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As part of the Large Hadron Collider Luminosity upgrade (HiLumi-LHC) program, the US LARP collaboration and CERN are working together to design and build 150-mm aperture Nb3Sn quadrupoles for the LHC interaction regions. A first series of 1.5-m-long coils were fabricated, assembled, and tested in the first short model. This paper presents the magnetic analysis, comparing magnetic field measurements with the expectations and the field quality requirements. The analysis is focused on the geometrical harmonics, iron saturation effect, and cold-warm correlation. Three-dimensional effects such as the variability of the field harmonics along the magnet axis and the contribution of the coil ends are also discussed. Moreover, we present the influence of the conductor magnetization and the dynamic effects.

Persistent magnetization currents are induced in superconducting filaments during the current ramping in magnets. The resulting perturbation to the design magnetic field leads to field quality degradation, particularly at low field, where the effect is stronger relative to the main field. The effects observed in NbTi accelerator magnets were reproduced well with the critical-state model. However, this approach becomes less accurate for the calculation of the persistent-current effects observed in Nb3Sn accelerator magnets. Here, a finite-element method based on the measured strand magnetization is validated using three state-of-the-art Nb3Sn accelerator magnets featuring different subelement diameters, conductor critical currents, magnet designs, and test temperatures. The temperature dependence of the persistent-current effects is reproduced. Based on the validated model, the impact of conductor design on the persistent-current effects is discussed. The strengths, limitations, and possible improvements of the approach are also discussed.

Background: BRAF V600E mutation is the most common molecular alteration found in papillary thyroid carcinoma (PTC) and has been linked to recurrent disease or possibly more aggressive behavior. Some studies have reported sickle-shaped nuclei (SSN) and plump pink cells (PPC) to be predictive markers of BRAF mutation in FNA cytology. We aimed to evaluate the reproducibility of the aforementioned cytologic features., Methods: A computerized search for diagnosed PTC surgical pathology cases tested for BRAF V600E mutation by Sanger DNA sequencing was performed. Blinded to BRAF results, the corresponding cytology was reviewed for presence of SSN and PPC. Classic nuclear PTC (CNPTC) features, cystic change, and psammoma bodies were also evaluated. The results were correlated with BRAF V600E mutational status and histologic subtypes., Results: Study cohort consisted of 113 cases (74 BRAF V600E mutated, 39 BRAF V600E wild type). SSN and combined CNPTC /SSN had positive predictive value of 74% and 75%, respectively. CNPTC showed 92% sensitivity and 20% specificity. Psammoma bodies had 92% specificity and 5% sensitivity. The presence of combined PPC/SSN showed 80% specificity, 27% sensitivity, and diagnostic accuracy of 45%. CNPTC was seen in 60/61 (98%) SSN and 45/45 (100%) PPC. There was no significant statistical association between SSN, PPC, and CNPTC with specific histologic subtypes and BRAF mutational status., Conclusion: CNPTC is sensitive but not specific for BRAF mutational status. SSN, PPC, and CNPTC are not predictive markers for the presence of BRAF mutation or histologic subtypes. Additional studies may be needed to further corroborate these findings., (© 2024 The Authors. Diagnostic Cytopathology published by Wiley Periodicals LLC.)

Background: Noninvasive follicular thyroid neoplasm with papillary-like features (NIFTP) was introduced in 2016 replacing noninvasive follicular variant of papillary thyroid carcinoma, with recommendations to label them "noncancer." To avoid reducing risk of malignancy (ROM) and overdiagnosing NIFTP as malignant, some authors required restricted cytologic criteria (RC) for a definitive diagnosis of papillary thyroid carcinoma (PTC), including papillae, psammoma bodies. or ≥3 nuclear pseudoinclusions. Since then, NIFTP criteria have been revised, biologic behavior better understood, and incidence reported to be much lower than initially anticipated. This study examines the impact of RC on PTC cytologic diagnoses, ROM, and detection of clinically significant carcinomas (CSC)., Materials and Methods: A total of 207 thyroid FNAs originally diagnosed as PTC and suspicious for PTC (SPTC) with surgical follow-up were evaluated. RC were retrospectively applied to cases as a requirement for diagnosing PTC, and cases that did not meet RC were reclassified as SPTC. ROMs and diagnostic accuracies of pre- and post-RC diagnoses were correlated with followup CSC., Results: RC were met in 118/142 (83%) and 20/65 (31%) of cases originally diagnosed as PTC and SPTC, respectively. Post-RC, 29% (19/65) of CSC originally diagnosed as SPTC were upgraded to PTC, and 17% (24/142) of CSC originally diagnosed as PTC were downgraded to SPTC. No NIFTPs were diagnosed as malignant., Conclusions: RC should not be required for a definitive diagnosis of PTC when other nuclear features of PTC are diffuse and overt. Applying RC, however, helps the pathologist arrive at a more definitive diagnosis of PTC in suspicious cases., (© 2024 The Authors. Cancer Cytopathology published by Wiley Periodicals LLC on behalf of American Cancer Society.)

Context: Brown-Séquard Syndrome (BSS) is a rare neurological condition associated with Spinal Cord Injury (SCI). Hemisection of the spinal cord causes paralysis of the homolateral side, and thermoalgesic dysfunction on the opposite side. Cardiopulmonary and metabolic alterations have been reported. For all these patients, regular physical activity is highly recommended and functional electrical stimulation (FES) may be a good option, especially for those with paraplegia. However, to our knowledge, the effects of FES have primarily been studied in those with complete SCI and data regarding application and effects in patients with incomplete lesions (with sensory feedback) is lacking. The present case report therefore evaluated the feasibility and effectiveness of a 3-month FES-rowing program in a patient with BSS., Methods: Knee extensor muscle strength and thickness, walking and rowing capacities as well as quality of life were evaluated before and after 3 months of FES-rowing (two sessions per week) in a 54 year old patient with BSS., Results: The individual had excellent tolerance and adherence to the training protocol. All measured parameters were greatly improved after 3 months: on average, + 30% rowing capacity, + 26% walking capacity, + 24.5% isometric strength, + 21.9% quadriceps muscle thickness, + 34.5% quality of life., Conclusion: FES-rowing appears to be well tolerated and highly beneficial for a patient with incomplete SCI and could therefore be considered as an appealing exercise option for these patients.

Background: Rehabilitation aims to improve hand-arm function, upper-limb strength, and functional independence that has been impaired by tetraplegia. On the basis of evidence derived from stroke rehabilitation, interventions aiming to increase intensity (i.e., duration and/or number of movements practiced) or alter brain plasticity (including motor imagery, virtual reality, transcranial direct-current or magnetic stimulations; i.e., neuromodulation) are now used during tetraplegic rehabilitation. However, no meta-analysis has investigated the efficacy of these interventions., Objective: This systematic review and meta-analysis investigated, separately, the efficacy of these interventions to alter hand-arm function, upper-limb strength, and functional independence of individuals with tetraplegia., Methods: Two independent reviewers followed the PROSPERO protocol (CRD42018098506) for this systematic review. MEDLINE, PEDro CENTRAL, and SCOPUS databases were searched for reports of randomized controlled trials of individuals with tetraplegia that were published in English. We performed a meta-analysis of intensive versus less intensive interventions and neuromodulation versus sham interventions considering hand-arm function, strength, and functional independence., Results: From 168 records identified, we included 29 studies (all but 1 were single-centre) in the systematic review (647 participants with C2 to T1 tetraplegia [American Spinal Injury Association impairment scale A to D]). Interventions lasted from 66 to 40,320min. Five studies were retained in the intensity meta-analyses and 5 in the neuromodulation meta-analyses. Overall, 3/5 and 1/5 studies had adequate methodology (Cochrane Risk of Bias score ≥6/10). For each outcome, the p-values for the overall effect were>0.05. Heterogeneity was low, but when analyzing intensity, it was moderate for functional independence and high for hand-arm function. Quality of evidence was very low to low., Conclusions: We can provide no recommendations for using intensive versus less intensive interventions or neuromodulation versus sham during tetraplegia rehabilitation. Further multicentre studies of high methodological quality are required to reduce uncertainty about the efficacy of these interventions., (Copyright © 2019 Elsevier Masson SAS. All rights reserved.)

Background: Findings regarding the impact of language bias on treatment effect estimates (TEE) are conflicting, and very few studies have assessed these impacts in rehabilitation. The purpose was to compare TEE between studies published in non-English language (SPNEL) and those published in English language (SPEL) included in a previously published meta-analysis assessing the effects of physical therapy on balance and postural control after stroke., Methods: Six databases were searched until January 2019. Two independent reviewers selected randomised trials, extracted data, and assessed risk of bias. We conducted subgroup meta-analyses according to the language of study publication, then compared TEE between SPEL and SPNEL subgroups by using a random-effects meta-regression model., Results: From 13,123 records, 132 SPEL (n = 5219) and 13 SPNEL (n = 693) were included. SPNEL had a weight in the pooled estimate (8.2%) significantly lower than SPEL (91.8%; p<0.001). Compared to SPEL, SPNEL had both significantly worse methodological quality (p = 0.002) and quality of reporting for blinding of outcome assessment (p<0.001); and a significantly worse quality of reporting for incomplete outcome data (p<0.001). SPNEL had a significantly worse precision (i.e. inverse of variance) of TEE than SPEL (p = 0.005). Overall, the TEE was not significantly different between SPNEL and SPEL (standardised mean difference -0.16, 95% confidence interval [-0.53; 0.22], heterogeneity I2 = 78%). However, when PT was compared to sham treatment or usual care, SPNEL significantly over-estimated treatment effects (SMD -0.68, 95%CI [-1.03; -0.33], I2 = 39%) compared to SPEL. Restriction of the search to SPEL only did not change the direction of TEE for 8 out of 9 comparisons., Conclusions: SPNEL had a worse methodological quality than SPEL and were likely to over-estimate treatment effect. If inclusion of SPNEL in a systematic review is considered to be relevant, the impact of such studies on TEE should be explored by sensitivity analyses to ensure the findings validity., Competing Interests: The authors have declared that no competing interests exist.

Prism adaptation (PA) is a promising treatment in the rehabilitation of post-stroke cognitive disorders such as unilateral spatial neglect or constructional deficits. Right brain damage can bring about another representational spatial disorder, termed «hyperschematia», and defined by a left-sided disproportionate expansion of drawings by copy and from memory, and by an overestimation of left lateral extent when a leftward movement is required. This case study aimed at evaluating the effect of PA induced by prismatic lenses creating a shift to the left on hyperschematia signs. A 63-year-old woman with left hyperschematia, consecutive to a right fronto-temporo-parietal hematoma, was exposed to a leftward optical deviation produced by prismatic lenses. An anatomical MRI studied topography of the brain lesion; the patient's lesion was then mapped onto tractography reconstructions of white matter pathways. Results showed that PA significantly reduced the left-sided expansion of drawing by copy and from memory, and the overestimation of left lateral extent, immediately after prism removal and 4 days later, indicating a persistent long lasting cognitive effect. MRI showed a right hemisphere disconnection of the posterior and long segments of the arcuate fasciculus, and of the inferior longitudinal and fronto-occipital fasciculi. Overall, these findings suggest that: i) PA is effective also in hyperschematia by re-orientating spatial attention towards the right side of space, with a relative rightward PA-induced unbalance, and re-setting the spatial representation to the left side of space, contralateral to the side of the lesion; ii) the left misrepresentation of lateral extent may be related to a disconnection between visual coordinates and attentional networks to the frontal lobe., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Background: Stroke results in balance disorders and these directly affect autonomy and quality of life. The purpose of this systematic review and meta-analysis was to determine the efficacy of physical therapy (PT) on balance and postural control after stroke., Methods: We included all randomized controlled trials assessing the efficacy of PT on balance and postural control in adult patients after stroke without language restriction. Medline, Embase/Scopus, Cochrane Central Register of Controlled Trials, PEDro, Pascal, and Francis databases were searched until January 2019. Primary outcomes were balance (Berg Balance scale and Postural Assessment Scale for Stroke) and postural control with postural deviation or stability measurement in sitting or standing static evaluation. A pair of independent reviewers selected studies, extracted data, and assessed risk of bias. Meta-analyses with subgroups (categories of PT, time post-stroke, and lesion location) and meta-regression (duration of PT) were conducted., Results: A total of 145 studies (n = 5912) were selected from the 13,123 records identified. For balance, evidence was found in favor of the efficacy of functional task-training alone (standardized mean difference 0.39, 95% confidence interval [0.09; 0.68], heterogeneity I2 = 63%) or associated with musculoskeletal intervention and/or cardiopulmonary intervention (0.37, [0.19; 0.55], I2 = 48%), electrostimulation (0.91, [0.49; 1.34], I2 = 52%) immediately after intervention, compared to sham treatment or usual care (ST/UC). For postural deviation eyes open, assistive devices were more effective than no treatment (-0.21, [-0.37; -0.05], I2 = 0%) immediately after intervention; for postural stability eyes open, functional task-training and sensory interventions were more effective than ST/UC (0.97, [0.35; 1.59], I2 = 65% and 0.80, [0.46; 1.13], I2 = 37% respectively) immediately after intervention., Conclusions: Functional task-training associated with musculoskeletal intervention and/or cardiopulmonary intervention and sensory interventions seem to be immediately effective in improving balance and postural stability, respectively. The heterogeneity of PT and the weak methodological quality of studies limited the interpretation and the confidence in findings., Competing Interests: The authors have declared that no competing interests exist.