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A Nanosized {Ni II 18 } Cluster with a ‘Flying Saucer’ Topology Exhibiting Slow Relaxation of Magnetisation Phenomena at Both 15 K and 1.3 K

A high-nuclearity {Ni 18 } complex (1) with a unique ‘flying saucer’ motif has been prepared from the organic chelate, α-methyl-2-pyridine-methanol (mpmH), in conjunction with bridging azido (N 3 - ) and peroxido (O 2 2- ) ligands. Magnetic susceptibility measurements revealed the presence of both ferro- and antiferromagnetic exchange interactions between the metal centres in 1, and the stabilization of spin states with appreciable S values at two different temperature regimes. The end-on bridging azido and alkoxido groups are in all likelihood the ferromagnetic mediators, while the η 3 :η 3 :μ 6 -bridging peroxides most likely promote the antiparallel alignment of the metals’ spin vectors, yielding an overall non-zero spin ground state for the centrosymmetric compound 1. Furthermore, the {Ni 18 } nanosized cluster behaves as a single-molecule magnet, exhibiting magnetic hysteresis at low temperatures and two relaxation processes at 15 K and 1.3 K, a very rare phenomenon in polynuclear magnetic 3d-metal clusters.

37 INORGANIC, ORGANIC, PHYSICAL, AND ANALYTICAL CH↗

Compactly‐Supported Nonstationary Kernels for Computing Exact Gaussian Processes on Big Data

The Gaussian process (GP) is a widely used method for analyzing large-scale data sets, including spatio-temporal measurements of nonlinear processes that are now commonplace in the environmental sciences. Traditional implementations of GPs involve stationary kernels (also termed covariance functions) that limit their flexibility, and exact methods for inference that prevent application to data sets with more than about 10,000 points. Modern approaches to address stationarity assumptions generally fail to accommodate large data sets, while all attempts to address scalability focus on approximating the Gaussian likelihood, which can involve subjectivity and lead to inaccuracies. In this work, we explicitly derive an alternative kernel that can discover and encode both sparsity and nonstationarity. We embed the kernel within a fully Bayesian GP model and leverage high-performance computing resources to enable the analysis of massive data sets. We demonstrate the favorable performance of our novel kernel relative to existing exact and approximate GP methods across a variety of synthetic data examples. Furthermore, we conduct space–time prediction based on more than 1 million measurements of daily maximum temperature and verify that our results outperform state-of-the-art methods in the Earth sciences. More broadly, having access to exact GPs that use ultra-scalable, sparsity-discovering, nonstationary kernels allows GP methods to truly compete with a wide variety of machine learning methods.

Gaussian processes↗

Dosimetric and biological impact of activity extravasation of radiopharmaceuticals in PET imaging

The increasing use of nuclear medicine and PET imaging has intensified scrutiny of radiotracer extravasation. To our knowledge, this topic is understudied but holds great potential for enhancing our understanding of extravasation in clinical PET imaging. This work aims to (1) quantify the absorbed doses from radiotracer extravasation in PET imaging, both locally at the site of extravasation and with the extravasation location as a source of exposure to bodily organs and (2) assess the biological ramifications within the injection site at the cellular level. A radiation dosimetry simulation was performed using a whole-body 4D Extended Cardiac-Torso (XCAT) phantom embedded in the GATE Monte Carlo platform. A 10-mCi dose of 18 F-FDG was chosen to simulate a typical clinical PET scan scenario, with 10% of the activity extravasated in the antecubital fossa of the right arm of the phantom. The extravasation volume was modeled as a 5.5 mL rectangle in the hypodermal layer of skin. Absorbed dose contributions were calculated for the first two half-lives, assuming biological clearance thereafter. Dose calculations were performed as absorbed doses at the organ and skin levels. Energy deposition was simulated both at the local extravasation site and in multiple organs of interest and converted to absorbed doses based on their respective masses. Each simulation was repeated ten times to estimate Monte Carlo uncertainties. Biological impacts on cells within the extravasated volume were evaluated by randomizing cells and exposing them to a uniform radiation source of 18 F and 68 Ga. Particle types, their energies, and direction cosines were recorded in phase space files using a separate Geant4 simulation to characterize their entry into the nucleus of the cellular volume. Subsequently, the phase space files were imported into the TOPAS-nBio simulation to assess the extent of DNA damage, including double-strand breaks (DSBs) and single-strand breaks (SSBs). Organ-level dosimetric estimations are presented for 18 F and 68 Ga radionuclides in various organs of interest. With 10% extravasation, the hypodermal layer of the skin received the highest absorbed dose of 1.32 ± 0.01 Gy for 18 F and 0.99 ± 0.01 Gy for 68 Ga. The epidermal and dermal layers received absorbed doses of 0.07 ± 0.01 Gy and 0.13 ± 0.01 Gy for 18 F, and 0.14 ± 0.01 Gy and 0.29 ± 0.01 Gy for 68 Ga, respectively. In the extravasated volume, 18 F caused an average absorbed dose per nucleus of 0.17 ± 0.01 Gy, estimated to result in 10.58 ± 0.50 DSBs and 268.11 ± 12.43 SSBs per nucleus. For 68 Ga, the absorbed dose per nucleus was 0.11 ± 0.01 Gy, leading to an estimated 6.49 ± 0.34 DSBs and 161.24 ± 8.12 SSBs per nucleus. Absorbed doses in other organs were on the order of micro-gray (µGy). The likelihood of epidermal erythema resulting from extravasation during PET imaging is low, as the simulated absorbed doses to the epidermis remain below the thresholds that trigger such effects. Moreover, the organ-level absorbed doses were found to be clinically insignificant across various simulated organs. The minimal DNA damage at the extravasation site suggests that long-term harm, such as radiation-induced carcinogenesis, is highly unlikely.

DNA strand breaks↗

Synthesizing realistic sand assemblies with denoising diffusion in latent space

Abstract The shapes and morphological features of grains in sand assemblies have far‐reaching implications in many engineering applications, such as geotechnical engineering, computer animations, petroleum engineering, and concentrated solar power. Yet, our understanding of the influence of grain geometries on macroscopic response is often only qualitative, due to the limited availability of high‐quality 3D grain geometry data. In this paper, we introduce a denoising diffusion algorithm that uses a set of point clouds collected from the surface of individual sand grains to generate grains in the latent space. By employing a point cloud autoencoder, the three‐dimensional point cloud structures of sand grains are first encoded into a lower‐dimensional latent space. A generative denoising diffusion probabilistic model is trained to produce synthetic sand that maximizes the log‐likelihood of the generated samples belonging to the original data distribution measured by a Kullback‐Leibler divergence. Numerical experiments suggest that the proposed method is capable of generating realistic grains with morphology, shapes and sizes consistent with the training data inferred from an F50 sand database. We then use a rigid contact dynamic simulator to pour the synthetic sand in a confined volume to form granular assemblies in a static equilibrium state with targeted distribution properties. To ensure third‐party validation, 50,000 synthetic sand grains and the 1542 real synchrotron microcomputed tomography (SMT) scans of the F50 sand, as well as the granular assemblies composed of synthetic sand grains are made available in an open‐source repository.

Vlassis, Nikolaos N.↗

Out With the Old: Empirical Trends in U.S. Land‐Based Wind Turbine Decommissioning and Repowering

A growing number of wind turbines (WTs) across the globe are now reaching or exceeding their expected service lifetime; WT decommissioning is on the rise. Accordingly, questions pertaining to WT end-of-life have risen in importance in policy and practice. Yet, research on the various factors relating to WT decommissioning is relatively sparse. Moreover, the key assumptions underpinning that prior research (e.g., the lifespan of WTs, characteristics of WTs being decommissioned, and whether the site is repowered with new WTs) have never been empirically tested across a large set of decommissioned WTs. Leveraging a uniquely comprehensive and spatially explicit dataset of decommissioned WTs in the United States, this research analyzes spatial, technological, and temporal trends in WT decommissioning and develops a novel predictive model for WT decommissioning. Our analysis pinpoints more than 12,400 WTs that have been fully decommissioned in the United States., the majority of which have been relatively old (> 30 years) and small (< 200 kW). While a WT's age alone is a good predictor of the likelihood of decommissioning, other factors such as the size of the WT and recent performance are also important and significant predictors. Most sites where decommissioning has occurred have seen subsequent repowering, with repowered plants featuring substantially fewer WTs (−86 on average) and higher rated plant capacity (+62 MW on average). Many existing WTs in the U.S. are approaching the end of their expected life with roughly 7500 being 20 or more years old. Findings can help policymakers and stakeholders begin preparing for this potential wave of future decommissioning and repowering.

Decommissioning / End-of-life↗

Measurements of inclusive and differential cross sections for top quark production in association with a Z boson in proton-proton collisions at $\sqrt{s} $ = 13 TeV

Measurements are presented of inclusive and differential cross sections for Z boson associated production of top quark pairs ($ \textrm{t}\overline{\textrm{t}}\textrm{Z} $) and single top quarks (tZq or tWZ). The data were recorded in proton-proton collisions at a center-of-mass energy of 13 TeV, corresponding to an integrated luminosity of 138 fb$^{−1}$. Events with three or more leptons, electrons or muons, are selected and a multiclass deep neural network is used to separate three event categories, the $ \textrm{t}\overline{\textrm{t}}\textrm{Z} $ and tWZ processes, the tZq process, and the backgrounds. A profile likelihood approach is used to unfold the differential cross sections, to account for systematic uncertainties, and to determine the correlations between the two signal categories in one global fit. The inclusive cross sections for a dilepton invariant mass between 70 and 110 GeV are measured to be 1.14 ± 0.07 pb for the sum of $ \textrm{t}\overline{\textrm{t}}\textrm{Z} $ and tWZ, and 0.81 ± 0.10 pb for tZq, in good agreement with theoretical predictions.[graphic not available: see fulltext]

72 PHYSICS OF ELEMENTARY PARTICLES AND FIELDS↗

Constraints on standard model effective field theory for a Higgs boson produced in association with W or Z bosons in the H → $\textrm{b}\overline{\textrm{b}}$ decay channel in proton-proton collisions at $\sqrt{s}$ = 13 TeV

A standard model effective field theory (SMEFT) analysis with dimension-six operators probing nonresonant new physics effects is performed in the Higgs-strahlung process, where the Higgs boson is produced in association with a W or Z boson, in proton-proton collisions at a center-of-mass energy of 13 TeV. The final states in which the W or Z boson decays leptonically and the Higgs boson decays to a pair of bottom quarks are considered. The analyzed data were collected by the CMS experiment between 2016 and 2018 and correspond to an integrated luminosity of 138 fb −1 . An approach designed to simultaneously optimize the sensitivity to Wilson coefficients of multiple SMEFT operators is employed. Likelihood scans as functions of the Wilson coefficients that carry SMEFT sensitivity in this final state are performed for different expansions in SMEFT. The results are consistent with the predictions of the standard model.

72 PHYSICS OF ELEMENTARY PARTICLES AND FIELDS↗

Measurement of the inclusive WZ production cross section in pp collisions at $\sqrt{\textrm{s}}$ = 13.6 TeV

The inclusive WZ production cross section is measured in proton-proton collisions at a centre-of-mass energy of 13.6 TeV, using data collected during 2022 with the CMS detector, corresponding to an integrated luminosity of 34.7 fb −1 . The measurement uses multileptonic final states and a simultaneous likelihood fit to the number of events in four different lepton flavour categories: eee, ee μ , μμ e, and μμμ . The selection is optimized to minimize the number of background events, and relies on an efficient prompt lepton discrimination strategy. The WZ production cross section is measured in a phase space defined within a 30 GeV window around the Z boson mass, as σ total (pp → WZ) = 55.2 ± 1.2 (stat) ± 1.2 (syst) ± 0.8 (lumi) ± 0.3 (theo) pb. In addition, the cross section is measured in a fiducial phase space closer to the detector-level requirements. All the measurements presented in this paper are in agreement with standard model predictions.

72 PHYSICS OF ELEMENTARY PARTICLES AND FIELDS↗

Measurement of the top-quark mass using decays with a J/ψ meson at s=13 TeV with the ATLAS detector

The top-quark mass is measured using top-quark decays producing an isolated lepton and J/ψ meson reconstructed in its μ+μ− decay mode. The data sample was recorded with the ATLAS detector in proton-proton collisions at a centre-of-mass energy of s=13$$ \sqrt{s}=13 $$ TeV during Run 2 of the Large Hadron Collider, corresponding to an integrated luminosity of 140 fb−1. The measurement is based on the invariant mass m(ℓμ+μ−) of the system made of the isolated lepton ℓ from the W boson decay and the non-isolated μ+μ− pair from a J/ψ decay of a b-hadron, exploiting its sensitivity to the top-quark mass. An unbinned maximum-likelihood fit to the m(ℓμ+μ−) distribution is performed to extract the top-quark mass. The top-quark mass is measured to be mtop = 172.17 ± 0.80 (stat) ± 0.81 (syst) ± 1.07 (recoil) GeV, with a total uncertainty of 1.56 GeV. The third uncertainty arises from changing the dipole parton shower gluon-recoil scheme used in top-quark decays.

Aad, G↗

Inclusive and differential cross section measurements of $ \textrm{t}\overline{\textrm{t}}\textrm{b}\overline{\textrm{b}} $ production in the lepton+jets channel at $ \sqrt{s} $ = 13 TeV

Measurements of inclusive and normalized differential cross sections of the associated production of top quark-antiquark and bottom quark-antiquark pairs, $ \textrm{t}\overline{\textrm{t}}\textrm{b}\overline{\textrm{b}} $, are presented. The results are based on data from proton-proton collisions collected by the CMS detector at a centre-of-mass energy of 13 TeV, corresponding to an integrated luminosity of 138 fb$^{−1}$. The cross sections are measured in the lepton+jets decay channel of the top quark pair, using events containing exactly one isolated electron or muon and at least five jets. Measurements are made in four fiducial phase space regions, targeting different aspects of the $ \textrm{t}\overline{\textrm{t}}\textrm{b}\overline{\textrm{b}} $ process. Distributions are unfolded to the particle level through maximum likelihood fits, and compared with predictions from several event generators. The inclusive cross section measurements of this process in the fiducial phase space regions are the most precise to date. In most cases, the measured inclusive cross sections exceed the predictions with the chosen generator settings. The only exception is when using a particular choice of dynamic renormalization scale, $ {\mu}_{\textrm{R}}=\frac{1}{2}{\prod}_{i=\textrm{t},\overline{\textrm{t}},\textrm{b},\overline{\textrm{b}}}{m}_{\textrm{T},i}^{1/4} $, where $ {m}_{\textrm{T},i}^2={m}_i^2+{p}_{\textrm{T},i}^2 $ are the transverse masses of top and bottom quarks. The differential cross sections show varying degrees of compatibility with the theoretical predictions, and none of the tested generators with the chosen settings simultaneously describe all the measured distributions.[graphic not available: see fulltext]

72 PHYSICS OF ELEMENTARY PARTICLES AND FIELDS↗

Measurement of the Higgs boson production in association with top quarks in multilepton final states in pp collisions at s=13 TeV with the ATLAS detector

A measurement of the associated production of a top-quark pair with the Higgs boson (tt¯H$$ t\overline{t}H $$) in multilepton final states is presented. The analysis is based on a data sample of proton-proton collisions at s=13$$ \sqrt{s}=13 $$ TeV recorded with the ATLAS detector at the CERN Large Hadron Collider and corresponding to an integrated luminosity of 140 fb−1. Six final states defined by the number and flavour of reconstructed charged leptons are combined in a simultaneous likelihood fit to extract the tt¯H$$ t\overline{t}H $$ signal and constrain the most relevant backgrounds. The measured tt¯H$$ t\overline{t}H $$ cross-section normalised to Standard Model (SM) prediction is σtt¯H/σSM=0.63−0.19+0.20$$ {\sigma}_{t\overline{t}H}/{\sigma}^{\mathrm{SM}}=0.{63}_{-0.19}^{+0.20} $$. This result corresponds to an observed (expected) significance of 3.3σ (5.3σ). Additionally, two other fits are used to measure the tt¯H$$ t\overline{t}H $$ cross-section differentially in bins of the Higgs boson transverse momentum in the simplified template cross-section framework, and to extract the associated production cross-section of a single top-quark with the Higgs boson (tH) together with the tt¯H$$ t\overline{t}H $$ one. The CP structure of the top quark-Higgs boson Yukawa coupling is probed through an analysis of tt¯H$$ t\overline{t}H $$ and tH events. The results are compatible with the SM hypothesis, and values of the mixing angle between CP-even and CP-odd top-Higgs Yukawa couplings of |α| > 62° are excluded at 68% confidence level.

Aad, G↗

A new Monte Carlo generator for BSM physics in B → K*ℓ+ℓ− decays with an application to lepton non-universality in angular distributions

Abstract Within the widely used EvtGen framework, we have added a new event generator model forB → K * ℓ + ℓ − with improved standard model (SM) decay amplitudes and possible BSM physics contributions, which are implemented in the operator product expansion in terms of Wilson coefficients. This event generator can then be used to estimate the statistical sensitivity of a simulated experiment to the most general BSM signal resulting from dimension-six operators. We describe the advantages and potential of the newly developed ‘Sibidanov Physics Generator’ in improving the experimental sensitivity of searches for lepton non-universal BSM physics and clarifying signatures. The new generator can properly simulate BSM scenarios, interference between SM and BSM amplitudes, and correlations between different BSM observables as well as acceptance bias. We show that exploiting such correlations substantially improves experimental sensitivity. As a demonstration of the utility of the MC generator, we examine the prospects for improved measurements of lepton non-universality in angular distributions forB→K * ℓ + ℓ − decays from the expected 50 ab −1 data set of the Belle II experiment, using a four-dimensional unbinned maximum likelihood fit. We describe promising experimental signatures and correlations between observables. The use of lepton-universality violating ∆-observables significantly reduces uncertainties in the SM expectations due to QCD and resonance effects and is ideally suited for Belle II with the large data sets expected in the next decade. Thanks to the clean experimental environment of ane + e − machine, Belle II should be able to probe BSM physics in the Wilson coefficientsC 7 and$$ {C}_7^{\prime } $$ C 7 ′ , which appear at lowq 2 in the di-electron channel.

Physics↗

Test of light-lepton universality in τ decays with the Belle II experiment

We present a measurement of the ratio R µ = $\mathcal{B}$($τ^- → µ^-\overline{ν}_µν_τ$)/$\mathcal{B}(τ^- → e^-\overline{ν}_eν_τ$) of branching fractions B of the τ lepton decaying to muons or electrons using data collected with the Belle II detector at the SuperKEKB e + e - collider. The sample has an integrated luminosity of 362 ± 2 fb -1 at a centre-of-mass energy of 10.58 GeV. Using an optimised event selection, a binned maximum likelihood ft is performed using the momentum spectra of the electron and muon candidates. The result, R µ = 0.9675 ± 0.0007 ± 0.0036, where the first uncertainty is statistical and the second is systematic, is the most precise to date. It provides a stringent test of the light-lepton universality, translating to a ratio of the couplings of the muon and electron to the W boson in τ decays of 0.9974 ± 0.0019, in agreement with the standard model expectation of unity.

72 PHYSICS OF ELEMENTARY PARTICLES AND FIELDS↗

Measurements of W + W − production cross-sections in pp collisions at $\sqrt{s}=13$ TeV with the ATLAS detector

Measurements of W + W − → e ± νμ ∓ ν production cross-sections are presented, providing a test of the predictions of perturbative quantum chromodynamics and the electroweak theory. The measurements are based on data from pp collisions at $\sqrt{s}$ = 13 TeV recorded by the ATLAS detector at the Large Hadron Collider in 2015–2018, corresponding to an integrated luminosity of 140 fb −1 . The number of events due to top-quark pair production, the largest background, is reduced by rejecting events containing jets with b-hadron decays. An improved methodology for estimating the remaining top-quark background enables a precise measurement of W + W − cross-sections with no additional requirements on jets. The fiducial W + W − cross-section is determined in a maximum-likelihood fit with an uncertainty of 3.1%. The measurement is extrapolated to the full phase space, resulting in a total W + W − cross-section of 127 ± 4 pb. Differential cross-sections are measured as a function of twelve observables that comprehensively describe the kinematics of W + W − events. The measurements are compared with state-of-the-art theory calculations and excellent agreement with predictions is observed. A charge asymmetry in the lepton rapidity is observed as a function of the dilepton invariant mass, in agreement with the Standard Model expectation. A CP-odd observable is measured to be consistent with no CP violation. Limits on Standard Model effective field theory Wilson coefficients in the Warsaw basis are obtained from the differential cross-sections.

Accelerator Physics↗

Measurement of the $B^0_\mathrm{s}\to J/\psi K^0_\mathrm{S}$ effective lifetime from proton-proton collisions at $\sqrt{s} = 13$ TeV

The effective lifetime of the $ {\textrm{B}}_{\textrm{s}}^0 $ meson in the decay $ {\textrm{B}}_{\textrm{s}}^0\to \textrm{J}/{\uppsi \textrm{K}}_{\textrm{S}}^0 $ is measured using data collected during 2016–2018 with the CMS detector in $ \sqrt{s} $ = 13 TeV proton-proton collisions at the LHC, corresponding to an integrated luminosity of 140 fb$^{−1}$. The effective lifetime is determined by performing a two-dimensional unbinned maximum likelihood fit to the $ {\textrm{B}}_{\textrm{s}}^0 $ meson invariant mass and proper decay time distributions. The resulting value of 1.59 ± 0.07(stat) ± 0.03(syst) ps is the most precise measurement to date and is in good agreement with the expected value.[graphic not available: see fulltext]

72 PHYSICS OF ELEMENTARY PARTICLES AND FIELDS↗

Measurement of boosted Higgs bosons produced via vector boson fusion or gluon fusion in the H →$ \textrm{b}\overline{\textrm{b}} $ decay mode using LHC proton-proton collision data at $ \sqrt{s} $ = 13 TeV

A measurement is performed of Higgs bosons produced with high transverse momentum (p$_{T}$) via vector boson or gluon fusion in proton-proton collisions. The result is based on a data set with a center-of-mass energy of 13 TeV collected in 2016–2018 with the CMS detector at the LHC and corresponds to an integrated luminosity of 138 fb$^{−1}$. The decay of a high-p$_{T}$ Higgs boson to a boosted bottom quark-antiquark pair is selected using large-radius jets and employing jet substructure and heavy-flavor taggers based on machine learning techniques. Independent regions targeting the vector boson and gluon fusion mechanisms are defined based on the topology of two quark-initiated jets with large pseudorapidity separation. The signal strengths for both processes are extracted simultaneously by performing a maximum likelihood fit to data in the large-radius jet mass distribution. The observed signal strengths relative to the standard model expectation are $ {4.9}_{-1.6}^{+1.9} $ and $ {1.6}_{-1.5}^{+1.7} $ for the vector boson and gluon fusion mechanisms, respectively. A differential cross section measurement is also reported in the simplified template cross section framework.[graphic not available: see fulltext]

72 PHYSICS OF ELEMENTARY PARTICLES AND FIELDS↗

Evaluation of normalization strategies for mass spectrometry-based multi-omics datasets

Introduction Data normalization is crucial for multi-omics integration, reducing systematic errors and maximizing the likelihood of discovering true biological variation. Most studies assess normalization for a single omics type or use datasets from separate experiments. Few address time-course data, where normalization might bias temporal differentiation. In this study, we compared common normalization methods and a machine learning approach, Systematical Error Removal using Random Forest (SERRF), using multi-omics datasets generated from the same experiment—even from the same cell lysate. Objectives To develop a straightforward process to assess normalization effects and identify the most robust methods across multi-omics datasets. Methods We analyzed metabolomics, lipidomics, and proteomics datasets from primary human cardiomyocytes and motor neurons exposed to acetylcholine-active compounds over time. Normalization effectiveness was evaluated based on improvement in QC features consistency and observing the change in treatment and time-related variance. Results Probabilistic Quotient Normalization (PQN) and Locally Estimated Scatterplot Smoothing (LOESS) QC were identified as optimal for metabolomics and lipidomics, while PQN, Median, and LOESS normalization excelled for proteomics. These methods consistently enhanced QC feature consistency in metabolomics and lipidomics, and preserved time-related variance or treatment-related variance in proteomics, demonstrating their effectiveness and robustness. SERRF normalization, applied only to metabolomics in this study, outperformed other methods in some datasets but inadvertently masked treatment-related variance in others. Conclusion Our evaluation identified PQN and LoessQC as the top methods for metabolomics and lipidomics, and PQN, Median, and Loess normalization for proteomics, in multi-omics integration in a temporal study.

60 APPLIED LIFE SCIENCES↗

Emerging Tools to Support DILI Assessment in Clinical Trials with Abnormal Baseline Serum Liver Tests or Pre-existing Liver Diseases

Abstract Based on the late Dr. Hyman Zimmerman’s observation that hepatocellular drug-induced liver injury (DILI) leading to jaundice carries a ≥ 10% fatality risk (coined as Hy’s law by others), evaluation of Drug-Induced Serious Hepatotoxicity (eDISH) continues to play a central role in the assessment of a study drug’s liability for acute hepatocellular DILI. The eDISH identifies drugs in clinical trials with DILI fatality (death or transplant) risk that may be unacceptable in a post-market setting. As a two-dimensional graph that plots peak total bilirubin (TB) versus peak serum aminotransferase levels for each patient during study drug or comparator treatment, eDISH identifies potential cases of acute, modest, and serious hepatocellular DILI for in-depth analysis of liver tests (LT) and clinical course so that the likelihood of causal association with the study drug can be determined. Unfortunately, the generalizable utility of this tool only pertains to trials enrolling patients with normal or near normal (NNN) baseline (BL) serum LTs. The eDISH does not necessarily apply to trials of patients with abnormal baseline (ABN-BL) LTs that often coincide with underlying liver disorders. Because drug development programs being reviewed by the FDA increasingly target liver disorders, we are often challenged to evaluate DILI risk in trials of patients with ABN-BL LTs. Also, the high background prevalence of metabolic dysfunction associated steatotic liver disease (MASLD) means patients with LTs above NNN may need to be enrolled in trials treating non-liver disorders to reflect the target population. Such study populations create challenges for industry and regulators because eDISH may not reliably categorize or identify potential cases of DILI for further analysis, as it so efficiently does in NNN-BL trials. We describe the main functionalities of eDISH in NNN-BL trials to understand what should be emulated by new tools or eDISH modifications. We then discuss non-eDISH–based plots that may be useful in ABN-BL trials.

Amirzadegan, Jasmine↗