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In this work, we describe the use of a 1D-2V quasi-neutral hybrid electrostatic PIC with Monte-Carlo Coulomb collisions and non-uniform magnetic field to model the parallel transport and confinement in an axisymmetric tandem mirror device. End-plugs, based on simple-mirrors, are positioned at each end of the device and fueled with neutral beams (25 and 100 keV) to produce a sloshing ion population and increase the density of the end-plugs relative to the central cell. Results show the formation of a potential difference barrier between the central cell and the end-plugs. This potential confines a large fraction of the low energy thermal ions in the central cell which would otherwise be lost in a simple mirror, demonstrating the advantage of the beam-driven tandem mirror configuration relative to simple mirrors. In addition, we explore the effect of end-plug electron temperature on the confinement time of the device and compare it with theoretical estimates. Finally, we discuss the limitations of the code in its present form and describe the next logical steps to improve its predictive capability such as a fully nonlinear Fokker–Planck collision operator, multiply nested flux surface solutions and modeling the exhaust region up to the wall.
This paper explores the feasibility of a break-even-class mirror referred to as BEAM (break-even axisymmetric mirror): a neutral-beam-heated simple mirror capable of thermonuclear-grade parameters and $Q\sim 1$ conditions. Compared with earlier mirror experiments in the 1980s, BEAM would have: higher-energy neutral beams, a larger and denser plasma at higher magnetic field, both an edge and a core and capabilities to address both magnetohydrodynamic and kinetic stability of the simple mirror in higher-temperature plasmas. Axisymmetry and high-field magnets make this possible at a modest scale enabling a short development time and lower capital cost. Such a $Q\sim 1$ configuration will be useful as a fusion technology development platform, in which tritium handling, materials and blankets can be tested in a real fusion environment, and as a base for development of higher-$Q$ mirrors.
The Wisconsin high-temperature superconductor axisymmetric mirror experiment (WHAM) will be a high-field platform for prototyping technologies, validating interchange stabilization techniques and benchmarking numerical code performance, enabling the next step up to reactor parameters. A detailed overview of the experimental apparatus and its various subsystems is presented. WHAM will use electron cyclotron heating to ionize and build a dense target plasma for neutral beam injection of fast ions, stabilized by edge-biased sheared flow. At 25 keV injection energies, charge exchange dominates over impact ionization and limits the effectiveness of neutral beam injection fuelling. This paper outlines an iterative technique for self-consistently predicting the neutral beam driven anisotropic ion distribution and its role in the finite beta equilibrium. Beginning with recent work by Egedal et al. (Nucl. Fusion, vol. 62, no. 12, 2022, p. 126053) on the WHAM geometry, we detail how the FIDASIM code is used to model the charge exchange sources and sinks in the distribution function, and both are combined with an anisotropic magnetohydrodynamic equilibrium solver method to self-consistently reach an equilibrium. We compare this with recent results using the CQL3D code adapted for the mirror geometry, which includes the high-harmonic fast wave heating of fast ions.
Next generation sequencing technologies have facilitated a shift from a few targeted loci in population genetic studies to whole genome approaches. Here, we review the types of questions and inferences regarding the population biology and evolution of parasitic helminths being addressed within the field of population genomics. Topics include parabiome, hybridization, population structure, loci under selection and linkage mapping. We highlight various advances, and note the current trends in the field, particularly a focus on human-related parasites despite the inherent biodiversity of helminth species. We conclude by advocating for a broader application of population genomics to reflect the taxonomic and life history breadth displayed by helminth parasites. As such, our basic knowledge about helminth population biology and evolution would be enhanced while the diversity of helminths in itself would facilitate population genomic comparative studies to address broader ecological and evolutionary concepts.
Numerous studies have shown that arthroscopic partial meniscectomy (APM) is not (cost-) effective in patients with symptoms attributed to a degenerative meniscus tear. We aimed to assess the budget impact of reducing APM in routine clinical practice in this population.
Materials and methods
A patient-level state transition model was developed to simulate patients recently diagnosed with a degenerative meniscus tear. Three strategies were compared: “current guideline” (i.e., postpone surgery to at least 3 months after diagnosis), “APM at any time” (i.e., APM available directly after diagnosis), and “nonsurgical” (i.e., APM no longer performed). Total societal costs over 5 years were calculated to determine the budget impact. Probabilistic and deterministic sensitivity analyses were conducted to address uncertainty.
Results
The average cost per patient over 5 years were EUR 5,077, EUR 4,577, and EUR 4,218, for the “APM at any time,” “current guideline,” and “nonsurgical” strategy, respectively. Removing APM from the treatment mix (i.e., 30,000 patients per year) in the Netherlands, resulted in a reduction in health care expenditures of EUR 54 million (95 percent confidence interval [CI] EUR 38 million–EUR 70 million) compared to the “current guideline strategy” and EUR 129 million (95 percent CI EUR 102 million–EUR 156 million) compared to the “APM at any time” strategy. Sensitivity analyses showed that uncertainty did not alter our conclusions.
Conclusions
Substantial costs can be saved when APM is no longer performed to treat symptoms attributed to degenerative meniscus tears in the Netherlands. It is therefore recommended to further reduce the use of APM to treat degenerative meniscus tears.
In the present study, we aimed to describe the composition of endoparasites associated with anurans from an altitudinal rainforest enclave in northeastern Brazil. Additionally, we tested if microhabitat use influences endoparasite abundance and richness, as well as the hypothesis that larger frogs tend to be more parasitized. We sampled 306 individuals from 25 anuran species that were necropsied and analysed using a stereomicroscope. The total endoparasite prevalence was 79.08%, with a parasitic community consisting of 46 taxa. Overall, we found the common pattern described for Neotropical amphibians, which is the predominance of generalist and direct-cycle parasites. Twenty new host records and two possible new parasite species were found, highlighting the importance of this type of inventory. We also observed that microhabitat use was associated with a significant difference in parasite richness between groups, in which arboreal and terrestrial species, and aquatic and arboreal species contributed to these differences. Moreover, larger frogs tended to be more parasitized regarding only an interspecific view. Our results suggest that parasite richness is directly related to infection cycle and how the host exploits its habitat.
Following indirect-drive experiments which demonstrated promising performance for low convergence ratios (below 17), previous direct-drive simulations identified a fusion-relevant regime which is expected to be robust to hydrodynamic instability growth. This paper expands these results with simulated implosions at lower energies of 100 and 270 kJ, and ‘hydrodynamic equivalent’ capsules which demonstrate comparable convergence ratio, implosion velocity and in-flight aspect ratio without the need for cryogenic cooling, which would allow the assumptions of one-dimensional-like performance to be tested on current facilities. A range of techniques to improve performance within this regime are then investigated, including the use of two-colour and deep ultraviolet laser pulses. Finally, further simulations demonstrate that the deposition of electron energy into the hotspot of a low convergence ratio implosion through auxiliary heating also leads to significant increases in yield. Results include break even for 1.1 MJ of total energy input (including an estimated 370 kJ of short-pulse laser energy to produce electron beams for the auxiliary heating), but are found to be highly dependent upon the efficiency with which electron beams can be created and transported to the hotspot to drive the heating mechanism.
With regard to glycemic control in type 2 diabetes (T2D), treatment with antidepressant drugs is a double-edged sword. Real-world, population-based data on the impact of antidepressant treatment on glycemic control in T2D is absent from the literature.
Objectives
To estimate the impact of treatment initiation or termination with an antidepressant on HbA1c levels in individuals with T2D.
Methods
Population-based, within-subject, study design examining HbA1c levels in the 16 months leading up to - and the 16 months following - antidepressant treatment initiation or termination, respectively. All individuals with newly developed T2D between 1 January 2000 and 31 October 2016 were identified. Study population 1 consisted of individuals that initiated antidepressant treatment after incident T2D and age- and sex matched individuals with T2D and without antidepressant treatment. Study population 2 consisted of individuals with prevalent antidepressant use at the time of incident T2D, who terminated antidepressant treatment during follow-up, and age- and sex matched individuals with T2D and without antidepressant treatment.
Results
Antidepressant treatment initiation was associated with a decrease in HbA1c levels (7.05% to 6.89%). The age- and sex matched individuals did not have a change in mean HbA1c levels after the matched date. Antidepressant treatment termination was associated with a decrease in HbA1c levels (7.05% to 6.73%). Age- and sex matched individuals did not see a change in HbA1c levels after the matched date.
Conclusions
These findings suggest that antidepressant treatment initiation is not associated with adverse effects with regard to glycemic control in T2D. Rather, the data are indicative of a beneficial effect.
Conflict of interest
Aarhus University funded the study. CR was supported by the Danish Diabetes Academy, funded by the Novo Nordisk Foundation, grant number NNF17SA0031406. The funders had no role in the study design, data analysis, interpretation of data, or writing of the
Ice-covered lakes in Antarctica preserve records of regional hydroclimate and harbour extreme ecosystems that may serve as terrestrial analogues for exobiotic environments. Here, we examine the impacts of hydroclimate and landscape on the formation history of Lake Eggers, a small ice-sealed lake, located in the coastal polar desert of McMurdo Sound, Antarctica (78°S). Using ground penetrating radar surveys and three lake ice cores we characterize the ice morphology and chemistry. Lake ice geochemistry indicates that Lake Eggers is fed primarily from local snowmelt that accreted onto the lake surface during runoff events. Radiocarbon ages of ice-encased algae suggest basal ice formed at least 735 ± 20 calibrated years before present (1215 C.E.). Persisting through the Late Holocene, Lake Eggers alternated between periods of ice accumulation and sublimation driven by regional climate variability in the western Ross Sea. For example, particulate organic matter displayed varying δ15N ratios with depth, corresponding to sea ice fluctuations in the western Ross Sea during the Late Holocene. These results suggest a strong climatic control on the hydrologic regime shifts shaping ice formation at Lake Eggers.
Performing a stressful task under pressure is challenging. Strategies to optimise our training must focus on learning a skill correctly, and then practising that skill deliberately to avoid compromising that performance in the cauldron of the clinical environment. This chapter discusses ways of learning and training better: the techniques are based on practical strategies employed in anaesthesia, but developed primarily from practical cognitive psychology, elite sport and the military. It involves taking a skill, practising it until it becomes a habit and over time making it part of normal behaviour. The philosophy is simple (but difficult to apply): control what you can control and always do your best. The best summary of this strategy is: learn it right, practise it right, perform it right.
Rhabdias pocoto n. sp. is herein described from the lungs of the swamp frog Pseudopaludicola pocoto Magalhães, Loebmann, Nogueira, Kokubum, Baptista, Haddad & Garda, 2014, from the Caatinga biome in the state of Ceará, in north-eastern Brazil. The new species is characterized by a body that dilates posteriorly, six small lips (protuberances) and two rounded lateral expansions of cuticular inflation on the anterior end, each containing an amorphous gland-like structure inside and a short and conical tail. Additionally, molecular analysis and comparison of the partial mitochondrial cytochrome c oxidase I sequence of R. pocoto n. sp. revealed genetic divergence between the new species and the sequences of Rhabdias spp. previously deposited in GenBank. Phylogenetic analysis grouped the new taxon into the R. pseudosphaerocephala species complex + R. glaurungi clade. The new discovery represents the 19th species of Rhabdias spp. described in the Neotropical region, the ninth in Brazil and the first species of Rhabdias found parasitizing South American frogs of the genus Pseudopaludicola, as well as the first Caatinga biome species of Rhabdias.
Helminthological studies may contribute with valuable information on host biology and conservation. Herein, we provide new data on helminths infecting the lizard Norops fuscoauratus, testing one of the factors considered most important in parasitic ecology: host size. We analysed 25 specimens of N. fuscoauratus from three highland marshes in the Brazilian semi-arid. Eight taxa of helminths belonging to Nematoda, Trematoda and Acanthocephala were found. Physaloptera sp. showed the higher prevalence (40%), with a mean intensity of infection of 3.3 ± 1.46 (1–16) and mean abundance 1.32 ± 0.65 (0–16). Norops fuscoauratus represents four new host records for the helminths Cyrtosomum sp., Pharyngodon travassosi, Strongyloides sp. and Centrorhynchus sp. There is no relationship of host body size (P = 0.79) and mass (P = 0.50) with parasite richness. In addition, the present study contributes to the knowledge of the parasitic fauna of N. fuscoauratus and the Neotropical region.
This study investigated the effects of group cognitive behavioural therapy (CBT) for patients with bipolar disorder. The development of CBT for this disorder is relatively under-explored.
Method:
Participants with bipolar I or II disorder were treated with group CBT in addition to treatment as usual. The effectiveness of the protocol was explored through sequence analysis of daily mood monitoring prior to, during and after the intervention. Also, a repeated measures design was used assessing symptomatology, dysfunctional attitudes, sense of mastery, psychosocial functioning, and quality of life at start and end of intervention, and at follow-up 2 and 12 months later.
Results:
The results indicate that variation in mood states diminished over the course of the intervention. Also, there was a change from depressive states to more euthymic states. Greater number of reported lifetime depressive episodes was associated with greater diversity of mood states. There was an increase in overall psychosocial functioning and self-reported psychological health following the intervention. Improvement continued after treatment ended until follow-up at 2 months, and measured 1 year later, for outcomes representing depression, general psychosocial functioning and self-reported psychological health. Due to small sample size and the lack of a control group the results are preliminary.
Conclusions:
The results of this pilot study suggest that both offering CBT in group interventions and sequence analysis of time series data are helpful routes to further explore when improving standard CBT interventions for patients suffering from bipolar disorder.
Primary objective was to evaluate the influence of atomoxetine on standard variables of a computer-based Continuous Performance Test (cb-CPT) that reflects executive function and inhibitory control in children with ADHD.
Methods
Two-arm, 8-week, placebo-controlled, randomized, double-blind study in ADHD patients (6-12yrs). Atomoxetine was initiated at 0.5 mg/kg qd for 1 week, followed by 7 weeks on the target dose of 1.2 mg/kg qd. Primary outcome were the q-scores of the cb-CPT standard variables after 8 weeks using mixed models for repeated measurement. Additionally, ADHD-RS scores, WREMB (Weekly Ratings of Evening and Morning Behavior) and CGI-S-ADHD were assessed (weeks 0,1,2,4,6,8).
Results
N=128 patients were randomized, N=125 evaluated (atomoxetine/placebo: 63/62). Baseline characteristics were comparable (77.6% boys; 40.0% patients with ODD/CD; 24.8% prior stimulant treatment; mean (±SD) age 9.0±1.79yrs; mean ADHD-RS total score 36.99±11.56). At Week 8, all primary outcomes (cb-CPT q-scores) were significantly reduced vs. placebo (all p< 0.001) for mean (effect size [ES] 0.41), variance (ES=0.71), and normalized variance (ES=0.50) of “Reaction time”, “Number of microevents” (ES=1.00), “Commission errors” (ES=0.50), “Omission errors” (ES=0.70), “Distance of movement” (ES=0.90) and “Area of movement” (ES=1.08), “Time active” (ES=0.69), and “Motion simplicity” (ES=0.38). Secondary endpoints at Week 8 improved significantly in favor of atomoxetine: ADHD-RS: total score ES=1.30, p< 0.001; hyperactive/impulsive subscore ES=1.37, p< 0.001; inattentive subscore ES=1.07, p< 0.001). WREMB: total score ES=1.00, p< 0.001; morning subscore ES=0.59, p=0.002.; evening subscore ES=1.02, p< 0.001. CGI-S-ADHD: ES=1.11; p< 0.001.
Conclusions
Atomoxetine for 8 weeks significantly reduced ADHD symptoms as measured by the objective cb-CPT.
In personal and in political context, we often evaluate the risk of certain conditions. Therefore, two principal psychological approaches are suggested: the analytical consideration and the intuitive estimation, both with according discriminative brain activation. We investigated the neural basis on which non-experts evaluated high risk of different environmental hazards for the society compared with respective low risk.
Methods
Twenty healthy subjects underwent functional magnetic resonance imaging while evaluating the risk of fifty more or less risky conditions presented as written terms. We analyzed brain activations during the individual estimations of ‘high’ against ‘low’ risk. Further, the individual brain activations associated with ‘negative’ versus ‘not negative’ emotional valence of the terms were analyzed.
Results
Estimating hazards to be of high risk was associated with activation in medial thalamus, anterior insula, nucleus caudatus, posterior cingulate cortex and precuneus. These areas were not involved according to the analysis of the emotion ratings.
Conclusions
The results point to a substantial contribution of viscerosensitive areas to signal high risk and supports models of an intuitive “gut” feeling independent of the subjective emotional valence when estimating a high risk of environmental hazards.
The aim of this study was to investigate whether lower lithium levels (LoLi) or olanzapine doses (LoOL) are risk factors for future mood episodes in patients with bipolar I disorder.
Methods
A post-hoc analysis of the olanzapine-lithium-maintenance study [31] was performed using proportional hazards Cox regression models and marginal structural models (MSMs), adjusting for non-random assignments of dose during treatment.
Results
The LoLi group (< 0.6 mmol/L) had a significantly increased risk of manic/mixed (hazard ratio [HR] = 1.96, p = 0.042), but not depressive (HR = 2.11, p = 0.272) episodes, compared to the combined medium (0.6–0.79 mmol/L) and high lithium level (≥ 0.8 mmol/L) groups. There was no significant difference in risk between the two higher lithium level groups (0.6-0.79 mmol/L; ≥ 0.8 mmol/L) for new manic/mixed (HR = 0.96, p = 0.893) or depressive (HR = 0.95, p = 0.922) episodes. The LoOL group (< 10 mg/day) showed a significantly increased risk of depressive (HR = 2.24, p = 0.025) episodes compared to the higher olanzapine (HiOL) dose group (HiOL: 10–20 mg/day), while there was no statistically significant difference in risk for manic/mixed episodes between the two groups (HR = 0.94, p = 0.895).
Conclusion
Lithium levels ≥ 0.6 mmol/L and olanzapine doses ≥ 10 mg/day may be necessary for optimal protection against manic/mixed or depressive episodes, respectively in patients with bipolar I disorder.
Patients with affective disorders are at high risk of suicide, especially during inpatient treatment and during the first year after discharge.
Methods
A blinded case-control design was used. The study included a total national sample of patients with affective disorder admitted during the period from January 1, 1994 to December 31, 1995, who died because of suicide, either during admission or shortly after discharge.
Results
A history of suicide attempt was a significant risk factor (IRR 4.9; 95% CI 2.1–11.6). Loss of job during the year prior to the index admission was associated with an increase in suicide risk (IRR: 2.9; 95% CI 1.2–7.5). Clinical improvement during the index admission (IRR: 0.3; 95% CI 0.1–0.7), and treatment with antidepressant drugs at the censoring date (IRR: 0.3; 95% CI 0.1–0.7) were associated with a decrease in suicide risk.
Conclusion
Improved treatment may be a key factor in suicide prevention in patients during, and shortly after hospitalisation with affective disorders. Also, there is a need to be especially aware of suicide risk in patients with little or no improvement at discharge.
The purpose of this preliminary study was to examine the share of women with incorrect eating behavior in the group of young women studying courses join with food technology. The 120 women studying food technology, human nutrition, and dietetics (“food” group) and 118 women from the humanistic study (philosophy and pedagogic courses) (“humanistic” group) aged 20-24 years were examined by the Eating Attitude Test, designed according to DSM-IV and adapted to the Polish conditions. It was obtained statistically significant differences between different profiles of the study. However in the “humanistic” group 12% had early anorexia symptoms, in the “food” group it was approximately 29%. It could be in accordance with literature data concern interest in food, cocking, dietetic etc. in anorectics. The purpose of this study was also to compare the some elements of quality of life women with and without incorrect eating attitude in “food” group. There were significant differences in the assessment of own body shape (incorrect), imaging of perfect body shape (too thin), physical activity (high), reaction on stress situations (withdraws and escapes usually), frequency of physical symptoms (headache and stomachache, irregular menstruation) as well as home conflicts especially with old sisters or mothers. The social position of respondents were not influenced on expression of early symptoms of anorexia. This study suggests that profile of university education could depend on incorrect eating attitudes and should be common to focus on the candidates to recognize early anorexia symptoms and prevent to express them.