UNLABELLED: The trabecular bone score (TBS) is an indirect measure of vertebral bone microarchitecture. Our objective was to examine the effect of testosterone treatment on TBS. One hundred and ninety-seven hypogonadal men were randomized to testosterone or placebo. After 12 months, there was no difference in the changes in TBS by randomized group. INTRODUCTION: In the Bone Trial of the Testosterone Trials, testosterone treatment increased trabecular volumetric bone mineral density (vBMD) and increased estimated bone strength as determined by finite element analysis. The trabecular bone score (TBS) is an indirect measure of vertebral bone microarchitecture. TBS predicts fracture independent of lumbar spine areal (a) BMD. The objective of this study was to examine the effect of testosterone treatment on TBS compared to its effects on vBMD and aBMD. METHODS: Two hundred and eleven men were enrolled in the Bone Trial of the Testosterone Trials. Of these, 197 men had 2 repeat TBS and vBMD measurements; 105 men were allocated to receive testosterone, and 92 men to placebo for 1 year. TBS, aBMD, and vBMD were assessed at baseline and month 12. RESULTS: There was no difference in the percent change in TBS by randomized group: 1.6% (95% confidence intervals (CI) 0.2-3.9) in the testosterone group and 1.4% (95% CI -0.2, 3.1) in the placebo group. In contrast, vBMD increased by 6% (95% CI 4.5-7.5) in the testosterone group compared to 0.4% (95% CI -1.65-0.88) in the placebo groups. CONCLUSIONS: TBS is not clinically useful in monitoring the 1-year effect of testosterone treatment on bone structure in older hypogonadal men.

The National Spherical Torus Experiment (NSTX) is currently being upgraded to operate at twice the toroidal field and plasma current (up to 1T and 2MA), with a second, more tangentially aimed neutral beam (NB) for current and rotation control, allowing for pulse lengths up to 5s. Recent NSTX physics analyses have addressed topics that will allow NSTX-Upgrade to achieve the research goals critical to a Fusion Nuclear Science Facility. These include producing stable, 100% non-inductive operation in high-performance plasmas, assessing plasma-material interface (PMI) solutions to handle the high heat loads expected in the next-step devices and exploring the unique spherical torus (ST) parameter regimes to advance predictive capability. Non-inductive operation and current profile control in NSTX-U will be facilitated by co-axial helicity injection (CHI) as well as radio frequency (RF) and NB heating. CHI studies using NIMROD indicate that the reconnection process is consistent with the 2D Sweet-Parker theory. Full-wave AORSA simulations show that RF power losses in the scrape-off layer (SOL) increase significantly for both NSTX and NSTX-U when the launched waves propagate in the SOL. Toroidal Alfvén eigenmode avalanches and higher frequency Alfvén eigenmodes can affect NB-driven current through energy loss and redistribution of fast ions. The inclusion of rotation and kinetic resonances, which depend on collisionality, is necessary for predicting experimental stability thresholds of fast growing ideal wall and resistive wall modes. Neutral beams and neoclassical toroidal viscosity generated from applied 3D fields can be used as actuators to produce rotation profiles optimized for global stability. DEGAS-2 has been used to study the dependence of gas penetration on SOL temperatures and densities for the MGI system being implemented on the Upgrade for disruption mitigation. PMI studies have focused on the effect of ELMs and 3D fields on plasma detachment and heat flux handling. Simulations indicate that snowflake and impurity seeded radiative divertors are candidates for heat flux mitigation in NSTX-U. Studies of lithium evaporation on graphite surfaces indicate that lithium increases oxygen surface concentrations on graphite, and deuterium-oxygen affinity, which increases deuterium pumping and reduces recycling. In situ and test-stand experiments of lithiated graphite and molybdenum indicate temperature-enhanced sputtering, although that test-stand studies also show the potential for heat flux reduction through lithium vapour shielding. Non-linear gyro kinetic simulations have indicated that ion transport can be enhanced by a shear-flow instability, and that non-local effects are necessary to explain the observed rapid changes in plasma turbulence. Predictive simulations have shown agreement between a microtearing-based reduced transport model and the measured electron temperatures in a microtearing unstable regime. Two Alfvén eigenmode-driven fast ion transport models have been developed and successfully benchmarked against NSTX data. Upgrade construction is moving on schedule with initial physics research operation of NSTX-U planned for mid-2015.

Research on the National Spherical Torus Experiment, NSTX, targets physics understanding needed for extrapolation to a steady-state ST Fusion Nuclear Science Facility, pilot plant, or DEMO. The unique ST operational space is leveraged to test physics theories for next-step tokamak operation, including ITER. Present research also examines implications for the coming device upgrade, NSTX-U. An energy confinement time, τE, scaling unified for varied wall conditions exhibits a strong improvement of BTτE with decreased electron collisionality, accentuated by lithium (Li) wall conditioning. This result is consistent with nonlinear microtearing simulations that match the experimental electron diffusivity quantitatively and predict reduced electron heat transport at lower collisionality. Beam-emission spectroscopy measurements in the steep gradient region of the pedestal indicate the poloidal correlation length of turbulence of about ten ion gyroradii increases at higher electron density gradient and lower Ti gradient, consistent with turbulence caused by trapped electron instabilities. Density fluctuations in the pedestal top region indicate ion-scale microturbulence compatible with ion temperature gradient and/or kinetic ballooning mode instabilities. Plasma characteristics change nearly continuously with increasing Li evaporation and edge localized modes (ELMs) stabilize due to edge density gradient alteration. Global mode stability studies show stabilizing resonant kinetic effects are enhanced at lower collisionality, but in stark contrast have almost no dependence on collisionality when the plasma is off-resonance. Combined resistive wall mode radial and poloidal field sensor feedback was used to control n = 1 perturbations and improve stability. The disruption probability due to unstable resistive wall modes (RWMs) was surprisingly reduced at very high βN/li > 10 consistent with low frequency magnetohydrodynamic spectroscopy measurements of mode stability. Greater instability seen at intermediate βN is consistent with decreased kinetic RWM stabilization. A model-based RWM state-space controller produced long-pulse discharges exceeding βN = 6.4 and βN/li = 13. Precursor analysis shows 96.3% of disruptions can be predicted with 10 ms warning and a false positive rate of only 2.8%. Disruption halo currents rotate toroidally and can have significant toroidal asymmetry. Global kinks cause measured fast ion redistribution, with full-orbit calculations showing redistribution from the core outward and towards V∥/V = 1 where destabilizing compressional Alfvén eigenmode resonances are expected. Applied 3D fields altered global Alfvén eigenmode characteristics. High-harmonic fast-wave (HHFW) power couples to field lines across the entire width of the scrape-off layer, showing the importance of the inclusion of this phenomenon in designing future RF systems. The snowflake divertor configuration enhanced by radiative detachment showed large reductions in both steady-state and ELM heat fluxes (ELMing peak values down from 19 MW m-2 to less than 1.5 MW m-2). Toroidal asymmetry of heat deposition was observed during ELMs or by 3D fields. The heating power required for accessing H-mode decreased by 30% as the triangularity was decreased by moving the X-point to larger radius, consistent with calculations of the dependence of E × B shear in the edge region on ion heat flux and X-point radius. Co-axial helicity injection reduced the inductive start-up flux, with plasmas ramped to 1 MA requiring 35% less inductive flux. Non-inductive current fraction (NICF) up to 65% is reached experimentally with neutral beam injection at plasma current Ip = 0.7 MA and between 70-100% with HHFW application at Ip = 0.3 MA. NSTX-U scenario development calculations project 100% NICF for a large range of 0.6 < Ip (MA) < 1.35. © 2013 IAEA, Vienna.

In the last two experimental campaigns, the low aspect ratio NSTX has explored physics issues critical to both toroidal confinement physics and ITER. Experiments have made extensive use of lithium coatings for wall conditioning, correction of non-axisymmetric field errors and control of n = 1 resistive wall modes (RWMs) to produce high-performance neutral-beam heated discharges extending to 1.7 s in duration with non-inductive current fractions up to 0.7. The RWM control coils have been used to trigger repetitive ELMs with high reliability, and they have also contributed to an improved understanding of both neoclassical tearing mode and RWM stabilization physics, including the interplay between rotation and kinetic effects on stability. High harmonic fast wave (HHFW) heating has produced plasmas with central electron temperatures exceeding 6 keV. The HHFW heating was used to show that there was a 20-40% higher power threshold for the L-H transition for helium than for deuterium plasmas. A new diagnostic showed a depletion of the fast-ion density profile over a broad spatial region as a result of toroidicity-induced Alfvén eigenmodes (TAEs) and energetic-particle modes (EPMs) bursts. In addition, it was observed that other modes (e.g. global Alfvén eigenmodes) can trigger TAE and EPM bursts, suggesting that fast ions are redistributed by high-frequency AEs. The momentum pinch velocity determined by a perturbative technique decreased as the collisionality was reduced, although the pinch to diffusion ratio, Vpinch/χ, remained approximately constant. The mechanisms of deuterium retention by graphite and lithium-coated graphite plasma-facing components have been investigated. To reduce divertor heat flux, a novel divertor configuration, the 'snowflake' divertor, was tested in NSTX and many beneficial aspects were found. A reduction in the required central solenoid flux has been realized in NSTX when discharges initiated by coaxial helicity injection were ramped in current using induction. The resulting plasmas have characteristics needed to meet the objectives of the non-inductive start-up and ramp-up program of NSTX. © 2011 IAEA, Vienna.

The mission of the National Spherical Torus Experiment (NSTX) is the demonstration of the physics basis required to extrapolate to the next steps for the spherical torus (ST), such as a plasma facing component test facility (NHTX) or an ST based component test facility (ST-CTF), and to support ITER. Key issues for the ST are transport, and steady state high β operation. To better understand electron transport, a new high-k scattering diagnostic was used extensively to investigate electron gyro-scale fluctuations with varying electron temperature gradient scale length. Results from n = 3 braking studies are consistent with the flow shear dependence of ion transport. New results from electron Bernstein wave emission measurements from plasmas with lithium wall coating applied indicate transmission efficiencies near 70% in H-mode as a result of reduced collisionality. Improved coupling of high harmonic fast-waves has been achieved by reducing the edge density relative to the critical density for surface wave coupling. In order to achieve high bootstrap current fraction, future ST designs envision running at very high elongation. Plasmas have been maintained on NSTX at very low internal inductance li ∼ 0.4 with strong shaping (κ ∼ 2.7, δ ∼ 0.8) with βN approaching the with-wall β-limit for several energy confinement times. By operating at lower collisionality in this regime, NSTX has achieved record non-inductive current drive fraction fNI ∼ 71%. Instabilities driven by super-Alfvénic ions will be an important issue for all burning plasmas, including ITER. Fast ions from NBI on NSTX are super-Alfvénic. Linear toroidal Alfvén eigenmode thresholds and appreciable fast ion loss during multi-mode bursts are measured and these results are compared with theory. The impact of n > 1 error fields on stability is an important result for ITER. Resistive wall mode/resonant field amplification feedback combined with n = 3 error field control was used on NSTX to maintain plasma rotation with β above the no-wall limit. Other highlights are results of lithium coating experiments, momentum confinement studies, scrape-off layer width scaling, demonstration of divertor heat load mitigation in strongly shaped plasmas and coupling of coaxial helicity injection plasmas to ohmic heating ramp-up. These results advance the ST towards next step fusion energy devices such as NHTX and ST-CTF. © 2009 IAEA, Vienna.