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- Fenstermacher, M.E., et al.
(författare)
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DIII-D research advancing the physics basis for optimizing the tokamak approach to fusion energy
- 2022
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Ingår i: Nuclear Fusion. - : IOP Publishing. - 0029-5515 .- 1741-4326. ; 62:4
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Tidskriftsartikel (refereegranskat)abstract
- DIII-D physics research addresses critical challenges for the operation of ITER and the next generation of fusion energy devices. This is done through a focus on innovations to provide solutions for high performance long pulse operation, coupled with fundamental plasma physics understanding and model validation, to drive scenario development by integrating high performance core and boundary plasmas. Substantial increases in off-axis current drive efficiency from an innovative top launch system for EC power, and in pressure broadening for Alfven eigenmode control from a co-/counter-I p steerable off-axis neutral beam, all improve the prospects for optimization of future long pulse/steady state high performance tokamak operation. Fundamental studies into the modes that drive the evolution of the pedestal pressure profile and electron vs ion heat flux validate predictive models of pedestal recovery after ELMs. Understanding the physics mechanisms of ELM control and density pumpout by 3D magnetic perturbation fields leads to confident predictions for ITER and future devices. Validated modeling of high-Z shattered pellet injection for disruption mitigation, runaway electron dissipation, and techniques for disruption prediction and avoidance including machine learning, give confidence in handling disruptivity for future devices. For the non-nuclear phase of ITER, two actuators are identified to lower the L-H threshold power in hydrogen plasmas. With this physics understanding and suite of capabilities, a high poloidal beta optimized-core scenario with an internal transport barrier that projects nearly to Q = 10 in ITER at ∼8 MA was coupled to a detached divertor, and a near super H-mode optimized-pedestal scenario with co-I p beam injection was coupled to a radiative divertor. The hybrid core scenario was achieved directly, without the need for anomalous current diffusion, using off-axis current drive actuators. Also, a controller to assess proximity to stability limits and regulate β N in the ITER baseline scenario, based on plasma response to probing 3D fields, was demonstrated. Finally, innovative tokamak operation using a negative triangularity shape showed many attractive features for future pilot plant operation.
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- Kalaria, Raj, et al.
(författare)
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The 2022 symposium on dementia and brain aging in low- and middle-income countries: Highlights on research, diagnosis, care, and impact.
- 2024
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Ingår i: Alzheimer's & dementia : the journal of the Alzheimer's Association. - 1552-5279.
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Tidskriftsartikel (refereegranskat)abstract
- Two of every three persons living with dementia reside in low- and middle-income countries (LMICs). The projected increase in global dementia rates is expected to affect LMICs disproportionately. However, the majority of global dementia care costs occur in high-income countries (HICs), with dementia research predominantly focusing on HICs. This imbalance necessitates LMIC-focused research to ensure that characterization of dementia accurately reflects the involvement and specificities of diverse populations. Development of effective preventive, diagnostic, and therapeutic approaches for dementia in LMICs requires targeted, personalized, and harmonized efforts. Our article represents timely discussions at the 2022 Symposium on Dementia and Brain Aging in LMICs that identified the foremost opportunities to advance dementia research, differential diagnosis, use of neuropsychometric tools, awareness, and treatment options. We highlight key topics discussed at the meeting and provide future recommendations to foster a more equitable landscape for dementia prevention, diagnosis, care, policy, and management in LMICs. HIGHLIGHTS: Two-thirds of persons with dementia live in LMICs, yet research and costs are skewed toward HICs. LMICs expect dementia prevalence to more than double, accompanied by socioeconomic disparities. The 2022 Symposium on Dementia in LMICs addressed advances in research, diagnosis, prevention, and policy. The Nairobi Declaration urges global action to enhance dementia outcomes in LMICs.
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- Munch, Marie W., et al.
(författare)
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Effect of 12 mg vs 6 mg of Dexamethasone on the Number of Days Alive Without Life Support in Adults With COVID-19 and Severe Hypoxemia The COVID STEROID 2 Randomized Trial
- 2021
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Ingår i: Journal of the American Medical Association (JAMA). - : AMER MEDICAL ASSOC. - 0098-7484 .- 1538-3598. ; 326:18, s. 1807-1817
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Tidskriftsartikel (refereegranskat)abstract
- Question What is the effect of 12 mg vs 6 mg of dexamethasone on the number of days alive without life support at 28 days in patients with COVID-19 and severe hypoxemia? Findings In this randomized trial that included 1000 patients with COVID-19 and severe hypoxemia, treatment with 12 mg/d of dexamethasone resulted in 22.0 days alive without life support at 28 days compared with 20.5 days in those receiving 6 mg/d of dexamethasone. This difference was not statistically significant. Meaning Compared with 6 mg of dexamethasone, 12 mg of dexamethasone did not statistically significantly reduce the number of days alive without life support at 28 days. This multicenter randomized clinical trial compares the effects of 12 mg/d vs 6 mg/d of dexamethasone in patients with COVID-19 and severe hypoxemia. IMPORTANCE A daily dose with 6 mg of dexamethasone is recommended for up to 10 days in patients with severe and critical COVID-19, but a higher dose may benefit those with more severe disease. OBJECTIVE To assess the effects of 12 mg/d vs 6 mg/d of dexamethasone in patients with COVID-19 and severe hypoxemia. DESIGN, SETTING, AND PARTICIPANTS A multicenter, randomized clinical trial was conducted between August 2020 and May 2021 at 26 hospitals in Europe and India and included 1000 adults with confirmed COVID-19 requiring at least 10 L/min of oxygen or mechanical ventilation. End of 90-day follow-up was on August 19, 2021. INTERVENTIONS Patients were randomized 1:1 to 12 mg/d of intravenous dexamethasone (n = 503) or 6 mg/d of intravenous dexamethasone (n = 497) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was the number of days alive without life support (invasive mechanical ventilation, circulatory support, or kidney replacement therapy) at 28 days and was adjusted for stratification variables. Of the 8 prespecified secondary outcomes, 5 are included in this analysis (the number of days alive without life support at 90 days, the number of days alive out of the hospital at 90 days, mortality at 28 days and at 90 days, and >= 1 serious adverse reactions at 28 days). RESULTS Of the 1000 randomized patients, 982 were included (median age, 65 [IQR, 55-73] years; 305 [31%] women) and primary outcome data were available for 971 (491 in the 12 mg of dexamethasone group and 480 in the 6 mg of dexamethasone group). The median number of days alive without life support was 22.0 days (IQR, 6.0-28.0 days) in the 12 mg of dexamethasone group and 20.5 days (IQR, 4.0-28.0 days) in the 6 mg of dexamethasone group (adjusted mean difference, 1.3 days [95% CI, 0-2.6 days]; P = .07). Mortality at 28 days was 27.1% in the 12 mg of dexamethasone group vs 32.3% in the 6 mg of dexamethasone group (adjusted relative risk, 0.86 [99% CI, 0.68-1.08]). Mortality at 90 days was 32.0% in the 12 mg of dexamethasone group vs 37.7% in the 6 mg of dexamethasone group (adjusted relative risk, 0.87 [99% CI, 0.70-1.07]). Serious adverse reactions, including septic shock and invasive fungal infections, occurred in 11.3% in the 12 mg of dexamethasone group vs 13.4% in the 6 mg of dexamethasone group (adjusted relative risk, 0.83 [99% CI, 0.54-1.29]). CONCLUSIONS AND RELEVANCE Among patients with COVID-19 and severe hypoxemia, 12 mg/d of dexamethasone compared with 6 mg/d of dexamethasone did not result in statistically significantly more days alive without life support at 28 days. However, the trial may have been underpowered to identify a significant difference.
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- Long, Madeleine R., et al.
(författare)
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Understudied factors contributing to variability in cognitive performance related to language learning
- 2020
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Ingår i: Bilingualism. - : Cambridge University Press. - 1366-7289 .- 1469-1841. ; 23:4, s. 801-811
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Tidskriftsartikel (refereegranskat)abstract
- While much of the literature on bilingualism and cognition focuses on group comparisons (monolinguals vs bilinguals or language learners vs controls), here we examine the potential differential effects of intensive language learning on subjects with distinct language experiences and demographic profiles. Using an individual differences approach, we assessed attentional performance from 105 university-educated Gaelic learners aged 21-85. Participants were tested before and after beginner, elementary, and intermediate courses using tasks measuring i.) sustained attention, ii.) inhibition, and iii.) attention switching. We examined the relationship between attentional performance and Gaelic level, previous language experience, gender, and age. Gaelic level predicted attention switching performance: those in higher levels initially outperformed lower levels, however lower levels improved the most. Age also predicted performance: as age increased attention switching decreased. Nevertheless, age did not interact with session for any attentional measure, thus the impact of language learning on cognition was detectable across the lifespan.
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- Vega-Mendoza, Mariana, et al.
(författare)
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Language Learning for People Living with Dementia and Their Caregivers: Feasibility and the Quality of Experience
- 2024
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Ingår i: Healthcare. - : Multidisciplinary Digital Publishing Institute (MDPI). - 2227-9032. ; 12:7
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Tidskriftsartikel (refereegranskat)abstract
- Background: A body of research from around the world has reported positive effects of bilingualism on cognitive ageing and dementia. However, little is known about whether foreign language learning could be applied as an intervention for people already living with dementia. Yet, before it is possible to determine the efficacy of language courses as an intervention for people living with dementia (PLWD), it is necessary to establish whether such an intervention is feasible. Our study explored this possibility. Methods: We conducted an exploratory study to examine the feasibility and tolerability of 2-week Italian beginner courses for PLWD in early stages and their family carers in two Scottish Dementia Resource Centres (DRCs). The courses were delivered by trained tutors from Lingo Flamingo, a social enterprise specialising in language teaching for older learners and learners with dementia. Twelve PLWD and seven carers participated in the study. Focus groups preceded and followed the courses. Additional post-course open interviews with the DRC managers were conducted, with a follow-up via telephone approximately one year later. Results: Qualitative content analysis resulted in 12 themes, 5 reflected in the interview schedule and 7 arising from the focus groups and interviews. Overall, the courses were perceived positively by PLWD, carers, and DRC managers, although a few logistically and linguistically challenging aspects were also mentioned. The courses were found to positively impact both the individual by increasing self-esteem and producing a sense of accomplishment as well as the group by creating a sense of community. Notably, no adverse effects (in particular no confusion or frustration) were reported. Conclusion: The positive outcomes of our study open a novel avenue for future research to explore foreign language training in dementia as an intervention and its implications.
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- Vega Mendoza, Mariana, et al.
(författare)
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Language learning for people living with dementia and their carers: A feasibility study
- 2021
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Ingår i: Alzheimer's & Dementia. - : John Wiley & Sons. - 1552-5260 .- 1552-5279. ; 17:S6
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Tidskriftsartikel (refereegranskat)abstract
- Background Converging evidence from across the world suggests positive effects of bilingualism on cognitive ageing and dementia, including a ca. 4-6 years delay in the onset of dementia and’or Mild Cognitive Impairment. However, it is less clear whether language learning can also have a positive effect after the onset of dementia. A positive influence would include psychological and social variables, such as patients’ well-being and their relationship with relatives and carers.Method We examined the feasibility and tolerability of language learning for people in early stages of dementia and their family carers in two Scottish Dementia Day Care Centres. A total of 12 people with dementia and 7 family carers participated in the study. All participants had only limited experience of language learning and none were bi-/multilingual. The 2-week courses of beginners Italian were delivered by specially trained tutors from Lingo Flamingo, a social enterprise specialising in language teaching for older learners and learners with Dementia. Before and after the course, we conducted focus group sessions with learners and their carers as well as interviews with teachers and Day Centre care workers.Results Qualitative analyses revealed a positive perception of the courses by patients, carers, and centre managers, impacting both the individual (e.g., boosting self-esteem) and group (e.g., socialising) levels. No adverse effects (e.g., confusion) were reported. The family carers perceived the courses as empowering, as they allowed them to take an active part. The courses led also to a higher attendance in other activities conducted in the Day Care Centre.Conclusions Despite initial fears from professional carers that being confronted with the task of learning a new language might be stressful and lead to frustration and confusion, all participants reported a highly positive experience of the course, including a higher self-esteem and self-confidence as well as establishment of new social contacts and a more positive attitude to other activities of the day care centre. Further studies will be required to determine the optimal frequency, intensity and duration of language courses for people with dementia as well as the best practice of their delivery.
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- Xia, Lihua, et al.
(författare)
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A longitudinal investigation of the effects of language instruction versus immersion on cognitive functions in young adult Chinese speakers learning English
- 2023
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Ingår i: Studies in Second Language Acquisition. - : Cambridge University Press. - 0272-2631 .- 1470-1545. ; 45:1, s. 189-211
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Tidskriftsartikel (refereegranskat)abstract
- The current study examined cognitive effects of two pathways of second language (L2) acquisition longitudinally in Chinese speakers learning English in an L2-dominant environment. Thirty-nine participants who attended an intensive 10-week English course (L2-instruction group) were compared to 38 participants who attended regular university courses taught in English (L2-immersion group). Four repeated assessments were conducted over 10 weeks: precourse (baseline) and postcourse assessments, and two interim assessments every 3 weeks. Both groups matched on background variables (e.g., intelligence) and showed comparable cognitive performance in all measures at the baseline. The longitudinal results showed a similar improvement in both groups for most cognitive measures, such as visual and auditory inhibition. The only significant group difference was observed in the auditory inhibition test, where the L2-instruction group outperformed the L2-immersion group. Taken together, our results suggest a specific effect of language experience and an overall effect of linguistic context on cognitive functions.
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- Xia, Lihua, et al.
(författare)
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Interference suppression in bilingualism : Stimulus-Stimulus vs. Stimulus-Response conflict
- 2022
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Ingår i: Bilingualism. - : Cambridge University Press. - 1366-7289 .- 1469-1841. ; 25:2, s. 256-268
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Tidskriftsartikel (refereegranskat)abstract
- Studies examining the potential effects of bilingualism on interference suppression show inconsistent results. Our study approaches this topic by distinguishing two potential subcomponents within interference suppression (i.e., Stimulus-Stimulus and Stimulus-Response conflict). We investigated the two subcomponents through their operationalisation in different tasks and examined the role of language proficiency in modulating it. A sample of 111 young adult participants performed four non-linguistic cognitive tasks measuring both visual and auditory domains of cognitive control. Bilinguals outperformed monolinguals in tasks involving Stimulus-Stimulus conflict, but showed comparable performance in tasks involving Stimulus-Response conflict. Specific effects of language proficiency on cognitive control were observed: group differences in auditory inhibition and visual orienting were only observed between high-proficient bilinguals and monolinguals. Taken together, types of conflicts involved in interference tasks and language proficiency could differentially affect performance in monolinguals and bilinguals.
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