Bringing global gyrokinetic turbulence simulations to the transport timescale using a multiscale approach

The vast separation dividing the characteristic times of energy confinement and turbulence in the core of toroidal plasmas makes first-principles prediction on long timescales extremely challenging. Here we report the demonstration of a multiple-timescale method that enables coupling global gyrokinetic simulations with a transport solver to calculate the evolution of the self-consistent temperature profile. This method, which exhibits resiliency to the intrinsic fluctuations arising in turbulence simulations, holds potential for integrating nonlocal gyrokinetic turbulence simulations into predictive, whole-device models.Comment: 7 pages, 3 figure

High-order Discretization of a Gyrokinetic Vlasov Model in Edge Plasma Geometry

We present a high-order spatial discretization of a continuum gyrokinetic Vlasov model in axisymmetric tokamak edge plasma geometries. Such models describe the phase space advection of plasma species distribution functions in the absence of collisions. The gyrokinetic model is posed in a four-dimensional phase space, upon which a grid is imposed when discretized. To mitigate the computational cost associated with high-dimensional grids, we employ a high-order discretization to reduce the grid size needed to achieve a given level of accuracy relative to lower-order methods. Strong anisotropy induced by the magnetic field motivates the use of mapped coordinate grids aligned with magnetic flux surfaces. The natural partitioning of the edge geometry by the separatrix between the closed and open field line regions leads to the consideration of multiple mapped blocks, in what is known as a mapped multiblock (MMB) approach. We describe the specialization of a more general formalism that we have developed for the construction of high-order, finite-volume discretizations on MMB grids, yielding the accurate evaluation of the gyrokinetic Vlasov operator, the metric factors resulting from the MMB coordinate mappings, and the interaction of blocks at adjacent boundaries. Our conservative formulation of the gyrokinetic Vlasov model incorporates the fact that the phase space velocity has zero divergence, which must be preserved discretely to avoid truncation error accumulation. We describe an approach for the discrete evaluation of the gyrokinetic phase space velocity that preserves the divergence-free property to machine precision

Factors associated with COVID-19-related death in people with rheumatic diseases: results from the COVID-19 Global Rheumatology Alliance physician-reported registry

Objectives: To determine factors associated with COVID-19-related death in people with rheumatic diseases. Methods: Physician-reported registry of adults with rheumatic disease and confirmed or presumptive COVID-19 (from 24 March to 1 July 2020). The primary outcome was COVID-19-related death. Age, sex, smoking status, comorbidities, rheumatic disease diagnosis, disease activity and medications were included as covariates in multivariable logistic regression models. Analyses were further stratified according to rheumatic disease category. Results: Of 3729 patients (mean age 57 years, 68% female), 390 (10.5%) died. Independent factors associated with COVID-19-related death were age (66-75 years: OR 3.00, 95% CI 2.13 to 4.22; >75 years: 6.18, 4.47 to 8.53; both vs ≤65 years), male sex (1.46, 1.11 to 1.91), hypertension combined with cardiovascular disease (1.89, 1.31 to 2.73), chronic lung disease (1.68, 1.26 to 2.25) and prednisolone-equivalent dosage >10 mg/day (1.69, 1.18 to 2.41; vs no glucocorticoid intake). Moderate/high disease activity (vs remission/low disease activity) was associated with higher odds of death (1.87, 1.27 to 2.77). Rituximab (4.04, 2.32 to 7.03), sulfasalazine (3.60, 1.66 to 7.78), immunosuppressants (azathioprine, cyclophosphamide, ciclosporin, mycophenolate or tacrolimus: 2.22, 1.43 to 3.46) and not receiving any disease-modifying anti-rheumatic drug (DMARD) (2.11, 1.48 to 3.01) were associated with higher odds of death, compared with methotrexate monotherapy. Other synthetic/biological DMARDs were not associated with COVID-19-related death. Conclusion: Among people with rheumatic disease, COVID-19-related death was associated with known general factors (older age, male sex and specific comorbidities) and disease-specific factors (disease activity and specific medications). The association with moderate/high disease activity highlights the importance of adequate disease control with DMARDs, preferably without increasing glucocorticoid dosages. Caution may be required with rituximab, sulfasalazine and some immunosuppressants