Patient/Family Education for Newly Diagnosed Pediatric Oncology Patients

There is a paucity of data to support evidence-based practices in the provision of patient/family education in the context of a new childhood cancer diagnosis. Since the majority of children with cancer are treated on pediatric oncology clinical trials, lack of effective patient/family education has the potential to negatively affect both patient and clinical trial outcomes. The Children’s Oncology Group Nursing Discipline convened an interprofessional expert panel from within and beyond pediatric oncology to review available and emerging evidence and develop expert consensus recommendations regarding harmonization of patient/family education practices for newly diagnosed pediatric oncology patients across institutions. Five broad principles, with associated recommendations, were identified by the panel, including recognition that (1) in pediatric oncology, patient/family education is family-centered; (2) a diagnosis of childhood cancer is overwhelming and the family needs time to process the diagnosis and develop a plan for managing ongoing life demands before they can successfully learn to care for the child; (3) patient/family education should be an interprofessional endeavor with 3 key areas of focus: (a) diagnosis/treatment, (b) psychosocial coping, and (c) care of the child; (4) patient/family education should occur across the continuum of care; and (5) a supportive environment is necessary to optimize learning. Dissemination and implementation of these recommendations will set the stage for future studies that aim to develop evidence to inform best practices, and ultimately to establish the standard of care for effective patient/family education in pediatric oncology

The fourteenth-century poll tax returns and the study of English surname distribution

The modern-day distributions of English surnames have been considered in genealogical, historical, and philological research as possible indicators of their origins. However, many centuries have passed since hereditary surnames were first used, and so their distribution today does not necessarily reflect their original spread, misrepresenting their origins. Previously, medieval data with national coverage have not been available for a study of surname distribution, but with the recent publication of the fourteenth-century poll tax returns, this has changed. By presenting discrepancies in medieval and nineteenth-century distributions, it is shown that more recent surname data may not be a suitable guide to surname origins and can be usefully supplemented by medieval data in order to arrive at more accurate conclusions

Shattered pellet injection experiments at JET in support of the ITER disruption mitigation system design

A series of experiments have been executed at JET to assess the efficacy of the newly installed shattered pellet injection (SPI) system in mitigating the effects of disruptions. Issues, important for the ITER disruption mitigation system, such as thermal load mitigation, avoidance of runaway electron (RE) formation, radiation asymmetries during thermal quench mitigation, electromagnetic load control and RE energy dissipation have been addressed over a large parameter range. The efficiency of the mitigation has been examined for the various SPI injection strategies. The paper summarises the results from these JET SPI experiments and discusses their implications for the ITER disruption mitigation scheme

Disruption prediction at JET through deep convolutional neural networks using spatiotemporal information from plasma profiles

In view of the future high power nuclear fusion experiments, the early identification of disruptions is a mandatory requirement, and presently the main goal is moving from the disruption mitigation to disruption avoidance and control. In this work, a deep-convolutional neural network (CNN) is proposed to provide early detection of disruptive events at JET. The CNN ability to learn relevant features, avoiding hand-engineered feature extraction, has been exploited to extract the spatiotemporal information from 1D plasma profiles. The model is trained with regularly terminated discharges and automatically selected disruptive phase of disruptions, coming from the recent ITER-like-wall experiments. The prediction performance is evaluated using a set of discharges representative of different operating scenarios, and an in-depth analysis is made to evaluate the performance evolution with respect to the considered experimental conditions. Finally, as real-time triggers and termination schemes are being developed at JET, the proposed model has been tested on a set of recent experiments dedicated to plasma termination for disruption avoidance and mitigation. The CNN model demonstrates very high performance, and the exploitation of 1D plasma profiles as model input allows us to understand the underlying physical phenomena behind the predictor decision

New H-mode regimes with small ELMs and high thermal confinement in the Joint European Torus

New H-mode regimes with high confinement, low core impurity accumulation, and small edge-localized mode perturbations have been obtained in magnetically confined plasmas at the Joint European Torus tokamak. Such regimes are achieved by means of optimized particle fueling conditions at high input power, current, and magnetic field, which lead to a self-organized state with a strong increase in rotation and ion temperature and a decrease in the edge density. An interplay between core and edge plasma regions leads to reduced turbulence levels and outward impurity convection. These results pave the way to an attractive alternative to the standard plasmas considered for fusion energy generation in a tokamak with a metallic wall environment such as the ones expected in ITER.& nbsp;Published under an exclusive license by AIP Publishing

Overview of JET results for optimising ITER operation

The JET 2019–2020 scientific and technological programme exploited the results of years of concerted scientific and engineering work, including the ITER-like wall (ILW: Be wall and W divertor) installed in 2010, improved diagnostic capabilities now fully available, a major neutral beam injection upgrade providing record power in 2019–2020, and tested the technical and procedural preparation for safe operation with tritium. Research along three complementary axes yielded a wealth of new results. Firstly, the JET plasma programme delivered scenarios suitable for high fusion power and alpha particle (α) physics in the coming D–T campaign (DTE2), with record sustained neutron rates, as well as plasmas for clarifying the impact of isotope mass on plasma core, edge and plasma-wall interactions, and for ITER pre-fusion power operation. The efficacy of the newly installed shattered pellet injector for mitigating disruption forces and runaway electrons was demonstrated. Secondly, research on the consequences of long-term exposure to JET-ILW plasma was completed, with emphasis on wall damage and fuel retention, and with analyses of wall materials and dust particles that will help validate assumptions and codes for design and operation of ITER and DEMO. Thirdly, the nuclear technology programme aiming to deliver maximum technological return from operations in D, T and D–T benefited from the highest D–D neutron yield in years, securing results for validating radiation transport and activation codes, and nuclear data for ITER

Comparing pedestal structure in JET-ILW H-mode plasmas with a model for stiff ETG turbulent heat transport

A predictive model for the electron temperature profile of the H-mode pedestal is described, and its results are compared with the pedestal structure of JET-ILW plasmas. The model is based on a scaling for the gyro-Bohm normalized, turbulent electron heat flux qe/qe,gB resulting from electron temperature gradient (ETG) turbulence, derived from results of nonlinear gyrokinetic (GK) calculations for the steep gradient region. By using the local temperature gradient scale length L-Te in the normalization, the dependence of q(e)/q(e,g)B on the normalized gradients R/L-Te and R/(Lne) can be represented by a unified scaling with the parameter eta(e) = L-ne/L-Te, to which the linear stability of ETG turbulence is sensitive when the density gradient is sufficiently steep. For a prescribed density profile, the value of R/L-Te determined from this scaling, required to maintain a constant electron heat flux qe across the pedestal, is used to calculate the temperature profile. Reasonable agreement with measurements is found for different cases, the model providing an explanation of the relative widths and shifts of the T-e and n(e) profiles, as well as highlighting the importance of the separatrix boundary conditions. Other cases showing disagreement indicate conditions where other branches of turbulence might dominate.This article is part of a discussion meeting issue "H-mode transition and pedestal studies in fusion plasmas'

Testing a prediction model for the H-mode density pedestal against JET-ILW pedestals

The neutral ionisation model proposed by Groebner et al (2002 Phys. Plasmas 9 2134) to determine the plasma density profile in the H-mode pedestal, is extended to include charge exchange processes in the pedestal stimulated by the ideas of Mahdavi et al (2003 Phys. Plasmas 10 3984). The model is then tested against JET H-mode pedestal data, both in a 'standalone' version using experimental temperature profiles and also by incorporating it in the Europed version of EPED. The model is able to predict the density pedestal over a wide range of conditions with good accuracy. It is also able to predict the experimentally observed isotope effect on the density pedestal that eludes simpler neutral ionization models

Predictive JET current ramp-up modelling using QuaLiKiz-neural-network

This work applies the coupled JINTRAC and QuaLiKiz-neural-network (QLKNN) model on the ohmic current ramp-up phase of a JET D discharge. The chosen scenario exhibits a hollow T-e profile attributed to core impurity accumulation, which is observed to worsen with the increasing fuel ion mass from D to T. A dynamic D simulation was validated, evolving j, n(e), T-e, T-i, n(Be), n(Ni), and n(W) for 7.25 s along with self-consistent equilibrium calculations, and was consequently extended to simulate a pure T plasma in a predict-first exercise. The light impurity (Be) accounted for Z(eff) while the heavy impurities (Ni, W) accounted for Prad. This study reveals the role of transport on the Te hollowing, which originates from the isotope effect on the electron-ion energy exchange affecting T-i. This exercise successfully affirmed isotopic trends from previous H experiments and provided engineering targets used to recreate the D q-profile in T experiments, demonstrating the potential of neural network surrogates for fast routine analysis and discharge design. However, discrepancies were found between the impurity transport behaviour of QuaLiKiz and QLKNN, which lead to notable T-e hollowing differences. Further investigation into the turbulent component of heavy impurity transport is recommended

Performance Comparison of Machine Learning Disruption Predictors at JET

Reliable disruption prediction (DP) and disruption mitigation systems are considered unavoidable during international thermonuclear experimental reactor (ITER) operations and in the view of the next fusion reactors such as the DEMOnstration Power Plant (DEMO) and China Fusion Engineering Test Reactor (CFETR). In the last two decades, a great number of DP systems have been developed using data-driven methods. The performance of the DP models has been improved over the years both for a more appropriate choice of diagnostics and input features and for the availability of increasingly powerful data-driven modelling techniques. However, a direct comparison among the proposals has not yet been conducted. Such a comparison is mandatory, at least for the same device, to learn lessons from all these efforts and finally choose the best set of diagnostic signals and the best modelling approach. A first effort towards this goal is made in this paper, where different DP models will be compared using the same performance indices and the same device. In particular, the performance of a conventional Multilayer Perceptron Neural Network (MLP-NN) model is compared with those of two more sophisticated models, based on Generative Topographic Mapping (GTM) and Convolutional Neural Networks (CNN), on the same real time diagnostic signals from several experiments at the JET tokamak. The most common performance indices have been used to compare the different DP models and the results are deeply discussed. The comparison confirms the soundness of all the investigated machine learning approaches and the chosen diagnostics, enables us to highlight the pros and cons of each model, and helps to consciously choose the approach that best matches with the plasma protection needs