Background
Enhanced liver fibrosis (ELF) score is an accurate, noninvasive test for assessing the severity of liver fibrosis in chronic liver disease, including alcohol‐related liver disease. ...However, whether the ELF score changes during alcohol withdrawal is unknown. This pilot study assessed changes in the ELF score during withdrawal in patients with a history of excessive alcohol intake.
Methods
In this prospective study, ELF was performed on day 0 (D0, at the beginning of hospitalization), at day 7 (D7, on discharge from hospital), and at follow‐up visits on days 30 (D30) and 90 (D90). Transient elastography (TE) was also assessed on days 4 (D4) and D30.
Results
The study included 35 patients (71% male) with a mean alcohol intake of 139 g/day. On D30 and D90, 8 and 13 patients had resumed alcohol consumption (mean intake of 90 and 80 g/day, respectively). In patients who remained abstinent, the mean ELF score was 8.93 on D0, 9.14 on D30 (p = 0.32), and 9.27 on D90 (p = 0.14). In patients who resumed alcohol, mean ELF score was 9.7 on D0, 10.05 on D30 (p = 0.09), and 9.71 on D90 (p = 0.12). ELF score was comparable over the first months after withdrawal, although there was a slight increase in the first week (mean ELF score increased from 9.24 on D0 to 9.74 on D7, p < 0.001). Mean TE value was 7.9 kPa on D4 and 8.1 kPa on D30 (p = 0.84) in patients who resumed alcohol consumption, and 8.3 and 7.5 kPa (p = 0.03) on D4 and D30, respectively, in abstinent patients.
Conclusion
The ELF score is stable during the first months after withdrawal and thus appears to be a useful tool to assess liver fibrosis or cirrhosis in this setting. Nevertheless, because in the first week there is a transient increase in ELF score, caution in interpretation is warranted.
This study examined the evolution of Enhanced Liver Fibrosis (ELF) score, which is a non‐invasive test to assess liver fibrosis, during alcohol withdrawal in patients with a history of excessive alcohol intake. We showed that ELF score is broadly stable during the first three months of alcohol withdrawal and could be a useful tool to assess liver fibrosis in this situation, more precise than transient elastography which is known to decrease during this period.
Radiomics is a discipline that involves studying medical images through their digital data. Using "artificial intelligence" algorithms, radiomics utilizes quantitative and high-throughput analysis of ...an image's textural richness to obtain relevant information for clinicians, from diagnosis assistance to therapeutic guidance. Exploitation of these data could allow for a more detailed characterization of each phenotype, for each patient, making radiomics a new biomarker of interest, highly promising in the era of precision medicine. Moreover, radiomics is non-invasive, cost-effective, and easily reproducible in time. In the field of oncology, it performs an analysis of the entire tumor, which is impossible with a single biopsy but is essential for understanding the tumor's heterogeneity and is known to be closely related to prognosis. However, current results are sometimes less accurate than expected and often require the addition of non-radiomics data to create a performing model. To highlight the strengths and weaknesses of this new technology, we take the example of hepatocellular carcinoma and show how radiomics could facilitate its diagnosis in difficult cases, predict certain histological features, and estimate treatment response, whether medical or surgical.
Cultures of energy Strauss, Sarah; Rupp, Stephanie; Love, Thomas
2013, 20160616, 2016-06-16, 20130101
eBook
This path-breaking volume explores cultures of energy, the underlying but under-appreciated dimensions of both crisis and innovation in resource use around the globe. Theoretical chapters situate ...pressing energy issues in larger conceptual frames, and ethnographic case studies reveal energy as it is imagined, used, and contested in a variety of cultural contexts. Contributors address issues including the connection between resource flows and social relationships in energy systems; cultural transformation and notions of progress and collapse; the blurring of technology and magic; social tensions that accompany energy contraction; and sociocultural changes required in affluent societies to reduce dependence on fossil fuels. Each of five thematic sections concludes with an integrative and provocative conversation among the authors. The volume is an ideal tool for teaching unique, contemporary, and comparative perspectives on social theories of science and technology in undergraduate and graduate courses.
: Esophagectomy is recommended after endoscopic resection of an early esophageal cancer when pejorative histoprognostic criteria indicate a high risk of lymph node involvement. Our aim was to analyze ...the clinical outcomes of a non-surgical, organ preserving management in this clinical setting.
: This retrospective study was performed in two tertiary centers from 2015 to 2020. Patients were included if they had histologically complete resection of an early esophageal cancer, with poor differentiation, lymphovascular invasion or deep submucosal invasion. Endoscopic resection was followed by chemoradiotherapy or follow-up in case of surgical contraindications or patient refusal. Outcome measures were disease-free survival (DFS), overall survival (OS), cancer specific survival (CSS) and toxicity of chemoradiotherapy.
: Forty-one patients (36 with squamous cell carcinoma and 5 with adenocarcinomas) were included. The estimated high risk of lymph node involvement was based on poor differentiation (10/41; 24%), lympho-vascular invasion (11/41; 27%), muscularis mucosa invasion or deep sub-mucosal invasion (38/41; 93%). Thirteen patients (13/41; 32%) were closely monitored, and 28 (28/41; 68%) were treated by chemoradiotherapy or radiotherapy alone. In the close follow-up group, DFS, OS and CSS were 92%, 92% and 100%, respectively vs. 75%, 79% and 96%, respectively in the chemoradiotherapy group at the end of the follow-up. Serious adverse events related to chemoradiotherapy occurred in 10% of the patients. There were no treatment-related deaths.
: Our study shows that close follow-up may be an alternative to systematic esophagectomy after endoscopic resection of early esophageal cancer with a predicted high risk of lymph node involvement.
The new FNAL g-2 experiment is based on the muon storage ring previously used at BNL. The 1.45 T dipole magnetic field in the storage ring is required to have very high (1 ppm) homogeneity. The muon ...beam injected into the ring must be transported through the magnet yoke and the main superconducting coil cryostat with minimal distortions. The old inflector magnet shielded the main dipole fringe field inside the muon transport beam pipe, with an outer NbTi superconducting screen, and did not disturb the field in the area of circulating beam. Nevertheless, this magnet had coils with closed ends in which a large fraction of muon beam particles were lost. A new magnet is envisioned utilizing the same cross section as the original with open ends for improved beam transport. A model magnet has been wound utilizing 3D printed parts to verify the magnetic behavior of the magnet at room temperature and validate winding of the complicated geometry required for the magnet ends. Room temperature magnetic measurements have been performed and confirm the magnetic design.
The future High Luminosity upgrade of the Large Hadron Collider (HL-LHC) at CERN will include the low-beta inner triplets (Q1, Q2a/b, Q3) for two LHC insertion regions. The Q1, Q3 components consist ...of eight 10 m-long LMQXFA cryo-assemblies fabricated by the HL-LHC Accelerator Upgrade Project. Each LMQXFA Cold mass contains two Nb3Sn magnets connected in series. A stainless-steel shell is welded around the two magnets before the insertion into the cryostat. There is a limit on how much coil preload increase induced by the shell welding is allowed. Distributed Rayleigh backscattering fiber optics sensors were used for the first time to obtain a strain map over a wide area of a Nb3Sn magnet cold mass shell. Data were collected during welding of the first LMQXFA cold mass and the results confirm that the increase of the coil pole azimuthal pre-stress after welding do not exceed requirements.
Fermilab is fabricating ten full length cold masses for the high-luminosity Large Hadron Collider Accelerator Upgrade Project (HL-LHC AUP). One practice assembly and one pre-series assembly have been ...completed. This paper summarizes the con-struction details. Topics include incoming inspection, bus assembly, component machining, shell forming, beam tube insertion, bus expansion loop installation, instrumentation installation, electrical testing, heat exchanger installation and final assembly welding. In-process surveys, alignment measurements and testing are presented and explained. Problems encountered during construction and their solutions are discussed.
The Mu2e experiment at Fermilab is designed to search for charged-lepton flavor violation by looking for muon to electron conversions in the field of the nucleus. The concept of the experiment is to ...generate a low momentum muon beam, stopping the muons in a target and measuring the momentum of the outgoing electrons. The implementation of this approach utilizes a complex magnetic field composed of graded solenoidal and toroidal fields. Monitoring coil movements of the solenoids during cool down and magnet excitation and cool down is needed. A novel design of a Cold Mass Position Monitor System (CMPS) that will be implemented for the Mu2e experiment has been developed and a prototype CMPS has been built and tested. This paper describes the Mu2e Solenoid System CMPS including the description of the calibration, mounting effort and the CMPS DAQ.
The Deep Underground Neutrino Experiment (DUNE) formed a near detector design group (NDDG) which was tasked with delivering a CDR by the end of 2019. The DUNE Near Detectors will be housed in an ...underground hall on the Fermilab site. The two main detector systems are a liquid argon detector and a high-pressure gas time projection chamber (HPgTPC). The HPgTPC requires a magnet that generates a 0.5 T solenoidal magnetic field in a large volume of 6 m diameter, and 5 m length. In this paper, we present a superconducting magnet system design. We investigated: an open air core magnet with three coils, and a five-coil s system having two active fringe field shielding coils. Coils positions were optimized to obtain the specified field homogeneity in the magnet good field region, while minimizing the Lorentz forces and the superconductor volume. We discuss the magnetic, mechanical, and thermal conceptual designs.
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