Planar wire array performance scaling at multi-MA levels on the Saturn generator.

A series of twelve shots were performed on the Saturn generator in order to conduct an initial evaluation of the planar wire array z-pinch concept at multi-MA current levels. Planar wire arrays, in which all wires lie in a single plane, could offer advantages over standard cylindrical wire arrays for driving hohlraums for inertial confinement fusion studies as the surface area of the electrodes in the load region (which serve as hohlraum walls) may be substantially reduced. In these experiments, mass and array width scans were performed using tungsten wires. A maximum total radiated x-ray power of 10 {+-} 2 TW was observed with 20 mm wide arrays imploding in {approx}100 ns at a load current of {approx}3 MA, limited by the high inductance. Decreased power in the 4-6 TW range was observed at the smallest width studied (8 mm). 10 kJ of Al K-shell x-rays were obtained in one Al planar array fielded. This report will discuss the zero-dimensional calculations used to design the loads, the results of the experiments, and potential future research to determine if planar wire arrays will continue to scale favorably at current levels typical of the Z machine. Implosion dynamics will be discussed, including x-ray self-emission imaging used to infer the velocity of the implosion front and the potential role of trailing mass. Resistive heating has been previously cited as the cause for enhanced yields observed in excess of jxB-coupled energy. The analysis presented in this report suggests that jxB-coupled energy may explain as much as the energy in the first x-ray pulse but not the total yield, which is similar to our present understanding of cylindrical wire array behavior

Compact Wire Array Sources: Power Scaling and Implosion Physics.

A series of ten shots were performed on the Saturn generator in short pulse mode in order to study planar and small-diameter cylindrical tungsten wire arrays at {approx}5 MA current levels and 50-60 ns implosion times as candidates for compact z-pinch radiation sources. A new vacuum hohlraum configuration has been proposed in which multiple z pinches are driven in parallel by a pulsed power generator. Each pinch resides in a separate return current cage, serving also as a primary hohlraum. A collection of such radiation sources surround a compact secondary hohlraum, which may potentially provide an attractive Planckian radiation source or house an inertial confinement fusion fuel capsule. Prior to studying this concept experimentally or numerically, advanced compact wire array loads must be developed and their scaling behavior understood. The 2008 Saturn planar array experiments extend the data set presented in Ref. [1], which studied planar arrays at {approx}3 MA, 100 ns in Saturn long pulse mode. Planar wire array power and yield scaling studies now include current levels directly applicable to multi-pinch experiments that could be performed on the 25 MA Z machine. A maximum total x-ray power of 15 TW (250 kJ in the main pulse, 330 kJ total yield) was observed with a 12-mm-wide planar array at 5.3 MA, 52 ns. The full data set indicates power scaling that is sub-quadratic with load current, while total and main pulse yields are closer to quadratic; these trends are similar to observations of compact cylindrical tungsten arrays on Z. We continue the investigation of energy coupling in these short pulse Saturn experiments using zero-dimensional-type implosion modeling and pinhole imaging, indicating 16 cm/?s implosion velocity in a 12-mm-wide array. The same phenomena of significant trailing mass and evidence for resistive heating are observed at 5 MA as at 3 MA. 17 kJ of Al K-shell radiation was obtained in one Al planar array fielded at 5.5 MA, 57 ns and we compare this to cylindrical array results in the context of a K-shell yield scaling model. We have also performed an initial study of compact 3 mm diameter cylindrical wire arrays, which are alternate candidates for a multi-pinch vacuum hohlraum concept. These massive 3.4 and 6 mg/cm loads may have been impacted by opacity, producing a maximum x-ray power of 7 TW at 4.5 MA, 45 ns. Future research directions in compact x-ray sources are discussed

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to <90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], >300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of <15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P<0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P<0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Characterization of the time evolution of a microsecond electron beam diode with anode effects.

The time-evolution of a low aspect ratio, microsecond pulse length, electron beam diode with anode plasmas, operating at initial current densities of $\\approx$100 A/cm$\\sp2$, is studied using a variety of experimental and empirical techniques. Results for extensive diode current and voltage modeling, time-resolved spectroscopy (2000-7000 A) of the diode plasma, a time-resolved Cerenkov, beam-profile diagnostic, Faraday cup measurements, are reported. The theory of laminar flow in planar diodes with ions has also been extended. Very rapid cathode plasma closure velocities of from 8-11 cu/$\\mu$s were obtained, using a variety of techniques. This expansion leads to rapid 'self-filling' of the diode, principally on-axis, causing dense plasma formation from the anode, probably due to anode spot mechanisms. Due to the low aspect ratio diode design, many kA of electron current are still emitted, which interact with the plasma which has filled the diode from both the cathode and anode. Before self-filling, a low effective charge cathode plasma is observed, consisting almost exclusively of components derived from hydrocarbon surface impurities rather than substrate material (aluminum primarily). Evidence for cathode plasma instabilities are also noted. After self-filling, evidence for a beam-plasma interaction leading to RF emission, beam filamentation and collective effects are suggested. A highly ionized carbon plasma (up to CIV) was observed (T$\\rm\\sb{e} >$ 7 ev, n$\\rm\\sb{e} \\approx$ 10$\\sp{16}$ cm$\\sp{-3}$), possibly due to enhanced deposition/ionization from the beam-plasma interaction. Both active (laser deflection) and passive (spectroscopy) plasma diagnostics were used to investigate the diode plasma properties and motion, and complement each other well. The deflection diagnostic is noted as an extremely useful tool for investigating diode plasmas. In this work, the results of the laser probing technique are more reliable than those of spectroscopy. The spectroscopic technique, as applied in this work, is not very reliable, since cathode and anode plasma components may be similar. Empirical techniques to determine the cathode plasma motion, based on modeling of the diode voltage and current were the least reliable.Ph.D.Plasma physicsNuclear engineeringUniversity of Michiganhttp://deepblue.lib.umich.edu/bitstream/2027.42/162176/1/8920519.pd

Integration of MHD load models with circuit representations the Z generator.

MHD models of imploding loads fielded on the Z accelerator are typically driven by reduced or simplified circuit representations of the generator. The performance of many of the imploding loads is critically dependent on the current and power delivered to them, so may be strongly influenced by the generators response to their implosion. Current losses diagnosed in the transmission lines approaching the load are further known to limit the energy delivery, while exhibiting some load dependence. Through comparing the convolute performance of a wide variety of short pulse Z loads we parameterize a convolute loss resistance applicable between different experiments. We incorporate this, and other current loss terms into a transmission line representation of the Z vacuum section. We then apply this model to study the current delivery to a wide variety of wire array and MagLif style liner loads

Integration of MHD load models with circuit representations the Z generator.

MHD models of imploding loads fielded on the Z accelerator are typically driven by reduced or simplified circuit representations of the generator. The performance of many of the imploding loads is critically dependent on the current and power delivered to them, so may be strongly influenced by the generators response to their implosion. Current losses diagnosed in the transmission lines approaching the load are further known to limit the energy delivery, while exhibiting some load dependence. Through comparing the convolute performance of a wide variety of short pulse Z loads we parameterize a convolute loss resistance applicable between different experiments. We incorporate this, and other current loss terms into a transmission line representation of the Z vacuum section. We then apply this model to study the current delivery to a wide variety of wire array and MagLif style liner loads

Technique [Volume 89, Issue 28]

A global trek with view from TechAll Div. I sports need support, not just b-ballAtlanta's Indigo Girls release new true-to-self CD/DVDBand helps Cagers keep "pep" in their stepBaseball team improves record with UGA upsetBeyond the White and GoldBreaking the BubbleBuzzPort implements system upgradesby the numbersCampus Research ReviewCelebrating Teaching Day showcases Tech's education effortsCommittee tables grade substitution proposalCouncil Clippings Senate and HouseEntertainment BriefsFaces at Georgia TechFaces n the CrowdFire strikes Home Park residencesHanks, Wayans deliver empty comedy with LadykillersJFC's actions lack professionalism, respectNCAA Tournament NotebookNews BriefsNew system offers degree trackingNot quite Clerks, still feels like SmithOUR VIEWS Consensus OpinionOUR VIEWS Hot or NotPresidential hopefuls face off in debateRamblin' with Philip PerrySoftball team makes trip to quarterfinals of Buzz ClassicSport ShortsStudent activity fee budget releasedStudents get down, get funky at first-ever Dance MarathonTech faces Wolf Pack in Sweet 16Tishamingo's self-titled album provides quality southern rock...Two BitsYOUR VIEWS Letters to the Edito