| 1. |
- DeAngelis, Nicola, et al.
(författare)
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2020 WSES guidelines for the detection and management of bile duct injury during cholecystectomy
- 2021
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Ingår i: World Journal of Emergency Surgery. - : BMC. - 1749-7922. ; 16:1
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Forskningsöversikt (refereegranskat)abstract
- Bile duct injury (BDI) is a dangerous complication of cholecystectomy, with significant postoperative sequelae for the patient in terms of morbidity, mortality, and long-term quality of life. BDIs have an estimated incidence of 0.4-1.5%, but considering the number of cholecystectomies performed worldwide, mostly by laparoscopy, surgeons must be prepared to manage this surgical challenge. Most BDIs are recognized either during the procedure or in the immediate postoperative period. However, some BDIs may be discovered later during the postoperative period, and this may translate to delayed or inappropriate treatments. Providing a specific diagnosis and a precise description of the BDI will expedite the decision-making process and increase the chance of treatment success. Subsequently, the choice and timing of the appropriate reconstructive strategy have a critical role in long-term prognosis. Currently, a wide spectrum of multidisciplinary interventions with different degrees of invasiveness is indicated for BDI management. These World Society of Emergency Surgery (WSES) guidelines have been produced following an exhaustive review of the current literature and an international expert panel discussion with the aim of providing evidence-based recommendations to facilitate and standardize the detection and management of BDIs during cholecystectomy. In particular, the 2020 WSES guidelines cover the following key aspects: (1) strategies to minimize the risk of BDI during cholecystectomy; (2) BDI rates in general surgery units and review of surgical practice; (3) how to classify, stage, and report BDI once detected; (4) how to manage an intraoperatively detected BDI; (5) indications for antibiotic treatment; (6) indications for clinical, biochemical, and imaging investigations for suspected BDI; and (7) how to manage a postoperatively detected BDI.
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| 2. |
- Maggi, C. F., et al.
(författare)
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Isotope identity experiments in JET-ILW with H and D L-mode plasmas
- 2019
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Ingår i: Nuclear Fusion. - : Institute of Physics Publishing (IOPP). - 0029-5515 .- 1741-4326. ; 59:7
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Tidskriftsartikel (refereegranskat)abstract
- NBI-heated L-mode plasmas have been obtained in JET with the Be/W ITER-like wall (JET-ILW) in H and D, with matched profiles of the dimensionless plasma parameters, rho*, nu*, beta and q in the plasma core confinement region and same T-i/T-e and Z(eff). The achieved isotope identity indicates that the confinement scale invariance principle is satisfied in the core confinement region of these plasmas, where the dominant instabilities are Ion Temperature Gradient (ITG) modes. The dimensionless thermal energy confinement time, Omega(i) tau(E,th), and the scaled core plasma heat diffusivity, A chi(eff)/B-T, are identical in H and D within error bars, indicating lack of isotope mass dependence of the dimensionless L-mode thermal energy confinement time in JET-ILW. Predictive flux driven simulations with JETTO-TGLF of the H and D identity pair is in very good agreement with experiment for both isotopes: the stiff core heat transport, typical of JET-ILW NBI heated L-modes, overcomes the local gyro-Bohm scaling of gradient-driven TGLF, explaining the lack of isotope mass dependence in the confinement region of these plasmas. The effect of E x B shearing on the predicted heat and particle transport channels is found to be negligible for these low beta and low momentum input plasmas.
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| 3. |
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| 4. |
- Aiba, N., et al.
(författare)
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Numerical analysis of ELM stability with rotation and ion diamagnetic drift effects in JET
- 2017
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Ingår i: Nuclear Fusion. - : IOP PUBLISHING LTD. - 0029-5515 .- 1741-4326. ; 57:12
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Tidskriftsartikel (refereegranskat)abstract
- Stability to the type-I edge localized mode (ELM) in JET plasmas was investigated numerically by analyzing the stability to a peeling-ballooning mode with the effects of plasma rotation and ion diamagnetic drift. The numerical analysis was performed by solving the extended Frieman-Rotenberg equation with the MINERVA-DI code. To take into account these effects in the stability analysis self-consistently, the procedure of JET equilibrium reconstruction was updated to include the profiles of ion temperature and toroidal rotation, which are determined based on the measurement data in experiments. With the new procedure and MINERVA-DI, it was identified that the stability analysis including the rotation effect can explain the ELM trigger condition in JET with ITER like wall (JET-ILW), though the stability in JET with carbon wall (JET-C) is hardly affected by rotation. The key difference is that the rotation shear in JET-ILW plasmas analyzed in this study is larger than that in JET-C ones, the shear which enhances the dynamic pressure destabilizing a peeling-ballooning mode. In addition, the increase of the toroidal mode number of the unstable MHD mode determining the ELM trigger condition is also important when the plasma density is high in JET-ILW. Though such modes with high toroidal mode number are strongly stabilized by the ion diamagnetic drift effect, it was found that plasma rotation can sometimes overcome this stabilizing effect and destabilizes the peeling-ballooning modes in JET-ILW.
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| 5. |
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| 6. |
- Bombarda, F., et al.
(författare)
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Runaway electron beam control
- 2019
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Ingår i: Plasma Physics and Controlled Fusion. - : IOP Publishing. - 1361-6587 .- 0741-3335. ; 61:1
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Tidskriftsartikel (refereegranskat)
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| 7. |
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| 8. |
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| 9. |
- Bowman, C., et al.
(författare)
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Pedestal evolution physics in low triangularity JET tokamak discharges with ITER-like wall
- 2018
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Ingår i: Nuclear Fusion. - : IOP Publishing. - 0029-5515 .- 1741-4326. ; 58:1
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Tidskriftsartikel (refereegranskat)abstract
- The pressure gradient of the high confinement pedestal region at the edge of tokamak plasmas rapidly collapses during plasma eruptions called edge localised modes (ELMs), and then re-builds over a longer time scale before the next ELM. The physics that controls the evolution of the JET pedestal between ELMs is analysed for 1.4 MA, 1.7 T, low triangularity, delta = 0.2, discharges with the ITER-like wall, finding that the pressure gradient typically tracks the ideal magneto-hydrodynamic ballooning limit, consistent with a role for the kinetic ballooning mode. Furthermore, the pedestal width is often influenced by the region of plasma that has second stability access to the ballooning mode, which can explain its sometimes complex evolution between ELMs. A local gyrokinetic analysis of a second stable flux surface reveals stability to kinetic ballooning modes; global effects are expected to provide a destabilising mechanism and need to be retained in such second stable situations. As well as an electronscale electron temperature gradient mode, ion scale instabilities associated with this flux surface include an electro-magnetic trapped electron branch and two electrostatic branches propagating in the ion direction, one with high radial wavenumber. In these second stability situations, the ELM is triggered by a peeling-ballooning mode; otherwise the pedestal is somewhat below the peeling-ballooning mode marginal stability boundary at ELM onset. In this latter situation, there is evidence that higher frequency ELMs are paced by an oscillation in the plasma, causing a crash in the pedestal before the peeling-ballooning boundary is reached. A model is proposed in which the oscillation is associated with hot plasma filaments that are pushed out towards the plasma edge by a ballooning mode, draining their free energy into the cooler plasma there, and then relaxing back to repeat the process. The results suggest that avoiding the oscillation and maximising the region of plasma that has second stability access will lead to the highest pedestal heights and, therefore, best confinement-a key result for optimising the fusion performance of JET and future tokamaks, such as ITER.
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| 10. |
- Chang, Kuang Yu, et al.
(författare)
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Observational constraints reduce model spread but not uncertainty in global wetland methane emission estimates
- 2023
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Ingår i: Global Change Biology. - 1354-1013. ; 29:15, s. 4298-4312
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Tidskriftsartikel (refereegranskat)abstract
- The recent rise in atmospheric methane (CH4) concentrations accelerates climate change and offsets mitigation efforts. Although wetlands are the largest natural CH4 source, estimates of global wetland CH4 emissions vary widely among approaches taken by bottom-up (BU) process-based biogeochemical models and top-down (TD) atmospheric inversion methods. Here, we integrate in situ measurements, multi-model ensembles, and a machine learning upscaling product into the International Land Model Benchmarking system to examine the relationship between wetland CH4 emission estimates and model performance. We find that using better-performing models identified by observational constraints reduces the spread of wetland CH4 emission estimates by 62% and 39% for BU- and TD-based approaches, respectively. However, global BU and TD CH4 emission estimate discrepancies increased by about 15% (from 31 to 36 TgCH4 year−1) when the top 20% models were used, although we consider this result moderately uncertain given the unevenly distributed global observations. Our analyses demonstrate that model performance ranking is subject to benchmark selection due to large inter-site variability, highlighting the importance of expanding coverage of benchmark sites to diverse environmental conditions. We encourage future development of wetland CH4 models to move beyond static benchmarking and focus on evaluating site-specific and ecosystem-specific variabilities inferred from observations.
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