It’s possible that I shall make an ass of myself. But in that case one can always get out of it with a little dialectic. I have, of course, so worded my proposition as to be right either way (K.Marx, Letter to F.Engels on the Indian Mutiny)
Saturday, December 30, 2023
SCI-FI-TEK
Korean Artificial Sun, KSTAR, installation of a tungsten divertor for long pulse operations
The aim is to operate 300 seconds at 100-million-degree by 2026
The Korean artificial sun, KSTAR, has completed divertor upgrades, allowing it to operate for extended periods sustaining high-temperature plasma over the 100 million degrees.
The Korea Institute of Fusion Energy announced the successful installation of the newly developed tungsten divertor for KSTAR. KSTAR, now equipped with the new divertor, commenced a plasma experiment on the 21st of December 2023.
The divertor, a crucial plasma-facing component installed at the bottom of the vacuum vessel in a magnetic fusion device known as a Tokamak, manages the exhaust of waste gas and impurities from the reactor and also endures the highest surface heat loads. This is why it is important to develop and deploy a divertor that is highly heat-resistant.
Initially, KSTAR had a carbon divertor, but for KSTAR’s enhanced performance and prolonged operations at 100 million ℃, the heat flux exceeded the limit of the carbon divertor.
Consequently, the development of a divertor using tunsten has begun in 2018. The first prototype was completed in 2021, and installation of a new divertor took place from September 2022 for approximately one year. The recently installed divertor consists of 64 cassettes, each crafted from tungsten mono-blocks. These 64 cassettes fully surround the bottom of the vacuum vessel.
Tungsten material possesses a high melting point and low sputtering characteristics. Therefore, the heat flux limit has improved by over two-fold compared to the carbon divertor, reaching 10 MW/m².
The plasma experiments of KSTAR in the new tungsten divertor environment will continue until February 2024. The primary objectives include verifying stable operations in the new tungsten divertor environment and reproducing KSTAR’s 100-million-degree plasma.
KFE President, Dr. Suk Jae Yoo stated, "In KSTAR, we have implemented a divertor with tungsten material which is also the choice made in ITER. We will strive to contribute our best efforts in obtaining the necessary data for ITER through KSTAR experiments.”
Previously, KSTAR has demonstrated high performance plasma operation for 30 seconds with an ion temperatures over 100 million degrees, and now the goal is to achieve 300 seconds by the end of 2026 with this new divertor.
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The Korea Institute of Fusion Energy(KFE) is Korea's only research institute specializing in nuclear fusion. Based on our development and operation of KSTAR, a superconducting fusion research device, the KFE seeks to achieve groundbreaking research results, develop core technology for commercializing nuclear fusion, and train outstanding nuclear fusion personnel. In addition, the institute is spearheading a joint effort to open the era of nuclear fusion energy in the mid-21st century through active participation in the ITER Project.
The Korean artificial sun, KSTAR, has completed divertor upgrades, allowing it to operate for extended periods sustaining high-temperature plasma over the 100 million degrees.
SCIENCE SEZ
Endocrine Society applauds Ohio governor veto of state ban on gender-affirming care for minors
Move recognizes parental rights, medical decision-making over politics
WASHINGTON—The Endocrine Society, the world’s oldest and largest professional medical society devoted to the study and treatment of hormone-related conditions, applauds Governor Mike Dewine’s veto of a proposed Ohio law that would have banned gender-affirming care for minors. The bill he vetoed contradicts mainstream medical practice and scientific evidence and would have taken medical decision-making out of the hands of families and their physicians and instead relied upon government officials.
More than 2,000 scientific studies have examined aspects of gender-affirming care since 1975, including more than 260 studies cited in the Endocrine Society’s Clinical Practice Guideline.
Major medical and scientific organizations including the American Medical Association, the American Psychological Association, and the American Academy of Pediatrics are in alignment with the Endocrine Society on the importance of gender-affirming care.
In June, the Endocrine Society worked with other medical societies in American Medical Association (AMA) House of Delegates to pass a resolution with overwhelming support to protect access to evidence-based gender-affirming care for transgender and gender-diverse individuals. In the resolution, the AMA committed to opposing any criminal and legal penalties against patients seeking gender-affirming care, family members or guardians who support them in seeking medical care, and health care facilities and clinicians who provide gender-affirming care.
Pediatric gender-affirming care is designed to take a conservative approach. When young children experience feelings that their gender identity does not match the sex recorded at birth, the first course of action is to support the child in exploring their gender identity and to provide mental health support, as needed.
Medical intervention is reserved for older adolescents and adults, with treatment plans tailored to the individual and designed to maximize the time teenagers and their families have to make decisions about their transitions.
As Governor DeWine noted, only a small number of Ohio’s children would be impacted by the proposed legislation, but it would have profound and even life-threatening consequences for those affected by gender dysphoria. Around 300,000 teenagers ages 13-17 in the United States, or 1.4% of the population, identify as transgender, according to the Williams Institute. An estimated 4,780 adolescents with a diagnosis of gender dysphoria started puberty-delaying medication between 2017 and 2021, according to an analysis performed by Komodo Health Inc for Reuters.
Gender-affirming care can be life saving for a population with high suicide rates. For example, a 2020 study analyzed survey data from 89 transgender adults who had access to puberty-delaying medication while adolescents and data from more than 3,400 transgender adults who did not. The study found that those who received puberty-delaying hormone treatment had lower likelihood of lifetime suicidal ideation than those who wanted puberty-delaying treatment but did not receive it, even after adjusting for demographic variables and level of family support. Approximately nine in ten transgender adults who wanted puberty-delaying treatment, but did not receive it, reported lifetime suicidal ideation.
Medical decisions should be made by patients, their relatives and health care providers, not politicians.
Endocrinologists are at the core of solving the most pressing health problems of our time, from diabetes and obesity to infertility, bone health, and hormone-related cancers. The Endocrine Society is the world’s oldest and largest organization of scientists devoted to hormone research and physicians who care for people with hormone-related conditions.
The Society has more than 18,000 members, including scientists, physicians, educators, nurses and students in 122 countries. To learn more about the Society and the field of endocrinology, visit our site at www.endocrine.org. Follow us on Twitter at @TheEndoSociety and @EndoMedia.
Johns Hopkins researchers: Regret rarer than believed among patients who undergo gender affirming surgery
In a Viewpoint article published Dec. 27, 2023, in JAMA Surgery, three Johns Hopkins researchers urge the medical community to dismiss a widely held, but scientifically unsupported belief that many people who are transgender and gender diverse (TGD), and undergo gender affirming surgery (GAS), later regret their decision to undergo such procedures.
The researchers are:
Harry Barbee, Ph.D., assistant professor and interdisciplinary social scientist at the Johns Hopkins Bloomberg School of Public Health
Bashar Hassan, M.D., a postdoctoral research fellow in plastic and reconstructive surgery at the Johns Hopkins Center for Transgender and Gender Expansive Health (CTH) and the University of Maryland Medical Center’s R Adams Cowley Shock Trauma Center
Fan Liang, M.D., medical director at the CTH and assistant professor of plastic and reconstructive surgery at the Johns Hopkins University School of Medicine
In their article, the three report findings from a retrospective look at the limited amount of evidence-based studies addressing post-GAS regret. They also describe how research, health care and public policy can be guided by using scientific data to properly define post-surgical regret — currently believed to be very low — to address health needs across diverse populations.
Among the findings from their review of the available-to-date medical literature on post-GAS regret are:
Less than 1% of TGD people who receive GAS report regret, which appears dramatically lower than rates of surgical regret among people who are cisgender.
Differences in post-GAS regret between people who are TGD and those who are cisgender may be linked to the reasons each group has for undergoing the surgery (for example, gender alignment vs. cancer treatment).
That reduction in regret also may due to careful implementation of existing evidence-based, multidisciplinary guidelines and standards of care for those who are TGD, such as requiring a well-documented history of gender dysphoria (feeling mismatch between biological sex and gender identity).
Accurately evaluating patient satisfaction and regret following GAS remains a significant challenge.
To improve the assessment and understanding of post-GAS regret, the researchers recommend:
Using Gender-Q, a promising specific and comprehensive patient-reported outcome measure currently undergoing international field testing and validation.
Assessing post-GAS regret no earlier than one year following surgery to overcome any biases.
Incorporating baseline assessments of factors that may influence regret, such as age, race, education level and quality of life.
More nuanced research of post-GAS regret that could uncover opportunities to improve public policy, and consequently, the long-term health of the population identifying as TGD.
Anyone in the media having questions, needing additional materials or wanting to set up an interview with Barbee, Hassan or Liang, should contact Michael E. Newman, Johns Hopkins Medicine media relations at mnewma25@jhmi.edu or 240-602-5365.
JOURNAL
JAMA Surgery
ARTICLE PUBLICATION DATE
27-Dec-2023
Medicaid coverage of physical, behavioral health together does not improve access, care
Health care systems in the United States have gradually embraced the concept that mental health should be treated on par with physical health, especially in light of increased rates of anxiety and depression during and after the COVID-19 pandemic.
To improve access to mental health treatment, many Medicaid programs have required their managed care organizations to pay for behavioral health and physical health together. That’s in contrast to the traditional approach in which behavioral health, including treatment for substance use disorders, was “carved out” from typical health care coverage — forcing patients to get coverage through a totally different insurance plan.
However, a new study led by Oregon Health & Science University reveals that integration of behavioral and physical health did not lead to significant changes in access or quality of health services in the state of Washington.
“There was a hope that this would be a significant catalyst,” said lead author John McConnell, Ph.D., director of the OHSU Center for Health Systems Effectiveness. “The idea was that integrating care within managed care organizations would drive positive changes at the clinical level, and that didn’t really happen — at least not yet.”
Published today in JAMA Health Forum, the study concludes that the administrative change may be necessary but insufficient on its own to improve access, quality and overall health outcomes for patients.
To achieve those outcomes, McConnell said it may require new training and incentives, including shifting from traditional fee-for-service payment models — where providers are paid for every medical visit — to alternatives such as those that pay providers for a set number of patients covered by the practice overall.
Researchers studied changes in Washington state, which has been a pioneer in promoting integrated care models to improve mental health treatment.
The new study assessed claims-based measures, such as mental health visits; health outcomes, such as reported incidents of self-harm; and general quality of life, such as rates of arrests, employment and homelessness among 1.4 million patients covered by Medicaid in Washington state. The analysis tracked a staggered rollout of financial integration across Washington’s 39 counties between 2014 and 2019.
“The surprising result was that nothing really changed,” McConnell said.
Although researchers weren’t able to discern statistically significant improvements in access or outcomes for patients across the Evergreen State, McConnell noted that financial integration didn’t make matters worse either. That’s important, he said.
“It probably simplified things,” he said.
In addition to McConnell, co-authors include Sara Edelstein, M.P.P., Jennifer Hall, M.P.H., Anna Levy, M.P.H., Maria Danna, M.A., Deborah Cohen, Ph.D., Stephan Lindner, Ph.D., and Jane Zhu, M.D., of OHSU; and Jürgen Unützer, M.D., M.P.H., of the University of Washington.
Funding support for the new publication was provided by the National Institute of Mental Health of the National Institutes of Health, award numbers 1R01MH123416 and K08MH123624. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.
POHANG UNIVERSITY OF SCIENCE & TECHNOLOGY (POSTECH)
Last year, Typhoon Hinnamnor – which caused 36 fatalities – gained notoriety as the first super typhoon that developed at a high latitude as 25°N since Korea Meteorological Administration records began. This year in Osong, Chungcheongbuk-do, an unanticipated intense downpour, caused rivers to suddenly overflow, resulting in numerous casualties. Earth's rising temperatures are triggering unprecedented typhoons, torrential rains, and other extreme weather events. Without reliable predictions of climate extremes prompted by global warming, mitigating the resultant damages remains a challenge.
Professor Seung-Ki Min and Dr. Minkyu Lee, from the Division of Environmental Science and Engineering at Pohang University of Science and Technology (POSTECH), have used a high-resolution climate model to conduct a pioneering quantitative analysis of the impact of global warming on typhoons making landfall on the Korean Peninsula. This research has been recently published in npj Climate and Atmospheric Science.
Notably, global warming is giving way to a surge in more powerful typhoons which maintain its intensity longer and thereby cause stronger damage. Accurate typhoon prediction and damage reduction necessitate better understanding of the global warming influences, for which climate model simulations with a km-scale resolution are eccential. However, studies quantifying the anthropogenic warming contribution to typhoons affecting Korea, especially research into the rainfall extremes accompanying typhoons, remain scant.
To overcome this, the research team designed a 3 km high-resolution regional climate model simulation to investigate the impact of global warming on typhoon intensity and extreme precipitation. Four extremely strong typhoons that made landfall on the Korean Peninsula between 2011 and 2020 were chosen for simulation under current climate condition and counterfactual condition without human-induced warming. To reduce the uncertainties in regional sea surface temperature changes due to global warming, they utilized diverse ocean warming patterns estimated from CMIP6multiple climate models.
The findings show that accounting for global warming from human activities augmented overall typhoon intensity and precipitation. The research team observed that the impact of warming was pronounced more strongly at maximum typhoon intensity than the average intensity. This implies more frequent occurrences of powerful super typhoons over East Asia in the future. Additionally, the area exposed to extreme rainfall generated by typhoons expanded 16 to 37 percent due to warmer climate conditions. Further, the expansion of extreme precipitation area is attributed to the strengthening of upward motion near the typhoon center and the increase in atmospheric water vapor due to the ocean surface warming.
Professor Min explained, “Our results from high-resolution climate model simulations provide conclusive evidence that global warming has amplified the strength of recent typhoons making landfall on the Korean Peninsula. Continued escalation of global warming could lead to stronger typhoons and more extensive occurrences of rainfall extremes, demanding heightened sector-specific preparedness measures.”
This study received support from the Mid-Career Researcher Program of the National Research Foundation of Korea and the Korea Meteorological Administration Research and Development Program on Climate and Climate Change Monitoring and Prediction Information Application Technology.
Convection-permitting simulations reveal expanded rainfall extremes of tropical cyclones affecting South Korea due to anthropogenic warming
Unraveling the mysteries of fog in complex terrain
With Heber Valley study, U researchers shed new light on how fog forms in mountainous areas, providing insights for improving forecasts for a weather phenomenon that poses serious travel hazards
Of the world’s various weather phenomena, fog is perhaps the most mysterious, forming and dissipating near the ground with fluctuations in air temperature and humidity interacting with the terrain itself.
While fog presents a major hazard to transportation safety, meteorologists have yet to figure out how to forecast it with the precision they have achieved for precipitation, wind and other stormy events.
This is because the physical processes resulting in fog formation are extremely complex, according to Zhaoxia Pu, a professor of atmospheric sciences at the University of Utah.
“Our understanding is limited. In order to accurately forecast fog we should better understand the process that controls fog formation,” said Pu, who led a fog study focusing on a northern Utah valley.
Also working on the project, funded by a $1.17 million grant from the National Science Foundation, were several other members of the U Department of Atmospheric Sciences, including Gannet Hallar and Sebastian Hoch, along with Eric Pardyjak of the Department of Mechanical Engineering, a group of scientists from the National Center for Atmospheric Research (NCAR), and Dr. Ismail Gultepe from Ontario Tech University, Canada.
Because it reduces visibility, fog poses serious hazards to the traveling public. For example, fog is the second leading cause of aircraft accidents after high winds. It leads to automobile crashes and disrupts ferry operations.
Between 1995 and 2004 in the United States, 13,720 have died in fog-related accidents.
Improving fog forecasting would make traveling more safe, Pu said.
Today, most forecasting uses a computer model known as Numerical Weather Prediction (NWP), which processes massive meteorological observations with computer models to output predictions for precipitation, temperature, and all sorts of other elements of the weather. However the current computer model doesn’t work well for fog, and Pu’s team hopes that improvements can be made using the masses of data they gathered over seven weeks in the winter of 2022 at several sites in the Heber Valley.
“Fog involves a lot of physics processes so it requires a computer model that can better represent all these processes,” Pu said. “Because fog is clouds near the ground, it requires a high-resolution model to resolve it, so we need models at a very fine scale, which are computationally very expensive. The current models (relatively coarser in resolution) are not capable of resolving the fog processes, and we need to improve the models for better fog prediction.”
Located bout 50 miles southeast of Salt Lake City, Heber Valley is nestled behind the Wasatch Mountains and framed by two major reservoirs on the Provo River.
This scenic basin is a typical mountain valley, hemmed by Mt. Timpanogos and other high peaks, with the reservoirs serving as a moisture source. The seven-week study window covered the time of year when Heber Valley is the foggiest.
Valley fog is a perfect example of how topography and atmospheric processes converge to create a distinctive weather phenomenon.
The ground is cooling overnight while denser, cooler air drops from mountain tops collecting in the valleys, in a phenomenon known as “cold air drainage.” Cooled by the ground, the dropping air temperature can approach the dew point, and if there is sufficient moisture in the air, fog begins to form, becoming the most dense around sunrise when surface temperatures are lowest.
Winter nights create favorable conditions for different forms of fog, such as cold-air pool fog, ephemeral mountain valley fog and radiative ice fog.
The Heber Valley project homed in on cold-air fog which forms in freezing temperatures below zero degrees Celsius, according to Pu. However by observing how these varying kinds of fog form and dissipate, the researchers are continuing to learn about the meteorological conditions and physical processes governing the formation of fog.
For the CFACT study, the NCAR and U team set up two major data-collecting stations, one near Deer Creek Reservoir and another a few miles up the Provo River. These are low spots in the valley, about 5,450 feet above sea level, that see the densest fog. These sites were equipped with 100-foot towers to support an array of instruments that captured various meteorological data associated with humidity, wind, visibility, temperature, even snow depths, and soil moisture. The recordings were made from both in situ and remote-sensing platforms.
Additionally, the team recorded a lesser array of data points at nine satellite sites.
During the seven-week CFACT field campaign, nine intensive observation periods (IOPs), each conducted over 24-hour periods, yielded a dataset that included high-frequency radiosonde profiles, tethered balloon profiles, remotely sensed thermodynamic and wind profiles, surface meteorological observations and microphysical and aerosol measurements.
Besides fog IOPs, the variety of non-fog IOPs provided valuable observations for understanding near-surface inversion, ice crystal formation, moisture advection and transportation, and stable boundary layers over complex terrain, all of which are essential factors related to fog formation. Comprehensive studies are ongoing for an improved understanding of cold fog over complex terrain.
The study appeared Nov. 15 in the Bulletin of the American Meteorological Society. U researchers involved with the study included Zhaoxia Pu, Sebastian Hoch, A. Gannet Hallar, Rebecca Beal, Geraldo Carrillo-Cardenas, Xin Li and Maria Garcia of the Department of Atmospheric Sciences and Eric Pardyjak and Alexei Perelet of the Department of Mechanical Engineering.
COLUMBUS, Ohio – Amid the threat of dramatic sea level rise, coastal communities face unprecedented dangers, but a new study reveals that as flooding intensifies, disadvantaged populations will be the ones to experience some of the most severe burdens of climate change.
While accelerating sea level rise will result in widespread intermittent flooding and long-term inundation in many coastal communities, the paper, recently published in Nature Communications, showed that when these levels increase above 4 feet, minority populations will be disproportionately at risk of isolation.
Rising sea levels could lead to isolation by disrupting transportation networks and roads, meaning that those affected lose access to essential locations such as critical emergency services and schools.
The study further exposed that renters and older adults face a greater risk of isolation, highlighting the growing connection between historical drivers of existing social inequality and the groups that incur the most risk of climate change.
According to Kelsea Best, lead author of the study and an assistant professor of civil, environmental and geodetic engineering at The Ohio State University, the first step in better characterizing these threats is changing how researchers assess community risk, as most studies measure this by exclusively determining impacts via direct flooding. But concentrating on this sole measurement neglects more complex aftereffects of sea level rise, such as isolation, and reinforces inequality in coastal areas, Best said.
“We need to re-conceptualize how we measure who is burdened by sea level rise because there are so many ways that people might be burdened before their home is flooded,“ she said.
Current reports estimate that around 20 million coastal residents in the U.S. will be affected by rising sea levels by 2030, but the paper notes that this number doesn’t include the whole impact global warming will have on certain communities and demographics.
Notably, because people need access to essential places like grocery stores, public schools, hospitals and fire stations, Best and her colleagues argue that an inability to reach these places impacts individuals just as negatively as if they were living in inundated homes themselves, and should be documented as such.
Most importantly, their results expose one of the main reasons for these vast differences in risk: A group’s risk of isolation is intimately entwined with specific road networks and where vital services are located in relation to where affected individuals reside.
They identified these disparities in risk by overlaying OpenStreetMap (OSM) road network data with National Oceanographic and Atmospheric Administration (NOAA) mean higher high water (MHHW) scenarios. These projections were then combined with recent census data to estimate the percentage of a population that would be left out or missed in estimates of who would be impacted by sea level rise if researchers only counted those who suffered direct inundation.
“If we take a one-size-fits-all approach, or a seemingly ‘neutral’ approach to understanding who gets access to safe, affordable housing and community in a world with climate change, then we’re really just exacerbating these inequities and it’s not good enough,” said Best. “We have to deliberately seek to provide access to adaptation resources to groups of people who have historically been left out and therefore have fewer resources to respond in the first place.”
The researchers showed that Hispanic populations are often overrepresented in the total citizenry for being at risk of isolation beginning at 4 feet of sea level rise, and Black populations are overrepresented after 6 feet. Alternatively, white populations are underrepresented after 5 feet of sea level rise.
But to determine when these disparities will begin to develop, Best’s team compared two long-term sea level rise scenarios: an intermediate scenario in which global sea level rise increased by a meter by 2100, and a high scenario in which that number increased to 2 meters by the same year.
Alarmingly, the study found strong evidence that these isolation effects would set in by 2120 in the intermediate scenario and as early as 2090 in the high scenario. “This timeline matters from a planning and adaptation perspective,” said Best. “Part of why we included the temporal piece is to say this issue would not be as much of a problem if we had urgent, aggressive mitigation.
“The effects of climate change are going to be further reaching and more cascading than might be directly obvious, and those effects are not going to be felt equitably,” said Best. “So we need to be thinking about those populations most at risk from the beginning and develop policies to support them.”
The work was supported by the Clark Distinguished Chair Endowment (given to study co-author Deb. A. Neimeier of the University of Maryland) and the National Science Foundation. Other co-authors were Qian He from Rowan University, Allison C. Reilly from the University of Maryland, and Mitchell Anderson and Tom Logan from the University of Canterbury.