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IntroductionSystemic sclerosis (SSc) is associated with esophageal dysmotility. Autologous hematopoietic cell transplantation (HCT) results in improvement of skin tightness and lung function. Whether esophageal motility improves after HCT is unknown.MethodsEsophageal motility was studied using high-resolution esophageal manometry in 21 SSc patients before and at multiple time points after autologous HCT. Median posttransplant follow-up was 2 years (range, 6 months to 5 years).ResultsPrior to HCT, all 21 patients had abnormal motility—10 (48%) had unmeasurable and 11 (52%) had measurable peristalsis. Manometric diagnosis in the former 10 patients was “absent contractility” and in the latter 11 patients “ineffective esophageal motility (IEM).” After HCT, among the 10 patients with absent contractility, 9 continued to have absent contractility and one demonstrated weak measurable peristalsis. Of the 11 patients with IEM, 5 experienced SSc relapse, and 2 out of these 5 patients developed absent contractility. Among the 6 non-relapsed patients, 4 continued to have IEM, and 2 developed normal motility.ConclusionsHCT appears to have no beneficial effect on motility in patients with unmeasurable peristalsis. In patients with measurable peristalsis, HCT appears to stabilize and in some normalize motility, unless relapse occurs.Key Points• In patients with systemic sclerosis, esophageal dysmotility is a significant contributor to morbidity and so far, there has been no data describing the effects of hematopoietic cell transplantation on esophageal motility.• Our work demonstrated that in patients with systemic sclerosis and unmeasurable esophageal peristalsis prehematopoietic cell transplantation, there was no measurable beneficial effect of transplantation on esophageal motility.• In patients with systemic sclerosis and measurable peristalsis prehematopoietic cell transplantation, esophageal motility stabilized, except in relapsed patients.

It is well known that the imperfection of pulse power sources that drive the linear induction accelerators can lead to time-varying fluctuation in the accelerating voltages, which in turn leads to longitudinal emittance growth. We show that this source of emittance growth is correctable, even in space-charge dominated beams with significant transients induced by space-charge waves. Two correction methods are proposed, and their efficacy in reducing longitudinal emittance is demonstrated with three-dimensional particle-in-cell simulations.

Study design: Single-center retrospective study. Objectives: To evaluate the monitoring rate, sensitivity and specificity of intraoperative monitoring (IOM) during removal of intradural extramedullary (IDEM) or epidural metastatic spinal tumors. Also, to assess the efficacy of monitoring somatosensory-evoked potentials (SSEP) when motor-evoked potentials (MEP) are not measurable. Setting: The Neuro-Oncology Clinic, National Cancer Center, Korea. Methods: Patients ( n =101) with IDEM or epidural metastatic spinal tumors at the cord level underwent surgeries monitored with SSEP and/or MEP. The monitoring rate was defined as negative when MEP or SSEP could not be measured after reversal of the neuromuscular block under general anesthesia. Positive IOM changes included more than a 50% change in the MEP or SSEP amplitude and more than a 10% delay in SSEP latency. Results: MEP was measurable in 73% of patients. The MEP monitoring rate in patients with motor power grades of 3 or less was 39%, which was lower than that of SSEP (83%). The sensitivity, specificity and predictability of MEP for motor changes were 93, 90 and 91%, respectively. Conversely, the sensitivity, specificity and predictability of SSEP were 62, 97 and 89%, respectively. In patients in whom MEP was not measurable ( n =24), SSEP was monitored with a predictability of 83%. Conclusion: In cases of extramedullary spinal tumors, MEP shows a higher sensitivity than SSEP does. However, the monitoring rate of MEP in non-ambulatory patients was lower than that of SSEP. In those cases, SSEP can be useful to monitor for postoperative neurological deficits.

Assessing the degree to which fusion alpha particles contribute to the fusion yield is essential to understanding the onset of the thermal runaway process of thermonuclear ignition. It is shown that in inertial confinement fusion, the yield enhancement due to alpha particle heating (before ignition occurs) depends on the generalized Lawson parameter that can be inferred from experimental observables. A universal curve valid for arbitrary laser-fusion targets shows the yield amplification due to alpha heating for a given value of the Lawson parameter. The same theory is used to determine the onset of the burning plasma regime when the alpha heating exceeds the compression work. This result can be used to assess the performance of current ignition experiments at the National Ignition Facility.

We developed three-dimensional electrospun silk fibroin (ESF) scaffolds with controllable pore size. The purpose of this study was to evaluate ESF scaffolds with pores (P-ESF) for bone regeneration via in vitro and in vivo studies, with a comparison to a commercially available porous three-dimensional polylactic acid (PLA) scaffold. P-ESF supported significantly higher proliferation and alkaline phosphatase activity of osteoblasts than PLA in vitro ( p  < 0.05). Moreover, higher expression levels of activated adhesion-related proteins, including focal adhesion kinase, were observed in the P-ESF than in PLA, as confirmed by western blot analyses. Microcomputed tomography revealed that 78.30% of the original bone volume was attained in the P-ESF implantation group at 7 weeks after critical bone defect formation in rat calvaria. Comparatively, the PLA implantation group showed only 49.31%. Histological evaluation also showed new bone tissue formation upon P-ESF implantation. Taken together, the P-ESF scaffold may be a good bone substitute for bone regeneration.

Rivers of the Mackenzie Basin exhibit several seasonal flow patterns that include the nival (snowmelt dominated), proglacial (influenced by glacier melt), wetland, prolacustrine (below large lakes), and regulated flow regimes. The Mackenzie amalgamates and moderates these regimes to deliver spring peak flows, followed by declining summer discharge and low winter flows, to the Arctic Ocean. The mountainous sub-basins in the west (Liard, Peace, and northern mountains) contribute about 60% of the Mackenzie flow, while the interior plains and eastern Canadian Shield contribute only about 25%, even though the two regions have similar total areas (each occupying about 40% of the total Mackenzie Basin). The mountain zone is the dominant flow contributor to the Mackenzie in both high-flow and low-flow years. A case study of the Great Slave system demonstrates the effects of natural runoff, regulated runoff, and lake storage on streamflow, as well as the large year-to-year variability of lake levels and discharge. Despite a warming trend in the past three decades, annual runoff of the Mackenzie Basin has not changed. Significant warming at most climatic stations in April (and at some, also in May or June) could have triggered earlier snowmelt. The first day of hydrograph rise for the main trunk of the Mackenzie (seen as a proxy for breakup) has advanced by about three days per decade, though the trend was not statistically significant for the mountain rivers. Peak flows do not reveal any trend, but the arrival of the spring peaks has become more variable. More evidence is needed to interpret these flow phenomena properly. /// Les rivières du bassin du Mackenzie manifestent plusieurs modèles d'écoulement qui comprennent les régimes d'écoulement nival (dominé par la fonte des neiges), proglaciaire (influencé par la fonte glaciaire), de marécages, prolascustre (en aval de grands lacs) et régularisé. Le Mackenzie combine et modère ces régimes pour donner des débits de pointe au printemps, suivis d'un débit à la baisse en été, puis de faibles débits en hiver, en direction de l'océan Arctique. Les sous-bassins montagneux occidentaux (Liard, Peace et montagnes du Nord) contribuent pour environ 60 % au débit du Mackenzie, tandis que les plaines intérieures et le Bouclier canadien oriental ne contribuent que pour environ 25 %, même si les deux régions ont une superficie globale semblable (chacune occupant environ 40 % de la superficie totale du bassin du Mackenzie). La zone montagneuse apporte la contribution majeure au régime du Mackenzie, dans les années à fort débit comme dans celles à faible débit. Une étude de cas du réseau du Grand lac des Esclaves révèle l'impact sur le débit fluvial de l'écoulement naturel, de l'écoulement régularisé et de la hauteur d'eau dans le lac, ainsi que la grande variabilité d'une année sur l'autre du niveau et du débit des lacs. Malgré la tendance au réchauffement des trois dernières décennies, l'écoulement annuel du bassin du Mackenzie n'a pas changé. Un réchauffement notable enregistré à la plupart des stations climatiques en avril (et à certaines aussi en mai ou juin) pourrait avoir provoqué une fonte nivale précoce. Le premier jour où se manifeste l'augmentation du régime hydrique pour l'artère principale du Mackenzie (considéré comme un indicateur de la débâcle) a avancé d'environ trois jours par décennie, bien que statistiquement cette tendance ne soit pas significative pour les rivières de montagne. Les débits de pointe ne révèlent aucune tendance, mais l'arrivée des pics printaniers est devenue plus variable. Il faudrait des preuves supplémentaires pour interpréter correctement ces phénomènes d'écoulement.

Irradiating a small capsule containing deuterium and tritium fuel directly with intense laser light causes it to implode, which creates a plasma hot enough to initiate fusion reactions between the fuel nuclei. Here we report on such laser direct-drive experiments and observe that the fusion reactions produce more energy than the amount of energy in the central so-called hot-spot plasma. This condition is identified as having a hot-spot fuel gain greater than unity. A hot-spot fuel gain of around four was previously accomplished at the National Ignition Facility in indirect-drive inertial confinement fusion experiments where the capsule is irradiated by X-rays. In that case, up to 1.9 MJ of laser energy was used, but in contrast, our experiments on the OMEGA laser system require as little as 28 kJ. As the hot-spot fuel gain is predicted to grow with laser energy and target size, our work establishes the direct-drive approach to inertial fusion as a promising path towards burning and ignited plasmas in the laboratory. Additionally, we report a record (direct-drive) fusion yield of 0.9 kJ on OMEGA, which we achieved with thin-ice deuterium–tritium liner targets. Inertial confinement fusion experiments in a direct-drive configuration report more energy produced in deuterium–tritium fusion reactions than the amount of energy in the central part of the plasma created by laser irradiation of the fuel capsule.

Focussing laser light onto the surface of a small target filled with deuterium and tritium implodes it and leads to the creation of a hot and dense plasma, in which thermonuclear fusion reactions occur. In order for the plasma to become self-sustaining, the heating of the plasma must be dominated by the energy provided by the fusion reactions—a condition known as a burning plasma. A metric for this is the generalized Lawson parameter, where values above around 0.8 imply a burning plasma. Here, we report on hydro-equivalent scaling of experimental results on the OMEGA laser system and show that these have achieved core conditions that reach a burning plasma when the central part of the plasma, the hotspot, is scaled in size by at least a factor of 3.9 ± 0.10, which would require a driver laser energy of at least 1.7 ± 0.13 MJ. In addition, we hydro-equivalently scale the results to the 2.15 MJ of laser energy available at the National Ignition Facility and find that these implosions reach 86% of the Lawson parameter required for ignition. Our results support direct-drive inertial confinement fusion as a credible approach for achieving thermonuclear ignition and net energy in laser fusion. Hydro-equivalent scaling of recent direct-drive inertial confinement fusion implosions shows that a burning plasma can be achieved with a higher laser energy.

Climate has been proposed conventionally as the primary factor that determines periglacial river activity (aggradation) and pattern (braided). This concept does not explain the rich diversity in river patterns and morphological processes in both the present and past periglacial environments: besides braided rivers and sandur, meandering, anabranching, transitional and deltaic rivers also occur. A first attempt is made to combine past and present periglacial river types with regard to their morphology, processes and environments. The processes that control river energy and morphology are discussed especially for periglacial conditions. This approach permits an assessment of the responses of periglacial rivers to climatic conditions and the modulation of the responses due to changes in the basin properties. Examples drawn from palaeo- and present-day periglacial rivers and environments demonstrate that there is no unique type of periglacial river but rather an azonal fluvial system with a number of periglacial variants.

The MacKenzie Global Energy and Water Cycle Experiment (GEWEX) Study, Phase 1, seeks to improve understanding of energy and water cycling in the Mackenzie River basin (MRB) and to initiate and test atmospheric, hydrologic, and coupled models that will project the sensitivity of these cycles to climate change and to human activities. Major findings from the study are outlined in this paper. Absorbed solar radiation is a primary driving force of energy and water, and shows dramatic temporal and spatial variability. Cloud amounts feature large diurnal, seasonal, and interannual fluctuations. Seasonality in moisture inputs and outputs is pronounced. Winter in the northern MRB features deep thermal inversions. Snow hydrological processes are very significant in this high-latitude environment and are being successfully modeled for various landscapes. Runoff processes are distinctive in the major terrain units, which is important to overall water cycling. Lakes and wetlands compose much of MRB and are prominent as hydrologic storage systems that must be incorporated into models. Additionally, they are very efficient and variable evaporating systems that are highly sensitive to climate variability. Mountainous high-latitude subbasins comprise a mosaic of land surfaces with distinct hydrological attributes that act as variable source areas for runoff generation. They also promote leeward cyclonic storm generation. The hard rock terrain of the Canadian Shield exhibits a distinctive energy flux regimen and hydrologic regime. The MRB has been warming dramatically recently, and ice breakup and spring outflow into the Polar Sea has been occurring progressively earlier. This paper presents initial results from coupled atmospheric-hydrologic modeling and delineates distinctive cold region inputs needed for developments in regional and global climate modeling.