Background

Two-dimensional magnetic resonance elastography (2D-MRE) is an advanced magnetic resonance method with high diagnostic accuracy for predicting advanced fibrosis in non-alcoholic fatty liver disease (NAFLD) patients. However, no prospective, head-to-head comparisons between 2D-MRE and clinical prediction rules (CPRs) have been performed in patients with biopsy-proven NAFLD.

Aim

To compare the diagnostic utility of 2D-MRE against that of eight CPRs (AST:ALT ratio, APRI, BARD, FIB-4, NAFLD Fibrosis Score, Bonacini cirrhosis discriminant score, Lok Index and NASH CRN model) for predicting advanced fibrosis in a prospective cohort with paired liver biopsy as the gold standard.

Methods

This is a cross-sectional analysis of a prospective study of 102 patients (58.8% women) with biopsy-proven NAFLD, 2D-MRE and clinical research assessment within 90 days of biopsy. Receiver operating characteristic (ROC) analysis was performed to assess the performance of 2D-MRE and CPRs for predicting advanced fibrosis.

Results

The mean (±s.d.) age and BMI were 51.3 (±14.0) years and 31.7 (±5.5) kg/m(2) respectively. 48, 26, 9, 13 and 6 patients had stage 0, 1, 2, 3 and 4 fibrosis respectively. The area under ROC curve (AUROC) was 0.957 for 2D-MRE and between 0.796 and 0.861 for the CPRs. FIB-4 was the best-performing CPR at predicting advanced fibrosis with AUROC of 0.861. In head-to-head comparisons using the DeLong test, 2D-MRE had significantly better AUROC (P < 0.05) than each CPR for predicting advanced fibrosis.

Conclusion

Compared to clinical prediction rules, 2D-MRE provides significantly higher accuracy for the diagnosis of advanced fibrosis in NAFLD patients.

Background

Pentraxin-2 (PTX-2), a serum protein, inhibits inflammation and fibrosis, and recombinant PTX-2 is being tested as an anti-fibrotic agent.

Aim

To evaluate the association between serum PTX-2 levels and fibrosis stage in patients with non-alcoholic fatty liver disease (NAFLD).

Methods

Serum pentraxin-2 levels were compared between four groups of well-characterised patients including NAFLD with no fibrosis, NAFLD with mild-moderate fibrosis (stage 1-2), NAFLD with advanced fibrosis (stage 3-4), and age-sex matched non-NAFLD controls.

Results

Sixty subjects were included in the study. The mean age was 58.9 years, 68% were male and 58% were Caucasian. In univariate analysis, serum PTX-2 levels significantly decreased from non-NAFLD controls to mild NAFLD with no fibrosis, to NAFLD with mild-moderate fibrosis and were lowest in patients with NAFLD and advanced fibrosis, in a dose-dependent manner (P < 0.0001). In multivariable-adjusted analyses controlling for age, sex, albumin, and CRP, the results remained consistent and statistically significant. Serum PTX-2 level had an AUROC of 0.84 (95% CI: 0.71-0.97) for the diagnosis of NAFLD, and an AUROC of 0.77 (95% CI: 0.65-0.90) for the diagnosis of advanced fibrosis in NAFLD. Serum PTX-2 levels also decreased with increasing liver stiffness as estimated by magnetic resonance elastography (r = -0.31, P = 0.02).

Conclusions

PTX-2 levels are significantly lower in patients with NAFLD compared to non-NAFLD controls, and decline further in patients with advanced fibrosis. PTX-2 may therefore be both a biomarker of disease and a potential target for anti-fibrotic therapy with the recombinant pentraxin-2.

High-accuracy metrology is vitally important in manufacturing ultra-high-quality free-form mirrors designed to manipulate X-ray light with nanometer-scale wavelengths. However, surface topography measurements are instrument dependent, and without the knowledge of how the instrument performs under the practical usage conditions, the measured data contain some degree of uncertainty. Binary Pseudo Random Array (BPRA) “white noise” artifact are effective and useful for characterizing the Instrument Transfer Function (ITF) of surface topography metrology tools and wavefront measurement instrument. BPRA artifact contains features with all spatial frequencies in the instrument bandpass with equal weight. As a result, power spectral density of the patterns has a deterministic white-noise-like character that allows direct determination of the ITF with uniform sensitivity over the entire spatial frequency range. The application examples include electron microscopes, x-ray microscopes, interferometric microscopes, and large field-of-view Fizeau Interferometers. Furthermore, we will introduce the application of BPRA method to characterizing the ITF of Cylindrical Wavefront Interferometry (CWI), by developing the BPRA artifact which matches the radius of curvature of the cylindrical wavefront. The data acquisition and analysis procedures for different applications of the ITF calibration technique developed are also discussed.

On 23rd November 2009, during the early commissioning of the CERN Large Hadron Collider (LHC), two counter-rotating proton bunches were circulated for the first time concurrently in the machine, at the LHC injection energy of 450 GeV per beam. Although the proton intensity was very low, with only one pilot bunch per beam, and no systematic attempt was made to optimize the collision optics, all LHC experiments reported a number of collision candidates. In the ALICE experiment, the collision region was centred very well in both the longitudinal and transverse directions and 284 events were recorded in coincidence with the two passing proton bunches. The events were immediately reconstructed and analyzed both online and offline. We have used these events to measure the pseudorapidity density of charged primary particles in the central region. In the range |η|<0.5, we obtain dNch/dη=3. 10±0. 13(stat.)±0. 22(syst.) for all inelastic interactions, and dNch/dη=3.51±0. 15(stat.)±0. 25(syst.) for non-single diffractive interactions. These results are consistent with previous measurements in proton-antiproton interactions at the same centre-of-mass energy at the CERN Spp̄S collider. They also illustrate the excellent functioning and rapid progress of the LHC accelerator, and of both the hardware and software of the ALICE experiment, in this early start-up phase. © CERN 2009.

The pseudorapidity density and multiplicity distribution of charged particles produced in proton-proton collisions at the LHC, at a centre-of-mass energy √s= 7 TeV, were measured in the central pseudorapidity region {pipe}η{pipe} < 1. Comparisons are made with previous measurements at √s = 0.9 TeV and 2.36 TeV. At √s = 7 TeV, for events with at least one charged particle in {pipe}η{pipe} < 1, we obtain dNch/dη = 6.01 ± 0.01(stat.)+0.20-0.12(syst.). This corresponds to an increase of 57.6% ± 0.4%(stat.)+3.6-1.8%(syst.) relative to collisions at 0.9 TeV, significantly higher than calculations from commonly used models. The multiplicity distribution at 7 TeV is described fairly well by the negative binomial distribution. © 2010 CERN for the benefit of the ALICE collaboration.

Charged-particle production was studied in proton-proton collisions collected at the LHC with the ALICE detector at centre-of-mass energies 0.9 TeV and 2.36 TeV in the pseudorapidity range {pipe}η{pipe}<1.4. In the central region ({pipe}η{pipe}<0.5), at 0.9 TeV, we measure charged-particle pseudorapidity density dNch/dη= 3.02 ± 0.01 (stat.)-0.05+0.08(syst.) for inelastic interactions, and dNch/dη = 3.58 ± 0.01 (stat.)-0.12+0.12(syst.) for non-single-diffractive interactions. At 2.36 TeV, we find dNch/dη = 3.77 ± 0.01 (stat.)-0.12+0.25(syst.) for inelastic, and dNch/dη = 4.43 ± 0.01(stat.)-0.12+0.17(syst.) for non-single-diffractive collisions. The relative increase in charged-particle multiplicity from the lower to higher energy is 24.7% ± 0.5%(stat.)-2.8+5.7(syst.) for inelastic and 23.7% ± 0.5%(stat.)-1.1+4.6% 1.1%(syst.) for non-single-diffractive interactions. This increase is consistent with that reported by the CMS collaboration for non-single-diffractive events and larger than that found by a number of commonly used models. The multiplicity distribution was measured in different pseudorapidity intervals and studied in terms of KNO variables at both energies. The results are compared to proton-antiproton data and to model predictions. © 2010 CERN for the benefit of the ALICE collaboration.