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One of the critical challenges in future high-current tokamaks is the avoidance of runaway electrons during disruptions. Here, we investigate disruptions mitigated with combined deuterium and noble gas injection in SPARC. We use multi-objective Bayesian optimisation of the densities of the injected material, taking into account limits on the maximum runaway current, the transported fraction of the heat loss and the current quench time. The simulations are conducted using the numerical framework Dream (disruption runaway electron analysis model). We show that during deuterium operation, runaway generation can be avoided with material injection, even when we account for runaway electron generation from deuterium–deuterium induced Compton scattering. However, when including the latter, the region in the injected-material-density space corresponding to successful mitigation is reduced. During deuterium–tritium operation, acceptable levels of runaway current and transported heat losses are only obtainable at the highest levels of achievable injected deuterium densities. Furthermore, disruption mitigation is found to be more favourable when combining deuterium with neon, compared with deuterium combined with helium or argon.
Objectives/Goals: High-performing translational teams (TTs) effectively draw knowledge from empirical data to develop health solutions. However, some TTs lack rigorous data approaches, resulting in inefficiency. The ICTR data science initiative integrates team-oriented data science for more innovative and reproducible translational research. Methods/Study Population: To help TTs better leverage data science, the Institute for Clinical and Translational Research (ICTR) at the University of Wisconsin-Madison orchestrated a strategic initiative involving four main actions. • Assess needs. Determine how TTs are using data science and identify essential tools for success. • Establish partnerships. Develop strategic relationships to centralize resources and engage data scientists. Provide team science training to ensure effective integration. • Develop educational pathways. Design and implement workshops to demystify novel data science tools and upskill translational scientists. • Facilitate culture change. Identify ways that all ICTR services can help identify needs, foster educational pathways, and encourage partnerships to help TTs better leverage data science. Results/Anticipated Results: Initial assessments indicated that fewer than 25% of TTs receiving pilot awards used data science tools, and only 10% had a data scientist on their team. Data from collaboration planning sessions indicated that few TTs used data science, but all were interested in learning more. To address this deficiency, ICTR partnered with the Data Science Institute and the Section of Applied Clinical Informatics. This expertise informed resource development (e.g., a data science primer, websites) and generated workshops. Educational opportunities include tailored workshops to help TTs better curate data and create more efficient workflows, graduate course modules to improve rigor and reproducibility, and seminars illustrating translational applications of AI, visualizations, and large data integration. Discussion/Significance of Impact: The ICTR Data Science Initiative was designed to empower TTs to more effectively integrate data to power translation. As data science approaches and expertise are embedded within teams, we anticipate continued increases in interest and usage of data science tools, collaborative publications, and data rich applications for extramural funding.
The Clinical and Translational Science Awards (CTSA) Program supports a national network of medical research institutions working to expedite the development of treatments and interventions. High-performing translational teams (TTs) involving inter-institutional collaborations are critical for advancing these evidence-based approaches. However, management of these complex teams can be difficult, and tailored project management may help TTs overcome the unique challenges they face.
Methods:
We conducted qualitative interviews with 14 dedicated project managers (PMs) from six CTSAs to learn more about their experiences with TTs. Information derived from the thematic analysis of the data was used to identify barriers and facilitators for effective project management.
Results:
Barriers included a lack of institutional support, communication issues, pushback, role confusion, and a need for agility. Facilitators included transparent communication, supportive team environments, shared leadership with autonomy, and opportunities for professional development. The PMs interviewed for this study provided descriptions of their work that depicted a more expansive view of project management than the more traditional approach focused on meeting deadlines and managing deliverables.
Conclusion:
Our findings have been used to inform development, training, and guidance for an innovative project management resource, the Project Management Innovation Center of Excellence (PROMICE) recently launched at the UW-Madison Institute for Clinical and Translational Research (ICTR). Through the development of a dedicated career path, PROMICE recognizes the value that PMs bring to translational science and provides the support that they need to be innovative, leading their teams to success.
Anxiety disorders are associated with aberrant neural responses to negative emotions. Yet, the diverse range of contrasts and stimuli used to investigate these responses has produced variable, complex, and sometimes conflicting results.
Methods
To characterize brain activation during negative emotion processing in anxiety disorders, we conducted a meta-analysis of studies contrasting activation to negative stimuli versus perceptually similar neutral stimuli and examined the differential effects of two types of visual stimuli—scenes and faces. The relevant functional magnetic resonance imaging (fMRI) studies that employed these contrasts were identified using PubMed, Web of Science, and EMBASE databases, and the meta-analysis was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
Results
Across 20 studies, patients with anxiety disorders (n = 348) had increased activation in core cortical regions of default mode and frontal–parietal networks during negative emotion processing compared to healthy controls (n = 335). Further, differential and greater regional activation was found during the processing of negative scenes than faces and greater activation was associated with sex and age of patients across studies.
Conclusions
These results highlight the importance of self-reference- and cognitive regulation-related functional disturbances in the cortex rather than emotional response-related subcortical alteration during negative emotion processing and indicate a more robust effect from emotional scenes in anxiety disorders.
Although behavioral mechanisms in the association among depression, anxiety, and cancer are plausible, few studies have empirically studied mediation by health behaviors. We aimed to examine the mediating role of several health behaviors in the associations among depression, anxiety, and the incidence of various cancer types (overall, breast, prostate, lung, colorectal, smoking-related, and alcohol-related cancers).
Methods
Two-stage individual participant data meta-analyses were performed based on 18 cohorts within the Psychosocial Factors and Cancer Incidence consortium that had a measure of depression or anxiety (N = 319 613, cancer incidence = 25 803). Health behaviors included smoking, physical inactivity, alcohol use, body mass index (BMI), sedentary behavior, and sleep duration and quality. In stage one, path-specific regression estimates were obtained in each cohort. In stage two, cohort-specific estimates were pooled using random-effects multivariate meta-analysis, and natural indirect effects (i.e. mediating effects) were calculated as hazard ratios (HRs).
Results
Smoking (HRs range 1.04–1.10) and physical inactivity (HRs range 1.01–1.02) significantly mediated the associations among depression, anxiety, and lung cancer. Smoking was also a mediator for smoking-related cancers (HRs range 1.03–1.06). There was mediation by health behaviors, especially smoking, physical inactivity, alcohol use, and a higher BMI, in the associations among depression, anxiety, and overall cancer or other types of cancer, but effects were small (HRs generally below 1.01).
Conclusions
Smoking constitutes a mediating pathway linking depression and anxiety to lung cancer and smoking-related cancers. Our findings underline the importance of smoking cessation interventions for persons with depression or anxiety.
Epigenetic changes are plausible molecular sources of clinical heterogeneity in schizophrenia. A subgroup of schizophrenia patients with elevated inflammatory or immune-dysregulation has been reported by previous studies. However, little is known about epigenetic changes in genes related to immune activation in never-treated first-episode patients with schizophrenia (FES) and its consistency with that in treated long-term ill (LTS) patients.
Methods
In this study, epigenome-wide profiling with a DNA methylation array was applied using blood samples of both FES and LTS patients, as well as their corresponding healthy controls. Non-negative matrix factorization (NMF) and k -means clustering were performed to parse heterogeneity of schizophrenia, and the consistency of subtyping results from two cohorts. was tested.
Results
This study identified a subtype of patients in FES participants (47.5%) that exhibited widespread methylation level alterations of genes enriched in immune cell activity and a significantly higher proportion of neutrophils. This clustering of FES patients was validated in LTS patients, with high correspondence in epigenetic and clinical features across two cohorts
Conclusions
In summary, this study demonstrated a subtype of schizophrenia patients across both FES and LTS cohorts, defined by widespread alterations in methylation profile of genes related to immune function and distinguishing clinical features. This finding illustrates the promise of novel treatment strategies targeting immune dysregulation for a subpopulation of schizophrenia patients.
The Clinical and Translational Science Awards (CTSA) Program supports a national network of medical research institutions working to improve the translational process. High-performing translational teams (TTs) are critical for advancing evidence-based approaches that improve human health. When focused on content-appropriate knowledge, skills, and attitudes, targeted training results in the substantial internalization of training content, producing new skills that can be applied to improve team outputs, outcomes, and benefits. More rigorous approaches to develop, test, and evaluate interventions are needed, and we used the Wisconsin Interventions in Team Science framework as a model to systematize our efforts. We designed, built, and tested a five-session TT Training Program for translational researchers. The 90-minute sessions were pilot-tested with 47 postdoctoral fellows and evaluated through a structured evaluation plan. Ninety-five percent of post-session survey respondents indicated that the content and skills provided would make them more effective collaborators, and one hundred percent would recommend the sessions to colleagues. Respondents’ scores increased from pretest to posttest for most learning outcomes. Refinements from participant feedback are described. This work provides a foundation for the continued evolution of evidence-based training programs in the CTSA environment.
Despite understanding its impact on organizational effectiveness, practical guidance on how to train translational team (TT) leaders is lacking. Previously, we developed an evolutionary learning model of TT maturation consisting of three goal-directed phases: (1). team assembly (Formation); (2). conducting research (Knowledge Generation); and (3). dissemination and implementation (Translation). At each phase, the team acquires group-level knowledge, skills, and attitudes (KSAs) that enhance its performance. Noting that the majority of team-emergent KSAs are promoted by leadership behaviors, we examine the SciTS literature to identify the relevant behaviors for each phase. We propose that effective team leadership evolves from a hierarchical, transformational model early in team Formation to a shared, functional leadership model during Translation. We synthesized an integrated model of TT leadership, mapping a generic “functional leadership” taxonomy to relevant leadership behaviors linked to TT performance, creating an evidence-informed Leadership and Skills Enhancement for Research (LASER) training program. Empirical studies indicate that leadership behaviors are stable across time; to enhance leadership skills, ongoing reflection, evaluation, and practice are needed. We provide a comprehensive multi-level evaluation framework for tracking the growth of TT leadership skills. This work provides a framework for assessing and training relevant leadership behaviors for high-performance TTs.
Identification of treatment-specific predictors of drug therapies for bipolar disorder (BD) is important because only about half of individuals respond to any specific medication. However, medication response in pediatric BD is variable and not well predicted by clinical characteristics.
Methods
A total of 121 youth with early course BD (acute manic/mixed episode) were prospectively recruited and randomized to 6 weeks of double-blind treatment with quetiapine (n = 71) or lithium (n = 50). Participants completed structural magnetic resonance imaging (MRI) at baseline before treatment and 1 week after treatment initiation, and brain morphometric features were extracted for each individual based on MRI scans. Positive antimanic treatment response at week 6 was defined as an over 50% reduction of Young Mania Rating Scale scores from baseline. Two-stage deep learning prediction model was established to distinguish responders and non-responders based on different feature sets.
Results
Pre-treatment morphometry and morphometric changes occurring during the first week can both independently predict treatment outcome of quetiapine and lithium with balanced accuracy over 75% (all p < 0.05). Combining brain morphometry at baseline and week 1 allows prediction with the highest balanced accuracy (quetiapine: 83.2% and lithium: 83.5%). Predictions in the quetiapine and lithium group were found to be driven by different morphometric patterns.
Conclusions
These findings demonstrate that pre-treatment morphometric measures and acute brain morphometric changes can serve as medication response predictors in pediatric BD. Brain morphometric features may provide promising biomarkers for developing biologically-informed treatment outcome prediction and patient stratification tools for BD treatment development.
Lithium has a narrow therapeutic index with a risk of toxicity and potential to increase morbidity and mortality, particularly in the elderly with co-morbid illness and polypharmacy. Lithium therapy and monitoring of lithium levels require precision and several guidelines have been issued including recommendations for strict control of lithium levels in the elderly population.
RESEARCH OBJECTIVE:
We evaluated the effect of implementation of a multifaceted management programme on the compliance with international practice standards for lithium monitoring in patients under the care of Psychiatry of Old Age (POA), Sligo Leitrim Mental Health Services in the North West of Ireland.
METHODS:
Results from a prior audit performed in February 2020 involving a cohort of 18 patients prescribed lithium under the care of POA were analysed and compared to accepted standards. The guideline used as the benchmark for compliance was the National Institute for Clinical Excellence (NICE) guidelines on the use and monitoring of lithium therapy, as published in 2014. Several deficits were found and therefore a designated Lithium Management Programme was established. A subsequent audit, performed using a simplified audit tool incorporating the NICE guidelines, delivered results which were directly compared to the initial findings and analysed to evaluate the effect of the implemented management programme.
PRELIMINARY RESULTS OF THE ONGOING STUDY:
In comparison with findings from 2020, there had been a significant improvement in most facets of lithium management and compliance to practice standards. Of particular note was the improvement of biochemical monitoring, side effect screening, polypharmacy surveillance, patient education and interdisciplinary communication.
CONCLUSION:
The launch of a dedicated Lithium Management Programme with specific features aimed at identifying and addressing poor compliance with monitoring guidelines has led to improved adherence to accepted international practice standards. Our model provides a dynamic, multi-layered system which paves the way for better patient outcomes, timely access to care and furthering education for patients and staff members.
The SPARC tokamak is a critical next step towards commercial fusion energy. SPARC is designed as a high-field ($B_0 = 12.2$ T), compact ($R_0 = 1.85$ m, $a = 0.57$ m), superconducting, D-T tokamak with the goal of producing fusion gain $Q>2$ from a magnetically confined fusion plasma for the first time. Currently under design, SPARC will continue the high-field path of the Alcator series of tokamaks, utilizing new magnets based on rare earth barium copper oxide high-temperature superconductors to achieve high performance in a compact device. The goal of $Q>2$ is achievable with conservative physics assumptions ($H_{98,y2} = 0.7$) and, with the nominal assumption of $H_{98,y2} = 1$, SPARC is projected to attain $Q \approx 11$ and $P_{\textrm {fusion}} \approx 140$ MW. SPARC will therefore constitute a unique platform for burning plasma physics research with high density ($\langle n_{e} \rangle \approx 3 \times 10^{20}\ \textrm {m}^{-3}$), high temperature ($\langle T_e \rangle \approx 7$ keV) and high power density ($P_{\textrm {fusion}}/V_{\textrm {plasma}} \approx 7\ \textrm {MW}\,\textrm {m}^{-3}$) relevant to fusion power plants. SPARC's place in the path to commercial fusion energy, its parameters and the current status of SPARC design work are presented. This work also describes the basis for global performance projections and summarizes some of the physics analysis that is presented in greater detail in the companion articles of this collection.
SPARC is being designed to operate with a normalized beta of $\beta _N=1.0$, a normalized density of $n_G=0.37$ and a safety factor of $q_{95}\approx 3.4$, providing a comfortable margin to their respective disruption limits. Further, a low beta poloidal $\beta _p=0.19$ at the safety factor $q=2$ surface reduces the drive for neoclassical tearing modes, which together with a frozen-in classically stable current profile might allow access to a robustly tearing-free operating space. Although the inherent stability is expected to reduce the frequency of disruptions, the disruption loading is comparable to and in some cases higher than that of ITER. The machine is being designed to withstand the predicted unmitigated axisymmetric halo current forces up to 50 MN and similarly large loads from eddy currents forced to flow poloidally in the vacuum vessel. Runaway electron (RE) simulations using GO+CODE show high flattop-to-RE current conversions in the absence of seed losses, although NIMROD modelling predicts losses of ${\sim }80$ %; self-consistent modelling is ongoing. A passive RE mitigation coil designed to drive stochastic RE losses is being considered and COMSOL modelling predicts peak normalized fields at the plasma of order $10^{-2}$ that rises linearly with a change in the plasma current. Massive material injection is planned to reduce the disruption loading. A data-driven approach to predict an oncoming disruption and trigger mitigation is discussed.
In order to inform core performance projections and divertor design, the baseline SPARC tokamak plasma discharge is evaluated for its expected H-mode access, pedestal pressure and edge-localized mode (ELM) characteristics. A clear window for H-mode access is predicted for full field DT plasmas, with the available 25 MW of design auxiliary power. Additional alpha heating is likely needed for H-mode sustainment. Pressure pedestal predictions in the developed H-mode are surveyed using the EPED model. The projected SPARC pedestal would be limited dominantly by peeling modes and may achieve pressures in excess of 0.3 MPa at a density of approximately 3 × 1020 m−3. High pedestal pressure is partially enabled by strong equilibrium shaping, which has been increased as part of recent design iterations. Edge-localized modes (ELMs) with >1 MJ of energy are projected, and approaches for reducing the ELM size, and thus the peak energy fluence to divertor surfaces, are under consideration. The high pedestal predicted for SPARC provides ample margin to satisfy its high fusion gain (Q) mission, so that even if ELM mitigation techniques result in a 2× reduction of the pedestal pressure, Q > 2 is still predicted.
To identify alterations in neural networks for visual motion perception and pursuit tracking and their interrelationship in schizophrenia, and secondarily to evaluate their comparability to findings in psychotic bipolar disorder.
Methods
Untreated first-episode patients with schizophrenia (N=24) and psychotic bipolar disorder (N=13), and 20 matched healthy participants performed a passive visual motion processing task and a pursuit eye tracking task, which patients have been shown to perform as well as healthy subjects, during functional neuroimaging. Available subjects were retested after four weeks, during which both patient groups received second generation antipsychotics.
Results
During the motion processing task, neither patient group showed reduced activation in V5, but activations in its projection fields in posterior parietal cortex were reduced in both groups. Pursuit related neural activation in both patients groups was not reduced in sensorimotor systems, but was enhanced in anterior intraparietal sulcus and insula. In schizophrenia, activation was also enhanced in dorsolateral prefrontal cortex and dorsomedial thalamus. Greater V5 activation during passive motion processing predicted greater activation in posterior parietal cortex during pursuit in healthy individuals but not in patients. The only significant change at follow-up was decreased anterior cingulate activation during pursuit in schizophrenia.
Conclusions
Reduced transfer of visual motion information to parietal association cortex may compromise information about target speed and tracking error needed for sensorimotor transformations during pursuit tracking in psychotic disorders. Enhanced activation of a prefrontal-thalamo-parietal network during pursuit tracking in schizophrenia may represent compensation for this deficit.
The identification of natural bioactive compounds which can prevent the post-weaning growth check and enhance gastrointestinal health in the absence of in-feed medications is an urgent priority for the swine industry. The objective of this experiment was to determine the effects of increasing dietary inclusion levels of laminarin in the first 14 d post-weaning on pig growth performance and weaning associated intestinal dysfunction. At weaning, ninety-six pigs (8·4 (sd 1·09) kg) (meatline boars × (large white × landrace sows)) were blocked by live weight, litter and sex and randomly assigned to: (1) basal diet; (2) basal + 100 parts per million (ppm) laminarin; (3) basal + 200 ppm laminarin and (4) basal + 300 ppm laminarin (three pigs/pen). The appropriate quantity of a laminarin-rich extract (65 % laminarin) was added to the basal diet to achieve the above dietary inclusion levels of laminarin. After 14 d of supplementation, eight pigs from the basal group and the best-performing laminarin group were euthanised for sample collection. The 300 ppm laminarin group was selected as this group had higher ADFI compared with all other groups and higher ADG than the basal group (P < 0·05). Laminarin supplementation increased villus height in the duodenum and jejunum (P < 0·05). Laminarin supplementation increased the expression of SLC2A8/GLUT8 in the duodenum, SLC2A2/GLUT2, SLC2A7/GLUT7, SLC15A1/PEPT1 and FABP2 in the jejunum and SLC16A1/MCT1 in the colon. Laminarin supplementation reduced Enterobacteriaceae numbers in the caecum (P < 0·05) and increased lactobacilli numbers (P < 0·05), total volatile fatty acid concentrations and the molar proportions of butyrate (P < 0·01) in the colon. In conclusion, 300 ppm laminarin from a laminarin-rich extract has potential, as a dietary supplement, to improve performance and prevent post-weaning intestinal dysfunction.
The aim of the study was to determine the main factors (sociodemographic, anthropometric, lifestyle and health status) associated with high Na excretion in a representative population of Chile.
Design
Na excretion (g/d), a valid marker of Na intake, was determined by urine analysis and Tanaka’s formulas. Blood pressure was measured by trained staff and derived from the mean of three readings recorded after 15 min rest. The associations of Na excretion with blood pressure and the primary correlates of high Na excretion were determined using logistic regression.
Setting
Chileans aged ≥15 years.
Participants
Participants (n 2913) from the Chilean National Health Survey 2009–2010.
Results
Individuals aged 25 years or over, those who were obese and those who had hypertension, diabetes or metabolic syndrome were more likely to have higher Na excretion. The odds for hypertension increased by 10·2 % per 0·4 g/d increment in Na excretion (OR=1·10; 95 % CI 1·06, 1·14; P < 0·0001). These findings were independent of major confounding factors.
Conclusions
Age, sex, adiposity, sitting behaviours and existing co-morbidities such as diabetes were associated with higher Na excretion levels in the Chilean population. These findings could help policy makers to implement public health strategies tailored towards individuals who are more likely to consume high levels of dietary salt.
The Channeled Scabland–Palouse region of the Pacific Northwest (PNW) of the United States preserves geomorphic and pedosedimentary records that inform understanding of late Pleistocene–Holocene paleoclimate change in a region proximal to the last glacial period Cordilleran Ice Sheet. We present a clumped (Δ47) and conventional (δ18O, δ13C) isotopic study of Palouse loess–paleosol carbonates in combination with carbonate radiocarbon (14C) dating to provide new measures of regional late–last glacial (~31–20 cal ka BP) and Holocene soil conditions. Average clumped isotope temperatures (T(Δ47)) for last glacial Palouse loess–paleosol carbonates (9±4°C) are significantly lower than those for Holocene-aged carbonates (T(Δ47)=18±2°C) in study sections. Calculated soil water δ18OVSMOW values (−16±2‰) for last glacial carbonates are also offset relative to those for Holocene-aged samples (−11±1‰), whereas calculated soil CO2 δ13CVPDB values are similar for the Holocene (−16.9±0.2‰) and late–last glacial (−16.7±1.1‰) periods. Together, these paleoclimate metrics indicate late–last glacial conditions of pedogenic carbonate formation in the C3 grassland soils of the Palouse were measurably colder (9±5°C) than during the Holocene and potentially reflect a more arid last glacial paleoclimate across the Palouse, findings in agreement with previous proxy studies and climate model simulations for the region.
Topographic and climatic influences have controlled thick loess accumulation at the southern margin of the Palouse loess in northern Oregon. Juniper and Cold Springs Canyons, located on the upwind flank of the Horse Heaven Hills, are oriented perpendicular to prevailing southwesterly winds. These canyons are topographic traps that separate eolian sand on the upwind side from thick accumulations (nearly 8 m) of latest Pleistocene to Holocene L1 loess on the downwind side. Silt- and sand-rich glacial outburst flood sediment in the Umatilla Basin is the source of eolian sand and loess for the region. Sediment from this basin also contributes to loess accumulations across much of the Columbia Plateau to the northeast. Downwind of Cold Springs Canyon, Mt. St. Helens set S and Glacier Peak tephras bracket 4 m of loess, demonstrating that approximately 2500 g m−2 yr−1 of loess accumulated between about 15,400–13,100 cal yr B.P. Mass accumulation rates decreased to approximately 250 g m−2 yr−1 from 13,100 cal yr B.P. to the present. Tephrochronology suggests that the bulk of near-source Palouse loess accumulated in one punctuated interval in the latest Pleistocene characterized by a dry and windy climate.
The Kulshan caldera formed at ∼1.15 Ma on the present-day site of Mt. Baker, Washington State, northwest USA and erupted a compositionally zoned (dacite-rhyolite) magma and a correlative eruptive, the Lake Tapps tephra. This tephra has previously been described, but only from the Puget Lowland of NW Washington. Here an occurrence of a Kulshan caldera correlative tephra is described from the Quaternary Palouse loess at the Washtucna site (WA-3). Site WA-3 is located in east-central Washington, ∼340 km southeast of the Kulshan caldera and ∼300 km east-southeast of the Lake Tapps occurrence in the Puget Lowland. Major- and trace element chemistry and location of the deposit at Washtucna within reversed polarity sediments indicates that it is not correlative with the Mesa Falls, Rockland, Bishop Ash, Lava Creek B or Huckleberry Ridge tephras. Instead the Washtucna deposit is related to the Lake Tapps tephra by fractional crystallisation, but is chemically distinct, a consequence of its eruption from a compositionally zoned magma chamber. The correlation of the Washtucna occurrence to the Kulshan caldera-forming eruption indicates that it had an eruptive volume exceeding 100 km3, and that its tephra could provide a valuable early-Pleistocene chronostratigraphic marker in the Pacific Northwest.