Design and simulation of an imaging neutral particle analyzer for the ASDEX Upgrade tokamak.

An Imaging Neutral Particle Analyzer (INPA) diagnostic has been designed for the ASDEX Upgrade (AUG) tokamak. The AUG INPA diagnostic will measure fast neutrals escaping the plasma after charge exchange reactions. The neutrals will be ionized by a 20 nm carbon foil and deflected toward a scintillator by the local magnetic field. The use of a neutral beam injector (NBI) as an active source of neutrals will provide radially resolved measurements, while the use of a scintillator as an active component will allow us to cover the whole plasma along the NBI line with unprecedented phase-space resolution (<12 keV and 8 cm) and a fast temporal response (up to 1 kHz with the high resolution acquisition system and above 100 kHz with the low resolution one), making it suitable to study localized fast-ion redistributions in phase space.

Upgrade and absolute calibration of the JET scintillator-based fast-ion loss detector.

The JET FILD is a scintillator-based Fast-ion Loss Detector optimized to measure fusion-born alpha-particle losses. This work covers its upgrade and absolute calibration in preparation for the following JET DT experiments. A fast scintillator material (TG-Green) has been installed in the JET FILD. A heater jacket is installed around the fiber bundle, responsible for transmitting the light from the scintillator plate, to anneal the fiber obscuring due to neutron damage. The JET FILD has been upgraded with a 1 Mpx camera and 2 MHz photomultiplier data acquisition hardware. Full-orbit simulations give an estimate of the shading effects on the scintillator plate of the first wall structures and provide a synthetic signal of the JET FILD. A detector instrument function enables absolute values of fast-ion losses using calibration factors. The calibration factors are made available in a shot-to-shot basis for the characterized species and energies and with corrections for the diagnostic conditions. The fast acquisition system sets the Nyquist frequency (1 MHz) above the typical mode frequencies (≈102 kHz), thus making it possible to identify MHD-induced fast-ion losses.

Utility of the EAT-10 in the detection of dysphagia in high-risk hospitalisation units at a university hospital: a cross-sectional study.

INTRODUCTION: Introduction: the objective was to assess the utility of the Eating Assessment Tool (EAT-10) in hospitalisation units with patients at high risk of dysphagia. Patients and methods: a cross-sectional study was conducted in the Neurology and Internal Medicine wards; patients with admission < 24 hours and in a terminal stage of disease were excluded. In the first 24-48 hours of admission the presence of dysphagia as assessed with the EAT-10, the risk of malnutrition as assessed with the Malnutrition Universal Screening Tools (MUST), and comorbidities using the Charlson index were screened. Results: a total of 169 patients were recruited (76.0 years, 52 % women); 19.5 % were at risk of malnutrition. The EAT-10 instrument could be administered in 80.6 % of the patients, and was positive in 26.6 % (women 34.1 % vs. men 18.4 %; p = 0.025). When comparing patients with higher comorbidity with those with a lower Charlson index, a lower response rate to EAT-10 was observed (78.4 % vs. 93.9 %; p = 0.038), without differences in screening positivity (28.3 % vs. 19.4 %; p = 0.310). The prevalence of dysphagia risk was higher in the Internal Medicine unit than in the Neurology unit (30.4 % vs. 19.6 %; p = 0.133), as was the percentage of cases in which screening could not be performed (21.1 % vs. 11.1 %; p = 0.011). There were no significant differences in risk of malnutrition, mortality, hospital stay, or readmission according to the EAT-10. Conclusions: The EAT-10 has limited utility in the studied hospitalisation units due to a high rate of unfeasible tests, especially among patients at higher risk of dysphagia.

INTRODUCCIÓN: Introducción: el objetivo del estudio fue evaluar la utilidad del Eating Assessment Tool (EAT-10) en unidades de hospitalización con pacientes de alto riesgo de disfagia. Pacientes y métodos: estudio transversal de pacientes hospitalizados en Medicina Interna y Neurología; los pacientes con ingreso < 24 horas y en fase terminal de la enfermedad fueron excluidos. En las primeras 24-48 horas de ingreso se cribó la disfagia con el EAT-10, el riesgo de desnutrición con el Malnutrition Universal Screening Tool (MUST) y la comorbilidad con el índice de Charlson. Resultados: se reclutaron 196 pacientes (76,0 años, 52 % mujeres). El 19,5 % estaban en riesgo de desnutrición. El EAT-10 se pudo realizar en el 80,6 % de la muestra y fue positivo en el 26,6 % (mujeres 34,1 % vs. hombres 18,4 %; p = 0,025). Al comparar a los pacientes con mayor comorbilidad con aquellos que tenían un índice de Charlson más bajo, se observó una tasa de respuesta más baja al EAT-10 (78,4 % vs. 93,9 %; p = 0,038), sin diferencias en la positividad del cribado (28,3 % vs. 19,4 %; p = 0,310). La prevalencia del riesgo de disfagia fue mayor en la unidad de Medicina Interna que en la de Neurología (30,4 % vs. 19,6 %; p = 0,133), así como el número de casos en que no se pudo realizar el cribado (21,1 % vs. 11,1 %; p = 0,011). No hubo diferencias significativas en el riesgo de desnutrición, mortalidad, estancia hospitalaria o reingreso según el EAT-10. Conclusiones: el EAT-10 tiene una utilidad limitada en las unidades de hospitalización estudiadas debido a una alta tasa de pruebas no realizables, especialmente entre los pacientes con mayor riesgo de disfagia.

The secreted matrix protein mindin increases prostate tumor progression and tumor-bone crosstalk via ERK 1/2 regulation.

Advanced prostate cancer cells preferentially metastasize to bone by acquiring a bone phenotype that allows metastatic cells to thrive in the skeletal environment. Identification of factors that promote the expression of ectopic bone genes-process known as osteomimicry-leading to tumor progression is crucial to prevent and treat metastatic prostate cancer and prolong life expectancy for patients. Here, we identify the extracelular matrix protein mindin in the secretome of prostate adenocarcinoma cells and show that mindin overexpression in human and mouse TRAMP-C1-induced prostate tumors correlates with upregulated levels of bone-related genes in the tumorigenic prostate tissues. Moreover, mindin silencing decreased osteomimicry in adenocarcinoma cells and in the prostate tumor mice model, as well as reduced tumor cell proliferation, migration and adhesion to bone cells. Inhibition of the extracellular signal-regulated kinase 1/2 (ERK 1/2) phosphorylation decreased the proliferative, migratory and pro-adhesion actions of mindin on prostate tumor cells. In addition, conditioned media obtained by crosstalk stimulation of either osteocytes or osteoblasts with the secretome of TRAMP-C1 cells promoted osteomimicry in prostate tumor cells; an effect inhibited by mindin silencing of TRAMP-C1 cells. In vivo, tibiae of primary tumor-bearing mice overexpressed the pro-angiogenic and pro-metastattic factor vascular endothelial growth factor receptor 2 (VEGFR2) in a mindin-dependent manner. Our findings indicate that mindin is a novel regulator of osteomimicry in prostate tumors and potentially mediates tumor-bone cell crosstalk, suggesting its promising role as a target to inhibit bone metastases.

A rotary and reciprocating scintillator based fast-ion loss detector for the MAST-U tokamak.

The design and unique feature of the first fast-ion loss detector (FILD) for the Mega Amp Spherical Tokamak - Upgrade (MAST-U) is presented here. The MAST-U FILD head is mounted on an axially and angularly actuated mechanism that makes it possible to independently adapt the orientation [0°, 90°] and radial position [1.40 m, 1.60 m] of the FILD head, i.e., its collimator, thus maximizing the detector velocity-space coverage in a broad range of plasma scenarios with different q95. The 3D geometry of the detector has been optimized to detect fast-ion losses from the neutral beam injectors. Orbit simulations are used to calculate the strike map and predict the expected signals. The results show a velocity-space range of [4 cm, 13 cm] in gyroradius and [30°, 85°] in pitch angle, covering the entire neutral beam ion energy range. The optical system will provide direct sight of the scintillator and simultaneous detection with two cameras, giving high spatial and temporal resolution. The MAST-U FILD will shed light on the dominant fast-ion transport mechanisms in one of the world's two largest spherical tokamaks through absolute measurements of fast-ion losses.

First measurements of a scintillator based fast-ion loss detector near the ASDEX Upgrade divertor.

A new reciprocating scintillator based fast-ion loss detector has been installed a few centimeters above the outer divertor of the ASDEX Upgrade tokamak and between two of its lower Edge Localized Modes (ELM) mitigation coils. The detector head containing the scintillator screen, Faraday cup, calibration lamp, and collimator systems are installed on a motorized reciprocating system that can adjust its position via remote control in between plasma discharges. Orbit simulations are used to optimize the detector geometry and velocity-space coverage. The scintillator image is transferred to the light acquisition systems outside of the vacuum via a lens relay (embedded in a 3D-printed titanium holder) and an in-vacuum image guide. A charge coupled device camera, for high velocity-space resolution, and an 8 × 8 channel avalanche photo diode camera, for high temporal resolution (up to 2 MHz), are used as light acquisition systems. Initial results showing velocity-space of neutral beam injection prompt losses and fast-ion losses induced by a (2, 1) neoclassical tearing mode are presented.

A fast feedback controlled magnetic drive for the ASDEX Upgrade fast-ion loss detectors.

A magnetically driven fast-ion loss detector system for the ASDEX Upgrade tokamak has been designed and will be presented here. The device is feedback controlled to adapt the detector head position to the heat load and physics requirements. Dynamic simulations have been performed taking into account effects such as friction, coil self-induction, and eddy currents. A real time positioning control algorithm to maximize the detector operational window has been developed. This algorithm considers dynamical behavior and mechanical resistance as well as measured and predicted thermal loads. The mechanical design and real time predictive algorithm presented here may be used for other reciprocating systems.

Conceptual design of the ITER fast-ion loss detector.

A conceptual design of a reciprocating fast-ion loss detector for ITER has been developed and is presented here. Fast-ion orbit simulations in a 3D magnetic equilibrium and up-to-date first wall have been carried out to revise the measurement requirements for the lost alpha monitor in ITER. In agreement with recent observations, the simulations presented here suggest that a pitch-angle resolution of ∼5° might be necessary to identify the loss mechanisms. Synthetic measurements including realistic lost alpha-particle as well as neutron and gamma fluxes predict scintillator signal-to-noise levels measurable with standard light acquisition systems with the detector aperture at ∼11 cm outside of the diagnostic first wall. At measurement position, heat load on detector head is comparable to that in present devices.

Carcinoma suprarrenal virilizante prepuberal / Prepuberal virilizing adrenocortical carcinoma

El carcinoma suprarrenal es una entidad poco frecuente y excepcional como productor de síndrome adrenogenital prepuberal. Sus criterios de malignidad, al igual que la eficacia de tratamiento adyuvante, son tema de discusión, lo que unido a su pronóstico sombrío mueve a la publicación de casos aislados de distintos grupos quirúrgicos en un intento de conocer esta patología. Presentamos un caso de carcinoma suprarrenal virilizante en paciente prepuberal tratado mediante suprarrenalectomía; la paciente se encuentra asintomática tras 5 años de la intervención (AU)

Colectomía subtotal por estreñimiento crónico idiopático / Subtotal colectomy to treat chronic idiopathic constipation

El estreñimiento crónico idiopático rara vez necesita tratamiento quirúrgico, pero puede estar indicado ante el grado avanzado del cuadro, la mala calidad de vida o la existencia de complicaciones. Están indicadas diversas técnicas, según el segmento de colon y/o recto afectado y las alteraciones funcionales responsables del estreñimiento. Presentamos el caso de una mujer adulta que precisó de una colectomía subtotal con anastomosis cecorrectal ante la existencia de un gran megacolon, la realización de deposiciones cada 20-25 días y la existencia de dolores abdominales secundarios a crisis de volvulaciones transitorias (AU)

[Latex allergy. Reaction to intraoperative anaphylaxis]. / Alergia al látex. Reacción de anafilaxia intraoperatoria.

We report a case of anaphylaxis during surgery as a result of reaction to latex. The patient was a 26-year old woman undergoing emergency exploratory laparotomy. Sixty minutes after the start of the procedure, rash, confluent cutaneous wheals and severe bronchospasm appeared. An allergic reaction was suspected and treatment with corticoids, H1 and H2 antihistamines, theophylline and adrenalin was begun, after which the symptoms disappeared. We wish to emphasize that in the presurgical taking of the patient's case history, no relevant diseases or known allergies were mentioned, and that all complementary analytical data obtained before surgery were within the normal limits. The woman had had a cesarean section seven months before, with no anesthetic complications. Later, the patient mentioned suffering sinusitis and food allergies, describing a clear history of atopy.

[Intraperitoneal hemorrhage after labor as manifestation of renal angiomyolipoma]. / Hemorragia intraperitoneal tras parto como manifestación de un angiomiolipoma renal.

We report a case of renal angiomyolipoma in a patient who, following normal delivery, presented with abdominal pain and acute abdomen with severe hemodynamic compromise that led to hypovolemic shock. Following diagnosis by emergency exploratory laparotomy, a left nephrectomy was performed. We underscore the difficulty involved in the diagnosis of acute abdomen from hemoperitoneum resulting from a ruptured angiomyolipoma, and highlight the rarity of this condition. Our patient was submitted to radical surgery because of vessel (hilum) invasion. The tumor was benign and no complications were observed. Patient work up eight years postoperatively revealed no local or systemic evidence of disease.

Frecuencia de las parasitosis intestinales en poblaciones de la zona sur del Distrito Federal / Frequency of intestinal parasitosis in populations of the southern zone of Federal District

Se realizo un estudio de la frecuencia de las parasitosis intestinales en colonias comprendidas en dos delegaciones del area sur del Distrito Federal por medio de examenes coproparasitoscopicos cualitativos con el metodo de Faust. Se obtuvieron frecuencia de protozoosis y helmintiasis inse senalan en cuadros. Se hacen comentarios de los resultados obtenidos en esta encuesta epidemiologica.encuesta epidemiologica