Portal vein thrombosis (PVT) may occur at any time following liver transplantation. We describe our experience with portal vein recanalization in cases of thrombosis after liver transplantation. ...Twenty‐eight children (5%) out of 566 liver transplant recipients underwent portal vein recanalization using a transmesenteric approach. All children received left hepatic segments, developed PVT, and had symptoms or signs of portal hypertension. Portal vein recanalization was performed via the transmesenteric route in all cases. Twenty‐two (78.6%) patients underwent successful recanalization and stent placement. They received oral anticoagulants after the procedure, and clinical symptoms subsided. Symptoms recurred due to portal vein restenosis/thrombosis in seven patients. On an intention‐to‐treat basis, the success rate of the proposed treatment was 60.7%. Only 17 out of 28 children with posttransplant chronic PVT retained stent patency (primary + assisted) at the end of the study period. In cases of portal vein obstruction, the transmesenteric approach via minilaparotomy is technically feasible with good clinical and hemodynamic results. It is an alternative procedure to reestablish the portal flow to the liver graft that can be performed in selected cases and a therapeutic addition to other treatment strategies currently used to treat chronic PVT.
The authors demonstrate the long‐term outcomes of portal vein recanalization with stent placement using a transmesenteric approach in cases of chronic portal vein thrombosis after pediatric liver transplantation.
Atopic dermatitis (AD) therapeutic approach calls for a long‐term treatment. Treatment options for AD have recently undergone a revolutionary change by the introduction of the first biologic drug. ...Availability in daily practice of the last version of international AD guidelines, taking peculiarities of the country into account, can contribute to good clinical practice in Italy. To adapt European Dermatology Forum (EDF) guidelines for AD to the Italian medical–legal context, the EDF guidelines were assessed independently by two independent Italian renowned experts in the field and further integrated with articles published and systematically reviewed before May 2019. The first draft was collegially corrected and updated by the members of the SIDEMAST, ADOI, and SIDAPA. Recommendation levels (A; B; C; D) were graded based on the evidence levels (1–4). The adapted guidelines presented here focus on topical and systemic therapies in AD patients, both children and adults. As opposed to previous Italian guidelines, they include indications about biologics. New relevant evidence available from very recent literature and peculiarities of the Italian medical and legal context have been integrated in the revision process. If compared to general guidelines for AD not adapted to a specific national and cultural context, a revision for specific Italian needs is now available: It comprises the option of implementing the new biologic treatments and is likely to provide an important contribution to the improvement of clinical practice in Italy. Cooperation between patients, dermatologists, allergologists, and pediatricians remains mandatory in AD management. The authors of the present revision recommend an update of the Italian guidelines to be performed at least every second year.
Resistive Plate Chamber detectors are largely used in current High Energy Physics experiments, typically operated in avalanche mode with large fractions of Tetrafluoroethane (C2H2F4), a gas recently ...banned by the European Union due to its high Global Warming Potential (GWP). An intense R&D activity is ongoing to improve RPC technology in view of future HEP applications. In the last few years the RPC EcoGas@GIF++ Collaboration has been putting in place a joint effort between the ALICE, ATLAS, CMS, LHCb/SHiP and EP-DT Communities to investigate the performance of present and future RPC generations with eco-friendly gas mixtures. Detectors with different layout and electronics have been operated with ecological gas mixtures, with and without irradiation at the CERN Gamma Irradiation Facility (GIF++). Results of these performance studies together with plans for an aging test campaign are discussed in this article.
The CMS Barrel resistive plate chambers quality tests are performed at three different sites (Bari, Pavia and Sofia), where equivalent software and hardware tools are used. Data from the first 210 ...detectors are available for a comprehensive analysis. The paper describes the general experimental set-up, the test procedure and the cosmic muon test results. The muon trajectory reconstruction algorithm, used for precise studies, is presented. The criteria to accept or reject a detector are also given. The CMS final-design chambers show an average efficiency greater than 95%.
Performances of the Gas Gain Monitoring system of the CMS RPC muon detectors after one year of operation at the scaled down closed loop recirculation gas system are presented. The GGM is made of 12 ...single-gap RPC's arranged in a cosmic ray telescope, with charge readout for online monitoring of working point. Preliminary results on sensitivity to gas changes and to environmental variables will be reported on.
Several small single gap Resistive Plate Chambers and two RB1 CMS final stations have been exposed during the last year at the CERN Gamma Irradiation Facility to study possible long-term ageing ...effects. Up to now, an integrated charge of about 0.05C/(cm2gap) and 0.025 C/(cm2 gap) has been accumulated for the small RPCs and the large RB1 stations, respectively. Current, rate, fast charge and efficiency have been continuously monitored with muon beam or cosmics. Results concerning operation with a moisty mixture are also reported.
Abstract How are rainforest photosynthesis and turbulent fluxes influenced by clouds? To what extent are clouds affected by local processes driven by rainforest energy, water and carbon fluxes? These ...interrelated questions were the main drivers of the intensive field experiment CloudRoots-Amazon22 which took place at the ATTO/Campina supersites in the Amazon rainforest during the dry season, in August 2022. CloudRoots-Amazon22 collected observational data to derive cause-effect relationships between processes occurring at the leaf-level up to canopy scales in relation to the diurnal evolution of the clear-to-cloudy transition. First, we studied the impact of cloud and canopy radiation perturbations on the sub-diurnal variability of stomatal conductance. Stoma opening is larger in the morning, modulated by the cloud optical thickness. Second, we combined 1 Hz-frequency measurements of the stable isotopologues of carbon dioxide and water vapor with measurements of turbulence to determine carbon dioxide and water vapor sources and sinks within the canopy. Using scintillometer observations, we inferred 1-minute sensible heat flux that responded within minutes to the cloud passages. Third, collocated profiles of state variables and greenhouse gases enabled us to determine the role of clouds in vertical transport. We then inferred, using canopy and upper-atmospheric observations and a parameterization, the cloud cover and cloud mass flux to establish causality between canopy and cloud processes. This shows the need of comprehensive observational set to improve weather and climate model representations. Our findings contribute to advance our knowledge of the coupling between cloudy boundary layers and primary carbon productivity of the Amazon rainforest.
In the CERN CMS experiment at LHC Collider special trigger signals called
Technical Triggers will be used for the purpose of test and calibration. The Resistive Plate Chambers (RPC) based Technical ...Trigger system is a part of the CMS muon trigger system and is designed to detect cosmic muon tracks. It is based on two boards, namely RBC (RPC Balcony Collector) and TTU (Technical Trigger Unit). The proposed tracking algorithm (TA) written in VHDL and implemented in the TTU board detects single or multiple cosmic muon tracks at every bunch crossing along with their track lengths and corresponding chamber coordinates. The TA implementation in VHDL and its preliminary simulation results are presented.
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