| 1. |
- Glasbey, JC, et al.
(författare)
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- 2021
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swepub:Mat__t
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| 2. |
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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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| 4. |
- Drake, TM, et al.
(författare)
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Surgical site infection after gastrointestinal surgery in children: an international, multicentre, prospective cohort study
- 2020
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Ingår i: BMJ global health. - : BMJ. - 2059-7908. ; 5:12
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Tidskriftsartikel (refereegranskat)abstract
- Surgical site infection (SSI) is one of the most common healthcare-associated infections (HAIs). However, there is a lack of data available about SSI in children worldwide, especially from low-income and middle-income countries. This study aimed to estimate the incidence of SSI in children and associations between SSI and morbidity across human development settings.MethodsA multicentre, international, prospective, validated cohort study of children aged under 16 years undergoing clean-contaminated, contaminated or dirty gastrointestinal surgery. Any hospital in the world providing paediatric surgery was eligible to contribute data between January and July 2016. The primary outcome was the incidence of SSI by 30 days. Relationships between explanatory variables and SSI were examined using multilevel logistic regression. Countries were stratified into high development, middle development and low development groups using the United Nations Human Development Index (HDI).ResultsOf 1159 children across 181 hospitals in 51 countries, 523 (45·1%) children were from high HDI, 397 (34·2%) from middle HDI and 239 (20·6%) from low HDI countries. The 30-day SSI rate was 6.3% (33/523) in high HDI, 12·8% (51/397) in middle HDI and 24·7% (59/239) in low HDI countries. SSI was associated with higher incidence of 30-day mortality, intervention, organ-space infection and other HAIs, with the highest rates seen in low HDI countries. Median length of stay in patients who had an SSI was longer (7.0 days), compared with 3.0 days in patients who did not have an SSI. Use of laparoscopy was associated with significantly lower SSI rates, even after accounting for HDI.ConclusionThe odds of SSI in children is nearly four times greater in low HDI compared with high HDI countries. Policies to reduce SSI should be prioritised as part of the wider global agenda.
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| 7. |
- Murari, A., et al.
(författare)
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A control oriented strategy of disruption prediction to avoid the configuration collapse of tokamak reactors
- 2024
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Ingår i: Nature Communications. - 2041-1723 .- 2041-1723. ; 15:1
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Tidskriftsartikel (refereegranskat)abstract
- The objective of thermonuclear fusion consists of producing electricity from the coalescence of light nuclei in high temperature plasmas. The most promising route to fusion envisages the confinement of such plasmas with magnetic fields, whose most studied configuration is the tokamak. Disruptions are catastrophic collapses affecting all tokamak devices and one of the main potential showstoppers on the route to a commercial reactor. In this work we report how, deploying innovative analysis methods on thousands of JET experiments covering the isotopic compositions from hydrogen to full tritium and including the major D-T campaign, the nature of the various forms of collapse is investigated in all phases of the discharges. An original approach to proximity detection has been developed, which allows determining both the probability of and the time interval remaining before an incoming disruption, with adaptive, from scratch, real time compatible techniques. The results indicate that physics based prediction and control tools can be developed, to deploy realistic strategies of disruption avoidance and prevention, meeting the requirements of the next generation of devices.
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| 11. |
- Apponi, A., et al.
(författare)
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Heisenberg's uncertainty principle in the PTOLEMY project : A theory update
- 2022
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Ingår i: Physical Review D. - : American Physical Society. - 2470-0010 .- 2470-0029. ; 106:5
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Tidskriftsartikel (refereegranskat)abstract
- We discuss the consequences of the quantum uncertainty on the spectrum of the electron emitted by the beta-processes of a tritium atom bound to a graphene sheet. We analyze quantitatively the issue recently raised by Cheipesh, Cheianov, and Boyarsky [Phys. Rev. D 104, 116004 (2021)], and discuss the relevant timescales and the degrees of freedom that can contribute to the intrinsic spread in the electron energy. We perform careful calculations of the potential between tritium and graphene with different coverages and geometries. With this at hand, we propose possible avenues to mitigate the effect of the quantum uncertainty.
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| 12. |
- Villanueva-Perez, P., et al.
(författare)
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Scanning Compton X-ray microscopy
- 2021
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Ingår i: Optics Letters. - 0146-9592. ; 46:8, s. 1920-1923
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Tidskriftsartikel (refereegranskat)abstract
- X-ray microscopy offers the opportunity to image biological and radiosensitive materials without special sample preparations, bridging optical and electron microscopy capabilities. However, the performance of such microscopes, when imaging radiosensitive samples, is not limited by their intrinsic resolution, but by the radiation damage induced on such samples. Here, we demonstrate a novel, to the best of our knowledge, radio-efficient microscope, scanning Compton X-ray microscopy (SCXM), which uses coherently and incoherently (Compton) scattered photons to minimize the deposited energy per unit of mass for a given imaging signal. We implemented SCXM, using lenses capable of efficiently focusing 60 keV X-ray photons into the sub-micrometer scale, and probe its radio-efficient capabilities. SCXM, when implemented in high-energy diffraction-limited storage rings, e.g., European Synchrotron Radiation Facility Extremely Brilliant Source and PETRA IV, will open the opportunity to explore the nanoscale of unstained, unsectioned, and undamaged radiosensitive materials.
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| 13. |
- Apponi, A., et al.
(författare)
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Implementation and optimization of the PTOLEMY transverse drift electromagnetic filter
- 2022
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Ingår i: Journal of Instrumentation. - : IOP Publishing Ltd. - 1748-0221. ; 17:5
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Tidskriftsartikel (refereegranskat)abstract
- The PTOLEMY transverse drift filter is a new concept to enable precision analysis of the energy spectrum of electrons near the tritium beta-decay endpoint. This paper details the implementation and optimization methods for successful operation of the filter for electrons with a known pitch angle. We present the first demonstrator that produces the required magnetic field properties with an iron return-flux magnet. Two methods for the setting of filter electrode voltages are detailed. The challenges of low-energy electron transport in cases of low field are discussed, such as the growth of the cyclotron radius with decreasing magnetic field, which puts a ceiling on filter performance relative to fixed filter dimensions. Additionally, low pitch angle trajectories are dominated by motion parallel to the magnetic field lines and introduce non-adiabatic conditions and curvature drift. To minimize these effects and maximize electron acceptance into the filter, we present a three-potential-well design to simultaneously drain the parallel and transverse kinetic energies throughout the length of the filter. These optimizations are shown, in simulation, to achieve low-energy electron transport from a 1 T iron core (or 3 T superconducting) starting field with initial kinetic energy of 18.6 keV drained to < 10 eV (< 1 eV) in about 80 cm. This result for low field operation paves the way for the first demonstrator of the PTOLEMY spectrometer for measurement of electrons near the tritium endpoint to be constructed at the Gran Sasso National Laboratory (LNGS) in Italy.
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| 14. |
- Echelmeier, A., et al.
(författare)
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Segmented flow generator for serial crystallography at the European X-ray free electron laser
- 2020
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Ingår i: Nature Communications. - : Nature Research. - 2041-1723. ; 11:1
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Tidskriftsartikel (refereegranskat)abstract
- Serial femtosecond crystallography (SFX) with X-ray free electron lasers (XFELs) allows structure determination of membrane proteins and time-resolved crystallography. Common liquid sample delivery continuously jets the protein crystal suspension into the path of the XFEL, wasting a vast amount of sample due to the pulsed nature of all current XFEL sources. The European XFEL (EuXFEL) delivers femtosecond (fs) X-ray pulses in trains spaced 100 ms apart whereas pulses within trains are currently separated by 889 ns. Therefore, continuous sample delivery via fast jets wastes >99% of sample. Here, we introduce a microfluidic device delivering crystal laden droplets segmented with an immiscible oil reducing sample waste and demonstrate droplet injection at the EuXFEL compatible with high pressure liquid delivery of an SFX experiment. While achieving ~60% reduction in sample waste, we determine the structure of the enzyme 3-deoxy-D-manno-octulosonate-8-phosphate synthase from microcrystals delivered in droplets revealing distinct structural features not previously reported.
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| 15. |
- Mariani, A., et al.
(författare)
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First-principle based predictions of the effects of negative triangularity on DTT scenarios
- 2024
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Ingår i: Nuclear Fusion. - : IOP Publishing. - 0029-5515 .- 1741-4326. ; 64:4
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Tidskriftsartikel (refereegranskat)abstract
- Plasmas with negative triangularity (NT) shape have been recently shown to be able to achieve H-mode levels of confinement in L-mode, avoiding detrimental edge localised modes. Therefore, this plasma geometry is now studied as a possible viable option for a future fusion reactor. Within this framework, an NT option is under investigation for the full power scenario of the Divertor Tokamak Test (DTT) facility, under construction in Italy, with δ t o p = − 0.32 / δ b o t t o m ≃ 0.02 top/bottom triangularity values at the separatrix. The transport properties of this scenario are studied in this work. Gyrokinetic GENE simulations and integrated modelling using ASTRA with the quasi-linear trapped gyro-Landau fluid (TGLF) model have been performed. The emerging picture from the ASTRA-TGLF runs with boundary conditions at ρ t o r = 0.94 is that, in the L-mode NT option, the larger peaking of the kinetic profiles in the edge region is not sufficient to recover the loss of the PT H-mode pedestal, and reach similar central temperature values. Two additional shapes are also considered, obtained by flipping the triangularity of the scenarios, to single out the effect of the triangularity sign. A negligible ‘direct’ effect of the triangularity is found for the L-mode, while a small beneficial effect is observed for the H-mode. The ASTRA-TGLF results are validated by GENE and TGLF stand-alone at two selected radii. GENE shows ITG dominant micro-instability and explains the small beneficial effect of the NT for the H-mode as due to a strong reduction of the heat fluxes, when reversing the triangularity, with a relatively high T i stiffness. An improvement of the predicted performances of the NT DTT scenario could come from ρ tor ≳ 0.9 , as indicated by some recent experiments at the tokamak à configuration variable (TCV) and ASDEX Upgrade.
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| 16. |
- Nocente, M., et al.
(författare)
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Generation and observation of fast deuterium ions and fusion-born alpha particles in JET D-He-3 plasmas with the 3-ion radio-frequency heating scenario
- 2020
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Ingår i: Nuclear Fusion. - : IOP PUBLISHING LTD. - 0029-5515 .- 1741-4326. ; 60:12
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Tidskriftsartikel (refereegranskat)abstract
- Dedicated experiments to generate energetic D ions and D-(3) He fusion-born alpha particles were performed at the Joint European Torus (JET) with the ITER-like wall (ILW). Using the 3-ion D-(D-NBI)-(3) He radio frequency (RF) heating scenario, deuterium ions from neutral beam injection (NBI) were accelerated in the core of mixed D-(3) He plasmas to higher energies with ion cyclotron resonance frequency (ICRF) waves, in turn leading to a core-localized source of alpha particles. The fast-ion distribution of RF-accelerated D-NBI ions was controlled by varying the ICRF and NBI power (P-ICRF approximate to 4-6 MW, P-NBI approximate to 3-20 MW), resulting in rather high D-D neutron (approximate to 1x10(16) s(-1)) and D-(3) He alpha rates (approximate to 2x10(16) s(-1)) at moderate input heating power. Theory and TRANSP analysis shows that large populations of co-passing MeV-range D ions were generated using the D-(D-NBI)-(3) He 3-ion ICRF scenario. This important result is corroborated by several experimental observations, in particular gamma-ray measurements. The developed experimental scenario at JET provides unique conditions for probing several aspects of future burning plasmas, such as the contribution from MeV range ions to global confinement, but without introducing tritium. Dominant fast-ion core electron heating with T-i approximate to T-e and a rich variety of fast-ion driven Alfven eigenmodes (AEs) were observed in these D-(3) He plasmas. The observed AE activities do not have a detrimental effect on the thermal confinement and, in some cases, may be driven by the fusion born alpha particles. A strong continuous increase in neutron rate was observed during long-period sawteeth (>1 s), accompanied by the observation of reversed shear AEs, which implies that a non monotonic q profile was systematically developed in these plasmas, sustained by the large fast-ion populations generated by the 3-ion ICRF scenario.
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