关键词： Fusion   DEMO   Superconducting magnets   PF coil   CIC forced flow cable  

摘要： The EUROfusion DEMO machine is at its pre-conceptual stage. The design of the magnet system for this machine is being developed in collaboration with several European research centers. The Poloidal Field (PF) coils proposed by the Swiss Plasma Center (SPC) use a multiple-in-hand Pancake winding technique. A design based on updated plasma scenarios (2018) was recently proposed. The Winding Pack (WP) aspect ratio was kept close to one, similar to the baseline design in the EUROfusion 2018 DEMO baseline document. In this publication, we study the effects of changing WP aspect ratio. A vertically elongated WP cross-section is beneficial in the reduction of the peak magnetic field at WP cross-section, the machine radial extent, and the hydraulic lengths. However, it increases the bending stress on the WP. An updated PF design is presented. The dimensioning and allocation of materials is based on 3-dimensional electromagnetic calculations. Mechanical performance is evaluated against both dynamic fatigue stress and static stresses. The static stresses are evaluated through 3-dimensional finite element simulations to take into account also the ripple effect of TF coils and increase in bending stresses due to the elongation of the WP cross-section. The thermal-hydraulic analysis verifies a temperature margin of 1.5 K and confirms sufficient coolant flow for the prescribed pressure drop. The quench analysis determines the hot-spot temperatures during various quench scenarios.

关键词： Euthanasia   Barbiturates   Potassium chloride   Magnesium Chloride  

摘要： Barbiturate overdose as a method of euthanasia is becoming unacceptable. This has made alternative methods of euthanasia very important. Gunshot or captive bolt euthanasia is among methods that are acceptable, but they may not be esthetically acceptable. This has led to the use of other methods of euthanasia. Inducing anesthesia prior to euthanasia offers an easier method of control. Adjunctive techniques using intravenous potassium or magnesium salts administered intravenously and intracardiac administration of potassium chloride or intrathecal lidocaine offer alternatives that work well and are more environmentally safer than barbiturates. Pithing and exsanguination are also environmentally safer but may not be as esthetically acceptable as the other methods.

关键词： Coronary artery   COVID-19   IVIG   Kawasaki disease  

摘要： Objective To study the clinical profile and outcome of children with MIS-C treated with methylprednisolone pulse therapy and/or intravenous immunoglobulin (IVIG). Method This prospective observational study included children satisfying CDC MIS-C criteria admitted from September to November, 2020. Primary outcome was persistence of fever beyond 36 hours after start of immunomodulation therapy. Secondary outcomes included duration of ICU stay, mortality, need for repeat immunomodulation, time to normalization of CRP and persistence of coronary abnormalities at 2 weeks. Results Study population included 32 patients with MIS-C with median (IQR) age of 7.5 (5-9.5) years. The proportion of children with gastrointestinal symptoms was 27 (84%), cardiac was 29 (91%) and coronary artery dilatation was 11 (34%). Pulse methylprednisolone and intravenous immunoglobulin were used as first line therapy in 26 (81%), and 6 (19%) patients, respec-tively. Treatment failure was observed in 2/26 patients in methylprednisolone group and 2/6 patients in IVIG group. C-reactive protein levels less than 60mg/L by day 3 was seen in 17(74%) in methylprednisolone group and 2 (25%) in IVIG group (P=0.014). There was no mortality. At 2 weeks follow-up coronary artery dilatation persisted in 4 in methylprednisolone group and 1 in IVIG group. Conclusion In patients with SARS-CoV-2 related MIS-C, methylprednisolone pulse therapy was associated with favorable short-term outcomes.

关键词： Phase II study   Breast cancer   Preventive medicine   Exemestane   Drug schedule and alternative dose  

摘要： Introduction: Aromatase inhibitors are effective in lowering breast cancer incidence among postmenopausal women, but adverse events represent a barrier to their acceptability and adherence as a preventive treatment. This study aims to assess whether lowering exemestane schedule may retain biological activity while improving tolerability in breast cancer patients. Methods/design: We are conducting a, pre-surgical, non-inferiority phase IIb study in postmenopausal women with newly diagnosed estrogen receptor-positive breast cancer. Participants are randomized to receive either exemestane 25 mg/day or 25 mg/three times-week or once a week for 4 to 6 weeks prior to surgery. The primary endpoint is the percentage change of serum estradiol concentration between baseline and surgery comparing the three arms. Sample size of 180 women was calculated assuming a 6% non-inferiority of the percent change of estradiol in the lower dose arms compared with the 80% decrease predicted in the full dose arm, with 80% power and using a one-sided 5% significance level and a two-sample t-test. Main secondary outcomes are: safety;change in Ki-67 in cancer and adjacent pre-cancer tissue, circulating sex hormones, adipokines, lipid profile, insulin and glucose changes, in correlation with drug and metabolites concentrations. Results and discussion: The present paper is focused on methodology and operational aspects of the study. A total of 180 participants have ben enrolled. The trial is still blinded, and the analyses are ongoing. Despite the short term duration, results may have relevant implications for clinical management of women at increased risk of developing a ER positive breast cancer.

摘要： Among the top 5 leading causes of cancer deaths in the United States, PC is the only malignancy for which screening is not recommended (2). Because of the overall low incidence of PC (1,2), even a fairly specific test with high positive predictive value would yield an unacceptable large burden of false-positives. See PDF] With the recent recommendation that all individuals with newly diagnosed PC undergo germline genetic testing to potentially guide treatment options, germline mutation carriers will be more readily identified and their family members would benefit from testing for the familial gene (14). Cascade testing, or testing of at-risk family members of patients with PC found to have a germline mutation at initial diagnosis, will potentially identify an increasing number of individuals who could benefit from PC screening. [...]PC screening is currently reserved for HRI who have an inherited predisposition and high lifetime risk of PC development and not recommended in the general population (4,7,8).

关键词： lone‐   pair ns   (2) electronic configurations   material design   optoelectronic applications   performance enhancement   structural dimensionality  

摘要： Lead halide perovskites have emerged in the last decade as advantageous high-performance optoelectronic semiconductors, and have undergone rapid development for diverse applications such as solar cells, light-emitting diodes , and photodetectors. While material instability and lead toxicity are still major concerns hindering their commercialization, they offer promising prospects and design principles for developing promising optoelectronic materials. The distinguished optoelectronic properties of lead halide perovskites stem from the Pb2+ cation with a lone-pair 6s(2) electronic configuration embedded in a mixed covalent-ionic bonding lattice. Herein, we summarize alternative Pb-free semiconductors containing lone-pair ns(2) cations, intending to offer insights for developing potential optoelectronic materials other than lead halide perovskites. We start with the physical underpinning of how the ns(2) cations within the material lattice allow for superior optoelectronic properties. We then review the emerging Pb-free semiconductors containing ns(2) cations in terms of structural dimensionality, which is crucial for optoelectronic performance. For each category of materials, the research progresses on crystal structures, electronic/optical properties, device applications, and recent efforts for performance enhancements are overviewed. Finally, the issues hindering the further developments of studied materials are surveyed along with possible strategies to overcome them, which also provides an outlook on the future research in this field.

摘要： A growing movement to integrate the arts and humanities into health professions education is afoot. While educators may easily conceive how arts-based teaching can improve clinically relevant skills such as observation and critical thinking, they may not realize it also has the potential to transform learners in myriad ways beyond sharpening these fundamental skills. In this article, the authors review how visual arts-based education can promote clinical excellence by enhancing communication and interpersonal skills, professionalism and humanism, diagnostic acumen and clinical reasoning, and passion for clinical medicine. They describe the most widely studied visual arts-based education method, Visual Thinking Strategies, in detail as an exemplar of how arts-based pedagogy can help health care professionals strive for and ultimately achieve clinical excellence.

关键词： alternative splicing   RNA-binding protein   transcription factor   TF-RBP-AS triplets   regulation mechanism  

摘要： Aberrant alternative splicing (AS) is increasingly linked to cancer;however, how AS contributes to cancer development still remains largely unknown. AS events (ASEs) are largely regulated by RNA-binding proteins (RBPs) whose ability can be modulated by a variety of genetic and epigenetic mechanisms. In this study, we used a computational framework to investigate the roles of transcription factors (TFs) on regulating RBP-AS interactions. A total of 6519 TF-RBP-AS triplets were identified, including 290 TFs, 175 RBPs, and 16 ASEs from TCGA-KIRC RNA sequencing data. TF function categories were defined according to correlation changes between RBP expression and their targeted ASEs. The results suggested that most TFs affected multiple targets, and six different classes of TF-mediated transcriptional dysregulations were identified. Then, regulatory networks were constructed for TF-RBP-AS triplets. Further pathway-enrichment analysis showed that these TFs and RBPs involved in triplets were enriched in a variety of pathways that were associated with cancer development and progression. Survival analysis showed that some triplets were highly associated with survival rates. These findings demonstrated that the integration of TFs into alternative splicing regulatory networks can help us in understanding the roles of alternative splicing in cancer.