Comparing pedestal structure in JET-ILW H-mode plasmas with a model for stiff ETG turbulent heat transport.

A predictive model for the electron temperature profile of the H-mode pedestal is described, and its results are compared with the pedestal structure of JET-ILW plasmas. The model is based on a scaling for the gyro-Bohm normalized, turbulent electron heat flux [Formula: see text] resulting from electron temperature gradient (ETG) turbulence, derived from results of nonlinear gyrokinetic (GK) calculations for the steep gradient region. By using the local temperature gradient scale length [Formula: see text] in the normalization, the dependence of [Formula: see text] on the normalized gradients [Formula: see text] and [Formula: see text] can be represented by a unified scaling with the parameter [Formula: see text], to which the linear stability of ETG turbulence is sensitive when the density gradient is sufficiently steep. For a prescribed density profile, the value of [Formula: see text] determined from this scaling, required to maintain a constant electron heat flux [Formula: see text] across the pedestal, is used to calculate the temperature profile. Reasonable agreement with measurements is found for different cases, the model providing an explanation of the relative widths and shifts of the [Formula: see text] and [Formula: see text] profiles, as well as highlighting the importance of the separatrix boundary conditions. Other cases showing disagreement indicate conditions where other branches of turbulence might dominate. This article is part of a discussion meeting issue 'H-mode transition and pedestal studies in fusion plasmas'.

Uncovering turbulent plasma dynamics via deep learning from partial observations.

One of the most intensely studied aspects of magnetic confinement fusion is edge plasma turbulence which is critical to reactor performance and operation. Drift-reduced Braginskii two-fluid theory has for decades been widely applied to model boundary plasmas with varying success. Towards better understanding edge turbulence in both theory and experiment, we demonstrate that a physics-informed deep learning framework constrained by partial differential equations can accurately learn turbulent fields consistent with the two-fluid theory from partial observations of electron pressure which is not otherwise possible using conventional equilibrium models. This technique presents a paradigm for the advanced design of plasma diagnostics and validation of magnetized plasma turbulence theories in challenging thermonuclear environments.

Global Theory of Microtearing Modes in the Tokamak Pedestal.

The pedestal of H-mode tokamaks displays strong magnetic fluctuations correlated with the evolution of the electron temperature. The microtearing mode (MTM), a temperature-gradient-driven instability that alters magnetic topology, is compatible with these observations. Here we extend the conventional theory of the MTM to include the global variation of the temperature and density profiles. The offset between the rational surface and the location of the pressure gradient maximum (µ) emerges as a crucial parameter for MTM stability. The extended theory matches observations on the Joint European Torus tokamak.

Self-monitoring diabetes with multiple mobile health devices.

OBJECTIVE: The purpose of this study was to examine the use of multiple mobile health technologies to generate and transmit data from diverse patients with type 2 diabetes mellitus (T2DM) in between clinic visits. We examined the data to identify patterns that describe characteristics of patients for clinical insights. METHODS: We enrolled 60 adults with T2DM from a US healthcare system to participate in a 6-month longitudinal feasibility trial. Patient weight, physical activity, and blood glucose were self-monitored via devices provided at baseline. Patients also responded to biweekly medication adherence text message surveys. Data were aggregated in near real-time. Measures of feasibility assessing total engagement in device submissions and survey completion over the 6 months of observation were calculated. RESULTS: It was feasible for participants from different socioeconomic, educational, and racial backgrounds to use and track relevant diabetes-related data from multiple mobile health devices for at least 6 months. Both the transmission and engagement of the data revealed notable patterns and varied by patient characteristics. DISCUSSION: Using multiple mobile health tools allowed us to derive clinical insights from diverse patients with diabetes. The ubiquitous adoption of smartphones across racial, educational, and socioeconomic populations and the integration of data from mobile health devices into electronic health records present an opportunity to develop new models of care delivery for patients with T2DM that may promote equity as well.

Age, burnout and physical and psychological work ability among nurses.

Background: The ageing of the US labour force highlights the need to examine older adults' physical and psychological ability to work, under varying levels of occupational burnout. Aims: To examine how age and burnout interact in predicting physical and psychological work ability. Methods: Using a cohort of actively working nurses, we assessed factors on the Work Ability Index at 12-month follow-up and determined how these were related to age and exhaustion-related burnout at baseline. Results: The study group consisted of 402 nurses aged 25-67 (mean = 41.7). Results indicated age by burnout interactions in which decrements in physical work ability with greater age were observed at all but the lowest level of burnout (1.5 SD below mean: ß = -0.14, 95% CI -0.36, 0.07; 1 SD below: ß = -0.23, 95% CI -0.39, -0.06; mean: ß = -0.39, 95% CI -0.50, -0.29; 1 SD above: ß = -0.56, 95% CI -0.70, -0.42; 1.5 SD above: ß = -0.64, 95% CI -0.83, -0.46). In contrast, we observed decrements in psychological work ability with age at higher levels of burnout only (1 SD above: ß = -0.20, 95% CI -0.35, -0.05; 1.5 SD above: ß = -0.30, 95% CI -0.49, -0.11); at lower levels of burnout, older age was associated with improvements in this (1 SD below: ß = 0.19, 95% CI 0.03, 0.35; 1.5 SD below: ß = 0.29, 95% CI 0.08, 0.50). Conclusions: Findings indicated physical and psychological dimensions of work ability that differed by age and occupational burnout. This emphasizes the need for interventions to reduce burnout and to address age-related strengths and vulnerabilities relating to physical and psychological work ability.

Characteristics and clinical assessment of antibiotic delivery by chitosan sponge in the high-risk diabetic foot: a case series.

OBJECTIVE: The local delivery of antimicrobials is attractive for a number of reasons. Chitosan, a biodegradable polysaccharide sponge material, has been proposed as medium to deliver antibiotics directly to wounds. In this report we evaluate the safety and practicality of antimicrobial delivery via chitosan sponge. METHOD: We present the clinical course and systemic absorption characteristics of three cases of people with diabetic foot wounds treated with antibiotic soaked chitosan sponge (Sentrex BioSponge, Bionova Medical, Germantown, TN). The antibiotic sponge was made by reconstituting 1.2g tobramycin or 100mg doxycycline in 10-15ml saline and saturating the sponge with the solution. The sponge was then applied to the wounds. Serum levels of each respective antibiotic were evaluated after application. Additional in vitro studies were conducted evaluating elution of antibiotics from the chitosan sponge at established minimum inhibitory concentrations (MIC) for Staphylococcus aureus over 28 days. RESULTS: No patient experienced adverse local or systemic effects due to the sponge treatment. The measured serum levels applied antibiotics remained far less than established minimums after intravenous therapy. Each patient required further treatment, however local infection or contamination resolved during the course of their hospital stay after the chitosan/antibiotic application. CONCLUSION: The use of antibiotic-impregnated chitosan sponges appears a safe and effective mechanism of local delivery of antimicrobials in wounds. Future studies and clinical trials are ongoing to confirm these results and to guide clinical applications.

Stellarator Turbulence: Subdominant Eigenmodes and Quasilinear Modeling.

Owing to complex geometry, gyrokinetic simulations in stellarator geometry produce large numbers of subdominant unstable and stable, near-orthogonal eigenmodes. Here, results based on the full eigenmode spectrum in stellarator geometry are presented for the first time. In the nonlinear state of a low-magnetic-shear ion-temperature-gradient-driven case, a multitude of these modes are active and imprint the system. Turbulent frequency spectra are broadband as a consequence, in addition to a nonlinear, narrow signature at electron frequencies. It is shown that successful quasilinear, mixing-length transport modeling is possible in stellarators, where it is essential to account for all subdominant unstable modes.

Refractory status epilepticus after inadvertent intrathecal injection of tranexamic acid treated by magnesium sulfate.

We present a case of accidental injection of tranexamic acid during spinal anesthesia for an elective cesarean delivery. Immediately following intrathecal injection of 2mL of solution, the patient complained of severe back pain, followed by muscle spasm and tetany. As there was no evidence of spinal block, the medications given were checked and a 'used' ampoule of tranexamic acid was found on the spinal tray. General anesthesia was induced but muscle spasm and tetany persisted despite administration of a non-depolarizing muscle relaxant. Hemodynamic instability, ventricular tachycardia, and status epilepticus developed, which were refractory to phenytoin, diazepam, and infusions of thiopental, midazolam and amiodarone. Magnesium sulfate was administered postoperatively in the intensive care unit, following which the frequency of seizures decreased, eventually stopping. Unfortunately, on postoperative day three the patient died from cardiopulmonary arrest after an oxygen supply failure that was not associated with the initial event. This report underlines the importance of double-checking medications before injection in order to avoid a drug error. As well, it suggests that magnesium sulfate may be useful in stopping seizures caused by the intrathecal injection of tranexamic acid.

Subdominant modes in zonal-flow-regulated turbulence.

From numerical solutions of a gyrokinetic model for ion temperature gradient turbulence it is shown that nonlinear coupling is dominated by three-wave interactions that include spectral components of the zonal flow and damped subdominant modes. Zonal flows dissipate very little energy injected by the instability, but facilitate its transfer from the unstable mode to dissipative subdominant modes, in part due to the small frequency sum of such triplets. Although energy is transferred to higher wave numbers, consistent with shearing, a large fraction is transferred to damped subdominant modes within the instability range. This is a new aspect of regulation of turbulence by zonal flows.

Transition between saturation regimes of gyrokinetic turbulence.

A gyrokinetic model of ion temperature gradient driven turbulence in magnetized plasmas is used to study the injection, nonlinear redistribution, and collisional dissipation of free energy in the saturated turbulent state over a broad range of driving gradients and collision frequencies. The dimensionless parameter L(T)/L(C), where L(T) is the ion temperature gradient scale length and L(C) is the collisional mean free path, is shown to parametrize a transition between a saturation regime dominated by nonlinear transfer of free energy to small perpendicular (to the magnetic field) scales and a regime dominated by dissipation at large scales in all phase space dimensions.

Nonuniversal power-law spectra in turbulent systems.

Turbulence is generally associated with universal power-law spectra in scale ranges without significant drive or damping. Although many examples of turbulent systems do not exhibit such an inertial range, power-law spectra may still be observed. As a simple model for such situations, a modified version of the Kuramoto-Sivashinsky equation is studied. By means of semianalytical and numerical studies, one finds power laws with nonuniversal exponents in the spectral range for which the ratio of nonlinear and linear time scales is (roughly) scale independent.

Extreme heat fluxes in gyrokinetic simulations: a new critical ß.

A hitherto unexplained feature of electromagnetic simulations of ion temperature gradient turbulence is the apparent failure of the transport levels to saturate for certain parameters; this effect, termed here nonzonal transition, has been referred to as the high-ß runaway. The resulting large heat fluxes are shown to be a consequence of reduced zonal flow activity, brought on by magnetic field perturbations shorting out flux surfaces.

Origin of magnetic stochasticity and transport in plasma microturbulence.

Nonlinear excitation of linearly stable microtearing modes--with zonal modes acting as a catalyst--is shown to be responsible for the near-ubiquitous magnetic stochasticity and associated electromagnetic electron heat transport in electromagnetic gyrokinetic simulations of plasma microturbulence.

Soil mineral N retention and N(2) O emissions following combined application of (15) N-labelled fertiliser and weed residues.

RATIONALE: The combination of plant residues with inorganic fertiliser-N provides the potential to increase N-use efficiency in agricultural fruit production systems, such as olive orchards. The development of weeds in the inter-canopy area of olive orchards is encouraged as a novel strategy to reduce soil erosion. However, little is known about soil N retention or N(2) O production following the combined application of inorganic-N with the mulched weed residues. METHODS: Emissions of (15) N-N(2) O and soil mineral (15) N retention were measured following combined applications of (15) N-labelled fertiliser and a range of olive crop weed residues to a silty loam soil under controlled conditions. These plant residues differed in their C:N ratios, lignin and polyphenol contents. RESULTS: The magnitude of soil (15) N-NO(3) (-) retention from combining plant residues and fertiliser-N was highly dependent on potential N mineralisation (r = -0.96) and the (lignin + polyphenol)-to-N ratio (r = 0.98) of the residues. Fertiliser-N-derived retention was zero for a legume-based mulch but up to 80% in the treatment containing plant residues with a high (lignin + polyphenol)-to-N ratio. N(2) O emissions increased after the addition of residues, and increased further (up to 128%) following the combined application of inorganic fertiliser and residues. Fertiliser-derived (15) N-N(2) O was <1.4% of the total (14+15) N-N(2) O emission and <0.01% of the applied (15) N-NO(3) (-) . Enhanced N(2) O emissions following the application of residues and the fertiliser-N values were positively correlated with the C:N ratio of the residue. Thus, combining organic- and inorganic-N immobilised a significant proportion of the inorganic N with little increase in N(2) O, especially in low C:N ratio residues. CONCLUSIONS: The results demonstrate that whilst there is potential for N(2) O emissions to be controlled by combining weed residues and inorganic fertilisers, this is not easy to achieve as the magnitude and direction of interactions vary between different species due to their varying substrate qualities.

Facilitating dynamo action via control of large-scale turbulence.

The magnetohydrodynamic dynamo effect is considered to be the major cause of magnetic field generation in geo- and astrophysical systems. Recent experimental and numerical results show that turbulence constitutes an obstacle to dynamos; yet its role in this context is not totally clear. Via numerical simulations, we identify large-scale turbulent vortices with a detrimental effect on the amplification of the magnetic field in a geometry of experimental interest and propose a strategy for facilitating the dynamo instability by manipulating these detrimental "hidden" dynamics.

Gross and net rates of nitrogen mineralisation in soil amended with composted olive mill pomace.

Olive mill pomace is the major waste product in the olive oil industry and composting these by-products for the purpose of recycling nutrients and organic matter is a sound environmental strategy. Yet little is known about the quantity and timing of nitrogen (N) release from composted olive mill pomace. This paper assesses both gross (using the (15)N dilution technique) and net (aerobic incubation) nitrogen (N) mineralisation and N(2)O emissions of soil amended with seven commercially available composts of olive mill pomace (COMP). All are currently produced in Andalusia and differ in the proportions of raw materials co-composted with the pomace. The absence of significant differences in net N or gross mineralisation and nitrification in COMP-amended soil compared with a control, except for COMP combined with poultry manure, highlighted the recalcitrant nature of the COMP-N. Applications of COMP are hence unlikely to supply available N in available forms, at least in the short-term. Furthermore, N(2)O emissions from COMP-amended soil were negligible and, therefore, applications in the field should not result in increased N loss through denitrification.

High rates of nitrogen cycling in volcanic soils from Chilean grasslands.

There are over one million hectares of pasture in Chile, and 80% and 50% of the country's milk and meat comes from 72% of this area, situated in the lake region of southern Chile. The soils are volcanic and a major characteristic is that they have very high organic matter (OM) contents with the potential to support plant growth with only moderate levels of added nitrogen (N). To understand better the potential fertility of these soils in order to maximise production and minimise losses of N, we undertook studies using the stable isotope of N ((15)N) to resolve the rates of the main internal N cycling processes in three soils representing the two main volcanic soil types: Osorno and Chiloé (Andisol) and Cudico (Ultisol). We also assessed the longer-term potential of these soils to sustain N release using anaerobic incubation. Gross rates (µg N g(-1) day(-1)) of mineralisation were 27.9, 27.1 and 15.5 and rates of immobilisation were 5.9, 12.0 and 6.3 for Osorno, Chiloé and Cudico, respectively, implying high rates of net mineralisation in these soils. This was confirmed by anaerobic incubation which gave potential seasonal net mineralisation indices of 1225, 1059 and 450 kg N ha(-1) in the top 10 cm soil layers of the three soils. However, plant production may still benefit from added N, as the release of N from organic sources may not be closely synchronised with crop demand. The low rates of nitrification that we found with these acidic soils suggest that the more mobile N (viz. nitrate-N) would be in limited supply and plants would have to compete for the less mobile ammonium-N with the soil microbial biomass. Nitrogen was mineralised in appreciable amounts even down to 60 cm depth, so that leaching could become significant, particularly if the soils were limed, which could enhance nitrification and N mobility through the soil profile.

Gyrokinetic microtearing turbulence.

The nonlinear dynamics of microtearing modes in standard tokamak plasmas are investigated by means of ab initio gyrokinetic simulations. The saturation levels of the magnetic field fluctuations can be understood in the framework of a balance between (small poloidal wave number) linear drive and small-scale dissipation. The resulting heat transport is dominated by the electron magnetic component, and the transport levels are found to be experimentally relevant. Microtearing modes thus constitute another candidate for explaining turbulent transport in such toroidal systems.

Saturation of gyrokinetic turbulence through damped eigenmodes.

In the context of toroidal gyrokinetic simulations, it is shown that a hierarchy of damped modes is excited in the nonlinear turbulent state. These modes exist at the same spatial scales as the unstable eigenmodes that drive the turbulence. The larger amplitude subdominant modes are weakly damped and exhibit smooth, large-scale structure in velocity space and in the direction parallel to the magnetic field. Modes with increasingly fine-scale structure are excited to decreasing amplitudes. In aggregate, damped modes define a potent energy sink. This leads to an overlap of the spatial scales of energy injection and peak dissipation, a feature that is in contrast with more traditional turbulent systems.