•Review of experiments and modelling of dust remobilization in fusion plasmas.•Steady state remobilization: competition between plasma-induced and contact forces.•Transient plasma remobilization: ...heat transfer aspects become dominant.•Adhesion has a central role and surface roughness adds a probabilistic component.•Wetting-induced coagulation in clusters as an adhered dust growth mechanism.
Remobilization is one of the most prominent unresolved fusion dust-relevant issues, strongly related to the lifetime of dust in plasma-wetted regions, the survivability of dust on hot plasma-facing surfaces and the formation of dust accumulation sites. A systematic cross-machine study has been initiated to investigate the remobilization of tungsten micron-size dust from tungsten surfaces implementing a newly developed technique based on controlled pre-adhesion by gas dynamics methods. It has been utilized in a number of devices and has provided new insights on remobilization under steady-state and transient conditions. The experiments are interpreted with contact mechanics theory and heat conduction models.
•First heat transfer and hydrodynamic simulations of transient melting of an inclined W sample.•Post-mortem melt displacement adequately reproduced with the shallow water approximation.•Motion ...dominated by the J × B force but also affected by thermo-capillary flows, viscous damping.•Final surface deformation profile strongly depends on the treatment of the spatially varying B-field inclination.
The first MEMOS 3D simulations of liquid metal motion on an inclined bulk tungsten sample transiently molten by edge-localized modes (ELMs) are reported. The exposures took place at the outer ASDEX-Upgrade divertor with the tungsten surface tangent intersecting the magnetic field at ∼ 18°. Simulations confirm that the observed poloidal melt motion is caused by the volumetric J × B force with J the bulk replacement current triggered by thermionic emission. The final erosion profile and total melt build up are reproduced by employing the escaping thermionic current dependence on the incident heat flux derived from dedicated particle-in-cell simulations. Modelling reveals that melt dynamics is governed by the volumetric Lorentz force, capillary flows due to thermal surface tension gradients and viscous deceleration. The effect of the evolving surface deformation, that locally alters the field-line inclination modifying the absorbed power flux and the escaping thermionic current, in the final surface morphology is demonstrated to be significant.
Abstract An overview of the modelling approaches, validation methods and recent main results of analysis and modelling activities related to the plasma-wall interaction in JET experiments, including ...the recent H/D/T campaigns is presented in the paper. Code applications to JET experiments improve general erosion/migration/retention prediction capabilities as well as various physics extensions for instance a treatment of dust particles transport and the detailed description of melting and splashing of PFC induced by transient events at JET. 2D plasma edge transport codes like SOLPS-ITER code as well as plasma-surface interaction (PSI) codes are key to realistic description of relevant physical processes in power and particle exhaust. Validation of the PSI and edge transport models across JET experiments considering various effects (isotope effects, first wall geometry, including detailed 3D shaping of plasma-facing components, self-sputtering, thermo-forces, physical and chemically assisted physical sputtering formation of W and Be hydrides) is very important for predictive simulations of W and Be erosion and migration in ITER as well as for increasing quantitative credibility of the models. JET presents also a perfect test-bed for the investigation and modelling of melt material dynamics, its splashing and droplet ejection mechanisms. At that we attribute the second group of processes rather for the transient events as for the steady state and, thus, treat those as an independent addition outside the interplay with the first group.
Context: Previous randomized trials have suggested an association between radioiodine treatment for Graves’ hyperthyroidism and thyroid-associated ophthalmopathy (TAO).
Objectives: The aim of the ...study was to compare the occurrence of worsening or development of TAO in patients who were treated with radioiodine or antithyroid drugs.
Design: We conducted a randomized trial (TT 96) with a follow-up of 4 yr.
Patients, Setting, and Intervention: Patients with a recent diagnosis of Graves’ hyperthyroidism were randomized to treatment with iodine-131 (163 patients) or 18 months of medical treatment (150 patients). Early substitution with T4 was given in both groups.
Main Outcome Measure: Worsening or development of TAO was significantly more common in the iodine-131 treatment group (63 patients; 38.7%) compared with the medical treatment group (32 patients; 21.3%) (P < 0.001).
Results: The risk for de novo development of TAO was greater in patients treated with iodine-131 (53 patients) than with medical treatment (23 patients). However, worsening of TAO in the 41 patients who had ophthalmopathy already before the start of treatment was not more common in the radioiodine group (10 patients) than in the medical group (nine patients). Smoking was shown to influence the risk of worsening or development of TAO, and smokers treated with radioiodine had the overall highest risk for TAO. However, in the group of smokers, worsening or development of TAO was not significantly associated with the choice of treatment for hyperthyroidism.
Conclusions: Radioiodine treatment is a significant risk factor for development of TAO in Graves’ hyperthyroidism. Smokers run the highest risk for worsening or development of TAO irrespective of treatment modality.
Radioiodine treatment for Graves’ hyperthyroidism (when compared to anti-thyroid drug treatment),and smoking increase the risk for the development of thyroid associated ophthalmopathy.
About the meeting: The purpose of the European Stroke Organisation (ESO)-Karolinska Stroke Update Conference is to provide updates on recent stroke therapy research and to give an opportunity for the ...participants to discuss how these results may be implemented into clinical routine. Several scientific sessions discussed in the meeting and each session produced consensus statements. The meeting started 20 years ago as Karolinska Stroke Update, but since 2014, it is a joint conference with ESO. Importantly, it provides a platform for discussion on the ESO guidelines process and on recommendations to the ESO guidelines committee on specific topics. By this, it adds a direct influence from stroke professionals otherwise not involved in committees and work groups on the guidelines procedure. The discussions at the conference may also inspire new guidelines when motivated. The topics raised at the meeting are selected by the scientific programme committee mainly based on recent important scientific publications. The ESO-Karolinska Stroke Update consensus statement and recommendations will be published every 2 years and it will work as implementation of ESO-guidelines
Background
This year’s ESO-Karolinska Stroke Update Meeting was held in Stockholm on 13–15 November 2016. There were 10 scientific sessions discussed in the meeting and each session produced a consensus statement (Full version with background, issues, conclusions and references are published as web-material and at http://www.eso-karolinska.org/2016 and http://eso-stroke.org) and recommendations which were prepared by a writing committee consisting of session chair(s), secretary and speakers and presented to the 312 participants of the meeting. In the open meeting, general participants commented on the consensus statement and recommendations and the final document were adjusted based on the discussion from the general participants.
Recommendations (grade of evidence) were graded according to the 1998 Karolinska Stroke Update meeting with regard to the strength of evidence. Grade A Evidence: Strong support from randomised controlled trials and statistical reviews (at least one randomised controlled trial plus one statistical review). Grade B Evidence: Support from randomised controlled trials and statistical reviews (one randomised controlled trial or one statistical review). Grade C Evidence: No reasonable support from randomised controlled trials, recommendations based on small randomised and/or non-randomised controlled trials evidence.
Many different polymerase chain reaction (PCR) protocols have been used for detection and characterization of avian influenza (AI) virus isolates, mainly in research settings. Blind ring trials were ...conducted to determine the most sensitive and specific AI PCR protocols from a group of six European Union (EU) laboratories. In part 1 of the ring trial the laboratories used their own methods to test a panel of 10 reconstituted anonymized clinical specimens, and the best methods were selected as recommended protocols for part 2, in which 16 RNA specimens were tested. Both panels contained H5, H7, other AI subtypes, and non-AI avian pathogens. Outcomes included verification of 1) generic AI identification by highly sensitive and specific M-gene real-time PCR, and 2) conventional PCRs that were effective for detection and identification of H5 and H7 viruses. The latter included virus pathotyping by amplicon sequencing. The use of recommended protocols resulted in improved results among all six laboratories in part 2, reflecting increased sensitivity and specificity. This included improved H5/H7 identification and pathotyping observed among all laboratories in part 2. Details of these PCR methods are provided. In summary, this study has contributed to the harmonization of AI PCR protocols in EU laboratories and influenced AI laboratory contingency planning following the first European reports of H5N1 highly pathogenic AI during autumn 2005.
An apparently novel neurological disease clinically characterized by shaking, tremors, seizures, staggering gait, and ataxia was first observed in farmed mink kits in Denmark in 2000 and subsequently ...in Sweden, Denmark, and Finland in 2001, and again in Denmark in 2002. Lymphoplasmacytic encephalomyelitis was found in the affected kits. The lesions were most severe in the brainstem and cerebellum and consisted of neuronal degeneration and necrosis, neuronophagia, focal and diffuse gliosis, perivascular cuffs formed by lymphocytes, plasma cells and macrophages, and segmental loss of Purkinje cells. Testing was conducted to determine the cause of the disease, including general virological investigations (virus culture, negative-staining electron microscopy, immunoelectron microscopy, polymerase chain reaction for herpesviruses, adenoviruses, pestiviruses, and coronaviruses), tests for specific viral diseases (canine distemper, Borna disease, Louping ill, West Nile virus infection, tick-borne encephalitis, Aleutian disease), tests for protozoa (Toxoplasma gondii, Neospora caninum, Encephalitozoon cuniculi), bacteria (general culture, listeria, Clamydophila psittaci), and intracerebral inoculation of neonatal mice. The results of all these investigations were negative. One group of 3 mink kits inoculated intracerebrally with brain homogenate of affected mink developed clinical signs and histological lesions similar to those observed in naturally infected mink. Based on the histopathological features, it is postulated that the disease is caused by a yet unidentified virus.
There is evidence in the literature of a relationship between dose and response to adjuvant chemotherapy for breast cancer, although published results are conflicting. We therefore retrospectively ...analysed the role of dose response in patients included in four adjuvant trials of the International Breast Cancer Study Group (IBCSG, formerly the Ludwig Breast Cancer Study Group (trials I, II, III and V), all using ‘classical’ cyclophosphamide, methotrexate, and 5-fluorouracil (CMF). A total of 1385 node-positive patients were treated with oral cyclophosphamide, and intravenous methotrexate plus 5-fluorouracil (CMF) for at least six 4 week courses. 1350 of these were included in 6 month landmark treatment outcome analyses. A total of 1029 patients were premenopausal, 321 were postmenopausal; 800 had one to three and 550 more than three involved axillary nodes at surgery. The median follow-up ranged from 12 years for trial V to 15 years for trials I–III. Patients were grouped according to three prospectively defined dose levels based on the percentage of the protocol prescribed dose that was actually administered (level I ≥85%, level II 65–84%, level III <65%). Patients who received dose level II had a higher disease-free (
P=0.07) and overall survival (
P=0.03) than those who received a higher (level I) or lower (level III) percentage. The 10 year overall survival was 60% for dose level II, 56% for dose level I, 51% for dose level III. The results were generally consistent within trial, menopausal status, and oestrogen receptor status groups. The results within nodal groups showed a large difference among the dose levels for the group with one to three positive nodes (
P=0.02), but no difference for the group with four or more positive nodes. Our results indicate that the dose–response effect remains a crucial factor in adjuvant chemotherapy of breast cancer. Reductions larger than 35% in the dose administered of oral CMF adversely influenced the outcome of breast cancer patients and should be avoided. The better outcome of the intermediate dose group indicates the need to investigate other aspects involved in the cytotoxicity of adjuvant CMF chemotherapy.
The objective of this study was to investigate quality of life (QoL) in patients with Graves' disease treated with radioiodine or antithyroid drugs.
The design of the study consists of an open, ...prospective, randomized multicenter trial between radioiodine and medical treatment. A total of 308 patients were included in the study group: 145 patients in the medical group and 163 patients in the radioiodine group. QoL was measured with a 36-item Short Form Health Status Survey questionnaire (SF-36) at six time points during the 48-month study period.
Patient who developed or got worse of thyroid-associated ophthalmopathy (TAO) at any time point during the 4-year study period (TAO group) had lower QoL when no respect was paid to the mode of treatment. TAO occurred in 75 patients who had radioiodine treatment at some time point during the study period as compared with TAO in 40 medically treated patients (P<0.0009). Comparisons between the group of patients who have had TAO versus the group without TAO, in relation to treatments and time, showed significantly decreased QoL scores for the TAO groups at several time points during the study. In patients without TAO, there were no differences in QoL related to mode of treatment.
The QoL in patients with Graves' ophthalmopathy was similar in radioiodine and medically treated patients, but patients who developed or had worsening of TAO had decreased QoL independent of mode of treatment. Furthermore, patients with TAO recovered physically within 1 year but it took twice as long for them to recover mentally.
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