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Background Patient‐specific quality assurance (PSQA) is crucial in radiation therapy to ensure accurate and safe dose delivery. The Elekta Unity MR‐Linac system, which combines MRI with a linear accelerator, presents unique challenges for conventional PSQA methods due to its adaptive capabilities and the presence of a magnetic field. Purpose This study introduced a novel PSQA method for the Elekta Unity MR‐Linac system, utilizing treatment log files and fluence map verification to provide a more efficient alternative to traditional measurement‐based techniques. Methods The proposed method analyzed log file data, including monitor units (MU), multi‐leaf collimator (MLC) positions, and jaw positions, comparing them with treatment planning system (TPS) values. Fluence maps were generated for each gantry angle and evaluated using gamma analysis. A user‐friendly interface was developed to streamline the process. Results The method was tested on nine stereotactic body radiation therapy (SBRT) cases, showing strong concordance between planned and delivered parameters. MU deviations were within 0.5 MU, X‐jaw and MLC leaf position deviations were under 1 mm, and gamma analysis of fluence maps achieved passing rates above 98% for all gantry angles. Conclusion This log file‐based PSQA method offered distinct advantages over traditional measurement‐based approaches, including reduced QA time, direct assessment of the delivered plan, and comprehensive evaluation of treatment parameters. This method provided an efficient and accurate alternative PSQA solution for MR‐guided adaptive radiotherapy.

A bstract We study mass deformations of N = 4, d = 4 SYM theory that are spatially modulated in one spatial dimension and preserve some residual supersymmetry. We focus on generalisations of N = 1 ∗ theories and show that it is also possible, for suitably chosen supersymmetric masses, to preserve d = 3 conformal symmetry associated with a co-dimension one interface. Holographic solutions can be constructed using D = 5 theories of gravity that arise from consistent truncations of SO(6) gauged supergravity and hence type IIB supergravity. For the mass deformations that preserve d = 3 superconformal symmetry we construct a rich set of Janus solutions of N = 4 SYM theory which have the same coupling constant on either side of the interface. Limiting classes of these solutions give rise to RG interface solutions with N = 4 SYM on one side of the interface and the Leigh-Strassler (LS) SCFT on the other, and also to a Janus solution for the LS theory. Another limiting solution is a new supersymmetric AdS 4 × S 1 × S 5 solution of type IIB supergravity.

A bstract We construct gravitational solutions that holographically describe two different d = 4 SCFTs joined together at a co-dimension one, planar RG interface and preserving d = 3 superconformal symmetry. The RG interface joins N = 4 SYM theory on one side with the N = 1 Leigh-Strassler SCFT on the other. We construct a family of such solutions, which in general are associated with spatially dependent mass deformations on the N = 4 SYM side, but there is a particular solution for which these deformations vanish. We also construct a Janus solution with the Leigh-Strassler SCFT on either side of the interface. Gravitational solutions associated with superconformal interfaces involving ABJM theory and two d = 3 N = 1 SCFTs with G 2 symmetry are also discussed and shown to have similar properties, but they also exhibit some new features.

A bstract We construct consistent Kaluza-Klein truncations of type IIA supergravity on (i) Σ 2 × S 3 and (ii) Σ 3 × S 3 , where Σ 2 = S 2 / Γ, ℝ 2 / Γ, or ℍ 2 / Γ, and Σ 3 = S 3 / Γ, ℝ 3 / Γ, or ℍ 3 / Γ, with Γ a discrete group of symmetries, corresponding to NS5-branes wrapped on Σ 2 and Σ 3 . The resulting theories are a D = 5, N = 4 gauged supergravity coupled to three vector multiplets with scalar manifold SO(1 , 1) × SO(5 , 3) / (SO(5) × SO(3)) and gauge group SO(2) × (SO(2) ⋉ Σ 2 ℝ 4 ) which depends on the curvature of Σ 2 , and a D = 4, N = 2 gauged supergravity coupled to one vector multiplet and two hypermultiplets with scalar manifold SU(1 , 1) / U(1) × G 2(2) / SO(4) and gauge group ℝ + × ℝ + for truncations (i) and (ii) respectively. Instead of carrying out the truncations at the 10-dimensional level, we show that they can be obtained directly by performing Inönü-Wigner contractions on the 5 and 4-dimensional gauged supergravity theories that come from consistent truncations of 11-dimensional supergravity associated with M5-branes wrapping Σ 2 and Σ 3 . This suggests the existence of a broader class of lower-dimensional gauged supergravity theories related by group contractions that have a 10 or 11-dimensional origin.

A bstract We construct infinite new classes of AdS 4 × S 1 × S 5 solutions of type IIB string theory which have non-trivial SL(2 , ℤ) monodromy along the S 1 direction. The solutions are supersymmetric and holographically dual, generically, to N = 1 SCFTs in d = 3. The solutions are first constructed as AdS 4 × ℝ solutions in D = 5 SO(6) gauged supergravity and then uplifted to D = 10. Unlike the known AdS 4 × ℝ S-fold solutions, there is no continuous symmetry associated with the ℝ direction. The solutions all arise as limiting cases of Janus solutions of d = 4, N = 4 SYM theory which are supported both by a different value of the coupling constant on either side of the interface, as well as by fermion and boson mass deformations. As special cases, the construction recovers three known S-fold constructions, preserving N = 1 , 2 and 4 supersymmetry, as well as a recently constructed N = 1 AdS 4 × S 1 × S 5 solution (not S-folded). We also present some novel “one-sided Janus” solutions that are non-singular.

Background Historically, a priori power and sample size calculations have not been routinely performed cost-effectiveness analyses (CEA), partly because the absence of published cost and effectiveness correlation and variance data, which are essential for power and sample size calculations. Importantly, the empirical correlation between cost and effectiveness has not been examined with respect to the estimation of value-for-money in clinical literature. Therefore, it is not well established if cost-effectiveness studies embedded within randomized-controlled-trials (RCTs) are under- or over-powered to detect changes in value-for-money. However, recently guidelines (such as those from ISPOR) and funding agencies have suggested sample size and power calculations should be considered in CEAs embedded in clinical trials. Methods We examined all RCTs conducted by the Canadian Cancer Trials Group with an embedded cost-effectiveness analysis. Variance and correlation of effectiveness and costs were derived from original-trial data. The incremental net benefit method was used to calculate the power of the cost-effectiveness analysis, with exploration of alternative correlation and willingness-to-pay values. Results We identified four trials for inclusion. We observed that a hypothetical scenario of correlation coefficient of zero between cost and effectiveness led to a conservative estimate of sample size. The cost-effectiveness analysis was under-powered to detect changes in value-for-money in two trials, at willingness-to-pay of $100,000. Based on our observations, we present six considerations for future economic evaluations, and an online program to help analysts include a priori sample size and power calculations in future clinical trials. Conclusion The correlation between cost and effectiveness had a potentially meaningful impact on the power and variance of value-for-money estimates in the examined cost-effectiveness analyses. Therefore, the six considerations and online program, may facilitate a priori power calculations in embedded cost-effectiveness analyses in future clinical trials. Highlights • Analysts may use the online program presented in the present study to examine the a priori power of cost-effectiveness analyses. • Analysts may potentially apply the considerations presented in this paper in the planning stage of future cost-effectiveness analyses.

Purpose To describe the modern incidence and predictors of ICU admission for adult patients newly diagnosed with a hematologic malignancy. Methods We conducted a population-based cohort study of adults with a new diagnosis of hematologic malignancy (April 1, 2006–March 31, 2017) in Ontario, Canada. We described the baseline demographic, clinical and laboratory predictors of ICU admission and subsequent mortality. The primary outcome was the incidence of ICU admission within 1 year of hematologic malignancy diagnosis. We assessed the predictors of ICU admission using Cox-proportional models that accounted for the competing risk of death and reported as subdistribution hazard ratios (sHR) with 95% confidence intervals (CI). Results A total of 87,965 patients (mean [SD] age, 67.8 (15.7) years) were included. The 1-year incidence of ICU admission was 13.9% (median time 35 days), ranging from 7.3% (indolent lymphoma) to 22.5% (acute myeloid leukemia). After multivariable adjustment, compared to indolent lymphoma, acute myeloid leukemia (sHR, 3.09; 95% CI 2.84–3.35), aggressive non-Hodgkin lymphoma (sHR, 2.47; 95% CI 2.31–2.65) and acute lymphoblastic leukemia (sHR, 2.46; 95% CI 2.15–2.80) had the highest risk of ICU admission. Comorbidities such as cardiovascular disease (sHR, 2.09; 95% CI 2.01–2.19), chronic obstructive pulmonary disease (sHR, 1.33; 95% CI 1.26–1.39) and baseline laboratory abnormalities (anemia, thrombocytopenia and high creatinine) were also associated with ICU admission. Among ICU patients, 36.7% required invasive mechanical ventilation and in-hospital mortality was 31%. Conclusion Critical illness in patients with a newly diagnosed hematologic malignancy is frequent, occurring early after diagnosis. Certain baseline characteristics can help identify those patients at the highest risk.

Skorupski et al present several facts about preoperative anemia in major elective surgery. An estimated 23%-45% of patients undergoing major surgery have anemia, with the most common causes being iron deficiency anemia and anemia of inflammation or chronic disease.

Silverstein et al share things to know about Vitamin B12 deficiency wherein its incidence increases with age. Common symptoms of Vitamin B12 deficiency are fatigue and pallor, but features can also include cognitive deficits, subacute combined degeneration of the dorsal and lateral columns of the spinal cord and peripheral neuropathies. Hematologic findings include macrocytic anemia, hypersegmented neutrophils on blood film and pancytopenia. Plasma concentrations of B12 should be assessed if macrocytosis is identified. Marginal deficiency, defined by plasma concentrations of 148-221 pmol/L, is observed in 20% of patients older than 60 years and seldom leads to hematologic abnormalities. Testing for methylmalonic acid and homocysteine levels can be considered in patients with an equivocal plasma concentration of B12 and symptoms or signs compatible with deficiency.