Psoas Sarcopaenia Outcomes in Elderly Patients After Acute Lower Gastrointestinal Bleeding.

Introduction Sarcopaenia has been examined as a predictor of frailty in surgical patients and may predict mortality. The hypothesis of this study is that sarcopaenia is associated with an increased risk of death following an episode of acute lower gastrointestinal bleeding (ALGB). Methods This study included patients admitted with ALGB between January 2017 and June 2022, who underwent cross-sectional imaging (CSI).

The impact of low-mode symmetry on inertial fusion energy output in the burning plasma state.

Indirect Drive Inertial Confinement Fusion Experiments on the National Ignition Facility (NIF) have achieved a burning plasma state with neutron yields exceeding 170 kJ, roughly 3 times the prior record and a necessary stage for igniting plasmas. The results are achieved despite multiple sources of degradations that lead to high variability in performance. Results shown here, for the first time, include an empirical correction factor for mode-2 asymmetry in the burning plasma regime in addition to previously determined corrections for radiative mix and mode-1.

National Diagnostic Working Group (NDWG) for inertial confinement fusion (ICF)/high-energy density (HED) science: The whole exceeds the sum of its parts.

The National Diagnostic Working Group (NDWG) has led the effort to fully exploit the major inertial confinement fusion/high-energy density facilities in the US with the best available diagnostics. These diagnostics provide key data used to falsify early theories for ignition and suggest new theories, recently leading to an experiment that exceeds the Lawson condition required for ignition. The factors contributing to the success of the NDWG, collaboration and scope evolution, and the methods of accomplishment of the NDWG are discussed in this Review.

Neutron time of flight (nToF) detectors for inertial fusion experiments.

Neutrons generated in Inertial Confinement Fusion (ICF) experiments provide valuable information to interpret the conditions reached in the plasma. The neutron time-of-flight (nToF) technique is well suited for measuring the neutron energy spectrum due to the short time (100 ps) over which neutrons are typically emitted in ICF experiments. By locating detectors 10s of meters from the source, the neutron energy spectrum can be measured to high precision.

First UK patient cohort treated with stereotactic ablative radiotherapy for primary kidney cancer.

Aims: Stereotactic ablative radiotherapy (SABR) for primary renal cell carcinoma (RCC) is a promising non-invasive ablative treatment option. A prospective interventional clinical trial published showed that treatment was feasible and well tolerated. We present the first single-institution UK cohort of patients with primary RCC receiving protocol-based SABR with prospective follow-up.

Design of the high-yield time-gated x-ray hot-spot imager for OMEGA.

Time-resolved x-ray self-emission imaging of hot spots in inertial confinement fusion experiments along several lines of sight provides critical information on the pressure and the transient morphology of the hot spot on the University of Rochester's OMEGA Laser System. At least three quasi-orthogonal lines of sight are required to infer the tomographic information of the hot spots of deuterium-tritium cryogenic layered implosions. OMEGA currently has two time-gated x-ray hot-spot imagers: the time-resolved Kirkpatrick-Baez x-ray microscope and the single-line-of-sight, time-resolved x-ray imager (SLOS-TRXI).

Constraining time-dependent ion temperature measurements in inertial confinement fusion (ICF) implosions with an intermediate distance neutron time-of-flight (nToF) detector.

A concept for using an intermediate distance (0.3-3.0 m) neutron time-of-flight (nToF) to provide a constraint on the measurement of the time-dependence of ion temperature in inertial confinement fusion implosions is presented.

A 2-4 keV multilayer mirrored channel for the NIF Dante system.

During inertial confinement fusion experiments at the National Ignition Facility (NIF), a capsule filled with deuterium and tritium (DT) gas, surrounded by a DT ice layer and a high-density carbon ablator, is driven to the temperature and densities required to initiate fusion. In the indirect method, 2 MJ of NIF laser light heats the inside of a gold hohlraum to a radiation temperature of 300 eV; thermal x rays from the hohlraum interior couple to the capsule and create a central hotspot at tens of millions degrees Kelvin and a density of 100-200 g/cm. During the laser interaction with the gold wall, m-band x rays are produced at ∼2.

Design of a multi-detector, single line-of-sight, time-of-flight system to measure time-resolved neutron energy spectra.

In the dynamic environment of burning, thermonuclear deuterium-tritium plasmas, diagnosing the time-resolved neutron energy spectrum is of critical importance. Strategies exist for this diagnosis in magnetic confinement fusion plasmas, which presently have a lifetime of ∼10 longer than inertial confinement fusion (ICF) plasmas. Here, we present a novel concept for a simple, precise, and scale-able diagnostic to measure time-resolved neutron spectra in ICF plasmas.

Performance of a hardened x-ray streak camera at Lawrence Livermore National Laboratory's National Ignition Facility.

Electron tubes continue to provide the highest speeds possible for recording dynamics of hot high-energy density plasmas. Standard streak camera drive electronics and CCD readout are not compatible with the radiation environment associated with high DT fusion yield inertial confinement fusion experiments >10 14 MeV DT neutrons or >10 n cm ns. We describe a hardened x-ray streak camera developed for the National Ignition Facility and present preliminary results from the first experiment on which it has participated, recording the time-resolved bremsstrahlung spectrum from the core of an inertial confinement fusion implosion at more than 40× the operational neutron yield limit of the previous National Ignition Facility x-ray streak cameras.

Phased plan for the implementation of the time-resolving magnetic recoil spectrometer on the National Ignition Facility (NIF).

The time-resolving magnetic recoil spectrometer (MRSt) is a transformative diagnostic that will be used to measure the time-resolved neutron spectrum from an inertial confinement fusion implosion at the National Ignition Facility (NIF). It uses a CD foil on the outside of the hohlraum to convert fusion neutrons to recoil deuterons. An ion-optical system positioned outside the NIF target chamber energy-disperses and focuses forward-scattered deuterons.

Hot Spot Evolution Measured by High-Resolution X-Ray Spectroscopy at the National Ignition Facility.

Evolution of the hot spot plasma conditions was measured using high-resolution x-ray spectroscopy at the National Ignition Facility. The capsules were filled with DD gas with trace levels of Kr and had either a high-density-carbon (HDC) ablator or a tungsten (W)-doped HDC ablator. Time-resolved measurement of the Kr Heβ spectra, absolutely calibrated by a simultaneous time-integrated measurement, allows inference of the electron density and temperature through observing Stark broadening and the relative intensities of dielectronic satellites.

Design of the ion-optics for the MRSt neutron spectrometer at the National Ignition Facility (NIF).

A new Magnetic Recoil Spectrometer (MRSt) is designed to provide time-resolved measurements of the energy spectrum of neutrons emanating from an inertial confinement fusion implosion at the National Ignition Facility. At present, time integrated parameters are being measured using the existing magnet recoil and neutron time-of-flight spectrometers. The capability of high energy resolution of 2 keV and the extension to high time resolution of about 20 ps are expected to improve our understanding of conditions required for successful fusion experiments.

A Case-Based Overview of the Role of Radiological Imaging in Emergency General Surgery.

This article aims to give an overview of some of the common conditions seen in emergency general surgery and the recommended choice of imaging. For junior doctors, choosing the correct imaging modality can be difficult so we aim to provide a summary of the evidence behind radiology for emergency general surgery. Four of the most important acute surgical conditions were chosen, alongside abdominal aortic aneurysm.

Burning plasma achieved in inertial fusion.

Obtaining a burning plasma is a critical step towards self-sustaining fusion energy. A burning plasma is one in which the fusion reactions themselves are the primary source of heating in the plasma, which is necessary to sustain and propagate the burn, enabling high energy gain. After decades of fusion research, here we achieve a burning-plasma state in the laboratory.

Observation of Hydrodynamic Flows in Imploding Fusion Plasmas on the National Ignition Facility.

Inertial confinement fusion implosions designed to have minimal fluid motion at peak compression often show significant linear flows in the laboratory, attributable per simulations to percent-level imbalances in the laser drive illumination symmetry. We present experimental results which intentionally varied the mode 1 drive imbalance by up to 4% to test hydrodynamic predictions of flows and the resultant imploded core asymmetries and performance, as measured by a combination of DT neutron spectroscopy and high-resolution x-ray core imaging. Neutron yields decrease by up to 50%, and anisotropic neutron Doppler broadening increases by 20%, in agreement with simulations.

Top-level physics requirements and simulated performance of the MRSt on the National Ignition Facility.

The time-resolving Magnetic Recoil Spectrometer (MRSt) for the National Ignition Facility (NIF) has been identified by the US National Diagnostic Working Group as one of the transformational diagnostics that will reshape the way inertial confinement fusion (ICF) implosions are diagnosed. The MRSt will measure the time-resolved neutron spectrum of an implosion, from which the time-resolved ion temperature, areal density, and yield will be inferred. Top-level physics requirements for the MRSt were determined based on simulations of numerous ICF implosions with varying degrees of alpha heating, P2 asymmetry, and mix.

The five line-of-sight neutron time-of-flight (nToF) suite on the National Ignition Facility (NIF).

Measurement of the neutron spectrum from inertial confinement fusion implosions is one of the primary diagnostics of implosion performance. Analysis of the spectrum gives access to quantities such as neutron yield, hot-spot velocity, apparent ion temperature, and compressed fuel ρr through measurement of the down-scatter ratio. On the National Ignition Facility, the neutron time-of-flight suite has been upgraded to include five independent, collimated lines of sight, each comprising a high dynamic range bibenzyl/diphenylacetylene-stilbene scintillator [R.

A novel injury site-natural antibody targeted complement inhibitor protects against lung transplant injury.

Complement is known to play a role in ischemia and reperfusion injury (IRI). A general paradigm is that complement is activated by self-reactive natural IgM antibodies (nAbs), after they engage postischemic neoepitopes. However, a role for nAbs in lung transplantation (LTx) has not been explored.

Evaluation of minimally invasive small intestinal exploration and targeted abdominal organ biopsy with use of a wound retraction device in dogs: 27 cases (2010-2017).

Objective: To describe surgical technique, biopsy sample quality, and short-term outcome of minimally invasive small intestinal exploration and targeted abdominal organ biopsy (MISIETB) with use of a wound retraction device (WRD) in dogs.

Animals: 27 client-owned dogs that underwent MISIETB with a WRD at 1 of 4 academic veterinary hospitals between January 1, 2010, and May 1, 2017.

Procedures: Medical records were retrospectively reviewed, and data collected included signalment; medical history; findings from physical, ultrasonographic, laparoscopic, cytologic, and histologic evaluations; surgical indications, procedures, duration, and complications; and short-term (14-day) outcomes.

The Crystal Backlighter Imager: A spherically bent crystal imager for radiography on the National Ignition Facility.

The Crystal Backlighter Imager (CBI) is a quasi-monochromatic, near-normal incidence, spherically bent crystal imager developed for the National Ignition Facility (NIF), which will allow inertial confinement fusion capsule implosions to be radiographed close to stagnation. This is not possible using the standard pinhole-based area-backlighter configuration, as the self-emission from the capsule hotspot overwhelms the backlighter signal in the final stages of the implosion. The CBI mitigates the broadband self-emission from the capsule hot spot by using the extremely narrow bandwidth inherent to near-normal-incidence Bragg diffraction.

Emphysema-associated Autoreactive Antibodies Exacerbate Post-Lung Transplant Ischemia-Reperfusion Injury.

Chronic obstructive pulmonary disease-associated chronic inflammation has been shown to lead to an autoimmune phenotype characterized in part by the presence of lung autoreactive antibodies. We hypothesized that ischemia-reperfusion injury (IRI) liberates epitopes that would facilitate preexisting autoantibody binding, thereby exacerbating lung injury after transplant. We induced emphysema in C57BL/6 mice through 6 months of cigarette smoke (CS) exposure.