Experimental characterization of gaseous ion beams produced with the advanced ion source for hadrontherapy (AISHa) at 18 GHz

The Advanced Ion Source for Hadrontherapy (AISHa) is an electron cyclotron resonance ion source operating at 18 GHz, developed at the Istituto Nazionale di Fisica Nucleare-Laboratori Nazionali del Sud, with the aim of producing high intensity and low emittance highly charged ion beams for hadrontherapy purposes. Moreover, thanks to its unique peculiarities, AISHa is a suitable choice for industrial and scientific applications. In the framework of the INSpIRIT and IRPT projects, in collaboration with the Centro Nazionale di Adroterapia Oncologica, new candidates for cancer treatment are being developed. In particular, the paper presents the results of the commissioning of four ion beams of interest for hadrontherapy: H+, C4+, He2+, and O6+. Their charge state distribution in the best experimental conditions, their emittance, and brightness will be critically discussed, along with the role of ion source tuning and space charge effects in beam transport. Perspectives for further developments will also be presented.

POS1486-HPR DETECTION OF ASSOCIATED FIBROMYALGIA IN PATIENTS WITH OSTEOARTHRITIS OF THE KNEE ACCORDING TO THE MULTIDIMENSIONAL HEALTH ASSESSMENT QUESTIONNAIRE/ FIBROMYALGIA ASSESSMENT SCREENING TOOLS (MDHAQ/FAST4)

Background

Osteoarthritis is the most prevalent joint pathology. knee Osteoarthritis is one of the most frequent locations and has the greatest impact on the health of patients. It can be associated up to 11% with depression and 23% with neuropathic pain. It has also been reported that it can coincide with fibromyalgia (FM) between 6% and 22.83%. This difference may be attributed to some factors, e.g., sample size and/or socioeconomic status. Therefore, the clinical interpretation of symptoms in knee osteoarthritis may be overestimated by the presence of FM. Pincus T. et al. used the FAST4 to identify the coexistence of FM in patients with various rheumatic pathologies. The FAST4 consists of using the MDHAQ (symptom checklist, painful joint count, fatigue and pain). A FAST4 score ≥ 3 allows the association of FM to be considered. The authors demonstrated good concordance with the 2011 FM criteria according to the ACR (with a sensitivity of 70.4% and a specificity of 97.1%)

Objectives

To detect the presence of associated FM in patients with early and established knee osteoarthritis employing the MDHAQ/FAST4

Methods

Patients ≥18 years, of both sexes, from our community with early and established knee osteoarthritis (Luyten, FP 2018 and Altman, R 1986 Classification Criteria respectively). All answered the MDHAQ/FAST3-F questionnaire, in addition to the Patient Health Questionnaire (PHQ9) and the Neuropathic Pain 4 Questions (DN4). Depression was considered respectively with a score ≥3 of the PHQ9 and neuropathic pain with 4 points of the DN4

Results

100 patients (96 with a diagnosis of early knee osteoarthritis and 4 with established knee osteoarthritis [Luyten - ACR]) with a median age of 58 (RIC 16) and female sex were included 72%.We observed associated FM (FAST4-F) in 31% of patients (27 with early knee osteoarthritis and 4 with established knee osteoarthritis). Median VAS pain, patient and physician global assessment of the disease was higher in patients with FM (p<0.0001). Disease activity by RAPID 3 was low in 4%, moderate in 38% and high in 58% of patients. The cohort had a median pain score of 60 (RIC 60) with absence of neuropathic pain (DN4) in 90% of patients. Depression (PHQ9) was observed in 29% of cases.OA evolution time in months in patients with FM 48 (RIC 12) vs. 36 (RIC 24) without FM (p< 0.0001).Binary logistic regression was performed. In the bivariate analysis, it was observed that the presence of early OA by Luyten’s criteria (p=0.002), the presence of depression by PHQ9 (p=0.001), patients of white ethnicity (p=0.03), sobrepeso (p=0.002), low RAPID 3 disease activity (p=0.001), kellgren and lawrence grades II and III (p=0.001), were significant in the bivariate model, although none were statistically significant in the multivariate model

Conclusion

The evaluation of knee osteoarthritis can be complicated in those patients who coexist with FM. In our study 31% met criteria for this entity according to MDHAQ/FAST4. We consider this questionnaire to be single and practical for detecting associated FM. The results obtained give hierarchy to the use of PROMs (Patient Reported Outcomes Measures) that can recognize clues of associated diseases such as FM and/or depression. And thus be able to establish a timely and appropriate treatment when these pathologies are overlapping, in order to change the patient’s prognosis and improve their quality of life

References

[1]Pincus T, Schmukler J, Castrejon I. Patient questionnaires in osteoarthritis: what patients teach doctors about their osteoarthritis on a multidimensional health assessment questionnaire (MDHAQ) in clinical trials and clinical care. Clin Exp Rheumatol 2019; 37(Suppl. 120): S100-S111.

[2]Gibson K, Castrejon I, Descallar J, et al. Fibromyalgia Assessment Screening Tool: Clues to Fibromyalgia on a Multidimensional Health Assessment Questionnaire for Routine Care. J Rheumatol. 2020;47(5):761-69

Acknowledgements

Unidad de investigación de la Sociedad Argentina de Reumatología(UNISAR)

Disclosure of Interests

None declared

Experimental characterization of the AISHa ion source

The Advanced Ion Source for Hadrontherapy (AISHa) has been designed to generate high brightness multiply charged ion beams for hadron therapy applications. AISHa is a compact electron cyclotron resonance ion source whose hybrid magnetic system consists of a permanent Halbach-type hexapole magnet and a set of independently energized superconducting coils. This has allowed us to achieve high performances in a cost effective way. During the commissioning phase, a few criticalities have been observed and fixed in 2018/19; the improvements will be briefly described and the results of the operations with a single 18 GHz generator will be presented. Particular relevance will be given to the production of high intensity beams of oxygen, argon, and carbon, the latter having huge importance for hadron therapy applications. Perspectives for further improvements, including double frequency heating, will also be highlighted.

The first measurement of plasma density in an ECRIS-like device by means of a frequency-sweep microwave interferometer

The note presents the first plasma density measurements collected by a novel microwave interferometer in a compact Electron Cyclotron Resonance Ion Sources (ECRIS). The developed K-band (18.5 ÷ 26.5 GHz) microwave interferometry, based on the Frequency-Modulated Continuous-Wave method, has been able to discriminate the plasma signal from the spurious components due to the reflections at the plasma chamber walls, when working in the extreme unfavorable condition λ_p ≃ L_p ≃ L_c (λ_p, L_p, and L_c being the probing signal wavelength, the plasma dimension and the plasma chamber length, respectively). The note describes the experimental procedure when probing a high density plasma (n_e > 1 ⋅ 10¹⁸ cm^-3) produced by an ECRIS prototype operating at 3.75 GHz.

A new H2 (+) source: Conceptual study and experimental test of an upgraded version of the VIS-Versatile ion source

The versatile ion source is an off-resonance microwave discharge ion source which produces a slightly overdense plasma at 2.45 GHz of pumping wave frequency extracting more than 60 mA proton beams and 50 mA He(+) beams. DAEδALUS and IsoDAR experiments require high intensities for H2 (+) beams to be accelerated by high power cyclotrons for neutrinos generation. In order to fulfill the new requirements, a new plasma chamber and injection system has been designed and manufactured for increasing the H2 (+) beam intensity. In this paper the studies for the increasing of the H2 (+)/p ratio and for the design of the new plasma chamber and injection system will be shown and discussed together with the experimental tests carried out at Istituto Nazionale di Fisica Nucleare-Laboratori Nazionali del Sud (INFN-LNS) and at Best Cyclotron Systems test-bench in Vancouver, Canada.

Experimental investigation of non-linear wave to plasma interaction in a quasi-flat magnetostatic field

A characterization of wave-to-plasma interaction in a quasi-flat magnetostatic field at 3.75 GHz has been carried out by using a small-wire movable RF antenna, connected to a spectrum analyzer. The coupling between electromagnetic and electrostatic waves leads to a characteristic spectral emission in low frequency range and around the pumping wave frequency. The most relevant results consist in the broadening of the pumping wave spectrum above critical RF power thresholds and in the generation of sidebands of the pumping frequency, with corresponding components in low frequency domain. The non-linearities are accompanied by the generation of overdense plasmas and intense fluxes of X-rays.