An extended hybrid magnetohydrodynamics gyrokinetic model for numerical simulation of shear Alfv\'en waves in burning plasmas

Adopting the theoretical framework for the generalized fishbonelike dispersion relation, an extended hybrid magnetohydrodynamics gyrokinetic simulation model has been derived analytically by taking into account both thermal ion compressibility and diamagnetic effects in addition to energetic particle kinetic behaviors. The extended model has been used for implementing an eXtended version of Hybrid Magnetohydrodynamics Gyrokinetic Code (XHMGC) to study thermal ion kinetic effects on Alfv\'enic modes driven by energetic particles, such as kinetic beta induced Alfv\'en eigenmodes in tokamak fusion plasmas

Theory and modeling of electron fishbones

Internal kink instabilities exhibiting fishbone like behavior have been observed in a variety of experiments where a high energy electron population, generated by strong auxiliary heating and/or current drive systems, was present. After briefly reviewing the experimental evidences of energetic electrons driven fishbones, and the main results of linear and nonlinear theory of electron fishbones, the results of global, self-consistent, nonlinear hybrid MHD-Gyrokinetic simulations will be presented. To this purpose, the extended/hybrid MHD-Gyrokinetic code XHMGC will be used. Linear dynamics analysis will enlighten the effect of considering kinetic thermal ion compressibility and diamagnetic response, and kinetic thermal electrons compressibility, in addition to the energetic electron contribution. Nonlinear saturation and energetic electron transport will also be addressed, making extensive use of Hamiltonian mapping techniques, discussing both centrally peaked and off-axis peaked energetic electron profiles. It will be shown that centrally peaked energetic electron profiles are characterized by resonant excitation and nonlinear response of deeply trapped energetic electrons. On the other side, off-axis peaked energetic electron profiles are characterized by resonant excitation and nonlinear response of barely circulating energetic electrons which experience toroidal precession reversal of their motion

How good are low back pain guidelines? A critical appraisal of the quality of clinical practice guidelines using the agree II tool

Clinical practice guidelines (CPGs) provide evidence-based recommendations for clinical practice, but their increasing number in the last few years arises possible concerns about their quality. Preliminary results on the methodological quality of CPGs for low back pain management (LBP) are here presented. The results of this review can help researchers and Italian policymakers select and adopt the highest quality Clinical Practice Guidelines (CPGs) for Low Back Pain (LBP) management in the CPG National Systems (Sistema Nazionale Linee Guida)

Nonlinear dynamics of beta induced Alfv\'en eigenmode driven by energetic particles

Nonlinear saturation of beta induced Alfv\'en eigenmode, driven by slowing down energetic particles via transit resonance, is investigated by the nonlinear hybrid magnetohyrodynamic gyro-kinetic code (XHMGC). Saturation is characterized by frequency chirping and symmetry breaking between co- and counter-passing particles, which can be understood as the the evidence of resonance-detuning. The scaling of the saturation amplitude with the growth rate is also demonstrated to be consistent with radial resonance detuning due to the radial non-uniformity and mode structure

Disentangling the Hypothesis of Host Dysosmia and SARS-CoV-2 : The Bait Symptom That Hides Neglected Neurophysiological Routes

The respiratory condition COVID-19 arises in a human host upon the infection with SARS-CoV-2, a coronavirus that was first acknowledged in Wuhan, China, at the end of December 2019 after its outbreak of viral pneumonia. The full-blown COVID-19 can lead, in susceptible individuals, to premature death because of the massive viral proliferation, hypoxia, misdirected host immunoresponse, microthrombosis, and drug toxicities. Alike other coronaviruses, SARS-CoV-2 has a neuroinvasive potential, which may be associated with early neurological symptoms. In the past, the nervous tissue of patients infected with other coronaviruses was shown to be heavily infiltrated. Patients with SARS-CoV-2 commonly report dysosmia, which has been related to the viral access in the olfactory bulb. However, this early symptom may reflect the nasal proliferation that should not be confused with the viral access in the central nervous system of the host, which can instead be allowed by means of other routes for spreading in most of the neuroanatomical districts. Axonal, trans-synaptic, perineural, blood, lymphatic, or Trojan routes can gain the virus multiples accesses from peripheral neuronal networks, thus ultimately invading the brain and brainstem. The death upon respiratory failure may be also associated with the local inflammation- and thrombi-derived damages to the respiratory reflexes in both the lung neuronal network and brainstem center. Beyond the infection-associated neurological symptoms, long-term neuropsychiatric consequences that could occur months after the host recovery are not to be excluded. While our article does not attempt to fully comprehend all accesses for host neuroinvasion, we aim at stimulating researchers and clinicians to fully consider the neuroinvasive potential of SARS-CoV-2, which is likely to affect the peripheral nervous system targets first, such as the enteric and pulmonary nervous networks. This acknowledgment may shed some light on the disease understanding further guiding public health preventive efforts and medical therapies to fight the pandemic that directly or indirectly affects healthy isolated individuals, quarantined subjects, sick hospitalized, and healthcare workers

The central role of iron in human nutrition : from folk to contemporary medicine

Iron is a fundamental element in human history, from the dawn of civilization to contemporary days. The ancients used the metal to shape tools, to forge weapons, and even as a dietary supplement. This last indication has been handed down until today, when martial therapy is considered fundamental to correct deficiency states of anemia. The improvement of the martial status is mainly targeted with dietary supplements that often couple diverse co-factors, but other methods are available, such as parenteral preparations, dietary interventions, or real-world approaches. The oral absorption of this metal occurs in the duodenum and is highly dependent upon its oxidation state, with many absorption influencers possibly interfering with the intestinal uptake. Bone marrow and spleen represent the initial and ultimate step of iron metabolism, respectively, and the most part of body iron circulates bound to specific proteins and mainly serves to synthesize hemoglobin for new red blood cells. Whatever the martial status is, today\u2019s knowledge about iron biochemistry allows us to embrace exceedingly personalized interventions, which however owe their success to the mythical and historical events that always accompanied this metal

Exploring circannual rhythms and chronotype effect in patients with Obsessive-Compulsive Tic Disorder (OCTD) : a pilot study

Background: The aim of this study was to test, through a chronobiologic approach, the existence of a significant circannual rhythm of tics and obsessive-compulsive symptoms in patients with Obsessive-Compulsive Tic Disorder (OCTD). The chronotype effect on tics and OC symptoms during seasons was also studied. Methods: Patients with a diagnosis of OCTD (N = 37; mean age = 18.78 \ub1 8.61) underwent four clinical evaluations: Winter (WIN), Spring (SPR), Summer (SUM) and Autumn (AUT). Tics were evaluated through Yale Global Tic Severity Scale (YGTSS) and OC symptoms through Yale-Brown Obsessive Compulsive Scale (Y-BOCS). Patients\u2019 chronotype was assessed by the Horne-Ostberg morningness-eveningness questionnaire (MEQ), which categorizes subjects according to the individuals'chronotype, being morning-type, evening-type, and neither-type. Results: A statistically significant circannual rhythm was observed for OC symptoms (p = 0.007), with the acrophase occurring between AUT and WIN. Y-BOCS differed along the year (p = 0.0003 and \u3b72p = 0.40) with lower results in SUM compared to WIN (p < 0.05) and AUT (p < 0.01). Tics displayed no circannual rhythm and YGTSS scores were comparable among seasons. Patients were classified as 15 morning-types (40.5%) 15 neither-types (40.5%) and 7 evening-types (19.0%). YGTSS data were similar for all chronotypes while Y-BOCS results were greater during SUM in evening-types than morning-type patients (p < 0.05; 15.7 \ub1 5.2 vs 3.4 \ub1 6.0). Limitations: It is essential to investigate the existence of tics and OC symptoms circannual rhythms over the course of more than one year with a larger sample. Conclusions: OC symptoms displayed a significant circannual rhythm and were influenced by patients\u2019 chronotype. On the contrary, tics resulted similar among seasons and chronotypes

Marketing a tourism industry in late stage decline: The case of the Isle of Man

Qualitative interviews in the Isle of Man uncovered local perceptions of a tourism industry in late stage decline. Social impacts of decline are pronounced including facilities loss, cultural changes and a heightening of perceived peripherality: which taken together undermine local identity. Tourists are welcomed as they help to affirm the pride residents have in their island in creating a more active atmosphere, provide social interaction opportunities and to combat negative stereotyping. Thus findings emphasise the diverse, unique and persistent benefits of tourism in the Isle of Man, despite its decline. Destination marketing recommendations are therefore made to better address the experiences and desires of communities experiencing decline