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Scheidingstechnieken voor dunne plaat en buis

Deze publicatie is binnen het project 'nieuwe materialen' ontwikkeld en geeft een overzicht van de scheidingstechnieken voor dunne metaalplaatmaterialen en buizen met diktes van 0,3 t/m ca. 3 mm. Een deel van de informatie is evenwel ook van toepassing voor grotere diktes. De behandelde technieken kunnen ook voor andere materialen (kunststoffen, enz.) worden gebruikt. Hierop wordt in deze publicatie verder niet ingegaan. In het kader van dit project zijn tevens uitgegeven: TI.04.18 'Hoge Sterkte Staal in dunne plaat en buis', TI.04.19 'Roestvast staal in dunne plaat en buis', TI.04.21 'Aluminium in dunne plaat en buis' en TI.04.22 'Ontwerpen van dunne plaat producten en de Eindige Elementen Methode'.

Dose to the masseter muscle and risk of trismus after chemoradiation for advanced head & neck cancer

Purpose / objective: Head and neck cancer patients treated with chemoradiation are at risk for developing trismus (reduced mouth opening). Trismus is often a persisting side-effect and difficult to manage. It impairs eating, speech and oral hygiene, affecting quality of life. Although several studies identified the masseter muscle (MM) as one of the main organs at risk, currently this structure is rarely considered during treatment planning. Prospective studies for chemoradiation are lacking. The aim of our study was to quantify the relationship between radiation dose to the MM and development of radiation-induced trismus in an IMRT-VMAT population. Results: At the first evaluation, 6-12 weeks post-treatment, fourteen patients had developed radiation-induced trismus (15%). On average, mouth opening decreased with 4.1 mm, or 8.2 % relative to baseline. Mean dose to the ipsilateral MM was a stronger predictor for trismus than mean dose to the contralateral MM, as indicated by the lowest -2 log likelihood (Table 1). Figure 1A shows the correlation between the ipsilateral mean masseter dose and the relative decrease in mouth opening, with trismus cases indicated in red. No trismus cases were observed in 33 patients (35%) with a mean dose to the ipsilateral MM < 20 Gy. The risk of trismus in the other 60 patients (65%) increased with higher mean doses to the ipsilateral MM. Figure 1B shows the fitted NTCP curve as a function of the mean dose, with a TD50 of 55 Gy. The actual incidence (with 1 SE) of trismus cases within 5 dose bins is indicated as well, showing a good correspondence with the NTCP fit with a relatively large uncertainty in the dose area > 50 Gy. Patients with tumors located in the oropharynx were at highest risk.

Taste intensities of ten vegetables commonly consumed in The Netherlands

Bitterness has been suggested to be the main reason for the limited palatability of several vegetables. Vegetable acceptance has been associated with preparation method. However, the taste intensity of a variety of vegetables prepared by differentmethods has not been studied yet. The objective of this study is to assess the intensity of the five basic tastes and fattiness of ten vegetables commonly consumed in the Netherlands prepared by different methods using the modified Spectrum method. Intensities of sweetness, sourness, bitterness, umami, saltiness and fattiness were assessed for ten vegetables (cauliflower, broccoli, leek, carrot, onion, red bell pepper, French beans, tomato, cucumber and iceberg lettuce) by a panel (n = 9) trained in a modified Spectrum method. Each vegetable was assessed prepared by different methods (raw, cooked, mashed and as a cold pressed juice). Spectrum based reference solutions were available with fixed reference points at 13.3 mm (R1), 33.3mm(R2) and 66.7mm(R3) for each tastemodality on a 100mmline scale. For saltiness, R1 and R3 differed (16.7 mm and 56.7 mm). Mean intensities of all taste modalities and fattiness for all vegetables were mostly below R1 (13.3 mm). Significant differences (p b 0.05) within vegetables between preparation methods were found. Sweetness was the most intensive taste, followed by sourness, bitterness, fattiness, umami and saltiness.In conclusion, all ten vegetables prepared by different methods showed low mean intensities of all taste modalities and fattiness. Preparation method affected taste and fattiness intensity and the effect differed by vegetable type.

Treatment planning of stereotactic radiosurgery for single brain metastases: impact of leaf width

Purpose/objective: Stereotactic radiosurgery of brain metastases requires highly conformal dose distributions. Besides beams setup, characteristics of the linear accelerator collimator may also play a role. In this study we compared the impact of leaf width on the dose outside the target for stereotactic radiosurgery of single brain metastases. Results: The mean dose was evaluated in the first 2 rings of 5 mm around the PTV(table 1). The difference in mean dose for the small lesions(Dpres=24 Gy) of the first ring of 5 mm is 1.8 Gy in favor of the Agility and 0.9 Gy for the larger lesions(Dpres=18 Gy)also in favor of the Agility. The difference is smaller for the larger lesions (figure1). Also for the second ring of 5 mm, adjacent to the first ring, the difference is is 1.1 Gy vs 0.8 Gy also in favor of the Agility. Conclusion: For the small lesions with a volume smaller than 4 cm³ the Agility shows a steeper gradient in the two surrounding rings than the MLCi1. Therefore we recommend the use of the Agility for treating the smaller lesions.

Radiation dose to the masseter and medial pterygoid muscle in relation to trismus after chemoradiotherapy for advanced head and neck cancer

Abstract Background: We studied the relationship between trismus (maximum interincisor opening [MIO] ≤35 mm) and the dose to the ipsilateral masseter muscle (iMM) and ipsilateral medial pterygoid muscle (iMPM). Methods: Pretreatment and post-treatment measurement of MIO at 13 weeks revealed 17% of trismus cases in 83 patients treated with chemoradiation and intensity-modulated radiation therapy. Logistic regression models were fitted with dose parameters of the iMM and iMPM and baseline MIO (bMIO). A risk classification tree was generated to obtain optimal cut-off values and risk groups. Results: Dose levels of iMM and iMPM were highly correlated due to proximity. Both iMPM and iMM dose parameters were predictive for trismus, especially mean dose and intermediate dose volume parameters. Adding bMIO, significantly improved Normal Tissue Complication Probability (NTCP) models. Optimal cutoffs were 58 Gy (mean dose iMPM), 22 Gy (mean dose iMM) and 46 mm (bMIO). Conclusions: Both iMPM and iMM doses, as well as bMIO, are clinically relevant parameters for trismus prediction.

Wearables bruikbaar voor monitoren beweeggedrag bij borstkanker survivors [Bespreking van: Nguyen NH, Hadgraft NT, Moore MM, Rosenberg DE, Lynch C, Reeves MM, Lynch BM (2017) A qualitative evaluation of breast cancer survivors' acceptance of and preferences for consumer wearable technology activity trackers]