| 1. |
- Bravo, L, et al.
(författare)
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- 2021
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swepub:Mat__t
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| 2. |
- Tabiri, S, et al.
(författare)
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- 2021
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swepub:Mat__t
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| 3. |
- Khatri, C, et al.
(författare)
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Outcomes after perioperative SARS-CoV-2 infection in patients with proximal femoral fractures: an international cohort study
- 2021
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Ingår i: BMJ open. - : BMJ. - 2044-6055. ; 11:11, s. e050830-
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Tidskriftsartikel (refereegranskat)abstract
- Studies have demonstrated high rates of mortality in people with proximal femoral fracture and SARS-CoV-2, but there is limited published data on the factors that influence mortality for clinicians to make informed treatment decisions. This study aims to report the 30-day mortality associated with perioperative infection of patients undergoing surgery for proximal femoral fractures and to examine the factors that influence mortality in a multivariate analysis.SettingProspective, international, multicentre, observational cohort study.ParticipantsPatients undergoing any operation for a proximal femoral fracture from 1 February to 30 April 2020 and with perioperative SARS-CoV-2 infection (either 7 days prior or 30-day postoperative).Primary outcome30-day mortality. Multivariate modelling was performed to identify factors associated with 30-day mortality.ResultsThis study reports included 1063 patients from 174 hospitals in 19 countries. Overall 30-day mortality was 29.4% (313/1063). In an adjusted model, 30-day mortality was associated with male gender (OR 2.29, 95% CI 1.68 to 3.13, p<0.001), age >80 years (OR 1.60, 95% CI 1.1 to 2.31, p=0.013), preoperative diagnosis of dementia (OR 1.57, 95% CI 1.15 to 2.16, p=0.005), kidney disease (OR 1.73, 95% CI 1.18 to 2.55, p=0.005) and congestive heart failure (OR 1.62, 95% CI 1.06 to 2.48, p=0.025). Mortality at 30 days was lower in patients with a preoperative diagnosis of SARS-CoV-2 (OR 0.6, 95% CI 0.6 (0.42 to 0.85), p=0.004). There was no difference in mortality in patients with an increase to delay in surgery (p=0.220) or type of anaesthetic given (p=0.787).ConclusionsPatients undergoing surgery for a proximal femoral fracture with a perioperative infection of SARS-CoV-2 have a high rate of mortality. This study would support the need for providing these patients with individualised medical and anaesthetic care, including medical optimisation before theatre. Careful preoperative counselling is needed for those with a proximal femoral fracture and SARS-CoV-2, especially those in the highest risk groups.Trial registration numberNCT04323644
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| 8. |
- 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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| 9. |
- Creely, A. J., et al.
(författare)
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Overview of the SPARC tokamak
- 2020
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Ingår i: Journal of Plasma Physics. - 0022-3778 .- 1469-7807. ; 86:5
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Tidskriftsartikel (refereegranskat)abstract
- The SPARC tokamak is a critical next step towards commercial fusion energy. SPARC is designed as a high-field (B-0 = 12.2 T), compact (R-0 = 1.85 m, a = 0.57 m), superconducting, D-T tokamak with the goal of producing fusion gain Q > 2 from a magnetically confined fusion plasma for the first time. Currently under design, SPARC will continue the high-field path of the Alcator series of tokamaks, utilizing new magnets based on rare earth barium copper oxide high-temperature superconductors to achieve high performance in a compact device. The goal of Q > 2 is achievable with conservative physics assumptions (H-98,H- y2 = 0.7) and, with the nominal assumption of H-98,H- y2 = 1, SPARC is projected to attain Q approximate to 11 and P-fusion approximate to 140 MW. SPARC will therefore constitute a unique platform for burning plasma physics research with high density (< n(e)> approximate to 3 x 10(20) m(-3)), high temperature (< Te > approximate to 7 keV) and high power density (P-fusion/V-plasma approximate to 7 MWm(-3)) relevant to fusion power plants. SPARC's place in the path to commercial fusion energy, its parameters and the current status of SPARC design work are presented. This work also describes the basis for global performance projections and summarizes some of the physics analysis that is presented in greater detail in the companion articles of this collection.
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| 10. |
- Lomanowski, B., et al.
(författare)
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Experimental study on the role of the target electron temperature as a key parameter linking recycling to plasma performance in JET-ILW*
- 2022
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Ingår i: Nuclear Fusion. - : IOP Publishing. - 0029-5515 .- 1741-4326. ; 62:6
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Tidskriftsartikel (refereegranskat)abstract
- Changes in global and edge plasma parameters (H (98(y,2)), dimensionless collisionality nu *, core density peaking, separatrix density n (e,sep)) with variations in the D-2 fueling rate and divertor configuration are unified into a single trend when mapped to ⟨T (e,ot)⟩, the spatially averaged spectroscopically derived outer target electron temperature. Dedicated JET with the ITER-like wall (JET-ILW) experiments in combination with an extended JET-ILW database of unseeded low-triangularity H-mode plasmas spanning a wide range of D-2 fueling rates, I (p), B (t) and heating power have demonstrated the importance of ⟨T (e,ot)⟩ as a key physics parameter linking the recycling particle source and detachment with plasma performance. The remarkably robust H (98(y,2)) trend with ⟨T (e,ot)⟩ is connected to a strong inverse correlation between ⟨T (e,ot)⟩, n (e,sep) and nu *, thus directly linking changes in the divertor recycling moderated by ⟨T (e,ot)⟩ with the previously established relationship between nu *, core density peaking and core pressure resulting in a degradation in core plasma performance with decreasing ⟨T (e,ot)⟩ (increasing nu *). A strong inverse correlation between the separatrix to pedestal density ratio, n (e,sep)/n (e,ped), and ⟨T (e,ot)⟩ is also established, with the rise in n (e,sep)/n (e,ped) saturating at ⟨T (e,ot)⟩ > 10 eV. A strong reduction in H (98(y,2)) is observed as ⟨T (e,ot)⟩ is driven from 30 to 10 eV via additional D-2 gas fueling, while the divertor remains attached. Consequently, the pronounced performance degradation in attached divertor conditions has implications for impurity seeding radiative divertor scenarios, in which H (98(y,2)) is already low (similar to 0.7) before impurities are injected into the plasma since moderate gas fueling rates are required to promote high divertor neutral pressure. A favorable pedestal pressure, p (e,ped), dependence on I (p) has also been observed, with an overall increase in p (e,ped) at I (p) = 3.4 MA as ⟨T (e,ot)⟩ is driven down from attached to high-recycling divertor conditions. In contrast, p (e,ped) is reduced with decreasing ⟨T (e,ot)⟩ in the lower I (p) branches. Further work is needed to (i) clarify the potential role of edge opacity on the observed favorable pedestal pressure I (p) scaling; as well as to (ii) project the global and edge plasma performance trends with ⟨T (e,ot)⟩ to reactor-scale devices to improve predictive capability of the coupling between recycling and confined plasma fueling in what are foreseen to be more opaque edge plasma conditions.
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