Bronchiectasis is a multidimensional disease associated with substantial morbidity and mortality. Two disease-specific clinical prediction tools have been developed, the Bronchiectasis Severity Index ...(BSI) and the FACED score, both of which stratify patients into severity risk categories to predict the probability of mortality.
We aimed to compare the predictive utility of BSI and FACED in assessing clinically relevant disease outcomes across seven European cohorts independent of their original validation studies.
The combined cohorts totalled 1612. Pooled analysis showed that both scores had a good discriminatory predictive value for mortality (pooled area under the curve (AUC) 0.76, 95% CI 0.74 to 0.78 for both scores) with the BSI demonstrating a higher sensitivity (65% vs 28%) but lower specificity (70% vs 93%) compared with the FACED score. Calibration analysis suggested that the BSI performed consistently well across all cohorts, while FACED consistently overestimated mortality in 'severe' patients (pooled OR 0.33 (0.23 to 0.48), p<0.0001). The BSI accurately predicted hospitalisations (pooled AUC 0.82, 95% CI 0.78 to 0.84), exacerbations, quality of life (QoL) and respiratory symptoms across all risk categories. FACED had poor discrimination for hospital admissions (pooled AUC 0.65, 95% CI 0.63 to 0.67) with low sensitivity at 16% and did not consistently predict future risk of exacerbations, QoL or respiratory symptoms. No association was observed with FACED and 6 min walk distance (6MWD) or lung function decline.
The BSI accurately predicts mortality, hospital admissions, exacerbations, QoL, respiratory symptoms, 6MWD and lung function decline in bronchiectasis, providing a clinically relevant evaluation of disease severity.
Abstract
Consorzio RFX and INFN-LNL have designed, built and operated the compact radiofrequency negative ion source NIO1 (Negative Ion Optimization phase 1) with the aim of studying the production ...and acceleration of H
-
ions. In particular, NIO1 was designed to keep plasma generation and beam extraction continuously active for several hours. Since 2020 the production of negative ions at the plasma grid (the first grid of the acceleration system) has been enhanced by a Cs layer, deposited though active Cs evaporation in the source volume. For the negative ion sources applied to fusion neutral beam injectors, it is essential to keep the beam current and the fraction of co-extracted electrons stable for at least 1 h, against the consequences of Cs sputtering and redistribution operated by the plasma. The paper presents the latest results of the NIO1 source, in terms of caesiation process and beam performances during continuous (6 ÷ 7 h) plasma pulses. Due to the small dimensions of the NIO1 source (20 cm×∅10 cm), the Cs density in the volume is high (10
15
÷ 10
16
m
-3
) and dominated by plasma-wall interaction. The maximum beam current density and minimum fraction of co-extracted electrons were respectively about 30 A/m
2
and 2. Similarly to what done in other negative ion sources, the plasma grid temperature in NIO1 was raised for the first time, up to 80 °C, although this led to a minimal improvement of the beam current and to an increase of the co-extracted electron current.
Abstract The experimental fusion reactor ITER will feature two (or three) heating neutral beam injectors (NBI) capable of delivering 33(or 50) MW of power into the plasma. A NBI consists of a plasma ...source for production of negative ions (extracted negative ion current up to 329 A/m 2 in H and 285 A/m 2 in D) then accelerated up to 1 MeV for one hour. The negative ion beam is neutralized, and the residual ions are electrostatically removed before injection. The beamline was designed for a beam divergence between 3 and 7 mrad. The ion source in ITER NBIs relies on RF-driven, Inductively-Coupled Plasmas (ICP), based on the prototypes developed at IPP Garching; RF-driven negative-ion beam sources have never been employed in fusion devices up to now. The recent results of SPIDER, the full size ITER NBI ion source operating at NBTF in Consorzio RFX, Padova, measure a beamlet divergence minimum of 12mrad and highlighted beam spatial non-uniformity. SPIDER results confirmed the experimental divergence found in smaller prototype sources, which is larger compared to filament-arc ion sources. Although prototype experiments have shown that the extracted current requirement can be achieved with minor design improvements, the beamlet divergence is expected to marginally achieve the design value of 7 mrad, which in multi-grid long accelerators results in unexpected heat loads over the accelerator grids. A contributor to the beam divergence is the energy/temperature of the extracted negative ions, so it is believed that plasma differences between the two source types play a role. Research is focused on the plasma parameters in the ion source. One RF driver, identical to the ones used in SPIDER, installed in a relatively small-scale experimental set-up, inherently more flexible than large devices, is starting operations devoted to the investigation of the properties of RF-generated plasmas, so as to contribute to the assessment of negative ion precursors, and of their relationship with the plasma parameters, particularly when enhancing plasma confinement. The scientific questions, that have arisen from the preliminary results of SPIDER, guided the design of the test stand, which are described in this contribution, together with the diagnostic systems and related simulation tools. The test stand, which shares with the larger experiment all the geometrical features and constraints, will allow technological developments and optimized engineering solutions related to the ICP design for the ITER NBIs.
The ion source NIO1 (Negative Ion Optimization 1) is a versatile multiaperture H− source capable of continuous regime operation, with the plasma generated by a 2 MHz/2.5 kW radiofrequency (rf) power ...supply and extraction of nine beamlets. It aims to partly reproduce the conditions of much larger ion sources, built or in construction for the neutral beam injectors of fusion devices, in a compact and modular ion source, where effects of individual source components can be rapidly verified and compared to simulation code results. Several modifications of the magnetic configuration (both inside the ion source and the embedded magnets inside the accelerator grids) were investigated. Saturation of beneficial effect of filter field at large strength (>0.01 T) leads us to use softer magnetic filters, and the advantages of a crossed deflection field are noted. The rf system takes full advantage of the generator bandwidth (0/ + 20 kHz used). The result database and the integration of major diagnostic systems with the control system are also summarized, with some details on voltage holding and beam uniformity.
Source for production of ion of deuterium extracted from rf plasma (SPIDER) is the 100 keV negative ion source prototype of the ITER neutral beam injector. The cooling plant is one of the SPIDER ...auxiliary systems where ultrapure water (UPW) is used as the cooling media, thanks to its advantageous properties such as good cooling performance and high resistivity. Water resistivity needs to be maintained above certain values during SPIDER operation to enable the electrical insulation of in-vessel components that operate at different voltages. Nonetheless, degradation of water resistivity was observed in some circuits during operation. Water resistivity degradation had a negative impact on the SPIDER experimental campaign since it limits cooling plant availability. To understand the cause for the observed water degradation, sampling points were installed to sample water during operation. Ad hoc experiments have been performed on the worst affected circuit, and water samples were analyzed by inductively coupled plasma mass spectrometry (ICP-MS). Circulation experiments were conducted at constant temperature, pressure, and flow rate to assess water degradation by monitoring water conductivity increase. ICP-MS analyses on water from the worst affected circuit revealed the presence of Cu in relevant quantities and Zn. Corrosion induced by the presence of a non-compatible component with SPIDER requirements was found. The identified component was made of a galvanized steel plate, carbon steel, and brass. This was found responsible for the contamination of the cooling loop and its water properties' degradation.
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