Completion of the 8 MW Multi-Frequency ECRH System at ASDEX Upgrade

Over the last 15 years, the Electron Cyclotron Resonance Heating (ECRH) system at the ASDEX Upgrade tokamak has been upgraded from a 2 MW, 2 s, 140 GHz system to an 8 MW, 10 s, dual frequency system (105/140 GHz). Eight gyrotrons were in routine operation during the current experimental campaign. All gyrotrons are step-tunable operating at 105 and 140 GHz with a maximum output power of about 1 MW and 10 s pulse length. The system includes 8 transmission lines, mainly consisting of oversized corrugated waveguides (I.D. = 87 mm) with overall lengths between 50 and 70 meters including quasi-optical sections at both ends. Further improvements of the transmission lines with respect to power handling and reliability are underway

Exploring fusion-reactor physics with high-power electron cyclotron resonance heating on ASDEX Upgrade

The electron cyclotron resonance heating (ECRH) system of the ASDEX Upgrade tokomak has been upgraded over the last 15 years from a 2MW, 2 s, 140 GHz system to an 8MW, 10 s, dual frequency system (105/140 GHz). The power exceeds the L/H power threshold by at least a factor of two, even for high densities, and roughly equals the installed ion cyclotron range of frequencies power. The power of both wave heating systems together (>10MW in the plasma) is about half of the available neutral beam injection (NBI) power, allowing significant variations of torque input, of the shape of the heating profile and of Qe/Qi, even at high heating power. For applications at a low magnetic field an X3-heating scheme is routinely in use. Such a scenario is now also forseen for ITER to study the first H-modes at one third of the full field. This versatile system allows one to address important issues fundamental to a fusion reactor: H-mode operation with dominant electron heating, accessing low collisionalities in full metal devices (also related to suppression of edge localized modes with resonant magnetic perturbations), influence of Te/Ti and rotational shear on transport, and dependence of impurity accumulation on heating profiles. Experiments on all these subjects have been carried out over the last few years and will be presented in this contribution. The adjustable localized current drive capability of ECRH allows dedicated variations of the shape of the q-profile and the study of their influence on non-inductive tokamak operation (so far at q$_{95}$>5.3). The ultimate goal of these experiments is to use the experimental findings to refine theoretical models such that they allow a reliable design of operational schemes for reactor size devices. In this respect, recent studies comparing a quasi-linear approach (TGLF) with fully non-linear modeling (GENE) of non-inductive high-beta plasmas will be reported

Omecamtiv mecarbil in chronic heart failure with reduced ejection fraction, GALACTIC‐HF: baseline characteristics and comparison with contemporary clinical trials

Aims: The safety and efficacy of the novel selective cardiac myosin activator, omecamtiv mecarbil, in patients with heart failure with reduced ejection fraction (HFrEF) is tested in the Global Approach to Lowering Adverse Cardiac outcomes Through Improving Contractility in Heart Failure (GALACTIC‐HF) trial. Here we describe the baseline characteristics of participants in GALACTIC‐HF and how these compare with other contemporary trials. Methods and Results: Adults with established HFrEF, New York Heart Association functional class (NYHA) ≥ II, EF ≤35%, elevated natriuretic peptides and either current hospitalization for HF or history of hospitalization/ emergency department visit for HF within a year were randomized to either placebo or omecamtiv mecarbil (pharmacokinetic‐guided dosing: 25, 37.5 or 50 mg bid). 8256 patients [male (79%), non‐white (22%), mean age 65 years] were enrolled with a mean EF 27%, ischemic etiology in 54%, NYHA II 53% and III/IV 47%, and median NT‐proBNP 1971 pg/mL. HF therapies at baseline were among the most effectively employed in contemporary HF trials. GALACTIC‐HF randomized patients representative of recent HF registries and trials with substantial numbers of patients also having characteristics understudied in previous trials including more from North America (n = 1386), enrolled as inpatients (n = 2084), systolic blood pressure < 100 mmHg (n = 1127), estimated glomerular filtration rate < 30 mL/min/1.73 m2 (n = 528), and treated with sacubitril‐valsartan at baseline (n = 1594). Conclusions: GALACTIC‐HF enrolled a well‐treated, high‐risk population from both inpatient and outpatient settings, which will provide a definitive evaluation of the efficacy and safety of this novel therapy, as well as informing its potential future implementation

Feasibility of Using Electrocochleography for Objective Estimation of Electro-Acoustic Interactions in Cochlear Implant Recipients with Residual Hearing

Although cochlear implants (CI) traditionally have been used to treat individuals with bilateral profound sensorineural hearing loss, a recent trend is to implant individuals with residual low-frequency hearing. Patients who retain some residual acoustic hearing after surgery often can benefit from electro-acoustic stimulation (EAS) technologies, which combine conventional acoustic amplification with electrical stimulation. However, interactions between acoustic and electrical stimulation may affect outcomes adversely and are time-consuming and difficult to assess behaviorally. This study demonstrated the feasibility of using the Advanced Bionics HiRes90K Advantage implant electronics and HiFocus Mid Scala/1j electrode to measure electrocochleography (ECochG) responses in the presence of electrical stimulation to provide an objective estimate of peripheral physiologic EAS interactions. In general, electrical stimulation reduced ECochG response amplitudes to acoustic stimulation. The degree of peripheral EAS interaction varied as a function of acoustic pure tone frequency and the intra-cochlear location of the electrically stimulated electrode. Further development of this technique may serve to guide and optimize clinical EAS system fittings in the future

Design and evaluation of a cochlear implant strategy based on a "Phantom" channel.

Unbalanced bipolar stimulation, delivered using charge balanced pulses, was used to produce "Phantom stimulation", stimulation beyond the most apical contact of a cochlear implant's electrode array. The Phantom channel was allocated audio frequencies below 300 Hz in a speech coding strategy, conveying energy some two octaves lower than the clinical strategy and hence delivering the fundamental frequency of speech and of many musical tones. A group of 12 Advanced Bionics cochlear implant recipients took part in a chronic study investigating the fitting of the Phantom strategy and speech and music perception when using Phantom. The evaluation of speech in noise was performed immediately after fitting Phantom for the first time (Session 1) and after one month of take-home experience (Session 2). A repeated measures of analysis of variance (ANOVA) within factors strategy (Clinical, Phantom) and interaction time (Session 1, Session 2) revealed a significant effect for the interaction time and strategy. Phantom obtained a significant improvement in speech intelligibility after one month of use. Furthermore, a trend towards a better performance with Phantom (48%) with respect to F120 (37%) after 1 month of use failed to reach significance after type 1 error correction. Questionnaire results show a preference for Phantom when listening to music, likely driven by an improved balance between high and low frequencies

Results for the HSM sentence test during the second session.

<p>No significant difference was observed after Bonferroni correction (paired t-test p = 0.034).</p

Results for the question about the “overall impression” of music.

<p>The Phantom strategy was rated to sound significantly better than F120 (wilcoxon signed rank test p = 0.037).</p

Schematic illustration of the Phantom effect for <i>σ</i> = 0 (a) and <i>σ</i> = 0.625 (b) on pitch perception.

<p>The electrical field is simulated using triangular functions and assuming linear superposition of the electrical field produced by each electrode. The center of masses of the electrical field is assumed to be related to the pitch elicited by the stimulation. Using Phantom stimulation it is possible to push the electrical field away from the most apical electrode.</p

Stimulation pattern for one cycle of Phantom strategy stimulation.

<p>CSR is the Channel Stimulation Rate for one electrode. In the Phantom strategy, the electrode contacts 1 and 2 are stimulated simultaneously but out of phase prior to stimulating the rest of analysis bands using the standard in phase current steering technique.</p

Subject demographics.

<p>Subject demographics.</p