| 1. |
- Fullman, N., et al.
(author)
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Measuring performance on the Healthcare Access and Quality Index for 195 countries and territories and selected subnational locations: a systematic analysis from the Global Burden of Disease Study 2016
- 2018
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In: Lancet. - : Elsevier BV. - 0140-6736. ; 391:10136, s. 2236-2271
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Journal article (peer-reviewed)abstract
- Background A key component of achieving universal health coverage is ensuring that all populations have access to quality health care. Examining where gains have occurred or progress has faltered across and within countries is crucial to guiding decisions and strategies for future improvement. We used the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) to assess personal health-care access and quality with the Healthcare Access and Quality (HAQ) Index for 195 countries and territories, as well as subnational locations in seven countries, from 1990 to 2016. Methods Drawing from established methods and updated estimates from GBD 2016, we used 32 causes from which death should not occur in the presence of effective care to approximate personal health-care access and quality by location and over time. To better isolate potential effects of personal health-care access and quality from underlying risk factor patterns, we risk-standardised cause-specific deaths due to non-cancers by location-year, replacing the local joint exposure of environmental and behavioural risks with the global level of exposure. Supported by the expansion of cancer registry data in GBD 2016, we used mortality-to-incidence ratios for cancers instead of risk-standardised death rates to provide a stronger signal of the effects of personal health care and access on cancer survival. We transformed each cause to a scale of 0-100, with 0 as the first percentile (worst) observed between 1990 and 2016, and 100 as the 99th percentile (best); we set these thresholds at the country level, and then applied them to subnational locations. We applied a principal components analysis to construct the HAQ Index using all scaled cause values, providing an overall score of 0-100 of personal health-care access and quality by location over time. We then compared HAQ Index levels and trends by quintiles on the Socio-demographic Index (SDI), a summary measure of overall development. As derived from the broader GBD study and other data sources, we examined relationships between national HAQ Index scores and potential correlates of performance, such as total health spending per capita. Findings In 2016, HAQ Index performance spanned from a high of 97.1 (95% UI 95.8-98.1) in Iceland, followed by 96.6 (94.9-97.9) in Norway and 96.1 (94.5-97.3) in the Netherlands, to values as low as 18.6 (13.1-24.4) in the Central African Republic, 19.0 (14.3-23.7) in Somalia, and 23.4 (20.2-26.8) in Guinea-Bissau. The pace of progress achieved between 1990 and 2016 varied, with markedly faster improvements occurring between 2000 and 2016 for many countries in sub-Saharan Africa and southeast Asia, whereas several countries in Latin America and elsewhere saw progress stagnate after experiencing considerable advances in the HAQ Index between 1990 and 2000. Striking subnational disparities emerged in personal health-care access and quality, with China and India having particularly large gaps between locations with the highest and lowest scores in 2016. In China, performance ranged from 91.5 (89.1-936) in Beijing to 48.0 (43.4-53.2) in Tibet (a 43.5-point difference), while India saw a 30.8-point disparity, from 64.8 (59.6-68.8) in Goa to 34.0 (30.3-38.1) in Assam. Japan recorded the smallest range in subnational HAQ performance in 2016 (a 4.8-point difference), whereas differences between subnational locations with the highest and lowest HAQ Index values were more than two times as high for the USA and three times as high for England. State-level gaps in the HAQ Index in Mexico somewhat narrowed from 1990 to 2016 (from a 20.9-point to 17.0-point difference), whereas in Brazil, disparities slightly increased across states during this time (a 17.2-point to 20.4-point difference). Performance on the HAQ Index showed strong linkages to overall development, with high and high-middle SDI countries generally having higher scores and faster gains for non-communicable diseases. Nonetheless, countries across the development spectrum saw substantial gains in some key health service areas from 2000 to 2016, most notably vaccine-preventable diseases. Overall, national performance on the HAQ Index was positively associated with higher levels of total health spending per capita, as well as health systems inputs, but these relationships were quite heterogeneous, particularly among low-to-middle SDI countries. Interpretation GBD 2016 provides a more detailed understanding of past success and current challenges in improving personal health-care access and quality worldwide. Despite substantial gains since 2000, many low-SDI and middle-SDI countries face considerable challenges unless heightened policy action and investments focus on advancing access to and quality of health care across key health services, especially non-communicable diseases. Stagnating or minimal improvements experienced by several low-middle to high-middle SDI countries could reflect the complexities of re-orienting both primary and secondary health-care services beyond the more limited foci of the Millennium Development Goals. Alongside initiatives to strengthen public health programmes, the pursuit of universal health coverage upon improving both access and quality worldwide, and thus requires adopting a more comprehensive view and subsequent provision of quality health care for all populations. Copyright (C) 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.
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| 2. |
- Aaltonen, T., et al.
(author)
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Combination of CDF and D0 measurements of the W boson helicity in top quark decays
- 2012
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In: Physical Review D. - 1550-7998 .- 1550-2368. ; 85:7, s. 071106-
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Journal article (peer-reviewed)abstract
- We report the combination of recent measurements of the helicity of the W boson from top quark decay by the CDF and D0 collaborations, based on data samples corresponding to integrated luminosities of 2.7-5.4 fb(-1) of p (p) over bar collisions collected during Run II of the Fermilab Tevatron collider. Combining measurements that simultaneously determine the fractions of W bosons with longitudinal (f(0)) and right-handed (f(+)) helicities, we find f(0) = 0.722 +/- 0.081[+/- 0.062(stat) +/- 0.052(syst)] and f(+) = -0.033 +/- 0.046[+/- 0.034(stat) +/- 0.031(syst)]. Combining measurements where one of the helicity fractions is fixed to the value expected in the standard model, we find f(0) = 0.682 +/- 0.057[+/- 0.035(stat) +/- 0.046(syst)] for fixed f(+) and f(+) = -0.015 +/- 0.035[+/- 0.018(stat) +/- 0.030(syst)] for fixed f(0). The results are consistent with standard model expectations.
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| 3. |
- Aaltonen, T., et al.
(author)
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Evidence for a Particle Produced in Association with Weak Bosons and Decaying to a Bottom-Antibottom Quark Pair in Higgs Boson Searches at the Tevatron
- 2012
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In: Physical Review Letters. - 0031-9007 .- 1079-7114. ; 109:7, s. 071804-
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Journal article (peer-reviewed)abstract
- We combine searches by the CDF and D0 Collaborations for the associated production of a Higgs boson with a W or Z boson and subsequent decay of the Higgs boson to a bottom-antibottom quark pair. The data, originating from Fermilab Tevatron p (p) over bar collisions at root s = 1.96 TeV, correspond to integrated luminosities of up to 9.7 fb(-1). The searches are conducted for a Higgs boson with mass in the range 100-150 GeV/c(2). We observe an excess of events in the data compared with the background predictions, which is most significant in the mass range between 120 and 135 GeV/c(2). The largest local significance is 3.3 standard deviations, corresponding to a global significance of 3.1 standard deviations. We interpret this as evidence for the presence of a new particle consistent with the standard model Higgs boson, which is produced in association with a weak vector boson and decays to a bottom-antibottom quark pair.
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| 4. |
- Agredano Torres, Manuel, et al.
(author)
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Coils and power supplies design for the SMART tokamak
- 2021
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In: Fusion engineering and design. - : Elsevier BV. - 0920-3796 .- 1873-7196. ; 168, s. 112683-112683
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Journal article (peer-reviewed)abstract
- A new spherical tokamak, the SMall Aspect Ratio Tokamak (SMART), is currently being designed at the University of Seville. The goal of the machine is to achieve a toroidal field of 1 T, a plasma current of 500 kA and a pulse length of 500 ms for a plasma with a major radius of 0.4 m and minor radius of 0.25 m. This contribution presents the design of the coils and power supplies of the machine. The design foresees a central solenoid, 12 toroidal field coils and 8 poloidal field coils. Taking the current waveforms for these set of coils as starting point, each of them has been designed to withstand the Joule heating during the tokamak operation time. An analytical thermal model is employed to obtain the cross sections of each coil and, finally, their dimensions and parameters. The design of flexible and modular power supplies, based on IGBTs and supercapacitors, is presented. The topologies and control strategy of the power supplies are explained, together with a model in MATLAB Simulink to simulate the power supplies performance, proving their feasibility before the construction of the system.
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| 5. |
- Doyle, S.J., et al.
(author)
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Magnetic equilibrium design for the SMART tokamak
- 2021
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In: Fusion engineering and design. - : Elsevier BV. - 0920-3796 .- 1873-7196. ; 171, s. 112706-112706
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Journal article (peer-reviewed)abstract
- The SMall Aspect Ratio Tokamak (SMART) device is a new compact (plasma major radius Rgeo≥0.40 m, minor radius a≥0.20 m, aspect ratio A≥1.7) spherical tokamak, currently in development at the University of Seville. The SMART device has been designed to achieve a magnetic field at the plasma center of up to Bϕ=1.0 T with plasma currents up to Ip=500 kA and a pulse length up to τft=500 ms. A wide range of plasma shaping configurations are envisaged, including triangularities between −0.50≤δ≤0.50 and elongations of κ≤2.25. Control of plasma shaping is achieved through four axially variable poloidal field coils (PF), and four fixed divertor (Div) coils, nominally allowing operation in lower-single null, upper-single null and double-null configurations. This work examines phase 2 of the SMART device, presenting a baseline reference equilibrium and two highly-shaped triangular equilibria. The relevant PF and Div coil current waveforms are also presented. Equilibria are obtained via an axisymmetric Grad-Shafranov force balance solver (Fiesta), in combination with a circuit equation rigid current displacement model (RZIp) to obtain time-resolved vessel and plasma currents.
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| 6. |
- Doyle, S J, et al.
(author)
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Single and double null equilibria in the SMART Tokamak
- 2021
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In: Plasma Research Express. - : IOP Publishing. - 2516-1067. ; 3:4
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Journal article (peer-reviewed)abstract
- The SMall Aspect Ratio Tokamak (SMART) device is a novel, compact (Rgeo = 0.42 m, a = 0.22 m, A 1.70) spherical tokamak, currently under development at the University of Seville. The SMART device is being developed over 3 phases, with target on-axis toroidal magnetic fields between 0.1 ≼ Bf ≼ 1.0 T, and target plasma currents of between 35 ≼ Ip ≼ 400 kA; with phases 2 and 3 enabling access to a wide range of elongations (κ ≼ 2.30) and triangularities (− 0.50 ≼ δ ≼ 0.50). SMART employs four internal divertor coils with two internal and two external poloidal field coils, enabling operation in lower-single, upper-single and double-null configurations. This work examines phase 3 of the SMART device, presenting a prospective L-mode discharge scenario without external heating, before examining five highly-shaped equilibria, including: two double null triangular configurations, two single null triangular configurations and a baseline double null configuration. All equilibria are obtained via an axisymmetric Grad-Shafranov force balance solver (Fiesta), in combination with a circuit equation rigid current displacement model (RZIp) to obtain time-resolved vessel and plasma currents.
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| 7. |
- Mancini, A., et al.
(author)
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Mechanical and electromagnetic design of the vacuum vessel of the SMART tokamak
- 2021
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In: Fusion engineering and design. - : Elsevier BV. - 0920-3796 .- 1873-7196. ; 171
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Journal article (peer-reviewed)abstract
- The SMall Aspect Ratio Tokamak (SMART) is a new spherical device that is currently being designed at the University of Seville. SMART is a compact machine with a plasma major radius () greater than 0.4 m, plasma minor radius () greater than 0.2 m, an aspect ratio () over than 1.7 and an elongation () of more than 2. It will be equipped with 4 poloidal field coils, 4 divertor field coils, 12 toroidal field coils and a central solenoid. The heating system comprises of a Neutral Beam Injector (NBI) of 600 kW and an Electron Cyclotron Resonance Heating (ECRH) of 6 kW for pre-ionization. SMART has been designed for a plasma current () of 500 kA, a toroidal magnetic field () of 1 T and a pulse length of 500 ms preserving the compactness of the machine. The free boundary equilibrium solver code FIESTA [1] coupled to the linear time independent, rigid plasma model RZIP [2] has been used to calculate the target equilibria taking into account the physics goals, the required plasma parameters, vacuum vessel structures and power supply requirements. We present here the final design of the SMART vacuum vessel together with the Finite Element Model (FEM) analysis carried out to ensure that the tokamak vessel provides high quality vacuum and plasma performance withstanding the electromagnetic loads caused by the interaction between the eddy currents induced in the vessel itself and the surrounding magnetic fields. A parametric model has been set up for the topological optimization of the vessel where the thickness of the wall has been locally adapted to the expected forces. An overview of the new machine is presented here.
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| 8. |
- Munk, P., et al.
(author)
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Genomic analysis of sewage from 101 countries reveals global landscape of antimicrobial resistance
- 2022
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In: Nature Communications. - : Springer Science and Business Media LLC. - 2041-1723. ; 13:1
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Journal article (peer-reviewed)abstract
- Antimicrobial resistance (AMR) is a major threat to global health. Understanding the emergence, evolution, and transmission of individual antibiotic resistance genes (ARGs) is essential to develop sustainable strategies combatting this threat. Here, we use metagenomic sequencing to analyse ARGs in 757 sewage samples from 243 cities in 101 countries, collected from 2016 to 2019. We find regional patterns in resistomes, and these differ between subsets corresponding to drug classes and are partly driven by taxonomic variation. The genetic environments of 49 common ARGs are highly diverse, with most common ARGs carried by multiple distinct genomic contexts globally and sometimes on plasmids. Analysis of flanking sequence revealed ARG-specific patterns of dispersal limitation and global transmission. Our data furthermore suggest certain geographies are more prone to transmission events and should receive additional attention.
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| 9. |
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Overview of the JET results
- 2015
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In: Nuclear Fusion. - : IOP Publishing. - 0029-5515 .- 1741-4326. ; 55:10
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Journal article (peer-reviewed)
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| 10. |
- Pulit, S. L., et al.
(author)
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Atrial fibrillation genetic risk differentiates cardioembolic stroke from other stroke subtypes
- 2018
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In: Neurology-Genetics. - : Ovid Technologies (Wolters Kluwer Health). - 2376-7839. ; 4:6
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Journal article (peer-reviewed)abstract
- Objective We sought to assess whether genetic risk factors for atrial fibrillation (AF) can explain cardioembolic stroke risk. We evaluated genetic correlations between a previous genetic study of AF and AF in the presence of cardioembolic stroke using genome-wide genotypes from the Stroke Genetics Network (N = 3,190 AF cases, 3,000 cardioembolic stroke cases, and 28,026 referents). We tested whether a previously validated AF polygenic risk score (PRS) associated with cardioembolic and other stroke subtypes after accounting for AF clinical risk factors. We observed a strong correlation between previously reported genetic risk for AF, AF in the presence of stroke, and cardioembolic stroke (Pearson r = 0.77 and 0.76, respectively, across SNPs with p < 4.4 x 10(-4) in the previous AF meta-analysis). An AF PRS, adjusted for clinical AF risk factors, was associated with cardioembolic stroke (odds ratio [OR] per SD = 1.40, p = 1.45 x 10(-48)), explaining similar to 20% of the heritable component of cardioembolic stroke risk. The AF PRS was also associated with stroke of undetermined cause (OR per SD = 1.07,p = 0.004), but no other primary stroke subtypes (all p > 0.1). Genetic risk of AF is associated with cardioembolic stroke, independent of clinical risk factors. Studies are warranted to determine whether AF genetic risk can serve as a biomarker for strokes caused by AF.
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