By studying a simple model problem, we examine the time evolution of magnetic field islands which are induced by perturbing the boundary surrounding an incompressible plasma with a resonant surface inside. We find that for sufficiently small boundary perturbations, the reconnection and island formation process occurs on the tearing mode time scale defined by Furth, Killeen, and Rosenbluth. For larger perturbations the time scal<~ is that defined by Rutherford. The resulting asymptotic equilibrium is such that surface currents in the resonant region vanish. A detailed analytical picture of this reconnection process is presented.

An energy-conserving set of the nonlinear electrostatic gyrokinetic Vlasov and Poisson equations is derived for the first time in the presence of equilibrium E×B velocity uE∼vTi, via phase-space Lagrangian Lie-perturbation theory. In this general formulation, only the basic small parameter ε with ω/Ω∼k∥/k⊥∼ε and δn/n0∼1/k⊥L∼ε, is used, while no device-specific expansion has been made. Here, L is the equilibrium scale length. For application to microturbulence in tokamak core transport barriers, an additional small ordering parameter δB≡Bθ/B≪1 is utilized. This leads to a useful form of the nonlinear gyrokinetic system which is applicable to a realistic situation in which the gradient lengths of the equilibrium radial electric field and pressure are of the same order as the ion poloidal gyroradius. The ordering for fluctuations is also modified to δn/n0∼εδB≪1/k⊥L∼δB for a better description of sub-mixing-length level fluctuations. uE/vTi∼δB and ρθi∼Lp put the pressure-gradient contribution to Er and the toroidal-flow contribution to Er at the same order. δB∼ε is shown to be a maximal ordering for studying the E×B flow shear suppression of turbulence.

This paper examines the stability of tearing modes in a sheared slab when the width of the tearing layer is much smaller than the ion Larmor radius. The ion response is nonlocal, and the quasineutrality retains its full integral form. An expansion procedure is introduced to solve the quasineutrality equation in powers of the width of the tearing layer over the ion Larmor radius. The expansion procedure is applied to the collisionless and semicollisional tearing modes. It is found that first-order terms in the expansion are strongly stabilizing. The physics of the mode and of the stabilization are discussed. Tearing modes are observed in experiments even though the slab theory predicts stability. It is proposed that these modes grow from an equilibrium with islands at the rational surfaces. If the equilibrium islands are wider than the ion Larmor radius, the mode is unstable when Δ′ is positive.

In the high-LM score patients, PR anaesthesia results in less blood loss and a better surgical conditions for ESS than SR anaesthesia.

A general polarization density which consists of classical and neoclassical parts is systematically derived via modern gyrokinetics and bounce-kinetics by employing a phase-space 80, 724 (1998)], an analytical formula for the generalized neoclassical polarization including both finite-banana-width (FBW) and finite-Larmor-radius (FLR) effects for arbitrary radial wavelength in comparison to banana width and gyroradius is derived. In additional to the contribution from trapped particles, the contribution of passing particles to the neoclassical polarization is also explicitly calculated. Our analytic expression agrees very well with the previous numerical results for a wide range of radial wavelength.

This paper presents a pedagogical review of the physics of mesoscopic transport events and their role in the breakdown of Fick's Law for turbulent transport in magnetically confined plasma. It is now clear that the conventional picture of localized turbulence and quasi-linear calculation of fluxes fails to address and account for the phenomenology of tokamak transport. One key issue is the observed departure from the expected gyro-Bohm transport scaling. The causes of this breakdown of Fickian thinking include turbulent avalanching and pulse propagation (turbulence spreading). Both are mesoscopic transport events, and both tend to de-localize the flux-gradient relation. Turbulence spreading is the process of self-scattering and expansion of a slug or other local exciton of turbulence. Spreading is described by theoretically-motivated, phenomenological reaction-diffusion models for the turbulence activity (intensity) field, much in the spirit of Ginzburg-Landau theory. Such models imply that spreading will occur by propagation of intensity fronts. After discussing the basic theory, this paper presents several critical tests of turbulence spreading models using gyrokinetic simulation. Applications include rho-star scaling, penetration of transport barriers and core-edge coupling. Relevant experiment-theory comparisons are addressed, as well. Avalanching refers to a process whereby correlated topplings of nearby localized cells overturn sequentially and drive a burst of transport. Avalanching is a process intrinsic to systems that support a broad range of scales l between a cell size ∆ and system size L, i.e. ∆ < l < L. Avalanching is also a natural way to produce transport events on scales that exceed the cell size or correlation length. Therefore, the PDF (probability distribution function) of avalanches as a function of l is a crucial quantity, necessary for predicting confinement in a system like ITER, with a very large-scale separation between L and ∆. Avalanching emerged from the theory of selforganized criticality but is a more general phenomenon. The paper traces the intellectual prehistory of avalanching through the advent of self-organized criticality. Special focus is devoted to reduced continuum models of avalanching. The physics of avalanching in confined plasma is discussed in detail, via several multi-faceted comparisons to flux-driven fluid and gyrokinetic simulations. The dominance of bursty, large transport events in the flux is identified. Evidence for avalanching in basic and confinement experiments is summarized. The paper concludes with sections on selected special topics, a discussion of the relation between turbulence spreading and avalanching, and a list of possible future directions. Throughout the paper, an effort is made to set fusion theory and phenomenology in the context of ideas discussed in the broader scientific community.

Background: Interscalene brachial plexus block of the C5-C6 roots provides highly effective postoperative analgesia after shoulder surgery but usually results in hemidiaphragmatic paresis. Injection around the superior trunk of the brachial plexus is an alternative technique that may reduce this risk. The authors hypothesized that the superior trunk block would provide noninferior postoperative analgesia compared with the interscalene block and reduce hemidiaphragmatic paresis. Methods: Eighty patients undergoing arthroscopic shoulder surgery were randomized to receive a preoperative injection of 15 ml of 0.5% ropivacaine and 5 μg • ml −1 epinephrine around either (1) the C5-C6 nerve roots (interscalene block group) or (2) the superior trunk (superior trunk block group). The primary outcome was pain intensity 24 h after surgery measured on an 11-point numerical rating score; the prespecified noninferiority limit was 1. Diaphragmatic function was assessed using both ultrasonographic measurement of excursion and incentive spirometry by a blinded investigator before and 30 min after block completion. Results: Seventy-eight patients completed the study. The pain score 24 h postoperatively (means ± SDs) was 1.4 ± 1.0 versus 1.2 ± 1.0 in the superior trunk block (n = 38) and interscalene block (n = 40) groups, respectively. The mean difference in pain scores was 0.1 (95% CI, −0.3 to 0.6), and the upper limit of the 95% CI was lower than the prespecified noninferiority limit. Analgesic requirements and all other pain measurements were similar between groups. Hemidiaphragmatic paresis was observed in 97.5% of the interscalene block group versus 76.3% of the superior trunk block group (P = 0.006); paresis was complete in 72.5% versus 5.3% of the patients, respectively. The decrease in spirometry values from baseline was significantly greater in the interscalene block group. conclusions: The superior trunk block provided noninferior analgesia compared with interscalene brachial plexus block for up to 24 h after arthroscopic shoulder surgery and resulted in significantly less hemidiaphragmatic paresis.

Many factors are associated with the development of low back pain. Among them, exercise, obesity, smoking, age, educational level and stress are the most common. This study examined the association of these factors with low back pain. An additional aim was to determine a procedure for preventing low back pain. This study analyzed the responses to a questionnaire sent to 772 individuals who had undergone a medical examination at this hospital in 2003 and excluded the individuals who had shown symptoms or their test results indicated a particular disease. Assuming that there were no variables, individuals who exercised regularly 3-4 times per week would have a lower chance of having low back pain than those who did not exercise regularly. The analysis revealed that individuals with a college degree or higher education have a lower chance of experiencing low back pain than those with only a high school education or even college drop-outs. When the other variables were constant, age, extent of obesity (body mass index), smoking and level of stress were not found to affect the development of low back pain. The level of education was associated with the development of low back pain. However, regular exercise 3-4 times per week or more would be most effective in reducing the incidence and duration of low back pain.