Intrinsic rotation with gyrokinetic models

The generation of intrinsic rotation by turbulence and neoclassical effects in tokamaks is considered. To obtain the complex dependences observed in experiments, it is necessary to have a model of the radial flux of momentum that redistributes the momentum within the tokamak in the absence of a preexisting velocity. When the lowest order gyrokinetic formulation is used, a symmetry of the model precludes this possibility, making small effects in the gyroradius over scale length expansion necessary. These effects that are usually small become important for momentum transport because the symmetry of the lowest order gyrokinetic formulation leads to the cancellation of the lowest order momentum flux. The accuracy to which the gyrokinetic equation needs to be obtained to retain all the physically relevant effects is discussed

Differences in treatment for substance use disorders by insurance status: Self-help only versus outpatient medical treatment

Background: The role of insurance on substance use disorders (SUD) treatment utilization generally is poorly understood and still less is known on how insurance status relates to the use of evidence-based treatment (i.e., medicalization approach) compared to other treatments, like single self-help groups, where the research on effectiveness is less supportive. This study examines associations between health insurance and any SUD treatment utilization as well as use of single self- help versus medicalization approach. Methods: A cross-sectional study design was used. Data were from the 2015-2017, public use National Surveys on Drug Use and Health (NSDUH). Adjusted logistic regressions were used to examine the associations controlling for socio-demographics, recent major depressive episode, and survey year. All analyses used survey weights to be representative of the US population and account for the NSDUH’s complex survey design. Results: After adjustment for covariates, those with publicly insured remained more likely to use any SUD treatment in the past year (odd ratio [OR] 1.82; 95% CI: 1.36-2.43), compared to those without insurance. Further, compared with uninsured, those with public insurance reported lower odds of using only self-help treatment (OR 0.42; 95% CI: 0.23-0.74) versus medicalization approach utilization. Conclusions: Publicly insured persons with SUD are more likely to use SUD treatment in the past year than the uninsured. Uninsured people with SUD are more likely to use single self-help as a substitute for medicalization approach.https://scholarscompass.vcu.edu/gradposters/1098/thumbnail.jp

Chronic Obstructive Pulmonary Disease: A Growing but Neglected Global Epidemic

Peter Barnes argues that COPD is a major and increasing global health epidemic that has received insufficient attention from the health-care profession, governments, and the pharmaceutical industry

Corticosteroids: still at the frontline in asthma treatment?

Inhaled corticosteroids (ICS) have led to improved asthma control and reduced asthma mortality in the Western world. ICS are effective in combating T-helper type 2-driven inflammation featuring mast cell and eosinophilic airway infiltration. Their effect on innate immunity-driven neutrophilic inflammation is poor and their ability to prevent airway remodeling and accelerated lung decline is controversial. Although ICS remain pivotal drugs in asthma management, research is needed to find drugs complementary to the combination ICS/long-acting beta2-agonist in refractory asthma and perhaps a new class of drugs as a first-line treatment in mild to moderate noneosinophilic asthma.Peer reviewe