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At least 361 records · Page 20

What is the Quark-Gluon Plasma made of?

This article surveys our present understanding of the internal structure of the fully developed quark-gluon plasma at temperatures outside the crossover region. The theoretical part of the review covers perturbative and nonperturbative approaches to quark-gluon plasma structure, in particular, hard-thermal loop effective theory, lattice QCD and the functional renormalization group. The phenomenological part of the review scrutinizes the information that has been derived from bulk observables and hard probes in relativistic heavy ion collisions in terms of how it informs our knowledge about the structure of the quark-gluon plasma. The final section lists possible avenues for future progress.

FOS: Physical sciences↗

Development of an ultrahigh affinity, trimeric ACE2 biologic as a universal SARS-CoV-2 antagonist

Abstract Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), responsible for the COVID-19 pandemic, utilizes membrane-bound, angiotensin-converting enzyme II (ACE2) for internalization and infection. We describe the development of a biologic that takes advantage of the proximity of the N-terminus of bound ACE2 to the three-fold symmetry axis of the spike protein to create an ultrapotent, trivalent ACE2 entry antagonist. Distinct disulfide bonds were added to enhance serum stability and a single point mutation was introduced to eliminate enzymatic activity. Through surface plasmon resonance, pseudovirus neutralization assays, and single-particle cryo-electron microscopy, we show this antagonist binds to and inhibits SARS-CoV-2 variants. We further show the antagonist binds to and inhibits a 2003 SARS-CoV-1 strain. Collectively, structural insight has allowed us to design a universal trivalent antagonist against all variants of SARS-CoV-2 tested, suggesting it will be active against the emergence of future mutants.

Gonzales, Juliet (ORCID:0000000327219566)↗

A Survey of Open-Source Tools for Transmission and Distribution Systems Research

This work presents a review of open-source electric power transmission and distribution systems analysis tools suitable for use by industry professionals and academic researchers. Due to the high complexity of the electric grid, there exist numerous tools and extensive research pertaining to nearly every aspect of the design, operation, and control of transmission and distribution networks. In addition to the commercial tools, a wide range of free, open-source tools, models, and data usable by the scientific community for related research have been developed by different organizations, including both international and US universities and national laboratories. However, due to the absence of a catalog of available tools, models and data, researchers often lack a knowledge of existing capabilities and may develop duplicative software and tools. Increasing awareness of these available resources seeks to accelerate their broader use, leading to more efficient and standardized grid analysis. This review paper (which is part of a larger survey effort that studied over 400 tools in the transmission, distribution, buildings, and electric vehicles space) outlines selected open-source resources that have been developed in power transmission and distribution systems research. It is anticipated that this work can serve as a guide for industry and academic researchers alike, ensuring that research efforts are well-channeled.

24 POWER TRANSMISSION AND DISTRIBUTION↗

Integrated Heat Exchanger-Phase Change Material Thermal Energy Storage System

The purpose of this study is to experimentally investigate the thermal performance of an innovative thermal energy storage (TES) system that combines the advantages of the phase-change material (PCM)/graphite foam latent heat TES medium developed at Argonne National Laboratory (Argonne) and the internally supported plate-fin (ISPE) cell architecture heat transfer fluid (HTF) flow channels developed at Brayton Energy (Brayton). Several essential tasks were accomplished: (1) Thermal property characterization. Thermal properties of the graphite foam were characterized, providing necessary data for experimental result analysis and numerical simulation. (2) Design and optimization of lab-scale test module. Based on Brayton’s full-scale heat exchanger (HX)-TES system, the experimental test module was designed, optimized, and fabricated. (3) Thermal performance testing and data analysis. Five cycle tests were successfully conducted—including one with approximately 3.5 psig of pressure applied to the diaphragms—to investigate the thermal performance of the experimental test module for charging and discharging. Temperature profiles were generated for each charging test and discharging test as a function of time. The temperature profiles clearly show three TES stages: sensible heat (temperature increase), latent heat (melting), and sensible heat (temperature increase) for the charging process. Similarly, the temperature profiles clearly show three thermal energy release stages: sensible heat (temperature decrease), latent heat (solidification), and sensible heat (temperature decrease). Melting and solidification of the PCM generally occurred in relatively narrow temperature ranges, indicated by the flattened temperature regions in the temperature profiles. These phase changes ranged approximately 3°C for melting and 3.5°C for solidification. The charging and discharging temperature profiles were similar for similar experimental parameter tests whether or not pressure was applied to the diaphragm to eliminate the gap between the HX surface and the TES subsystem. This indicates that the effect of a small gap between the HX surface and the TES subsystem is insignificant for charging and discharging. (4) Comparison of experimental data and simulation results. We compared the experimental data to the numerical simulation results. Numerical simulations were conducted by using the ANSYS FLUENT 2019 R3 commercial computational fluid dynamics software. The predicted phase-change times agreed reasonably well with those from the experimental data. In most cases, the estimated time differences between the relative phase changes were within 16%. The predicted start and end times for the charging process agreed well with those from the experimental data. However, the simulation results showed earlier start and end times than the experimental data for the discharging process. Overall, the experimental data and its comparison with the simulation predictions verified the technical viability of the integrated ISPF HX-PCM/graphite foam latent-heat TES system.

25 ENERGY STORAGE↗

Update on NEA-TDB Database Development and Database Formatting Tool

This progress report (Level 4 Milestone Number M4SF-21LL010302062) summarizes research conducted at Lawrence Livermore National Laboratory (LLNL) within the Crystalline International Collaborations Activity Number SF-21LL01030206. The activity is focused on our long-term commitment of engaging our partners in international nuclear waste repository research. This includes participation in the Nuclear Energy Agency Thermochemical Database (NEA TDB) Project (Cindy Atkins-Duffin) and development of methodologies for integrating US and international thermodynamic databases for use in SFWST Generic Disposal System Assessment (GDSA) efforts. LLNL is supporting the overall objectives of the Disposal Research (DR) Crystalline International Collaborations Research and Development (R&D) control account. The objective of this control account is to advance our understanding of long-term disposal of spent fuel in crystalline rocks (including both granitic and metamorphic rocks) and to develop necessary experimental and computational capabilities to evaluate various disposal concepts in such media.

12 MANAGEMENT OF RADIOACTIVE AND NON-RADIOACTIVE W↗

Refining a Novel Process Monitoring Method to Safeguard Continuously Cycling Designs Using Isotopic Ratios

In advanced reactor (AR) designs, a common feature is continuous chemical processing and circulation of the nuclear material. This work bridges a significant measurement gap in safeguarding reactors with circulating fuel or continuous refueling by leveraging and building on the isotope ratio method first developed by our team under an FY21 Advanced Reactors International Safeguards Engagement (ARISE) project (Uribe et al. 2021). In circulating fuel designs, the radioisotope inventory changes from traditional effects (e.g., radioactive decay, fission) but also includes material transport due to pressure and temperature gradients. Such designs may also require regular or continuous additions or removals during operation, which significantly increases the rate of inventory change compared to traditional pressurized water reactor (PWR)s. Thus, directly tracking the nuclear inventory is ineffective since the isotopes are continuously added and removed. The isotope ratio method instead focuses on detecting changes to the input and output flows of radioisotopes. Previous work showed that for well-chosen pairs of isotopes, the isotopic ratio provides a sensitive and lasting indicator of deviation from normal conditions (e.g., startup, shutdown, diversion). The isotope ratio method is a process monitoring method with potential for application in for forward-looking approaches to International Atomic Energy Agency (IAEA) safeguards. The original process monitoring method was developed for a specific case—the decay tank of a thorium-fueled molten salt breeder reactor. In this expanded work, we explored other types of reactors and processes with nonstationary (e.g., flowing) nuclear material, which are difficult to safeguard with traditional methods because of the transient nature of the systems. The goal of the present work is to generalize the isotope ratio method for use in processes with continuously flowing nuclear material. All continuous processes have an average time for isotopes to be replaced in the system. The isotope ratio method works by choosing radioisotopes with half-lives both above and below the processing time. The present work seeks to explore which isotopes are suitable for the method by simulating the nuclear inventory, radioisotope emissions, and detector responses for several classes of advanced reactors. While the method can in principle be applied to other processes (e.g., enrichment or reprocessing facilities), the present work limits scope to ARs with continuously flowing fuel. Section 2 details the mathematics supporting the isotope ratio method, and Section 3 introduces the representative ARs selected for this work. Section 4 discusses how each reactor was analyzed, and Section 5 showcases the results for each representative reactor. Finally, Section 6 provides concluding remarks and suggests pathways for further analysis.

98 NUCLEAR DISARMAMENT, SAFEGUARDS, AND PHYSICAL P↗

ART Graphite R&D Program Status - 2020

Structure of the program Graphite material issues of interest How do things fit together Status of the program Baseline AGC Experiment Update AGC-4 and HDG-1 Irradiation Oxidation Modeling ASME Code development Discussion of how the data can be used Modeling behavior of core components Licensing/code development Interaction with vendors Collaborations (domestic and international)

11 NUCLEAR FUEL CYCLE AND FUEL MATERIALS↗

Application of Cable Condition Monitoring Technologies to Assess Age-Related Degradation of Industrial Cables Installed in Harsh Environments

The aging of electrical cables has been the subject of substantial research and development (R&D) projects performed by national and international laboratories, universities, and private organizations for many years. This R&D was conducted to develop guidance, equipment, and techniques to support aging management of in-service cables in industrial facilities such as nuclear power plants, research reactors, waste facilities, and fuel fabrication plants. Through these research efforts, condition monitoring technologies have been developed that can determine the severity of age-related degradation that occurs in industrial cables and insulation polymers during service. This paper summarizes the results of aging assessments that were performed for cables installed in two U.S. nuclear power plants, one a pressurized water reactor and one a boiling water reactor. These cables had been in service for over 40 years and during plant operation were exposed to harsh environmental conditions including elevated temperatures and radiation. For these assessments, a comprehensive series of measurements was performed to assess the aged condition of the cables. These cables came from different manufacturers, were manufactured in different years, and were constructed with a variety of jacket and insulation polymers including chloro-sulfonated polyethylene (CSPE), cross-linked polyethylene (XLPE)/cross-linked polyolefin (XLPO), neoprene, and ethylene propylene rubber (EPR). The goal of these assessments was to determine the current aged condition of the cable polymers and provide an estimate of how long the cable insulation materials could remain exposed to their in-service environmental conditions before reaching their end-of-life condition. Both nuclear power plants have received license renewals to extend their operation from 40 to 60 years, and the utilities need objective evidence to show that critical components such as cables will be able to function safely and reliably during the extended operating period. Furthermore, the results of these assessments showed that the cables exhibited different aged conditions depending on the type of polymers they were constructed with and the environment they were exposed to during service. Some of the cables and insulation polymers showed signs of significant age-related degradation and were estimated to have approximately 5 years of remaining service life. Other cables exhibited no signs of significant age-related degradation and were estimated to have 50 years or more of remaining service life. Using the results of these cable aging assessments, plant personnel were able to (1) determine the overall aged condition of cables and insulation polymers using objective test results, (2) identify aged or degraded cables before they caused operability issues, and (3) avoid unnecessary and costly replacement of cables that can continue to operate safely and reliably.

36 MATERIALS SCIENCE↗

A Design Document: Custom Analytical Tools and Automation for the Industrial Hygienist

This report outlines an approach for developing a modular and scalable web-based application suite, Internal Data Access and Visualization (I-DAV), that would be developed to meet the specific analytic requirements for Industrial Hygienist (IH) analysts and tank vapors Subject Matter Expert’s (SME) at the Hanford site. Through interviews and requirements elicitation with IH analyst, and on-site in depth review of workflow patterns and expected outcomes, PNNL has developed a framework for proposed collection of interdependent goal oriented software applications. Commercial off the shelf applications, which require only minimal custom code, were deployed this year as a mechanism of rapid prototyping and providing proof of concept. This report describes these efforts and accomplishments to date, as well as concepts for future applications and general enhancement of the DAV and core concepts for the I-DAV. Additional content was integrated into this report as of March 2019. Updated content was added to reflect the inclusion of I-DAV concepts and ideas, and refined versions of original concepts set forth as the work commenced and continued through the first half of FY19. New and refined concepts have been the product of ongoing weekly meetings, outreach, and elicitation with WRPS.

12 MANAGEMENT OF RADIOACTIVE AND NON-RADIOACTIVE W↗

A Design Document: Custom Analytical Tools and Automation for the Industrial Hygienist

This report outlines an approach for developing a modular and scalable web-based application suite, Internal Data Access and Visualization (I-DAV), that would be developed to meet the specific analytic requirements for Industrial Hygienist (IH) analysts and tank vapors Subject Matter Expert’s (SME) at the Hanford site. Through interviews and requirements elicitation with IH analyst, and on-site in depth review of workflow patterns and expected outcomes, PNNL has developed a framework for proposed collection of interdependent goal oriented software applications. Commercial off the shelf applications, which require only minimal custom code, were deployed this year as a mechanism of rapid prototyping and providing proof of concept. This report describes these efforts and accomplishments to date, as well as concepts for future applications and general enhancement of the DAV and core concepts for the I-DAV. Additional content was integrated into this report as of March 2019. Updated content was added to reflect the inclusion of I-DAV concepts and ideas, and refined versions of original concepts set forth as the work commenced and continued through the first half of FY19. New and refined concepts have been the product of ongoing weekly meetings, outreach, and elicitation with WRPS.

97 MATHEMATICS AND COMPUTING↗

Complete Performance Comparison Between the Optimized Image Construction Algorithm (U-MBIR) and the Existing Reconstruction Algorithm for Detecting Defects and Damage in Concrete

Reinforced concrete (RC) is a composite material subjected to mechanical, thermal, and chemical loads throughout its service life. Because of these external stressors and the susceptibility of RC structural members to shrinkage and microcracking, the material degrades throughout its life cycle. This deterioration can lead to a decrease in member capacity and, ultimately, poses a threat to the structural integrity. Thus, it is crucial that the damage caused by aging and degradation be monitored and assessed at regular intervals throughout the material’s service life. Since coring of the material is typically not feasible for in-service structural systems, non-destructive evaluation (NDE) methodologies are used to assess remaining structural capacity. NDE methods enable surface and subsurface examination without damaging or degrading the medium. Moreover, RC is a critical component of nuclear power plants; thus, its safety and reliability must be thoroughly examined throughout the life cycle of the structural system. Ultrasonic measurements have been an industry standard for both surface and subsurface inspections. To this end, Oak Ridge National Laboratory (ORNL) has researched and developed advanced image reconstruction algorithms to capture internal damage. The results and discussion presented herein summarize the current state of the ultrasonic model–based iterative reconstruction (U-MBIR) algorithm developed at ORNL. More specifically, this report presents a comparison between reconstruction images produced via a widely employed ultrasonic NDE technique—the synthetic aperture focusing technique (SAFT)—and the ORNL-developed U-MBIR algorithm. These NDE methodologies are demonstrated using ultrasonic data collected from four concrete specimens. Overall, the U-MBIR algorithm eliminates artifacts and noise that are typically present within the SAFT reconstructions, and it shows defects and anomalies more clearly than the SAFT images. In conclusion, this algorithm is suitable for identifying concrete defects, although more improvements and optimization could be done to better define internal defects.

36 MATERIALS SCIENCE↗

Evaluation of the Reconstruction Accuracy of the Ultrasound Model–Based Image Reconstruction (U-MBIR) Method for Concrete to Optimize Damage Detection

Reinforced concrete is a critical structural material used to construct nuclear power plants (NPPs). As such, its safety and performance must be thoroughly examined throughout the life cycle of the NPP infrastructure system. Ultrasonic measurements have been an industry standard for both surface and subsurface inspections. To support the development of these techniques, Oak Ridge National Laboratory (ORNL) has researched and developed advanced image reconstruction algorithms to capture internal damage. The results and discussion presented herein summarize the current state of the ultrasonic model–based iterative reconstruction (U-MBIR) algorithm developed at ORNL. In the work documented in this report, the U-MBIR methodology was applied to four sets of ultrasonic data collected from concrete specimens. The results demonstrate that the U-MBIR algorithm can successfully detect defects within the four concrete samples. The reconstruction images help identify the specimen thickness, regions of delamination, and location of rebar embedded within the concrete. The reconstruction images allow engineers and technicians to characterize the internal defects within concrete specimens and structural members. Ultimately, this knowledge can guide engineers in making informed decisions regarding the performance, safety, and reliability of structural materials (i.e., reinforced concrete) throughout the life cycle of NPPs.

22 GENERAL STUDIES OF NUCLEAR REACTORS↗

Responsibly Harnessing the Power of AI

Artificial Intelligence (AI) based applications are on the cusp of offering the public and private sectors tools of tremendous potential that will likely transform the world in much the same way that previous technological revolutions have. To harness these tools, a vast and rapidly increasing assortment of ethical AI guidelines and principles are being developed to manage the myriad of risks these tools pose. Documents, frameworks, standards, and regulations have been developed by private industry, research institutions, governments and nongovernmental organizations, international standards bodies and more. This work details representative approaches to ethically developing, managing, and operating current AI technologies. The various approaches are analyzed for commonality, divergence, and implementation strategy to help develop approaches for managing AI tools in the nuclear landscape. This work will support the creation of a common vocabulary and a deeper understanding of the ethical/ responsible AI landscape and advance the considerations required for structured frameworks in the international safeguards domain.

98 NUCLEAR DISARMAMENT, SAFEGUARDS, AND PHYSICAL P↗

The International Nuclear Material Transport Security Regime: A. Multi-Modal Tapestry of Conventions and Agreements

The international legal framework for transporting nuclear material is complex. The tapestry of conventions and agreements in place vary based on the material in transport, the mode or modes of transport used, and the location where the transport is taking place. The instruments range in scale from the international Convention on the Physical Protection of Nuclear Material and Nuclear Facilities and the Amendment to regional conventions and agreements such as those for rail transport (RID), inland waterway (ADN), and road (ADR). As part of their international commitments under the various conventions and agreements, signatories are required to abide by and harmonize their regulations to these international instruments. The challenge for Competent Authorities in drafting regulations consistent with a Member States obligation under international law can be complex. In addition to ensuring their own authority to draft regulations consistent with these conventions, a Competent Authority may need to coordinate with other ministries, departments, or agencies in mapping the various conventions, their annexes, the requirements therein, and understanding how to develop regulations that align both to international law and domestic law. This paper addresses each of these conventions and agreements; providing a summary description of what each means to individual entities that are transporting nuclear material, provide the total number of States Party to each, provide a graphical framework for unpacking the legal complexities at the international level to assist users and competent authorities in orienting themselves to the international instruments and how they apply to specific shipments. A detailed evaluation has been made of the various international and regional conventions and agreements that help govern the security during the international and in some cases the domestic transport of nuclear material, therein providing a tool for understanding the international transport regime for moving these materials.

Fialkoff, Marc↗

Pathways to Carbon Neutrality 2050 in Malaysia and Kuala Lumpur

Malaysia has recently set an ambitious target of achieving carbon neutrality as early as 2050. To accomplish this, the country will need to strategically reduce its emissions across all sectors. In 2020, Malaysia emitted approximately 368 MtCO2e, with the largest sources of emissions including electricity (36% of total emissions), transportation (17%), and industry (15%)1. We find that the greatest reductions in emissions can therefore come from decarbonizing power generation and electrifying end-use sectors. Digitalization, smart technologies, and improved energy efficiency will significantly reduce economy-wide energy consumption. By leveraging efficient technologies, both Malaysia and Kuala Lumpur can address the challenges posed by rapid urbanization and climate change. Digitalization is a broad category that includes a variety of measures; for example, the wide adoption of high-efficiency appliances and lighting or improved building energy codes in the buildings sector. Similarly, technological improvements can advance industrial energy efficiency, and for transportation, smart technologies cover a shift from private to public transportation and the greater use of electric vehicles. While renewable energy (RE) will play a crucial role in decarbonization, achieving carbon neutrality in certain sectors will be difficult without emerging technologies like carbon capture and storage (CCS) and innovative fuel sources such as hydrogen. In order for Malaysia to rely on CCS as a mitigation option, early investment and incentives to the private sector will be critical. This holds for the use of hydrogen as well: investing in the necessary technology, infrastructure, and human capital will allow Malaysia to position itself as an innovator in the region and leverage these advanced technologies as a key part of its climate strategy. Another possible carbon removal option other than CCS would be a land-use sink; however, given that Malaysia is still developing and may deforest in the near-term, this report does not focus on the mitigation potential of land-use change. With its innovative and bold climate plans, Kuala Lumpur is primed to be a leader in regional climate change efforts. Kuala Lumpur is also engaged in several international collaborations to ensure sustainable city development such as the C40 network and the ASEAN Smart Cities Partnership. As such, the city will play a critical role in contributing to Malaysia’s overall climate goals and as a policy trendsetter through ambitious, scalable plans. One key factor in these emissions reductions is that Kuala Lumpur has full control over its building guidelines, allowing for ambitious policies resulting in significant emissions reductions. However, in other sectors, Kuala Lumpur has less direct control over regulations; for example, power generation and integration of RE are largely in the hands of the Malaysian government. With limited and primarily light industry, Kuala Lumpur’s contributions to emissions reductions here are curbed. And, while Kuala Lumpur has control over local transportation policies like increasing access to and quality of public transportation, broad shifts in transportation will stem from national-level policies. As such, multi-level governance is an integral component of Malaysia’s climate strategy and coordination between local and national governments will be essential in reducing emissions and achieving other climate goals. This report addresses these and other key challenges and opportunities Malaysia faces on the road to carbon neutrality.

29 ENERGY PLANNING, POLICY, AND ECONOMY↗

M4SF-20LL010302082- Thermodynamic Database for Generic Disposal System Assessment

This progress report (Level 4 Milestone Number M4SF-20LL010302082) summarizes research conducted at Lawrence Livermore National Laboratory (LLNL) within the Crystalline International Collaborations Activity Number SF-20LL010302081. The activity is focused on our long-term commitment of engaging our partners in international nuclear waste repository research. This includes participation in the Nuclear Energy Agency Thermochemical Database (NEA TDB) Project (Cindy Atkins-Duffin) and development of methodologies for integrating US and international thermodynamic databases for use in SFWST Generic Disposal System Assessment (GDSA) efforts.

12 MANAGEMENT OF RADIOACTIVE AND NON-RADIOACTIVE W↗

VTK-m User's' Guide (V.1.7)

High-performance computing relies on ever finer threading. Advances in processor technology include ever greater numbers of cores, hyperthreading, accelerators with integrated blocks of cores, and special vectorized instructions, all of which require more software parallelism to achieve peak performance. Traditional visualization solutions cannot support this extreme level of concurrency. Extreme scale systems require a new programming model and a fundamental change in how we design algorithms. To address these issues we created VTK-m: the visualization toolkit for multi-/many-core architectures. VTK-m supports a number of algorithms and the ability to design further algorithms through a top-down design with an emphasis on extreme parallelism. VTK-m also provides support for finding and building links across topologies, making it possible to perform operations that determine manifold surfaces, interpolate generated values, and find adjacencies. Although VTK-m provides a simplified high-level interface for programming, its template-based code removes the overhead of abstraction. VTK-m simplifies the development of parallel scientific visualization algorithms by providing a framework of supporting functionality that allows developers to focus on visualization operations. Consider the listings in Figure 1.1 that compares the size of the implementation for the Marching Cubes algorithm in VTK-m with the equivalent reference implementation in the CUDA software development kit. Because VTK-m internally manages the parallel distribution of work and data, the VTK-m implementation is shorter and easier to maintain. Additionally, VTK-m provides data abstractions not provided by other libraries that make code written in VTK-m more versatile.This book includes contributions from the VTK-m community including the VTK-m development team and the user community.

97 MATHEMATICS AND COMPUTING↗

Clinical practice gaps and challenges in non‐alcoholic steatohepatitis care: An international physician needs assessment

Abstract Background and aims Even as several pharmacological treatments for non‐alcoholic steatohepatitis (NASH) are in development, the incidence of NASH is increasing on an international scale. We aim to assess clinical practice gaps and challenges of hepatologists and endocrinologists when managing patients with NASH in four countries (Germany/Italy/United Kingdom/United States) to inform educational interventions. Methods A sequential mixed‐method design was used: qualitative semi‐structured interviews followed by quantitative online surveys. Participants were hepatologists and endocrinologists practising in one of the targeted countries. Interview data underwent thematic analysis and survey data were analysed with chi‐square and Kruskal‐Wallis tests. Results Most interviewees ( n = 24) and surveyed participants (89% of n = 224) agreed that primary care must be involved in screening for NASH, yet many faced challenges involving and collaborating with them. Endocrinologists reported low knowledge of which blood markers to use when suspecting NASH (56%), when to order an MRI (65%) or ultrasound/FibroScan® (46%), and reported sub‐optimal skills interpreting alanine aminotransferase (ALT, 37%) and aspartate aminotransferase (AST, 38%) blood marker test results, causing difficulty during diagnosis. Participants believed that more evidence is needed for upcoming therapeutic agents; yet, they reported sub‐optimal knowledge of eligibility criteria for clinical trials. Knowledge and skill gaps when managing comorbidities, as well as skill gaps facilitating patient lifestyle changes were reported. Conclusions Educational interventions are needed to address the knowledge and skill gaps identified and to develop strategies to optimize patient care, which include implementing relevant care pathways, encouraging referrals and testing, and multidisciplinary collaboration, as suggested by the recent Global Consensus statement on NAFLD.

Lazure, Patrice↗