First Results of the Implementation of the Doppler Backscattering Diagnostic for the Investigation of the Transition to H-Mode in the Spherical Tokamak Globus-M2

This paper presents the first results of a study of the LH transition on the new spherical Globus-M2 tokamak using the Doppler backscattering (DBS) diagnostic. New data characterizing the H-mode of discharges with higher values of the plasma parameters, such as magnetic field Bt up to 0.9 T and plasma current Ip up to 450 kA, were collected and analyzed. An upgraded neutral beam injection (NBI) system was used to initiate the LH transition. DBS allows the measurement of the poloidal rotation velocity and the turbulence amplitude of the plasma. The multi-frequency DBS system installed on Globus-M2 can simultaneously collect data in different areas spanning from the separatrix to the plasma core. This allowed for the radial profiles of the rotation velocity and electric field to be calculated before and after the LH transition. In addition, the values and temporal evolution of the velocity shear were obtained. The associated turbulence suppression after the transition to the H-mode was investigated using DBS

Clinical outcome in patients with venous thromboembolism receiving concomitant anticoagulant and antiplatelet therapy.

INTRODUCTION: Patients with arterial disease receiving antiplatelet agents may develop venous thromboembolism (VTE) and need anticoagulant therapy, although concomitant use of these drugs may increase bleeding risk. We analyzed RIETE data and compared clinical outcomes depending on decision to discontinue or maintain antiplatelet therapy at VTE diagnosis. METHODS: Consecutive patients with acute VTE were enrolled in RIETE. Only patients receiving antiplatelet therapy at baseline were included in this analysis. Primary outcomes were: rate of subsequent ischemic events, major bleeding or death during anticoagulation course. RESULTS: 1178 patients who received antiplatelet drugs at VTE diagnosis were included. Antiplatelet therapy was discontinued in 62% of patients. During anticoagulation course, patients also receiving antiplatelet therapy had higher rates of lower limb amputations (2.28 vs. 0.21 events per 100 patients-years; p<0.01), any ischemic events (5.7 vs. 2.28 events per 100 patients-years; p<0.05) or death (23.6 vs. 13.9 deaths per 100 patients-years; p<0.01). No differences in the rate of major bleeding or recurrent VTE were revealed. In matched analysis, patients on antiplatelet therapy were found to have a significantly higher rate of limb amputations (odds ratio: 15.3; 95% CI: 1.02-229) and an increased number of composite outcomes including all-cause deaths, arterial and VTE events (odds ratio: 1.46; CI: 1.03-2.06), with no differences in major bleeding rate. CONCLUSION: Concomitant anticoagulant and antiplatelet therapy in patients with VTE and arterial disease is not associated with increased risk for bleeding, recurrent VTE or death. The worse outcome observed in patients who continued antiplatelet therapy requires further investigations