General practitioners and national health insurance results of a national survey

Objective. To determine the attitudes of South African general practitioners (GPs) to national health insurance (NHI), social health insurance (SHI) and other related  health system reforms.Design. A national survey using postal questionnaires and telephonic follow-up of non-responders.Setting. GPs throughout South Africa.Participants. Four hundred and forty-three GPs were randomly selected from a  national sampling frame of 6 781 GPs.Main outcome measures. Acceptance of NHI and GP preferences with regard to financing, provision, benefits, coverage and the role of GPs.Main results. A response rate of 82.1% was achieved. Sixty two per cent of GPs approved of the introduction of some form of social or NHI in South Africa, while 24.1% disapproved. Approval rose to 81.6% if GPs were to maintain their independent status, e.g. own premises and working hours, to 75% if additional private top-up insurance was allowed, and to 79.9% if payment was by fee-for-service. Seventy per cent of GPs in the study stated that they had the capacity to treat more patients. The most important reason given for approving of NHI was to make health care more equitable and accessible to the majority of South Africans. A high proportion of GPs approved of increasing the level of interaction between GPs and district health authorities.Conclusions. Most GPs approved of some form of social or NHI system, provided that the system did not significantly threaten their professional autonomy or economic and financial situation

SIGGMA: A Survey of Ionized Gas in the Galaxy, Made with the Arecibo Telescope

A Survey of Ionized Gas in the Galaxy, made with the Arecibo telescope (SIGGMA) uses the Arecibo L-band Feed Array (ALFA) to fully sample the Galactic plane (30 < l < 75 and -2 < b < 2; 175 < l < 207 and -2 < b < 1) observable with the telescope in radio recombination lines (RRLs). Processed data sets are being produced in the form of data cubes of 2 degree (along l) x 4 degree (along b) x 151 (number of channels), archived and made public. The 151 channels cover a velocity range of 600 km/s and the velocity resolution of the survey changes from 4.2 km/s to 5.1 km/s from the lowest frequency channel to the highest frequency channel, respectively.RRL maps with 3.4 arcmin resolution and line flux density sensitivity of 0.5 mJy will enable us to identify new HII regions, measure their electron temperatures, study the physics of photodissociation regions (PDRs) with carbon RRLs, and investigate the origin of the extended low density medium (ELDM). Twelve Hn{\alpha} lines fall within the 300 MHz bandpass of ALFA; they are resampled to a common velocity resolution to improve the signal-to-noise ratio (SN) by a factor of 3 or more and preserve the line width. SIGGMA will produce the most sensitive fully sampled RRL survey to date. Here we discuss the observing and data reduction techniques in detail. A test observation toward the HII region complex S255/S257 has detected Hn{\alpha} and Cn{\alpha} lines with SN>10

An avalanche-photodiode-based photon-number-resolving detector

Avalanche photodiodes are widely used as practical detectors of single photons.1 Although conventional devices respond to one or more photons, they cannot resolve the number in the incident pulse or short time interval. However, such photon number resolving detectors are urgently needed for applications in quantum computing,2-4 communications5 and interferometry,6 as well as for extending the applicability of quantum detection generally. Here we show that, contrary to current belief,3,4 avalanche photodiodes are capable of detecting photon number, using a technique to measure very weak avalanches at the early stage of their development. Under such conditions the output signal from the avalanche photodiode is proportional to the number of photons in the incident pulse. As a compact, mass-manufactured device, operating without cryogens and at telecom wavelengths, it offers a practical solution for photon number detection.Comment: 12 pages, 4 figure

Changes in liver mitochondrial plasticity induced by brain tumor

BACKGROUND: Accumulating data suggest that liver is a major target organ of systemic effects observed in the presence of a cancer. In this study, we investigated the consequences of the presence of chemically induced brain tumors in rats on biophysical parameters accounting for the dynamics of water in liver mitochondria. METHODS: Tumors of the central nervous system were induced by intraveinous administration of ethylnitrosourea (ENU) to pregnant females on the 19th day of gestation. The mitochondrial crude fraction was isolated from the liver of each animal and the dynamic parameters of total water and its macromolecule-associated fraction (structured water, H(2)Ost) were calculated from Nuclear Magnetic Resonance (NMR) measurements. RESULTS: The presence of a malignant brain tumor induced a loss of water structural order that implicated changes in the physical properties of the hydration shells of liver mitochondria macromolecules. This feature was linked to an increase in the membrane cholesterol content, a way to limit water penetration into the bilayer and then to reduce membrane permeability. As expected, these alterations in mitochondrial plasticity affected ionic exchanges and led to abnormal features of mitochondrial biogenesis and caspase activation. CONCLUSION: This study enlightens the sensitivity of the structured water phase in the liver mitochondria machinery to external conditions such as tumor development at a distant site. The profound metabolic and functional changes led to abnormal features of ion transport, mitochondrial biogenesis and caspase activation

Shattered pellet injection experiments at JET in support of the ITER disruption mitigation system design

A series of experiments have been executed at JET to assess the efficacy of the newly installed shattered pellet injection (SPI) system in mitigating the effects of disruptions. Issues, important for the ITER disruption mitigation system, such as thermal load mitigation, avoidance of runaway electron (RE) formation, radiation asymmetries during thermal quench mitigation, electromagnetic load control and RE energy dissipation have been addressed over a large parameter range. The efficiency of the mitigation has been examined for the various SPI injection strategies. The paper summarises the results from these JET SPI experiments and discusses their implications for the ITER disruption mitigation scheme

New H-mode regimes with small ELMs and high thermal confinement in the Joint European Torus

New H-mode regimes with high confinement, low core impurity accumulation, and small edge-localized mode perturbations have been obtained in magnetically confined plasmas at the Joint European Torus tokamak. Such regimes are achieved by means of optimized particle fueling conditions at high input power, current, and magnetic field, which lead to a self-organized state with a strong increase in rotation and ion temperature and a decrease in the edge density. An interplay between core and edge plasma regions leads to reduced turbulence levels and outward impurity convection. These results pave the way to an attractive alternative to the standard plasmas considered for fusion energy generation in a tokamak with a metallic wall environment such as the ones expected in ITER.&amp; nbsp;Published under an exclusive license by AIP Publishing

Predictive JET current ramp-up modelling using QuaLiKiz-neural-network

This work applies the coupled JINTRAC and QuaLiKiz-neural-network (QLKNN) model on the ohmic current ramp-up phase of a JET D discharge. The chosen scenario exhibits a hollow T-e profile attributed to core impurity accumulation, which is observed to worsen with the increasing fuel ion mass from D to T. A dynamic D simulation was validated, evolving j, n(e), T-e, T-i, n(Be), n(Ni), and n(W) for 7.25 s along with self-consistent equilibrium calculations, and was consequently extended to simulate a pure T plasma in a predict-first exercise. The light impurity (Be) accounted for Z(eff) while the heavy impurities (Ni, W) accounted for Prad. This study reveals the role of transport on the Te hollowing, which originates from the isotope effect on the electron-ion energy exchange affecting T-i. This exercise successfully affirmed isotopic trends from previous H experiments and provided engineering targets used to recreate the D q-profile in T experiments, demonstrating the potential of neural network surrogates for fast routine analysis and discharge design. However, discrepancies were found between the impurity transport behaviour of QuaLiKiz and QLKNN, which lead to notable T-e hollowing differences. Further investigation into the turbulent component of heavy impurity transport is recommended

The role of ETG modes in JET-ILW pedestals with varying levels of power and fuelling

We present the results of GENE gyrokinetic calculations based on a series of JET-ITER-like-wall (ILW) type I ELMy H-mode discharges operating with similar experimental inputs but at different levels of power and gas fuelling. We show that turbulence due to electron-temperature-gradient (ETGs) modes produces a significant amount of heat flux in four JET-ILW discharges, and, when combined with neoclassical simulations, is able to reproduce the experimental heat flux for the two low gas pulses. The simulations plausibly reproduce the high-gas heat fluxes as well, although power balance analysis is complicated by short ELM cycles. By independently varying the normalised temperature gradients (omega(T)(e)) and normalised density gradients (omega(ne )) around their experimental values, we demonstrate that it is the ratio of these two quantities eta(e) = omega(Te)/omega(ne) that determines the location of the peak in the ETG growth rate and heat flux spectra. The heat flux increases rapidly as eta(e) increases above the experimental point, suggesting that ETGs limit the temperature gradient in these pulses. When quantities are normalised using the minor radius, only increases in omega(Te) produce appreciable increases in the ETG growth rates, as well as the largest increases in turbulent heat flux which follow scalings similar to that of critical balance theory. However, when the heat flux is normalised to the electron gyro-Bohm heat flux using the temperature gradient scale length L-Te, it follows a linear trend in correspondence with previous work by different authors

Spectroscopic camera analysis of the roles of molecularly assisted reaction chains during detachment in JET L-mode plasmas

The roles of the molecularly assisted ionization (MAI), recombination (MAR) and dissociation (MAD) reaction chains with respect to the purely atomic ionization and recombination processes were studied experimentally during detachment in low-confinement mode (L-mode) plasmas in JET with the help of experimentally inferred divertor plasma and neutral conditions, extracted previously from filtered camera observations of deuterium Balmer emission, and the reaction coefficients provided by the ADAS, AMJUEL and H2VIBR atomic and molecular databases. The direct contribution of MAI and MAR in the outer divertor particle balance was found to be inferior to the electron-atom ionization (EAI) and electron-ion recombination (EIR). Near the outer strike point, a strong atom source due to the D+2-driven MAD was, however, observed to correlate with the onset of detachment at outer strike point temperatures of Te,osp = 0.9-2.0 eV via increased plasma-neutral interactions before the increasing dominance of EIR at Te,osp &lt; 0.9 eV, followed by increasing degree of detachment. The analysis was supported by predictions from EDGE2D-EIRENE simulations which were in qualitative agreement with the experimental observations