Radiotherapy dosage:A neural network approach for uninvolved liver dose in stereotactic body radiation therapy for liver cancer

A recent study by Zhang et al developed a neural network-based predictive model for estimating doses to the uninvolved liver during stereotactic body radiation therapy(SBRT)in liver cancer.The study reported a significant advancement in personalized radiotherapy by improving accuracy and reducing treatment-related toxicity.The model demonstrated strong predictive performance with R-values above 0.8,indicating its potential to improve treatment consistency.However,concerns arise from the small sample size and exclusion criteria,which may limit generalizability.Future studies should incorporate larger,more diverse patient cohorts,explore potential confounding factors such as tumor characteristics and delivery technique variability,and address the long-term effects of SBRT.

CARE Dose 4D联合CARE kV技术在胸部CT扫描中的辐射剂量降低研究

目的:探究在胸部CT扫描过程中启用CARE Dose 4D联合CARE kV技术对降低CT辐射剂量的有效性。方法:回顾性分析2023年1月至12月期间在本院进行胸部CT扫描的100例患者影像资料,根据是否应用CARE Dose 4D联合CARE kV技术将患者分为A组(常规胸部CT扫描,n=50例)和B组(应用CARE Dose 4D联合CARE kV技术,n=50例)。采用德国西门子SOMATOM Force双源CT,详细设置包括自动毫安秒调节、120KV管电压等参数。比较两组的辐射剂量指标(CTDI(剂量指数)、DLP(剂量长度乘积)、ED(有效剂量))、图像质量客观评价(平均CT值、噪声(SD)、信号噪声比(SNR))和主观评分。结果:B组的辐射剂量指标显著低于A组(P<0.05);而两组的图像质量对比上无显著差异(P>0.05)。结论:胸部CT扫描中应用CARE Dose 4D联合CARE kV技术能显著减少辐射剂量,同时保持高质量的CT图像,为临床检查提供了一种安全有效的方法,为辐射防护最优化原则的实施提供了有力支持,具有广阔的临床应用前景。

Comparison of split-dosing vs non-split(morning) dosing regimen for assessment of quality of bowel preparation for colonoscopy

AIM: To compare(using the Ottawa Bowel Preparation Scale) the efficacy of split-dose vs morning administration of polyethylene glycol solution for colon cleansing in patients undergoing colonoscopy, and to assess the optimal preparation-to-colonoscopy interval.METHODS: Single-centre, prospective, randomized, investigator-blind stud in an academic tertiarycare centre. Two hundred patients requiring elective colonoscopy were assigned to receive one of the two preparation regimens(split vs morning) prior to colonoscopy. Main outcome measurements were bowel preparation quality and patient tolerability.RESULTS: Split-dose regimen resulted in better bowel preparation compared to morning regimen [Ottawascore mean 5.52(SD 1.23) vs 6.02(1.34); P = 0.017]. On subgroup analysis, for afternoon procedures, both the preparations were equally effective(P = 0.756). There was no difference in tolerability and compliance between the two regimens.CONCLUSION: Overall, previous evening- same morning split-dosing regimen results in better bowel cleansing for colonoscopy compared to morning preparation. For afternoon procedures, both schedules are equally effective; morning preparation may be more convenient to the patient.

Optimal dosing time of acid algaecide for restraining algal growth

Restraining algal growth by algaecide has been studied by many researchers, but the dosing time has not yet been studied. In this study, we examined the appropriate dosing time of algaecide through a series of experiments. In the experiments, the pH value of water is significantly affected by Microcystis aeruginosa, and the variation of the pH value is in favor of the growth of the alga. Therefore, using acid algaecide in the period with maximum pH values, i.e., the stable phase, would change the acidity-alkalinity of the water significantly, and would negatively affect algal growth. Acid algaecide does not eliminate the alga effectively if the acid algaecide is dosed in the logarithmic growth phase. Using acid algaecide in the decline phase after algal bloom not only is unfavorable for eliminating the alga, but also prolongs the decline phase, and even brings about next larger algal bloom.

Effect of potassium permanganate dosing position on the performance of coagulation/ultrafiltration combined process

The effects of potassium permanganate(KMnO_4)dosing position on the natural organic matter(NOM)removal as well as membrane fouling were investigated in the coagulation/ultrafiltration combined process.KMnO_4 oxidation altered the NOM characteristics in terms of hydrophobicity and molecular weight,and destroyed humic substances originated from terraneous organisms in raw water.The optimal KMnO_4 dosage was 0.5 mg·L^(-1) in the peroxidation enhanced coagulation process with respect to the dissolved organic carbon(DOC)removal.When KMnO_4 was dosed into both upstream and downstream of coagulation,namely in the proposed twoposition dosing mode,coagulation and KMnO_4 oxidation worked individually on the apparent DOC removal.However,compared to the KMnO_4 addition prior to or after coagulation,the two-position dosing mode dramatically alleviated membrane fouling and reduced fouling irreversibility.This was attributed to the change of NOM characteristics as a result of KMnO_4 addition prior to coagulation and the presence of MnO_2 on membrane surface as a result of KMnO_4 addition prior to ultrafiltration.This work may provide useful information for the application of KMnO_4 oxidation in the coagulation/ultrafiltration combined system.

Dynamic Flow Control Strategies of Vehicle SCR Urea Dosing System

Selective Catalyst Reduction（SCR）Urea Dosing System（UDS）directly affects the system accuracy and the dynamic response performance of a vehicle.However,the UDS dynamic response is hard to keep up with the changes of the engine＇s operating conditions.That will lead to low NO_χconversion efficiency or NH_3 slip.In order to optimize the injection accuracy and the response speed of the UDS in dynamic conditions,an advanced control strategy based on an air-assisted volumetric UDS is presented.It covers the methods of flow compensation and switching working conditions.The strategy is authenticated on an UDS and tested in different dynamic conditions.The result shows that the control strategy discussed results in higher dynamic accuracy and faster dynamic response speed of UDS.The inject deviation range is improved from being between-8%and 10%to-4%and 2%and became more stable than before,and the dynamic response time was shortened from 200 ms to 150 ms.The ETC cycle result shows that after using the new strategy the NH_3 emission is reduced by 60%,and the NO_χemission remains almost unchanged.The trade-off between NO_χconversion efficiency and NH_3 slip is mitigated.The studied flow compensation and switching working conditions can improve the dynamic performance of the UDS significantly and make the UDS dynamic response keep up with the changes of the engine＇s operating conditions quickly.

Application of FTA Method to Reliability Analysis of Vacuum Resin Shot Dosing Equipment

Faults of vacuum resin shot dosing equipment are studied systematically and the fault tree of the system is constructed by using the fault tree analysis(FTA) method. Then the qualitative and quantitative analysis of the tree is carried out, respectively, and according to the results of the analysis, the measures to improve the system are worked out and implemented. As a result, the reliability of the equipment is enhanced greatly.

Enoxaparin dosing errors in the emergency department

BACKGROUND:The study aimed to determine the frequency of enoxaparin dosing errors for patients who had a measured emergency department(ED)weight compared to those who did not have a measured ED weight,and to determine if demographic variables(e.g.,weight,height,age,Englishspeaking,race)impact the likelihood of receiving an inappropriate dose.METHODS:This is a retrospective,electronic chart review of patients who received a dose of enoxaparin in the ED between January 1,2008 and July 1,2013.We identified all patients>18 years who received a dose of enoxaparin while in the ED,were admitted,and had at least one inpatient weight within the first four days of hospitalization.Patients were excluded if they received enoxaparin for prophylaxis or a dose of more than 1.25mg/kg.RESULTS:A total of 1,944 patients were included.Patients were more likely to experience an error if they did not have a measured ED weight.Over-doses of>10mg were more likely to occur in patients without a measured ED weight.Patients with no documented ED weight or with a staffestimated ED weight were more likely to experience a dosing error than those with a patient-stated weight.Patients were more likely to experience an error if their first inpatient weight was more than 96kg,they were more than 175-cm tall,or were English speaking.CONCLUSION:Dosing errors are more likely to occur when patients are not weighed in the ED.Modifications to current workflows to incorporate weighing those patients who receive weightdosed medications may be warranted.

Toddlers’ choice:Yo-Yoing diabetes control or deci-unit insulin dosing?

While the incidence of toddlers’ diabetes is soaring,their mainstay insulins were withdrawn,namely the weak 10% or 20% insulin mixtures (WIM),which were injected only once or twice daily.Consequently,toddlers are coerced to use an insulin pump,multi-dose insulin regime (MuDIR),mix or dilute insulins.This paper highlights the difficulties and proposes a simple solution.While an insulin pump is the best available option,it is not readily available for everyone.Mixing insulins is not sufficiently precise in small doses.Although diluting insulin would allow precise dosing and reduce the dose variability secondary to dribbling after injections,it,like insulin mixing,deprives children from using the pen and related child-friendly accessories.In MuDIR,we inject 4-5 small doses of insulin instead of 1-2 daily larger doses of WIM.Thus,on using a half unit (unit) insulin pen,a dose of 0.5,1,1.5 and 2 units are adjusted in steps of 100%,50%,33% or 25%;unlike the advisable 5%-20%.This does not easily match the tiny erratic meals of grazing toddlers.Maternal anxiety peaks on watching yo-yoing glycemia.Carers have to accept either persistently high sugar or wild fluctuation.The risks of such poor glycemic pattern are increasingly recognized.Using insulin U20 in a unit disposable pen allows deci-unit dosing,with 5%-20% dose-tuning,greater accuracy on delivering small doses and reduction of dose variability from dribbling.Deci-unit dosing may help avoid wide glycemic swings and provide the affordable alternative to insulin pumps for toddlers.Deci-unit pen materializes the Human Rights of Children,a safer and effective treatment.

The PLC Control System of Vacuum Resin Shot Dosing Equipment

The principle and working process of Vacuum Resin Shot Dosing Equipment(VRSDE) are analyzed and the characteristics of IP1612-220PLC (Programmable Logical Controller) areintroduced briefly at first. Then the authors discuss the flow of program, the assignment of PLCI/O ports, the wiring diagram, and the ladder logic program of the PLC control system of VRSDE indetail. Some application issues of the system are accounted for in addition. Finally, according tothe information acquired from users, the authors draw the conclusion: this system owns a highreliability and a-vailability and greatly improves the automatic degree of VRDE.

Randomized clinical trial comparing fixed-time split dosing and split dosing of oral Picosulfate regimen for bowel preparation

AIM To compare the efficacy of fixed-time split dose and split dose of an oral sodium picosulfate for bowel preparation.METHODS This is study was prospective, randomized controlled study performed at a single Institution(2013-058). A total of 204 subjects were assigned to receive one of two sodium picosulfate regimens(i.e., fixed-time split or split) prior to colonoscopy. Main outcome measurements were bowel preparation quality and subject tolerability.RESULTS There was no statistical difference between the fixedtime split dose regimen group and the split dose regimen group(Ottawa score mean 2.57 ± 1.91 vs 2.80 ± 2.51, P = 0.457). Cecal intubation time and physician's satisfaction of inspection were not significantly different between the two groups(P = 0.428, P = 0.489). On subgroup analysis, for afternoon procedures, the fixed-time split dose regimen was equally effective as compared with the split dose regimen(Ottawa score mean 2.56 ± 1.78 vs 2.59 ± 2.27, P = 0.932). There was no difference in tolerability or compliance between the two groups. Nausea was 21.2% in the fixed-time split dose group and 14.3% in the split dose group(P = 0.136). Vomiting was 7.1% and 2.9%(P = 0.164), abdominal discomfort 7.1% and 4.8%(P = 0.484), dizziness 1% and 4.8%(P = 0.113), cold sweating 1% and 0%(P = 0.302) and palpitation 0% and 1%(P = 0.330), respectively. Sleep disturbance was two(2%) patients in the fixed-time split dose group and zero(0%) patient in the split dose preparation(P = 0.143) group.CONCLUSION A fixed-time split dose regimen with sodium picosulfate is not inferior to a split dose regimen for bowel preparation and equally effective for afternoon colonoscopy.

Anti-Malarial Targeting and Dosing Practices among Health Workers at Lower Level Health Facilities in Uganda

Background: Health worker shortages remain a significant challenge to delivery of health care services globally. Moving tasks, where appropriate, to less specialized health workers is recommended by the World Health Organization as a strategy to address this challenge. However, this concept is feared to raise specific quality concerns. This research aimed at assessing the performance of health workers to correctly prescribe (target) appropriate antimalarial treatment. Methods: We conducted a cross sectional study at three public health centre IVs in Uganda, with varying malaria transmission intensities (Kihihi-low, Kasambya-medium and Nagongera-high). We categorized prescribers into two groups: specialized prescribers (doctors and clinical officers) and less specialized prescribers (nurses and midwives). At each site, 100 records of patients seen between September and November 2011 and prescribed an antimalarial were retrieved for each group of prescribers. Correctness of the antimalarial drug prescribed and dose given were assessed for each group and compared to the 2005 Uganda national malaria treatment guidelines which recommend Artemether Lumefantrine (AL) for treatment of uncomplicated malaria and Quinine for complicated malaria. Results: Findings of the study showed that specialized health workers were more likely to target correctly as compared to the less specialized health workers [OR = 1.49 (1.00 - 2.22), p = 0.046]. Appropriateness of dosing was higher among specialized prescribers compared to less specialized prescribers however this was not significant [OR = 1.58 (0.77 - 3.25), p = 0.206]. Age of the participants, history of fever, diagnosis of malaria and prescription experience were not associated with correct targeting. Conclusion: This study shows that task shifting at the targeting level is not suitable;however, there is inadequate evidence to show that this also applies to anti-malarial dosing. Task shifting for the treatment of Malaria in Uganda should be investigated further using larger studies if it is to be considered as an option for solving the health worker shortages especially in regions with few specialized health workers but high malaria burden.

Novel Approach to Chemotherapy and Administration Selection with Metronomic/Fractionated Dosing

Metronomic dosing of chemotherapy was introduced in the early 2000s and has since gained recognition as a potential game changer in the manner of which chemotherapy can be administered. There are several known candidates for metronomic dosing of chemotherapy with the potential for many more to be elucidated in the future. Minimized overall side effects, longer durations of treatment, potential minimization of multidrug resistance (MDR) mutations, potential less refractory responses, and the potential to safely use more than one chemotherapy treatments also make metronomic dosing of chemotherapy attractive. Metronomic dosing reduces common side effects and has the potential to reduce neutropenia, lymphocytopenia, and cognitive changes associated with maximum tolerated dosages (MTD). Methods of enhancing chemotherapy including fasting and administration of insulin are also discussed. Metronomic dosing combined with a patient’s molecular profile derived from biomarkers is particularly exciting. It holds significant potential with regard to administrating the most relevant chemotherapies and offers maximal beneficial results.

Treatment Outcome of Pharmacokinetics-Based Dosing of Docetaxel and Fluorouracil in Advanced Head and Neck Cancer Patients

Introduction: Docetaxel, Cisplatin and 5-Fluorouracil (DPF) became the standard induction chemotherapy in advanced Head and Neck Cancer (HNC) but associated with high toxicity rate. Several studies reported higher response rates with better tolerability when chemotherapy dose is calculated based on Pharmacokinetics (PK) versus conventional Body Surface Area (BSA). Patients and Methods: Thirty nine patients with stage III and IV HNC who received induction DPF were included in the study. Dose of cycle 1 was BSA-based then Docetaxel and 5-FU doses were PK-adjusted starting from cycle 2 whereas Cisplatin dose was BSA-based throughout the study. Results: After median follow up period of 14 months the median overall survival (OS) and progression free survival (PFS) were 15.1 and 10.6 months respectively. Twenty nine patients were available for response assessment. Seven patients (24.1%) achieved complete response while partial response encountered in 19 patients (65.5%) with and Overall response rate of 89.6%. Both treatment related side effects and mortality significantly decreased after the application of PK dose adjustments (p-value 0.007 and 0.01 respectively). Conclusion: PK-guided dose adjustments of 5-FU and Docetaxel in DPF regimen can significantly decrease the treatment related side effects and mortality without compromising the tumor response rate. A randomized clinical trial is needed to compare the PK-guided dose adjustment with the standard BSA based protocol.

Dosing strategies for de novo once-daily extended release tacrolimus in kidney transplant recipients based on CYP3A5 genotype

BACKGROUND Tacrolimus extended-release tablets have been Food and Drug Administrationapproved for use in the de novo kidney transplant population.Dosing requirements often vary for tacrolimus based on several factors including variation in metabolism based on CYP3A5 expression.Patients who express CYP3A5 often require higher dosing of immediate-release tacrolimus,but this has not been established for tacrolimus extended-release tablets in the de novo setting.AIM To obtain target trough concentrations of extended-release tacrolimus in de novo kidney transplant recipients according to CYP3A5 genotype.METHODS Single-arm,prospective,single-center,open-label,observational study(ClinicalTrials.gov:NCT037-13645).Life cycle pharma tacrolimus(LCPT)orally once daily at a starting dose of 0.13 mg/kg/day based on actual body weight.If weight is more than 120%of ideal body weight,an adjusted body weight was used.LCPT dose was adjusted to maintain tacrolimus trough concentrations of 8-10 ng/mL.Pharmacogenetic analysis of CYP3A5 genotype was performed at study conclusion.RESULTS Mean time to therapeutic tacrolimus trough concentration was longer in CYP3A5 intermediate and extensive metabolizers vs CYP3A5 non-expressers(6 d vs 13.5 d vs 4.5 d;P=0.025).Mean tacrolimus doses and weight-based doses to achieve therapeutic concentration were higher in CYP3A5 intermediate and extensive metabolizers vs CYP3A5 non-expressers(16 mg vs 16 mg vs 12 mg;P=0.010)(0.20 mg/kg vs 0.19 mg/kg vs 0.13 mg/kg;P=0.018).CYP3A5 extensive metabolizers experienced lower mean tacrolimus trough concentrations throughout the study period compared to CYP3A5 intermediate metabolizers and non-expressers(7.98 ng/mL vs 9.18 ng/mL vs 10.78 ng/mL;P=00.008).No differences were identified with regards to kidney graft function at 30-d post-transplant.Serious adverse events were reported for 13(36%)patients.CONCLUSION Expression of CYP3A5 leads to higher starting doses and incremental dosage titration of extended-release tacrolimus to achieve target trough concentrations.We suggest a higher starting dose of 0.2 mg/kg/d for CYP3A5 expressers.

Evaluating Vancomycin Clinical Outcomes Using Area under the Curve versus Trough Based Dosing Strategies

Background: The 2020 consensus guidelines recommend AUC guided dosing as the preferred monitoring method for vancomycin. AUC based dosing has shown to reduce incidence of acute kidney injury (AKI), utilize lower daily doses in obese patients, and maintain efficacy. Several institutions have adjusted their protocols to utilize AUC guided dosing. However, there are limited studies comparing the clinical outcomes of AUC versus trough monitoring. Methods: This was a retrospective, observational, single centered study. The primary outcome was to evaluate the clinical success of AUC dosing versus trough based dosing of vancomycin for MRSA infections using a composite outcome of afebrile post treatment ( Results: Forty-seven patients were included in this study, 17 in the AUC group and 30 in the trough group. The primary composite outcome showed a significant benefit of AUC dosing (p = 0.04). The composite component culture clearance showed the largest improvement for the AUC group when compared with the trough group (p = 0.03). More patients achieved therapeutic target attainment and reached the target sooner (3 days versus 4 days, p = 0.2) in the AUC group. Over the study course, 94.1% of patients in the AUC group were considered therapeutic compared to 63.8% in the trough group (p = 0.03). Vancomycin levels were collected less frequently in the AUC group (3 versus 4, p = 0.2). Conclusion: The outcomes of this study may suggest AUC guided dosing as a beneficial alternative to trough based dosing. AUC based dosing may improve clinical success which can be further explored in larger prospective clinical trials.

A Fuzzy Mathematics Based Fault Auto-diagnosis System for Vacuum Resin Shot Dosing Equipment

On the basis of the analysis of faults and their causes of vacuum resin shot dosing equipment, the fuzzy model of fault diagnosis for the equipment is constructed, and the fuzzy relationship matrix, the symptom fuzzy vector, the fuzzy compound arithmetic operator, and the diagnosis principle of the model are determined. Then the fault auto-diagnosis system for the equipment is designed , and the functions for real-time monitoring its operation condition and for fault auto diagosis are realized. Finally, the experiments of fault auto-diagnosis are conducted in practical production and the veracity of the system is verified.

Helicobacter pylori:High dose amoxicillin does not improve primary or secondary eradication rates in an Irish cohort

BACKGROUND Helicobacter pylori(H.pylori)eradication rates have fallen globally,likely in large part due to increasing antibiotic resistance to traditional therapy.In areas of high clarithromycin and metronidazole resistance such as ours,Maastricht VI guidelines suggest high dose amoxicillin dual therapy(HDADT)can be considered,subject to evidence for local efficacy.In this study we assess efficacy of HDADT therapy for H.pylori eradication in an Irish cohort.AIM To assess the efficacy of HDADT therapy for H.pylori eradication in an Irish cohort as both first line,and subsequent therapy for patients diagnosed with H.pylori.METHODS All patients testing positive for H.pylori in a tertiary centre were treated prospectively with HDADT(amoxicillin 1 g tid and esomeprazole 40 mg bid×14 d)over a period of 8 months.Eradication was confirmed with Urea Breath Test at least 4 wk after cessation of therapy.A delta-over-baseline>4%was considered positive.Patient demographics and treatment outcomes were recorded,analysed and controlled for basic demographics and prior H.pylori treatment.RESULTS One hundred and ninety-eight patients were identified with H.pylori infection,10 patients were excluded due to penicillin allergy and 38 patients refused follow up testing.In all 139 were included in the analysis,55%(n=76)were female,mean age was 46.6 years.Overall,93(67%)of patients were treatment-naïve and 46(33%)had received at least one previous course of treatment.The groups were statistically similar.Self-reported compliance with HDADT was 97%,mild side-effects occurred in 7%.There were no serious adverse drug reactions.Overall the eradication rate for our cohort was 56%(78/139).Eradication rates were worse for those with previous treatment[43%(20/46)vs 62%(58/93),P=0.0458,odds ratio=2.15].Age and Gender had no effect on eradication status.CONCLUSION Overall eradication rates with HDADT were disappointing.Despite being a simple and possibly better tolerated regime,these results do not support its routine use in a high dual resistance country.Further investigation of other regimens to achieve the>90%eradication target is needed.

Correlation between dose-volume parameters and rectal bleeding after 12 fractions of carbon ion radiotherapy for prostate cancer

BACKGROUND Carbon ion radiotherapy(CIRT)is currently used to treat prostate cancer.Rectal bleeding is a major cause of toxicity even with CIRT.However,to date,a correlation between the dose and volume parameters of the 12 fractions of CIRT for prostate cancer and rectal bleeding has not been shown.Similarly,the clinical risk factors for rectal bleeding were absent after 12 fractions of CIRT.AIM To identify the risk factors for rectal bleeding in 12 fractions of CIRT for prostate cancer.METHODS Among 259 patients who received 51.6 Gy[relative biological effectiveness(RBE)],in 12 fractions of CIRT,15 had grade 1(5.8%)and nine had grade 2 rectal bleeding(3.5%).The dose-volume parameters included the volume(cc)of the rectum irradiated with at least x Gy(RBE)(Vx)and the minimum dose in the most irradiated x cc normal rectal volume(Dx).RESULTS The mean values of D6cc,D2cc,V10 Gy(RBE),V20 Gy(RBE),V30 Gy(RBE),and V40 Gy(RBE)were significantly higher in the patients with rectal bleeding than in those without.The cutoff values were D6cc=34.34 Gy(RBE),D2cc=46.46 Gy(RBE),V10 Gy(RBE)=9.85 cc,V20 Gy(RBE)=7.00 cc,V30 Gy(RBE)=6.91 cc,and V40 Gy(RBE)=4.26 cc.The D2cc,V10 Gy(RBE),and V20 Gy(RBE)cutoff values were significant predictors of grade 2 rectal bleeding.CONCLUSION The above dose-volume parameters may serve as guidelines for preventing rectal bleeding after 12 fractions of CIRT for prostate cancer.

Systematic analysis and modeling of the FLASH sparing effect as a function of dose and dose rate

Ultrahigh-dose-rate radiotherapy(FLASH-RT)is a revolutionary radiotherapy technology that can spare normal tissues without compromising tumor control.Although qualitative experimental results have been reported,quantitative and systematic analysis of data is necessary.Particularly,the FLASH effect response model to the dose or dose rate is still unclear.This study investigated the relationships between the FLASH effect and experimental parameters,such as dose,dose rate,and other factors by analyzing published in vivo experimental data from animal models.The data were modeled based on logistic regression analysis using the sigmoid function.The model was evaluated using prediction accuracy,receiver operating characteristic(ROC)curve,and area under the ROC curve.Results showed that the FLASH effect was closely related to the dose,mean dose rate,tissue type,and corresponding biological endpoints.The dose rate corresponding to a 50% probability of triggering cognitive protection in the brain was 45 Gy s^(-1).The dose rate corresponding to a 50% probability of triggering intestinal crypt survival and regeneration was 140 Gy s^(-1).For the skin toxicity effect,the dose corresponding to a 50% probability of triggering the FLASH effect was 24 Gy.This study helps to characterize the conditions underlying the FLASH effect and provides important information for optimizing experiments.