Introduction An optimally structured prehospital trauma care system can reduce the consequences of serious injuries. While trauma systems in some countries have adopted the policy of transporting major trauma patients directly to a trauma centre (TC) bypassing closer lower-level hospitals, other countries have been less directive in adopting this policy. Objective To explore the short-term survival of direct versus indirect transfer to a definitive care TC for major trauma patients injured in locations in Aotearoa New Zealand (NZ) where there was an opportunity for indirect transportation. Methods National administrative data from the NZ Trauma Registry and Emergency Medical Services (EMS) were linked. Major trauma patients for whom there was no hospital closer than the definitive care TC were excluded. Propensity-weighted adjusted models were used to compare mortality (2-week and 30-day) between those for whom EMS transported directly versus indirectly. Results Of 1,008 patients considered to have an opportunity for transfer, 370 (36.7%) were admitted at one hospital before their definitive care TC. Similar percentages of directly and indirectly transported patients died within 30 days (8.9% and 10.0% respectively; p = 0.6). Lower 2-week (aRR 0.64, 95%CI 0.38, 1.06) and 30-day mortality (aRR 0.70, 95%CI 0.42, 1.16) were observed for those transported indirectly. Older (≥55 years) indirectly transported patients were estimated to have a 30-day mortality aRR of 0.56 (95%CI 0.30, 1.05) that of those directly transported whereas, for younger patients, the direction and strength of evidence differed (aRR 1.31; 95%CI 0.64, 2.69). Conclusion For major trauma patients in NZ, this study found no evidence of a statistically significant difference in short-term mortality between those transported directly and indirectly, although point estimates suggest possible lower mortality, particularly for older patients, amongst those transported indirectly. Study limitations, including wide confidence intervals, are emphasised and additional research is needed to further confirm these findings and aid in nation-specific delivery of trauma care.

This study evaluated sociodemographic characteristics of students enrolled in dentistry, oral health and dental technology in Aotearoa New Zealand (NZ) between 2016 and 2020. Sociodemographic data were obtained from central student record systems and NZ population data from the 2018 Census. Age, gender and citizenship status were analysed for the whole cohort, whilst other categories were analysed for NZ citizens and permanent residents only. Descriptive statistics were presented as raw counts or rates per 100,000 of the population. Most NZ students were educated in the public system. For dentistry and dental technology, a third of the cohort were international students, contrasting with only 4% of oral health students. Most NZ-educated students attended schools serving socioeconomically privileged communities. For all programmes, most students came from urban areas and there were more female than male students enrolled. Māori and Pacific students represented 9.3% and 5.4% of enrolments, despite representing 20% and 9% of the NZ population. Māori and Pacific peoples and those from rural and low socioeconomic areas were underrepresented, despite efforts to address such inequities. Admission policies in NZ universities need to ensure that Māori and Pacific peoples and those from rural and low socioeconomic areas are considered from a social justice and equity positioning.

We explored the views of caregivers regarding the value of dogs and the effects of caregiver views on children in private and public spaces in New Zealand. This was an observational study utilizing a national anonymized online survey and focus groups in Auckland and Kaikohe to explore caregiver perceptions of the value of dogs within whanau (families) or the community, experiences of dog-related harm in the context of children, and the perceived importance of education as a prevention strategy. Quantitative and qualitative data were sought, using a general inductive approach. 256 caregivers responded to the online survey, and 12 caregivers participated in focus groups. Dogs were highly valued by Maori and non-Maori, predominantly as part of family. 233 dog-related incidents were described, occurring in both public and private settings, with both bite and non-bite harm from being charged at, knocked over, jumped on or attacked, as often significantly intimidating or traumatic experiences for children and their caregivers. Key themes were the emotional effect of an attack, the perception that children could avoid harm through education, blame placed on children, minimization of the trauma a dog can cause, and owner underestimation of risk. This study revealed a broader picture of how children are physically and emotionally affected by dogs in both private and public spaces, indicating the need for proactive approaches in both. Dogs may become activated to attack due to their nature and unpredictable tendencies in response to children's natural movements, and future strategies may need to include a focus on owner-perception of risk to children in addition to creating child-safe environments and addressing systemic issues, rather than relying on child or dog behavior to prevent harm. The finding of high value people have for dogs is important to understand as this may be a barrier to implementation of evidence-based strategies.

AIMS:Co-ordinated trauma systems ensure timely transport to the appropriate hospital for patients following acute trauma. The Aotearoa New Zealand National Trauma Network reports median transport times to definitive care annually but omits reporting specific prehospital time intervals. This study focusses on prehospital times for major trauma patients attended by emergency medical services (EMS) in Aotearoa New Zealand. METHODS:An analysis of routinely collected data from a retrospectively designed prospective cohort study was undertaken. Individuals of any age who suffered major trauma (Injury Severity Score [ISS] greater than 12 or died) between 2016 and 2018 and were attended by an EMS provider were included. Descriptive analyses were performed. RESULTS:A total of 3,334 patients met the eligibility criteria, of which 105 (3.1%) died prehospital and 121 (3.6%) died within 24 hours following hospital admission. Response time was significantly faster for patients who died prehospital (median 11.5 minutes cf 14.5 minutes for those that survived to the hospital; p=0.0002). Among hospitalised patients, the median total prehospital time was 80.6 minutes (interquartile range [IQR]: 55.2-114.0). Patients who died within 24 hours following admission had significantly faster response and transport times (p=0.0005 and 0.009 respectively). CONCLUSION:This study is the first to map out the distribution of prehospital times for major trauma patients in Aotearoa New Zealand. It establishes a crucial baseline for the timeliness of EMS care and shines a light on the significant sex and ethnic disparities among those affected by major trauma.

OBJECTIVE:To examine the relationship between prehospital Advanced Life Support (ALS) and survival to hospital for major trauma patients in New Zealand and explore its implications for Emergency Medical Service (EMS) practice. METHODS:A mixed-methods explanatory design was used. Data on major trauma patients attended by road EMS (December 2016-November 2018) was analysed. A multivariable model with propensity scores estimated the odds of survival for patients receiving Advanced versus Basic Life Support (BLS). Semi-structured interviews conducted with EMS stakeholders were analysed using thematic analysis. RESULTS:Among 1118 patients, 661 (59 %) received ALS. Only 52 (5 %) did not survive to hospital. Multivariable modeling estimated ALS recipients had 1.5 times higher odds of survival than BLS-only recipients (OR 1.49, 95 % CI 0.66-3.35). Interviews with five EMS clinical leaders highlighted two likely influences: clinical judgment and evidence use. Despite imprecise quantitative findings, stakeholders supported ALS based on clinical judgment. CONCLUSIONS:A tension between population-level results and provision of care based on clinical judgement exists. Quantitative analysis found no evidence that ALS offers a survival benefit, although considerable uncertainty exists, whereas stakeholders perceive ALS has clinical and equity benefits. Future research should assess equity, disability, and quality of life outcomes of ALS.

In Aotearoa New Zealand (NZ), healthcare access inequities exist for unintentional injuries between older Māori and non-Māori. We investigated the acceptability and exploratory efficacy of a co-designed paeārahi (navigator)-led injury prevention and care model for koeke (older Māori) in a prospective, non-randomised, pilot study. We enrolled 192 community-dwelling older Māori participants (≥ 55 years) from three primary healthcare clinics. The primary outcome was intervention acceptability, using an acceptability framework and kaupapa Māori theory to analyse focus group and interview data. Exploratory efficacy outcomes included changes in mobility, fall rates, koeke confidence in injury care, and healthcare utilisation. 132 koeke (mean ± SD age: 68.3 ± 8.5 years) completed the study, and 25 people participated in acceptability data collection (focus groups/interviews). The care model was acceptable to koeke, whānau (family), paeārahi and other health providers, and perceived as having a positive impact across multiple wellbeing domains and improving koeke and whānau control over healthcare. Paeārahi working within healthcare teams contributed to acceptability by assisting with referrals and healthcare access. Participants' confidence in preventing injury and accessing support increased (p = 0.004 and p = 0.009, respectively). Although assessment points need streamlining, these findings support further evaluation of this model among koeke in more community settings.

Nuclear fusion could offer clean, abundant energy. However, managing the power exhausted from the core fusion plasma towards the reactor wall remains a major challenge. This is compounded in emerging compact reactor designs promising more cost-effective pathways towards commercial fusion energy. Alternative Divertor Configurations (ADCs) are a potential solution. In this work, we demonstrate exhaust control in ADCs, employing a novel method to diagnose the neutral gas buffer, which shields the target. Our work on the Mega Ampere Spherical Tokamak Upgrade shows that ADCs tackle key risks and uncertainties for fusion energy. Their highly reduced sensitivity to perturbations enables active exhaust control in otherwise unfeasible situations and facilitates an increased passive absorption of transients, which would otherwise damage the divertor. We observe a strong decoupling of each divertor from other reactor regions, enabling near-independent control of the divertors and core plasma. Our work showcases the real-world benefits of ADCs for effective heat load management in fusion power reactors.

Exhausting power from the hot fusion core to the plasma-facing components is one fusion energy's biggest challenges. The MAST Upgrade tokamak uniquely integrates strong containment of neutrals within the exhaust area (divertor) with extreme divertor shaping capability. By systematically altering the divertor shape, this study shows the strongest evidence to date to our knowledge that long-legged divertors with a high magnetic field gradient (total flux expansion) deliver key power exhaust benefits without adversely impacting the hot fusion core. These benefits are already achieved with relatively modest geometry adjustments that are more feasible to integrate in reactor designs. Benefits include reduced target heat loads and improved access to, and stability of, a neutral gas buffer that 'shields' the target and enhances power exhaust (detachment). Analysis and model comparisons shows these benefits are obtained by combining multiple shaping aspects: long-legged divertors have expanded plasma-neutral interaction volume that drive reductions in particle and power loads, while total flux expansion enhances detachment access and stability. Containing the neutrals in the exhaust area with physical structures further augments these shaping benefits. These results demonstrate strategic variation in the divertor geometry and magnetic topology is a potential solution to one of fusion's power exhaust challenge.

Background There are many long-standing challenges in delivering equitable health care in Aotearoa-New Zealand's healthcare system. Little is known about inequities in EMS delivered care and transport pathways to hospital-level care, and any overlapping disparities by location of injury incident and ethnicity. Objective This study examines the inter-relationship between geographical location of injury and ethnicity in Emergency Medical Service (EMS) out-of-hospital processes and pathways following road traffic crashes (RTCs) in Aotearoa-New Zealand (NZ). Methods This retrospectively-designed prospective cohort study on out-of-hospital care identified trauma cases injured in a RTC among those aged under 85 years with a status 1 or 2 triage from national EMS data. Analyses of care pathways were stratified by geographical location of injury (rural/urban) and combined ethnicity-geographical location (rural Māori/rural non-Māori and urban Māori/urban non-Māori) with comparisons of proportions undertaken. Results A total of 746 major trauma cases injured following a RTC were attended by out-of-hospital EMS providers. Subsequently, 692 were transported to hospital. EMS pathways of transportation to in-hospital care was slower and longer for rurally located cases (47%). Indigenous Māori comprised 28% of cases, with rurally located Māori comparatively less likely to be triaged to priority transport pathways (allocated fastest dispatch, 92% rural-Māori vs 97% rural non-Māori, p=0.05); slowest to reach in-hospital care (≥113 minutes to reach first hospital, 55% vs 41%, p=0.02) and had lower levels of access to specialist trauma care (never reach L1 trauma hospital, 51% vs 73%, p=0.02). Conclusion Among RTC cases attended and transported by EMS, there is variability in out-of-hospital EMS pathways through to specialist trauma care strongly patterned by intersecting rural and ethnic disparities. These findings provide a strong equity focused evidence-base to guide clinical and policy decision makers to optimise the delivery of EMS care and to reduce disparities associated with out-of-hospital EMS care.

Background An optimally structured prehospital trauma care system can reduce the serious consequences of many injuries. Whether all major trauma patients should be directed to a trauma centre (TC), bypassing closer lower-level hospitals, is a contentious issue. In particular, it is unclear if direct transport reduces risk of death. Objective To explore the relationship between direct versus indirect transfer to a definitive care hospital on short-term survival following major trauma in Aotearoa-New Zealand (NZ). Methods This prospective cohort study using administrative data analysed patients aged <85 years with major trauma (Injury Severity Score>12) attended by Emergency Medical Services (EMS) who were admitted to a TC, either directly or indirectly. Patients for whom there was no intermediary hospital closer than the TC (ie direct was the obvious option) were excluded. Propensity scores were obtained from a logistic regression model with directness of transport to definitive care as the outcome variable and all other available variables accessible at the time of EMS retrieval and considered to be related to mortality. Crude and adjusted mortality rate were estimated using a generalised linear Poisson regression model with a log-link function and robust standard errors. Results Of 1,008 major trauma cases meeting the eligibility criteria, 370 (36.7%) had pathways to definitive care that involved one intermediary hospital. Similar percentages of direct and indirectly transported patients died within 30 days following the EMS call (8.9% and 10.0% respectively). The propensity-weighted adjusted model estimated an 8% lower 2-week mortality (95% CI -41%, 44%) for those that were transported indirectly compared to directly. For 30-day mortality, the adjusted relative risk estimate was 21% lower mortality (95% CI -48%, 19%) for those transported indirectly. Conclusion Study findings suggest that in NZ, major trauma patients secondarily transferred to TCs may have decreased mortality when compared to directly transported patients, although there was considerable uncertainty with these estimates. Residual confounding from the observational study design is a limitation as is the relatively small sample size.

Recent results from MAST Upgrade are presented, emphasising understanding the capabilities of this new device and deepening understanding of key physics issues for the operation of ITER and the design of future fusion power plants. The impact of MHD instabilities on fast ion confinement have been studied, including the first observation of fast ion losses correlated with Compressional and Global Alfvén Eigenmodes. High-performance plasma scenarios have been developed by tailoring the early plasma current ramp phase to avoid internal reconnection events, resulting in a more monotonic q profile with low central shear. The impact of m / n = 3/2, 2/1 and 1/1 modes on thermal plasma confinement and rotation profiles has been quantified, and scenarios optimised to avoid them have transiently reached values of normalised beta approaching 4.2. In pedestal and ELM physics, a maximum pedestal top temperature of ∼350 eV has been achieved, exceeding the value achieved on MAST at similar heating power. Mitigation of type-I ELMs with n = 1 RMPs has been observed. Studies of plasma exhaust have concentrated on comparing conventional and Super-X divertor configurations, while X-point target, X-divertor and snowflake configurations have been developed and studied in parallel. In L-mode discharges, the separatrix density required to detach the outer divertors is approximately a factor 2 lower in the Super-X than the conventional configuration, in agreement with simulations. Detailed analysis of spectroscopy data from studies of the Super-X configuration reveal the importance of including plasma-molecule interactions and D _2 Fulcher band emission to properly quantify the rates of ionisation, plasma-molecule interactions and volumetric recombination processes governing divertor detachment. In H-mode with conventional and Super-X configurations, the outer divertors are attached in the former and detached in the latter with no impact on core or pedestal confinement.

AIM:To describe the demographic and injury profile of major trauma among 20-65-year-old New Zealanders. METHODS:A retrospective analysis of routinely collected data from the New Zealand Major Trauma Registry for the period 1 July 2017 to 30 June 2020 was conducted. Sex, age and ethnicity-based rates were then calculated using census-based population estimates to compare the rates of injury across different demographic groups. RESULTS:Of the 4,186 major trauma incidents among 20-65-year-olds in New Zealand during the 3-year period reviewed, 235 died (5.6%). Males accounted for 77% of those injured. Māori (New Zealand's Indigenous population) had significantly higher rates of major trauma (79.2 per 100,000; 95% confidence interval [CI] 74.4-84.3) compared to non-Māori (44.4 per 100,000; 95% CI 42.9-46.0). The most common cause of injury was transport-related incidents (63%; n=2,632/4,186), followed by falls (19%; n=788/4,186). CONCLUSIONS:Demographic characteristics have a significant relationship with major trauma injuries among 20-65-year-old New Zealanders. Continued injury prevention efforts focussing on males, Māori and transport incidents are required. Interventions that improve the safety of roads, such as lane separators, speed limits and raised intersections, should be implemented in high-crash-risk areas to reduce risk.

In 2019 the UK launched the Spherical Tokamak for Energy Production (STEP) programme to design and build a prototype electricity producing nuclear fusion power plant, aiming to start operation around 2040. The plant should lay the foundation for the development of commercial nuclear fusion power plants. The design is based on the spherical tokamak principle, which opens a route to high pressure, steady state, operation. While facilitating steady state operation, the spherical design introduces some specific plasma control challenges: (i) All plasma current during the burn phase should to be generated through non-inductive means, dominated by bootstrap current. This leads to operation at high normalised plasma pressure beta N with high plasma elongation, which in turn imposes effective active stabilisation of the vertical plasma position. (ii) The tight aspect ratio means very limited space for a central solenoid, imposing that even the current ramp up must be non-inductively generated. (iii) The compact design leads to extreme heat loads on plasma facing components. A double null design has been chosen to spread this load, putting strict demands on the control of the unstable vertical plasma position. (iv) The heat pulses associated with unmitigated ELMs are unlikely to be acceptable imposing ELM free operation or active ELM control. (v) To reduce and spread heat loads, core and divertor radiation and momentum loss has to be controlled, aiming to operate with simultaneously detached upper and lower divertors. (vi) High pressure operation is likely to require active resistive wall mode (RWM) stabilisation. (vii) The conductivity distribution in structures near the plasma must be carefully selected to reduce the growth rates for the vertical instability and the RWM without damping the penetration of the of magnetic fields from active control coils too much. This article describes the initial work carried out to develop a STEP plasma control system.

AIM: To evaluate adherence to the New Zealand Major Trauma Destination Policy (MTDP). This audit assessed if, based on their injuries, Emergency Medical Services (EMS) attended major trauma cases were taken to the MTDP determined appropriate hospital. Findings will guide and further improve pre-hospital trauma care and associated patient outcomes. METHODS: A retrospective evaluation of adherence to the New Zealand MTDP for a random sample of 100 cases (ISS >12) injured between 31 November 2017-30 November 2018 who survived to hospital. The EMS electronic patient record (ePRF) was reviewed for each case. Adherence was indicated by the transport of injured patients from the scene to the appropriate initial destination based on meeting the respective regional MTDPs. RESULTS: Overall, there was a 94% adherence rate to the MTDP. For patients that were not classified as requiring transport to an advanced-level trauma centre, there was a 98.9% (n=86/87) adherence compared to 61.5% (n=8/13) adherence in those that did require transport to an advanced-level trauma centre. CONCLUSION: There was high adherence to the MTDP, with 94% of cases being taken to the appropriate destination directly from the incident scene. There is scope for improvement in cases whereby the nearest hospital should be bypassed in favour of a more distant advanced-level trauma centre.

Introduction: The out-of-hospital emergency medical service (EMS) care responses and the transportpathways to hospital play a vital role in patient survival following injury and are thefirst component of awell-functioning, optimised system of trauma care. Despite longstanding challenges in deliveringequitable healthcare services in the health system of Aotearoa-New Zealand (NZ), little is known aboutinequities in EMS-delivered care and transport pathways to hospital-level care. Methods: This population-level cohort study on out-of-hospital care, based on national EMS data,included trauma patients<85 years in age who were injured in a road traffic crash (RTC). In this study weexamined the combined relationship between ethnicity and geographical location of injury in EMS out-of-hospital care and transport pathways following RTCs in Aotearoa-NZ. Analyses were stratified bygeographical location of injury (rural and urban) and combined ethnicity-geographical location (ruralMaori, rural non-Maori, urban Maori, and urban non-Maori). Results: In a two-year period, therewere 746 eligible patients; of these, 692 were transported to hospital.Indigenous Maori comprised 28% (196) of vehicle occupants attended by EMS, while 47% (324) ofpatients'injuries occurred in a rural location. The EMS transport pathways to hospital for rural patientswere slower to reachfirst hospital (total in slowest tertile of time 44% vs 7%,P >= 0.001) and longer toreach definitive care (direct transport, 77% vs 87%,P=0.001) compared to urban patients. Maoripatients injured in a rural location were comparatively less likely than rural non-Maori to be triaged topriority transport pathways (fastest dispatch triage, 92% vs 97%, respectively,P=0.05); slower to reachfirst hospital (total in slowest tertile of time, 55% vs 41%,P=0.02); and had less access to specialisttrauma care (reached tertiary trauma hospital, 51% vs 73%,P=0.02). Conclusion: Among RTC patients attended and transported by EMS in NZ, there was variability in out-of-hospital EMS transport pathways through to specialist trauma care, strongly patterned by location of incidentand ethnicity. Thesefindings, mirroring other health disparities for Maori, provide an equity-focusedevidence base to guide clinical andpolicy decision makers to optimize the delivery of EMS care and reducedisparities associated with out-of-hospital EMS care.

ObjectivesTo characterise unintentional injury-related hospitalisation and mortality amongst older adults (aged 50+ years) in the Lakes and Bay of Plenty District Health Boards of Aotearoa New Zealand and to examine whether hospitalisation patterns differed by ethnicity.MethodsThis observational study analysed unintentional injury-related hospitalisations and deaths among older adults between 2014 and 2018. Routinely collected national data sets were used to calculate annualised, age-standardised injury rates. The independent variable of interest was ethnicity (Maori or non-Maori).ResultsThere were 11,834 unintentional injury-related hospitalisations in the study period (n = 1444 for Maori). Overall, there was no significant difference in the age-standardised hospitalisation rate between Maori and non-Maori (Standardised Rate Ratio [SRR] = 0.96 [95% CI 0.90, 1.02]). Falls were the most common mechanism of injury among Maori and non-Maori overall (50% and 71%) and relative risks of falls increased with age. Non-Maori were 57% less likely to be hospitalised for unintentional poisoning than Maori (SRR = 0.43, [0.34, 0.59]).ConclusionsThe mechanisms of injury, and variation in unintentional injury-related hospitalisation rates between Maori and non-Maori, change throughout older age, and incidence increase0073 with age. Falls cause significant injury-related hospitalisations for older Maori and responsive injury prevention and rehabilitation efforts are warranted to achieve equitable health outcomes.

Two reduced models for predicting detachment onset and divertor reattachment times are validated on MAST Upgrade (MAST-U). These models are essential for future tokamak reactor design, providing rapid calculations based primarily on engineering parameters. The first model predicts detachment onset using a qualifier developed on ASDEX Upgrade (AUG) and later tested on JET, while the second model provides an estimate for the time required for a given transient to burn through the neutral particles in the divertor. Experiments in H-mode plasma scenarios were conducted on MAST-U with double-null and single-null configurations, which involved D2 fuelling ramps and N2 seeding. The detachment onset was determined by monitoring divertor parameters, including the target heat flux profile, electron temperature, and electron density, with measurements showing consistency with AUG-derived predictions. Reattachment times were assessed during dynamic vertical shifts of the plasma centroid position, with observations indicating reattachment within milliseconds, consistent with model predictions. Overall, the results confirm the applicability of both reduced models to MAST-U, extending their validation beyond AUG and JET.

Success of the UK's Spherical Tokamak for Energy Production (STEP) programme requires a robust plasma control system. This system has to guide the plasma from initiation to the burning phase, maintain it there, produce the desired fusion power for the desired duration and then terminate the plasma safely. This has to be done in a challenging environment with limited sensors and without overloading plasma-facing components. The plasma parameters and the operational regime in the STEP prototype will be very different from tokamaks, which are presently in operation. During fusion burn, the plasma regime in STEP will be self-organizing, adding further complications to the plasma control system design. This article describes the work to date on the design of individual controllers for plasma shape and position, magneto hydrodynamic instabilities, heat load and fusion power. Having studied 'normal' operation, the article discusses the philosophy of how the system will handle exceptions, when things do not go exactly as planned.This article is part of the theme issue 'Delivering Fusion Energy - The Spherical Tokamak for Energy Production (STEP)'.

INTRODUCTION:Various attempts at automation have been made to reduce the administrative burden of manually assigning Abbreviated Injury Severity (AIS) codes to derive Injury Severity Scores (ISS) in trauma registry data. The accuracy of the resulting measures remains unclear, especially in the New Zealand (NZ) context. The aim of this study was to compare ISS derived from hospital discharge International Classification of Diseases Australian Modification (ICD-10-AM) codes with ISS recorded in the NZ Trauma Registry (NZTR). METHODS:Individuals admitted to hospital and enrolled in the NZTR between 1 December 2016 and 30 November 2018 were included. ISS were calculated using a modified ICD to AIS mapping tool. The agreement between both methods for raw scores was assessed by the Intraclass Correlation Coefficient (ICC), and for categorical scores the Kappa and weighted Kappa index were used. Analysis was conducted by gender, age, ethnicity, and mechanism of injury. RESULTS:3,156 patients fulfilled the inclusion criteria. The ICC for agreement between the methods was poor (0.40, 95 % CI: 0.37-0.43). The Kappa index indicated slight agreement between both methods when using a cut-off value of 12 (0.06; 95 % CI: 0.01-0.12) and 15 (0.13 6; 95 % CI: 0.09-0.17). CONCLUSION:Although the overall agreement between NZTR-ISS and ICD-ISS was slight, ICD-derived scores may be useful to describe injury patterns and for body region-specific estimations when manually coded ISS are not available.

In this paper we report on the development and demonstration of density feedback control for MAST-U. Sinusoidal perturbations are used to measure the frequency response from a deuterium gas valve (actuator) to line-integrated core electron density measured by the interferometer (sensor). In the frequency range relevant for control design, only two system-identification experiments were needed to regress a first-order dynamic model. This control-oriented model informs the offline design of a proportional integral controller with the established loop-shaping controller design method. After offline verification of the controller implementation, control is demonstrated by experimentally tracking a staircase reference for the line-integrated electron density. This paper demonstrates the efficiency of controller design using system-identification and loop-shaping, providing reliable density control for MAST-U.