Image-guided tumor ablation has become a well-established hallmark of local cancer therapy. The breadth of options available in this growing field increases the need for standardization of ...terminology and reporting criteria to facilitate effective communication of ideas and appropriate comparison among treatments that use different technologies, such as chemical (eg, ethanol or acetic acid) ablation, thermal therapies (eg, radiofrequency, laser, microwave, focused ultrasound, and cryoablation) and newer ablative modalities such as irreversible electroporation. This updated consensus document provides a framework that will facilitate the clearest communication among investigators regarding ablative technologies. An appropriate vehicle is proposed for reporting the various aspects of image-guided ablation therapy including classification of therapies, procedure terms, descriptors of imaging guidance, and terminology for imaging and pathologic findings. Methods are addressed for standardizing reporting of technique, follow-up, complications, and clinical results. As noted in the original document from 2003, adherence to the recommendations will improve the precision of communications in this field, leading to more accurate comparison of technologies and results, and ultimately to improved patient outcomes.
Rapid bifurcations in the plasma response to slowly varying n=2 magnetic fields are observed as the plasma transitions into and out of edge-localized mode (ELM) suppression. The rapid transition to ...ELM suppression is characterized by an increase in the toroidal rotation and a reduction in the electron pressure gradient at the top of the pedestal that reduces the perpendicular electron flow there to near zero. These events occur simultaneously with an increase in the inner-wall magnetic response. These observations are consistent with strong resonant field penetration of n=2 fields at the onset of ELM suppression, based on extended MHD simulations using measured plasma profiles. Spontaneous transitions into (and out of) ELM suppression with a static applied n=2 field indicate competing mechanisms of screening and penetration of resonant fields near threshold conditions. Magnetic measurements reveal evidence for the unlocking and rotation of tearinglike structures as the plasma transitions out of ELM suppression.
Density pumpout and edge-localized mode (ELM) suppression by applied n=2 magnetic fields in low-collisionality DIII-D plasmas are shown to be correlated with the magnitude of the plasma response ...driven on the high-field side (HFS) of the magnetic axis but not the low-field side (LFS) midplane. These distinct responses are a direct measurement of a multimodal magnetic plasma response, with each structure preferentially excited by a different n=2 applied spectrum and preferentially detected on the LFS or HFS. Ideal and resistive magneto-hydrodynamic (MHD) calculations find that the LFS measurement is primarily sensitive to the excitation of stable kink modes, while the HFS measurement is primarily sensitive to resonant currents (whether fully shielding or partially penetrated). The resonant currents are themselves strongly modified by kink excitation, with the optimal applied field pitch for pumpout and ELM suppression significantly differing from equilibrium field alignment.
Divertor detachment offers a promising solution to the challenge of plasma-wall interactions for steady-state operation of fusion reactors. Here, we demonstrate the excellent compatibility of ...actively controlled full divertor detachment with a high-performance (β
~ 3, H
~ 1.5) core plasma, using high-β
(poloidal beta, β
> 2) scenario characterized by a sustained core internal transport barrier (ITB) and a modest edge transport barrier (ETB) in DIII-D tokamak. The high-β
high-confinement scenario facilitates divertor detachment which, in turn, promotes the development of an even stronger ITB at large radius with a weaker ETB. This self-organized synergy between ITB and ETB, leads to a net gain in energy confinement, in contrast to the net confinement loss caused by divertor detachment in standard H-modes. These results show the potential of integrating excellent core plasma performance with an efficient divertor solution, an essential step towards steady-state operation of reactor-grade plasmas.
Active personal dosemeters (APD) have been found to be very efficient tools to reduce occupational doses in many applications of ionizing radiation. In order to be used in interventional radiology ...and cardiology (IR/IC), APDs should be able to measure low energy photons and pulsed radiation with relatively high instantaneous personal dose equivalent rates. A study concerning the optimization of the use of APDs in IR/IC was performed in the framework of the ORAMED project, a Collaborative Project (2008–2011) supported by the European Commission within its 7th Framework Program. In particular, eight commercial APDs were tested in continuous and pulsed X-ray fields delivered by calibration laboratories in order to evaluate their performances. Most of APDs provide a response in pulsed mode more or less affected by the personal dose equivalent rate, which means they could be used in routine monitoring provided that correction factors are introduced. These results emphasize the importance of adding tests in pulsed mode in type-test procedures for APDs. Some general recommendations are proposed in the end of this paper for the selection and use of APDs at IR/IC workplaces.
► Eight APDs were tested in continuous and pulsed X-ray fields in laboratory conditions. ► Most of APDs provide a correct response in continuous mode. ► Most of APDs provide a response in pulsed mode that can be affected by the personal dose equivalent rate. ► General recommendations are given to help in the selection and use of APDs at IR/IC workplaces.
We present precise photospheric parameters of 282 M dwarfs determined from fitting the most recent version of PHOENIX models to high-resolution CARMENES spectra in the visible (0.52–0.96
μ
m) and NIR ...wavelength range (0.96–1.71
μ
m). With its aim to search for habitable planets around M dwarfs, several planets of different masses have been detected. The characterization of the target sample is important for the ability to derive and constrain the physical properties of any planetary systems that are detected. As a continuation of previous work in this context, we derived the fundamental stellar parameters effective temperature, surface gravity, and metallicity of the CARMENES M-dwarf targets from PHOENIX model fits using a
χ
2
method. We calculated updated PHOENIX stellar atmosphere models that include a new equation of state to especially account for spectral features of low-temperature stellar atmospheres as well as new atomic and molecular line lists. We show the importance of selecting magnetically insensitive lines for fitting to avoid effects of stellar activity in the line profiles. For the first time, we directly compare stellar parameters derived from multiwavelength range spectra, simultaneously observed for the same star. In comparison with literature values we show that fundamental parameters derived from visible spectra and visible and NIR spectra combined are in better agreement than those derived from the same spectra in the NIR alone.
Summary
Background
Empiric triple therapy for Helicobacter pylori should be abandoned when clarithromycin resistance rate is >15–20%. Optimisation of triple therapy (high‐dose acid suppression and ...14‐day duration) can increase eradication rates by 10%.
Aim
To compare the efficacy and safety of optimised triple (OPT‐TRI) and nonbismuth quadruple concomitant (OPT‐CON) therapies.
Methods
Prospective multicentre study in 16 Spanish centres using triple therapy in clinical practice. In a 3‐month two‐phase fashion, the first 402 patients received an OPT‐TRI therapy esomeprazole (40 mg b.d.), amoxicillin (1 g b.d) and clarithromycin (500 mg b.d) for 14 days and the last 375 patients an OPT‐CON treatment OPT‐TRI therapy plus metronidazole (500 mg b.d).
Results
Seven‐hundred seventy‐seven consecutive patients were included (402 OPT‐TRI, 375 OPT‐CON). The OPT‐CON therapy achieved significantly higher eradication rates in the per‐protocol 82.3% (95% CI = 78–86%) vs. 93.8% (91–96%), P < 0.001 and intention‐to‐treat analysis 81.3% (78–86%) vs. 90.4% (87–93%), P < 0.001. Adverse events (97% mild/moderate) were significantly more common with OPT‐CON therapy (39% vs. 47%, P = 0.016), but full compliance with therapy was similar between groups (94% vs. 92%, P = 0.4). OPT‐CON therapy was the only significant predictor of successful eradication (odds ratio, 2.24; 95% CI: 1.48–3.51, P < 0.001). The rate of participating centres achieving cure rates ≥90% favoured OPT‐CON therapy (OPT‐TRI 25% vs. OPT‐CON 62%).
Conclusions
Empiric OPT‐CON therapy achieved significantly higher cure rates (>90%) compared to OPT‐TRI therapy. Addition of metronidazole to OPT‐TRI therapy increased eradication rates by 10%, resulting in more mild adverse effects, but without impairing compliance with therapy.
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