerator bunker depended on the neutron radiation level. The net count rates of the gamma peaks from the decays of the excited state (56)Fe* and (28)Si*, the result of the simple capture of the neutron, for the 20MV beam were almost one order of magnitude greater than those for the 15MV beam. Moreover, it turned out that the activation of the wedge - the main accelerator accessory was caused by neutrons.