Investigation of Electromagnetic Sub-Modeling Procedure for the Breeding Blanket System

The outcome of the electromagnetic (EM) analyses carried out during the DEMO pre-conceptual phase demonstrated that EM loads are relevant for the structural assessment of the breeding blanket (BB) and, in particular, for the definition of the boundary conditions at the attachment system with the vacuum vessel. However, within the scope of the previous campaign, the results obtained using simplified models only give a rough estimation of the EM loads inside the BB structure. This kind of data has been considered suitable for a preliminary assessment of the BB segments, but it is not considered representative as input for structural analysis in which a detailed BB internal structure (that considers cooling channels, thin plates, etc.) is analyzed. Indeed, mesh dimensions and computational time usually limit EM models that simulate a whole DEMO sector. In many cases, these constraints lead to a strong homogenization of the BB structure, not allowing the calculation of the EM loads on the internal structure with high precision. To overcome such limitations, an EM sub-modeling procedure was investigated using ANSYS EMAG. The sub-modeling feasibility is studied using the rigid boundary condition method. This method consists of running a global “coarse” mesh, including all the conducting structures that can have some impact on the component under investigation and inputting the obtained results on the detailed sub-model of the structure of interest as time-varying boundary conditions. The procedure was tested on the BB internal structure, taking as reference a DEMO 2017 baseline sector and the helium cooled pebble bed (HCPB) concept with its complex internal structure made by pins. The obtained results show that the method is also reliable in the presence of non-linear magnetic behaviour. The methodology is proposed for application in future BB system assessments

IXPE Mission System Concept and Development Status

The Goal of the Imaging X-Ray Polarimetry Explorer (IXPE) Mi SMEX), is to expand understanding of high-energy astrophysical processes and sources, in support of NASAs first science objective in Astrophysics: Discover how the universe works. IXPE, an international collaboration, will conduct X-ray imaging polarimetry for multiple categories of cosmic X-ray sources such as neutron stars, stellar-mass black holes, supernova remnants and active galactic nuclei. The Observatory uses a single science operational mode capturing the X-ray data from the targets. The IXPE Observatory consists of spacecraft and payload modules built up in parallel to form the Observatory during system integration and test. The payload includes three X-ray telescopes each consisting of a polarization-sensitive, gas pixel X-ray detector, paired with its corresponding grazing incidence mirror module assembly (MMA). A deployable boom provides the correct separation (focal length) between the detector units (DU) and MMAs. These payload elements are supported by the IXPE spacecraft which is derived from the BCP-small spacecraft architecture. This paper summarizes the IXPE mission science objectives, updates the Observatory implementation concept including the payload and spacecraft ts and summarizes the mission status since last years conference

Low in‑hospital mortality rate in patients with COVID‑19 receiving thromboprophylaxis: data from the multicentre observational START‑COVID Register

Abstract COVID-19 infection causes respiratory pathology with severe interstitial pneumonia and extra-pulmonary complications; in particular, it may predispose to thromboembolic disease. The current guidelines recommend the use of thromboprophylaxis in patients with COVID-19, however, the optimal heparin dosage treatment is not well-established. We conducted a multicentre, Italian, retrospective, observational study on COVID-19 patients admitted to ordinary wards, to describe clinical characteristic of patients at admission, bleeding and thrombotic events occurring during hospital stay. The strategies used for thromboprophylaxis and its role on patient outcome were, also, described. 1091 patients hospitalized were included in the START-COVID-19 Register. During hospital stay, 769 (70.7%) patients were treated with antithrombotic drugs: low molecular weight heparin (the great majority enoxaparin), fondaparinux, or unfractioned heparin. These patients were more frequently affected by comorbidities, such as hypertension, atrial fibrillation, previous thromboembolism, neurological disease,and cancer with respect to patients who did not receive thromboprophylaxis. During hospital stay, 1.2% patients had a major bleeding event. All patients were treated with antithrombotic drugs; 5.4%, had venous thromboembolism [30.5% deep vein thrombosis (DVT), 66.1% pulmonary embolism (PE), and 3.4% patients had DVT + PE]. In our cohort the mortality rate was 18.3%. Heparin use was independently associated with survival in patients aged ≥ 59 years at multivariable analysis. We confirmed the high mortality rate of COVID-19 in hospitalized patients in ordinary wards. Treatment with antithrombotic drugs is significantly associated with a reduction of mortality rates especially in patients older than 59 years

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570