Computational simulation of the predicted dosimetric impact of adjuvant yttrium-90 PET/CT-guided percutaneous ablation following radioembolization

Background: 90Y PET/CT post-radioembolization imaging has demonstrated that the distribution of 90Y in a tumor can be non-uniform. Using computational modeling, we predicted the dosimetric impact of post-treatment 90Y PET/CT-guided percutaneous ablation of the portions of a tumor receiving the lowest absorbed dose. A cohort of fourteen patients with non-resectable liver cancer previously treated using 90Y radioembolization were included in this retrospective study. Each patient exhibited potentially under-treated areas of tumor following treatment based on quantitative 90Y PET/CT. 90Y PET/CT was used to guide electrode placement for simulated adjuvant radiofrequency ablation in areas of tumor receiving the lowest dose. The finite element method was used to solve Penne’s bioheat transport equation, coupled with the Arrhenius thermal cell-death model to determine 3D thermal ablation zones. Tumor and unablated tumor absorbed-dose metrics (average dose, D50, D70, D90, V100) following ablation were compared, where D70 is the minimum dose to 70% of tumor and V100 is the fractional tumor volume receiving more than 100 Gy. Results: Compared to radioembolization alone, 90Y radioembolization with adjuvant ablation was associated with predicted increases in all tumor dose metrics evaluated. The mean average absorbed dose increased by 11.2 ± 6.9 Gy. Increases in D50, D70, and D90 were 11.0 ± 6.9 Gy, 13.3 ± 10.9 Gy, and 11.8 ± 10.8 Gy, respectively. The mean increase in V100 was 7.2 ± 4.2%. All changes were statistically significant (P \u3c 0.01). A negative correlation between pre-ablation tumor volume and D50, average dose, and V100 was identified (ρ \u3c − 0.5, P \u3c 0.05) suggesting that adjuvant radiofrequency ablation may be less beneficial to patients with large tumor burdens. Conclusions: This study has demonstrated that adjuvant 90Y PET/CT-guided radiofrequency ablation may improve tumor absorbed-dose metrics. These data may justify a prospective clinical trial to further evaluate this hybrid approach

Understanding the relationship between poverty and inequality: overview report

An understanding that poverty and inequality are inextricably linked has given rise to a number of large international organisations setting joint inequality-poverty reduction targets on the basis that poverty cannot be seriously tackled without addressing inequality. However, the evidence base was relatively weak with only limited information available on the relationship between the two phenomena. The programme was designed to expand the evidence base on the links between inequality and poverty and to fill this knowledge gap. In the research summarised in this report we explored the relationship between inequality and poverty by: • Examining philosophical concerns for poverty and inequality and how they may overlap • Estimating the empirical relationship between income inequality and a variety of poverty measures • Reviewing the existing evidence base on potential mechanisms that may drive any relationshi

Leveraging Space-based Data from the Nearest Solar-type Star to Better Understand Stellar Activity Signatures in Radial Velocity Data

Stellar variability is a key obstacle in reaching the sensitivity required to recover Earth-like exoplanetary signals using the radial velocity (RV) detection method. To explore activity signatures in Sun-like stars, we present SolAster, a publicly distributed analysis pipeline10 that allows for comparison of space-based measurements with ground-based disk-integrated RVs. Using high-spatial-resolution Dopplergrams, magnetograms, and continuum filtergrams from the Helioseismic and Magnetic Imager aboard the Solar Dynamics Observatory (SDO), we estimate "Sun-as-a-star" disk-integrated RVs due to rotationally modulated flux imbalances and convective blueshift suppression, as well as other observables such as unsigned magnetic flux. Comparing these measurements with ground-based RVs from the NEID instrument, which observes the Sun daily using an automated solar telescope, we find a strong relationship between magnetic activity indicators and RV variation, supporting efforts to examine unsigned magnetic flux as a proxy for stellar activity in slowly rotating stars. Detrending against measured unsigned magnetic flux allows us to improve the NEID RV measurements by ∼20% (∼50 cm s−1 in a quadrature sum), yielding an rms scatter of ∼60 cm s−1 over five months. We also explore correlations between individual and averaged spectral line shapes in the NEID spectra and SDO-derived magnetic activity indicators, motivating future studies of these observables. Finally, applying SolAster to archival planetary transits of Venus and Mercury, we demonstrate the ability to recover small amplitude (<50 cm s−1) RV variations in the SDO data by directly measuring the Rossiter–McLaughlin signals

Gravitational waves from high-power twisted light

Recent advances in high-energy and high-peak-power laser systems have opened up new possibilities for fundamental physics research. In this work, the potential of twisted light for the generation of gravitational waves in the high frequency regime is explored for the first time. Focusing on Bessel beams, novel analytic expressions and numerical computations for the generated metric perturbations and associated powers are presented. Compelling evidence is provided that the properties of the generated gravitational waves, such as frequency, polarisation states and direction of emission, are controllable by the laser pulse parameters and optical arrangements

Role of Optical Coherence Tomography in Diagnosis and Treatment of Patients with Acute Coronary Syndrome

Acute coronary syndrome (ACS) is the main cause of death worldwide and the leading cause of disease burden in high-income countries. ACS refers to a constellation of clinical symptoms that are compatible with acute myocardial ischemia. It describes a spectrum of clinical manifestations that result from a common pathophysiological process. The most common cause of ACS are rupture of an atherosclerotic lesion containing a large necrotic core and a thin fibrous cap followed by acute luminal thrombosis. It was thought that a high-resolution imaging modality would be ideal to detect high-risk plaques before their disruption and the formation of an occlusive thrombus. Optical coherence tomography has proven to be an invaluable tool in early detection of high-risk plaques and particularly in the understanding of ACS. This review focuses on the current evidence for the role of optical coherence tomography in the diagnosis and treatment of patients with ACS

Anti-müllerian hormone is not associated with cardiometabolic risk factors in adolescent females

<p>Objectives: Epidemiological evidence for associations of Anti-Müllerian hormone (AMH) with cardiometabolic risk factors is lacking. Existing evidence comes from small studies in select adult populations, and findings are conflicting. We aimed to assess whether AMH is associated with cardiometabolic risk factors in a general population of adolescent females.</p> <p>Methods: AMH, fasting insulin, glucose, HDLc, LDLc, triglycerides and C-reactive protein (CRP) were measured at a mean age 15.5 years in 1,308 female participants in the Avon Longitudinal Study of Parents and Children (ALSPAC). Multivariable linear regression was used to examine associations of AMH with these cardiometabolic outcomes.</p> <p>Results: AMH values ranged from 0.16–35.84 ng/ml and median AMH was 3.57 ng/ml (IQR: 2.41, 5.49). For females classified as post-pubertal (n = 848) at the time of assessment median (IQR) AMH was 3.81 ng/ml (2.55, 5.82) compared with 3.25 ng/ml (2.23, 5.05) in those classed as early pubertal (n = 460, P≤0.001). After adjusting for birth weight, gestational age, pubertal stage, age, ethnicity, socioeconomic position, adiposity and use of hormonal contraceptives, there were no associations with any of the cardiometabolic outcomes. For example fasting insulin changed by 0% per doubling of AMH (95%CI: −3%,+2%) p = 0.70, with identical results if HOMA-IR was used. Results were similar after additional adjustment for smoking, physical activity and age at menarche, after exclusion of 3% of females with the highest AMH values, after excluding those that had not started menarche and after excluding those using hormonal contraceptives.</p> <p>Conclusion: Our results suggest that in healthy adolescent females, AMH is not associated with cardiometabolic risk factors.</p&gt

AGNs on the Move: A Search for Off-nuclear AGNs from Recoiling Supermassive Black Holes and Ongoing Galaxy Mergers with the Zwicky Transient Facility

A supermassive black hole (SMBH) ejected from the potential well of its host galaxy via gravitational wave recoil carries important information about the mass ratio and spin alignment of the pre-merger SMBH binary. Such a recoiling SMBH may be detectable as an active galactic nucleus (AGN) broad-line region offset by up to 10 kpc from a disturbed host galaxy. We describe a novel methodology using forward modeling with The Tractor to search for such offset AGNs in a sample of 5493 optically variable AGNs detected with the Zwicky Transient Facility (ZTF). We present the discovery of nine AGNs that may be spatially offset from their host galaxies and are candidates for recoiling SMBHs. Five of these offset AGNs exhibit double-peaked broad Balmer lines, which may have arisen from unobscured accretion disk emission, and four show radio emission indicative of a relativistic jet. The fraction of double-peaked emitters in our spatially offset AGN sample is significantly larger than the 16% double-peaked emitter fraction observed for ZTF AGNs overall. In our sample of variable AGNs we also identified 52 merging galaxies, including a new spectroscopically confirmed dual AGN. Finally, we detected the dramatic rebrightening of SDSS 1133, a previously discovered variable object and recoiling SMBH candidate, in ZTF. The flare was accompanied by the reemergence of strong P Cygni line features, indicating that SDSS 1133 may be an outbursting luminous blue variable star