First principles fluid modelling of magnetic island stabilization by ECCD

International audienceTearing modes are MHD instabilities that reduce the performances of fusion devices. They can however be controlled and suppressed using Electron Cyclotron Current Drive (ECCD) as demonstrated in various tokamaks. In this work, simulations of islands stabilization by ECCD-driven current have been carried out using the toroidal nonlinear 3D full MHD code XTOR-2F, in which a current-source term modeling the ECCD has been implemented. The efficiency parameter is computed and its variations with respect to source width and location are computed. The influence of parameters such as current intensity, source width and position with respect to the island is evaluated and compared to the Modified Rutherford Equation. We retrieve a good agreement between the simulations and the analytical predictions concerning the variations of control efficiency with source width and position. We also show that the 3D nature of the current source term can lead to the onset of an island if the source term is precisely applied on a rational surface. We report the observation of a flip phenomenon in which the O-and X-Points of the island rapidly switch their position in order for the island to take advantage of the current drive to grow

Latin America and the Caribbean code against cancer: Developing evidence-based recommendations to reduce the risk of cancer in Latin America and the Caribbean

Latin America and the Caribbean (LAC) has a population of more than 650 million inhabitants (8.5% of the world population),1 with a cancer incidence of more than 1.4 million new patients and more than 670,000 deaths in 2018. These figures will increase by 78% by 2040 to more than 2.5 million people diagnosed with cancer each year, and these patients will require medical attention, care, and support. However, many of these new cancer diagnoses can be prevented through public policies, supportive environments, and lifestyles that promote health and prevent cancer (Fig 1).2 In the LAC region, there are many organizations and institutions providing information on cancer prevention, including national cancer institutes, cancer societies and foundations, and public health agencies. Nevertheless, the information is frequently confusing, overwhelming, or even contradictory. The scientific source and credibility, as well as the primary message, differ according to the type of organization that provides the information (eg, patient organization, scientific or governmental institution).For the LAC region, a coalition of institutions and international organizations has joined forces to adapt the European Code to the cancer risks and situation in the LAC region. This involves collecting, analyzing, and evaluating the scientific evidence to support suitable cancer prevention recommendations to the LAC context. A multistakeholder participation in the project is a key approach to ensure that all players will be owners of the Code and true promoters. The coalition is composed of the Pan-American Health Organization (PAHO; also part of the WHO) and the IARC as leading international organizations; a Scientific Committee of senior researchers and distinguished leaders in cancer prevention from LAC; and an Advocacy Group representing important organizations in LAC, including the Latin American and Caribbean Society of Medical Oncology, the Network of Latin-American Cancer Institutes, the Healthy Caribbean Coalition, and the Association of Latin American Leagues Against Cancer.Fil: Cazap, Eduardo. Sociedad Latinoamericana y del Caribe de Oncología Médica; ArgentinaFil: de Almeida, Liz Maria. Instituto Nacional de Câncer Brasil Jose Alencar Gomes da Silva; BrasilFil: Arrossi, Silvina. Centro de Estudios de Estado y Sociedad; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: García, Patricia J.. Universidad Cayetano Heredia; PerúFil: Garmendia, María Luisa. Universidad de Chile; ChileFil: Gil, Enrique. South America Pan-American Health Organization; PerúFil: Hassel, Trevor. Healthy Caribbean Coalition; BarbadosFil: Mayorga, Rubén. South America Pan-American Health Organization; PerúFil: Mohar, Alejandro. Universidad Nacional Autónoma de México; MéxicoFil: Murillo, Raúl. Centro Javeriano de Oncología; ColombiaFil: Owen, Gabriel O.. Healthy Caribbean Coalition; BarbadosFil: Paonessa, Diego. Liga Argentina de Lucha contra el Cancer; ArgentinaFil: Santamaría, Julio. Centro Hemato Oncológico Panamá; PanamáFil: Tortolero Luna, Guillermo. Universidad de Puerto Rico; Puerto RicoFil: Zoss, Walter. Red de Institutos e Instituciones Nacionales de Cancer; BrasilFil: Herrero, Rolando. Agencia Internacional para la Investigación del Cáncer; FranciaFil: Luciani, Silvana. Pan-American Health Organization; Estados UnidosFil: Schüz, Joachim. Agencia Internacional para la Investigación del Cáncer; FranciaFil: Espina, Carolina. Agencia Internacional para la Investigación del Cáncer; Franci

Mammography Services Quality Assurance: Baseline Standards for Latin America and the Caribbean

Fil: Barr, Helen. No especifíca;Fil: Blanco, Susana Alicia Ana. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Ministerio de Salud. Instituto Nacional del Cáncer; ArgentinaFil: Butler, Priscilla. No especifíca;Fil: da Paz, María Angela. No especifíca;Fil: Fleitas, Ileana. No especifíca;Fil: Craig, George. No especifíca;Fil: Jimenez, Pablo. No especifíca;Fil: Luciani, Silvana. No especifíca;Fil: Manrique, Javier. No especifíca;Fil: Mazal, Jonathan. No especifíca;Fil: Medlen, Kayiba. No especifíca;Fil: MIller, Colie. No especifíca;Fil: Mora, Patricia. No especifíca;Fil: Valdez Moreno, Martha Elena. No especifíca;Fil: Mosodeen, Murrie. No especifíca;Fil: Mysler, Gustavo. No especifíca;Fil: Nuche-Berenguer, Bernardo. No especifíca;Fil: Pastel, Mary. No especifíca;Fil: Pinochet, Miguel. No especifíca;Fil: Sisney, Gale. No especifíca;Fil: Ruiz Trejo, Cesar. No especifíca;Fil: Saraiya, Mona. No especifíca;Fil: Solis, Esteban. No especifíca;Fil: Swann, Phillip. No especifíca

Early impact of the COVID-19 pandemic on paediatric cancer care in Latin America

Although previous studies have suggested that the complications and mortality rate related to COVID-19 are substantially lower in the paediatric population,1 it is reasonable to consider that children with underlying conditions such as cancer will be at increased risk of severe disease...Fil: Vasquez, Liliana. Universidad de San Martín de Porres; Perú. Organización Panamericana de la Salud; PerúFil: Sampor, Claudia. Fundacion Hospital de Pediatria Professor Dr. Juan P. Garrahan; ArgentinaFil: Villanueva, Gabriela. Fundacion Hospital de Pediatria Professor Dr. Juan P. Garrahan; ArgentinaFil: Maradiegue, Essy. Instituto Nacional de Enfermedades Neoplasicas; PerúFil: Garcia Lombardi, Mercedes. Gobierno de la Ciudad de Buenos Aires. Hospital General de Niños "Ricardo Gutiérrez"; ArgentinaFil: Gomez García, Wendy. Hospital Infantil Dr. Robert Reid Cabral; República DominicanaFil: Moreno, Florencia. Ministerio de Salud. Instituto Nacional del Cáncer; ArgentinaFil: Diaz, Rosdali. Instituto Nacional de Enfermedades Neoplasicas; PerúFil: Cappellano, Andrea M.. Universidade Federal de Sao Paulo; BrasilFil: Portilla, Carlos Andres. Universidad del Valle; ColombiaFil: Salas, Beatriz. Hospital del Niño Manuel Ascencio Villarroel; BoliviaFil: Nava, Evelinda. Hospital de Niños Jesus Garcia Coello; VenezuelaFil: Brizuela, Silvia. Instituto de Previsión Social ; ParaguayFil: Jimenez, Soledad. Hospital Solca Núcleo de Loja; EcuadorFil: Espinoza, Ximena. Hospital de Niños Dr. Roberto del Río; ChileFil: Gassant, Pascale Yola. Hôpital Saint-Damien; HaitíFil: Quintero, Karina. Children's Hospital Dr Jose Renan Esquivel; PanamáFil: Fuentes Alabi, Soad. Hospital Nacional de Niños Benjamin Bloom; El SalvadorFil: Velasquez, Thelma. No especifíca;Fil: Fu, Ligia. Hospital Escuela de Tegucigalpa; HondurasFil: Gamboa, Yessika. National Children's Hospital; Costa RicaFil: Quintana, Juan. Clinica Las Condes; ChileFil: Castiglioni, Mariela. Hospital Pereira Rossell; UruguayFil: Nuñez, Cesar. Children's Cancer Hospital; Estados UnidosFil: Moreno, Arturo. Hospital Universitario de Puebla; MéxicoFil: Luna Fineman, Sandra. State University of Colorado at Boulder; Estados UnidosFil: Luciani, Silvana. Pan American Health Organization; Estados UnidosFil: Chantada, Guillermo Luis. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Gobierno de la Ciudad de Buenos Aires. Hospital de Pediatría "Juan P. Garrahan"; Argentina. Hospital Sant Joan de Deu Barcelona; Españ

Garantía de calidad de los servicios de mamografía: Normas básicas para América Latina y el Caribe

Fil: Barr, Helen. No especifíca;Fil: Blanco, Susana Alicia Ana. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Ministerio de Salud. Instituto Nacional del Cáncer; ArgentinaFil: Albarracín, Virginia Helena. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Priscilla, Butler. No especifíca;Fil: da Paz, María Angela. No especifíca;Fil: Fleitas, Ileana. No especifíca;Fil: Jiménez, Pablo. No especifíca;Fil: Luciani, Silvana. No especifíca;Fil: Manrique, Javier. No especifíca;Fil: Mazal, Jonathan. No especifíca;Fil: Medlen, Kayiba. No especifíca;Fil: Miller, Collie. No especifíca;Fil: Mora, Patricia. No especifíca;Fil: Valdez Moreno, Martha Elena. No especifíca;Fil: Mosodeen, Murrie. No especifíca;Fil: Mysler, Gustavo. No especifíca;Fil: Nusche Berenguer, Bernardo. No especifíca;Fil: Pastel, Mary. No especifíca;Fil: Pinochet, Miguel. No especifíca;Fil: Ruiz Trejo, Cesar. No especifíca;Fil: Sisney, Gale. No especifíca;Fil: Saraiya, Mona. No especifíca;Fil: Solis, Esteban. No especifíca;Fil: Swann, Phillip. No especifíca

Multicentric study of cervical cancer screening with human papillomavirus testing and assessment of triage methods in Latin America : the ESTAMPA screening study protocol

Q1Q1Introduction Human papillomavirus (HPV) testing is replacing cytology in primary screening. Its limited specificity demands using a second (triage) test to better identify women at high-risk of cervical disease. Cytology represents the immediate triage but its low sensitivity might hamper HPV testing sensitivity, particularly in low-income and middle-income countries (LMICs), where cytology performance has been suboptimal. The ESTAMPA (EStudio multicéntrico de TAMizaje y triaje de cáncer de cuello uterino con pruebas del virus del PApiloma humano; Spanish acronym) study will: (1) evaluate the performance of different triage techniques to detect cervical precancer and (2) inform on how to implement HPV-based screening programmes in LMIC. Methods and analysis Women aged 30–64 years are screened with HPV testing and Pap across 12 study centres in Latin America. Screened positives have colposcopy with biopsy and treatment of lesions. Women with no evident disease are recalled 18 months later for another HPV test; those HPV-positive undergo colposcopy with biopsy and treatment as needed. Biological specimens are collected in different visits for triage testing, which is not used for clinical management. The study outcome is histological high-grade squamous intraepithelial or worse lesions (HSIL+) under the lower anogenital squamous terminology. About 50 000 women will be screened and 500 HSIL+ cases detected (at initial and 18 months screening). Performance measures (sensitivity, specificity and predictive values) of triage techniques to detect HSIL+ will be estimated and compared with adjustment by age and study centre. Ethics and dissemination The study protocol has been approved by the Ethics Committee of the International Agency for Research on Cancer (IARC), of the Pan American Health Organisation (PAHO) and by those in each participating centre. A Data and Safety Monitoring Board (DSMB) has been established to monitor progress of the study, assure participant safety, advice on scientific conduct and analysis and suggest protocol improvements. Study findings will be published in peer-reviewed journals and presented at scientific meetings. Trial registration number NCT01881659Revista Internacional - Indexad

Sequential Bottlenecks Drive Viral Evolution in Early Acute Hepatitis C Virus Infection

Hepatitis C is a pandemic human RNA virus, which commonly causes chronic infection and liver disease. The characterization of viral populations that successfully initiate infection, and also those that drive progression to chronicity is instrumental for understanding pathogenesis and vaccine design. A comprehensive and longitudinal analysis of the viral population was conducted in four subjects followed from very early acute infection to resolution of disease outcome. By means of next generation sequencing (NGS) and standard cloning/Sanger sequencing, genetic diversity and viral variants were quantified over the course of the infection at frequencies as low as 0.1%. Phylogenetic analysis of reassembled viral variants revealed acute infection was dominated by two sequential bottleneck events, irrespective of subsequent chronicity or clearance. The first bottleneck was associated with transmission, with one to two viral variants successfully establishing infection. The second occurred approximately 100 days post-infection, and was characterized by a decline in viral diversity. In the two subjects who developed chronic infection, this second bottleneck was followed by the emergence of a new viral population, which evolved from the founder variants via a selective sweep with fixation in a small number of mutated sites. The diversity at sites with non-synonymous mutation was higher in predicted cytotoxic T cell epitopes, suggesting immune-driven evolution. These results provide the first detailed analysis of early within-host evolution of HCV, indicating strong selective forces limit viral evolution in the acute phase of infection

Molecular Mechanisms Generating and Stabilizing Terminal 22q13 Deletions in 44 Subjects with Phelan/McDermid Syndrome

In this study, we used deletions at 22q13, which represent a substantial source of human pathology (Phelan/McDermid syndrome), as a model for investigating the molecular mechanisms of terminal deletions that are currently poorly understood. We characterized at the molecular level the genomic rearrangement in 44 unrelated patients with 22q13 monosomy resulting from simple terminal deletions (72%), ring chromosomes (14%), and unbalanced translocations (7%). We also discovered interstitial deletions between 17–74 kb in 9% of the patients. Haploinsufficiency of the SHANK3 gene, confirmed in all rearrangements, is very likely the cause of the major neurological features associated with PMS. SHANK3 mutations can also result in language and/or social interaction disabilities. We determined the breakpoint junctions in 29 cases, providing a realistic snapshot of the variety of mechanisms driving non-recurrent deletion and repair at chromosome ends. De novo telomere synthesis and telomere capture are used to repair terminal deletions; non-homologous end-joining or microhomology-mediated break-induced replication is probably involved in ring 22 formation and translocations; non-homologous end-joining and fork stalling and template switching prevail in cases with interstitial 22q13.3. For the first time, we also demonstrated that distinct stabilizing events of the same terminal deletion can occur in different early embryonic cells, proving that terminal deletions can be repaired by multistep healing events and supporting the recent hypothesis that rare pathogenic germline rearrangements may have mitotic origin. Finally, the progressive clinical deterioration observed throughout the longitudinal medical history of three subjects over forty years supports the hypothesis of a role for SHANK3 haploinsufficiency in neurological deterioration, in addition to its involvement in the neurobehavioral phenotype of PMS

Commentary: setting priorities in NCD prevention and control

Abstract Decision making in health requires the use of sound evidence and context-specific information, guided by a priority setting methodology or framework. For noncommunicable disease (NCD) prevention and control, a decision-making methodology has been applied by the World Health Organization to delineate priorities, and options for cost-effective NCD interventions. A set of 14 interventions considered very cost-effective, affordable and feasible for implementation in various resource level settings were identified. Among them, tobacco control through taxation, bans on tobacco advertising, plain packaging, and smoke free public spaces stands out as perhaps the single most important interventions to tackle NCDs