Collateral Damage Research Articles

The Lives Saved: A Literature Review on the Role of Radiotherapy Improving Prognosis in Cancer Patients

Radiotherapy, also known as radiation therapy, is a treatment modality based on the use of high energy rays or radioactive substances, to damage tumoral cells and halt their growth and division. It is an effective tool for treating cancer of different kinds for more than 100 years with remarkable outcomes for cancer patients. This technique is characterised by notable technological innovations and methodologies, enhanced precision and effectiveness. Initially, precision and efficacy of radiotherapy are improved by technological advancements, such as the development of linear accelerators and brachytherapy. As a result, Radiotherapy has transformed the prognosis for cancer patients enhancing survival rates and improving quality of life. Also, it offers targeted and personalized treatment with advancements in imaging techniques such as Intensity- Modulated Radiation Therapy (IMRT) and Stereotactic Body Radiation Therapy (SBRT) and innovations like Image-Guided Radiation Therapy (IGRT), Adaptive Radiotherapy (ART) and Artificial Intelligence (AI). Additionally, techniques like proton therapy result in reduced side effects and collateral damage. Although, among the challenges and future perspectives we note the issue of affordability and accessibility. Ongoing research into immunotherapy and nanotechnology and their synergy with radiation therapy shows potential for further improving treatment outcomes. In conclusion, the evolution of radiotherapy has been a transformative journey, reshaping the prognosis and outcomes for cancer patients

Collateral Damage: Neurological Correlates of Non-Fatal Overdose in the Era of Fentanyl-Xylazine.

Non-fatal opioid overdoses are associated with significant morbidity. Hypoxic brain injury caused by opioid-induced respiratory depression is a key mechanism of such morbidity. For example, reports describe an amnestic syndrome in opioid users associated with acute injury to the hippocampus, a brain region that is highly susceptible to hypoxic injury. In our recent study we investigated the effects of non-fatal opioid overdose on the hippocampal volume in a well-characterized sample of opioid use disorder (OUD) patients with a history of overdose (OD) compared to those with no prior overdose (NOD). Using structural magnetic resonance imaging (MRI) and voxel-based morphometry, we observed lower hippocampal volume in patients with a history OD than in the NOD group. These findings support an association between non-fatal opioid overdose and hippocampal injury, which we hypothesize contributes to recently reported cases of OUD related amnestic syndrome. Here we review our study findings and the potential pathophysiological mechanisms underlying the acute and delayed hippocampal injury in nonfatal opioid overdose. We also discuss the implications for the risk of overdose and brain injury with the increased prevalence of fentanyl and xylazine contamination of the illicit opioid supply. Lastly, we highlight considerations for clinical management of the underappreciated neurological injury and cognitive dysfunction in OUD patients.

Phase-separated structures of tunable thermoresponsive and matrix polymers for large-scale temperature monitoring coatings.

Temperature monitoring is significant and fundamental in the fields of healthcare and medicine. In surgery, ultrasonic cutting devices are used for cutting, coagulation, and hemostasis. However, surgeons are concerned about the collateral thermal damages. For example, due to the limited space during endoscopic surgery, thermal damage is caused by touching the surrounding tissues of the targeted organ with the heated shaft of the ultrasonic cutting device. The present work exhibits thermoresponsive and reversible color-change coatings for temperature-distribution imaging. The phase-separated structures of the layered conjugated and matrix polymers enable both the tuned thermoresponsivity and large-scale coating. Layered polydiacetylene (PDA) with intercalated guests exhibits reversible and thermoresponsive gradual color changes from blue to red. A matrix polymer facilitates formation of the phase-separated layered PDA and large-scale coating. Spraying the precursor solution containing the diacetylene monomer, guest molecule, and matrix polymer provides the self-organized large-scale coatings on substrates. The temperature distribution on the shaft of an ultrasonic cutting device is monitored using the coatings. The phase-separated structure of thermoresponsive and matrix polymers can be applied to tunable temperature monitoring in a variety of fields.

Factors influencing magnetic resonance imaging changes associated with pelvic bone injury after high-intensity focused ultrasound ablation of uterine fibroids: a retrospective case-control study.

The application of high-intensity focused ultrasound (HIFU) in the treatment of uterine fibroids is becoming increasingly widespread, and postoperative collateral thermal damage to adjacent tissue has become a prominent subject of discussion. However, there is limited research related to bone injury. Therefore, the aim of this study was to investigate the potential factors influencing unintentional pelvic bone injury after HIFU ablation of uterine fibroids with magnetic resonance imaging (MRI). A total of 635 patients with fibroids treated with HIFU in the First Affiliated Hospital of Chongqing Medical University were enrolled. All patients underwent contrast-enhanced MRI (CE-MRI) pre- and post-HIFU. Based on the post-treatment MRI, the patients were divided into two groups: pelvic bone injury group and non-injury group, while the specific site of pelvic bone injury of each patient was recorded. The univariate and multivariate analyses were used to assess the correlations between the factors of fibroid features and treatment parameters and pelvic bone injury, and to further analyze the factors influencing the site of injury. Signal changes in the pelvis were observed on CE-MRI in 51% (324/635) of patients after HIFU. Among them, 269 (42.4%) patients developed sacral injuries and 135 (21.3%) had pubic bone injuries. Multivariate analyses showed that patients with higher age [P=0.003; odds ratio (OR), 1.692; 95% confidence interval (CI): 1.191-2.404], large anterior side-to-skin distance of fibroid (P<0.001; OR, 2.297; 95% CI: 1.567-3.365), posterior wall fibroid (P=0.006; OR, 1.897; 95% CI: 1.204-2.989), hyperintensity on T2-weighted imaging (T2WI, P=0.003; OR, 2.125; 95% CI: 1.283-3.518), and large therapeutic dose (TD, P<0.001; OR, 3.007; 95% CI: 2.093-4.319) were at higher risk of postoperative pelvic bone injury. Further analysis of the factors influencing the site of the pelvic bone injury showed that some of the fibroid features and treatment parameters were associated with it. Moreover, some postoperative pain-related adverse events were associated with the pelvic bone injury. Post-HIFU treatment, patients may experience pelvic injuries to the sacrum, pubis, or a combination of both, and some of them experienced adverse events. Some fibroid features and treatment parameters are associated with the injury. Taking its influencing factors into full consideration preoperatively, slowing down treatment, and prolonging intraoperative cooling phase can help optimize treatment decisions for HIFU.

The Microbiome and Acne: Perspectives for Treatment.

The skin microbiome consists of the microorganisms populating the human skin. Cutibacterium acnes (C.acnes, formerly named Propionibacterium acnes) is recognized as a key factor in acne development, regulating inflammatory and immune pathways. Dysbiosis has been described as the imbalance in skin microbiome homeostasis and may play a role in acne pathogenesis. Microbial interference has been shown to be a contributor to healthy skin homeostasis and staphylococcal strains may exclude acne-associated C.acnes phylotypes. In this review we present an update on the skin microbiome in acne and discuss how current acne treatments such as benzoyl peroxide, orally administered isotretinoin, and antibiotics may affect the skin microbiome homeostasis. We highlight the collateral damage of acne antibiotics on the skin microbiome, including the risk of antimicrobial resistance and the dysregulation of the microbiome equilibrium that may occur even with short-term antibiotic courses. Consequently, the interest is shifting towards new non-antibiotic pharmacological acne treatments. Orally administered spironolactone is an emerging off-label treatment for adult female patients and topical peroxisome proliferator-activated receptor gamma (PPARγ) modulation is being studied for patients with acne. The potential application of topical or oral probiotics, bacteriotherapy, and phage therapy for acne are further promising areas of future research.

Identification of microwave-related changes in tissue using an ultrasound scan

Microwave energy (ME) is used in the medical field to denature protein structures, resulting in inactivation or destruction of abnormal cells. Identifying the extent of destruction of abnormal tissue (cancer tissue or tissue with abnormal electrical activity) is essential for accomplishing successful therapy and reducing collateral damage. Our study was an ex vivo assessment of the changes on ultrasound scans (US) in chicken tissue exposed to ME. We hypothesized that any changes in tissue structures would be recognized on the reflected ultrasound waves. Ultrasound scans of tissues change with exposure to microwaves with increasing reflection of ultrasound waves. With exposure to microwaves, surface level brightness on the ultrasound scans increases statistically significantly. The findings could be used in heat related (ME and radiofrequency) procedures where clinicians would be able to actively assess lesions in real-time. Further studies are required to assess changes in tissue during active exposure to different types of energies.

Application of Oncolytic Poxviruses: An Emerging Paradigm in Cancer Therapy.

Despite the significant advancement of new tools and technology in the field of medical biology and molecular biology, the challenges in the treatment of most cancer types remain constant with the problem of developing resistance toward drugs and no substantial enhancement in the overall survival rate of cancer patients. Immunotherapy has shown the most promising results in different clinical and preclinical trials in the treatment of various cancer due to its higher efficacy and minimum collateral damage in many cancer patients as compared to conventional chemotherapy and radiotherapy. An oncolytic virus is a new class of immunotherapy that can selectively replicate in tumor cells and destroy them by the process of cell lysis while exerting minimum or no effect on a normal cell. Besides this, it can also activate the host's innate immune system, which generates an anti-tumor immune response to eliminate the tumor cells. Several wild types and genetically modified viruses have been investigated to show oncolytic behavior. Vaccinia virus has been studied extensively and tested for its promising oncolytic nature on various model systems and clinical trials. Recently, several engineered vaccinia viruses have been developed that express the desired genes encoded for selective penetration in tumor cells and enhanced activation of the immune system for generating anti-tumor immunity. However, further investigation is required to prove their potential and enhance their therapeutic efficacy.

DDS-type near-infrared light absorber enables deeper lesion treatment in laser photothermal therapy while avoiding damage to surrounding organs.

The efficacy of drug delivery system (DDS)-type near-infrared (NIR) absorbing agents in enhancing laser photothermal therapy is widely acknowledged. Despite the acknowledged efficacy, the therapeutic advantages of photothermal therapy using DDS-type NIR-absorbing agents over simple photothermal therapy without such agents have not been fully elucidated. This study was designed to investigate two primary objectives: firstly, the ability of DDS-type NIR-absorbing agents to induce cell death at greater depths within tumors, and secondly, their capacity to minimize collateral damage to adjacent healthy organs. To investigate these objectives, we employed a combination of indocyanine green lactosome-a DDS-type NIR-absorbing agent-and a precision-controlled laser hyperthermia system. An orthotopic neuroblastoma tumor model was used to closely simulate clinical conditions. The findings revealed that photothermal therapy using the DDS-type NIR-absorbing agent not only facilitates deeper penetration of cell death within tumors but also significantly mitigates thermal damage to surrounding healthy tissues, when compared to simple phototherapy without the agent. Furthermore, the combined treatment significantly prolonged the survival periods of the animals involved. This study is the first to analyze these therapeutic efficacies using quantitative data from an orthotopic tumor animal model and substantiated the potential of DDS-type NIR-absorbing agents to deepen the therapeutic impact of photothermal therapy while safeguarding vital organs, thereby enhancing overall treatment outcomes.

Monocytic Phagocytes in the Immunopathogenesis of Cytokine Storm Syndromes.

Cytokine storm syndromes (CSSs) are caused by a dysregulated host immune response to an inciting systemic inflammatory trigger. This maladaptive and harmful immune response culminates in collateral damage to host tissues resulting in life-threatening multisystem organ failure. Knowledge of the various immune cells that contribute to CSS pathogenesis has improved dramatically in the past decade. Monocytes, dendritic cells, and macrophages, collective known as monocytic phagocytes, are well-positioned within the immune system hierarchy to make key contributions to the initiation, propagation, and amplification of the hyperinflammatory response in CSS. The plasticity of monocytic phagocytes also makes them prime candidates for mediating immunoregulatory and tissue-healing functions in patients who recover from cytokine storm-mediated immunopathology. Therefore, approaches to manipulate the myriad functions of monocytic phagocytes may improve the clinical outcome of CSS.

Pregnancy-Related Complications During the COVID-19 Pandemic in Iran.

The COVID-19 pandemic has profoundly affected healthcare systems worldwide, with significant collateral damage to vulnerable populations, including the perinatal population. This study sought to compare pregnancy-related complications before and during the COVID-19 pandemic in Iran. This retrospective data analysis was performed from February 20 to August 20, 2019 (prior to the onset of the COVID-19 pandemic) and from February 20 to August 20, 2020 (during the pandemic), encompassing the initial wave of the pandemic and the subsequent lockdown. To collect data, we utilized the medical records of 168,358 women obtained from the Iranian Maternal and Neonatal Network, which is a comprehensive electronic health record database management system specifically designed to store information pertaining to maternal and neonatal health. A total of 168,358 medical records were analyzed, with 87388 (51.9%) and 80970 (48.1%) before and during the pandemic, respectively. The occurrence of pregnancy complications was found to be significantly more frequent during the pandemic compared to the pre-pandemic period. Notably, there was a higher likelihood of experiencing preeclampsia (odds ratio [OR]=1.14, 95% confidence interval [CI]: 1.07‒1.22, P=0.0001) and gestational diabetes (OR=1.14, 95% CI: 1.09‒1.19, P=0.0001) during the pandemic. Furthermore, cesarean section (CS) became more prevalent during the pandemic in comparison to vaginal delivery (OR=1.19, 95% CI: 1.17‒-1.22, P=0.0001). Our findings demonstrated a significant association between the COVID-19 pandemic and an escalation in adverse pregnancy outcomes, notably preeclampsia, gestational diabetes, and CS deliveries. However, further research is warranted to gain a richer understanding of the intricate interplay between the COVID-19 pandemic and pregnancy complications. This is particularly crucial in light of the evolving landscape of new coronavirus variants.

Unveiling the Interplay of Klotho Protein, Chemotherapy-Induced Klotho Protein Deficiency and the Pivotal Role of GLP-1 Agonists like Ozempic in Cancer Survivorship Patient Survival Rate after Chemotherapy Treatment

Cancer, a pervasive health challenge globally, prompts aggressive treatment measures, with chemotherapy as a primary approach targeting uncontrolled cell growth. While effective against tumors, chemotherapeutic agents, especially alkylating agents, antimetabolites, and other classes, introduce collateral damage to healthy tissues, notably the kidneys. This article explores the intricate impact of chemotherapy on renal proteins and enzymes, particularly the Klotho protein, a key player in aging and longevity. Alkylating agents induce renal toxicity through oxidative stress, affecting Klotho synthesis and antioxidant defenses. Antimetabolites disrupt DNA synthesis, potentially impairing renal function. Antitumor antibiotics, topoisomerase inhibitors, mitotic inhibitors, and hormone therapies each contribute to nephrotoxicity. As Klotho deficiency emerges as a critical factor in the shortened lifespan of cancer patients, the potential role of GLP-1 agonists like Ozempic in stimulating Klotho production is discussed. This dual-action approach could mitigate chemotherapy-induced nephrotoxicity, offering a novel strategy for enhancing the well-being and lifespan of cancer patients.

Are hospitals collateral damage? Assessing geospatial proximity of 2000 lb bomb detonations to hospital facilities in the Gaza Strip from October 7 to November 17, 2023.

After attacks in Israel led by Hamas militants on October 7, 2023, Israel launched a major military campaign in the Gaza Strip that has featured an unprecedented scale of destruction. This has included the use of highly destructive weapons in a densely populated area. Mark-84 bombs (M-84s) are 2000 lb air-dropped explosive munitions with the capacity to damage infrastructure and kill or cause severe injury hundreds of meters away. This study examines the proximity of M-84 bomb detonations to hospital infrastructure in the Gaza Strip. We combined geospatial data on hospital locations across the Gaza Strip with maps of the locations of M-84 bomb craters between October 7 and November 17, 2023, published by CNN and New York Times. We then measured and summarized the proximity of the bomb craters to hospitals across the territory. We identified 592 M-84 bomb craters. Of the 36 hospitals across the Gaza Strip, 25% (n = 9) had at least one bomb crater within the lethal range (360 m) and 83.3% (n = 30) within the infrastructure damage and injury range (800 m) of their facilities. The shortest distance of a bomb crater from a hospital was 14.7 m. Two hospitals had as many as 23 and 21 bomb craters within 800 m of their facilities and one hospital had seven bomb craters within 360 m. Thirty-eight M-84 bombs were detonated within 800 m of hospitals in the Israeli military defined evacuation zone. Given the known blast effect of these M-84 bombs, the impact from the bomb detonations near hospitals likely killed and injured people in and around the hospital area, which could include civilians and hospital staff, and likely damaged hospital infrastructure. The results of this study suggest indiscriminate bombing in dangerous proximities to hospital infrastructure, which is afforded special protection under international humanitarian law (IHL).

Application of stimuli-responsive hydrogel in brain disease treatment.

Treating brain diseases presents significant challenges due to neuronal degeneration, inflammation, and the intricate nature of the brain. Stimuli-responsive hydrogels, designed to closely resemble the brain's extracellular matrix, have emerged as promising candidates for controlled drug delivery and tissue engineering. These hydrogels have the unique ability to encapsulate therapeutic agents and release them in a controlled manner when triggered by environmental stimuli. This property makes them particularly suitable for delivering drugs precisely to targeted areas of the brain, while minimizing collateral damage to healthy tissue. Their preclinical success in treating various brain diseases in animal studies underscores their translational potential for human brain disease treatment. However, a deeper understanding of their long-term behavior, biodistribution, and biocompatibility within the brain remains crucial. Furthermore, exploring novel hydrogel systems and therapeutic combinations is paramount for advancing towards more effective treatments. This review summarizes the latest advancements in this field over the past 5years, specifically highlighting preclinical progress with novel stimuli-responsive hydrogels for treating brain diseases.

Mannan-oligosaccharides promote gut microecological recovery after antibiotic disturbance.

Antibiotic treatment often causes collateral damage to the gut microbiota, including changes in its diversity and composition. Dietary fiber helps maintain intestinal health, regulate short-chain fatty acids, and promote the recovery of the intestinal microbiome. However, it is currently unknown which specific plant-based dietary fiber is optimal as a dietary supplement for restoring the intestinal microbiota after antibiotic disturbance. Previously, we proposed predictive recovery-associated bacterial species (p-RABs) and identified the most important interventions. This study aimed to identify an optimal form of dietary fiber to recover the gut microbiome after antibiotic treatment. Therefore, we examined the types of dietary fibers associated with p-RABs through a p-RAB-metabolite bilayer network constructed from prior knowledge; we searched for dietary fiber that could provide nutritional support for Akkermansia muciniphila and Bacteroides uniformis. C57BL/6J mice were fed with 500 mg kg-1 of different types of dietary fibers daily for one week after being treated with ampicillin. The results showed that mannan-oligosaccharides could better promote the diversity of intestinal microbial growth, enhance the recovery of most genera, including Akkermansia and Bacteroides, and inhibit certain pathogenic bacteria, such as Proteus, compared to the other fiber types. Furthermore, mannan-oligosaccharides could regulate the levels of short-chain fatty acids, especially butyric acid. Functional predictions showed that starch metabolism, galactose metabolism, and the metabolism of other carbohydrates played key roles in the early recovery process. In conclusion, mannan-oligosaccharides could enhance the recovery of the intestinal microbiome after antibiotic treatment, offering valuable insights for targeted dietary strategies.

Policing the Park

This study explores how an undercover sting that targeted men soliciting sex with other men around public park toilets in Fresno, California, led to an increase in resources for local law enforcement, including a surveillance system that stretched beyond the park and into poor Black and Brown neighborhoods. We use the literature on policy entrepreneurship to make sense of the power of police both to quell opposition to unpopular public safety initiatives and to make the case for administrative expansion. This case study demonstrates that creating panic about public same-sex erotic activity can be utilized without appearing homophobic or drawing the wrath of LGBTQ+ rights groups, especially when focusing on the dangers to children. We argue that the men arrested for lewd conduct were simply collateral damage and not seen worthy of defense.

무력충돌시 문화재 파괴 행위에 대한 국제형사책임의 과제

Since the 1990s, situations in which culturally significant heritage sites serve as symbolic targets for intentional attacks, leading to the 'destruction of enemy communities,' have frequently occurred. The International Criminal Tribunal for the former Yugoslavia (ICTY), established to prosecute serious violations of international humanitarian law within the former Yugoslav territories, addresses prominent cases of intentional attacks and destruction of cultural property during the armed conflict, specifically targeting the annihilation of ethnic identity. This article examines the implications and limitations of international legal norms regarding the protection of cultural heritage during armed conflicts, focusing on the Dubrovnik Old Town shelling incident, a representative case of cultural property destruction prosecuted by the ICTY. Firstly, the intentional destruction of cultural heritage is undeniably a significant violation of values that the international community must protect. The pursuit of individual criminal responsibility for the destruction of cultural heritage within the international criminal tribunal signifies a substantial advancement in international efforts to protect cultural heritage during armed conflicts. The negative impact of the intentional destruction of cultural property on human dignity and universal human values is undeniable. However, ensuring effective protection of cultural property in the current normative context, where attacks on cultural property for military purposes may be justified, remains challenging. Secondly, military necessity, rooted in customary international law, limits attacks on enemy forces to military objectives, focusing on the centralization of enemy forces, balancing the military necessity of concentrated attacks on enemy forces with humanitarian considerations to protect civilian objects. However, determining what qualifies as a military objective can be challenging, as it depends on the circumstances of combat and operations. Regardless of whether the principle of proportionality is applicable, evaluating the military necessity from the perspective of cultural heritage protection is crucial. ICTY recognizes that even when military necessity justifies attacks on civilian objects, the intentional destruction of cultural heritage can have a significant impact on the psychological well-being of civilians and may upset the balance with military superiority. Thus, careful consideration is necessary when assessing the military necessity in cases where the protection of cultural property, with a higher need for protection than general civilian objects, is involved. Moreover, even if a target has dual-use, being considered a military objective, evaluating proportionality in the attack is essential to prevent harm to civilians, in accordance with the principle of proportionality. In conclusion, the intentional destruction of cultural heritage should be treated as a threat to the common values of the international community, necessitating appropriate legal and policy responses in line with the actual circumstances of the armed coflict. Military commanders should not only view attacks on cultural heritage as inevitable collateral damage but also recognize the gravity of such acts as war crimes and consider them strategically within military operations.

Proton Beam Therapy-Based Computation in the Treatment of Human Ovarian and Liver Cancer using Srim

Proton beam therapy is a promising technique used to cure various types of cancer diseases in the human body. This technique can selectively damage cancer cells while leaving surrounding cells unaffected thereby minimizing collateral damage to the healthy cells. The position and the width of the cancerous cells are determined to calculate the energy required to destroy the affected cells. The energy loss to the damaged cells and other body parts is calculated separately with high accuracy. Computational analysis indicates that proton beams with energies of 46 MeV, 47 MeV, and 48 MeV effectively destroy localized cancerous cells of the ovary from the epithelial cells to the more invasive cancerous growth while proton beam energy range of 50 MeV to 89 MeV should be considered for the treatment of liver cancer of both the periphery tumours and tumours in the hilum. Transport of ions in matter (TRIM) data shows that more than 80% of proton energy is given off during ion bombardment at Bragg’s peak, while the remaining percentage is lost by phonon production and by recoils.

Multimode temperature self-monitoring in photothermal nanoplatform based on Na3InF6: Nd3+, Yb3+, Ho3+ phosphor

An accurate deep-tissue thermometer with excellent photothermal conversion efficiency is desired for effective photo-thermal therapy (PTT), which will minimize collateral damages to normal cells from overheating or ineffective treatment from insufficient heat. Herein, a nano-thermometer with Nd3+/Yb3+/Ho3+ tri-doped Na3InF6 was designed by hydrothermal method to real-time monitor tissue temperature, and its luminescent performance and temperature sensing behavior based on the luminescence intensity ratio (LIR) technology in the visible and near infrared regions were analyzed under 808 nm excitation. The advantage of temperature probes located in the near infrared (NIR) biological window region was demonstrated by the penetration depth in simulating biological tissue agar. Furthermore, the feasibility of the sample as a self-monitoring photothermal platform was verified by in vitro bactericidal experiments, which expressed excellent photothermal conversion performance and sterilizing rates reached 59.8 % (E. coli) and 53.6 % (S. aureus), respectively. Results demonstrated that the present single-phased Na3InF6:Nd3+/Yb3+/Ho3+ nanophosphor could serve as a bifunctional photothermal agent with internal tissue temperature measurement and photothermal conversion.

Opportunities for interventional radiology in paediatric oncology

Interventional oncology (IO) has emerged as a pivotal field within interventional radiology (IR), gaining prominence in the past three decades. It has transcended its initial role in cancer care, expanding beyond biopsies and vascular access to offer a spectrum of percutaneous and transarterial procedures, transforming into a curative and palliative discipline. However, implementing IO in children presents distinctive challenges. While the technical aspects of IO procedures mirror those in adults, paediatric cases require specialised considerations. Radiologists must possess an in-depth understanding of the paediatric disease, tailor imaging modalities to the case, discern unique risks, and interpret disease markers specific to children. Notably, paediatric tumour biopsies demand significantly larger tissue samples for genetic sequencing, staging, and prognostication. Paediatric IO also confronts procedural disparities. Tumours in children may be larger relative to body size, necessitating precise radioembolisation dose calculations. The proximity of critical structures in small bodies amplifies the risk of collateral damage. When performing percutaneous ablation and endovascular therapies, these challenges must also be faced so that radiologists can navigate these complex clinical and technical considerations to ensure safe and effective interventions, all while prioritising the well-being of their young patients. This review summarises the current role and future opportunities for IO in paediatric cancer.

(Invited) Culprits or Collateral Damage? The Science behind Lithium-Ion Battery Failure Investigations

Thermal runaway failures of lithium-ion batteries have garnered a great deal of attention in recent years, including notable failures in the spaces of consumer products, electric vehicles, and energy storage systems. The growing public awareness of hazards associated with thermal runaway in lithium-ion batteries has coincided with increased scrutiny of lithium-ion batteries when they are found at fire scenes. Lithium-ion batteries can go into thermal runaway due to heating from an external fire, even if they are not the cause of the fire. As always, the fire investigator and other experts involved in the failure analysis need to remain guided by the scientific method when performing an origin and cause analysis, including when that analysis involves lithium-ion batteries.This presentation will encompass many of the tools and reasoning that may be relied upon when analyzing the role lithium-ion batteries at fire scenes, as well as in the post-scene analysis of batteries and battery-containing devices. Techniques for understanding heat release and heat release rate during thermal runaway failures will be discussed, as well as the associated literature that may be relied upon to estimate heat release based on chemistry and capacity of the cells in question. Also to be discussed are metallurgical approaches and techniques that may inform the conditions that likely existed during the failure of the battery.