Summary of Dissimilar Metal Joining Trials Conducted by Edison Welding Institute

Under the direction of the NASA-Glenn Research Center, the Edison Welding Institute (EWI) in Columbus, OH performed a series of non-fusion joining experiments to determine the feasibility of joining refractory metals or refractory metal alloys to Ni-based superalloys. Results, as reported by EWI, can be found in the project report for EWI Project 48819GTH (Attachment A, at the end of this document), dated October 10, 2005. The three joining methods used in this investigation were inertia welding, magnetic pulse welding, and electro-spark deposition joining. Five materials were used in these experiments: Mo-47Re, T-111, Hastelloy X, Mar M-247 (coarse-grained, 0.5 mm to several millimeter average grain size), and Mar M-247 (fine-grained, approximately 50 {micro}m average grain size). Several iterative trials of each material combination with each joining method were performed to determine the best practice joining method. Mo-47Re was found to be joined easily to Hastelloy X via inertia welding, but inertia welding of the Mo-alloy to both Mar M-247 alloys resulted in inconsistent joint strength and large reaction layers between the two metals. T-111 was found to join well to Hastelloy X and coarse-grained Mar M-247 via inertia welding, but joining to fine-grained Mar M-247 resulted in low joint strength. Magnetic pulse welding (MPW) was only successful in joining T-111 tubing to Hastelloy X bar stock. The joint integrity and reaction layer between the metals were found to be acceptable. This single joining trial, however, caused damage to the electromagnetic concentrators used in this process. Subsequent design efforts to eliminate the problem resulted in a loss of power imparted to the accelerating work piece, and results could not be reproduced. Welding trials of Mar M-247 to T-111 resulted in catastrophic failure of the bar stock, even at lower power. Electro-spark deposition joining of Mo-47Re, in which the deposited material was Hastelloy X, did not have a noticeable reaction layer. T-111 was found to have a small reaction layer at the interface with deposited Hastelloy X. Mar M-247 had a reaction layer larger than T-111. Hastelloy X joined well with a substrate of the same alloy, and throughout the experiments was found to have a density of {approx}99%, based on metallographic observations of porosity in the deposit. Of the three joining methods tested, inertial welding of bar stock appears to be the most mature at this time. MPW may be an attractive alternative due to the potential for high bond integrity, similar to that seen in explosion bonding. However, all three joining methods used in this work will require adaptation in order to join piping and tubing. Further investigations into the change in mechanical properties of these joints with time, temperature, irradiation, and the use of interlayers between the two materials must also be performed

The impact of eliminating age inequalities in stage at diagnosis on breast cancer survival for older women.

BACKGROUND: Older women with breast cancer have poorer relative survival outcomes, but whether achieving earlier stage at diagnosis would translate to substantial reductions in mortality is uncertain. METHODS: We analysed data on East of England women with breast cancer (2006-2010) aged 70+ years. We estimated survival for different stage-deprivation-age group strata using both the observed and a hypothetical stage distribution (assuming that all women aged 75+ years acquired the stage distribution of those aged 70-74 years). We subsequently estimated deaths that could be postponed beyond 5 years from diagnosis if women aged 75+ years had the hypothetical stage distribution. We projected findings to the English population using appropriate age and socioeconomic group weights. RESULTS: For a typically sized annual cohort in the East of England, 27 deaths in women with breast cancer aged 75+ years can be postponed within 5 years from diagnosis if their stage distribution matched that of the women aged 70-74 years (4.8% of all 566 deaths within 5 years post diagnosis in this population). Under assumptions, we estimate that the respective number for England would be 280 deaths (5.0% of all deaths within 5 years post diagnosis in this population). CONCLUSIONS: The findings support ongoing development of targeted campaigns aimed at encouraging prompt presentation in older women.This article is an independent research supported by different funding bodies, beyond the authors’ own employing organisations. MJR was partially funded by a Cancer Research UK Postdoctoral Fellowship (CRUK_A13275). GL is supported by a Postdoctoral Fellowship award by the National Institute for Health Research (NIHR PDF-2011-04-047) to end of 2014 and a Cancer Research UK Clinician Scientist Fellowship award (A18180) from 2015. We thank all staff at the National Cancer Registration Service, Public Health England, Eastern Office who helped collect and code data used in this study. We particularly acknowledge the help of Dr Clement H Brown and Dr Brian A Rous who were responsible for staging.This is the final published version. It first appeared at http://www.nature.com/bjc/journal/v112/n1s/full/bjc201551a.html#ack

Maternal and postnatal overnutrition differentially impact appetite regulators and fuel metabolism

Maternal obesity is increasing, and it is known that the intrauterine experience programs fetal and newborn metabolism. However, the relative contributions of pre- or postnatal factors are unknown. We hypothesized that maternal overnutrition caused by long-term maternal obesity would exert a stronger detrimental impact than postnatal overnutrition on offspring metabolic homeostasis, with additional postnatal overnutrition exaggerating these alterations. Female Sprague Dawley rats were exposed to chow or high-fat cafeteria diet for 5 wk before mating and throughout gestation and lactation. On postnatal d 1, litters were adjusted to three per litter to induce postnatal overnutrition (vs. 12 in control). Hypothalamic appetite regulators neuropeptide Y and proopiomelanocortin, glucose transporter 4, and lipid metabolic markers were measured. At postnatal d 20, male pups born of obese dams, or those overnourished postnatally, were 42% heavier than controls; combining both interventions led to 80% greater body weight. Maternal obesity increased pup adiposity and led to glucose intolerance in offspring; these were exaggerated by additional postnatal overnutrition during lactation. Maternal obesity was also linked to hyperlipidemia in offspring and reduced hypothalamic neuropeptide Y and increased proopiomelanocortin mRNA expression. Postnatal overnutrition of offspring from obese dams amplified these hypothalamic changes. Both maternal and postnatal overnutrition reduced muscle glucose transporter 4. Adipose carnitine palmitoyl-transferase-1 and adipose triglyceride lipase mRNA was up-regulated only by postnatal overnutrition. Maternal overnutrition appears to alter central appetite circuits and promotes early-onset obesity; postnatal overnutrition interacted to cause peripheral lipid and glucose metabolic disorders, supporting the critical message to reduce early-life adverse nutritional impact. Copyright © 2008 by The Endocrine Society

Understanding the impact of socioeconomic differences in colorectal cancer survival: potential gain in life-years

Background Colorectal cancer prognosis varies substantially with socioeconomic status. We investigated differences in life expectancy between socioeconomic groups and estimated the potential gain in life-years if cancer-related survival differences could be eliminated. Methods This population-based study included 470,000 individuals diagnosed with colon and rectal cancers between 1998 and 2013 in England. Using flexible parametric survival models, we obtained a range of life expectancy measures by deprivation status. The number of life-years that could be gained if differences in cancer-related survival between the least and most deprived groups were removed was also estimated. Results We observed up to 10% points differences in 5-year relative survival between the least and most deprived. If these differences had been eliminated for colon and rectal cancers diagnosed in 2013 then almost 8231 and 7295 life-years would have been gained respectively. This results for instance in more than 1-year gain for each colon cancer male patient in the most deprived group on average. Cancer-related differences are more profound earlier on, as conditioning on 1-year survival the main reason for socioeconomic differences were factors other than cancer. Conclusion This study highlights the importance of policies to eliminate socioeconomic differences in cancer survival as in this way many life-years could be gained

The impact of eliminating age inequalities in stage at diagnosis on breast cancer survival for older women

This is the final published version. Available from Springer Nature via the DOI in this record.BACKGROUND: Older women with breast cancer have poorer relative survival outcomes, but whether achieving earlier stage at diagnosis would translate to substantial reductions in mortality is uncertain.METHODS: We analysed data on East of England women with breast cancer (2006-2010) aged 70+ years. We estimated survival for different stage-deprivation-age group strata using both the observed and a hypothetical stage distribution (assuming that all women aged 75+ years acquired the stage distribution of those aged 70-74 years). We subsequently estimated deaths that could be postponed beyond 5 years from diagnosis if women aged 75+ years had the hypothetical stage distribution. We projected findings to the English population using appropriate age and socioeconomic group weights.RESULTS: For a typically sized annual cohort in the East of England, 27 deaths in women with breast cancer aged 75+ years can be postponed within 5 years from diagnosis if their stage distribution matched that of the women aged 70-74 years (4.8% of all 566 deaths within 5 years post diagnosis in this population). Under assumptions, we estimate that the respective number for England would be 280 deaths (5.0% of all deaths within 5 years post diagnosis in this population).CONCLUSIONS: The findings support ongoing development of targeted campaigns aimed at encouraging prompt presentation in older women.Cancer Research UKCancer Research UKNational Institute for Health Research (NIHR

Exercise-based cardiac rehabilitation improves exercise capacity and health-related quality of life in people with atrial fibrillation: A systematic review and meta-analysis of randomised and non-randomised trials

This is the final version. Available on open access from BMJ Publishing Group via the DOI in this recordObjective The aim of this study was to undertake a contemporary review of the impact of exercise-based cardiac rehabilitation (CR) targeted at patients with atrial fibrillation (AF). Methods We conducted searches of PubMED, EMBASE and the Cochrane Library of Controlled Trials (up until 30 November 2017) using key terms related to exercise-based CR and AF. Randomised and non-randomised controlled trials were included if they compared the effects of an exercise-based CR intervention to a no exercise or usual care control group. Meta-analyses of outcomes were conducted where appropriate. Results The nine randomised trials included 959 (483 exercise-based CR vs 476 controls) patients with various types of AF. Compared with control, pooled analysis showed no difference in all-cause mortality (risk ratio (RR) 1.08, 95% CI 0.77 to 1.53, p=0.64) following exercise-based CR. However, there were improvements in health-related quality of life (mean SF-36 mental component score (MCS): 4.00, 95% CI 0.26 to 7.74; p=0.04 and mean SF-36 physical component score: 1.82, 95% CI 0.06 to 3.59; p=0.04) and exercise capacity (mean peak VO2: 1.59 ml/kg/min, 95% CI 0.11 to 3.08; p=0.04; mean 6 min walk test: 46.9 m, 95% CI 26.4 to 67.4; p<0.001) with exercise-based CR. Improvements were also seen in AF symptom burden and markers of cardiac function. Conclusions Exercise capacity, cardiac function, symptom burden and health-related quality of life were improved with exercise-based CR in the short term (up to 6 months) targeted at patients with AF. However, high-quality multicentre randomised trials are needed to clarify the impact of exercise-based CR on key patient and health system outcomes (including health-related quality of life, mortality, hospitalisation and costs) and how these effects may vary across AF subtypes.National Institute for Health Research (NIHR

Interactions between hydrological sensitivity, radiative cooling, stability, and low-level cloud amount feedback

This is the author accepted manuscript. The final version is available from American Meteorological Society via the DOI in this record.Low-level cloud feedbacks vary in magnitude but are positive in most climate models, due to reductions in low-level cloud fraction. This study explores the impact of surface evaporation on low-level cloud fraction feedback by performing climate change experiments with the aquaplanet configuration of the HadGEM2-A climate model, forcing surface evaporation to increase at different rates in two ways. Forcing the evaporation diagnosed in the surface scheme to increase at 7% K -1 with warming (more than doubling the hydrological sensitivity) results in an increase in global mean low-level cloud fraction and a negative global cloud feedback, reversing the signs of these responses compared to the standard experiments. The estimated inversion strength (EIS) increases more rapidly in these surface evaporation forced experiments, which is attributed to additional latent heat release and enhanced warming of the free troposphere. Stimulating a 7% K -1 increase in surface evaporation via enhanced atmospheric radiative cooling, however, results in a weaker EIS increase compared to the standard experiments and a slightly stronger low-level cloud reduction. The low-level cloud fraction response is predicted better by EIS than surface evaporation across all experiments. This suggests that surface-forced increases in evaporation increase low-level cloud fraction mainly by increasing EIS. Additionally, the results herein show that increases in surface evaporation can have a very substantial impact on the rate of increase in radiative cooling with warming, by modifying the temperature and humidity structure of the atmosphere. This has implications for understanding the factors controlling hydrological sensitivity.Mark Webb was supported by the Joint UK BEIS/Defra Met Office Hadley Centre Climate Programme 726 (GA01101)

Early career choices and successful career progression in surgery in the UK: prospective cohort studies

<p>Abstract</p> <p>Background</p> <p>Changes to the structure of medical training worldwide require doctors to decide on their career specialty at an increasingly early stage after graduation. We studied trends in career choices for surgery, and the eventual career destinations, of UK graduates who declared an early preference for surgery.</p> <p>Methods</p> <p>Postal questionnaires were sent, at regular time intervals after qualification, to all medical qualifiers from all UK medical schools in selected qualification years between 1974 and 2005. They were sent in the first year after qualification, at year three and five years after qualification, and at longer time intervals thereafter.</p> <p>Results</p> <p>Responses were received from 27 749 of 38 280 doctors (73%) at year one, 23 468 of 33151 (71%) at year three, and 17 689 of 24 870 (71%) at year five. Early career preferences showed that surgery has become more popular over the past two decades. Looking forward from early career choice, 60% of respondents (64% of men, 48% of women) with a first preference for a surgical specialty at year one eventually worked in surgery (p < 0.001 for the male-female comparison). Looking backward from eventual career destinations, 90% of responders working in surgery had originally specified a first choice for a surgical specialty at year one. 'Match' rates between eventual destinations and early choices were much higher for surgery than for other specialties. Considering factors that influenced early specialty choice 'a great deal', comparing aspiring surgeons and aspiring general practitioners (GPs), a significantly higher percentage who chose surgery than general practice specified enthusiasm for the specialty (73% vs. 53%), a particular teacher or department (34% vs. 12%), inclinations before medical school (20% vs. 11%), and future financial prospects (24% vs. 13%); and a lower percentage specified that hours and working conditions had influenced their choice (21% vs. 71%). Women choosing surgery were influenced less than men by their inclinations before medical school or by their future financial prospects.</p> <p>Conclusions</p> <p>Surgery is a popular specialty choice in the UK. The great majority of doctors who progressed in a surgical career made an early and definitive decision to do so.</p