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After a long device enhancement phase, scientific operation resumed in 2022. The main new device components are the water cooling of all plasma facing components and the new water-cooled high heat flux divertor units. Water cooling allowed for the first long-pulse operation campaign. A maximum discharge length of 8 min was achieved with a total heating energy of 1.3 GJ. Safe divertor operation was demonstrated in attached and detached mode. Stable detachment is readily achieved in some magnetic configurations but requires impurity seeding in configurations with small magnetic pitch angle within the edge islands. Progress was made in the characterization of transport mechanisms across edge magnetic islands: Measurement of the potential distribution and flow pattern reveals that the islands are associated with a strong poloidal drift, which leads to rapid convection of energy and particles from the last closed flux surface into the scrape-off layer. Using the upgraded plasma heating systems, advanced heating scenarios were developed, which provide improved energy confinement comparable to the scenario, in which the record triple product for stellarators was achieved in the previous operation campaign. However, a magnetic configuration-dependent critical heating power limit of the electron cyclotron resonance heating was observed. Exceeding the respective power limit leads to a degradation of the confinement.

The ‘C/O monitor’ is a dedicated diagnostic system designed to monitor light impurities (B, C, N and O) in the Wendelstein 7-X (W7-X) stellarator. Its main goal is to provide fast (∼1 ms) information about the impurity level which is measured from a large plasma volume (high throughput). Its first subsystem dedicated to measure Lyman-α lines of H-like carbon (C5+ − 3.4 nm – used as PFC material) and oxygen (O7+ − 1.9 nm – common impurity absorbed by inner vessels’ walls) is going to be commissioned during the next Operational Phase of W7-X. Since the radiated photon intensity of a given impurity depends strongly on plasma kinetic parameters (Te, ne) and impurity transport, it is important to thoroughly understand the underlying correlation between these factors and registered signal. Because the dependences turn out to be non-trivial, a forward modelling was applied. This paper outlines the results of Lyman-α line intensities modelling performed for carbon and oxygen studies (including impurity transport), as only those two elements will be measured during the initial operational phase of the spectrometer. The obtained results indicates that the signals measured by the system will be weakly dependant on the plasma conditions.

Queer ethnic young people in Aotearoa New Zealand are a multi-marginalized group, many of whom are met with racism and exclusion from a predominantly white queer community. Very little is known about how young ethnic queers in Aotearoa navigate a community that inheres the ideals and structures of racism. This in-depth qualitative study of 43 queer ethnic young people living in two of the largest metropolitan cities in Aotearoa investigates their experiences and relationships with the white queer community through Persadie and Narain's mash-up analytical process. For these young ethnic queers, disrupting the racist behaviors and practices within queer spaces and of white queers were crucial in helping them challenge, resist, speak up to and reflect on their experiences with white saviourism, objectification, patronization, and rejection.

In reactor-relevant plasmas, neoclassical transport drives an outward particle flux in the core of large stellarators and predicts strongly hollow density profiles. However, this theoretical prediction is contradicted by experiments. In particular, in Wendelstein 7-X, the first large optimized stellarator, flat or weakly peaked density profiles are generally measured, indicating that neoclassical theory is not sufficient and that an inward contribution to the particle flux is missing in the core. In this Research Letter, it is shown that the turbulent contribution to the particle flux can explain the difference between experimental measurements and neoclassical predictions. The results of this Research Letter also prove that theoretical and numerical tools are approaching the level of maturity needed for the prediction of equilibrium density profiles in stellarator plasmas, which is a fundamental requirement for the design of operation scenarios of present devices and future reactors.

In the Wendelstein 7-X (W7-X) stellarator, turbulence is the dominant transport mechanism in most discharges. This leads to a ‘clamping’ of ion temperature over a wide range of heating power, predominantly flat density profiles where hollow profiles driven by neoclassical thermo-diffusion would be expected and by rapid impurity transport in injection experiments. Significantly reduced turbulent transport is observed in the presence of strong core density gradients found transiently after core pellet injection and irregularly after boronisation or boron pellet injection. Density peaking is also achieved in a controlled manner in purely neutral beam heated discharges where particle transport analysis reveals an abrupt reduction in the main-ion particle flux leading to significant density profile peaking not explained by the NBI particle source alone. The plasmas exhibit a heat diffusivity of around $\chi = 0.25 \pm 0.1\,\mathrm{m}^2\ \mathrm{s}^{-1}$ at mid radius, a factor of around 4 lower than ECRH dominated discharges. Despite the improved confinement, the achieved ion temperature is limited by broader heat deposition and the lower power-per-particle given the higher density. This is overcome with limited reintroduction of ECRH power, where the low heat diffusivity diffusivity is maintained, the density rise supressed and ion temperatures above the clamping limit are achieved. The applicability of these plasmas for a high performance scenario on transport relevant time scales is assessed, including initial predictions for planned heating upgrades of W7-X, based on a range of assumptions about particle transport.

The Campania Region has one of the highest renewable energy potentials in Italy. Despite this high potential, the lack of an integrated energy strategy has allowed for deregulated exploitation of the resources of the territory, e.g. surplus of wind energy occurs in Campania due to the large wind farms, geothermal energy is mainly used for thermal baths but its enthalpy could meet domestic heating demand, etc. A lack of an “integrated planning”, does not to make the best use of resources and to contribute to greenhouse gas (GHG) emission reduction.The aim of this work is to develop a possible scenario for achieving sustainable energy condition towards decarbonization in the Campania Region. The 2030 ‘transition scenario’ is characterized by a reduction in GHG emissions. In the ‘Campania 2050’ scenario, the region's energy system is mostly reliant upon biomethane and other local renewable resources. The new methodology, based on the classification of climatic zones, was designed to meet the hourly energy and production demands of both current and future energy plants in the territory. Different software tools were used to find a new integrated renewable energy system for Campania. The software EnergyPLAN was used to design the entire system and assess the integration of the different sectors (electric, thermal, and transport), and TRNSYS 17 and DesignBuilder were used to achieve the desired hourly energy production of individual plants.The results obtained show that the 2030 ‘transition’ scenario is characterized by a reduction in the “1990 CO2 emissions” of approximately 45%.The ‘Campania 2050’ scenario achieves the decarbonization objective of reducing the GHG emissions by 80% with respect to the 1990 values by combining different energy efficiency strategies, relying upon renewable energy sources, and electrifying the transport sector.

Radial impurity density profiles in two Wendelstein 7-X (W7-X) experiments heated by neutral beam injection (NBI) are analyzed with respect to their impurity transport properties. Local impurity densities are derived from charge exchange reactions with the W7-X NBI system using simulated neutral densities cross-validated with beam emission spectroscopy. Impurity profiles of argon and carbon are found to show an evolving central accumulation inside half radius. The properties of the underlying impurity transport are assessed using the one-dimensional transport code pySTRAHL. Comparisons between simulation and experiment indicate transport dominated by anomalous diffusion outside half radius. The observed central impurity accumulation is found to match best simulations with purely (neo-)classical transport in the accumulation region. This data implies a suppression of the anomalous impurity transport channel to below 35% of the (neo-)classical one. Experimental data is found to be matched best when invoking a time evolving, inward propagating zone where anomalous impurity transport is suppressed. An additional central power deposition into a plasma with central impurity accumulation via electron cyclotron resonance heating is found to affect the (neo-)classical transport components in case of operation times below 200 ms only. For longer operation times, it is found to re-introduce an altered level of anomalous diffusion. The existence of an inward directed anomalous pinch as an alternative explanation for the central impurity accumulation cannot explain the observed profiles.

The valorization of residual biomass plays today a decisive role in the concept of “circular economy”, according to which each waste material must be reused to its maximum extent. The collection and energy valorization at the local level of biomass from forest management practices and wildfire prevention cutting can be settled in protected areas to contribute to local decarbonization, by removing power generation from fossil fuels. Despite the evident advantages of bioenergy systems, several problems still hinder their diffusion, such as the need to assure their reliability by extending the operating range with materials of different origin. The Italian project “INNOVARE—Innovative plants for distributed poly-generation by residual biomass”, funded by the Italian Ministry of Economic Development (MISE), has the main scope of improving micro-cogeneration technologies fueled by biomass. A micro-combined heat and power (mCHP) unit was chosen as a case study to discuss pros and cons of biomass-powered cogeneration within a national park, especially due to its flexibility of use. The availability of local biomasses (woodchips, olive milling residuals) was established by studying the agro-industrial production and by identifying forest areas to be properly managed through an approach using a satellite location system based on the microwave technology. A detailed synergic numerical and experimental characterization of the selected cogeneration system was performed in order to identify its main inefficiencies. Improvements of its operation were optimized by acting on the engine control strategy and by also adding a post-treatment system on the engine exhaust gas line. Overall, the electrical output was increased by up to 6% using the correct spark timing, and pollutant emissions were reduced well below the limits allowed by legislation by working with a lean mixture and by adopting an oxidizing catalyst. Finally, the global efficiency of the system increased from 45.8% to 63.2%. The right blending of different biomasses led to an important improvement of the reliability of the entire plant despite using an agrifood residual, such as olive pomace. It was demonstrated that the use of this biomass is feasible if its maximum mass percentage in a wood matrix mixture does not exceed 25%. The project was concluded with a real operation demonstration within a national park in Southern Italy by replacing a diesel genset with the analyzed and improved biomass-powered plant and by proving a decisive improvement of air quality in the real environment during exercise.

The effect of the short-time exposure (12, 24 and 48 h) of increasing concentration (0.1, 1 and 10 mg/l) of intact (FLT) and photo-modified (phFLT) fluoranthene on the chlorophyll fluorescence parameters (F0, FV/FM and ΦII) in pea plants (Pisum sativum L. cv. Lantra) was investigated. Plants took up both forms of fluoranthene by two different ways, via roots or via leaves. The obtained results demonstrated a significant increase in F0 and decrease in FV/FM and ΦII in plants treated by 1 and 10 mg/l FLT and phFLT. An earlier response to presence of FLT and phFLT in the environment was demonstrated by application on cut leaves. The primary processes of photosynthesis were not significantly influenced by short-time phFLT treatment.

In this study we evaluate the performance of a fully automated analytical framework for FDOPA PET neuroimaging data, and its sensitivity to demographic and experimental variables and processing parameters. An instance of XNAT imaging platform was used to store the King's College London institutional brain FDOPA PET imaging archive, alongside individual demographics and clinical information. By re-engineering the historical Matlab-based scripts for FDOPA PET analysis, a fully automated analysis pipeline for imaging processing and data quantification was implemented in Python and integrated in XNAT. The final data repository includes 892 FDOPA PET scans organized from 23 different studies. We found good reproducibility of the data analysis by the automated pipeline (in the striatum for the Ki cer : for the controls ICC = 0.71, for the psychotic patients ICC = 0.88). From the demographic and experimental variables assessed, gender was found to most influence striatal dopamine synthesis capacity (F = 10.7, p < 0.001), with women showing greater dopamine synthesis capacity than men. Our automated analysis pipeline represents a valid resourse for standardised and robust quantification of dopamine synthesis capacity using FDOPA PET data. Combining information from different neuroimaging studies has allowed us to test it comprehensively and to validate its replicability and reproducibility performances on a large sample size.

Introduction: Structural MRI is the most frequently used method to investigate brain volume alterations in neuropsychiatric disease. Previous meta-analyses have typically focused on a single diagnosis, thereby precluding transdiagnostic comparisons., Methods and Analysis: We will include all structural MRI studies of adults that report brain volumes for participants from at least two of the following diagnostic groups: healthy controls, schizophrenia, schizoaffective disorder, delusional disorder, psychotic depression, clinical high risk for psychosis, schizotypal personality disorder, psychosis unspecified, bipolar disorder, autism spectrum disorder, major depressive disorder, attention deficit hyperactivity disorder, obsessive compulsive disorder, post-traumatic stress disorder, emotionally unstable personality disorder, 22q11 deletion syndrome, generalised anxiety disorder, social anxiety disorder, panic disorder, mixed anxiety and depression. Network meta-analysis will be used to synthesise eligible studies. The primary analysis will examine standardised mean difference in average volume, a secondary analysis will examine differences in variability of volumes., Discussion: This network meta-analysis will provide a transdiagnostic integration of structural neuroimaging studies, providing researchers with a valuable summary of a large literature., Prospero Registration Number: CRD42020221143., Competing Interests: Competing interests: RAM, GW, LV, CC, XG, TAH and OE declare no competing interests. AC has received research and consultancy fees from INCiPiT (Italian Network for Paediatric Trials), CARIPLO Foundation and Angelini Pharma, outside the submitted work. TP has participated in speaker meetings organised by Sunovion, Lundbeck, and Otsuka. ODH has received investigator-initiated research funding from and/or participated in advisory/ speaker meetings organised by Astra-Zeneca, Autifony, BMS, Eli Lilly, Heptares, Jansenn, Lundbeck, Lyden-Delta, Otsuka, Servier, Sunovion, Rand and Roche. Neither Dr Howes or his family have been employed by or have holdings/ a financial stake in any biomedical company., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

The response to antipsychotic treatment in schizophrenia appears to vary, and as such it has been proposed that different subtypes of schizophrenia exist, defined by treatment-response. This has not been formally examined using meta-analysis. Randomised controlled trials comparing placebo and antipsychotics in acute treatment of schizophrenia listed in PubMed, EMBASE and PsycINFO from inception until 30 November 2018 were examined. Relative variability of symptomatic improvement in antipsychotic-treated individuals compared to placebo-treated individuals was quantified using coefficient of variation ratio (CVR). Mean difference in symptom change was quantified using Hedges' g. In addition, individual patient data from two clinical trials was examined in terms of both the distribution of total symptom change, and the variability of individual symptoms and symptom factors. In total, 11,006 articles were identified. Sixty six met inclusion criteria, reporting on 17,202 patients. Compared with placebo, antipsychotic-treated patients demonstrated greater total symptom improvement (g = 0.47, p < 0.001) and reduced variability in symptomatic improvement for total (CVR = 0.86, p < 0.001), positive (CVR = 0.89, p < 0.001), and negative symptoms (CVR = 0.86, p = 0.001). Lower variability in antipsychotic-response relative to placebo was associated with studies published earlier (z = 3.98, p < 0.001), younger patients (z = 3.07, p = 0.002), higher dose treatments (z = -2.62, p = 0.009), and greater mean-difference in symptom-change (z = -5.70, p < 0.001). In the individual patient dataset (N = 522 patients), antipsychotic treated patients did not show significantly increased variability for any individual symptom, and there was no evidence of a bimodal distribution of response. Compared to placebo, antipsychotic treatment shows greater improvement and lower variability of change in total, positive and negative symptoms. This is contrary to the hypothesis that there is a subtype of antipsychotic non-responsive schizophrenia. Instead our findings, provide evidence for a relatively homogeneous effect of antipsychotic treatment in improving symptoms of schizophrenia.

The idea that a longer duration of untreated psychosis (DUP) leads to poorer outcomes has contributed to extensive changes in mental health ser-vices worldwide and has attracted considerable research interest over the past 30 years. However, the strength of the evidence underlying this notion is unclear. To address this issue, we conducted an umbrella review of available meta-analyses and performed a random-effects meta-analysis of primary studies. MEDLINE, Web of Science, PsycINFO and EMBASE were searched from inception to September 3, 2020 to identify relevant meta-analyses of studies including patients with schizophrenia spectrum disorders, first-episode psychosis, or affective and non-affective psychosis. Thirteen meta-analyses were included, corresponding to 129 individual studies with a total sample size of 25,657 patients. We detected potential violations of statistical assumptions in some of these meta-analyses. We therefore conducted a new random-effects meta-analysis of primary studies. The association between DUP and each outcome was graded according to a standardized classification into convincing, highly suggestive, suggestive, weak, or non-significant. At first presentation, there was suggestive evidence for a relationship between longer DUP and more severe negative symptoms (beta=-0.07, p=3.6×10 -5 ) and higher chance of previous self-harm (odds ratio, OR=1.89, p=1.1×10 -5 ). At follow-up, there was highly suggestive evidence for a relationship between longer DUP and more severe positive symptoms (beta=-0.16, p=4.5×10 -8 ), more severe negative symptoms (beta=-0.11, p=3.5×10 -10 ) and lower chance of remission (OR=2.16, p=3.0×10 -10 ), and suggestive evidence for a relationship between longer DUP and poorer overall functioning (beta=-0.11, p=2.2×10 -6 ) and more severe global psychopathology (beta=-0.16, p=4.7×10 -6 ). Results were unchanged when analysis was restricted to prospective studies. These effect sizes are clinically meaningful, with a DUP of four weeks predicting >20% more severe symptoms at follow-up relative to a DUP of one week. We conclude that DUP is an important prognostic factor at first presentation and predicts clinically relevant outcomes over the course of illness. We discuss conceptual issues in DUP research and methodological limitations of current evidence, and provide recommendations for future research., (© 2021 World Psychiatric Association.)

Background: Antipsychotic treatment is associated with metabolic disturbance. However, the degree to which metabolic alterations occur in treatment with different antipsychotics is unclear. Predictors of metabolic dysregulation are poorly understood and the association between metabolic change and change in psychopathology is uncertain. We aimed to compare and rank antipsychotics on the basis of their metabolic side-effects, identify physiological and demographic predictors of antipsychotic-induced metabolic dysregulation, and investigate the relationship between change in psychotic symptoms and change in metabolic parameters with antipsychotic treatment., Methods: We searched MEDLINE, EMBASE, and PsycINFO from inception until June 30, 2019. We included blinded, randomised controlled trials comparing 18 antipsychotics and placebo in acute treatment of schizophrenia. We did frequentist random-effects network meta-analyses to investigate treatment-induced changes in body weight, BMI, total cholesterol, LDL cholesterol, HDL cholesterol, triglyceride, and glucose concentrations. We did meta-regressions to examine relationships between metabolic change and age, sex, ethnicity, baseline weight, and baseline metabolic parameter level. We examined the association between metabolic change and psychopathology change by estimating the correlation between symptom severity change and metabolic parameter change., Findings: Of 6532 citations, we included 100 randomised controlled trials, including 25 952 patients. Median treatment duration was 6 weeks (IQR 6-8). Mean differences for weight gain compared with placebo ranged from -0·23 kg (95% CI -0·83 to 0·36) for haloperidol to 3·01 kg (1·78 to 4·24) for clozapine; for BMI from -0·25 kg/m 2 (-0·68 to 0·17) for haloperidol to 1·07 kg/m 2 (0·90 to 1·25) for olanzapine; for total-cholesterol from -0·09 mmol/L (-0·24 to 0·07) for cariprazine to 0·56 mmol/L (0·26-0·86) for clozapine; for LDL cholesterol from -0·13 mmol/L (-0.21 to -0·05) for cariprazine to 0·20 mmol/L (0·14 to 0·26) for olanzapine; for HDL cholesterol from 0·05 mmol/L (0·00 to 0·10) for brexpiprazole to -0·10 mmol/L (-0·33 to 0·14) for amisulpride; for triglycerides from -0·01 mmol/L (-0·10 to 0·08) for brexpiprazole to 0·98 mmol/L (0·48 to 1·49) for clozapine; for glucose from -0·29 mmol/L (-0·55 to -0·03) for lurasidone to 1·05 mmol/L (0·41 to 1·70) for clozapine. Greater increases in glucose were predicted by higher baseline weight (p=0·0015) and male sex (p=0·0082). Non-white ethnicity was associated with greater increases in total cholesterol (p=0·040) compared with white ethnicity. Improvements in symptom severity were associated with increases in weight (r=0·36, p=0·0021), BMI (r=0·84, p<0·0001), total-cholesterol (r=0·31, p=0·047), and LDL cholesterol (r=0·42, p=0·013), and decreases in HDL cholesterol (r=-0·35, p=0·035)., Interpretation: Marked differences exist between antipsychotics in terms of metabolic side-effects, with olanzapine and clozapine exhibiting the worst profiles and aripiprazole, brexpiprazole, cariprazine, lurasidone, and ziprasidone the most benign profiles. Increased baseline weight, male sex, and non-white ethnicity are predictors of susceptibility to antipsychotic-induced metabolic change, and improvements in psychopathology are associated with metabolic disturbance. Treatment guidelines should be updated to reflect our findings. However, the choice of antipsychotic should be made on an individual basis, considering the clinical circumstances and preferences of patients, carers, and clinicians., Funding: UK Medical Research Council, Wellcome Trust, National Institute for Health Research Oxford Health Biomedical Research Centre., (Copyright © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.)