Risk factors for pressure sores in adult patients with myelomeningocele – a questionnaire-based study

BACKGROUND: Myelomeningocele (MMC) is a part of a complex neural tube defect and a disorder of the cerebrospinal fluid system. Pressure sores are a frequent complication for patients with MMC. Little is known about the risk factors for pressure sores in adults with MMC. The aim of this study was to investigate an association between the presence of pressure sores and other patient characteristics, in order to develop an improved strategy for the management of sores. METHODS: A structured questionnaire regarding sores, medical condition, function and living factors was designed and sent to the 193 patients with MMC registered in the year 2003 at TRS, a National Centre for Rare Disorders in Norway. RESULTS: Out of 193 total, 87 patients participated and 71 patients (82%) reported sores; 26 (30%) at the time of the interview and 45 (52%) during the last 5 years. Sores were mostly localized on toes and feet and occurred exclusively in regions with reduced or missing sensibility. A significant association was found between sores and memory deficit (p = 0.02), Arnold Chiari malformation (p = 0.02) and a record of previous sores (p = 0.004). Sores were not significantly associated with hydrocephalus, syringomyelia, nutrition, body mass index, smoking, physical activity, employment or living together with other persons. Some patients (18, 21%) reported skin inspection by others and the remainder relied on self-inspection. CONCLUSION: Patients with sensory deficit, memory problems, and Arnold Chiari malformation had a higher risk of having pressure sores. This patient group needs improved skin inspection routines and sore treatment

Development of the 174 GHz collective Thomson scattering diagnostics at Wendelstein 7-X

In this paper, we present the design and commissioning results of the upgraded collective Thomson scattering diagnostic at the Wendelstein 7-X stellarator. The diagnostic has a new radiometer designed to operate between the second and third harmonics of the electron cyclotron emission from the plasma at 171–177 GHz, where the emission background has a minimum and is of order 10–100 eV. It allows us to receive the scattered electromagnetic field with a significantly improved signal-to-noise ratio and extends the set of possible scattering geometries compared to the case of the original instrument operated at 140 GHz. The elements of the diagnostic are a narrowband notch filter and a frequency stabilized probing gyrotron that will allow measuring scattered radiation spectra very close to the probing frequency. Here, we characterize the microwave components applied to the radiometer and demonstrate the performance of the complete system that was achieved during the latest experimental campaign, OP2.1

Large Scale CW ECRH Systems : Some considerations

Electron Cyclotron Resonance Heating (ECRH) is a key component in the heating arsenal for the next step fusion devices like W7-X and ITER. These devices are equipped with superconducting coils and are designed to operate steady state. ECRH must thus operate in CW-mode with a large flexibility to comply with various physics demands such as plasma start-up, heating and current drive, as well as configurationand MHD - control. The request for many different sophisticated applications results in a growing complexity, which is in conflict with the request for high availability, reliability, and maintainability. ‘Advanced’ ECRH-systems must, therefore, comply with both the complex physics demands and operational robustness and reliability. The W7-X ECRH system is the first CW- facility of an ITER relevant size and is used as a test bed for advanced components. Proposals for future developments are presented together with improvements of gyrotrons, transmission components and launchers