Multiobjective optimization techniques for the solution of free-boundary plasma equilibrium inverse problems

Lo scopo di questo studio è quello di sviluppare un codice per la soluzione numerica del problema inverso per l’equilibrio di plasmi confinati magneticamente con un approccio di ottimizzazione multiobiettivo e un controllo analitico funzionale della forma del boundary di plasma. Il problema inverso consiste nel determinare i valori ottimali di correnti circolanti nelle bobine attive della macchina tali da mantenere in equilibrio un plasma il cui boundary sia prestabilitoope

Modelling and control of RFX-mod tokamak equilibria

The subject that concerns this thesis is the modelling and control of plasma equilibria in the RFX-mod device operating as shaped tokamak. The aim was to develop an overall model of the plasma-conductors-controller system of RFX-mod shaped tokamak configuration for electromagnetic control purposes, with particular focus on vertical stability. Thus, the RFX-mod device is described by models of increasing complexity and involving both theoretical and experimental data. The CREATE-L code is used to develop 2D linearized plasma response models, with simplifying assumptions on the conducting structures (axisymmetric approximations). Such models, thanks to their simplicity, have been used for feedback controller design. The CarMa0 code is used to develop linearized plasma response models, but considering a detailed 3D description of the conducting structures. These models provide useful hints on the accuracy of the simplified models and on the importance of 3D structures in the plasma dynamics. The CarMa0NL code is used to model the time evolution of plasma equilibria, by taking into account also nonlinear effects which can come into play during specific phases (e.g. disruptions, limiter-to-divertor transitions, L-H transition etc.). The activity can be divided into two main parts: the first one involves the modelling of numerically generated low-β plasmas, which are used as a reference for the design and implementation of the plasma shape and position control system; the second part is related to the results of the experimental campaigns on shaped plasmas from low-β to H-mode regime, with particular efforts on the development of a novel plasma response model for the new equilibrium regimes achieved. Several challenges and peculiarities characterize the project in both the modelling and control frameworks. Strong plasma shape and different plasma regimes (i.e. low-β to H-mode plasmas), deeply affect the modelling activity and require the development of several numerical tools and methods of analysis. From the control system point of view, non-totally observable dynamic and model order reduction requirements allowed a full application of the model based approach in order to successfully design the plasma shape and vertical stability control system. The first part is based on theoretical data generated by the MAXFEA equilibrium code and used to derive the linearized model through the CREATE-L code. Two reference models have been produced for the magnetic configurations interested in shaped operations: the lower single null (LSN) and the upper single null (USN). The CREATE-L models are the most simple in terms of modelling complexity, because the conducting structures are described within the axisymmetric approximation. On the other hand, the simple but reliable properties of the CREATE-L model led to the successful design of the RFX-mod plasma shape and control system, which has been successfully tested and used to increase plasma performances involved in the second part of the thesis. Then, an investigation on the possible 3D effects of the conducting structures on these numerically generated plasma configurations has been carried out by producing plasma linearized models with an increased level of complexity. A detailed 3D volumetric description of the conducting structures of RFX-mod has been carried out and included in the plasma linearized models through the CarMa0 code. A comparison between the accuracy of this model and the previous 2D one has been performed. The different assumptions and approximations of the various models allow a clear identification of the key phenomena ruling the evolution of the n=0 vertical instability in RFX-mod tokamak discharges, and hence, provide fundamental information in the planning and the execution of related experiments and in refining the control system design. Finally, the nonlinear evolutionary equilibrium model including 3D volumetric structures CarMa0NL has been used to model nonlinear effects by simulating a "fictitious" linear current quench. The second part involves a modelling activity strictly related to the results of the experimental campaigns. In particular, new linearized models for the experimental plasmas in USN configuration have been carried out for all the plasma regimes involved in the experimental campaign, i.e. from low-β to H-mode. An iterative procedure for the production of accurate linearized plasma response models has been realized in order to handle the experimental data. The new plasma linearized models allowed further investigations on vertical stability, including 3D wall effects, in the three different plasma regimes (i.e. low-β, intermediate-β, H-mode). Furthermore, the axisymmetric plasma linearized models (CREATE-L) have been analyzed in the framework of the control theory revealing peculiar features in terms of associated SISO transfer function for vertical stability control and in terms of full MIMO model for shaping control. The MIMO model has been used to investigate the plasma wall-gaps oscillations experimentally observed in some intermediate-β plasma shots. A non-linear time evolution of the plasma discharge for a low-β plasma has been carried out by using the evolutionary equilibrium code CarMa0NL. Finally, it was investigated the vertical instability for the experimental plasmas in terms of a possible relation between plasma parameters and the occurrence of it; for these purposes, the solution of the inverse plasma equilibrium problem for the production of numerically generated plasma equilibria with variations on the plasma parameters observed experimentally was performed. This involves a wide class of numerical methods that will be described in details. Then, statistical hypothesis test has been adopted to compare the mean values of the parameters of both experimental and numerically generated plasmas showing different behaviours in terms of vertical stability

Implementation and Review of the Axisymmetric Equilibrium System of RFX-Mod2 within the MARTe2 Framework

A major refurbishment of the toroidal complex of the RFX-mod device is in progress and it will include the removal of the Inconel vacuum vessel and a modification of the stainless steel supporting structure to be made vacuum-tight. The axisymmetric equilibrium control in RFX-mod was responsible for the control of the plasma current, horizontal and vertical position along with its stability and the plasma shape. The new implementation framework, both hardware and software, is described. The system has been fully reviewed and modified, if needed, for its prospective use in RFX-mod2. In order to run tests in an operation-like context, the updated system has also been implemented in the MARTe2 framework, to be deployed for the real-time applications of RFX-mod2. The results of the previous versions were reproduced and the cycle-time requirements were met

COMUNICAÇÃO E RELAÇÕES SOCIAIS ESTABELECIDAS ENTRE PAIS ADOECIDOS PELO CÂNCER E SEUS FILHOS

Objetivos: identificar os fatores intervenientes nas relações interpessoais e no processo de comunicação entre pais com câncer e seus filhos, relativos ao processo de adoecimento e descrever as estratégias favorecedoras.Método: revisão integrativa, 25 artigos selecionados, entre 2007 e 2017. Utilizou-se a estratégia de seleção: Patient, Intervention, Comparison e Outcomes para responder as questões norteadoras.Resultados: a funcionalidade da estrutura familiar, bem como as atitudes no adoecimento influenciam a comunicação dos pais com câncer e seus filhos. Na perspectiva dos profissionais, há falta de preparo para estes auxiliarem a família. Quando estratégias são empreendidas, os resultados geram impacto positivo.Conclusão: a qualidade e efetividade da comunicação e das relações interpessoais são alcançadas com uma comunicação efetiva, direcionada e individualizada, amparada por equipe multidisciplinar preparada e articulada para auxiliar tanto os pais como seus filhos, além de estratégias presenciais, individuais e em grupo, bem como o uso de materiais educativos.Objetivos: identificar los factores que interfieren en las relaciones interpersonales y en el procesode comunicación entre padres con cáncer y sus hijos, en lo que se refiere al proceso deenfermedad y describir las estrategias favorables.Método: revisión integral, de 25 artículos seleccionados, entre 2007 y 2017. Se utilizó la estrategiade selección: Patient, Intervention, Comparison y Outcomes para contestar a laspreguntas orientadoras.Resultados: la funcionalidad de la estructura familiar, así como las actitudes en el proceso deenfermedad influencian la comunicación de los padres con cáncer y sus hijos. En la perspectivade los profesionales, hace falta preparación para que estos ayuden a la familia. Cuando seutilizan estrategias, los resultados generan impacto positivo.Conclusión: se puede alcanzar la cualidad y efectividad de la comunicación y de las relacionesinterpersonales por medio de una comunicación efectiva, direccionada y individualizada, consoporte del equipo multidisciplinar preparado y articulado para ayudar tanto a los padrescomo a sus hijos, además de adoptarse estrategias presenciales, individuales y en grupo, asícomo el uso de materiales educativos.Objectives: To identify the intervening factors in interpersonal relations and in the process ofcommunication between parents with cancer and their children, related to the disease processand describe the strategies that favor communication.Method: Integrative review, with 25 articles selected between 2007 and 2017. The selectionstrategy: Patient, Intervention, Comparison and Outcomes was used to answer the guidingquestions.Results: The functionality of the family structure, as well as the attitudes taken during thedisease process impact the communication of parents with cancer and their children. Healthprofessionals claim they are not prepared to assist these families. When strategies are undertaken,the results generate positive impact.Conclusion: The quality and effectiveness of communication and interpersonal relationshipsare achieved through effective and individualized communication, supported by a trained andwell-coordinated multidisciplinary team that can assist both the parents and their children,in addition to face-to-face, individual and group strategies, as well as the use of educationalmaterials

Bioaccumulation of dioxin-like substances and selected brominated flame retardant congeners in the fat and livers of black pigs farmed within the Nebrodi Regional Park of Sicily.

An observational study was designed to assess the bioaccumulation of polychlorodibenzodioxins (PCDD) and polychlorodibenzofurans (PCDF), dioxin-like polychlorobiphenyls (DL-PCB), and 13 selected polybromodiphenylethers (PBDE) in autochthonous pigs reared in the Nebrodi Park of Sicily (Italy). Perirenal fat and liver samples were drawn from animals representative of three different outdoor farming systems and from wild pigs and then analyzed for the chemicals mentioned previously. The highest concentrations of PCDD + PCDF and DL-PCB were detected in the fat (0.45 and 0.35 pg World Health Organization toxicity equivalents [WHO-TE] per g of fat base [FB], respectively) and livers (12.7 and 3.28 pg WHO-TE per g FB) of the wild group, whereas the free-ranging group showed the lowest levels (0.05 and 0.03 pg WHO-TE per g FB in fat and 0.78 and 0.27 pg WHO-TE per g FB in livers). The sum of PBDE congeners was highest in wild pigs (0.52 ng/g FB in fat and 5.64 ng/g FB in livers) and lowest in the farmed group (0.14 ng/g FB in fat and 0.28 ng/g FB in livers). The contamination levels in fat and livers of outdoor pigs had mean concentration values lower than those levels reported for intensively indoor-farmed animals. In wild pigs, bioaccumulation was associated with their free grazing in areas characterized by bush fires. The results of this study aid to emphasize the quality of the environment as a factor to guarantee food safety in typical processed pig meat products, specifically from outdoor and extensive Nebrodi farming systems

Tumor induced osteomalacia: a systematic review and individual patient's data analysis

Context: Tumor induced osteomalacia (TIO) is a rare paraneoplastic syndrome, usually caused by small, benign and slow-growing phosphaturic mesenchymal tumors. Clinically, TIO is characterized by renal phosphate leak, causing hypophosphatemia and osteomalacia. This review was performed to assess the clinical characteristics of TIO patients described worldwide so far. Evidence acquisition: On 06/26/2021, a systematic search was performed in Medline, Google Scholar, Google book, and Cochrane Library using the terms: "tumor induced osteomalacia", "oncogenic osteomalacia", "hypophosphatemia". There were no language restrictions. This review was performed according to PRISMA criteria. Evidence results: Overall, 1725 TIO cases were collected. TIO was more frequent in adult men, who showed a higher incidence of fractures compared to TIO women. The TIO causing neoplasms were identified in 1493 patients. The somatostatin receptor-based imaging modalities have the highest sensitivity for the identification of TIO-causing neoplasms. TIO causing neoplasms were equally located in bone and soft tissues; these latter showed a higher prevalence of fractures and deformities. The surgery is the preferred TIO definitive treatment (successful in >90% of patients). Promising non-surgical therapies are treatments with burosumab in TIO patients with elevated Fibroblast Growth Factor-23 levels, and with radiolabeled somatostatin analogs in patients with TIO-causing neoplasm identified by somatostatin receptor-based imaging techniques. Conclusion: TIO occurs preferentially in adult men. The TIO clinical expressiveness is more severe in men as well as in patients with TIO-causing neoplasms located to soft tissues. Treatments with burosumab and with radiolabeled somatostatin analogs are the most promising non-surgical therapies

Educational pamphlets on health: a reception study

OBJETIVOS Identificar o perfil socioeconômico e cultural de usuários de folhetos educativos, caracterizar o contexto de leitura do material e das pessoas envolvidas, descrever a avaliação dos usuários em relação ao estilo de linguagem empregada e a abrangência ou limitação dos conteúdos, caracterizar como o material educativo pôde auxiliar o usuário em relação ao atendimento das demandas de cuidados em domicílio. MÉTODO Estudo de recepção, transversal, qualitativo. Foram entrevistados 27 respondentes que receberam cinco folhetos educativos sobre sinais e sintomas em Oncologia, durante o atendimento ambulatorial. RESULTADOS Os integrantes do estudo eram adultos, com escolaridade média acima de 10 anos e baixo poder aquisitivo. Os folhetos foram avaliados como adequados quanto à clareza de linguagem, quantidade e qualidade dos conteúdos e, principalmente, em relação à capacidade de auxiliar nas decisões tomadas em domicílio. Verificou-se a importância de seu recebimento na fase inicial da doença. CONCLUSÃO A recepção dos usuários foi positiva e o estudo evidenciou aspectos que devem ser potencializados na elaboração dos folhetos educativos.OBJETIVOS Identificar el perfil socioeconómico y cultural de usuarios de folletos educativos, caracterizar el contexto de lectura del material y las personas involucradas, describir la evaluación de los usuarios con respecto al estilo de lenguaje empleado y al alcance o limitación de los contenidos, caracterizar como el material educativo pudo auxiliar al usuario con respecto a la atención de las demandas de cuidados a domicilio. MÉTODO Estudio de recepción, transversal, cualitativo. Se entrevistaron a 27 respondientes, quienes recibieron cinco folletos educativos acerca de las señales y los síntomas en Oncología, durante la atención ambulatoria. RESULTADOS Los integrantes del estudio eran adultos, con escolaridad media arriba de 10 años y bajo poder adquisitivo. Los folletos fueron evaluados como adecuados en cuanto a la claridad del lenguaje, la cantidad y calidad de los contenidos y, especialmente, con respecto a la capacidad de ayudar en las decisiones tomadas en domicilio. Se verificó la importancia de su recibido en la fase inicial de la enfermedad. CONCLUSIÓN La recepción de los usuarios fue positiva y el estudio evidenció aspectos que deben ser potenciados en el diseño de los folletos educativos.OBJECTIVES Identifying the socioeconomic and cultural profile of users/readers of educational pamphlets, characterizing the context of the reading material and people involved; describing the user/reader evaluation on language and style used, as well as content range or limitations, and its characterization as an educational material in assisting users for meeting homecare demands. METHOD A reception, cross-sectional, qualitative study. 27 respondents who had received five educational pamphlets were interviewed on Oncology signs and symptoms during primary care consultations. RESULTS Study participants were adults, with average schooling of more than 10 years and low income. Pamphlets were assessed as appropriate for consistent language, quantity and quality of content, and especially in relation to the capacity of helping in the homecare decision making process. The importance of receiving pamphlets at the initial stage of the disease was verified. CONCLUSION Users acceptance was positive and the study revealed aspects that should be reinforced in the creation of educational pamphlets

Computer-assisted navigation for intramedullary nailing of intertrochanteric femur fractures: a preliminary result

Aim To demonstrate a reduction of risk factors ray-depending in proximal femur nailing of intertrochanteric femur fractures, comparing standard technique with computer-assisted navigation system. Methods One hundred patients hospitalised between October 2021 and June 2022 with intertrochanteric femur fractures type 31-A1 and 31-A2 were prospectively enrolled and divided randomly into two groups. A study group was treated with computer-assisted navigation system ATLAS (Masmec Biomed, Modugno, Bari, Italy) (20 patients), while a control group received the standard nailing technique. The same intertrochanteric nail was implanted by a single senior surgeon, Endovis BA 2 (EBA2, Citieffe, Calderara di Reno, Bologna, Italy). The following data were recorded: the setup time of operating room (STOR; minutes); surgical time (ST; minutes); radiation exposure time (ETIR; seconds) and dose area product (DAP; cGy·cm2). Results Patients underwent femur nailing with computer-assisted navigation system reported more set-up time of operating room (24.87±4.58; p<0.01), less surgical time (26.15±5.80; p<0.01), less time of radiant exposure (4.84±2.07; p<0.01) and lower dose area product (16.26±2.91; p<0.01). Conclusion The preliminary study demonstrated that computerassisted navigation allowed a better surgical technique standardization, significantly reduced exposure to ionizing radiation, including a reduction in surgical time. The ATLAS system could also play a key role in residents improving learning curve

Denosumab in patients with aneurysmal bone systs: A case series with preliminary results

Abstract PURPOSE:: Aneurysmal bone cyst (ABC) is a rare skeletal tumor usually treated with surgery/embolization. We hypothesized that owing to similarities with giant cell tumor of bone (GCTB), denosumab was active also in ABC. METHODS:: In this observational study, a retrospective analysis of ABC patients treated with denosumab was performed. Patients underwent radiologic disease assessment every 3 months. Symptoms and adverse events were noted. RESULTS:: Nine patients were identified (6 male, 3 female), with a median age of 17 years (range 14-42 years). Primary sites were 6 spine-pelvis, 1 ulna, 1 tibia, and 1 humerus. Patients were followed for a median time of 23 months (range 3-55 months). Patients received a median of 8 denosumab administrations (range 3-61). All symptomatic patients had pain relief and 1 had paresthesia improvement. Signs of denosumab activity were observed after 3 to 6 months of administration: bone formation by computed tomography scan was demonstrated in all patients and magnetic resonance imaging gadolinium contrast media decrease was observed in 7/9 patients. Adverse events were negligible. At last follow-up, all patients were progression-free: 5 still on denosumab treatment, 2 off denosumab were disease-free 11 and 17 months after surgery, and the last 2 patients reported no progression 12 and 24 months after denosumab interruption and no surgery. CONCLUSIONS:: Denosumab has substantial activity in ABCs, with favorable toxicity profile. We strongly support the use of surgery and/or embolization for the treatment of ABC, but denosumab could have a role as a therapeutic option in patients with uncontrollable, locally destructive, or recurrent disease