Clinical Characteristics and Outcomes Among Individuals With Spinal Implant Infections: A Descriptive Study.

Little is known about the clinical presentation and outcomes associated with spinal implant infections. Here, we describe a single center's experience in a retrospective cohort of 109 individuals with spinal implant infections, including clinical, microbiological, therapeutic, and outcome data

Factors contributing to delayed diagnosis of cancer among Aboriginal people in Australia: a qualitative study.

BACKGROUND/OBJECTIVES: Delayed presentation of symptomatic cancer is associated with poorer survival. Aboriginal patients with cancer have higher rates of distant metastases at diagnosis compared with non-Aboriginal Australians. This paper examined factors contributing to delayed diagnosis of cancer among Aboriginal Australians from patient and service providers' perspectives. METHODS: In-depth, open-ended interviews were conducted in two stages (2006-2007 and 2011). Inductive thematic analysis was assisted by use of NVivo looking around delays in presentation, diagnosis and referral for cancer. PARTICIPANTS: Aboriginal patients with cancer/family members (n=30) and health service providers (n=62) were recruited from metropolitan Perth and six rural/remote regions of Western Australia. RESULTS: Three broad themes of factors were identified: (1) Contextual factors such as intergenerational impact of colonisation and racism and socioeconomic deprivation have negatively impacted on Aboriginal Australians' trust of the healthcare professionals; (2) health service-related factors included low accessibility to health services, long waiting periods, inadequate numbers of Aboriginal professionals and high staff turnover; (3) patient appraisal of symptoms and decision-making, fear of cancer and denial of symptoms were key reasons patients procrastinated in seeking help. Elements of shame, embarrassment, shyness of seeing the doctor, psychological 'fear of the whole health system', attachment to the land and 'fear of leaving home' for cancer treatment in metropolitan cities were other deterrents for Aboriginal people. Manifestation of masculinity and the belief that 'health is women's domain' emerged as a reason why Aboriginal men were reluctant to receive health checks. CONCLUSIONS: Solutions to improved Aboriginal cancer outcomes include focusing on the primary care sector encouraging general practitioners to be proactive to suspicion of symptoms with appropriate investigations to facilitate earlier diagnosis and the need to improve Aboriginal health literacy regarding cancer. Access to health services remains a critical problem affecting timely diagnosis

First trimester fetal heart rate as a predictor of newborn sex

OBJECTIVE: To predict the sex of newborns using first trimester fetal heart rate (FHR). METHODS: This was a retrospective review of medical records and ultrasounds performed between 8 and 13 weeks of gestation. Continuous variables were compared using Student\u27s t-tests while categorical variables were compared using Chi-square test. RESULTS: We found no significant differences between 332 (50.7%) female and 323 (49.3%) male FHRs during the first trimester. The mean FHR for female fetuses was 167.0 +/- 9.1 bpm and for male fetuses 167.3 +/- 10.1 bpm (p = 0.62). There was no significant difference in crown rump length between female and male fetuses (4.01 +/- 1.7 versus 3.98 +/- 1.7 cm; p = 0.78) or in gestational age at birth (38.01 +/- 2.1 versus 38.08 +/- 2.1 weeks; p = 0.67). The males were significantly heavier than females (3305.3 +/- 568.3 versus 3127.5 +/- 579.8 g; p \u3c 0.0001) but there were no differences in the proportion of small for gestational age (SGA), average for gestational age (AGA) and large for gestational age (LGA) infants. CONCLUSIONS: We found no significant difference between the female and male FHR during the first trimester in contrast to the prevailing lay view of females having a faster FHR. The only statistically significant difference was that males weighed more than female newborns

Engineering design of a radiative divertor for DIII-D

A new divertor configuration is being developed for the DIII-D tokamak. This divertor will operate in the radiative mode. Experiments and modeling form the basis for the new design. The Radiative Divertor reduces the heat flux on the divertor plates by dispersing the power with radiation in the divertor region. In addition, the Radiative Divertor structure will allow density control in plasma shapes required for advanced tokamak operation. The divertor structure allows for operation in either double-null or single-null plasma configurations. Four independently controlled divertor cryopumps will enable pumping at either the inboard (upper and lower) or the outboard (upper and lower) divertor plates. An upgrade to the DIII-D cryogenic system is part of this project. The increased capabilities of the cryogenic system will allow delivery of liquid helium and nitrogen to the three new cryopumps. The Radiative Divertor design is very flexible, and will allow physics studies of the effects of slot width and length. Radiative Divertor diagnostics are being designed in parallel to provide comprehensive measurements for diagnosing the divertor. The Radiative divertor installation is scheduled for late 1996. Engineering experience gained in the DIII-D Advanced Divertor program form a foundation for the design work on the Radiative Divertor

The DIII-D Radiative Divertor Project: Status and plans

New divertor hardware is being designed and fabricated for the Radiative Divertor modification of the DIII-D tokamak. The installation of the hardware has been separated into two phases, the first phase starting in October of 1996 and the second and final phase, in 1998. The phased approach enables the continuation of the divertor characterization research in the lower divertor while providing pumping for density control in high triangularity, single- or double-null advanced tokamak discharges. When completed, the Radiative Divertor Project hardware will provide pumping at all four strike points of a double-null, high triangularity discharge and provide baffling of the neutral particles from transport back to the core plasma. By puffing neutral gas into the divertor region, a reduction in the heat flux on the target plates will be be demonstrated without a large rise in core density. This reduction in heat flux is accomplished by dispersing the power with radiation in the divertor region. Experiments and modeling have formed the basis for the new design. The capability of the DIII-D cryogenic system is being upgraded as part of this project. The increased capability of the cryogenic system will allow delivery of liquid helium and nitrogen to three new cryopumps. Physics studies on the effects of slot width and length can be accomplished easily with the design of the Radiative Divertor. The slot width can be varied by installing graphite tiles of different geometry. The change in slot length, the distance from the X-point to the target plate, requires relocating the structure vertically and can be completed in about 6-8 weeks. Radiative Divertor diagnostics are being designed to provide comprehensive measurements for diagnosing the divertor. Required diagnostic modifications will be minimal for Phase 1, but extensive for Phase 2 installation. These Phase 2 diagnostics will be required to fully diagnose the high triangularity discharges in the divertor slots

Melatonin protects against alterations in hippocampal cholinergic system, trace metals and oxidative stress induced by gestational and lactational exposure to cadmium

Dietary exposure to cadmium, even at lower doses, can lead to free radical induced neurotoxicity, neurobehavioral changes and alteration in neurotransmitters. Such changes are likely to be more pronounced in the developing brain due to incompleteness of blood brain barrier (BBB). Hippocampus being the seat of intelligence has a role in learning and cognitive behavior and any damage to hippocampus during developmental stage is likely to result in neurodegenerative changes in later life. To this end, fetal and neonatal exposure to cadmium was induced by exposing pregnant dams of Swiss albino strain throughout the period of gestation and following parturition up till 5th day post partum (pp) through drinking water (3ppm/animal/day). The neonates were sacrificed on day 6 pp and indices of oxidative stress, levels of trace elements and changes in cholinergic system were evaluated in the hippocampus. Increased lipid peroxidation, surge in reactive oxygen species (ROS), depressed antioxidant defense, increased accumulation of cadmium, differential alterations in trace elements and decreased activity of AChE were the features of cadmium toxicity. Simultaneous administration of melatonin to cadmium challenged animals offset these detrimental changes. The results suggest that melatonin co-administration can effectively protect against the adverse effects of cadmium on endogenous antioxidant status, changes in trace metal concentrations and compromised hippocampal cholinergic system

HTR2008-58015 ROTOR SCALE MODEL TESTS FOR POWER CONVERSION UNIT OF GT-MHR

ABSTRACT A power-generating unit with the high-temperature helium reactor (GT-MHR) has a turbomachine (TM) that is intended for both conversion of coolant thermal energy into electric power in the direct gas-turbine cycle, and provision of helium circulation in the primary circuit. The vertically oriented TM is placed in the central area of the power conversion unit (PCU). TM consists of a turbocompressor (TC) and a generator. Their rotors are joined with a diaphragm coupling and supported by electro-magnetic bearings (EMB). The complexity and novelty of the task of the full electromagnetic suspension system development requires thorough stepwise experimental work, from small-scale physical models to full-scale specimen. On this purpose, the following is planned within the framework of the GT-MHR Project: investigations of the "flexible" rotor small-scale mockup with electro-magnetic bearings ("Minimockup" test facility); tests of the radial EMB; tests of the position sensors; tests of the TM rotor scale model; tests of the TM catcher bearings (CB) friction pairs; tests of the CB mockups; tests of EMB and CB pilot samples and investigation of the full-scale electromagnetic suspension system as a part of full-scale turbocompressor tests. The rotor scale model (RSM) tests aim at investigation of dynamics of rotor supported by electromagnetic bearings to validate GT-MHR turbomachine serviceability. Like the full-scale turbomachine rotor, the RSM consist of two parts: the generator rotor model and the turbocompressor rotor model that are joined with a coupling. Both flexible and rigid coupling options are tested. Each rotor is supported by one axial and two radial EMBs. The rotor is arranged vertically. The RSM rotor length is 10.54 m, and mass is 1171 kg. The designs of physical model elements, namely of the turbine, compressors, generator and exciter, are simplified and performed with account of rigid characteristics, which are identical to those of the full-scale turbomachine elements. INTRODUCTION A power-generating unit with the high-temperature helium reacto

‘I didn’t even recognise myself’: Survivors’ experiences of altered appearance and body image distress during and after treatment for head and neck cancer

Purpose: Preparation for head and neck cancer treatment is focused on practicalities of treatment. Little or no time is spent prior to treatment discussing aesthetic results of treatment or the psychosocial impact of living with an altered appearance after treatment. The objective of this study was to explore the experiences of survivors of head and neck cancers, with a focus on the psychosocial impact of altered appearance. Methods: A qualitative research approach based on social constructionist theory was used. Twenty-one semi-structured interviews were conducted with survivors of head and neck cancer who had been diagnosed in the previous six years. Thematic analysis was used to identify themes. Results: People diagnosed with HNC reported feeling rushed into treatment, with adequate procedural preparation but little or no preparation related to appear-ance. The main themes included: Preparation (sub-themes: Decision-making; and Preparation for Altered Appearance); Altered Appearance (sub-themes: Weight Loss; Face, Skin and Hair Changes; and Reconstructive Surgery); and Consequences (sub-themes Reactions from Others; Adapting to Altered Appearance). Conclusions: Body image distress related to altered appearance, contributed to psychosocial issues for many people diagnosed with head and neck cancer. Current practice provides information pre-treatment about many aspects of coping; however, the subject of appearance is not routinely addressed. Communication skills training for health professionals that improves their comfort and sensitivity in discussing and conveying compassion around issues of altered appearance, body image, and trauma, is needed to decrease suffering for survivors, support healthy adaptation to living with altered appearance, and increase their satisfaction with health care