Planck early results II : The thermal performance of Planck

Peer reviewe

Impact of Chlamydia trachomatis in the reproductive setting: British Fertility Society Guidelines for practice

Chlamydia trachomatis infection of the genital tract is the most common sexually transmitted infection and has a world-wide distribution. The consequences of infection have an adverse effect on the reproductive health of women and are a common cause of infertility. Recent evidence also suggests an adverse effect on male reproduction. There is a need to standardise the approach in managing the impact of C. trachomatis infection on reproductive health. We have surveyed current UK practice towards screening and management of Chlamydia infections in the fertility setting. We found that at least 90% of clinicians surveyed offered screening. The literature on this topic was examined and revealed a paucity of solid evidence for estimating the risks of long-term reproductive sequelae following lower genital tract infection with C. trachomatis. The mechanism for the damage that occurs after Chlamydial infections is uncertain. However, instrumentation of the uterus in women with C. trachomatis infection is associated with a high risk of pelvic inflammatory disease, which can be prevented by appropriate antibiotic treatment and may prevent infected women from being at increased risk of the adverse sequelae, such as ectopic pregnancy and tubal factor infertility. Recommendations for practice have been proposed and the need for further studies is identified

Velocity-space sensitivity of the time-of-flight neutron spectrometer at JET

The velocity-space sensitivities of fast-ion diagnostics are often described by so-called weight functions. Recently, we formulated weight functions showing the velocity-space sensitivity of the often dominant beam-target part of neutron energy spectra. These weight functions for neutron emission spectrometry (NES) are independent of the particular NES diagnostic. Here we apply these NES weight functions to the time-of-flight spectrometer TOFOR at JET. By taking the instrumental response function of TOFOR into account, we calculate time-of-flight NES weight functions that enable us to directly determine the velocity-space sensitivity of a given part of a measured time-of-flight spectrum from TOFOR

On the mechanisms governing gas penetration into a tokamak plasma during a massive gas injection

A new 1D radial fluid code, IMAGINE, is used to simulate the penetration of gas into a tokamak plasma during a massive gas injection (MGI). The main result is that the gas is in general strongly braked as it reaches the plasma, due to mechanisms related to charge exchange and (to a smaller extent) recombination. As a result, only a fraction of the gas penetrates into the plasma. Also, a shock wave is created in the gas which propagates away from the plasma, braking and compressing the incoming gas. Simulation results are quantitatively consistent, at least in terms of orders of magnitude, with experimental data for a D 2 MGI into a JET Ohmic plasma. Simulations of MGI into the background plasma surrounding a runaway electron beam show that if the background electron density is too high, the gas may not penetrate, suggesting a possible explanation for the recent results of Reux et al in JET (2015 Nucl. Fusion 55 093013)

Therapeutic options for mucinous ovarian carcinoma

OBJECTIVE: Mucinous ovarian carcinoma (MOC) is an uncommon ovarian cancer histotype that responds poorly to conventional chemotherapy regimens. Although long overall survival outcomes can occur with early detection and optimal surgical resection, recurrent and advanced disease are associated with extremely poor survival. There are no current guidelines specifically for the systemic management of recurrent MOC. We analyzed data from a large cohort of women with MOC to evaluate the potential for clinical utility from a range of systemic agents. METHODS: We analyzed gene copy number (n = 191) and DNA sequencing data (n = 184) from primary MOC to evaluate signatures of mismatch repair deficiency and homologous recombination deficiency, and other genetic events. Immunohistochemistry data were collated for ER, CK7, CK20, CDX2, HER2, PAX8 and p16 (n = 117-166). RESULTS: Molecular aberrations noted in MOC that suggest a match with current targeted therapies include amplification of ERBB2 (26.7%) and BRAF mutation (9%). Observed genetic events that suggest potential efficacy for agents currently in clinical trials include: KRAS/NRAS mutations (66%), TP53 missense mutation (49%), RNF43 mutation (11%), ARID1A mutation (10%), and PIK3CA/PTEN mutation (9%). Therapies exploiting homologous recombination deficiency (HRD) may not be effective in MOC, as only 1/191 had a high HRD score. Mismatch repair deficiency was similarly rare (1/184). CONCLUSIONS: Although genetically diverse, MOC has several potential therapeutic targets. Importantly, the lack of response to platinum-based therapy observed clinically corresponds to the lack of a genomic signature associated with HRD, and MOC are thus also unlikely to respond to PARP inhibition

Influência de fatores ambientais na distribuição de famílias de insetos aquáticos em rios no sul do Brasil

Os rios neotropicais sofrem os efeitos das ações humanas. Medidas conservacionistas, pela escassez de estudos na região e do conhecimento límnico, baseiam-se em dados referentes a outras regiões, sendo muitas vezes ineficazes pela inobservância das diferenças nas respostas das comunidades aquáticas às variáveis ambientais em escalas distintas. Este estudo teve como objetivos: conhecer a riqueza de insetos aquáticos em uma bacia neotropical; verificar qual a influência das variáveis ambientais na distribuição das famílias de insetos aquáticos em quatro tributários dessa bacia e observar se o padrão de distribuição das famílias de insetos aquáticos varia entre as ordens dos rios ou entre microbacias, de acordo com a influência de variáveis ambientais e espaciais. Foi encontrado um total de 9.135 indivíduos distribuídos em 26 famílias de macroinvertebrados. A estrutura das comunidades foi distinta entre as microbacias. As famílias de insetos aquáticos foram influenciadas pelas variáveis ambientais e espaciais diferentes em cada microbacia

Reimagining Dementia Care: A Complex Intervention Systematic Review on Optimising Social Prescribing (SP) for People Living With Dementia (PLWD) in the United Kingdom

Introduction: Dementia is a complex medical condition that poses significant challenges to healthcare systems and support services. People living with dementia (PLWD) often face complex needs, exacerbated by social isolation and difficulty accessing support. Social prescribing (SP) has been increasingly integrated into the United Kingdom's National Health Service (NHS) as a means to connect individuals with non‐clinical services to address these challenges. However, current research provides limited detail on specific SP interventions tailored to dementia care, leaving gaps in understanding the targeted needs, participation drivers, effectiveness and potential benefits for PLWD. Methods: A complex intervention systematic review of SP in dementia care was performed in the United Kingdom using an iterative logic model approach. Six databases and grey literature were searched, supplemented by hand searching for reference lists of included studies. Results were screened in a two‐step process, followed by data extraction. Risk of bias was assessed using Gough's Evidence of Framework. Reporting was informed by the Preferred Reporting Items for Systematic Review and Meta‐Analysis (PRISMA‐CI) extension statement and checklist. Results: Forty‐nine studies, reporting on PLWD, met the inclusion criteria. Findings indicate that SP for PLWD in the United Kingdom is varied and lacks focus, reflecting the diverse demographics involved. Interventions encompass cognitive, educational, psychosocial, physical, community and complementary therapies, of inconsistent classification, with some being umbrella interventions and others standalone services. Provided by the NHS, charities and integrated services, SP involves a range of referrers and connectors. Finally, individual outcomes show benefits such as increased independence and improved mood, but challenges pertaining to suitability and logistical issues, whereas systemic outcomes include cost savings and better service delivery, despite high implementation costs. Conclusion: SP pathways for PLWD are varied, with success relying heavily on adequately resourced and trained connectors.While benefits extend beyond health improvements, further research is needed to assess long‐term impacts, refine mechanisms and standardise evaluation metrics for SP effectiveness in dementia care. Patient and Public Contributions: A PPI advisory group, consisting of a person living with dementia and a caregiver, was actively involved throughout the review process, providing insights into the review questions, the logic model, emerging findings and interpretation of results

Scrape Off Layer (SOL) transport and filamentary characteristics in high density tokamak regimes

A detailed cross-device investigation on the role of filamentary dynamics in high density regimes has been performed within the EUROfusion framework comparing ASDEX Upgrade (AUG) and TCV tokamaks. Both devices have run density ramp experiments at different levels of plasma current, keeping toroidal field or q95 constant in order to disentangle the role of parallel connection length and the current. During the scan at constant toroidal field, in both devices SOL profiles tend to develop a clear Scrape Off Layer (SOL) density shoulder at lower edge density whenever current is reduced. The different current behavior is substantially reconciled in terms of edge density normalized to Greenwald fraction. During the scan at constant q95 AUG exhibits a similar behaviour whereas in TCV no signature of upstream profile modification has been observed at lower level of currents. The latter behaviour has been ascribed to the lack of target density roll-over. The relation between upstream density profile modification and detachment condition has been investigated. For both devices the relation between blob-size and SOL density e-folding length is found independent of the plasma current, with a clear increase of blob-size with edge density normalized to Greenwald fraction observed. ASDEX Upgrade has also explored the filamentary behaviour in H-Mode. The experiments on AUG focused on the role of neutrals, performing discharges with and without the cryogenic pumps, highlighting how large neutral pressure not only in the divertor but at the midplane is needed in order to develop a H-Mode SOL profile shoulder in AUG