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Non-alcoholic fatty liver disease (NAFLD) is gaining in importance and is linked to obesity. Especially,thedevelopmentoffibrosisandportalhypertensioninNAFLDpatientsrequirestreatment. Transgenic TGR(mREN2)27 rats overexpressing mouse renin spontaneously develop NAFLD with portal hypertension but without obesity. This study investigated the additional role of obesity in this model on the development of portal hypertension and fibrosis. Obesity was induced in twelve-week old TGR(mREN2)27 rats after receiving Western diet (WD) for two or four weeks. Liver fibrosis was assessed using standard techniques. Hepatic expression of transforming growth factor-β1 (TGF-β1), collagen type Iα1, α-smooth muscle actin, and the macrophage markers Emr1, as well as the chemoattractant Ccl2, interleukin-1β (IL1β) and tumor necrosis factor-α (TNFα) were analyzed. Assessment of portal and systemic hemodynamics was performed using the colored microsphere technique. Asexpected,WDinducedobesityandliverfibrosisasconfirmedbySiriusRedandOilRed O staining. The expression of the monocyte-macrophage markers, Emr1, Ccl2, IL1β and TNFα were increasedduringfeedingofWD,indicatinginfiltrationofmacrophagesintotheliver,eventhoughthis increase was statistically not significant for the EGF module-containing mucin-like receptor (Emr1) mRNA expression levels. Of note, portal pressure increased with the duration of WD compared to animals that received a normal chow. Besides obesity, WD feeding increased systemic vascular resistance reflecting systemic endothelial and splanchnic vascular dysfunction. We conclude that transgenic TGR(mREN2)27 rats are a suitable model to investigate NAFLD development with liver fibrosis and portal hypertension. Tendency towards elevated expression of Emr1 is associated with macrophage activity point to a significant role of macrophages in NAFLD pathogenesis, probably due to a shift of the renin–angiotensin system towards a higher activation of the classical pathway. The hepatic injury induced by WD in TGR(mREN2)27 rats is suitable to evaluate different stages of fibrosis and portal hypertension in NAFLD with obesity.
Acute‐on‐chronic liver failure (ACLF) is a syndrome with high short‐term mortality. Precipitating events, including hemorrhage and infections, contribute to ACLF development, but the role of surgery remains unknown. We investigated the development of ACLF in patients with cirrhosis undergoing surgery. In total, 369 patients with cirrhosis were included in the study. The clinical and laboratory data were collected prior to and on days 1‐2, 3‐8, and 9‐28, and at 3 and 12 months after surgery. Surgery type was classified as limited or extensive, as well as liver and nonliver surgery. A total of 39 patients had baseline ACLF. Surgery was performed during acute decompensation in 35% of the rest of the 330 patients, and 81 (24.5%) developed ACLF within 28 days after surgery. Surrogate markers of systemic inflammation were similar in patients who developed ACLF or not. Age, sex, serum sodium, baseline bacterial infection, and abdominal nonliver surgery were independent predictors for the development of ACLF after surgery. Patients who developed ACLF within 28 days after surgery had a higher mortality at 3, 6, and 12 months. Survival did not differ between patients with ACLF at surgery and those developing ACLF after surgery. Development of ACLF within 28 days after surgery and elevated alkaline phosphatase and international normalized ratio were independent predictors of 90‐day mortality. Independent predictors of 1‐year all‐cause mortality were alkaline phosphatase, Model for End‐Stage Liver Disease score, and preoperative hepatic encephalopathy, whereas nonliver surgery was associated with improved survival. ACLF frequently develops in patients with cirrhosis undergoing surgery, especially in those with active bacterial infection, lower serum sodium, and kidney or coagulation dysfunction. Prognoses of ACLF both at and after surgery are similarly poor. Patients with cirrhosis should be carefully managed perioperatively.
Evaluating model fit in nonlinear multilevel structural equation models (MSEM) presents a challenge as no adequate test statistic is available. Nevertheless, using a product indicator approach a likelihood ratio test for linear models is provided which may also be useful for nonlinear MSEM. The main problem with nonlinear models is that product variables are non-normally distributed. Although robust test statistics have been developed for linear SEM to ensure valid results under the condition of non-normality, they have not yet been investigated for nonlinear MSEM. In a Monte Carlo study, the performance of the robust likelihood ratio test was investigated for models with single-level latent interaction effects using the unconstrained product indicator approach. As overall model fit evaluation has a potential limitation in detecting the lack of fit at a single level even for linear models, level-specific model fit evaluation was also investigated using partially saturated models. Four population models were considered: a model with interaction effects at both levels, an interaction effect at the within-group level, an interaction effect at the between-group level, and a model with no interaction effects at both levels. For these models the number of groups, predictor correlation, and model misspecification was varied. The results indicate that the robust test statistic performed sufficiently well. Advantages of level-specific model fit evaluation for the detection of model misfit are demonstrated.
A new method of measuring quality factors in cavities is presented. This method is well suited to measure quality factors in undamped cavities as well as in heavily damped cavities, and in addition this method provides a possibility of separating modes and measuring quality factors especially in cases of overlapping modes. Measurements have been carried out on HOM-damped cavities for the DESY/THD linear collider project. Results are presented.
Determination of field strength and quality factor of heavily HOM damped accelerator cavities
(1992)
Two methods of of measuring field strength in accelerator cavities, heavily damped with respect to higher order modes (HOM), are presented. From the results of the field measurements the coupling (damping) factor and thus the quality factor of the damped resonator can be derived. Measurements of a pillbox resonator with heavily damped TM110-mode (Q < 20) demonstrate the usefulness of the techniques presented, even in this extreme range.
Damping cells for the higher order modes are necessary for the S-band linear collider to minimize BBU (Beam-Break-Up). The construction of the damper cells has to take into account the different field geometries of the higher order modes. So two different types of dampers have been designed: a wall slotted an an iris slotted cell. In order to optimize the two types of damping cells with respect to damping strength, impedance matching between coupling system and waveguide dampers and between damping cell and undamped cells and the tuning system, damping cells of both types have been built and examinated.
The effect of a single HOM-damper cell within a channel of undamped cells is described theoretically using an equivalent circuit model. From this a simple equation can be derived which relates the Q-value of the single damping-cell, the bandwidth of the passband under consideration, and the additional phase shift which is introduced by the damper cell to provide energy flow into the damper cell. This equation immediately shows the limitations of such single cell damping systems. Comparisons with experimental results are shown.
By replacing the irises in an electron linac by a slit one gets a structure capable of focussing/defocussing an electron beam (rf-quadrupoles). Therefore one can think of a combination of rf- and conventional magnetic quadrupoles for transversal focussing in linear-colliders. Furthermore they can meet the demands of BNS-damping without initial energy spread. Considering multibunch-operation of a collider, the long-range wake behaviour of this kind of structure has to be investigated. A three-cell structure has been built and investigated for dipole-type transversal long-range wakes. The experimental results are compared to numerical simulations done with MAFIA.