Equivalent Target Research Articles

Visual Outcomes After Cataract Surgery With the Light Adjustable Lens in Japanese Patients With and Without Prior Corneal Refractive Surgery.

To describe Light Adjustable Lens (RxSight, Inc) (LAL) visual and refractive outcomes in a Japanese patient population with and without prior refractive surgery. In this retrospective chart review of patients with cataract in a private eye clinic, 34 eyes from 21 patients underwent cataract surgery with LAL implantation. Eyes underwent light treatment to adjust the patients' refraction after implantation to meet individual visual goals. Standard visual and refractive outcomes were collected. Contrast sensitivity (to assess quality of vision), clinical defocus and vergence curves (to assess range of vision), and patient satisfaction were also collected. The mean prediction error of the light adjustment was -0.04 ± -0.48. Thirty-one eyes (91%) and 33 eyes (97%) were within ±0.25 and ±0.50 diopters (D) of manifest spherical equivalent target, respectively. Thirty-two eyes (94%) had residual refractive cylinder of 0.50 D or less. The full depth of focus was 3.68 D. Monocular contrast sensitivity shows frequencies equivalent to a normal population aged 50 to 60 years. The mean satisfaction score was 8.8 (scale: 1 to 10). There were no adverse events and no eyes lost corrected distance visual acuity from the light treatment. LALs in cataract refractive surgery hold great promise, including for the Japanese population, which have unique ocular biometrics. By providing a safe procedure and the ability for postoperative adjustments, the LAL provided a tailored approach to vision correction, ultimately improving patient outcomes and satisfaction. [J Refract Surg. 2024;40(11):e854-e862.].

Target-field design of surface permanent magnets

We present a target-field approach to analytically design magnetic fields using permanent magnets. We assume that their magnetization is bound to a two-dimensional surface and is composed of a complete basis of surface modes. By posing the Poisson’s equation relating the magnetic scalar potential to the magnetization using Green’s functions, we derive simple integrals that determine the magnetic field generated by each mode. This approach is demonstrated by deriving the governing integrals for optimizing axial magnetization on cylindrical and circular-planar surfaces. We approximate the governing integrals numerically and implement them into a regularized least-squares optimization routine to design permanent magnets that generate uniform axial and transverse target magnetic fields. The resulting uniform axial magnetic field profiles demonstrate more than a tenfold increase in uniformity across equivalent target regions compared to the field generated by an optimally separated axially magnetized pair of rings, as validated using finite element method simulations. We use a simple example to examine how two-dimensional surface magnetization profiles can be emulated using thin three-dimensional volumes and determine how many discrete intervals are required to accurately approximate a continuously varying surface pattern. Magnets designed using our approach may enable higher-quality bias fields for electric machines, nuclear fusion, fundamental physics, magnetic trapping, and beyond. Published by the American Physical Society 2024

Target-specific requirements for RNA interference can arise through restricted RNA amplification despite the lack of specialized pathways

Since double-stranded RNA (dsRNA) is effective for silencing a wide variety of genes, all genes are typically considered equivalent targets for such RNA interference (RNAi). Yet, loss of some regulators of RNAi in the nematode Caenorhabditis elegans can selectively impair the silencing of some genes. Here, we show that such selective requirements can be explained by an intersecting network of regulators acting on genes with differences in their RNA metabolism. In this network, the Maelstrom domain-containing protein RDE-10, the intrinsically disordered protein MUT-16, and the Argonaute protein NRDE-3 work together so that any two are required for silencing one somatic gene, but each is singly required for silencing another somatic gene, where only the requirement for NRDE-3 can be overcome by enhanced dsRNA processing. Quantitative models and their exploratory simulations led us to find that (1) changing cis-regulatory elements of the target gene can reduce the dependence on NRDE-3, (2) animals can recover from silencing in non-dividing cells, and (3) cleavage and tailing of mRNAs with UG dinucleotides, which makes them templates for amplifying small RNAs, are enriched within ‘pUG zones’ matching the dsRNA. Similar crosstalk between pathways and restricted amplification could result in apparently selective silencing by endogenous RNAs.

A profound study of damage behavior for Al 2024-T3 alloy worksheet produced by constrained groove pressing in the superior practical condition

Constrained groove pressing (CGP) process is one of the most efficient and novel methods of severe plastic deformation to manufacture ultra-fine sheet metal. The present research work is related to the study of CGP process of 2024-T3 Aluminum alloy sheet. The empirical and numerical simulation of CGPed- specimens have been examined at both room and elevated temperatures. In order to simulate the constrained groove pressing process in Abaqus software, the Johnson–Cook material model has been employed. The geometrical variables of the CGP process include the teeth number, teeth angle, and sheet thickness, and the criterion for the superiority of the numerical test is the maximum reduction of two equivalent strain and equivalent force factors, simultaneously. To determine the weight’s coefficients of the target factors and select the superior test, the Shannon’s Entropy and Simple Additive Weighting (SAW) methods have been used, respectively. After validating the numerical findings, the variation of damage parameter, stress triaxiality and the equivalent plastic strain distribution in the superior practical condition have been evaluated in detail. Based on the Entropy-SAW hybrid technique, the weight’s coefficients of equivalent strain and equivalent force target factors were computed to, in turn, 0.38 and 0.62. Also, the results revealed that the CGP process could not be performed at room temperature based on high damage evolution. But, at elevated temperature, the damage parameter (D) doesn't exceed 0.26. Also, the maximum stress triaxiality and equivalent plastic strain (PEEQ) at this process temperature reached to 0.5 and 0.1, respectively.

Three-Month Comprehensive Outcomes of Topography-Guided LASIK Versus Keratorefractive Lenticule Extraction (KLEx): A Prospective Contralateral Study.

The aim of this study was to compare outcomes of topography-guided laser-assisted in situ keratomileusis (TG-LASIK) and small incision lenticule extraction (SMILE®) for correcting myopia and myopic astigmatism. In this prospective, randomized contralateral study, 34 patients (68 eyes) received TG-LASIK in one eye, and SMILE in their fellow eye. Efficacy, safety, predictability, higher-order aberrations, corneal tomography, biomechanics, and patient-reported outcomes (PROs) were assessed preoperatively and up to 3months postoperatively. Both platforms showed comparable efficacy at 3months (TG-LASIK 1.08 ± 0.19; SMILE 0.98 ± 0.17, p = 0.055). However, TG-LASIK demonstrated quicker visual recovery, with 63% and 89% achieving uncorrected distance visual acuity (UDVA) of 20/16 or better at 1day and 1week, respectively, compared to SMILE (34% and 63%; p < 0.05). Safety index at 3months did not significantly differ between TG-LASIK and SMILE (p = 0.223). TG-LASIK and SMILE had 44% and 56% of eyes within 0.13D of spherical equivalent (SEQ) target, respectively. SMILE induced more total higher-order aberrations (HOAs), vertical coma, and oblique trefoil than TG-LASIK at 3months (p < 0.05). Both platforms showed similar increases in epithelial remodeling, but SMILE induced thicker epithelium than TG-LASIK at the 7.0-mm nasal zonal area. No significant differences were found in corneal hysteresis (CH) or corneal resistance factor (CRF) at 3months (p > 0.05). Reported symptoms of glare, halos, rings, starbursts, or dry eye did not significantly differ between groups at 3months (p > 0.05). Overall, 59% of patients preferred their TG-LASIK treated eye at 1month, but 65% of patients had no specific eye preference at 3months. TG-LASIK and SMILE demonstrate excellent and comparable efficacy, safety, and predictability at 3months, but TG-LASIK offers faster postoperative visual recovery at 1day and 1week. TG-LASIK induces fewer HOAs than SMILE, but both procedures affect corneal biomechanics similarly. ClincialTrials.gov identifier, NCT05611294.

An equivalent target plate damage probability calculation mathematics model and damage evaluation method

Aiming at the requirement of damage testing and evaluation of equivalent target plate based on the explosion of intelligent ammunition, this paper proposes a novel method for damage testing and evaluation method of circumferential equivalent target plate. Leveraging the dispersion characteristics parameters of fragment, we establish a calculation model of the fragment power situation and the damage calculation model under the condition of fragment ultimate penetration equivalent target plate. The damage model of equivalent target plate involves the fragment dispersion density, the local perforation damage criterion, the tearing damage model, and the damage probability. We use the camera to obtain the image of the equivalent target plate with fragment perforation, and research the algorithm of fragment distribution position recognition and fragment perforation area calculation method on the equivalent target plate by image processing technology. Based on the obtained parameters of the breakdown position and perforation area of fragments on equivalent target plate, we apply to damage calculation model of equivalent target plate, and calculate the damage probability of each equivalent target plate, and use the combined probabilistic damage calculation method to obtain the damage evaluation results of the circumferential equivalent target plate in an intelligent ammunition explosion experiment. Through an experimental testing, we verify the feasibility and rationality of the proposed damage evaluation method by comparison, the calculation results can reflect the actual damage effect of the equivalent target plate.

Target-specific requirements for RNA interference can arise through restricted RNA amplification despite the lack of specialized pathways.

Since double-stranded RNA (dsRNA) is effective for silencing a wide variety of genes, all genes are typically considered equivalent targets for such RNA interference (RNAi). Yet, loss of some regulators of RNAi in the nematode C. elegans can selectively impair the silencing of some genes. Here we show that such selective requirements can be explained by an intersecting network of regulators acting on genes with differences in their RNA metabolism. In this network, the Maelstrom domain-containing protein RDE-10, the intrinsically disordered protein MUT-16, and the Argonaute protein NRDE-3 work together so that any two are required for silencing one somatic gene, but each is singly required for silencing another somatic gene, where only the requirement for NRDE-3 can be overcome by enhanced dsRNA processing. Quantitative models and their exploratory simulations led us to find that (1) changing cis-regulatory elements of the target gene can reduce the dependence on NRDE-3, (2) animals can recover from silencing in non-dividing cells and (3) cleavage and tailing of mRNAs with UG dinucleotides, which makes them templates for amplifying small RNAs, is enriched within 'pUG zones' matching the dsRNA. Similar crosstalk between pathways and restricted amplification could result in apparently selective silencing by endogenous RNAs.

A Full-Scale Tidal Blade Fatigue Test using the FastBlade Facility

Fatigue testing of tidal turbine blades requires the application of cyclic loads without the ability to match the natural frequency of the blade due to their high stiffness and the associated thermal issues of testing composite materials at those frequencies (i.e., 18–20 Hz). To solve this, loading the blades with an auxiliary system is necessary; in most cases, a conventional hydraulic system tends to be highly energy-demanding and inefficient. A regenerative digital displacement hydraulic pump system was employed in the FastBlade fatigue testing facility, which saved up to 75 % compared to a standard hydraulic system. A series of equivalent target loads were defined using Reynolds-Averaged Navier Stokes (RANS) simulations (based on on-site collected water velocity data) and utilised in FastBlade to demonstrate an efficient way to perform fatigue testing. During the test, a series of measurements were performed on the blade response and the Fastblade test structure itself, providing novel insights into the mechanical behaviour of a blade, and enabling improved testing practice for FastBlade. Without catastrophic failure, the blade withstood the principal tidal loading for 20 years (equivalent). This test data will enable FastBlade to identify improvements to the testing procedures, i.e., control strategies, load introduction, instrumentation layout, instrument calibration, and test design.

Dosimetric Advantage of Combined IMRT for Whole Lung and Abdomen Irradiation for Wilms Tumor

In patients with Wilms tumor with lung metastases, a cardiac-sparing intensity modulated radiation therapy (CS-IMRT) technique is increasingly being adopted for whole lung irradiation. However, the standard technique for flank and whole abdomen radiation remains 2-dimensional anterioposterior (AP), and overlap at the junction between the whole lung CS-IMRT and abdominal AP fields can result in overdose to normal organs. Here, we compared the dosimetry of patients who received whole lung irradiation and flank or abdominal radiation therapy with CS-IMRT with AP abdominal field (IMRT-AP) versus CS-IMRT with IMRT abdominal field (combined IMRT). We retrospectively reviewed the radiation plans of 2 patients with Wilms tumor who received CS-IMRT and flank or whole abdomen irradiation with a combined IMRT approach. Comparison IMRT-AP plans were generated with equivalent target coverage of 95% receiving the prescribed dose. Maximum doses to normal organs were compared at the junctional overlap. Overlap at the junction between CS-IMRT and abdominal fields resulted in a significantly lower dose with combined IMRT plans compared with IMRT-AP plan. Differences in maximum doses (in cGy) to normal organs between combined IMRT versus IMRT-AP plans were most significant in the vertebral body (patient 1 = 1277 vs 2065; patient 2 = 1334 vs 2287), lungs (patient 1 = 1298 vs 2081; patient 2 = 1234 vs 1820), spinal cord (patient 1 = 1235 vs 1975; patient 2 = 1345 vs 2253), stomach (patient 1 = 1264 vs 1977; patient 2 = 1118 vs 2062), and liver (patient 1 = 1297 vs 1889; patient 2 = 1334 vs 2237). The combined IMRT approach for Wilms patients who require whole lung and abdomen irradiation can provide more uniform dose distribution in the junction area and significantly lower doses to normal organs at the junctional overlap.

Clinical VMAT machine parameter optimization for localized prostate cancer using deep reinforcement learning.

Volumetric modulated arc therapy (VMAT) machine parameter optimization (MPO) remains computationally expensive and sensitive to input dose objectives creating challenges for manual and automatic planning. Reinforcement learning (RL) involves machine learning through extensive trial-and-error, demonstrating performance exceeding humans, and existing algorithms in several domains. To develop and evaluate an RL approach for VMAT MPO for localized prostate cancer to rapidly and automatically generate deliverable VMAT plans for a clinical linear accelerator (linac) and compare resultant dosimetry to clinical plans. We extended our previous RL approach to enable VMAT MPO of a 3D beam model for a clinical linac through a policy network. It accepts an input state describing the current control point and predicts continuous machine parameters for the next control point, which are used to update the input state, repeating until plan termination. RL training was conducted to minimize a dose-based cost function for prescription of 60Gy in 20 fractions using CT scans and contours from 136 retrospective localized prostate cancer patients, 20 of which had existing plans used to initialize training. Data augmentation was employed to mitigate over-fitting, and parameter exploration was achieved using Gaussian perturbations. Following training, RL VMAT was applied to an independent cohort of 15 patients, and the resultant dosimetry was compared to clinical plans. We also combined the RL approach with our clinical treatment planning system (TPS) to automate final plan refinement, and creating the potential for manual review and edits as required for clinical use. RL training was conducted for 5000 iterations, producing 40 000 plans during exploration. Mean±SD execution time to produce deliverable VMAT plans in the test cohort was 3.3±0.5 s which were automatically refined in the TPS taking an additional 77.4±5.8 s. When normalized to provide equivalent target coverage, the RL+TPS plans provided a similar mean±SD overall maximum dose of 63.2±0.6Gy and a lower mean rectum dose of 17.4±7.4 compared to 63.9±1.5Gy (p=0.061) and 21.0±6.0 (p=0.024) for the clinical plans. An approach for VMAT MPO using RL for a clinical linac model was developed and applied to automatically generate deliverable plans for localized prostate cancer patients, and when combined with the clinical TPS shows potential to rapidly generate high-quality plans. The RL VMAT approach shows promise to discover advanced linac control policies through trial-and-error, and algorithm limitations and future directions are identified and discussed.

Abstract 6802: CXCR4 transgene improves in vivo migration and efficacy of engineered iPSC-derived natural killer cells

Abstract Chimeric antigen receptor (CAR)-engineered induced pluripotent stem cell (iPSC)-derived natural killer (iNK) cells have shown a favorable safety profile and early evidence of clinical efficacy in the treatment of patients with certain hematologic malignancies. CAR-iNK cells retain phenotypic and functional similarities to primary natural killer cells, with additional capabilities for recognition of tumors. For the treatment of cancers that are located in the bone marrow, it is critical that iNK cells are able to migrate efficiently to relevant sites of disease. CXCR4 (C-X-C chemokine receptor type 4) is a chemokine receptor specific for stromal-derived-factor-1 (SDF-1), and mediates the migration of hematopoietic cells to the bone marrow upon binding SDF-1. Here we describe novel engineering of iPSCs resulting in efficient migration and efficacy of iNK cells. iPSC were sequentially engineered at defined loci with Crispr/MAD7/HDR to incorporate Allo-EvasionTM edits, a CAR targeting antigens expressed on different hematological malignancies, constitutive interleukin-15 (IL-15) cytokine support, with and without wild-type CXCR4. iPSCs were then differentiated into natural killer cells using a proprietary differentiation process. Cytolysis of a panel of target cells by iNK was evaluated using an Incucyte-based killing assay. Anti-tumor efficacy was tested in disseminated xenograft models of hematological malignancies following intravenous injection of engineered iNK cells. Additionally, in vivo migration was evaluated using immunohistochemistry (IHC) and flow cytometry (FACS) of blood, bone marrow, and other organs. Engineering with CXCR4 resulted in a bulk population of iNK with a heterogenous expression of CXCR4. No significant impact of CXCR4 engineering was detected on iPSC differentiation, phenotype, or iNK yield. iNKCXCR4+ and iNKCXCR4− cells had equivalent target tumor cell cytolysis in vitro, indicating the CXCR4 transgene does not affect killing potential. In vivo, iNKCXCR4+ cells migrated to the bone marrow of both tumor-bearing and non-tumor-bearing animals, and the presence of these cells was enhanced in tumor-bearing mice, indicating CXCR4-mediated migration and possibly CAR-mediated expansion and/or retention of iNK. Migration to the bone marrow was not observed with iNKCXCR4− cells. As a result, iNKCXCR4+ cells significantly impacted anti-tumor efficacy, effectively eliminating bone disease. We have demonstrated the CAR-specific killing and enhanced iNK migration and subsequent tumor killing in the bone marrow, with the addition of a CXCR4 transgene in iPSC-derived NK cells. The addition of the CXCR4 transgene in iPSC-derived effector cells may allow for a higher therapeutic response in axial-skeletal located tumors. Citation Format: Hillary J. Millar, David Walker, Liam R. Campion, Ciara Budd, Aarti Kolluri, Harsh Sharma, Buddha Gurung, Jill M. Carton, Daniel J. Perry, Nicholas Alexander, Hyam Levitsky, Michael Naso, Barry A. Morse. CXCR4 transgene improves in vivo migration and efficacy of engineered iPSC-derived natural killer cells [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 6802.

A full-scale composite tidal blade fatigue test using single and multiple actuators

In order to perform fatigue testing on tidal turbine blades, it is necessary to apply cyclic loads that do not match the blade’s natural frequency. This is due to the high stiffness of the blades and the thermal challenges associated with testing composite materials at frequencies typically around 18–20 Hz. To overcome this challenge, auxiliary systems are used to load the blades. However, conventional hydraulic systems commonly used for this purpose are known to be energy-intensive and inefficient. In this work, we present results obtained at the FastBlade fatigue testing facility, which utilises a regenerative digital displacement hydraulic pump system to address these issues. This innovative system has proven to be highly efficient, resulting in up to 75% energy savings compared to standard hydraulic systems. To perform these tests, we first performed a series of Reynolds-Averaged Navier–Stokes (RANS) simulations using on-site water velocity data to determine equivalent target hydrodynamic loads. These target loads are applied to the blades using initially a single contact point and, later, three load contact points. The FastBlade facility showcases an effective approach to fatigue testing during these tests. Throughout the testing process, comprehensive measurements are taken to evaluate the response of the blades and the FastBlade test structure itself. These measurements provide valuable insights into the mechanical behaviour of the blades when a single or multi-actuator setup is used to match the root bending moment and contribute to the refinement of testing practices. Notably, the blades successfully endured the equivalent of 20 years of tides in an accelerated fatigue loading test without experiencing catastrophic failure. The data obtained from these tests will enable the identification of improvements in testing procedures, including control strategies, load introduction methods, instrumentation layout, instrument calibration, and test design. This knowledge will lead to enhanced performance and reliability of the FastBlade facility, further advancing the field of tidal turbine blade testing.

A study of high-velocity penetration on icy lunar regolith simulants

Understanding the mechanical response of a high-speed penetrator penetrating icy lunar regolith (ILR) is essential for designing penetrators in lunar permanently shadowed regions and interpreting the detection data from the device. Experimental research on the penetrators is limited in engineering due to the difficulties in preparing large-scale icy lunar regolith simulants (ILRS). Such limitation urges the need to construct a theoretical model and verify a numerical simulation model based on the scaled-down penetration experimental results, which provide insights into the mechanical response of penetrator penetrating ILR. Projectile penetration experiments were conducted on ILRS targets with four typical water content levels in a cryogenic chamber at 110 K. The experimental results show that the ILRS with higher water content exhibits greater brittleness and a faster crack growth rate. Consequently, the diameters of cratering and scabbing areas are augmented on the target surface upon projectile penetration. Moreover, increased mechanical strength decreases the plugging height on the ILRS targets. Based on the projectile residual velocities, the equivalent target strength parameter R were calculated and fitted to a functional relationship with the uniaxial compressive strength. RHT model parameters were calibrated using the test results of the dynamic and static mechanical properties of the simulants. Numerical simulation of projectile penetration into semi-infinite and thick targets were conducted using the calibrated model. The simulation results demonstrate high consistency with the experimental and theoretical calculations, indicating the effectiveness of the constitutive model in describing the mechanical response of the ILRS under projectile penetration.

Research on the high-speed impact of projectiles on reinforced concrete equivalent targets

Due to the prolonged production cycle of reinforced concrete target plates and the need for a series of preparations and tests before use, it is essential to study the equivalent relationship between reinforced concrete target plates and steel target plates. Numerical simulations of the process of projectiles vertically penetrating reinforced concrete target plates were conducted using LS-DYNA software. Models for both reinforced concrete and steel targets were established, and the equivalent thickness conversion relationship between the two was obtained. Simulation results indicated an inverse proportional relationship between projectile residual kinetic energy and target thickness. Curve fitting using Origin software was performed to obtain the conversion relationship between the thicknesses of reinforced concrete target plates and steel targets. The simulation results were validated, showing an error in concrete target plate thickness conversion of less than 10%. The research results provide theoretical support and data references for the equivalent study of reinforced concrete target plates and steel target plates.

Increased reliance on temporal coding when target sound is softer than the background

Everyday environments often contain multiple concurrent sound sources that fluctuate over time. Normally hearing listeners can benefit from high signal-to-noise ratios (SNRs) in energetic dips of temporally fluctuating background sound, a phenomenon called dip-listening. Specialized mechanisms of dip-listening exist across the entire auditory pathway. Both the instantaneous fluctuating and the long-term overall SNR shape dip-listening. An unresolved issue regarding cortical mechanisms of dip-listening is how target perception remains invariant to overall SNR, specifically, across different tone levels with an ongoing fluctuating masker. Equivalent target detection over both positive and negative overall SNRs (SNR invariance) is reliably achieved in highly-trained listeners. Dip-listening is correlated with the ability to resolve temporal fine structure, which involves temporally-varying spike patterns. Thus the current work tests the hypothesis that at negative SNRs, neuronal readout mechanisms need to increasingly rely on decoding strategies based on temporal spike patterns, as opposed to spike count. Recordings from chronically implanted electrode arrays in core auditory cortex of trained and awake Mongolian gerbils that are engaged in a tone detection task in 10 Hz amplitude-modulated background sound reveal that rate-based decoding is not SNR-invariant, whereas temporal coding is informative at both negative and positive SNRs.

A Comprehensive Retrospective Analysis of EVO/EVO+ Implantable Collamer Lens: Evaluating Refractive Outcomes in the Largest Single Center Study of ICL Patients in the United States.

We evaluate visual outcomes in patients with EVO/EVO+™ (posterior chamber phakic intraocular lens with a central port) within approved United States (US) age and refractive range indications. This single-center retrospective study evaluated one-month, single-center postoperative data for 225 eyes meeting inclusion criteria and undergoing EVO/EVO+ implantation from April to October 2022. Data included lens size (mm), lens power (diopters of spherical and cylindrical power), preoperative best corrected visual acuity, preoperative spherical equivalent from manifest refraction, achieved postoperative uncorrected visual acuity, postoperative refraction, intraocular pressure (mmHg), and adverse events. A total of 225 eyes underwent EVO/EVO+ Implantable Collamer Lens (ICL) implantation from April to October 2022, with 51.5% receiving toric lenses. The most common ICL size was 12.6mm (56.4%), followed by 13.2mm (27.5%), 12.1mm (15.1%), and 13.7mm (0.9%). Among patients with preoperative BCVA of 20/20 or better (149 eyes), 95.2% achieved postoperative UCVA of 20/20 or better, and 99.3% achieved UCVA of 20/25 or better at postoperative month one. About 75% of eyes were within a spherical equivalent target of ±0.50 D and 94% within ±1.00 D. Toric ICLs were implanted in 116 eyes (51.8%). Of these, anticipated residual cylinder >1 diopter was seen in 21 eyes (18.1%) resulting in three rotations, three explants, and three laser vision correction (LVC) enhancements. The postoperative adjustment rate (including rotations, exchanges, and LVC enhancement) was minimal (4.8%). Incidence of major adverse events was 0%. Our study, the largest US single-center analysis of EVO/EVO+ ICL implantation, demonstrates strong early results and infrequent adverse events, supporting ICL safety and effectiveness. High predictability and favorable visual outcomes, including 20/20 or better, highlight the reliability of this technology. Despite study limitations, our findings underscore this technology's effectiveness. Future research should refine patient criteria and assess long-term outcomes in this evolving landscape.

Efficacy of the collapsed cone algorithm calculated radiotherapy plans in intensity-modulated radiation therapy (IMRT) and volumetric-modulated arc therapy (VMAT): A comparative dosimetric study in tumors of thorax.

In this study, efficacy of collapsed cone algorithm-generated intensity-modulated radiation therapy (IMRT) and volumetric-modulated arc therapy (VMAT) were evaluated for treatment of thoracic esophageal cancer. Ten previously treated patients with VMAT were considered for evaluation. The planning parameters were evaluated in terms of max dose, mean dose, Homogeneity Index, Conformity Index for planning target volume, and organ at risk doses. Total monitor unit, treatment time, and gamma passing index were also reported. The target dose coverage of the VMAT and IMRT plans achieved the clinical dosimetric criteria for all ten patients in the evaluation. Under the condition of equivalent target dose distribution, the VMAT plan's Conformity Index, monitor unit, treatment time, and gamma passing index rate were superior than in the IMRT plan, and the result was statistically significant. Collapsed cone algorithm-based VMAT can have a more effective and better approach for esophageal cancer than IMRT.

Deep learning-based prediction of the remaining time and future distribution of pebble flow from real-scene images

Pebble flow dynamics is a crucial issue for designing and operating pebble bed reactors. The existing experimental or simulation methods are often associated with high time, resource, and effort costs. Therefore, image-based deep learning methods are explored to make real-time predictions of pebble flow dynamics directly from images. Real-scene images, captured by the high-speed camera during pebble flow experiments are used as the dataset. This paper proposes an RT-Net model based on Convolutional Neural Network (CNN) to predict the remaining time of pebble flow from experimental images. The core of the RT-Net model is the mergeable multi-branch convolutional component called ConvBlock, which effectively improves accuracy and reduces computational costs compared to traditional convolutional operators. Results show that this model is superior in both accuracy and efficiency metrics compared with typical convolutional neural networks (like AlexNet and VGGs). The proportion of test sets with prediction error within 0.05 s reaches 96.7 %, and the parameters count and inference time are 5.02 M and 1.99 ms respectively. Furthermore, to anticipate the pebble distribution at a given future time, a dual-input PreNet that combines CNN and Generative Adversarial Network (GAN) is designed, where the input includes the current pebble flow image and an arbitrarily chosen temporal displacement Δt. Targeted evaluation metrics, such as Target Similarity (TS) and Equivalent Target Similarity (TSeq) are proposed to quantitatively evaluate the model’s performance. Results indicate that the Pre-Net model can make quite satisfactory predictions of the future distribution of most data, while more efforts such as a task-specific loss function are encouraged to achieve better performance.

Direction Modulated Brachytherapy Tandem Model Applicators for Treatment Planning of Multi-Institutional Cervical Cancer Cases

Direction Modulated Brachytherapy (DMBT) offers a means of utilizing an anisotropic source to create more conformal dose distributions when integrated with image-guided adaptive brachytherapy (IGABT). Authors sought to validate the implementation of nine unique six-channeled, MRI-compatible, novel DMBT tandem applicators of varying physical dimensions within Varian's BrachyVision® (v16.1) treatment planning system (BV-TPS). A total of 110 retrospective clinically delivered high-dose-rate (HDR) cervical cancer brachytherapy plans, from three institutions, were re-planned for each of the nine DMBT tandem models within the BV-TPS, using the latest VEGO® inverse optimization algorithm, with dose heterogeneity accounted for through AcurosBV®. Plans consisted of both intracavitary (77 plans) and interstitial (33 plans) cases with an average prescription dose and high-risk clinical target volumes (CTVHR) of 607±113 cGy and 26.96±14.95 [range 6.70-69.58] cm3, respectively. During re-planning, the conventional tandems were replaced by one of the nine DMBT tandem models while leaving ovoids or rings, and needles (if present), in place. A two-step inverse optimization process was performed such that the lowest possible organs at risk (OAR) D2cc doses could be achieved while 1) keeping equivalent target coverage (ΔCTVHR-D90 to within ±0.5%) and, at the same time, 2) maintaining the general pear-shape dose distribution of the original plans. Noteworthy improvements in plan quality were achieved by all nine DMBT tandem models, which are presented in Table 1. Irrespective of the model, about ∼50 cGy reduction in D2cc across all OARs appear feasible. There is also a general trend of D2cc reductions' magnitude becoming smaller as the CTVHR volume increased due to loss in modulation at distance. Additionally, D2cc reductions in terms of EQD2 [Gy] were calculated assuming each re-plan was delivered throughout the course of treatment, which includes the external beam radiotherapy dose of 45 Gy and showed significant reductions of -6.29±4.38 Gy, -3.80±2.06 Gy, and -4.86±3.02 Gy for the bladder, rectum, and sigmoid, respectively, for DMBT model #9 for example. We have successfully incorporated nine DMBT tandem models into a commercial TPS and re-planned 110 cases, to a total of 990 plans. All nine DMBT tandem models were each able to generate notable D2cc reductions to OARs (∼50 cGy), without compromising target coverage, across plans from multiple institutions with various clinical/optimization practices. The results indicate both a promising impact and smooth integration of DMBT tandem technology into modern clinical IGABT workflow.

Direction Modulated Brachytherapy Tandem Model Applicators for Treatment Planning of Multi-Institutional Cervical Cancer Cases: Removing Needles in Intracavitary-Interstitial Techniques

To evaluate the potential of nine direction modulated brachytherapy (DMBT) tandem applicator models of various designs to obviate the need for needles during intracavitary-interstitial (IC-IS) cervical cancer brachytherapy. A cohort of 33 retrospective clinical high dose-rate (HDR) brachytherapy plans, from three institutions, were re-planned with Varian's BrachyVision® (v16.1) treatment planning system (BV-TPS), using the latest VEGO® inverse optimization algorithm, with dose heterogeneity accounted for through the AcurosBV® model-based dose calculation algorithm. All plans consisted of IC-IS cases, with a range of 2-4 freehand-loaded needles, with an average prescription dose of 706±54 cGy and average high-risk clinical target volume (HRCTV) of 36.0±17.4 [range 9.8-69.6] cm3. Nine novel DMBT tandem models of varying physical dimensions were integrated for the first time into the BV-TPS, with thicknesses (4-8 mm). During re-planning, the conventional tandems and all of the needles were replaced by one of the nine DMBT tandem models while leaving the ovoids/rings in place. An optimization process was performed such that the lowest possible organs at risk (OAR) D2cc doses could be achieved while keeping equivalent target coverage (ΔHRCTV-D90 to within ±0.5%) and maintaining a pear-shape dose distribution. The process was repeated for each of the nine DMBT tandem models resulting in (33 × 9 =) 297 plans. Average ΔHRCTV-D90 was +0.35±0.39% (+2.8±3.1 cGy). OAR D2cc reductions were achieved by all models for all plans. The performance of the thickest DMBT model (8 mm) was the best in terms of achieving the lowest D2cc for all OARs, with 31 out of 33 plans (94%) achieving lower D2cc doses for all three OARs. The two cases in which the D2cc doses could not be reduced had HRCTV volumes ranging between 50 cm3 and 60 cm3. Additionally, D2cc reductions in terms of EQD2 [Gy] were calculated assuming each re-plan was delivered throughout the entire course of a patient's treatment, which included the external beam radiotherapy dose of 45 Gy, showed significant reductions of -2.64±2.67 Gy, -1.65±1.97 Gy, and -2.80±2.20 Gy for bladder, rectum, and sigmoid, respectively. According to the results, it is clinically feasible to replace the conventional IC-IS cases, with 2-4 freehand-loaded needles, with the DMBT tandem technology, effectively avoiding the need for needle involvement.