A Randomized, Controlled Clinical Trial Comparing Efficacy, Safety and Cost Effectiveness of Lornoxicam with Diclofenac Sodium in Patients of Osteoarthritis Knee

Osteoarthritis is a chronic painful condition affecting larger joints; mostcommonly knee joint. Pharmacological control of pain is the mainstay of management of osteoarthritis. Many patientsfail to achieve satisfactory reduction in pain with one of the most commonly prescribed drugs, diclofenac sodium, even after maximum daily allowed doses. Lornoxicam is a newer molecule in the Indian market promising better pain relief incontext of low back pain and post knee replacement surgery pain as compared to standard therapies. As per profile of lornoxicam, if it is better than diclofenac sodium then it will be helpful in managing the patients of osteoarthritis more effectively. Till date no comparative clinical trial has been done to compare these two drugs for the management ofosteoarthritis knee. So, to evaluate the same we carried out this study to compare safety, efficacy and cost effectiveness of lornoxicam and diclofenac sodium in relieving pain in patients of osteoarthritis knee. This study is a randomized, open labeled, controlled clinical trial having 40 newly diagnosed patients with osteoarthritis knee. After random allocationinto two groups i.e. group D and group L (each having 20 patients); group D received diclofenac sodium 50 mg 12 hourly and group L received lornoxicam 4 mg 8 hourly for a period of 3 months. All patients were assessed with visual analogue scale and 100 meter walking test before starting of therapy, at 15 days and at 1, 2 and 3 months of therapy.Adverse drug reactions and cost of therapy was monitored during the study period. Mean decrease in visual analogue scale and time of 100 meter walking test was statistically significant in lornoxicam group as compared to diclofenac sodium. Gastric irritation was reported in one patient from group L and two patients from group D. Lornoxicam significantly relieves pain of osteoarthritis knee than diclofenac sodium without adversely affecting the tolerability to the patients

A new mechanism for increasing density peaking in tokamaks: improvement of the inward particle pinch with edge E x B shearing

Developing successful tokamak operation scenarios, as well as confident extrapolation of present-day knowledge requires a rigorous understanding of plasma turbulence, which largely determines the quality of the confinement. In particular, accurate particle transport predictions are essential due to the strong dependence of fusion power or bootstrap current on the particle density details. Here, gyrokinetic turbulence simulations are performed with physics inputs taken from a JET power scan, for which a relatively weak degradation of energy confinement and a significant density peaking is obtained with increasing input power. This way physics parameters that lead to such increase in the density peaking shall be elucidated. While well-known candidates, such as the collisionality, previously found in other studies are also recovered in this study, it is furthermore found that edge E x B shearing may adopt a crucial role by enhancing the inward pinch. These results may indicate that a plasma with rotational shear could develop a stronger density peaking as compared to a non-rotating one, because its inward convection is increased compared to the outward diffusive particle flux as long as this rotation has a significant on E x B flow shear stabilization. The possibly significant implications for future devices, which will exhibit much less torque compared to present day experiments, are discussed

First principles and integrated modelling achievements towards trustful fusion power predictions for JET and ITER

Predictability of burning plasmas is a key issue for designing and building credible future fusion devices. In this context, an important effort of physics understanding and guidance is being carried out in parallel to JET experimental campaigns in H and D by performing analyses and modelling towards an improvement of the understanding of DT physics for the optimization of the JET-DT neutron yield and fusion born alpha particle physics. Extrapolations to JET-DT from recent experiments using the maximum power available have been performed including some of the most sophisticated codes and a broad selection of models. There is a general agreement that 11-15 MW of fusion power can be expected in DT for the hybrid and baseline scenarios. On the other hand, in high beta, torque and fast ion fraction conditions, isotope effects could be favourable leading to higher fusion yield. It is shown that alpha particles related physics, such as TAE destabilization or fusion power electron heating, could be studied in ITER relevant JET-DT plasmas

Deep neural networks for plasma tomography with applications to JET and COMPASS

Convolutional neural networks (CNNs) have found applications in many image processing tasks, such as feature extraction, image classification, and object recognition. It has also been shown that the inverse of CNNs, so-called deconvolutional neural networks, can be used for inverse problems such as plasma tomography. In essence, plasma tomography consists in reconstructing the 2D plasma profile on a poloidal cross-section of a fusion device, based on line-integrated measurements from multiple radiation detectors. Since the reconstruction process is computationally intensive, a deconvolutional neural network trained to produce the same results will yield a significant computational speedup, at the expense of a small error which can be assessed using different metrics. In this work, we discuss the design principles behind such networks, including the use of multiple layers, how they can be stacked, and how their dimensions can be tuned according to the number of detectors and the desired tomographic resolution for a given fusion device. We describe the application of such networks at JET and COMPASS, where at JET we use the bolometer system, and at COMPASS we use the soft X-ray diagnostic based on photodiode arrays

Ion cyclotron resonance heating scenarios for DEMO

The present paper offers an overview of the potential of ion cyclotron resonance heating (ICRH) or radio frequency heating for the DEMO machine. It is found that various suitable heating schemes are available. Similar to ITER and in view of the limited bandwidth of about 10 MHz that can be achieved to ensure optimal functioning of the launcher, it is proposed to make core second harmonic tritium heating the key ion heating scheme, assisted by fundamental cyclotron heating He-3 in the early phase of the discharge; for the present design of DEMO-with a static magnetic field strength of B-o = 5.855 T-that places the T and 3He layers in the core for f = 60 MHz and suggests centering the bandwidth around that main operating frequency. In line with earlier studies for hot, dense plasmas in large-size magnetic confinement machines, it is shown that good single pass absorption is achieved but that the size as well as the operating density and temperature of the machine cause the electrons to absorb a non-negligible fraction of the power away from the core when core ion heating is aimed at. Current drive and alternative heating options are briefly discussed and a dedicated computation is done for the traveling wave antenna, proposed for DEMO in view of its compatibility with substantial antenna-plasma distances. The various tasks that ICRH can fulfill are briefly listed. Finally, the impact of transport and the sensitivity of the obtained results to changes in the machine parameters is commented on

Synthetic diagnostic for the JET scintillator probe lost alpha measurements

A synthetic diagnostic has been developed for the JET lost alpha scintillator probe, based on the ASCOT fast ion orbit following code and the AFSI fusion source code. The synthetic diagnostic models the velocity space distribution of lost fusion products in the scintillator probe. Validation with experimental measurements is presented, where the synthetic diagnostic is shown to predict the gyroradius and pitch angle of lost DD protons and tritons. Additionally, the synthetic diagnostic reproduces relative differences in total loss rates in multiple phases of the discharge, which can be used as a basis for total loss rate predictions

Role of fast ion pressure in the isotope effect in JET L-mode plasmas

This paper presents results of JET ITER-like wall L-mode experiments in hydrogen and deuterium (D) plasmas, dedicated to the study of the isotope dependence of ion heat transport by determination of the ion critical gradient and stiffness by varying the ion cyclotron resonance heating power deposition. When no strong role of fast ions in the plasma core is expected, the main difference between the two isotope plasmas is determined by the plasma edge and the core behavior is consistent with a gyro-Bohm scaling. When the heating power (and the fast ion pressure) is increased, in addition to the difference in the edge region, also the plasma core shows substantial changes. The stabilization of ion heat transport by fast ions, clearly visible in D plasmas, appears to be weaker in H plasmas, resulting in a higher ion heat flux in H with apparent anti-gyro-Bohm mass scaling. The difference is found to be caused by the different fast ion pressure between H and D plasmas, related to the heating power settings and to the different fast ion slowing down time, and is completely accounted for in non-linear gyrokinetic simulations. The application of the TGLF quasi-linear model to this set of data is also discussed

Recurrence Plots for Dynamic Analysis of Type-I ELMs at JET With a Carbon Wall

In this paper, the dynamic characteristics of type-I edge-localized modes (ELM) time series from the JET tokamak, the world's largest magnetic confinement plasma physics experiment, have been investigated through recurrence plots (RPs). The analysis has been focused on RPs of pedestal temperature, line averaged electron density, and outer divertor D-alpha time series during experiments with a carbon wall. The analysis of RPS shows the patterns similar to those characteristics of signals exhibiting type-2 intermittency, in particular, a characteristic kite-like shape; this gives useful hints to model the temperature signal as well as the D-alpha radiation time series, with simple nonlinear maps capturing the nearly periodic behavior of type-I ELMs

Interpretative and predictive modelling of Joint European Torus collisionality scans

Transport modelling of Joint European Torus (JET) dimensionless collisionality scaling experiments in various operational scenarios is presented. Interpretative simulations at a fixed radial position are combined with predictive JETTO simulations of temperatures and densities, using the TGLF transport model. The model includes electromagnetic effects and collisions as well as (E)over-right-arrow x (b)over-right-arrow shear in Miller geometry. Focus is on particle transport and the role of the neutral beam injection (NBI) particle source for the density peaking. The experimental 3-point collisionality scans include L-mode, and H-mode (D and H and higher beta D plasma) plasmas in a total of 12 discharges. Experimental results presented in (Tala et al 2017 44th EPS Conf.) indicate that for the H-mode scans, the NBI particle source plays an important role for the density peaking, whereas for the L-mode scan, the influence of the particle source is small. In general, both the interpretative and predictive transport simulations support the experimental conclusions on the role of the NBI particle source for the 12 JET discharges

Overview of JET results for optimising ITER operation

The JET 2019-2020 scientific and technological programme exploited the results of years of concerted scientific and engineering work, including the ITER-like wall (ILW: Be wall and W divertor) installed in 2010, improved diagnostic capabilities now fully available, a major neutral beam injection upgrade providing record power in 2019-2020, and tested the technical and procedural preparation for safe operation with tritium. Research along three complementary axes yielded a wealth of new results. Firstly, the JET plasma programme delivered scenarios suitable for high fusion power and alpha particle (alpha) physics in the coming D-T campaign (DTE2), with record sustained neutron rates, as well as plasmas for clarifying the impact of isotope mass on plasma core, edge and plasma-wall interactions, and for ITER pre-fusion power operation. The efficacy of the newly installed shattered pellet injector for mitigating disruption forces and runaway electrons was demonstrated. Secondly, research on the consequences of long-term exposure to JET-ILW plasma was completed, with emphasis on wall damage and fuel retention, and with analyses of wall materials and dust particles that will help validate assumptions and codes for design and operation of ITER and DEMO. Thirdly, the nuclear technology programme aiming to deliver maximum technological return from operations in D, T and D-T benefited from the highest D-D neutron yield in years, securing results for validating radiation transport and activation codes, and nuclear data for ITER