► The WEST programme is a unique opportunity to experience the industrial scale manufacture of tungsten plasma-facing components similar to the ITER divertor ones. ► In Tore Supra, it will bring ...important know how for actively cooled W divertor operation. ► This can be done by a reasonable modification of the Tore Supra tokamak. ► A fast implementation of the project would make this information available in due time. ► This allows a significant contribution to the W ITER divertor risk minimization in its manufacturing and operation phase.
The WEST programme consists in transforming the Tore Supra tokamak into an X point divertor device, while taking advantage of its long discharge capability. This is obtained by inserting in vessel coils to create the X point while adapting the in-vessel elements to this new geometry. This will allow the full tungsten divertor technology to be used on ITER to be tested in anticipation of its use on ITER under relevant heat loading conditions and pulse duration. The early manufacturing of a significant industrial series of ITER-similar W plasma-facing units will contribute to the ITER divertor manufacturing risk mitigation and to that associated with early W divertor plasma operation on ITER.
► An extensive study on the integration of diagnostics in a port plug of ITER has been performed. ► It has shown that the diagnostic performances could not be reached if their number was not ...decreased. ► A design of Diagnostic Shield Modules has been validated through mechanical and thermal analyses. ► These analyses have confirmed that the highest loads are concentrated in the vicinity of the plasma.
Diagnostics in ITER are mandatory to characterize the parameters of plasma and study its interactions with plasma-facing components. Diagnostics components in the vicinity of the plasma are supported by metallic structures called port plugs. At the tokamak mid-plane, these components are installed in port plugs through intermediate structures called drawers. Apart from hosting the diagnostics, the port plugs act as shielding against neutrons and gammas, in order to limit the nuclear loads in crucial components (such as diagnostics and superconducting coils) as well as the dose levels in the controlled zones of the tokamak. The radiation shielding function of the port plugs is ensured through an optimized mixture of heavy metallic materials and water, forming shielding blocks surrounding the diagnostics and called Diagnostic Shield Modules (DSMs). These DSMs constitute the rear part of the drawers (the front part being composed of the Diagnostic First Wall). This paper presents the main results of a study performed in Europe on the integration of a particular diagnostics port plug, the Equatorial Port Plug 1 (EPP1). The paper first provides the results of the EPP1 diagnostics integration analysis. In a second step it focuses on the design of the EPP1 DSMs and summarizes the major results of a thorough set of analyses aiming at studying the DSMs behaviour under different loads, suggesting recommendations to improve their current design.
We aimed to compare closed-loop glucose control for people with type 1 diabetes undertaking high-intensity interval exercise (HIIE) versus moderate-intensity exercise (MIE).
Adults with type 1 ...diabetes established on insulin pumps undertook HIIE and MIE stages in random order during automated insulin delivery via a closed-loop system (Medtronic). Frequent venous sampling for glucose, lactate, ketones, insulin, catecholamines, cortisol, growth hormone, and glucagon levels was performed. The primary outcome was plasma glucose <4.0 mmol/L for ≥15 min, from exercise commencement to 120 min postexercise. Secondary outcomes included continuous glucose monitoring and biochemical parameters.
Twelve adults (age mean ± standard deviation 40 ± 13 years) were recruited; all completed the study. Plasma glucose of one participant fell to 3.4 mmol/L following MIE completion; no glucose levels were <4.0 mmol/L for HIIE (primary outcome). There were no glucose excursions >15.0 mmol/L for either stage. Mean (±standard error) plasma glucose did not differ between stages pre-exercise; was higher during exercise in HIIE than MIE (11.3 ± 0.5 mmol/L vs. 9.7 ± 0.6 mmol/L, respectively; P < 0.001); and remained higher until 60 min postexercise. There were no differences in circulating free insulin before, during, or postexercise. During HIIE compared with MIE, there were greater increases in lactate (P < 0.001), catecholamines (all P < 0.05), and cortisol (P < 0.001). Ketones increased more with HIIE than MIE postexercise (P = 0.031).
Preliminary findings suggest that closed-loop glucose control is safe for people undertaking HIIE and MIE. However, the management of the postexercise rise in ketones secondary to counter-regulatory hormone-induced insulin resistance observed with HIIE may represent a challenge for closed-loop systems.
To compare evening and overnight hypoglycemia risk after late afternoon exercise with a nonexercise control day in adults with type 1 diabetes using automated insulin delivery (AID).
Thirty adults ...with type 1 diabetes using AID (Minimed 670G) performed in random order 40 min high intensity interval aerobic exercise (HIE), resistance (RE), and moderate intensity aerobic exercise (MIE) exercise each separated by >1 week. The closed-loop set-point was temporarily increased 2 h pre-exercise and a snack eaten if plasma glucose was ≤126 mg/dL pre-exercise. Exercise commenced at ∼16:00. A standardized meal was eaten at ∼20:40. Hypoglycemic events were defined as a continuous glucose monitor (CGM) reading <70 mg/dL for ≥15 min. Four-hour postevening meal and overnight (00:00-06:00) CGM metrics for exercise were compared with the prior nonexercise day.
There was no severe hypoglycemia. Between 00:00 and 06:00, the proportion of nights with hypoglycemia did not differ postexercise versus control for HIE (18% vs. 11%;
= 0.688), RE (4% vs. 14%;
= 0.375), and MIE (7% vs. 14%;
= 0.625). Time in range (TIR) (70-180 mg/dL), >75% for all nights, did not differ between exercise conditions and control. Hypoglycemia episodes postmeal after exercise versus control did not differ for HIE (22% vs. 7%;
= 0.219) and MIE (10% vs. 14%;
> 0.999), but were greater post-RE (39% vs. 10%;
= 0.012).
Overnight TIR was excellent with AID without increased hypoglycemia postexercise between 00:00 and 06:00 compared with nonexercise days. In contrast, hypoglycemia risk was increased after the first meal post-RE, suggesting the importance of greater vigilance and specific guidelines for meal-time dosing, particularly with vigorous RE. ACTRN12618000905268.
Abstract Objective To compare anxiety levels experienced during 4 stressful periods of in vitro fertilization (IVF) and treatment outcomes between women taking fluoxetine and a placebo. Methods A ...prospective, randomized, double-blind, placebo-controlled trial of patients allocated to receive either fluoxetine (FLX) or folic acid (FA). Anxiety state was assessed at the beginning of ovarian stimulation (OS), ovum pick-up, embryo transfer, and on the day of the pregnancy test (DPT) using the State-Trait Anxiety Inventory (STAI). Results Baseline STAI-S and STAI-T were normal. From OS to DPT, STAI-S increased from 42.8 ± 10.6 to 44 ± 9.0 in the FLX group and from 40.9 ± 8.1 to 45.3 ± 8.3 in the FA group ( P = 0.03 and P = 0.001, respectively). IVF outcome was not affected by the treatment in the two groups. Conclusions Caution is needed in prescribing fluoxetine to alleviate anxiety in patients undergoing IVF. Studies are needed to determine whether other selective serotonin reuptake inhibitors or higher fluoxetine doses can relieve emotional distress without affecting IVF outcome.
Over the past 15 years, the economies in Central America and the Caribbean (CAC) recorded an average annual GDP growth of around 4 percent, higher than the growth rates achieved by the Latin American ...average and most developed economies, but well below most other developing regions; regions such as South Asia and sub-Saharan Africa—and countries such as China or India—exhibited average annual growth of more than 5 percent during this period. ...only three countries (Costa Rica, the Dominican Republic, and Panama) have grown above the regional average over the last 30 years, and only the former two exhibited higher than average growth rates in both analyzed periods. According to the latest UN forecasts, CAC’s demographic pyramid will be flattened by 2050, and it is therefore expected that the working-age population will see growth rates decrease to only about 1 percent per year by 2030. According to the World Bank, rapid urbanization in the region has posed several challenges including “inadequate housing, vulnerability to natural disasters, and low economic growth in urban centers.”
