Intrinsic ELMing in ASDEX Upgrade and global control system-plasma self-entrainment

It is well established that edge localized modes can be entrained to the frequency of applied global magnetic perturbations. These perturbations are delivered to the plasma using the vertical control system field coil currents. These field coils are part of an active control system that is required to maintain the plasma in a steady state. We perform time domain timeseries analysis of natural ELMing when there are no applied perturbations in the ASDEX Upgrade tokamak. We find that the plasma can transition into a state in which the control system field coil currents continually oscillate and are synchronized with oscillations in characteristic plasma parameters such as plasma edge position and total MHD energy. These synchronous oscillations have a one-to-one correlation with the naturally occurring ELMs; the ELMs all occur when the control system coil current is around a specific temporal phase. Large and small ELMs may be distinguished by the amplitude of inward movement of the edge following an ELM. Large ELMs are then found to occur preferentially around a specific temporal phase of the vertical position control coil current. Small ELMs are most likely in antiphase to this. The large and small natural ELMs occur at the opposite extrema of the oscillations in the control system vertical position control coil current. The control system coil current phase may thus provide a useful parameter to order the observed ELM dynamics. We have identified a class of natural ELMing which is a self-entrained state, in which there is a continual non-linear feedback between the global plasma dynamics and the active control system that is intrinsic to the cyclic dynamics of naturally occurring ELMs. Control system-plasma feedback thus becomes an essential component for integration into future models of natural ELM dynamics

Improvement in liver pathology of patients with β-thalassemia treated with deferasirox for at least 3 years.

International audienceBACKGROUND & AIMS: Most data on the effects of iron chelation therapy for patients with liver fibrosis come from small studies. We studied the effects of the oral iron chelator deferasirox on liver fibrosis and necroinflammation in a large population of patients with iron overload β-thalassemia. METHODS: We studied data from 219 patients with β-thalassemia, collected from histologic analyses of biopsy samples taken at baseline and after at least 3 years of treatment with deferasirox. Treatment response was assessed from liver iron concentrations at baseline and the end of the study. Liver fibrosis, necroinflammation, and markers of iron overload and liver enzymes were recorded. Patients were also assessed, by serologic analysis at baseline, for hepatitis C virus infection. RESULTS: By the end of the study, stability of Ishak fibrosis staging scores (change of -1, 0, or +1) or improvements (change of ≤-2) were observed in 82.6% of patients; Ishak necroinflammatory scores improved by a mean value of -1.3 (P<.001). Improvements in fibrosis stage and necroinflammation were independent of hepatitis C virus exposure or reduction in liver iron concentration defined by the response criteria. Absolute changes in concentrations of liver iron by the end of the study did not correlate with improved Ishak fibrosis or necroinflammatory scores. CONCLUSIONS: Deferasirox treatment for 3 or more years reversed or stabilized liver fibrosis in 83% of patients with iron-overloaded β-thalassemia. This therapeutic effect was independent of reduced concentration of liver iron (defined by the response criteria) or previous exposure to hepatitis C virus

La géographie culturelle vue d’Italie

L’Europe est un défi permanent pour conjuguer l’unité avec les diversités, qu'elles soient culturelles, nationales, politiques et linguistiques. Ce défi vaut également pour le savoir. C’est dans cet esprit que Géographie et cultures ouvre ses pages à sept géographes italiens qui font état des thèmes et tendances de la géographie culturelle dans leur pays. Le lecteur français mesurera l'étendue des différences et ressemblances sur les thèmes abordés, les approches utilisées et même sur la forme des textes

Long-term safety and efficacy of deferasirox (Exjade (R)) for up to 5 years in transfusional iron-overloaded patients with sickle cell disease

To date, there is a lack of long-term safety and efficacy data for iron chelation therapy in transfusion-dependent patients with sickle cell disease (SCD). To evaluate the long-term safety and efficacy of deferasirox (a once-daily oral iron chelator), patients with SCD completing a 1-year, Phase II, randomized, deferoxamine (DFO)-controlled study entered a 4-year extension, continuing to receive deferasirox, or switching from DFO to deferasirox. Average actual deferasirox dose was 19·4 ± 6·3 mg/kg per d. Of 185 patients who received at least one deferasirox dose, 33·5% completed the 5-year study. The most common reasons for discontinuation were withdrawal of consent (23·8%), lost to follow-up (9·2%) and adverse events (AEs) (7·6%). Investigator-assessed drug-related AEs were predominantly gastrointestinal [including nausea (14·6%), diarrhoea (10·8%)], mild-to-moderate and transient in nature. Creatinine clearance remained within the normal range throughout the study. Despite conservative initial dosing, serum ferritin levels in patients with ≥4 years deferasirox exposure significantly decreased by −591 μg/l (95% confidence intervals, −1411, −280 μg/l; P=0·027; n=67). Long-term deferasirox treatment for up to 5 years had a clinically acceptable safety profile, including maintenance of normal renal function, in patients with SCD. Iron burden was substantially reduced with appropriate dosing in patients treated for at least 4 years