Wide Coverage, fine Resolution, Geosynchronous SAR for Atmosphere and Terrain Observation

The paper proposes a COMmunication SATellite (COMSAT) compatible Synthetic Aperture RADAR (SAR), with regional coverage and continuous observations. Such a system could provide deformations and water-vapour maps over regions of hundreds of kilometers with resolutions in time-space otherwise impossible with that coverage. The basic monostatic concept is reviewed together with its multistatic evolution, capable of exploiting the present clusters of COMSATs at the same longitudinal node. Attention is brought to the most critical issues, such as atmospheric turbulence, target coherence, and clutter decorrelation

Impact of the COVID-19 pandemic on the care and outcomes of patients with NAFLD-related cirrhosis

The COVID-19 pandemic has had a strong, negative impact on health systems and many chronic diseases globally. We aimed to evaluate the impact of the first year of the pandemic on the outcomes of NAFLD cirrhosis patients.Before-after study conducted in 4 University hospitals in Catalonia, Spain. Study subperiods were divided in Pre-pandemic (March/2019-February/2020) vs. Pandemic (March/2020-February/2021). Primary outcome was the rate of first liver-related events (LRE). Overall clinical outcomes (LRE plus cardiovascular plus all-cause mortality) were also assessed.354 patients were included, all of whom were compensated at the beginning of the study period but 83 subjects (23.5%) had presented a prior hepatic decompensation. Mean age was 67.3 years and 48.3% were female. Median BMI was 31.2kg/m2 and type-2 diabetes (T2D) was present in 72.8% patients. The rates of first LRE in the Pre-pandemic and Pandemic periods were 7.4% and 11.3% (p=0.12) respectively. Whilst the rate of overall events was significantly higher in the Pandemic period (9.9% vs. 17.8%; p=0.009), this was strongly associated to COVID-19-related deaths. The rate of worsened metabolic status was significantly higher in the Pandemic period (38.4% vs.46.1%; p=0.041), yet this was not associated with the risk of first LRE during the Pandemic period, whereas T2D (OR 3.77,95%CI 1.15-12.32; p=0.028), albumin2.67 (OR 15.74,95%CI 2.01-123.22; p=0.009) were identified as risk factors in the multivariable analysis.Overall, patients with NAFLD cirrhosis did not present poorer liver-related outcomes during the first year of the pandemic. Health systems preparedness seems key to ensure NAFLD cirrhotic patients receive appropriate care during health crises.Mobility restrictions and social stress induced by the COVID-19 pandemic have led to increased alcohol drinking and worsened metabolic control (e.g., weight gain, poor control of diabetes) in a large proportion of the population from many countries. We aimed at analyzing whether patients with cirrhosis due non-alcoholic fatty liver disease, whom are particularly vulnerable to such lifestyle modifications, were significantly impacted during the first year of the pandemic. With that purpose, we studied 354 patients and compared their clinical situation one year before the pandemic outbreak and one year after. We found that although metabolic control was indeed worse after the first year of the pandemic and patients presented worse clinical outcomes, the latter was mostly due to non-liver causes but rather to COVID-19. Moreover, the care provided to cirrhotic patients with NAFLD did not worsen during the first year of the pandemic.© 2022 The Authors. Published by Elsevier B.V. on behalf of European Association for the Study of the Liver (EASL)

Development, validation, and prognostic evaluation of a risk score for long-term liver-related outcomes in the general population: a multicohort study

Liver cirrhosis is a major cause of death worldwide. Cirrhosis develops after a long asymptomatic period of fibrosis progression, with the diagnosis frequently occurring late, when major complications or cancer develop. Few reliable tools exist for timely identification of individuals at risk of cirrhosis to allow for early intervention. We aimed to develop a novel score to identify individuals at risk for future liver-related outcomes. We derived the LiverRisk score from an international prospective cohort of individuals from six countries without known liver disease from the general population, who underwent liver fibrosis assessment by transient elastography. The score included age, sex, and six standard laboratory variables. We created four groups: minimal risk, low risk, medium risk, and high risk according to selected cutoff values of the LiverRisk score (6, 10, and 15). The model's discriminatory accuracy and calibration were externally validated in two prospective cohorts from the general population. Moreover, we ascertained the prognostic value of the score in the prediction of liver-related outcomes in participants without known liver disease with median follow-up of 12 years (UK Biobank cohort). We included 14 726 participants: 6357 (43·2%) in the derivation cohort, 4370 (29·7%) in the first external validation cohort, and 3999 (27·2%) in the second external validation cohort. The score accurately predicted liver stiffness in the development and external validation cohorts, and was superior to conventional serum biomarkers of fibrosis, as measured by area under the receiver-operating characteristics curve (AUC; 0·83 [95% CI [0·78-0·89]) versus the fibrosis-4 index (FIB-4; 0·68 [0·61-0·75] at 10 kPa). The score was effective in identifying individuals at risk of liver-related mortality, liver-related hospitalisation, and liver cancer, thereby allowing stratification to different risk groups for liver-related outcomes. The hazard ratio for liver-related mortality in the high-risk group was 471 (95% CI 347-641) compared with the minimal risk group, and the overall AUC of the score in predicting 10-year liver-related mortality was 0·90 (0·88-0·91) versus 0.84 (0·82-0·86) for FIB-4. The LiverRisk score, based on simple parameters, predicted liver fibrosis and future development of liver-related outcomes in the general population. The score might allow for stratification of individuals according to liver risk and thus guide preventive care. None. [Abstract copyright: Copyright © 2023 Elsevier Ltd. All rights reserved.