| 1. |
- Bombarda, F., et al.
(författare)
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Runaway electron beam control
- 2019
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Ingår i: Plasma Physics and Controlled Fusion. - : IOP Publishing. - 1361-6587 .- 0741-3335. ; 61:1
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Tidskriftsartikel (refereegranskat)
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| 2. |
- Murari, A., et al.
(författare)
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A control oriented strategy of disruption prediction to avoid the configuration collapse of tokamak reactors
- 2024
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Ingår i: Nature Communications. - 2041-1723 .- 2041-1723. ; 15:1
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Tidskriftsartikel (refereegranskat)abstract
- The objective of thermonuclear fusion consists of producing electricity from the coalescence of light nuclei in high temperature plasmas. The most promising route to fusion envisages the confinement of such plasmas with magnetic fields, whose most studied configuration is the tokamak. Disruptions are catastrophic collapses affecting all tokamak devices and one of the main potential showstoppers on the route to a commercial reactor. In this work we report how, deploying innovative analysis methods on thousands of JET experiments covering the isotopic compositions from hydrogen to full tritium and including the major D-T campaign, the nature of the various forms of collapse is investigated in all phases of the discharges. An original approach to proximity detection has been developed, which allows determining both the probability of and the time interval remaining before an incoming disruption, with adaptive, from scratch, real time compatible techniques. The results indicate that physics based prediction and control tools can be developed, to deploy realistic strategies of disruption avoidance and prevention, meeting the requirements of the next generation of devices.
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| 3. |
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| 4. |
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| 5. |
- Joffrin, E., et al.
(författare)
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Overview of the JET preparation for deuterium-tritium operation with the ITER like-wall
- 2019
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Ingår i: Nuclear Fusion. - : IOP Publishing. - 1741-4326 .- 0029-5515. ; 59:11
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Forskningsöversikt (refereegranskat)abstract
- For the past several years, the JET scientific programme (Pamela et al 2007 Fusion Eng. Des. 82 590) has been engaged in a multi-campaign effort, including experiments in D, H and T, leading up to 2020 and the first experiments with 50%/50% D-T mixtures since 1997 and the first ever D-T plasmas with the ITER mix of plasma-facing component materials. For this purpose, a concerted physics and technology programme was launched with a view to prepare the D-T campaign (DTE2). This paper addresses the key elements developed by the JET programme directly contributing to the D-T preparation. This intense preparation includes the review of the physics basis for the D-T operational scenarios, including the fusion power predictions through first principle and integrated modelling, and the impact of isotopes in the operation and physics of D-T plasmas (thermal and particle transport, high confinement mode (H-mode) access, Be and W erosion, fuel recovery, etc). This effort also requires improving several aspects of plasma operation for DTE2, such as real time control schemes, heat load control, disruption avoidance and a mitigation system (including the installation of a new shattered pellet injector), novel ion cyclotron resonance heating schemes (such as the three-ions scheme), new diagnostics (neutron camera and spectrometer, active Alfven eigenmode antennas, neutral gauges, radiation hard imaging systems...) and the calibration of the JET neutron diagnostics at 14 MeV for accurate fusion power measurement. The active preparation of JET for the 2020 D-T campaign provides an incomparable source of information and a basis for the future D-T operation of ITER, and it is also foreseen that a large number of key physics issues will be addressed in support of burning plasmas.
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| 6. |
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| 7. |
- Krasilnikov, A., et al.
(författare)
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Evidence of 9 Be + p nuclear reactions during 2ω CH and hydrogen minority ICRH in JET-ILW hydrogen and deuterium plasmas
- 2018
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Ingår i: Nuclear Fusion. - : IOP Publishing. - 1741-4326 .- 0029-5515. ; 58:2
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Tidskriftsartikel (refereegranskat)abstract
- The intensity of 9Be + p nuclear fusion reactions was experimentally studied during second harmonic (2ω CH) ion-cyclotron resonance heating (ICRH) and further analyzed during fundamental hydrogen minority ICRH of JET-ILW hydrogen and deuterium plasmas. In relatively low-density plasmas with a high ICRH power, a population of fast H+ ions was created and measured by neutral particle analyzers. Primary and secondary nuclear reaction products, due to 9Be + p interaction, were observed with fast ion loss detectors, γ-ray spectrometers and neutron flux monitors and spectrometers. The possibility of using 9Be(p, d)2α and 9Be(p, α)6Li nuclear reactions to create a population of fast alpha particles and study their behaviour in non-active stage of ITER operation is discussed in the paper.
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| 8. |
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- 2018
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Ingår i: Nuclear Fusion. - : IOP Publishing. - 1741-4326 .- 0029-5515. ; 58:1
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Forskningsöversikt (refereegranskat)
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| 9. |
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| 10. |
- Abel, I, et al.
(författare)
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Overview of the JET results with the ITER-like wall
- 2013
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Ingår i: Nuclear Fusion. - : IOP Publishing. - 1741-4326 .- 0029-5515. ; 53:10, s. 104002-
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Tidskriftsartikel (refereegranskat)abstract
- Following the completion in May 2011 of the shutdown for the installation of the beryllium wall and the tungsten divertor, the first set of JET campaigns have addressed the investigation of the retention properties and the development of operational scenarios with the new plasma-facing materials. The large reduction in the carbon content (more than a factor ten) led to a much lower Z(eff) (1.2-1.4) during L- and H-mode plasmas, and radiation during the burn-through phase of the plasma initiation with the consequence that breakdown failures are almost absent. Gas balance experiments have shown that the fuel retention rate with the new wall is substantially reduced with respect to the C wall. The re-establishment of the baseline H-mode and hybrid scenarios compatible with the new wall has required an optimization of the control of metallic impurity sources and heat loads. Stable type-I ELMy H-mode regimes with H-98,H-y2 close to 1 and beta(N) similar to 1.6 have been achieved using gas injection. ELM frequency is a key factor for the control of the metallic impurity accumulation. Pedestal temperatures tend to be lower with the new wall, leading to reduced confinement, but nitrogen seeding restores high pedestal temperatures and confinement. Compared with the carbon wall, major disruptions with the new wall show a lower radiated power and a slower current quench. The higher heat loads on Be wall plasma-facing components due to lower radiation made the routine use of massive gas injection for disruption mitigation essential.
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| 11. |
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| 12. |
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| 13. |
- Romanelli, F, et al.
(författare)
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Overview of the JET results
- 2011
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Ingår i: Nuclear Fusion. - : IOP Publishing. - 1741-4326 .- 0029-5515. ; 51:9
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Tidskriftsartikel (refereegranskat)abstract
- Since the last IAEA Conference JET has been in operation for one year with a programmatic focus on the qualification of ITER operating scenarios, the consolidation of ITER design choices and preparation for plasma operation with the ITER-like wall presently being installed in JET. Good progress has been achieved, including stationary ELMy H-mode operation at 4.5 MA. The high confinement hybrid scenario has been extended to high triangularity, lower ρ*and to pulse lengths comparable to the resistive time. The steady-state scenario has also been extended to lower ρ*and ν*and optimized to simultaneously achieve, under stationary conditions, ITER-like values of all other relevant normalized parameters. A dedicated helium campaign has allowed key aspects of plasma control and H-mode operation for the ITER non-activated phase to be evaluated. Effective sawtooth control by fast ions has been demonstrated with3He minority ICRH, a scenario with negligible minority current drive. Edge localized mode (ELM) control studies using external n = 1 and n = 2 perturbation fields have found a resonance effect in ELM frequency for specific q95values. Complete ELM suppression has, however, not been observed, even with an edge Chirikov parameter larger than 1. Pellet ELM pacing has been demonstrated and the minimum pellet size needed to trigger an ELM has been estimated. For both natural and mitigated ELMs a broadening of the divertor ELM-wetted area with increasing ELM size has been found. In disruption studies with massive gas injection up to 50% of the thermal energy could be radiated before, and 20% during, the thermal quench. Halo currents could be reduced by 60% and, using argon/deuterium and neon/deuterium gas mixtures, runaway electron generation could be avoided. Most objectives of the ITER-like ICRH antenna have been demonstrated; matching with closely packed straps, ELM resilience, scattering matrix arc detection and operation at high power density (6.2 MW m-2) and antenna strap voltages (42 kV). Coupling measurements are in very good agreement with TOPICA modelling. © 2011 IAEA, Vienna.
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| 23. |
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| 24. |
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| 25. |
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| 26. |
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| 27. |
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| 28. |
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| 29. |
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| 30. |
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| 31. |
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| 32. |
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Overview of the JET results
- 2015
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Ingår i: Nuclear Fusion. - : IOP Publishing. - 0029-5515 .- 1741-4326. ; 55:10
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Tidskriftsartikel (refereegranskat)
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| 33. |
-
- 2018
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Ingår i: Nuclear Fusion. - : IOP Publishing. - 1741-4326 .- 0029-5515. ; 58:9
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Tidskriftsartikel (refereegranskat)
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| 34. |
- Fenstermacher, M.E., et al.
(författare)
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DIII-D research advancing the physics basis for optimizing the tokamak approach to fusion energy
- 2022
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Ingår i: Nuclear Fusion. - : IOP Publishing. - 0029-5515 .- 1741-4326. ; 62:4
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Tidskriftsartikel (refereegranskat)abstract
- DIII-D physics research addresses critical challenges for the operation of ITER and the next generation of fusion energy devices. This is done through a focus on innovations to provide solutions for high performance long pulse operation, coupled with fundamental plasma physics understanding and model validation, to drive scenario development by integrating high performance core and boundary plasmas. Substantial increases in off-axis current drive efficiency from an innovative top launch system for EC power, and in pressure broadening for Alfven eigenmode control from a co-/counter-I p steerable off-axis neutral beam, all improve the prospects for optimization of future long pulse/steady state high performance tokamak operation. Fundamental studies into the modes that drive the evolution of the pedestal pressure profile and electron vs ion heat flux validate predictive models of pedestal recovery after ELMs. Understanding the physics mechanisms of ELM control and density pumpout by 3D magnetic perturbation fields leads to confident predictions for ITER and future devices. Validated modeling of high-Z shattered pellet injection for disruption mitigation, runaway electron dissipation, and techniques for disruption prediction and avoidance including machine learning, give confidence in handling disruptivity for future devices. For the non-nuclear phase of ITER, two actuators are identified to lower the L-H threshold power in hydrogen plasmas. With this physics understanding and suite of capabilities, a high poloidal beta optimized-core scenario with an internal transport barrier that projects nearly to Q = 10 in ITER at ∼8 MA was coupled to a detached divertor, and a near super H-mode optimized-pedestal scenario with co-I p beam injection was coupled to a radiative divertor. The hybrid core scenario was achieved directly, without the need for anomalous current diffusion, using off-axis current drive actuators. Also, a controller to assess proximity to stability limits and regulate β N in the ITER baseline scenario, based on plasma response to probing 3D fields, was demonstrated. Finally, innovative tokamak operation using a negative triangularity shape showed many attractive features for future pilot plant operation.
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| 35. |
- Taddei, C, et al.
(författare)
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Repositioning of the global epicentre of non-optimal cholesterol
- 2020
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Ingår i: Nature. - : Springer Science and Business Media LLC. - 1476-4687 .- 0028-0836. ; 582:7810, s. 73-
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Tidskriftsartikel (refereegranskat)abstract
- High blood cholesterol is typically considered a feature of wealthy western countries1,2. However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world3 and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health4,5. However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol—which is a marker of cardiovascular risk—changed from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95% credible interval 3.7 million–4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world.
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| 36. |
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| 37. |
- Lönnroth, J. -S, et al.
(författare)
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Integrated ELM modelling
- 2006
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Ingår i: Contributions to Plasma Physics. - : Wiley. - 0863-1042 .- 1521-3986. ; 46:7-9, s. 726-738
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Tidskriftsartikel (refereegranskat)abstract
- This paper presents a short overview of current trends and progress in integrated ELM modelling. First, the concept of integrated ELM modelling is introduced, various interpretations of it are given and the need for it is discussed. Then follows an overview of different techniques and methods used in integrated ELM modelling presented roughly according to physics approached in use and in order of increasing complexity. The paper concludes with a short discussion of open issues and future modelling requirements within the field of integrated ELM modelling.
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| 38. |
- Ongena, J., et al.
(författare)
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Recent progress on JET towards the ITER reference mode of operation at high density
- 2001
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Ingår i: Plasma Physics and Controlled Fusion. - 0741-3335 .- 1361-6587. ; 43, s. A11-A30
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Tidskriftsartikel (refereegranskat)abstract
- Recent progress towards obtaining high density and high confinement in JET as required for the ITER reference scenario at Q = 10 is summarized. Plasmas with simultaneous confinement H-98(y.2) = 1 and densities up to n/n(Gw) similar to 1 are now routinely obtained. This has been possible (i) by using plasmas at high (delta similar to 0.5) and medium (delta similar to 0.3-0.4) triangularity with sufficient heating power to maintain Type I ELMs, (ii) with impurity seeded plasmas at high (delta similar to 0.5) and low (delta less than or equal to 0.2) triangularity, (iii) with an optimized pellet injection sequence, maintaining the energy confinement and raising the density, and (iv) by carefully tuning the gas puff rate leading to plasmas with peaked density profiles and good confinement at long time scales. These high performance discharges exhibit Type I ELMs, with a new and more favourable behaviour observed at high densities, requiring further studies. Techniques for a possible mitigation of these ELMs are discussed, and first promising results are obtained with impurity seeding in discharges at high triangularity. Scaling studies using the new data of this year show a strong dependence of confinement on upper triangularity, density and proximity to the Greenwald limit. Observed MHD instabilities and methods to avoid these in high density and high confinement plasmas are discussed.
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| 39. |
- Ismail, AA, et al.
(författare)
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Incidence of limb fracture across Europe: Results from the European Prospective Osteoporosis Study (EPOS)
- 2002
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Ingår i: Osteoporosis International. - : Springer Science and Business Media LLC. - 1433-2965 .- 0937-941X. ; 13:7, s. 565-571
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this population-based prospective study was to determine the incidence of limb fracture by site and gender in different regions of Europe. Men and women aged 50-79 years were recruited from population registers in 31 European centers. Subjects were invited to attend for an interviewer-administered questionnaire and lateral spinal radiographs. Subjects were subsequently followed up using an annual postal questionnaire which included questions concerning the occurrence of new fractures. Self-reported fractures were confirmed where possible by radiograph, attending physician or subject interview. There were 6451 men and 6936 women followed for a median of 3.0 years. During this time there were 140 incident limb fractures in men and 391 in women. The age-adjusted incidence of any limb fracture was 7,3/1000 person-years [pyrs] in men and 19 per 1000 pyrs in women, equivalent to a 2,5 times excess in women. Among women, the incidence of hip, humerus and distal forearm fracture, though not 'other' limb fracture, increased with age, while in men only the incidence of hip and humerus fracture increased with age. Among women, there was evidence of significant variation in the occurrence of hip, distal forearm and humerus fractures across Europe, with incidence rates higher in Scandinavia than in other European regions. though for distal forearm fracture the incidence in east Europe was similar to that observed in Scandinavia. Among men, there was no evidence of significant geographic variation in the occurrence of these fractures. This is the first large population-based study to characterize the incidence of limb fracture in men and women over 50 years of age across Europe. There are substantial differences in the descriptive epidemiology of limb fracture by region and gender.
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| 40. |
- Kaptoge, S., et al.
(författare)
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Whom to treat? The contribution of vertebral X-rays to risk-based algorithms for fracture prediction. Results from the European Prospective Osteoporosis Study
- 2006
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Ingår i: Osteoporosis International. - : Springer Science and Business Media LLC. - 1433-2965 .- 0937-941X. ; 17:9, s. 1369-1381
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Vertebral fracture is a strong risk factor for future spine and hip fractures; yet recent data suggest that only 5-20% of subjects with a spine fracture are identified in primary care. We aimed to develop easily applicable algorithms predicting a high risk of future spine fracture in men and women over 50 years of age. Methods: Data was analysed from 5,561 men and women aged 50+ years participating in the European Prospective Osteoporosis Study (EPOS). Lateral thoracic and lumbar spine radiographs were taken at baseline and at an average of 3.8 years later. These were evaluated by an experienced radiologist. The risk of a new (incident) vertebral fracture was modelled as a function of age, number of prevalent vertebral fractures, height loss, sex and other fracture history reported by the subject, including limb fractures occurring between X-rays. Receiver Operating Characteristic (ROC) curves were used to compare the predictive ability of models. Results: In a negative binomial regression model without baseline X-ray data, the risk of incident vertebral fracture significantly increased with age [RR 1.74, 95% CI (1.44, 2.10) per decade], height loss [1.08 (1.04, 1.12) per cm decrease], female sex [1.48 (1.05, 2.09)], and recalled fracture history; [1.65 (1.15, 2.38) to 3.03 (1.66, 5.54)] according to fracture site. Baseline radiological assessment of prevalent vertebral fracture significantly improved the areas subtended by ROC curves from 0.71 (0.67, 0.74) to 0.74 (0.70, 0.77) P=0.013 for predicting 1+ incident fracture; and from 0.74 (0.67, 0.81) to 0.83 (0.76, 0.90) P=0.001 for 2+ incident fractures. Age, sex and height loss remained independently predictive. The relative risk of a new vertebral fracture increased with the number of prevalent vertebral fractures present from 3.08 (2.10, 4.52) for 1 fracture to 9.36 (5.72, 15.32) for 3+. At a specificity of 90%, the model including X-ray data improved the sensitivity for predicting 2+ and 1+ incident fractures by 6 and 4 fold respectively compared with random guessing. At 75% specificity the improvements were 3.2 and 2.4 fold respectively. With the modelling restricted to the subjects who had BMD measurements (n=2,409), the AUC for predicting 1+ vs. 0 incident vertebral fractures improved from 0.72 (0.66, 0.79) to 0.76 (0.71, 0.82) upon adding femoral neck BMD (P=0.010). Conclusion: We conclude that for those with existing vertebral fractures, an accurately read spine X-ray will form a central component in future algorithms for targeting treatment, especially to the most vulnerable. The sensitivity of this approach to identifying vertebral fracture cases requiring anti-osteoporosis treatment, even when X-rays are ordered highly selectively, exceeds by a large margin the current standard of practice as recorded anywhere in the world.
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| 41. |
- Lerche, E., et al.
(författare)
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Optimization of ICRH for core impurity control in JET-ILW
- 2016
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Ingår i: Nuclear Fusion. - JET, Culham Sci Ctr, EUROfus Consortium, Abingdon OX14 3DB, Oxon, England. [Lerche, E.; Van Eester, D.; Crombe, K.; Kazakov, Y.; Krivska, A.; Ongena, J.] TEC Partner, Assoc EUROFUS Belgian State, LPP ERM KMS, Brussels, Belgium. [Lerche, E.; Jacquet, P.; Giroud, C.; Monakhov, I.; Casson, F. J.; Rimini, F.; Blackman, T.; Brix, M.; Challis, C.; Graham, M.; Kiptily, V.; Lennholm, M.; Lomas, P.; Maggi, C.; Mathews, G.; Mayoral, M. -L.; Santala, M.; Shaw, A.; Stamp, M.] Euratom CCFE Fus Assoc, Culham Sci Ctr, Abingdon, Oxon, England. [Goniche, M.; Colas, L.; Fedorczak, N.; Joffrin, E.; Monier-Garbet, P.] Assoc EUROFUS CEA, IRFM, St Paul Les Durance, France. [Bobkov, V.; Angioni, C.; Hobirk, J.; Puetterich, T.; Reich, M.] EUROFUS Assoziat, Max Planck Inst Plasmaphys, Garching, Germany. [Baruzzo, M.] EUROFUS ENEA Assoc, Consorzio RFX, Padua, Italy. [Brezinsek, S.] TEC Partner, EUROFUS Assoziat, Forschungszentrum Juelich, Julich, Germany. [Czarnecka, A.] EUROFUS Assoc, IPPLM, Warsaw, Poland. [Eriksson, J.] Uppsala Univ, Dept Phys & Astron, Assoc EUROFUS VR, Uppsala, Sweden. [Graves, J. P.] Assoc EUROFUS Confederat Suisse, CRPP EPFL, Lausanne, Switzerland. [Gorini, G.; Mantica, P.; Nocente, M.; Tardocchi, M.; Valisa, M.] EUROFUS ENEA CNR Assoc, Inst Fis Plasma, Milan, Italy. [Johnson, T.] KTH, EES, Fus Plasma Phys, Assoc EUROFUS VR, Stockholm, Sweden. [Meneses, L.; Nave, M. F.; Nunes, I.] EUROFUS IST Assoc, Inst Plasmas & Fusao Nucl, Lisbon, Portugal. [Mlynar, J.; Petrzilka, V.] EUROFUS IPP CR Assoc, Inst Plasma Phys, Prague, Czech Republic. [Petravich, G.] EUROFUS Assoc, MTA Wigner FK RMI, Budapest, Hungary. [Solano, E. R.] EUROFUS Assoc, LNF CIEMAT, Madrid, Spain. [Solano, E. R.] Culham Sci Ctr, EUROfus PMU, Abingdon OX14 3DB, Oxon, England. [Sips, G.] Culham Sci Ctr, JET Exploitat Unit, Abingdon OX14 3DB, Oxon, England. [Tsalas, M.] EUROFUS Assoc, FOM Inst DIFFER, Nieuwegein, Netherlands. : Institute of Physics (IOP). - 0029-5515 .- 1741-4326. ; 56:3
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Tidskriftsartikel (refereegranskat)abstract
- Ion cyclotron resonance frequency (ICRF) heating has been an essential component in the development of high power H-mode scenarios in the Jet European Torus ITER-like wall (JET-ILW). The ICRF performance was improved by enhancing the antenna-plasma coupling with dedicated main chamber gas injection, including the preliminary minimization of RF-induced plasma-wall interactions, while the RF heating scenarios where optimized for core impurity screening in terms of the ion cyclotron resonance position and the minority hydrogen concentration. The impact of ICRF heating on core impurity content in a variety of 2.5 MA JET-ILW H-mode plasmas will be presented, and the steps that were taken for optimizing ICRF heating in these experiments will be reviewed.
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| 42. |
- Marcer, G., et al.
(författare)
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Analytical and MonteCarlo approaches to infer the total gamma ray emission from the JET tokamak
- 2023
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Ingår i: Journal of Instrumentation. - : IOP Publishing. - 1748-0221. ; 18
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Tidskriftsartikel (refereegranskat)abstract
- A single gamma-ray spectrometer installed at the end of a collimator can be used to infer the total emission from a tokamak plasma if the transport of gamma-rays from the plasma to the detector is known. In such analysis, the plasma emission profile plays a fundamental role, since it impacts the fraction of plasma volume intercepted by the detector line of sight. In this work, the DT 17 MeV fusion gamma-rays emission profile of the JET discharge #99608 from second 46 to 48 has been estimated both with the TRANSP code and reconstructed through tomographic inversion based on the neutron camera data, assuming that fusion gamma-rays have the same profile as the 14 MeV fusion neutrons. The gamma-ray transport has been evaluated both by MonteCarlo simulations and analytical calculations. By combining MonteCarlo and analytical evaluations of the gamma-ray transport in different ways with the estimated radiation emission profile, we provide four different routes to determine the total gamma-ray yield from measurements whose results agree within better than 10%.
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| 43. |
- Zhou, Bin, et al.
(författare)
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Worldwide trends in diabetes since 1980: A pooled analysis of 751 population-based studies with 4.4 million participants
- 2016
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Ingår i: The Lancet. - : Elsevier B.V.. - 0140-6736 .- 1474-547X. ; 387:10027, s. 1513-1530
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Tidskriftsartikel (refereegranskat)abstract
- Background: One of the global targets for non-communicable diseases is to halt, by 2025, the rise in the age standardised adult prevalence of diabetes at its 2010 levels. We aimed to estimate worldwide trends in diabetes, how likely it is for countries to achieve the global target, and how changes in prevalence, together with population growth and ageing, are aff ecting the number of adults with diabetes.Methods: We pooled data from population-based studies that had collected data on diabetes through measurement of its biomarkers. We used a Bayesian hierarchical model to estimate trends in diabetes prevalence-defined as fasting plasma glucose of 7.0 mmol/L or higher, or history of diagnosis with diabetes, or use of insulin or oral hypoglycaemic drugs-in 200 countries and territories in 21 regions, by sex and from 1980 to 2014. We also calculated the posterior probability of meeting the global diabetes target if post-2000 trends continue.Findings: We used data from 751 studies including 4372000 adults from 146 of the 200 countries we make estimates for. Global age-standardised diabetes prevalence increased from 4.3% (95% credible interval 2.4-17.0) in 1980 to 9.0% (7.2-11.1) in 2014 in men, and from 5.0% (2.9-7.9) to 7.9% (6.4-9.7) in women. The number of adults with diabetes in the world increased from 108 million in 1980 to 422 million in 2014 (28.5% due to the rise in prevalence, 39.7% due to population growth and ageing, and 31.8% due to interaction of these two factors). Age-standardised adult diabetes prevalence in 2014 was lowest in northwestern Europe, and highest in Polynesia and Micronesia, at nearly 25%, followed by Melanesia and the Middle East and north Africa. Between 1980 and 2014 there was little change in age-standardised diabetes prevalence in adult women in continental western Europe, although crude prevalence rose because of ageing of the population. By contrast, age-standardised adult prevalence rose by 15 percentage points in men and women in Polynesia and Micronesia. In 2014, American Samoa had the highest national prevalence of diabetes (>30% in both sexes), with age-standardised adult prevalence also higher than 25% in some other islands in Polynesia and Micronesia. If post-2000 trends continue, the probability of meeting the global target of halting the rise in the prevalence of diabetes by 2025 at the 2010 level worldwide is lower than 1% for men and is 1% for women. Only nine countries for men and 29 countries for women, mostly in western Europe, have a 50% or higher probability of meeting the global target.Interpretation: Since 1980, age-standardised diabetes prevalence in adults has increased, or at best remained unchanged, in every country. Together with population growth and ageing, this rise has led to a near quadrupling of the number of adults with diabetes worldwide. The burden of diabetes, both in terms of prevalence and number of adults aff ected, has increased faster in low-income and middle-income countries than in high-income countries.
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| 44. |
- Armbrecht, Gabriele, et al.
(författare)
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Degenerative inter-vertebral disc disease osteochondrosis intervertebralis in Europe : Prevalence, geographic variation and radiological correlates in men and women aged 50 and over
- 2017
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Ingår i: Rheumatology. - : Oxford University Press (OUP). - 1462-0324 .- 1462-0332. ; 56:7, s. 1189-1199
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Tidskriftsartikel (refereegranskat)abstract
- Objectives. To assess the prevalences across Europe of radiological indices of degenerative inter-vertebral disc disease (DDD); and to quantify their associations with, age, sex, physical anthropometry, areal BMD (aBMD) and change in aBMD with time. Methods. In the population-based European Prospective Osteoporosis Study, 27 age-stratified samples of men and women from across the continent aged 50+ years had standardized lateral radiographs of the lumbar and thoracic spine to evaluate the severity of DDD, using the Kellgren-Lawrence (KL) scale. Measurements of anterior, mid-body and posterior vertebral heights on all assessed vertebrae from T4 to L4 were used to generate indices of end-plate curvature. Results. Images from 10 132 participants (56% female, mean age 63.9 years) passed quality checks. Overall, 47% of men and women had DDD grade 3 or more in the lumbar spine and 36% in both thoracic and lumbar spine. Risk ratios for DDD grades 3 and 4, adjusted for age and anthropometric determinants, varied across a three-fold range between centres, yet prevalences were highly correlated in men and women. DDD was associated with flattened, non-ovoid inter-vertebral disc spaces. KL grade 4 and loss of inter-vertebral disc space were associated with higher spine aBMD. Conclusion. KL grades 3 and 4 are often used clinically to categorize radiological DDD. Highly variable European prevalences of radiologically defined DDD grades 3+ along with the large effects of age may have growing and geographically unequal health and economic impacts as the population ages. These data encourage further studies of potential genetic and environmental causes.
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| 45. |
- Danaei, Goodarz, et al.
(författare)
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Effects of diabetes definition on global surveillance of diabetes prevalence and diagnosis: a pooled analysis of 96 population-based studies with 331288 participants
- 2015
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Ingår i: The Lancet Diabetes & Endocrinology. - 2213-8595 .- 2213-8587. ; 3:8, s. 624-637
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Tidskriftsartikel (refereegranskat)abstract
- Background Diabetes has been defined on the basis of different biomarkers, including fasting plasma glucose (FPG), 2-h plasma glucose in an oral glucose tolerance test (2hOGTT), and HbA(1c). We assessed the effect of different diagnostic definitions on both the population prevalence of diabetes and the classification of previously undiagnosed individuals as having diabetes versus not having diabetes in a pooled analysis of data from population-based health examination surveys in different regions. Methods We used data from 96 population-based health examination surveys that had measured at least two of the biomarkers used for defining diabetes. Diabetes was defined using HbA(1c) (HbA(1c) >= 6 . 5% or history of diabetes diagnosis or using insulin or oral hypoglycaemic drugs) compared with either FPG only or FPG-or-2hOGTT definitions (FPG >= 7 . 0 mmol/L or 2hOGTT >= 11 . 1 mmol/L or history of diabetes or using insulin or oral hypoglycaemic drugs). We calculated diabetes prevalence, taking into account complex survey design and survey sample weights. We compared the prevalences of diabetes using different definitions graphically and by regression analyses. We calculated sensitivity and specificity of diabetes diagnosis based on HbA1c compared with diagnosis based on glucose among previously undiagnosed individuals (ie, excluding those with history of diabetes or using insulin or oral hypoglycaemic drugs). We calculated sensitivity and specificity in each survey, and then pooled results using a random-effects model. We assessed the sources of heterogeneity of sensitivity by meta-regressions for study characteristics selected a priori. Findings Population prevalence of diabetes based on FPG- or-2hOGTT was correlated with prevalence based on FPG alone (r= 0 . 98), but was higher by 2-6 percentage points at different prevalence levels. Prevalence based on HbA(1c) was lower than prevalence based on FPG in 42 . 8% of age-sex-survey groups and higher in another 41 . 6%; in the other 15 . 6%, the two definitions provided similar prevalence estimates. The variation across studies in the relation between glucose-based and HbA(1c)-based prevalences was partly related to participants' age, followed by natural logarithm of per person gross domestic product, the year of survey, mean BMI, and whether the survey population was national, subnational, or from specific communities. Diabetes defined as HbA(1c) 6 . 5% or more had a pooled sensitivity of 52 . 8% (95% CI 51 . 3-54 . 3%) and a pooled specificity of 99 . 74% (99 . 71-99 . 78%) compared with FPG 7 . 0 mmol/L or more for diagnosing previously undiagnosed participants; sensitivity compared with diabetes defined based on FPG-or-2hOGTT was 30 . 5% (28 . 7-32 . 3%). None of the preselected study-level characteristics explained the heterogeneity in the sensitivity of HbA(1c) versus FPG. Interpretation Different biomarkers and definitions for diabetes can provide different estimates of population prevalence of diabetes, and differentially identify people without previous diagnosis as having diabetes. Using an HbA(1c)-based definition alone in health surveys will not identify a substantial proportion of previously undiagnosed people who would be considered as having diabetes using a glucose-based test.
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| 46. |
- Monier-Garbet, P, et al.
(författare)
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Impurity-seeded ELMy H-modes in JET, with high density and reduced heat load
- 2005
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Ingår i: Nuclear Fusion. - : IOP Publishing. - 0029-5515 .- 1741-4326. ; 45:11, s. 1404-1410
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Tidskriftsartikel (refereegranskat)abstract
- Experiments performed at JET during the past two years show that, in high triangularity H-mode plasmas with I-p = 2.5 MA, n(e)/n(Gr) approximate to 1.0, it is possible to radiate separately up to approximate to 40% of the total injected power on closed flux surfaces in the pedestal region (argon seeding) and up to approximate to 50% of the injected power in the divertor region (nitrogen seeding), while maintaining the confinement improvement factor at the value required for ITER, H98(y, 2) 1.0. The total radiated power fraction achieved in both cases (65-70%) is close to that required for ITER. However, Type I ELMS observed with impurity seeding have the same characteristics as that observed in reference pulses without seeding: decreasing plasma energy loss per ELM with increasing pedestal collisionality. One has to reach the Type III ELM regime to decrease the transient heat load to the divertor to acceptable values for ITER, although at the expense of confinement. The feasibility of an integrated scenario with Type-III ELMS, and q(95) = 2.6 to compensate for the low H factor, has been demonstrated on JET. This scenario would meet ITER requirements at 17 MA provided that the IPB98 scaling for energy content is accurate enough, and provided that a lower dilution is obtained when operating at higher absolute electron density.
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| 47. |
- O'Neill, TW, et al.
(författare)
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Back pain, disability, and radiographic vertebral fracture in European women: a prospective study
- 2004
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Ingår i: Osteoporosis International. - : Springer Science and Business Media LLC. - 1433-2965 .- 0937-941X. ; 15:9, s. 760-765
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Tidskriftsartikel (refereegranskat)abstract
- Vertebral fractures are associated with back pain and disability. There are, however, few prospective data looking at back pain and disability following identification of radiographic vertebral fracture. The aim of this analysis was to determine the impact of radiographically identified vertebral fracture on the subsequent occurrence of back pain and disability. Women aged 50 years and over were recruited from population registers in 18 European centers for participation in the European Prospective Osteoporosis Study. Participants completed an interviewer-administered questionnaire which included questions about back pain in the past year and various activities of daily living, and they had lateral spine radiographs performed. Participants in these centers were followed prospectively and had repeat spine radiographs performed a mean of 3.7 years later. In addition they completed a questionnaire with the same baseline questions concerning back pain and activities of daily living. The presence of prevalent and incident vertebral fracture was defined using established morphometric criteria. The data were analyzed using logistic regression with back pain or disability (present or absent) at follow-up as the outcome variable with adjustment made for the baseline value of the variable. The study included 2,260 women, mean age 62.2 years. The mean time between baseline and follow-up survey was 5.0 years. Two hundred and forty participants had prevalent fractures at the baseline survey, and 85 developed incident fractures during follow-up. After adjustment for age, center, and the baseline level of disability, compared with those without baseline prevalent fracture, those with a prevalent fracture (odds ratio [OR]=1.4; 95% confidence interval [CI] 1.0 to 2.0) or an incident fracture (OR=1.7; 95% CI, 0.9 to 3.2) were more likely to report disability at follow-up, though the confidence intervals embraced unity. Those with both a prevalent and incident fracture, however, were significantly more likely to report disability at follow-up (OR=3.1; 95% CI, 1.4 to 7.0). After adjustment for age, center, and frequency of back pain at baseline, compared with those without baseline vertebral fracture, those with a prevalent fracture were no more likely to report back pain at follow-up (OR=1.2; 95%CI, 0.8 to 1.7). There was a small increased risk among those with a preexisting fracture who had sustained an incident fracture during follow-up (OR=1.6; 95%CI, 0.6 to 4.1) though the confidence intervals embraced unity. In conclusion, although there was no significant increase in the level of back pain an average of 5 years following identification of radiographic vertebral fracture, women who suffered a further fracture during follow-up experienced substantial levels of disability with impairment in key physical functions of independent living.
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| 48. |
- Solano, E. R., et al.
(författare)
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Observation of Confined Current Ribbon in JET Plasmas
- 2010
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Ingår i: Physical Review Letters. - 0031-9007 .- 1079-7114. ; 104:18, s. 185003-
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Tidskriftsartikel (refereegranskat)abstract
- We report the identification of a localized current structure inside the JET plasma. It is a field-aligned closed helical ribbon, carrying current in the same direction as the background current profile (cocurrent), rotating toroidally with the ion velocity (corotating). It appears to be located at a flat spot in the plasma pressure profile, at the top of the pedestal. The structure appears spontaneously in low density, high rotation plasmas, and can last up to 1.4 s, a time comparable to a local resistive time. It considerably delays the appearance of the first edge localized mode.
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| 49. |
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| 50. |
- Tala, T., et al.
(författare)
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Toroidal and poloidal momentum transport studies in tokamaks
- 2007
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Ingår i: Plasma Physics and Controlled Fusion. - : IOP Publishing. - 1361-6587 .- 0741-3335. ; 49:12B, s. B291-B302
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Tidskriftsartikel (refereegranskat)abstract
- The present status of understanding of toroidal and poloidal momentum transport in tokamaks is presented in this paper. Similar energy confinement and momentum confinement times, i.e. tau(E)/tau(phi)approximate to 1 have been reported on several tokamaks. It is more important though, to study the local transport both in the core and edge plasma separately as, for example, in the core plasma, a large scatter in the ratio of the local effective momentum diffusivity to the ion heat diffusivity chi(phi eff)/chi(i.eff) among different tokamaks can be found. For example, the value of effective Prandtl number is typically around chi(phi eff)/chi(i.eff)approximate to 0.2 on JET while still tau(E)/tau(phi)approximate to 1 holds. Perturbative NBI modulation experiments on JET have shown, however, that a Prandtl number chi(phi)/chi(i) of around 1 is valid if there is an additional, significant inward momentum pinch which is required to explain the amplitude and phase behaviour of the momentum perturbation. The experimental results, i.e. the high Prandtl number and pinch, are in good qualitative and to some extent also in quantitative agreement with linear gyro-kinetic simulations. In contrast to the toroidal momentum transport which is clearly anomalous, the poloidal velocity is usually believed to be neo-classical. However, experimental measurements on JET show that the carbon poloidal velocity can be an order of magnitude above the predicted value by the neo-classical theory within the ITB. These large measured poloidal velocities, employed for example in transport simulations, significantly affect the calculated radial electric field and therefore the E x B flow shear and hence modify and can significantly improve the simulation predictions. Several fluid turbulence codes have been used to identify the mechanism driving the poloidal velocity to such high values. CUTIE and TRB turbulence codes and also the Weiland model predict the existence of an anomalous poloidal velocity, peaking in the vicinity of the ITB and driven dominantly by the flow due to the Reynold's stress. It is worth noting that these codes and models treat the equilibrium in a simplified way and this affects the geodesic curvature effects and geodesic acoustic modes. The neo-classical equilibrium is calculated more accurately in the GEM code and the simulations suggest that the spin-up of poloidal velocity is a consequence of the plasma profiles steepening when the ITB grows, following in particular the growth of the toroidal velocity within the ITB.
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