A global call to action to improve the care of people with fragility fractures

The ageing of society is driving an enormous increase in fragility fracture incidence and imposing a massive burden on patients, their families, health systems and societies globally. Disrupting the status quo has therefore become an obligation and a necessity. Initiated by the Fragility Fracture Network (FFN) at a �Presidents' Roundtable� during the 5th FFN Global Congress in 2016 several leading organisations agreed that a global multidisciplinary and multiprofessional collaboration, resulting in a Global Call to Action (CtA), would be the right step forward to improve the care of people presenting with fragility fractures. So far global and regional organisations in geriatrics/internal medicine, orthopaedics, osteoporosis/metabolic bone disease, rehabilitation and rheumatology were contacted as well as national organisations in five highly populated countries (Brazil, China, India, Japan and the United States), resulting in 81societies endorsing the CtA. We call for implementation of a systematic approach to fragility fracture care with the goal of restoring function and preventing subsequent fractures without further delay. There is an urgent need to improve: � Acute multidisciplinary care for the person who suffers a hip, clinical vertebral and other major fragility fractures� Rapid secondary prevention after first occurrence of all fragility fractures, including those in younger people as well as those in older persons, to prevent future fractures� Ongoing post-acute care of people whose ability to function is impaired by hip and major fragility fracturesTo address this fragility fracture crisis, the undersigned organisations pledge to intensify their efforts to improve the current management of all fragility fractures, prevent subsequent fractures, and strive to restore functional abilities and quality of life.</p

Erosion and deposition in the JET divertor during the second ITER-like wall campaign

Erosion of plasma-facing materials and successive transport and redeposition of eroded material are crucial processes determining the lifetime of plasma-facing components and the trapped tritium inventory in redeposited material layers. Erosion and deposition in the JET divertor were studied during the second JET ITER-like wall campaign ILW-2 in 2013-2014 by using a poloidal row of specially prepared divertor marker tiles including the tungsten bulk tile 5. The marker tiles were analyzed using elastic backscattering with 3-4.5 MeV incident protons and nuclear reaction analysis using 0.8-4.5 MeV 3He ions before and after the campaign. The erosion/deposition pattern observed during ILW-2 is qualitatively comparable to the first campaign ILW-1 in 2011-2012: deposits consist mainly of beryllium with 5-20 at.% of carbon and oxygen and small amounts of Ni and W. The highest deposition with deposited layer thicknesses up to 30 μm per campaign is still observed on the upper and horizontal parts of the inner divertor. Outer divertor tiles 5, 6, 7 and 8 are net W erosion areas. The observed D inventory is roughly comparable to the inventory observed during ILW-1. The results obtained during ILW-2 therefore confirm the positive results observed in ILW-1 with respect to reduced material deposition and hydrogen isotopes retention in the divertor

Tractable flux-driven temperature, density, and rotation profile evolution with the quasilinear gyrokinetic transport model QuaLiKiz

Quasilinear turbulent transport models are a successful tool for prediction of core tokamak plasma profiles in many regimes. Their success hinges on the reproduction of local nonlinear gyrokinetic fluxes. We focus on significant progress in the quasilinear gyrokinetic transport model QuaLiKiz (Bourdelle et al 2016 Plasma Phys. Control. Fusion 58 014036), which employs an approximated solution of the mode structures to significantly speed up computation time compared to full linear gyrokinetic solvers. Optimisation of the dispersion relation solution algorithm within integrated modelling applications leads to flux calculations faster than local nonlinear simulations. This allows tractable simulation of flux-driven dynamic profile evolution including all transport channels: ion and electron heat, main particles, impurities, and momentum. Furthermore, QuaLiKiz now includes the impact of rotation and temperature anisotropy induced poloidal asymmetry on heavy impurity transport, important for W-transport applications. Application within the JETTO integrated modelling code results in 1 s of JET plasma simulation within 10 h using 10 CPUs. Simultaneous predictions of core density, temperature, and toroidal rotation profiles for both JET hybrid and baseline experiments are presented, covering both ion and electron turbulence scales. The simulations are successfully compared to measured profiles, with agreement mostly in the 5%-25% range according to standard figures of merit. QuaLiKiz is now open source and available at www.qualikiz.com