CBCT-to-CT synthesis with a single neural network for head-and-neck, lung and breast cancer adaptive radiotherapy

Purpose: CBCT-based adaptive radiotherapy requires daily images for accurate dose calculations. This study investigates the feasibility of applying a single convolutional network to facilitate CBCT-to-CT synthesis for head-and-neck, lung, and breast cancer patients. Methods: Ninety-nine patients diagnosed with head-and-neck, lung or breast cancer undergoing radiotherapy with CBCT-based position verification were included in this study. CBCTs were registered to planning CTs according to clinical procedures. Three cycle-consistent generative adversarial networks (cycle-GANs) were trained in an unpaired manner on 15 patients per anatomical site generating synthetic-CTs (sCTs). Another network was trained with all the anatomical sites together. Performances of all four networks were compared and evaluated for image similarity against rescan CT (rCT). Clinical plans were recalculated on CT and sCT and analysed through voxel-based dose differences and {\gamma}-analysis. Results: A sCT was generated in 10 seconds. Image similarity was comparable between models trained on different anatomical sites and a single model for all sites. Mean dose differences < 0.5% were obtained in high-dose regions. Mean gamma (2%,2mm) pass-rates > 95% were achieved for all sites. Conclusions: Cycle-GAN reduced CBCT artefacts and increased HU similarity to CT, enabling sCT-based dose calculations. The speed of the network can facilitate on-line adaptive radiotherapy using a single network for head-and-neck, lung and breast cancer patients.Comment: Submitted to Medical Physics; 2019-12-2

The effects of disk and dust structure on observed polarimetric images of protoplanetary disks

Imaging polarimetry is a powerful tool for imaging faint circumstellar material. For a correct analysis of observations we need to fully understand the effects of dust particle parameters, as well as the effects of the telescope, atmospheric seeing, and assumptions about the data reduction and processing of the observed signal. Here we study the major effects of dust particle structure, size-dependent grain settling, and instrumental properties. We performed radiative transfer modeling using different dust particle models and disk structures. To study the influence of seeing and telescope diffraction we ran the models through an instrument simulator for the ExPo dual-beam imaging polarimeter mounted at the 4.2m William Herschel Telescope (WHT). Particle shape and size have a strong influence on the brightness and detectability of the disks. In the simulated observations, the central resolution element also contains contributions from the inner regions of the protoplanetary disk besides the unpolarized central star. This causes the central resolution element to be polarized, making simple corrections for instrumental polarization difficult. This effect strongly depends on the spatial resolution, so adaptive optics systems are needed for proper polarization calibration. We find that the commonly employed homogeneous sphere model gives results that differ significantly from more realistic models. For a proper analysis of the wealth of data available now or in the near future, one must properly take the effects of particle types and disk structure into account. The observed signal depends strongly on the properties of these more realistic models, thus providing a potentially powerful diagnostic. We conclude that it is important to correctly understand telescope depolarization and calibration effects for a correct interpretation of the degree of polarization.Comment: Accepted for publication in A&

High-contrast imaging constraints on gas giant planet formation - The Herbig Ae/Be star opportunity

Planet formation studies are often focused on solar-type stars, implicitly considering our Sun as reference point. This approach overlooks, however, that Herbig Ae/Be stars are in some sense much better targets to study planet formation processes empirically, with their disks generally being larger, brighter and simply easier to observe across a large wavelength range. In addition, massive gas giant planets have been found on wide orbits around early type stars, triggering the question if these objects did indeed form there and, if so, by what process. In the following I briefly review what we currently know about the occurrence rate of planets around intermediate mass stars, before discussing recent results from Herbig Ae/Be stars in the context of planet formation. The main emphasis is put on spatially resolved polarized light images of potentially planet forming disks and how these images - in combination with other data - can be used to empirically constrain (parts of) the planet formation process. Of particular interest are two objects, HD100546 and HD169142, where, in addition to intriguing morphological structures in the disks, direct observational evidence for (very) young planets has been reported. I conclude with an outlook, what further progress we can expect in the very near future with the next generation of high-contrast imagers at 8-m class telescopes and their synergies with ALMA.Comment: Accepted by Astrophysics and Space Science as invited short review in special issue about Herbig Ae/Be stars; 12 pages incl. 5 figures, 2 tables and reference

GASPS observations of Herbig Ae/Be stars with PACS/Herschel. The atomic and molecular content of their protoplanetary discs

We observed a sample of 20 representative Herbig Ae/Be stars and five A-type debris discs with PACS onboard of Herschel. The observations were done in spectroscopic mode, and cover far-IR lines of [OI], [CII], CO, CH+, H2O and OH. We have a [OI]63 micron detection rate of 100% for the Herbig Ae/Be and 0% for the debris discs. [OI]145 micron is only detected in 25%, CO J=18-17 in 45% (and less for higher J transitions) of the Herbig Ae/Be stars and for [CII] 157 micron, we often found spatially variable background contamination. We show the first detection of water in a Herbig Ae disc, HD 163296, which has a settled disc. Hydroxyl is detected as well in this disc. CH+, first seen in HD 100546, is now detected for the second time in a Herbig Ae star, HD 97048. We report fluxes for each line and use the observations as line diagnostics of the gas properties. Furthermore, we look for correlations between the strength of the emission lines and stellar or disc parameters, such as stellar luminosity, UV and X-ray flux, accretion rate, PAH band strength, and flaring. We find that the stellar UV flux is the dominant excitation mechanism of [OI]63 micron, with the highest line fluxes found in those objects with a large amount of flaring and greatest PAH strength. Neither the amount of accretion nor the X-ray luminosity has an influence on the line strength. We find correlations between the line flux of [OI]63 micron and [OI]145 micron, CO J = 18-17 and [OI]6300 \AA, and between the continuum flux at 63 micron and at 1.3 mm, while we find weak correlations between the line flux of [OI]63 micron and the PAH luminosity, the line flux of CO J = 3-2, the continuum flux at 63 micron, the stellar effective temperature and the Brgamma luminosity. (Abbreviated version)Comment: 20 pages, 29 figures, accepted by Astronomy and Astrophysic

Circumstellar disks and planets. Science cases for next-generation optical/infrared long-baseline interferometers

We present a review of the interplay between the evolution of circumstellar disks and the formation of planets, both from the perspective of theoretical models and dedicated observations. Based on this, we identify and discuss fundamental questions concerning the formation and evolution of circumstellar disks and planets which can be addressed in the near future with optical and infrared long-baseline interferometers. Furthermore, the importance of complementary observations with long-baseline (sub)millimeter interferometers and high-sensitivity infrared observatories is outlined.Comment: 83 pages; Accepted for publication in "Astronomy and Astrophysics Review"; The final publication is available at http://www.springerlink.co

Perceived need for mental health care among non-western labour migrants

Background There is a supposed higher prevalence of common mental disorders among many migrant groups. At the same time, problems are reported regarding underutilisation of mental health services by migrants. Since perceived need for care is a powerful predictor of actual care utilisation, we aimed to study the hypothesis that, given the same level of mental morbidity, non-Western migrants would perceive less need for mental health care than ethnic Dutch residents. Additionally, we studied the extent to which needs are met in both groups, as well as several possible barriers to care. Methods A cross-sectional study with data from the 2004/2005 Amsterdam Health Monitor. Data were complete from 626 ethnic Dutch and non-Western (Turkish and Moroccan) labour migrants. Respondents participated in a structured interview in their own language, which included the perceived need for care questionnaire (PNCQ) and the composite international diagnostic interview (CIDI) version 2.1 for anxiety and depressive disorders. Results Perceived need was much higher among Turkish migrants. Among Moroccans the perceived need was comparable to ethnic Dutch. Turkish migrants also reported that needs were met less often than ethnic Dutch. Differences were explained by a higher prevalence of common mental disorders and higher symptom levels among Turkish. When differences in mental morbidity were taken into account, Moroccans perceived less need for information, drugs, referral to specialised mental health care, or for counselling. The most important barrier to care in all ethnic groups was the preference to solve the problem on one’s own. Conclusion In case of similar mental morbidity, perceived need for care was lower than among ethnic Dutch. The results did not support the hypothesis that in case of similar mental distress, needs of migrants were less often met than needs of ethnic Dutch

Building space for children's voices:The added value of participatory and creative approaches for child-centred integrated obesity care

Background: Paediatric obesity is increasing across the globe. In search for solutions, it is important to engage children, as they have their own unique perspectives on what it means to be a child with obesity within their so-ciocultural context. Though this is increasingly acknowledged, the question remains how to meaningfully engage children in paediatric obesity care as they are often in an unequal position in relation to adults.Aim: In this study, we reflect on what can be learned from a participatory research approach to improve child-centred paediatric obesity care.Design and methods: We reflect on four years of participatory research with children and care professionals to un-derstand the mechanisms that facilitated child participation within the research process. Secondly, we reflect on how these lessons relate to care practices. We conducted qualitative content analysis on the data gathered, in-cluding interviews, observations and working sessions with children and care professionals.Results: We identified three elements that facilitated child participation: (1) adopting a participatory attitude, (2) connecting to children's living environment and (3) doing activities together. This helped to build trusting relationships and gain in-depth understanding of what works well and why.Conclusion: Our findings underscore the significance of building communicative spaces where children's voices can be articulated at their own pace, about issues of their own choice, based on their own experiences.Practical implications: Working together with children as knowledgeable partners in paediatric obesity care can improve care delivery and provide solutions that better reflect their everyday realities and needs

Ethnic differences in total and HDL cholesterol among Turkish, Moroccan and Dutch ethnic groups living in Amsterdam, the Netherlands.

<p>Abstract</p> <p>Background</p> <p>High total cholesterol and low HDL (high-density lipoprotein) cholesterol are important determinants of cardiovascular disease. Little is known about dyslipidemia among Turkish and Moroccan migrants, two of the largest ethnic minority groups in several European countries. This study examines ethnic differences in total and HDL cholesterol levels between Dutch, Turkish and Moroccan ethnic groups.</p> <p>Methods</p> <p>Data were collected in the setting of a general health survey, in Amsterdam, the Netherlands, in 2004. Total response rate was 45% (Dutch: 46%, Turks: 50%, Moroccans: 39%). From 1,220 adults information on history of hypercholesterolemia, lifestyle and demographic background was obtained via health interviews. In a physical examination measurements of anthropometry and blood pressure were performed and blood was collected. Total and HDL cholesterol were determined in serum.</p> <p>Results</p> <p>Total cholesterol levels were lower and hypercholesterolemia was less prevalent among the Moroccan and Turkish than the Dutch ethnic population. HDL cholesterol was also relatively low among these migrant groups. The resulting total/HDL cholesterol ratio was particularly unfavourable among the Turkish ethnic group. Controlling for Body Mass Index and alcohol abstinence substantially attenuated ethnic differences in HDL cholesterol levels and total/HDL cholesterol ratio.</p> <p>Conclusions</p> <p>Total cholesterol levels are relatively low in Turkish and Moroccan migrants. However part of this advantage is off-set by their relatively low levels of HDL cholesterol, resulting in an unfavourable total/HDL cholesterol ratio, particularly in the Turkish population. Important factors in explaining ethnic differences are the relatively high Body Mass Index and level of alcohol abstinence in these migrant groups.</p