Search

As power plant design programmes approach the transition between the pre-conceptual and conceptual design phases, the systems code PROCESS has been improved to incorporate more detailed plasma physics, engineering, and analysis modules. Unlike many systems codes, PROCESS combines the physics modelling with both technology and costs analysis. Some of the key topics in the conceptual design phase are toroidal field (TF) magnet design, divertor power handling, operational sensitivity, and economic uncertainty analysis. Models covering these areas have been integrated or improved in PROCESS. During pre-conceptual design, systems codes are an essential tool for exploring fusion power plant concepts. They allow one to model the interaction of the plant systems and quickly perform reactor optioneering. To be able to carry out these large scoping studies, the fidelity of the models can be restricted to reduce the computational time. For example, the EUROfusion EU-DEMO baseline designs are created using the systems code PROCESS and the ability to measure these trade-offs has led to important design choices being examined during the DEMO pre-conceptual design phase. Ruling out unfeasible designs allows one to efficiently identify where in the design space to carry out detailed design work. The paper describes how PROCESS has begun retooling for use in later stages of power plant conceptual design. Details are given for new additions to the PROCESS uncertainty quantification tools, high-temperature superconducting magnet model, TF coil model, and new models for spherical tokamaks (STEP). Additionally, the paper covers recent developments on the novel systems code BLUEPRINT, which is being used in both the EUROfusion and STEP projects. The paper concludes with an outlook on systems code activities at UKAEA and work with external partners. [ABSTRACT FROM AUTHOR]

Background: Research in telerehabilitation (TR) in neurology tends to focus on patients with low to moderate disability. For neurology patients with severe mobility limitations, TR can help to enable rehabilitation for people whose mobility limitations make it difficult for them to access rehabilitation facilities. The aim of this study is to evaluate the interest of people with neurological disability caused by multiple sclerosis (MS) in TR services. Methods: This electronic survey targeted individuals with MS, specifically those with a higher level of disability. Results: A total of 355 patients with MS (155 with severe disabilities) participated in this study. There was no difference in interest in rehabilitation between people with mild-to-moderate and severe disabilities ( p  = 0.1258, confidence interval [CI] = 95%). However, we found a higher interest in upper limb exercises ( p  = 0.0006, CI = 95%) and balance training ( p  = 0.0000, CI = 95%) among people with higher disability. Conclusion: The results of this study may help to improve the planning and targeting of TR interventions, where a different focus of intervention is appropriate for patients with different levels of disability. This may enable TR to be maximally tailored to patient capabilities and current greatest limitations. For example, for people with severe disabilities, it is appropriate to focus on training the upper limb function to maintain self-sufficiency and implement interventions to prevent falls.

Background: Anorectal dysfunction (ARD), especially bowel incontinence, frequently compromises the quality of life in multiple sclerosis (MS) patients. The effect of rehabilitation procedures has not been clearly established., Objective: To determine the effect of an individualized rehabilitation approach on bowel incontinence and anorectal pressures., Methods: MS patients with ARD underwent 6-months of individually targeted biofeedback rehabilitation. High resolution anorectal manometry (HRAM) and St. Mark's Fecal Incontinence Scores (SMIS) were completed prior to rehabilitation, after 10 weeks of supervised physiotherapy, and after 3 months of self-treatment., Results: Ten patients (50%) completed the study. Repeated measures analysis of variance (ANOVA) demonstrated significant improvement in the SMIS questionnaire over time [14.00 baseline vs. 9.70 after supervised physiotherapy vs. 9.30 after self-treatment (p = 0.005)]. No significant improvements over time were noted in any HRAM readings: maximal pressure [49.85 mmHg baseline vs. 57.60 after supervised physiotherapy vs. 60.88 after self-treatment (p = 0.58)], pressure endurance [36.41 vs. 46.89 vs. 49.95 (p = 0.53)], resting pressure [55.83, vs 52.69 vs. 51.84 (p = 0.704)], or area under the curve [230.0 vs. 520.8 vs. 501.9 (p = 0.16)]., Conclusions: The proposed individualized rehabilitation program supports a positive overall effect on anorectal dysfunction in MS patients.

Background: The abdominal muscles play an important respiratory and stabilization role, and in coordination with other muscles regulate the intra-abdominal pressure stabilizing the spine. The evaluation of postural trunk muscle function is critical in clinical assessments of patients with musculoskeletal pain and dysfunction. This study evaluates the relationship between intra-abdominal pressure measured as anorectal pressure with objective abdominal wall tension recorded by mechanical-pneumatic-electronic sensors., Methods: In a cross-sectional observational study, thirty-one asymptomatic participants (mean age = 26.77 ± 3.01 years) underwent testing to measure intra-abdominal pressure via anorectal manometry, along with abdominal wall tension measured by sensors attached to a trunk brace (DNS Brace). They were evaluated in five different standing postural-respiratory situations: resting breathing, Valsalva maneuver, Müller's maneuver, instructed breathing, loaded breathing when holding a dumbbell., Findings: Strong correlations were demonstrated between anorectal manometry and DNS Brace measurements in all scenarios; and DNS Brace values significantly predicted intra-abdominal pressure values for all scenarios: resting breathing (r = 0.735, r 2  = 0.541, p < 0.001), Valsalva maneuver (r = 0.836, r 2  = 0.699, p < 0.001), Müller's maneuver (r = 0.651, r 2  = 0.423, p < 0.001), instructed breathing (r = 0.708, r 2  = 0.501, p < 0.001), and loaded breathing (r = 0.921, r 2  = 0.848, p < 0.001)., Interpretation: Intra-abdominal pressure is strongly correlated with, and predicted by abdominal wall tension monitored above the inguinal ligament and in the area of superior trigonum lumbale. This study demonstrates that intra-abdominal pressure can be evaluated indirectly by monitoring the abdominal wall tension., (Copyright © 2021. Published by Elsevier Ltd.)