DEMO ion cyclotron heating: Status of ITER-type antenna design

The ITER ICRF system will gain in complexity relative to the existing systems on modern devices, and the same will hold true for DEMO. The accumulated experience can help greatly in designing an ICRF system for DEMO. In this paper the current status of the pre-conceptual design of the DEMO ICRF antenna and some related components is presented. While many aspects strongly resemble the ITER system, in some design solutions we had to take an alternative route to be able to adapt to DEMO specific. One of the key points is the toroidal antenna extent needed for the requested ICRF heating performance, achieved by splitting the antenna in halves, with appropriate installation. Modelling of the so far largest ICRF antenna in RAPLICASOL and associated challenges are presented. Calculation are benchmarked with TOPICA. Results of the analysis of the latest model and an outlook for future steps are given.Comment: Published in Fusion Engineering and Design 165 (2021) 11226

Value of flow cytometry for MRD-based relapse prediction in B-cell precursor ALL in a multicenter setting

PCR of TCR/Ig gene rearrangements is considered the method of choice for minimal residual disease (MRD) quantification in BCP-ALL, but flow cytometry analysis of leukemia-associated immunophenotypes (FCM-MRD) is faster and biologically more informative. FCM-MRD performed in 18 laboratories across seven countries was used for risk stratification of 1487 patients with BCP-ALL enrolled in the NOPHO ALL2008 protocol. When no informative FCM-marker was available, risk stratification was based on real-time quantitative PCR. An informative FCM-marker was found in 96.2% and only two patients (0.14%) had non-informative FCM and non-informative PCR-markers. The overall 5-year event-free survival was 86.1% with a cumulative incidence of relapse (CIR5y) of 9.5%. FCM-MRD levels on days 15 (HzR 4.0, p 10(-4) associated with a CIR5y = 22.1%. In conclusion, FCM-MRD performed in a multicenter setting is a clinically useful method for MRD-based treatment stratification in BCP-ALL.Peer reviewe

Optimized cytogenetic risk-group stratification of <em>KMT2A</em>-rearranged pediatric acute myeloid leukemia

\ua9 2024 by The American Society of Hematology.A comprehensive international consensus on the cytogenetic risk-group stratification of KMT2A-rearranged (KMT2A-r) pediatric acute myeloid leukemia (AML) is lacking. This retrospective (2005-2016) International Berlin-Frankfurt-M\ufcnster Study Group study on 1256 children with KMT2A-r AML aims to validate the prognostic value of established recurring KMT2A fusions and additional cytogenetic aberrations (ACAs) and to define additional, recurring KMT2A fusions and ACAs, evaluating their prognostic relevance. Compared with our previous study, 3 additional, recurring KMT2A-r groups were defined: Xq24/KMT2A::SEPT6, 1p32/KMT2A::EPS15, and 17q12/t(11;17)(q23;q12). Across 13 KMT2A-r groups, 5-year event-free survival probabilities varied significantly (21.8%-76.2%; P &lt; .01). ACAs occurred in 46.8% of 1200 patients with complete karyotypes, correlating with inferior overall survival (56.8% vs 67.9%; P &lt; .01). Multivariable analyses confirmed independent associations of 4q21/KMT2A::AFF1, 6q27/KMT2A::AFDN, 10p12/KMT2A::MLLT10, 10p11.2/KMT2A::ABI1, and 19p13.3/KMT2A::MLLT1 with adverse outcomes, but not those of 1q21/KMT2A::MLLT11 and trisomy 19 with favorable and adverse outcomes, respectively. Newly identified ACAs with independent adverse prognoses were monosomy 10, trisomies 1, 6, 16, and X, add(12p), and del(9q). Among patients with 9p22/KMT2A::MLLT3, the independent association of French-American-British-type M5 with favorable outcomes was confirmed, and those of trisomy 6 and measurable residual disease at end of induction with adverse outcomes were identified. We provide evidence to incorporate 5 adverse-risk KMT2A fusions into the cytogenetic risk-group stratification of KMT2A-r pediatric AML, to revise the favorable-risk classification of 1q21/KMT2A::MLLT11 to intermediate risk, and to refine the risk-stratification of 9p22/KMT2A::MLLT3 AML. Future studies should validate the associations between the newly identified ACAs and outcomes and unravel the underlying biological pathogenesis of KMT2A fusions and ACAs

ICRH operations and experiments during the JET-ILW tritium and DTE2 campaigns

2021 has culminated with the completion of the JET-ILW DTE2 experimental campaign. This contribution summarizes Ion Cyclotron Resonance Heating (ICRH) operations from system and physics point of view. Improvements to the (ICRH) system, to operation procedures and to real time RF power control were implemented to address specific constraints from tritium and deuterium-tritium operations and increase the system reliability and power availability during D-T pulses. ICRH was operated without the ITER-Like Antenna (ILA) because water leaked from an in-vessel capacitor into the vessel on day-2 of the D-T campaign. Three weeks were required to identify and isolate the leak and resume plasma operations. Dedicated RF-Plasma Wall Interaction (PWI) experiments were conducted; tritium plasmas exhibit a higher level of Be sputtering on the outer wall and impurity content when compared to deuterium or hydrogen plasmas. The JET-DTE2 campaigns provided the opportunity to characterize ICRH schemes foreseen for the ITER operation, in the ITER like wall environment in ELMy H-mode scenarios aiming at maximizing fusion performance. The second harmonic tritium resonance heating and to a lesser extent minority 3He heating (ITER D-T ICRH reference schemes) lead to improved ion temperature and fusion performance when compared to hydrogen minority ICRH. However, these discharges suffered from a lack of stationarity and gradual impurity accumulation potentially because of a deficit of ICRH power when using JET antennas at lower frequencies. Fundamental deuterium ICRH was used in tritium-rich plasmas and with deuterium Neutral Beam Heating; this ICRH scheme proved to be very efficient boosting ion temperature and fusion performance in these plasmas

Long-Term Impact of Single Epilepsy Training on Knowledge, Attitude and Practices: Comparison of Trained and Untrained Rwandan Community Health Workers

Objectives: To close the epilepsy treatment gap and reduce related stigma, eradication of misconceptions is importantIn 2014, Community Health Workers (CHWs) from Musanze (Northern Rwanda) were trained on different aspects of epilepsy. This study compared knowledge, attitude and practices (KAPs) towards epilepsy of trained CHWs 3 years after training, to untrained CHWs from Rwamagana (Eastern Rwanda).Methods: An epilepsy KAP questionnaire was administered to 96 trained and 103 untrained CHWs. Demographic and intergroup KAP differences were analysed by response frequencies. A multivariate analyses was performed based on desired and undesired response categories.Results: Epilepsy awareness was high in both groups, with better knowledge levels in trained CHWs. Negative attitudes were lowest in trained CHWs, yet 17% still reported misconceptions. Multivariate analysis demonstrated the impact of the training, irrespective of age, gender and educational level. Knowing someone with epilepsy significantly induced more desired attitudes.Conclusion: Despite demographic differences between trained and untrained CHWs, a single epilepsy training resulted in significant improvement of desired KAPs after 3 years. Nation-wide CHW training programs with focus on training-resistant items, e.g., attitudes, are recommended