Renal replacement therapy in Europe : A summary of the 2013 ERA-EDTA Registry Annual Report with a focus on diabetes mellitus

Publisher Copyright: © The Author 2016. Published by Oxford University Press on behalf of ERA-EDTA.Background: This article provides a summary of the 2013 European Renal Association-European Dialysis and Transplant Association (ERA-EDTA) Registry Annual Report (available at http://www.era-edta-reg.org), with a focus on patients with diabetes mellitus (DM) as the cause of end-stage renal disease (ESRD). Methods: In 2015, the ERA-EDTA Registry received data on renal replacement therapy (RRT) for ESRD from 49 national or regional renal registries in 34 countries in Europe and bordering the Mediterranean Sea. Individual patient datawere provided by 31 registries, while 18 registries provided aggregated data. The total population covered by the participating registries comprised 650 million people. Results: In total, 72 933 patients started RRT for ESRD within the countries and regions reporting to the ERA-EDTA Registry, resulting in an overall incidence of 112 per million population (pmp). The overall prevalence on 31 December 2013was 738 pmp (n = 478 990). Patients with DM as the cause of ESRD comprised 24% of the incident RRT patients (26 pmp) and 17% of the prevalent RRT patients (122 pmp).Whencompared with the USA, the incidence of patients starting RRTpmpsecondary toDMin Europe was five times lower and the incidence of RRT due to other causes of ESRD was two times lower. Overall, 19 426 kidney transplants were performed (30 pmp). The 5-year adjusted survival for all RRT patients was 60.9% [95% confidence interval (CI) 60.5-61.3] and 50.6% (95% CI 49.9-51.2) for patients with DM as the cause of ESRD.publishersversionPeer reviewe

On the mechanisms governing gas penetration into a tokamak plasma during a massive gas injection

A new 1D radial fluid code, IMAGINE, is used to simulate the penetration of gas into a tokamak plasma during a massive gas injection (MGI). The main result is that the gas is in general strongly braked as it reaches the plasma, due to mechanisms related to charge exchange and (to a smaller extent) recombination. As a result, only a fraction of the gas penetrates into the plasma. Also, a shock wave is created in the gas which propagates away from the plasma, braking and compressing the incoming gas. Simulation results are quantitatively consistent, at least in terms of orders of magnitude, with experimental data for a D 2 MGI into a JET Ohmic plasma. Simulations of MGI into the background plasma surrounding a runaway electron beam show that if the background electron density is too high, the gas may not penetrate, suggesting a possible explanation for the recent results of Reux et al in JET (2015 Nucl. Fusion 55 093013)

Ion cyclotron resonance heating for tungsten control in various JET H-mode scenarios

Ion cyclotron resonance heating (ICRH) in the hydrogen minority scheme provides central ion heating and acts favorably on the core tungsten transport. Full wave modeling shows that, at medium power level (4 MW), after collisional redistribution, the ratio of power transferred to the ions and the electrons vary little with the minority (hydrogen) concentration n H/n e but the high-Z impurity screening provided by the fast ions temperature increases with the concentration. The power radiated by tungsten in the core of the JET discharges has been analyzed on a large database covering the 2013-2014 campaign. In the baseline scenario with moderate plasma current (I p = 2.5 MA) ICRH modifies efficiently tungsten transport to avoid its accumulation in the plasma centre and, when the ICRH power is increased, the tungsten radiation peaking evolves as predicted by the neo-classical theory. At higher current (3-4 MA), tungsten accumulation can be only avoided with 5 MW of ICRH power with high gas injection rate. For discharges in the hybrid scenario, the strong initial peaking of the density leads to strong tungsten accumulation. When this initial density peaking is slightly reduced, with an ICRH power in excess of 4 MW,very low tungsten concentration in the core (∼10-5) is maintained for 3 s. MHD activity plays a key role in tungsten transport and modulation of the tungsten radiation during a sawtooth cycle is correlated to the fishbone activity triggered by the fast ion pressure gradient

Effect of PFC Recycling Conditions on JET Pedestal Density

There is experimental evidence that the pedestal dynamics in type-I ELMy H-mode discharges is significantly affected by a change in the recycling conditions at the tungsten plasma-facing components (W-PFCs) after an ELM event. The integrated code JINTRAC has been employed to assess the impact of recycling conditions during type-I ELMs in JET ITER-like wall H-mode discharges. By employing a heuristic approach, a model to mimic the physical processes leading to formation and release (i.e. outgassing) of finite near-surface fuel reservoirs in W-PFCs has been implemented into the EDGE2D-EIRENE plasma-wall interaction code being part of JINTRAC. As main result it is shown, that a delay in the density pedestal build-up after an ELM event can be provoked by reduced recycling induced by depleted W-PFC particle near-surface reservoirs. However the pedestal temperature evolution is barely affected by the change in recycling parameters suggesting that the presented model is incomplete

JET experience on managing radioactive waste and implications for ITER

The reduced radiotoxicity and half-life of radioactive waste arisings from nuclear fusion reactors as compared to current fission reactors is one of the key benefits of nuclear fusion. As a result of the research programme at the Joint European Torus (JET), significant experience on the management of radioactive waste has been gained which will be of benefit to ITER and the nuclear fusion community.The successful management of radioactive waste is dependent on accurate and efficient tracking and characterisation of waste streams. To accomplish this all items at JET which are removed from radiological areas are identified and pre-characterised, by recording the radiological history, before being removed from or moved between radiological areas. This system ensures a history of each item is available when it is finally consigned as radioactive waste and also allows detailed forecasting of future arisings. All radioactive waste generated as part of JET operations is transferred to dedicated, on-site, handling facilities for further sorting, sampling and final streaming for off-site disposal. Tritium extraction techniques including leaching, combustion and thermal treatment followed by liquid scintillation counting are used to determine tritium content.Recent changes to government legislation and Culham specific disposal permit conditions have allowed CCFE to adopt additional disposal routes for fusion wastes requiring new treatment and analysis techniques. Facilities currently under construction include a water de-tritiation facility and a materials de-tritiation facility, both of which are relevant for ITER. The procedures used to manage radioactive waste from generation to off-site disposal have been assessed for relevance to ITER and a number have been shown to be significant. The procedures and de-tritiation factors demonstrated by radioactive waste treatment plants currently under construction will be important to tritium recovery and waste minimisation in ITER and DEMO

COREDIV and SOLPS Numerical Simulations of the Nitrogen Seeded JET ILW L-mode Discharges

In this paper we present the comparison of simulations with the numerical codes COREDIV and SOLPS5.0 for JET L-mode discharges with ITER like wall (ILW). The simulations have been performed for L-mode shots with and without nitrogen seeding (#82291 - 9) which are characterised by relatively low auxiliary heating power (PNBI = 1.1 MW) and low electron density (ne = 2.35 × 1019 m–3). Comparisons are made to the experimental measurements (e.g. radiation levels, plasma profiles) and the differences between the results from the two codes (e.g. temperature and density profiles at the outer divertor plate) are shown and discussed

An FPGA-based bolometer for the MAST-U Super-X divertor

A new resistive bolometer system has been developed for MAST-Upgrade. It will measure radiated power in the new Super-X divertor, with millisecond time resolution, along 16 vertical and 16 horizontal lines of sight. The system uses a Xilinx Zynq-7000 series Field-Programmable Gate Array (FPGA) in the D-TACQ ACQ2106 carrier to perform real time data acquisition and signal processing. The FPGA enables AC-synchronous detection using high performance digital filtering to achieve a high signal-to-noise ratio and will be able to output processed data in real time with millisecond latency. The system has been installed on 8 previously unused channels of the JET vertical bolometer system. Initial results suggest good agreement with data from existing vertical channels but with higher bandwidth and signal-to-noise ratio

Sawtooth pacing with on-axis ICRH modulation in JET-ILW

A novel technique for sawteeth control in tokamak plasmas using ion-cyclotron resonance heating (ICRH) has been developed in the JET-ILW tokamak. Unlike previous ICRH methods, that explored the destabilization of the internal kink mode when the radio-frequency (RF) wave absorption was placed near the q = 1 surface, the technique presented here consists of stabilizing the sawteeth as fast as possible by applying the ICRH power centrally and subsequently induce a sawtooth crash by switching it off at the appropriate instant. The validation of this method in JET-ILW L-mode discharges, including preliminary tests in H-mode plasmas, is presented

Hybrid cancellation of ripple disturbances arising in AC/DC converters

In AC/DC converters, a peculiar periodic nonsmooth waveform arises, the so-called ripple. In this paper we propose a novel model that captures this nonsmoothness by means of a hybrid dynamical system performing state jumps at certain switching instants, and we illustrate its properties with reference to a three phase diode bridge rectifier. As the ripple corrupts an underlying desirable signal, we propound two observer schemes ensuring asymptotic estimation of the ripple, the first with and the second without knowledge of the switching instants. Our theoretical developments are well placed in the context of recent techniques for hybrid regulation and constitute a contribution especially for our second observer, where the switching instants are estimated. Once asymptotic estimation of the ripple is achieved, the ripple can be conveniently canceled from the desirable signal, and thanks to the inherent robustness properties of the proposed hybrid formulation, the two observer schemes require only that the desirable signal is slowly time varying compared to the ripple. Exploiting this fact, we illustrate the effectiveness of our second hybrid observation law on experimental data collected from the Joint European Torus tokamak