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This contribution deals with H-modes with significant heat exchange between electrons and ions, but which can still show large differences between electron and ion-temperatures especially inside half minor radius. These conditions are referred to as moderately collisional. A systematic study shows that an increasing fraction of electron heating increases the transport in the ion channel mainly due to the dependence of the ITG dominated ion transport on the ratio Te/Ti in agreement with modeling. The rotational shear in the plasmas under study was so small that it hardly influences ITG stability, such that variations of the rotation profile due to a change of the heating method were of minor importance. These findings connect to studies of advanced tokamak scenarios using ECCD as a tool to modify the q-profile. The electron heating connected to the ECCD tends to increase the transport in the ion channel quite in contrast to the goal to operate at reduced current but with increased confinement. The confinement only increases as the fraction of ion heating is increased by adding more NBI. An ITER case was modeled as well. Due to the larger value of νei ・ τE the ratio Te/Ti is only moderately reduced even with strong electron heating and the confinement reduction is small even for the hypothetic case of using only ECRH as additional heating. Finally the paper discusses the ongoing upgrade of the AUG ECRH-system.

The development of diplexers for ECRH has been pursued at a number of institutes because of their attractive variety of applications: Power combination, non-mechanical, electrically controlled switching (of combined beams) between launchers with tens of kHz, and discrimination of low-power ECE signals from high-power ECRH is feasible. In a first part, this paper reports on plasma experiments with a ring resonator (Mk IIa) at ASDEX Upgrade. Commissioning experiments on fast switching between two launchers for synchronous stabilization of neoclassical tearing modes, as well as in-line ECE measurements have been performed, and experimental issues and first results are discussed. A clear influence of the switching phase on the amplitude of the 3/2 NTM mode was measured, complete stabilization could, however, not be demonstrated yet mainly due to imperfect resonator control. Concepts for improved tracking of the diplexers to the gyrotron frequency are presented. In a second part, the design of diplexers with ring resonators matched to HE11 fields is briefly discussed; these devices can be connected to corrugated waveguides without any mode converters. A compact version (MQ IV) is under investigation, which is compatible with the ITER ECRH system (170 GHz, 63.5 mm waveguide, vacuum tight casing), with the final goal of high-power tests at the 170 GHz gyrotron facility at JAEA in Naka, Japan. First low-power test results are presented.

On ASDEX Upgrade a concept for real-time stabilization of NTMs has been realized and successfully applied to (3,2)- and (2,1)-NTMs. Since most of the work has meanwhile been published elsewhere, a short summary with the appropriate references is given. Limitations, deficits and future extensions of the system are discussed. In a second part the recent work on using modulated ECCD for NTM stabilisation is described in some detail. In these experiments ECCD power is modulated according to a magnetic footprint of the rotating NTM. In agreement with earlier results it could be shown that O-point heating reduces the necessary average power for stabilisation whereas X-point heating hampers stabilisation. Although this modulated scheme is not relevant for routine NTM stabilisation on ASDEX Upgrade it may be mandatory for ITER or DEMO. On ASDEX Upgrade it has been re-developed to demonstrate the usage of a FAst DIrectional Switch to continously heat the O-point of the rotating island with only one gyrotron switching between two launchers which target the mode at locations separated in phase by 180 degrees as described in [1].

Sensitive millimeter wave diagnostics need often to be protected against unwanted radiation like, for example, stray radiation from high power Electron Cyclotron Heating applied in nuclear fusion plasmas. A notch filter based on a waveguide Bragg reflector (photonic band-gap) may provide several stop bands of defined width within up to two standard waveguide frequency bands. A Bragg reflector that reflects an incident fundamental TE11 into a TM1n mode close to cutoff is combined with two waveguide tapers to fundamental waveguide diameter. Here the fundamental TE11 mode is the only propagating mode at both ends of the reflector. The incident TE11 mode couples through the taper and is converted to the high order TM1n mode by the Bragg structure at the specific Bragg resonances. The TM1n mode is trapped in the oversized waveguide section by the tapers. Once reflected at the input taper it will be converted back into the TE11 mode which then can pass through the taper. Therefore at higher order Bragg resonances, the filter acts as a reflector for the incoming TE11 mode. Outside of the Bragg resonances the TE11 mode can propagate through the oversized waveguide structure with only very small Ohmic attenuation compared to propagating in a fundamental waveguide. Coupling to other modes is negligible in the non-resonant case due to the small corrugation amplitude (typically 0.05·λ0, where λ0 is the free space wavelength). A Bragg reflector for 105 and 140 GHz was optimized by mode matching (scattering matrix) simulations and manufactured by SWISSto12 SA, where the required mechanical accuracy of ± 5 μm could be achieved by stacking stainless steel rings, manufactured by micro-machining, in a high precision guiding pipe. The two smooth-wall tapers were fabricated by electroforming. Several measurements were performed using vector network analyzers from Agilent (E8362B), ABmm (MVNA 8-350) and Rohde&Schwarz (ZVA24) together with frequency multipliers. The stop bands around 105 GHz (- 55dB) and 140 GHz (-60dB) correspond to the TE11-TM12 and TE11-TM13 Bragg resonances. Experiments are in good agreement with theory.

Marco Cascella,1 Federica Monaco,2 Ornella Piazza1 1Anesthesia and Pain Medicine, Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Baronissi, 84081, Italy; 2Anesthesia and Pain Management, ASL NA/1, Naples, ItalyCorrespondence: Marco Cascella, Anesthesia and Pain Medicine, Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via S. Allende, Baronissi, 84081, Italy, Email m.cascella@istitutotumori.na.it; mcascella@unisa.it

A CW capable inline electron cyclotron emission (ECE) separation system for feedback control, featuring oversized corrugated waveguides, is commissioned on ASDEX upgrade (AUG). The system is based on a combination of a polarization independent, non-resonant, Mach-Zehnder diplexer equipped with dielectric plate beam splitters [2, 3] employed as corrugated oversized waveguide filter, and a resonant Fast Directional Switch, FADIS [4, 5, 6, 7] as ECE/ECCD separation system. This paper presents an overview of the system, the low power characterisation tests and first high power commissioning on AUG.

Characteristics of ring resonator diplexers for high-power ECRH are briefly reviewed. Commissioning experiments performed on ASDEX Upgrade with the diplexer Mk IIa are presented, which demonstrate slow and fast switching of the power between two launchers, and thus the capability for efficient suppression of neoclassical tearing modes and simultaneous central heating of the plasma. The development of the compact diplexer Mk IIIb is discussed, and test results are presented. Finally, an evacuated design for 170 GHz is shown.

High-power resonant diplexers for millimetre waves have various promising applications in ECRH systems. The round-trip resonator length of a diplexer needs to be accurately tuned to match its prescribed functionality. For this purpose one of the mirrors in the FADIS MkIIa diplexer has been mounted on a motion system, in order to control the mirror to its desired location despite the presence of substantial disturbances. The mechanical properties and control strategy for the mirror motion system have been designed such as to meet the overall system requirements. The performance of the motion system has been experimentally validated in various high power mm-wave tests.

The ASDEX Upgrade (AUG) ECRH system now delivers a total of 3.9 MW to the plasma at 140 GHz. Three new units are capable of 2-frequency operation and may heat the plasma alternatively with 2.1 MW at 105 GHz. The system is routinely used with X2, O2, and X3 schemes. For Bt = 3.2 T also an ITER-like O1-scheme can be run using 105 GHz. The new launchers are capable of fast poloidal movements necessary for real-time control of the location of power deposition. Here real-time control of NTMs is summarized, which requires a fast analysis of massive data streams (ECE and Mirnov correlation) and extensive calculations (equilibria, ray-tracing). These were implemented at AUG using a modular concept of standardized real-time diagnostics. The new realtime capabilities have also been used during O2 heating to keep the first reflection of the non-absorbed beam fraction on the holographic reflector tile which ensures a well defined second pass of the beam through the central plasma. Sensors for the beam position are fast thermocouples at the edge of the reflector tile. The enhanced ECRH power was used for several physics studies related to the unique feature of pure electron heating without fueling and without momentum input. As an example the effect of the variation of the heating mix in moderately heated H-modes is demonstrated using the three available heating systems, i.e. ECRH, ICRH and NBI. Keeping the total input power constant, strong effects are seen on the rotation, but none on the pedestal parameters. Also global quantities as the stored energy are hardly modified. Still it is found that the central ion temperature drops as the ECRH fraction exceeds a certain threshold.

Due to imperfection of the single path absorption, ECRH at ASDEX Upgrade (AUG) is always accompanied by stray radiation in the vacuum vessel. New ECRH scenarios with O2 and X3 heating schemes extend the operational space, but they have also the potential to increase the level of stray radiation. There are hazards for invessel components. Damage on electric cables has already been encountered. It is therefore necessary to monitor and control the ECRH with respect to the stray radiation level. At AUG a system of Sniffer antennas equipped with microwave detection diodes is installed. The system is part of the ECRH interlock circuit. We notice, however, that during plasma operation the variations of the Sniffer antenna signal are very large. In laboratory measurements we see variations of up to 20 dB in the directional sensitivity and we conclude that an interference pattern is formed inside the copper sphere of the antenna. When ECRH is in plasma operation at AUG, the plasma is acting as a phase and mode mixer for the millimeter waves and thus the interference pattern inside the sphere changes with the characteristic time of the plasma dynamics. In order to overcome the difficulty of a calibrated measurement of the average stray radiation level, we installed bolometer and pyroelectric detectors, which intrinsically average over interference structures due to their large active area. The bolometer provides a robust calibration but with moderate temporal resolution. The pyroelectric detector provides high sensitivity and a good temporal resolution, but it raises issues of possible signal drifts in long pulses.

Background: Acute kidney injury (AKI) is a serious and common complication of cardiac surgery, for which reduced kidney perfusion is a key contributing factor. Intravenous amino acids increase kidney perfusion and recruit renal functional reserve. However, the efficacy of amino acids in reducing the occurrence of AKI after cardiac surgery is uncertain. Methods: In a multinational, double-blind trial, we randomly assigned adult patients who were scheduled to undergo cardiac surgery with cardiopulmonary bypass to receive an intravenous infusion of either a balanced mixture of amino acids, at a dose of 2 g per kilogram of ideal body weight per day, or placebo (Ringer's solution) for up to 3 days. The primary outcome was the occurrence of AKI, defined according to the Kidney Disease: Improving Global Outcomes creatinine criteria. Secondary outcomes included the severity of AKI, the use and duration of kidney-replacement therapy, and all-cause 30-day mortality. Results: We recruited 3511 patients at 22 centers in three countries and assigned 1759 patients to the amino acid group and 1752 to the placebo group. AKI occurred in 474 patients (26.9%) in the amino acid group and in 555 (31.7%) in the placebo group (relative risk, 0.85; 95% confidence interval [CI], 0.77 to 0.94; P = 0.002). Stage 3 AKI occurred in 29 patients (1.6%) and 52 patients (3.0%), respectively (relative risk, 0.56; 95% CI, 0.35 to 0.87). Kidney-replacement therapy was used in 24 patients (1.4%) in the amino acid group and in 33 patients (1.9%) in the placebo group. There were no substantial differences between the two groups in other secondary outcomes or in adverse events. Conclusions: Among adult patients undergoing cardiac surgery, infusion of amino acids reduced the occurrence of AKI. (Funded by the Italian Ministry of Health; PROTECTION ClinicalTrials.gov number, NCT03709264.). [ABSTRACT FROM AUTHOR]

Marco Solmi,1,2 Andrea Murru,3 Isabella Pacchiarotti,3 Juan Undurraga,4,5 Nicola Veronese,2,6 Michele Fornaro,7,8 Brendon Stubbs,2,9–11 Francesco Monaco,2 Eduard Vieta,3 Mary V Seeman,12 Christoph U Correll,13,14 André F Carvalho2,15 1Neuroscience Department, University of Padua, 2Institute for Clinical Research and Education in Medicine, Padua, Italy; 3Bipolar Disorders Unit, Institute of Neuroscience, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain; 4Department of Psychiatry, Faculty of Medicine, Clínica Alemana Universidad del Desarrollo, 5Early Intervention Program, J. Horwitz Psychiatric Institute, Santiago, Chile; 6National Research Council, Ageing Section, Padua, 7Laboratory of Molecular and Translational Psychiatry, Department of Neuroscience, School of Medicine, University “Federico II”, Naples, Italy; 8New York State Psychiatric Institute, Columbia University, New York, NY, USA; 9Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, 10Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, 11Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, UK; 12Institute of Medical Science, Toronto, ON, Canada; 13Department of Psychiatry Research, Zucker Hillside Hospital, Northwell Health, Glen Oaks, 14Department of Psychiatry and Molecular Medicine Hempstead, Hofstra Northwell School of Medicine, Hempstead, NY, USA; 15Translational Psychiatry Research Group and Department of Clinical Medicine, Faculty of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil Abstract: Since the discovery of chlorpromazine (CPZ) in 1952, first-generation antipsychotics (FGAs) have revolutionized psychiatric care in terms of facilitating discharge from hospital and enabling large numbers of patients with severe mental illness (SMI) to be treated in the community. Second-generation antipsychotics (SGAs) ushered in a progressive shift from the paternalistic management of SMI symptoms to a patient-centered approach, which emphasized targets important to patients – psychosocial functioning, quality of life, and recovery. These drugs are no longer limited to specific Diagnostic and Statistical Manual of Mental Disorders (DSM) categories. Evidence indicates that SGAs show an improved safety and tolerability profile compared with FGAs. The incidence of treatment-emergent extrapyramidal side effects is lower, and there is less impairment of cognitive function and treatment-related negative symptoms. However, treatment with SGAs has been associated with a wide range of untoward effects, among which treatment-emergent weight gain and metabolic abnormalities are of notable concern. The present clinical review aims to summarize the safety and tolerability profile of selected FGAs and SGAs and to link treatment-related adverse effects to the pharmacodynamic profile of each drug. Evidence, predominantly derived from systematic reviews, meta-analyses, and clinical trials of the drugs amisulpride, aripiprazole, asenapine, brexpiprazole, cariprazine, clozapine, iloperidone, lurasidone, olanzapine, paliperidone, quetiapine, risperidone, sertindole, ziprasidone, CPZ, haloperidol, loxapine, and perphenazine, is summarized. In addition, the safety and tolerability profiles of antipsychotics are discussed in the context of the “behavioral toxicity” conceptual framework, which considers the longitudinal course and the clinical and therapeutic consequences of treatment-emergent side effects. In SMI, SGAs with safer metabolic profiles should ideally be prescribed first. However, alongside with safety, efficacy should also be considered on a patient-tailored basis. Keywords: antipsychotics, side effects, tolerability, safety, psychosis, psychiatry