Unraveling Diffusion in Fusion Plasma: A Case Study of In Situ Processing and Particle Sorting

This work starts an in situ processing capability to study a certain diffusion process in magnetic confinement fusion. This diffusion process involves plasma particles that are likely to escape confinement. Such particles carry a significant amount of energy from the burning plasma inside the tokamak to the diverter and damaging the diverter plate. This study requires in situ processing because of the fast changing nature of the particle diffusion process. However, the in situ processing approach is challenging because the amount of data to be retained for the diffusion calculations increases over time, unlike in other in situ processing cases where the amount of data to be processed is constant over time. Here we report our preliminary efforts to control the memory usage while ensuring the necessary analysis tasks are completed in a timely manner. Compared with an earlier naive attempt to directly computing the same diffusion displacements in the simulation code, this in situ version reduces the memory usage from particle information by nearly 60% and computation time by about 20%

Isotope effects under the influence of global radial electric fields in a helical configuration

Isotope effects under the influence of a radial electric field are examined in a helical magnetic field configuration. We perform global gyrokinetic simulations with additional poloidal rotations to estimate quasi-linear heat flux due to ion temperature gradient mode under the mixing length model. In single-ion-species plasmas, the mass number dependency of heat flux agrees with gyro-Bohm scaling in the absence of a radial electric field. Favorable mass number dependencies violating gyro-Bohm scaling are observed in the presence of a global radial electric field or a heavy hydrogen component in multi-ion-species plasmas. The radial electric field and the heavy hydrogen component affect the heat flux through an increase of wavelength as well as mode stabilization. Poloidal Mach number characterizes the transition from unfavorable to favorable mass number dependency under radial electric fields. While the heat flux is independent of mass number for a given poloidal Mach number, the heat flux decreases for higher mass numbers in a given radial electric field. The heat flux is also independent of average mass number in multi-ion-species plasmas because the heavy hydrogen component effectively enhances the light hydrogen heat flux. The present results are potentially relevant to the violation of gyro-Bohm scaling observed in the recent deuterium experiments in the Large Helical Device

Clinical determinants of recurrence in pTa bladder cancer following transurethral resection of bladder tumor

Non-muscle invasive bladder cancer can be controlled by transurethral resection of bladder (TURB), but suffers from frequent recurrences in 60–70% of cases. Although, recurrence interval after TURB influences treatment course and prognosis, its implication and risk factors have not been fully elucidated. We evaluated the risk factors of early (within 1yr) and late (after 1yr) recurrence of pTa bladder cancer and clinical significance of recurrence interval on disease progression and overall survival. In this study, pTa bladder cancer patients enrolled in prospective patient registry system of Seoul National University, SUPER-UC, were retrospectively examined to determine the clinical risk factors for recurrence and its significance regarding to recurrence interval. A total of 1067 bladder cancer patients who underwent TURB between March 20 and June 2021 were included and classified into three groups of no recurrence, early, or late recurrence to be comparatively analyzed. Early recurrence was associated with poorer cystectomy-free survival and overall survival than late recurrence. Risk factors for early recurrence included a high number of previous TURB, tumor multiplicity, tumor location, tumor shape, incompleteness of TURB, and high tumor grade. Otherwise, late recurrence was associated with low-grade tumors with insufficient TURB depth. Patients with risk factors for early recurrence should be closely followed up with special cautions

Development of a Gyrokinetic Particle-in-Cell Code for Whole-Volume Modeling of Stellarators

We present initial results in the development of a gyrokinetic particle-in-cell code for the whole-volume modeling of stellarators. This is achieved through two modifications to the X-point Gyrokinetic Code (XGC), originally developed for tokamaks. One is an extension to three-dimensional geometries with an interface to Variational Moments Equilibrium Code (VMEC) data. The other is a connection between core and edge regions that have quite different field-line structures. The VMEC equilibrium is smoothly extended to the edge region by using a virtual casing method. Non-axisymmetric triangular meshes in which triangle nodes follow magnetic field lines in the toroidal direction are generated for field calculation using a finite-element method in the entire region of the extended VMEC equilibrium. These schemes are validated by basic benchmark tests relevant to each part of the calculation cycle, that is, particle push, particle-mesh interpolation, and field solver in a magnetic field equilibrium of Large Helical Device including the edge region. The developed code also demonstrates collisionless damping of geodesic acoustic modes and steady states with residual zonal flow in the core region

Association between decreased ipsilateral renal function and aggressive behavior in renal cell carcinoma

Background To assess prognostic value of pre-operative ipsilateral split renal function (SRF) on disease-free survival (DFS) and its association with aggressive pathological features in renal cell carcinoma (RCC) patients.  Methods We examined patients registered in SNUG-RCC-Nx who underwent partial or radical nephrectomy at Seoul National University Hospital between January 1, 2010 and December 31, 2020. Patients with the following criteria were excluded from the study. 1) non-kidney origin cancer or benign renal tumor, 2) no pre-operative Tc 99 m-DTPA renal scan, 3) single kidney status or previous partial or radical nephrectomy, and 4) bilateral renal mass. Finally, 1,078 patients were included. Results Among 1,078 patients, 899 (83.4%) showed maintained ipsilateral SRF on DTPA renal scan; 179 patients (16.6%) showed decreased SRF. The decreased SRF group showed significantly large tumor size (maintained vs. decreased SRF; 3.31 ± 2.15 vs. 6.85 ± 3.25, p < 0.001), high Fuhrman grade (grade 3–4) (41.7% vs. 55.6%, p < 0.001), and high T stage (T stage 3–4) (9.0% vs. 20.1%, p < 0.001). Pathological invasive features, including invasion of the renal capsule, perirenal fat, renal sinus fat, vein, and collecting duct system, were associated with low SRF of the ipsilateral kidney. Univariate Cox regression analysis identified higher SSIGN (The stage, size, grade, and necrosis) score and decreased ipsilateral SRF as significant risk factors, while multivariate analysis showed SSIGN (5–7) (hazard ratio [HR] 11.9, p < 0.001) and SSIGN (8–10) (HR 69.2, p < 0.001) were significantly associated with shortened DFS, while decreased ipsilateral SRF (HR 1.75, p = 0.065) showed borderline significance. Kaplan–Meier analysis showed that decreased ipsilateral SRF (< 45%) group had shorter DFS than the other group (median DFS: 90.3 months vs. not reached, p < 0.001). Conclusions Among unilateral RCC patients, those with low ipsilateral SRF showed poor prognosis with pathologically invasive features. Our novel approach may facilitate risk stratification in RCC patients, helping formulate a treatment strategy

Clinical features and Surgical Outcome of Clear Cell Papillary Renal Cell Tumor: result from a prospective cohort

Background Clear cell papillary renal cell tumor (CCPRCT) was first reported in 2006 a patient with end stage renal disease. After that it was discovered in the kidney without end stage renal disease in the 2010s and started to be mentioned in pathology and urology. The incidence of CCPRCT is low and most of it is discovered incidentally, so there is a lack of reports on clinical characteristics and surgical outcome. Methods This study used clinical data from the Seoul National University Prospectively Enrolled Registry for Renal Cell Carcinoma-Nephrectomy (SUPER-RCC-Nx). Between August 2016 and July 2022, patients who underwent radical or partial nephrectomy with clear cell papillary RCC with pathological finding were included in this study. All patients pathologic reports were reviewed by 1 pathologist. Clinical characteristics and surgical outcomes were presented through descriptive statistics, and Kaplan-Meier curve used for survival analysis. Results Of the 2057 patients, CCPRCT was reported in 36 patients (1.8%). The median follow up period was 26.8 months. The median age was 67 years, and there were 10 females and 26 males. The median tumor size was 1.2cm. Twenty-nine patients underwent partial nephrectomy. Seven patients with end-stage renal disease underwent radical nephrectomy. The median operative time for patients who underwent partial nephrectomy was 97.5min and the estimated blood loss was 100cc. The median hospital days was 4 and 30-day complications were 2 cases with clavien-dindo classification III or higher. During the follow-up period, there was no recurrence and cancer specific mortality. Conclusions The size of CCPRCT was small and there was no advanced stage at that time of diagnosis. There was no recurrence or cancer specific mortality during the follow-up period. A multi-center study with a large scale is needed in the future. Trial registration Seoul National University Hospital (SNUH) Institutional Review Board (IRB) (approval number: 2210-126-1371)

Stroke awareness decreases prehospital delay after acute ischemic stroke in korea

BACKGROUND: Delayed arrival at hospital is one of the major obstacles in enhancing the rate of thrombolysis therapy in patients with acute ischemic stroke. Our study aimed to investigate factors associated with prehospital delay after acute ischemic stroke in Korea. METHODS: A prospective, multicenter study was conducted at 14 tertiary hospitals in Korea from March 2009 to July 2009. We interviewed 500 consecutive patients with acute ischemic stroke who arrived within 48 hours. Univariate and multivariate analyses were performed to evaluate factors influencing prehospital delay. RESULTS: Among the 500 patients (median 67 years, 62% men), the median time interval from symptom onset to arrival was 474 minutes (interquartile range, 170-1313). Early arrival within 3 hours of symptom onset was significantly associated with the following factors: high National Institutes of Health Stroke Scale (NIHSS) score, previous stroke, atrial fibrillation, use of ambulance, knowledge about thrombolysis and awareness of the patient/bystander that the initial symptom was a stroke. Multivariable logistic regression analysis indicated that awareness of the patient/bystander that the initial symptom was a stroke (OR 4.438, 95% CI 2.669-7.381), knowledge about thrombolysis (OR 2.002, 95% CI 1.104-3.633) and use of ambulance (OR 1.961, 95% CI 1.176-3.270) were significantly associated with early arrival. CONCLUSIONS: In Korea, stroke awareness not only on the part of patients, but also of bystanders, had a great impact on early arrival at hospital. To increase the rate of thrombolysis therapy and the incidence of favorable outcomes, extensive general public education including how to recognize stroke symptoms would be important.ope