Robust Avoidance of Edge-Localized Modes alongside Gradient Formation in the Negative Triangularity Tokamak Edge

In a series of high performance diverted discharges on DIII-D, we demonstrate that strong negative triangularity (NT) shaping robustly suppresses all edge-localized mode (ELM) activity over a wide range of plasma conditions: ⟨n⟩=0.1-1.5×10^{20}  m^{-3}, P_{aux}=0-15  MW, and |B_{t}|=1-2.2  T, corresponding to P_{loss}/P_{LH08}∼8. The full dataset is consistent with the theoretical prediction that magnetic shear in the NT edge inhibits access to ELMing H-mode regimes; all experimental pressure profiles are found to be at or below the infinite-n ballooning stability limit. Our present dataset also features edge pressure gradients in strong NT that are closer to an H-mode than a typical L-mode plasma, supporting the consideration of NT for reactor design.

Impact of COVID-19 pandemic on incidence of long-term conditions in Wales: a population data linkage study using primary and secondary care health records

BACKGROUND

The COVID-19 pandemic has directly and indirectly had an impact on health service provision owing to surges and sustained pressures on the system. The effects of these pressures on the management of long-term or chronic conditions are not fully understood.

AIM

To explore the effects of COVID-19 on the recorded incidence of 17 long-term conditions.

DESIGN AND SETTING

This was an observational retrospective population data linkage study on the population of Wales using primary and secondary care data within the Secure Anonymised Information Linkage (SAIL) Databank.

METHOD

Monthly rates of new diagnosis between 2000 and 2021 are presented for each long-term condition. Incidence rates post-2020 were compared with expected rates predicted using time series modelling of pre-2020 trends. The proportion of annual incidence is presented by sociodemographic factors: age, sex, social deprivation, ethnicity, frailty, and learning disability.

RESULTS

A total of 5 476 012 diagnoses from 2 257 992 individuals are included. Incidence rates from 2020 to 2021 were lower than mean expected rates across all conditions. The largest relative deficit in incidence was in chronic obstructive pulmonary disease corresponding to 343 (95% confidence interval = 230 to 456) undiagnosed patients per 100 000 population, followed by depression, type 2 diabetes, hypertension, anxiety disorders, and asthma. A GP practice of 10 000 patients might have over 400 undiagnosed long-term conditions. No notable differences between sociodemographic profiles of post- and pre-2020 incidences were observed.

CONCLUSION

There is a potential backlog of undiagnosed patients with multiple long-term conditions. Resources are required to tackle anticipated workload as part of COVID-19 recovery, particularly in primary care.

The impact of COVID-19 pandemic on trends in the recorded incidence of Long-Term Conditions identified from routine electronic health records between 2000 and 2021 in Wales: a population data linkage study

BackgroundThe COVID-19 pandemic has resulted in delayed diagnosis and treatment for cancer patients and increases in elective surgery waiting lists. The impact on other ‘long-term’ conditions (LTCs) is unclear. We examined the effects of the pandemic on the recorded incidence of 20 LTCs to inform decisions on treatment pathways and resource allocation. ApproachWe included Welsh residents diagnosed with any of 20 LTCs for the first time between 2000-2021. Data were accessed and analysed within the Secure Anonymised Information Linkage (SAIL) Databank. The primary aim was to assess the impact of the COVID-19 pandemic on trends in recorded incidence. Secondarily we examined incidence by socio-demographic and clinical subgroups: age, sex, deprivation quintile, ethnicity, frailty score and learning disability. Incidence were presented as monthly rates for each LTC. We performed interrupted time series analyses to estimate; the immediate and long-term change in rates following the pandemic; and the size of the undiagnosed population. ResultsWe included 2,206,070 individuals diagnosed with at least one LTC. An immediate reduction in recording of new diagnoses was observed in April 2020 across all 20 LTCs, followed by a gradual recovery towards pre-pandemic levels over the next 18 months, though at different rates across conditions. The largest difference between observed and expected (as predicted using pre-pandemic trends) incidence between January 2020 and June 2021 were in the diagnoses of COPD (-43%, 95% CI (-50%, -34%)), Asthma, Hypertension and Depression and the smallest difference was in Type 1 diabetes, dementia, stroke and TIA (-8%, 95% CI (-19% ,5%)). Differences in the proportions of incidence by socio-demographic and clinical subgroups in the years preceding and following the pandemic have also been analysed (results to be finalised). ConclusionThere was an abrupt reduction in the observed incidence of all 20 LTCs after March 2020 followed by a gradual recovery over consequent months towards pre-pandemic levels. Of 20 LTCs, 15 strongly indicate a reservoir of yet undiagnosed patients. The results from this study will have implications in resource allocation.

Are two cues always better than one? The role of multiple intra-sensory cues compared to multi-cross-sensory cues in children's incidental category learning

Simultaneous presentation of multisensory cues has been found to facilitate children's learning to a greater extent than unisensory cues (e.g., Broadbent, White, Mareschal, & Kirkham, 2017). Current research into children's multisensory learning, however, does not address whether these findings are due to having multiple cross-sensory cues that enhance stimuli perception or a matter of having multiple cues, regardless of modality, that are informative to category membership. The current study examined the role of multiple cross-sensory cues (e.g., audio-visual) compared to multiple intra-sensory cues (e.g., two visual cues) on children's incidental category learning. On a computerized incidental category learning task, children aged six to ten years (N = 454) were allocated to either a visual-only (V: unisensory), auditory-only (A: unisensory), audio-visual (AV: multisensory), Visual-Visual (VV: multi-cue) or Auditory-Auditory (AA: multi-cue) condition. In children over eight years of age, the availability of two informative cues, regardless of whether they had been presented across two different modalities or within the same modality, was found to be more beneficial to incidental learning than with unisensory cues. In six-year-olds, however, the presence of multiple auditory cues (AA) did not facilitate learning to the same extent as multiple visual cues (VV) or when cues were presented across two different modalities (AV). The findings suggest that multiple sensory cues presented across or within modalities may have differential effects on children's incidental learning across middle childhood, depending on the sensory domain in which they are presented. Implications for the use of multi-cross-sensory and multiple-intra-sensory cues for children's learning across this age range are discussed.

Incidental category learning and cognitive load in a multisensory environment across childhood

Multisensory information has been shown to facilitate learning (Bahrick & Lickliter, 2000; Broadbent, White, Mareschal, & Kirkham, 2017; Jordan & Baker, 2011; Shams & Seitz, 2008). However, although research has examined the modulating effect of unisensory and multisensory distractors on multisensory processing, the extent to which a concurrent unisensory or multisensory cognitive load task would interfere with or support multisensory learning remains unclear. This study examined the role of concurrent task modality on incidental category learning in 6- to 10-year-olds. Participants were engaged in a multisensory learning task while also performing either a unisensory (visual or auditory only) or multisensory (audiovisual) concurrent task (CT). We found that engaging in an auditory CT led to poorer performance on incidental category learning compared with an audiovisual or visual CT, across groups. In 6-year-olds, category test performance was at chance in the auditory-only CT condition, suggesting auditory concurrent tasks may interfere with learning in younger children, but the addition of visual information may serve to focus attention. These findings provide novel insight into the use of multisensory concurrent information on incidental learning. Implications for the deployment of multisensory learning tasks within education across development and developmental changes in modality dominance and ability to switch flexibly across modalities are discussed.

Upgraded flowing liquid lithium limiter for improving Li coverage uniformity and erosion resistance in EAST device

We report on design and technology improvements for a flowing liquid lithium (FLiLi) limiter inserted into auxiliary heated discharges in the experimental advanced superconducting tokamak device. In order to enhance Li coverage uniformity and erosion resistance, a new liquid Li distributor with homogenous channels was implemented. In addition, two independent electromagnetic pumps and a new horizontal capillary structure contributed to an improvement in the observed Li flow uniformity (from 30% in the previous FLiLi design to >80% in this FLiLi design). To improve limiter surface erosion resistance, hot isostatic press technology was applied, which improved the thermal contact between thin stainless steel protective layers covering the Cu heat sink. The thickness of the stainless steel layer was increased from 0.1 mm to 0.5 mm, which also helped macroscopic erosion resilience. Despite the high auxiliary heating power up to 4.5 MW, no Li bursts were recorded from FLiLi, underscoring the improved performance of this new design.

Specialized Pheromone and Lure Application Technology as an Alternative Male Annihilation Technique to Manage Bactrocera tryoni (Diptera: Tephritidae)

The results of this study suggest that a novel male annihilation technique (specialized pheromone and lure application technology [SPLAT] incorporating cue-lure [CL] plus spinosad) is as effective as industry standard male annihilation controls, and is worth exploring further to manage Bactrocera tryoni (Froggatt) populations. Three lures were evaluated in a contact and feeding bioassay and a cage attractancy trial: 1) SPLAT-CL + spinosad; 2) SPLAT-CL without spinosad; and 3) wick-CL + malathion. In a field attraction trial, lures (1) and (3) were evaluated with a third treatment, caneite blocks-CL + malathion. Lures were weathered for 0, 1, 2, 4, or 8 wk, with an additional weathering treatment of 12 wk included in the field trial. In the contact and feeding bioassay, lures with SPLAT-CL + spinosad were >97% effective at 48 h for up to 2 wk weathering; however, wicks-CL + malathion killed B. tryoni within 2 h of exposure under all weathering periods. In the cage attractancy trial, SPLAT-CL + spinosad was as effective as, or performed better than, wicks-CL + malathion under all weathering treatments. The field study trap catches were similar for SPLAT-CL + spinosad and blocks-CL + malathion, and both had higher trap catches than wicks-CL + malathion at all weathering periods, except week 12. Overall, SPLAT-CL + spinosad compared favorably with current standard techniques for male annihilation and warrants further research. SPLAT-CL + spinosad may be a reduced-risk alternative for wicks-CL + malathion or blocks-CL + malathion for B. tryoni and other CL-responding fruit flies, such as Bactrocera cucurbitae Coquillett, because it contains a reduced-risk insecticide that poses a lower risk to humans and the environment and does not require labor-intensive handling and placement.

Protein kinase C regulates ezrin-radixin-moesin phosphorylation in canine osteosarcoma cells

The development of metastasis is the most significant cause of death for both canine and human patients with osteosarcoma (OS). Ezrin has been associated with tumour progression and metastasis in human, canine and murine OS. Ezrin activation is dynamically regulated by protein kinase C (PKC) during metastatic progression in human and murine OS. To include the dog in the development of therapeutics that target ezrin biology, we characterized four new canine OS cell lines and confirmed the relationship between PKC and ezrin in these cells. Three of four cell lines formed tumours in mice that were histologically consistent with OS. All cell lines were markedly aneuploid and expressed ezrin and PKC. Finally, both ezrin phosphorylation and cell migration were inhibited using a PKC inhibitor. These data suggest that an association between PKC-mediated activation of ezrin and the metastatic phenotype in canine OS cells.

Soft x-ray virtual diagnostics for tokamak simulations

The numerical toolset, FAR-TECH Virtual Diagnostic Utility, for generating virtual experimental data based on theoretical models and comparing it with experimental data, has been developed for soft x-ray diagnostics on DIII-D. The virtual (or synthetic) soft x-ray signals for a sample DIII-D discharge are compared with the experimental data. The plasma density and temperature radial profiles needed in the soft x-ray signal modeling are obtained from experimental data, i.e., from Thomson scattering and electron cyclotron emission. The virtual soft x-ray diagnostics for the equilibriums have a good agreement with the experimental data. The virtual diagnostics based on an ideal linear instability also agree reasonably well with the experimental data. The agreements are good enough to justify the methodology presented here for utilizing virtual diagnostics for routine comparison of experimental data. The agreements also motivate further detailed simulations with improved physical models such as the nonideal magnetohydrodynamics contributions (resistivity, viscosity, nonaxisymmetric error fields, etc.) and other nonlinear effects, which can be tested by virtual diagnostics with various stability modeling.

Magnesium-rich minerals in sediment and suspended particulates of South Florida water bodies: implications for turbidity

Fine sediments in shallow water bodies such as Lake Okeechobee are prone to resuspension. Predominantly inorganic "mud" sediment that covers approximately 670 km2 of the lake has been recognized as a persistent source of turbidity. The objective of this study was to determine if mineral components of sediments in Lake Okeechobee and water conveyances of the northern Everglades also occur as suspended sediment and hence constitute a potential abiotic contributor to turbidity. Sediment samples were collected from nine stations within the lake and eight locations north of Water Conservation Area 2A in the Everglades. Water samples were also collected at selected locations. The silt and clay mineralogy of sediment and suspended particles was determined using X-ray diffraction, thermogravimetry, scanning-electron microscopy, energy-dispersive X-ray elemental microanalysis, and high-resolution transmission-electron microscopy. Clay fractions of the lake sediment contained the Mg silicate minerals sepiolite and palygorskite, along with smectite, dolomite, calcite, and kaolinite. Sediment silt fractions were dominated by carbonates and/or quartz, with smaller amounts of Ca phosphates and sepiolite. Mineralogy of the mud sediment was similar to that reported for geologic phosphate deposits. This suggests that the mud sediment might have accumulated by stream transport of minerals from these deposits. Suspended solids and mud-sediment mineralogy were similar, except that smectite was more abundant in suspended solids. Everglade samples also contained Mg-rich minerals. The small size, low density, and fibrous or platy nature of the prevalent mud sediment minerals make them an abiotic, hydrodynamically sensitive source of persistent turbidity in a shallow lake. Mitigation efforts focused exclusively on P-induced biogeochemical processes do not address the origin or effects of these minerals. Ecological management issues such as turbidity control, P retention, geologic P input, and suitability of dredging are related to mud-sediment properties and provenance.

Effect of Monensin Delivery Method on Dry Matter Intake, Body Condition Score, and Metabolic Parameters in Transition Dairy Cows

An investigation was conducted to compare the effects of the monensin controlled-release capsule, monensin sodium in feed, and a negative control on feed intake and metabolic parameters in a randomized and blinded clinical trial. A total of 136 Holstein cows and heifers were assigned to a negative control group, administered a monensin controlled-release capsule (CRC) or administered 22 mg/kg of dry matter of monensin sodium in the total mixed ration (premix). Cows were enrolled 3 wk prior to expected calving; at this time monensin treatment began. Cows were located at the Elora Dairy Research Centre (Elora, Ontario, Canada). Blood samples were obtained at enrollment, at 1 wk prior to expected calving date, at calving, and at 1 and 2 wk postpartum. Sera from these samples were analyzed for beta-hydroxybutyrate (BHBA), nonesterified fatty acids, glucose, urea, bilirubin, aspartate aminotransferase activity, insulin, and cortisol. Cows were assigned a body condition score upon enrollment and upon completion of the trial. The dry matter intake was measured for all cows for the entire experimental period (12.0, 11.7, and 11.3 kg/d for control, premix, and CRC groups, respectively). However, no differences in dry matter intake between treatment groups were noted. The interaction of experimental group and sampling time was significant for serum concentration of BHBA and urea. Both monensin delivery methods significantly decreased serum BHBA postpartum. Urea concentrations were increased in the postpartum period compared with the prepartum samples. The CRC group had a significant impact on reducing the loss in body condition over the study period. Serum concentrations of all measured metabolic parameters varied over the peripartum period. Calving season, parity, and body condition score at the start of the study period influenced many of the measured metabolic parameters.

Characterization of virulence, colony morphotype and the glycopeptidolipid of Mycobacterium avium strain 104

SETTING

Members of the Mycobacterium avium complex (MAC) are responsible for mycobacterial disease in children, the aged and in immunocompromised individuals. The complex consists of different species, serovars and morphologic forms that vary in virulence. One isolate of the MAC is currently being sequenced (MAC 104) and was chosen based on its derivation from an AIDS patient and the fact that it could be genetically manipulated.

OBJECTIVE

MAC 104 was therefore analyzed for virulence, colony morphotype and expression of the glycopeptidolipid (GPL) responsible for serotying differences and the rough to smooth morphological switch.

RESULTS

The isolate was found to be virulent in the murine model of low-dose aerosol infection in that it could colonize the lung, proliferate within the tissue and disseminate to other organs. MAC 104 expressed a variety of colony morphotypes, the most prevalent of which were smooth opaque, smooth transparent and rough. All three morphotypes could persist in the lung; however, the transparent and rough morphotypes grew more rapidlyinvivo. The rough morphotype was unusual in that it expressed an atypical form of the GPL usually absent from rough morphotypes.

CONCLUSION

This characterization complements the genome data and confirms that MAC 104 behaves similarly to other MAC isolates.

Effect of one morning meal and a bolus of dexamethasone on 24-hour variation of serum leptin levels in humans

OBJECTIVE

We have previously shown that morning administration of dexamethasone in combination with food induces a doubling of serum leptin levels starting at 7 hours after dexamethasone administration, with a maximum effect at 10 hours, the latest time point that we have studied. However, dexamethasone given in the absence of food had no effect on serum leptin at 10 hours. The present experiment was undertaken to determine the duration of the effect of dexamethasone on 24-hour serum leptin under fasted and fed conditions in humans.

RESEARCH METHODS AND PROCEDURES

Six healthy non-obese male volunteers were studied under the following four conditions: 1) dexamethasone (2 mg intravenously, given at 0900 hours) with fasting; 2) dexamethasone with food (1,700 kcal, 55% carbohydrate, 15% protein, and 30% fat, given in one meal 2 hours after dexamethasone administration at 1100 hours); 3) saline with food (same meal); 4) saline with fasting. Serum leptin, glucose, insulin, and cortisol were monitored every 30 minutes for 24 hours.

RESULTS

1) Under the fasting condition, dexamethasone increased leptin nocturnal secretion between 2100 and 2400 hours. 2) A single meal (1,700 kcal) at 1100 hours increased nocturnal leptin secretion when compared with the fasting condition. The peak increase of leptin was 123% over baseline between 2100 and 2400 hours, 10 to 14 hours after the meal. 3) In the fed + dexamethasone condition, leptin levels increased from baseline starting 8 hours after dexamethasone injection, reached a maximum increase of 260% between 2100 and 2400 hours, then decreased thereafter, remaining elevated compared to baseline for 16 hours. There was a correlation between 24-hour leptin secretion and insulin secretion after a single morning meal.

DISCUSSION

A single bolus of dexamethasone, given before a single large meal, produces a delayed (6-hour) but long-lasting increase in serum leptin (over 16 hours). Under fasted conditions, dexamethasone does not increase daytime leptin but does increase leptin during the night.

The prevalence, composition, and function of ethics committees in nursing facilities: results of a random, national survey of American Health Care Association members

OBJECTIVES

To determine the prevalence, composition, and function of ethics committees in extended care facilities in the United States.

DESIGN

Descriptive survey by mail.

SETTING

A 5% random sample (n = 851) of nursing facility members of the American Health Care Association (n = 17,020). Most of these facilities (75%) are intermediate care facilities; the remainder include a varying number of skilled beds.

METHODS

An eight-item questionnaire was sent to the randomly selected 851 extended care facilities. The questionnaire inquired about the existence of an ethics committee, plans for formation when applicable, composition of the ethics committee, and its function. Survey data was coded and merged with information on facility characteristics that are part of the American Health Care Association's database.

RESULTS

Of the responding facilities (n = 394), 34% reported the presence of a functioning ethics committee, with an additional 19% indicating definite plans for ethic committee formation. Forty-three percent expressed no interest in establishing an ethics committee, and 4% reported having had an ethics committee sometime in the past. The greatest proportion of committee time was spent in case review (39%) with lesser amounts of time expended in areas of policy formation (27%) and education (27%). Forty percent of the ethics committees performed two or fewer case reviews per year. Nearly all committees included the following disciplines in the membership: nurses (96%), physicians (95%), and social workers (89%). Facility administrators (77%) and clergy (70%) were frequently represented. Very few facilities reported representation by residents (8%) and Certified Nursing Assistants (2%). The Medical Director served as a committee member on 75% of the ethics committees, and in more than one-half of those instances, he/she was the sole physician on the committee.

CONCLUSION

Ethics committees are currently active in or there are plans for their development in more than 50% of extended care facilities in the U.S. this represents a very significant increase in prevalence during the last decade. This tendency to form ethics committee's may slow considerably in the future. Ethics committees exhibit considerable variability in structure and function.

Do the social sciences create phenomena?: the example of public opinion research

This paper is an investigation into the philosophy and the history of the social sciences. Some philosophers of the social sciences have suggested that a key feature of the natural sciences is their capacity to create phenomena, and that the social sciences do not meet this criterion. We suggest, to the contrary, that the social sciences can and do create phenomena, in the sense of new ways of describing and acting that have been used to produce all sorts of effects. Like the natural sciences, the social sciences create their phenomena through the procedures that are established to discover them. But the creation of phenomena is a complex, technically difficult and contested process and its success rare. Historically, this argument is developed through a case-study of the development and evolution of public opinion research in the USA and Britain. We argue that by the 1950s public opinion produced a version of the world that had entered 'into the true'. Special attention is given to technical considerations in the development of public opinion research, especially the genealogy of a particular research technology, that of the representative sample. Whilst we are not concerned with demarcation criteria, we argue that there are some important differences between the social and the natural sciences; that the former have a less concentrated 'spatial mix' and a slower 'tempo of creativity'. None the less, in this particular case, the social sciences have played a key role in the creation of opinioned persons and an opinionated society.

Light-induced modulation of coupling between AII amacrine cells in the rabbit retina

The rod-driven, AII amacrine cells in the mammalian retina maintain homologous gap junctions with one another as well as heterologous gap junctions with on-cone bipolar cells. We used background illumination to study whether changes in the adaptational state of the retina affected the permeabilities of these two sets of gap junctions. To access changes in permeability, we injected single AII amacrine cells with the biotinylated tracer, Neurobiotin, and measured the extent of tracer coupling to neighboring AII cells and neighboring cone bipolar cells. We also measured the center-receptive field size of AII cells to assess concomitant changes in electrical coupling. Our results indicate that in well dark-adapted retinas, AII cells form relatively small networks averaging 20 amacrine cells and covering about 75 microns. The size of these networks matched closely to the size of AII cell on-center receptive fields. However, over most of their operating range, AII cells formed dramatically larger networks, averaging 326 amacrine cells, which corresponded to an increased receptive-field size. As the retina was light adapted beyond the operating range of the AII cells, they uncoupled to form networks comparable in size to those seem in well dark-adapted retinas. Our results, then, indicate that the adaptational state of the retina has a profound effect on the extent of electrical coupling between AII amacrine cells. Although we observed light-induced changes in the number of tracer-coupled cone bipolar cells, these appeared to be an epiphenomenon of changes in homologous coupling between AII amacrine cells. Therefore, in contrast to the robust changes in AII-AII coupling produced by background illumination, our data provided no evidence of a light-induced modulation of coupling between AII cells and on-cone bipolar cells.

Epidemiology as an investigative paradigm: the College of General Practitioners in the 1950s

This paper focuses upon the research investigations of the College of General Practitioners in Britain in the 1950s. Beginning with a discussion of Michel Foucault's concept of 'pastoral power', the paper proceeds to analyse the ways in which the College attempted to set up an epidemiological scrutiny of general practices across Britain; from practice by practice observational studies to the first National Morbidity Study. The paper concludes by arguing that the epidemiological paradigm in general practice was beset by particular internal 'limits', and was replaced increasingly from the 1960s by an emphasis upon psychotherapeutic approaches.