Multiphysics approach to plasma neutron source modelling at the JET tokamak

A novel multiphysics methodology for the computation of realistic plasma neutron sources has been developed. The method is based on state-of-the-art plasma transport and neutron spectrum calculations, coupled with a Monte Carlo neutron transport code, bridging the gap between plasma physics and neutronics. In the paper two JET neutronics tokamak models are used to demonstrate the application of the developed plasma neutron sources and validate them. Diagnostic data for the record JET D discharge 92436 are used as input for the TRANSP code, modelling neutron emission in two external plasma heating scenarios, namely using only neutral beam injection and a combination of the latter and ion cyclotron resonance heating. Neutron spectra, based on plasma transport results, are computed using the DRESS code. The developed PLANET code package is employed to generate plasma neutron source descriptions and couple them with the MCNP code. The effects of using the developed sources in neutron transport calculations on the response of JET neutron diagnostic systems is studied and compared to the results obtained with a generic plasma neutron source. It is shown that, although there are significant differences in the emissivity profiles, spectra shape and anisotropy between the neutron sources, the integral response of the time-resolved ex-vessel neutron detectors is largely insensitive to source changes, with major relative deviations of up to several percent. However it is calculated that, due to the broadening of neutron spectra as a consequence of external plasma heating, larger differences may occur in activation of materials which have threshold reactions located at DD neutron peak energies. The PLANET plasma neutron source computational methodology is demonstrated to be suitable for detailed neutron source effect studies on JET during DT experiments and can be applied to ITER analyses

Cardiovascular Efficacy and Safety of Bococizumab in High-Risk Patients

Bococizumab is a humanized monoclonal antibody that inhibits proprotein convertase subtilisin- kexin type 9 (PCSK9) and reduces levels of low-density lipoprotein (LDL) cholesterol. We sought to evaluate the efficacy of bococizumab in patients at high cardiovascular risk. METHODS In two parallel, multinational trials with different entry criteria for LDL cholesterol levels, we randomly assigned the 27,438 patients in the combined trials to receive bococizumab (at a dose of 150 mg) subcutaneously every 2 weeks or placebo. The primary end point was nonfatal myocardial infarction, nonfatal stroke, hospitalization for unstable angina requiring urgent revascularization, or cardiovascular death; 93% of the patients were receiving statin therapy at baseline. The trials were stopped early after the sponsor elected to discontinue the development of bococizumab owing in part to the development of high rates of antidrug antibodies, as seen in data from other studies in the program. The median follow-up was 10 months. RESULTS At 14 weeks, patients in the combined trials had a mean change from baseline in LDL cholesterol levels of -56.0% in the bococizumab group and +2.9% in the placebo group, for a between-group difference of -59.0 percentage points (P<0.001) and a median reduction from baseline of 64.2% (P<0.001). In the lower-risk, shorter-duration trial (in which the patients had a baseline LDL cholesterol level of ≥70 mg per deciliter [1.8 mmol per liter] and the median follow-up was 7 months), major cardiovascular events occurred in 173 patients each in the bococizumab group and the placebo group (hazard ratio, 0.99; 95% confidence interval [CI], 0.80 to 1.22; P = 0.94). In the higher-risk, longer-duration trial (in which the patients had a baseline LDL cholesterol level of ≥100 mg per deciliter [2.6 mmol per liter] and the median follow-up was 12 months), major cardiovascular events occurred in 179 and 224 patients, respectively (hazard ratio, 0.79; 95% CI, 0.65 to 0.97; P = 0.02). The hazard ratio for the primary end point in the combined trials was 0.88 (95% CI, 0.76 to 1.02; P = 0.08). Injection-site reactions were more common in the bococizumab group than in the placebo group (10.4% vs. 1.3%, P<0.001). CONCLUSIONS In two randomized trials comparing the PCSK9 inhibitor bococizumab with placebo, bococizumab had no benefit with respect to major adverse cardiovascular events in the trial involving lower-risk patients but did have a significant benefit in the trial involving higher-risk patients

Cardiovascular Efficacy and Safety of Bococizumab in High-Risk Patients

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