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In the management of symptomatic inoperable retroperitoneal sarcomas (RPS), palliative radiotherapy (RT) is a potential treatment option. However, the efficacy of low doses used in palliative RT is limited in these radioresistant tumors. Therefore, exploring dose escalation strategies targeting specific regions of the tumor may enhance the therapeutic effect of RT in relieving or preventing symptoms.In this case report, we present the case of an 87-year-old patient with rapidly growing undifferentiated liposarcoma in the retroperitoneum, where surgical and systemic therapies were ruled out due to age and comorbidities. RT was administered using volumetric modulated arc therapy, delivering 20 Gy in 4 fractions twice daily to the macroscopic tumor and 40 Gy in 4 fractions twice daily (simultaneous integrated boost) to the central part of the tumor (Gross Tumor Volume minus 2 cm). An 18F−FDG-PET-CT scan performed after RT demonstrated a complete metabolic response throughout the entire tumor mass. Although the patient eventually succumbed to metastatic spread to the bone, liver, and lung after 9 months, no local disease progression or pain/obstructive symptoms were observed.This case highlights the technical and clinical feasibility of delivering ablative doses of RT to the central region of the tumor and suggests the potential for achieving a complete metabolic response and durable tumor control.

At present more than 1600 mustatil have been recorded across Arabia. These monumental ritual structures have been interpreted as markers of territoriality and a key component in constructing and consolidating kinship ties and communal social identities in the Late Neolithic. Perhaps most strikingly, these structures are marked by a homogeneity of architectural form, over a vast geographic area, some 350,000 km2. In AlUla County, ten mustatil have been excavated, including seven by the AAKSA and PAKEP projects. These excavations have revealed chronologically contemporaneous ritual deposits of faunal remains, specifically the horns and upper cranial elements of domesticated sheep, goat, and cattle, as well as wild taxa, such as gazelle and ibex. Despite the overall similarity of architectural form across these examples, the faunal composition of these deposits varies, with some structures marked by higher proportions of wild taxa, whilst others are predominantly composed of cattle and/or caprines. In this paper, we present the data from each of the excavated mustatils and explore the possibility that these assemblages represent the pastoral economies of the group(s) who constructed the mustatil, shedding new light on the various lifeways and herding practices of the 6th and 5th millennia BC. In addition, comparison with contemporary domestic occupation suggests that the appearance of the mustatil marks the emergence of a sacral architectural form in northwest Arabia during the Neolithic, with a clear architectural distinction maintained between the sacred and profane.

The COVID-19 pandemic has had a profound societal impact with unprecedented impact on women's labor force participation, including among academic mothers. Yet, persistent gendered and racialized inequities in academia remain structurally unaddressed, including in social work. We believe that as social work educators we are well-positioned to develop an academic culture that helps us refocus on what matters most; redefine excellence in teaching, service, and research; and make academic practice more equitable. To this end, we convened a group of social work academic mothers, representing various identities at teaching and research-intensive institutions, to offer collective perspectives and recommendations for structural change within the social work academy to buffer the impact of the COVID-19 pandemic and exacerbating racial and gendered disparities.

Sarcopenia (SP) is a syndrome characterized by age-associated loss of skeletal muscle mass and function. SP worsens both acute and late radiation-induced toxicity, prognosis, and quality of life. Myosteatosis is a pathological infiltration of muscle tissue by adipose tissue which often precedes SP and has a proven correlation with prognosis in cancer patients. Sarcopenic obesity is considered a “hidden form” of SP (due to large fat mass) and is independently related to higher mortality and worse complications after surgery and systemic treatments with worse prognostic impact compared to SP alone. The evaluation of SP is commonly based on CT images at the level of the middle of the third lumbar vertebra. On this scan, all muscle structures are contoured and then the outlined surface area is calculated. Several studies reported a negative impact of SP on overall survival in patients undergoing RT for tumors of the head and neck, esophagus, rectum, pancreas, cervix, and lung. Furthermore, several appetite-reducing side effects of RT, along with more complex radiation-induced mechanisms, can lead to SP through, but not limited to, reduced nutrition. In particular, in pediatric patients, total body irradiation was associated with the onset of SP and other changes in body composition leading to an increased risk of cardiometabolic morbidity in surviving adults. Finally, some preliminary studies showed the possibility of effectively treating SP and preventing the worsening of SP during RT. Future studies should be able to provide information on how to prevent and manage SP before, during, or after RT, in both adult and pediatric patients.

BackgroundA CE- and FDA-approved cloud-based Deep learning (DL)-tool for automatic organs at risk (OARs) and clinical target volumes segmentation on computer tomography images is available. Before its implementation in the clinical practice, an independent external validation was conducted.MethodsAt least a senior and two in training Radiation Oncologists (ROs) manually contoured the volumes of interest (VOIs) for 6 tumoral sites. The auto-segmented contours were retrieved from the DL-tool and, if needed, manually corrected by ROs. The level of ROs satisfaction and the duration of contouring were registered. Relative volume differences, similarity indices, satisfactory grades, and time saved were analyzed using a semi-automatic tool.ResultsSeven thousand seven hundred sixty-five VOIs were delineated on the CT images of 111 representative patients. The median (range) time for manual VOIs delineation, DL-based segmentation, and subsequent manual corrections were 25.0 (8.0-115.0), 2.3 (1.2-8) and 10.0 minutes (0.3-46.3), respectively. The overall time for VOIs retrieving and modification was statistically significantly lower than for manual contouring (p

Since the 1970s, monumental stone structures now called mustatil have been documented across Saudi Arabia. However, it was not until 2017 that the first intensive and systematic study of this structure type was undertaken, although this study could not determine the precise function of these features. Recent excavations in AlUla have now determined that these structures fulfilled a ritual purpose, with specifically selected elements of both wild and domestic taxa deposited around a betyl. This paper outlines the results of the University of Western Australia's work at site IDIHA-0008222, a 140 m long mustatil (IDIHA-F-0011081), located 55 km east of AlUla. Work at this site sheds new and important light on the cult, herding and 'pilgrimage' in the Late Neolithic of north-west Arabia, with the site revealing one of the earliest chronometrically dated betyls in the Arabian Peninsula and some of the earliest evidence for domestic cattle in northern Arabia.

IntroductionTotal body irradiation (TBI) is an important component of the conditioning regimen in patients undergoing hematopoietic stem cell transplants. TBI is used in very few patients and therefore it is generally delivered with standard linear accelerators (LINACs) and not with dedicated devices. Severe pulmonary toxicity is the most common adverse effect after TBI, and patient-specific lead blocks are used to reduce mean lung dose. In this context, online treatment setup is crucial to achieve precise positioning of the lung blocks. Therefore, in this study we aim to report our experience at generating 3D-printed patient-specific lung blocks and coupling a dedicated couch (with an integrated onboard image device) with a modern LINAC for TBI treatment.Material and methodsTBI was planned and delivered (2Gy/fraction given twice a day, over 3 days) to 15 patients. Online images, to be compared with planned digitally reconstructed radiographies, were acquired with the couch-dedicated Electronic Portal Imaging Device (EPID) panel and imported in the iView software using a homemade Graphical User Interface (GUI). In vivo dosimetry, using Metal-Oxide Field-Effect Transistors (MOSFETs), was used to assess the setup reproducibility in both supine and prone positions.Results3D printing of lung blocks was feasible for all planned patients using a stereolithography 3D printer with a build volume of 14.5×14.5×17.5 cm3. The number of required pre-TBI EPID-images generally decreases after the first fraction. In patient-specific quality assurance, the difference between measured and calculated dose was generally

Measurement(s) tau neutrino Technology Type(s) detector Sample Characteristic - Environment neutrino beam Sample Characteristic - Location Laboratori Nazionali del Gran Sasso Machine-accessible metadata file describing the reported data: https://doi.org/10.6084/m9.figshare.14979858

Abstract An event topology with two secondary vertices compatible with the decay of short-lived particles was found in the analysis of neutrino interactions in the OPERA target. The observed topology is compatible with tau neutrino charged current (CC) interactions with charm production and neutrino neutral current (NC) interactions with $$c\overline{c}$$ cc¯ pair production. However, other processes can mimic this topology. A dedicated analysis was implemented to identify the underlying process. A Monte Carlo simulation was developed and complementary procedures were introduced in the kinematic reconstruction. A multivariate analysis technique was used to achieve an optimal separation of signal from background. Most likely, this event is a $$\nu _{\tau }$$ ντ CC interaction with charm production, the tau and charm particle decaying into 1 prong and 2 prongs, respectively. The significance of this observation is evaluated.

This proof-of-concept study lays the foundations for the development of a delivery strategy for radioactive lanthanides, such as Yttrium-90, against recurrent glioblastoma. Our appealing hypothesis is that by taking advantage of the combination of biocompatible polyvinyl alcohol (PVA) microbubbles (MBs) and endovascular radiopharmaceutical infusion, a minimally invasive selective radioembolization can be achieved, which can lead to personalized treatments limiting off-target toxicities for the normal brain. The results show the successful formulation strategy that turns the ultrasound contrast PVA-shelled microbubbles into a microdevice, exhibiting good loading efficiency of Yttrium cargo by complexation with a bifunctional chelator. The selective targeting of Yttrium-loaded MBs on the glioblastoma-associated tumor endothelial cells can be unlocked by the biorecognition between the overexpressed αVβ3 integrin and the ligand Cyclo(Arg-Gly-Asp-D-Phe-Lys) at the PVA microbubble surface. Hence, we show the suitability of PVA MBs as selective Y-microdevices for in situ injection via the smallest (i.e., 1.2F) neurointerventional microcatheter available on the market and the accumulation of PVA MBs on the HUVEC cell line model of integrin overexpression, thereby providing ~6 × 10−15 moles of Y90 per HUVEC cell. We further discuss the potential impact of using such versatile PVA MBs as a new therapeutic chance for treating glioblastoma multiforme recurrence.

Space radiobiology is an interdisciplinary science that examines the biological effects of ionizing radiation on humans involved in aerospace missions. The dose-effect models are one of the relevant topics of space radiobiology. Their knowledge is crucial for optimizing radioprotection strategies (e.g., spaceship and lunar space station-shielding and lunar/Mars village design), the risk assessment of the health hazard related to human space exploration, and reducing damages induced to astronauts from galactic cosmic radiation. Dose-effect relationships describe the observed damages to normal tissues or cancer induction during and after space flights. They are developed for the various dose ranges and radiation qualities characterizing the actual and the forecast space missions [International Space Station (ISS) and solar system exploration]. Based on a Pubmed search including 53 papers reporting the collected dose-effect relationships after space missions or in ground simulations, 7 significant dose-effect relationships (e.g., eye flashes, cataract, central nervous systems, cardiovascular disease, cancer, chromosomal aberrations, and biomarkers) have been identified. For each considered effect, the absorbed dose thresholds and the uncertainties/limitations of the developed relationships are summarized and discussed. The current knowledge on this topic can benefit from further in vitro and in vivo radiobiological studies, an accurate characterization of the quality of space radiation, and the numerous experimental dose-effects data derived from the experience in the clinical use of ionizing radiation for diagnostic or treatments with doses similar to those foreseen for the future space missions. The growing number of pooled studies could improve the prediction ability of dose-effect relationships for space exposure and reduce their uncertainty level. Novel research in the field is of paramount importance to reduce damages to astronauts from cosmic radiation before Beyond Low Earth Orbit exploration in the next future. The study aims at providing an overview of the published dose-effect relationships and illustrates novel perspectives to inspire future research.

Background: Transarterial radioembolization (TARE) relies on directly injected 90Y- or 166Ho-loaded microspheres in the hepatic arteries. The activity to be injected is generally based on pre-TARE 99mTc-macro-aggregated-albumin (MAA) imaging, while the actual dose distribution is based on post-treatment images. The volume of interest (VOIs) propagation methods (i.e., rigid and deformable) from pre- to post-TARE imaging might affect the estimation of the mean absorbed dose in the tumor and non-tumoral liver (NTL), i.e., DT and DNTL, respectively. Methods: In 101 consecutive patients, liver and tumor were delineated on pre-TARE images and semi-automatically transferred on 90Y-PET/CT images with a rigid or deformable registration approach. Pre- and post-TARE volumes and DT/DNTL/DL were compared using correlation coefficient (CC) indexes, such as intra-class (ICC), Pearson’s (PCC), concordance (CCCo) and Bland–Altman analyses. The Kaplan–Meier curves of overall survival (OS) were calculated according to DT. Results: All computed CCs indicated very good (>0.92) agreement for volume comparison, while they suggested good (ICC ≥ 0.869, PCC ≥ 0.876 and CCCo ≥ 0.790) and moderate agreement in the intra- and inter-modality DT/DNTL/DL comparisons, respectively. Bland–Altman analyses showed percentage differences between the manual and deformable approaches of up to about −31%, 9% and 62% for tumoral volumes, DT and DNTL, respectively. The overall survival analysis showed statistically significant differences using DT cutoffs of 110, 90 and 85 Gy for the manual, rigid and deformable approaches, respectively. Conclusions: The semi-automatic transfer of VOIs from pre- and post-TARE imaging is feasible, but the selected method might affect prognostic DT/DNTL constraints.

Background: Few studies have focused on predicting the overall survival (OS) of patients affected by SARS-CoV-2 (i.e., COVID-19) using radiomic features (RFs) extracted from computer tomography (CT) images. Reconstruction of CT scans might potentially affect the values of RFs. Methods: Out of 435 patients, 239 had the scans reconstructed with a single modality, and hence, were used for training/testing, and 196 were reconstructed with two modalities were used as validation to evaluate RFs robustness to reconstruction. During training, the dataset was split into train/test using a 70/30 proportion, randomizing the procedure 100 times to obtain 100 different models. In all cases, RFs were normalized using the z-score and then given as input into a Cox proportional-hazards model regularized with the Least Absolute Shrinkage and Selection Operator (LASSO-Cox), used for feature selection and developing a robust model. The RFs retained multiple times in the models were also included in a final LASSO-Cox for developing the predictive model. Thus, we conducted sensitivity analysis increasing the number of retained RFs with an occurrence cut-off from 11% to 60%. The Bayesian information criterion (BIC) was used to identify the cut-off to build the optimal model. Results: The best BIC value indicated 45% as the optimal occurrence cut-off, resulting in five RFs used for generating the final LASSO-Cox. All the Kaplan-Meier curves of training and validation datasets were statistically significant in identifying patients with good and poor prognoses, irrespective of CT reconstruction. Conclusions: The final LASSO-Cox model maintained its predictive ability for predicting the OS in COVID-19 patients irrespective of CT reconstruction algorithms.

This is a critical moment of extraordinary rates of teacher burnout exacerbated by the COVID-19 pandemic. In order to implement effective intervention and policy, we must identify the drivers of educators’ stress and factors that may act as protective mechanisms. The complexity of this problem calls for a social–ecological approach. In this study, we investigated the impact of individual, organizational, and relational factors on educators’ pandemic-related stress. Using hierarchical multiple regression, we found that secondary traumatic stress and family, school, student, and community relationships significantly predicted pandemic-related stress after controlling for race, age, and gender. Family, school, and community collaboration is well-documented to benefit students; however, our results suggest that these relationships also benefit teachers, and may have been a protective factor on pandemic-related stress. That is, the positive influence of family, school, and community relationships flows both ways—to students and their families as well as to educators. Our findings highlight the importance of more research on secondary traumatic stress and home–school–community collaborations to mitigate teacher stress and burnout, as well as the implication for practice to increase emphasis on these issues in teacher preparation and ongoing professional development.

Background: Radiomics is a field of research medicine and data science in which quantitative imaging features are extracted from medical images and successively analyzed to develop models for providing diagnostic, prognostic, and predictive information. The purpose of this work was to develop a machine learning model to predict the survival probability of 85 cervical cancer patients using PET and CT radiomic features as predictors. Methods: Initially, the patients were divided into two mutually exclusive sets: a training set containing 80% of the data and a testing set containing the remaining 20%. The entire analysis was separately conducted for CT and PET features. Genetic algorithms and LASSO regression were used to perform feature selection on the initial PET and CT feature sets. Two different survival models were employed: the Cox proportional hazard model and random survival forest. The Cox model was built using the subset of features obtained with the feature selection process, while all the available features were used for the random survival forest model. The models were trained on the training set; cross-validation was used to fine-tune the models and to obtain a preliminary measurement of the performance. The models were then validated on the test set, using the concordance index as the metric. In addition, alternative versions of the models were developed using tumor recurrence as an adjunct feature to evaluate its impact on predictive performance. Finally, the selected CT and PET features were combined to build a further Cox model. Results: The genetic algorithm was superior to the LASSO regression for feature selection. The best performing model was the Cox model, which was built using the selected CT features; it achieved a concordance index score of 0.707. With the addition of tumor recurrence as a predictive feature, the Cox CT model reached a concordance index score of 0.776. PET features, however, proved to be inadequate for survival prediction. The CT model performed better than the model with combined PET and CT features. Conclusions: The results showed that radiomic features can be used to successfully predict survival probability in cervical cancer patients. In particular, CT radiomic features proved to be better predictors than PET radiomic features in this specific case.

In recent decades, artificial intelligence (AI) tools have been applied in many medical fields, opening the possibility of finding novel solutions for managing very complex and multifactorial problems, such as those commonly encountered in radiotherapy (RT). We conducted a PubMed and Scopus search to identify the AI application field in RT limited to the last four years. In total, 1824 original papers were identified, and 921 were analyzed by considering the phase of the RT workflow according to the applied AI approaches. AI permits the processing of large quantities of information, data, and images stored in RT oncology information systems, a process that is not manageable for individuals or groups. AI allows the iterative application of complex tasks in large datasets (e.g., delineating normal tissues or finding optimal planning solutions) and might support the entire community working in the various sectors of RT, as summarized in this overview. AI-based tools are now on the roadmap for RT and have been applied to the entire workflow, mainly for segmentation, the generation of synthetic images, and outcome prediction. Several concerns were raised, including the need for harmonization while overcoming ethical, legal, and skill barriers.

Abstract Direct Dark Matter searches are nowadays one of the most fervid research topics with many experimental efforts devoted to the search for nuclear recoils induced by the scattering of Weakly Interactive Massive Particles (WIMPs). Detectors able to reconstruct the direction of the nucleus recoiling against the scattering WIMP are opening a new frontier to possibly extend Dark Matter searches beyond the neutrino background. Exploiting directionality would also prove the galactic origin of Dark Matter with an unambiguous signal-to-background separation. Indeed, the angular distribution of recoiled nuclei is centered around the direction of the Cygnus constellation, while the background distribution is expected to be isotropic. Current directional experiments are based on gas TPC whose sensitivity is limited by the small achievable detector mass. In this paper we present the discovery potential of a directional experiment based on the use of a solid target made of newly developed nuclear emulsions and of optical read-out systems reaching unprecedented nanometric resolution.

Abstract The OPERA experiment has discovered the tau neutrino appearance in the CNGS muon neutrino beam, in agreement with the 3 neutrino flavour oscillation hypothesis. The OPERA neutrino interaction target, made of Emulsion Cloud Chambers, was particularly efficient in the reconstruction of electromagnetic showers. Moreover, thanks to the very high granularity of the emulsion films, showers induced by electrons can be distinguished from those induced by π 0s, thus allowing the detection of charged current interactions of electron neutrinos. In this paper the results of the search for electron neutrino events using the full dataset are reported. An improved method for the electron neutrino energy estimation is exploited. Data are compatible with the 3 neutrino flavour mixing model expectations and are used to set limits on the oscillation parameters of the 3+1 neutrino mixing model, in which an additional mass eigenstate m 4 is introduced. At high Δm 412 (≳0.1 eV2), an upper limit on sin2 2θ μe is set to 0.021 at 90% C.L. and Δm 412 ≳ 4 × 10− 3 eV2 is excluded for maximal mixing in appearance mode.

Abstract The OPERA experiment was designed to search for $$\nu _{\mu } \rightarrow \nu _{\tau }$$ νμ→ντ oscillations in appearance mode through the direct observation of tau neutrinos in the CNGS neutrino beam. In this paper, we report a study of the multiplicity of charged particles produced in charged-current neutrino interactions in lead. We present charged hadron average multiplicities, their dispersion and investigate the KNO scaling in different kinematical regions. The results are presented in detail in the form of tables that can be used in the validation of Monte Carlo generators of neutrino–lead interactions.

Abstract Muography is an imaging technique based on the measurement of absorption profiles for muons as they pass through rocks and earth. Muons are produced in the interactions of high-energy cosmic rays in the Earth’s atmosphere. The technique is conceptually similar to usual X-ray radiography, but with extended capabilities of investigating over much larger thicknesses of matter thanks to the penetrating power of high-energy muons. Over the centuries a complex system of cavities has been excavated in the yellow tuff of Mt. Echia, the site of the earliest settlement of the city of Naples in the 8th century BC. A new generation muon detector designed by us, was installed under a total rock overburden of about 40 metres. A 26 days pilot run provided about 14 millions of muon events. A comparison of the measured and expected muon fluxes improved the knowledge of the average rock density. The observation of known cavities proved the validity of the muographic technique. Hints on the existence of a so far unknown cavity was obtained. The success of the investigation reported here demonstrates the substantial progress of muography in underground imaging and is likely to open new avenues for its widespread utilisation.

Lung tumors are often associated with a poor prognosis although different schedules and treatment modalities have been extensively tested in the clinical practice. The complexity of this disease and the use of combined therapeutic approaches have been investigated and the use of high dose-rates is emerging as effective strategy. Technological improvements of clinical linear accelerators allow combining high dose-rate and a more conformal dose delivery with accurate imaging modalities pre- and during therapy. This paper aims at reporting the state of the art and future direction in the use of radiobiological models and radiobiological-based optimizations in the clinical practice for the treatment of lung cancer. To address this issue, a search was carried out on PubMed database to identify potential papers reporting tumor control probability and normal tissue complication probability for lung tumors. Full articles were retrieved when the abstract was considered relevant, and only papers published in English language were considered. The bibliographies of retrieved papers were also searched and relevant articles included. At the state of the art, dose–response relationships have been reported in literature for local tumor control and survival in stage III non-small cell lung cancer. Due to the lack of published radiobiological models for SBRT, several authors used dose constraints and models derived for conventional fractionation schemes. Recently, several radiobiological models and parameters for SBRT have been published and could be used in prospective trials although external validations are recommended to improve the robustness of model predictive capability. Moreover, radiobiological-based functions have been used within treatment planning systems for plan optimization but the advantages of using this strategy in the clinical practice are still under discussion. Future research should be directed toward combined regimens, in order to potentially improve both local tumor control and survival. Indeed, accurate knowledge of the relevant parameters describing tumor biology and normal tissue response is mandatory to correctly address this issue. In this context, the role of medical physicists and the AAPM in the development of radiobiological models is crucial for the progress of developing specific tool for radiobiological-based optimization treatment planning.

BACKGROUND:Preclinical in vivo studies using small animals are considered crucial in translational cancer research and clinical implementation of novel treatments. This is of paramount relevance in radiobiology, especially for any technological developments permitted to deliver high doses in single or oligo-fractionated regimens, such as stereotactic ablative radiotherapy (SABR). In this context, clinical success in cancer treatment needs to be guaranteed, sparing normal tissue and preventing the potential spread of disease or local recurrence. In this work we introduce a new dose-response relationship based on relevant publications concerning preclinical models with regard to delivered dose, fractionation schedule and occurrence of biological effects on non-irradiated tissue, abscopal effects. METHODS:We reviewed relevant publications on murine models and the abscopal effect in radiation cancer research following PRISMA methodology. In particular, through a log-likelihood method, we evaluated whether the occurrence of abscopal effects may be related to the biologically effective dose (BED). To this aim, studies accomplished with different tumor histotypes were considered in our analysis including breast, colon, lung, fibrosarcoma, pancreas, melanoma and head and neck cancer. For all the tumors, the α / β ratio was assumed to be 10 Gy, as generally adopted for neoplastic cells. RESULTS:Our results support the hypothesis that the occurrence rate of abscopal effects in preclinical models increases with BED. In particular, the probability of revealing abscopal effects is 50% when a BED of 60 Gy is generated. CONCLUSION:Our study provides evidence that SABR treatments associated with high BEDs could be considered an effective strategy in triggering the abscopal effect, thus shedding light on the promising outcomes revealed in clinical practice.