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Funding Acknowledgements Type of funding sources: None. Background Covid-19 infection is associated with coagulopathy and possible heparin resistance, raising concerns that routine heparin during percutaneous coronary intervention (PCI) is failing to achieve adequate anticoagulation. We examined heparin requirements and efficacy in patients treated by PCI before and after the first reported UK case of Covid-19 (January 31st 2020). Methods We retrospectively compared heparin dose, Activated Clotting Time (ACT) and coronary flow (TIMI grade) for PCI procedures at a London cardiac centre in the 3 months before the UK pandemic and the three months afterwards. Testing for COVID was not routinely performed. Pre-specified analyses in patients with STEMI, NSTEMI and Stable angina were undertaken. Results Of 1227 PCI procedures performed over the period of observation, 690 were pre-pandemic and 537 were afterwards. Overall median heparin dose per case was 11000units versus 11500units (p = 0.137) and maximum ACTs were 291s versus 305s, respectively (p = 0.135). Pre-PCI TIMI 3 flow was lower during the pandemic than before (60% v 65%, p = 0.005) but Post-PCI flow was similar (96% versus 96%, p = 0.839). There were no statistically significant differences in heparin dose or achieved ACT among patients with STEMI, NSTEMI or Stable presentations. Conclusion In spite of the increasing evidence that COVID-19 infection causes thrombosis, it appears that standard heparin management during PCI is sufficient to achieve effective anticoagulation and avoid peri-procedural thrombotic complications. Group 1 Pre PandemicGroup 2 PandemicP valueNumber of doses given3 (3 to 4)3 (3 to 4)0.952Total Heparin dose (units)11000 (8000 to 14000)11500 (9000 to 14000)0.137Number of ACTs measured2 (1 to 2)2 (1 to 2)0.194First ACT (seconds)240 (199 to 318)248 (206 to 326)0.256Maximum ACT (seconds)291 (230 to 368)305 (239 to 369)0.135Heparin dose and Activated Clotting Times (ACT) in patients undergoing PCI before Covid-19 pandemic (Group 1) and during pandemic (Group 2); median and interquartile rangesAbstract Figure. Clinical Presentation

C-2 is a unique, large compact-toroid (CT) device at Tri Alpha Energy that produces field-reversed configuration (FRC) plasmas by colliding and merging oppositely directed CTs. Significant progress has recently been made on C-2, achieving ~5 ms stable plasmas with a dramatic improvement in confinement, far beyond the prediction from the conventional FRC scaling. This stable, long-lived FRC plasma state is called the high-performance FRC (HPF) regime. The key approaches to achieve the HPF regime are as follows: (i) dynamic FRC formation by collision/merging of super-Alfvenic CTs, (ii) effective control of stability and transport by end-on plasma guns and neutral-beam (NB) injection, and (iii) active wall conditioning using titanium and lithium gettering systems. Moreover, further improvement in FRC confinement has been obtained with improved open-field-line plasma properties such as a lower fluctuation level, reduced transport rates in radial/axial directions, and lower background neutral density a...

TAE Technologies' research is devoted to producing high temperature, stable, long-lived field-reversed configuration (FRC) plasmas by neutral-beam injection (NBI) and edge biasing/control. The newly constructed C-2W experimental device (also called "Norman") is the world's largest compact-toroid (CT) device, which has several key upgrades from the preceding C-2U device such as higher input power and longer pulse duration of the NBI system as well as installation of inner divertors with upgraded electrode biasing systems. Initial C-2W experiments have successfully demonstrated a robust FRC formation and its translation into the confinement vessel through the newly installed inner divertor with adequate guide magnetic field. They also produced dramatically improved initial FRC states with higher plasma temperatures (Te ~250+ eV; total electron and ion temperature g1.5 keV, based on pressure balance) and more trapped flux (up to ~15 mWb, based on rigid-rotor model) inside the FRC immediately after the merger of collided two CTs in the confinement section. As for effective edge control on FRC stabilization, a number of edge biasing schemes have been tried via open field-lines, in which concentric electrodes located in both inner and outer divertors as well as end-on plasma guns are electrically biased independently. As a result of effective outer-divertor electrode biasing alone, FRC plasma diamagnetism duration has reached up to ~9 ms which is equivalent to C-2U plasma duration. Magnetic field flaring/expansion in both inner and outer divertors plays an important role in creating a thermal insulation on open field-lines to reduce a loss rate of electrons, which leads to improvement of the edge and core FRC confinement properties. Experimental campaign with inner-divertor magnetic-field flaring has just commenced and early result indicates that electron temperature of the merged FRC stays relatively high and increases for a short period of time, presumably by NBI and ExB heating.

Department of Physics and Astronomy, UCLA, Los Angeles, CA 90095, USAA high temperature, stable, long-lived field-reversed configuration (FRC) plasma state has been produced in the C-2 device by dynamically colliding and merging two oppositely directed compact toroids, with combining effects of biasing edge plasma near the FRC separatrix from an end-plasma-gun with magnetic-mirror-plugs andof neutral-beam (NB) injection. The plasma-gun creates an inward radial electric field which mitigates the n = 2rotational instability. The gun also produces E×B velocity shear in the FRC edge layer, which may explain observations of improved transport properties. The FRCs are nearly axisymmetric which enables fast ion confinement, and increasing NB power input clearly extends the FRC lifetime. The combined effects of the plasma-gun with mirror-plugs and of NB injection yield anew High Performance FRC regime with confinement times improved by factors 2 to 4 and FRC lifetimes extended from 1 to 3 ms.

Conventional field-reversed configurations (FRC) face notable stability and confinement concerns, which can be ameliorated by introducing and maintaining a significant fast ion population in the system. This is the conjecture first introduced by Norman Rostoker multiple decades ago and adopted as the central design tenet in Tri Alpha Energy’s advanced beam driven FRC concept. In fact, studying the physics of such neutral beam (NB) driven FRCs over the past decade, considerable improvements were made in confinement and stability. Next to NB injection, the addition of axially streaming plasma guns, magnetic end plugs, as well as advanced surface conditioning lead to dramatic reductions in turbulence driven losses and greatly improved stability. In turn, fast ion confinement improved significantly and allowed for the build-up of a dominant fast particle population. This recently led to the breakthrough of sustaining an advanced beam driven FRC, thereby demonstrating successful maintenance of trapped magnetic flux, plasma dimensions and total pressure inventory for times much longer than all characteristic system time scales and only limited by hardware and electric supply constraints.

The Field Reversed Configuration (FRC) is a high-beta Compact Toroid that includes closed and open field line regions of poloidal magnetic field. Improving the transport properties of both regions ...

The experiments on negative hydrogen ion beam production in a multi-aperture long-pulse surface-plasma source are described. H- ions are produced on the surface of a plasma grid covered by cesium and illuminated by fast plasma particles. The source uses a radio-frequency driver to generate plasma. A composite magnet system made of external permanent magnets confines and filters electrons in the plasma region, and deflects them in the extraction area. A multiaperture, multi-electrode ion optical system is used for beam formation. The electrode heating and cooling during long pulses is accomplished by circulating a heat transfer fluid through channels drilled in the electrodes bodies. H- ions extraction through a single aperture and 21 apertures was performed and studied. A stable H- beam with the current up to 0.7 A, energy up to 74 kV, and pulse duration up to 7 s was routinely obtained

Hematuria is the most common presenting sign of renal injury. Its presence in athletes may indicate a benign entity such as exercise-induced hematuria or a more serious injury in the presence of trauma. Exercise-induced hematuria can originate in the kidney, bladder, urethra, or prostate. The type of activity, as well as activity duration and intensity, contributes to its development. A wide differential diagnosis must be considered if hematuria persists longer than 24 to 72 hours. Trauma to the kidney can occur from a direct blow or deceleration; contact and collision sports are most commonly involved. Fortunately, most sports-related renal trauma is mild, and can be managed expectantly. A sporting injury rarely results in nephrectomy. Determining return to play for the athlete with a single kidney remains a controversial issue that requires patient education and an individualized approach.

Objective:To compare outcomes of 2 rehabilitation protocols on patellar tendinitis subjects.Design:Prospective, randomized, blinded, controlled clinical trial.Setting:Outpatient rehabilitation clinic.Subjects:Randomized into 2 rehabilitation groups—traditional (n= 10) and ASTM AdvantEDGE (n= 10).Main Outcome Measures:Clinical data and self-reported questionnaires collected at 0, 6, and 12 weeks.Results:On completion of the 6th week, 100% of the ASTM AdvantEDGE group and 60% of the traditional group had resolved. The unresolved subjects were crossed over to the ASTM AdvantEDGE for additional therapy. At the end of the additional therapy, 50% of the crossover subjects had resolved. The ASTM AdvantEDGE group's clinical outcomes and weekly journals indicated a statistically significant (P= .04) improvement in subjective pain and functional-impairment ratings.Conclusions:Findings suggest that ASTM AdvantEDGE resulted in improved clinical outcomes in treating patellar tendinitis.

Lateral epicondylitis is a common condition treated by many physical therapists. Although multiple treatment methods exist, scientific research has found that few have been consistently effective in treating lateral epicondylitis. Initially, lateral epicondylitis is often treated with rest, ice, braces and/or injections. When the condition is chronic or not responding to initial treatment, physical therapy is introduced. Common therapeutic modalities often utilized are ultrasound, phonophoresis, electric stimulation, manipulation, soft tissue mobilization, neural tension, friction massage, ASTM AdvantEDGE™, in addition to stretching and strengthening exercises. ASTM AdvantEDGE™ is becoming a more standard treatment process owing to its ability to help with the detection in changes in the soft tissue texture as the patient progresses through the therapeutic process. Laser and acupuncture are also becoming more popular. Finally, in resistant cases of lateral epicondylitis, patients can receive surge...

The Korea Superconducting Tokamak Advanced Research (KSTAR) project is the major effort of the national fusion programme of the Republic of Korea. Its aim is to develop a steady state capable advanced superconducting tokamak to establish a scientific and technological basis for an attractive fusion reactor. The major parameters of the tokamak are: major radius 1.8 m, minor radius 0.5 m, toroidal field 3.5 T and plasma current 2 MA, with a strongly shaped plasma cross-section and double null divertor. The initial pulse length provided by the poloidal magnet system is 20 s, but the pulse length can be increased to 300 s through non-inductive current drive. The plasma heating and current drive system consists of neutral beams, ion cyclotron waves, lower hybrid waves and electron cyclotron waves for flexible profile control in advanced tokamak operating modes. A comprehensive set of diagnostics is planned for plasma control, performance evaluation and physics understanding. The project has completed its conceptual design and moved to the engineering design and construction phase. The target date for the first plasma is 2002.

To compare different types of rehabilitation for anterior knee pain.Prospective, randomized, blinded, and controlled study of 64 participants with anterior knee pain.Outpatient rehabilitation clinic and testing laboratory.Participants were assigned in randomized fashion to three rehabilitation groups: traditional home rehabilitation (n = 20); physical therapy (n = 21); and home rehabilitation with a modified vastus medialis obliquis (VMO) specific straight leg raise (Muncie method; n = 23).Clinical data was obtained at 0, 2, 6, and 12 weeks. Cybex testing was performed at 0, 6, and 12 weeks.Clinical outcome for the Muncie method indicated a statistically significant improvement in subjective pain and functional impairment ratings. Cybex testing in patients using the Muncie method demonstrated a statistically significant improvement in pain-free isometric contractions and maximum voluntary contraction. There were no significant differences between traditional home therapy and physical therapy.Findings suggest that the Muncie method results in improved clinical outcome at a lower cost than traditional home and physical therapy and possibly improved VMO/quadriceps muscle balance. Patients with anterior knee pain may benefit from applying the Muncie method in a home therapy program.

The Korea Superconducting Tokamak Advanced Research (KSTAR) Project is the major effort of the Korean National Fusion Program (KNFP) to develop a steady-state-capable advanced superconducting tokamak to establish a scientific and technological basis for an attractive fusion reactor. Major parameters of the tokamak are: major radius 1.8 m, minor radius 0.5 m, toroidal field 3.5 Tesla, and plasma current 2 mA with a strongly shaped plasma cross-section and double-null divertor. The initial pulse length provided by the poloidal magnet system is 20 s, but the pulse length can be increased to 300 s through non-inductive current drive. The plasma heating and current drive system consists of neutral beam, ion cyclotron waves, lower hybrid waves, and electron–cyclotron waves for flexible profile control. A comprehensive set of diagnostics is planned for plasma control and performance evaluation and physics understanding. The project has completed its conceptual design phase and moved to the engineering design phase. The target date of the first plasma is set for year 2002.

This clinical case report demonstrates the clinical effectiveness of a new form of soft tissue mobilization in the treatment of excessive connective tissue fibrosis (scar tissue) around an athlete's injured ankle. The scar tissue was causing the athlete to have pain with activity, pain on palpation of the ankle, decreased range of motion, and loss of function. Surgery and several months of conventional physical therapy failed to alleviate the athlete's symptoms. As a final resort, augmented soft tissue mobilization (ASTM) was administered. ASTM is an alternative nonsurgical treatment modality that is being researched at Performance Dynamics (Muncip, IN). ASTM is a process that uses ergonomically designed instruments that assist therapists in the rapid localization and effective treatment of areas exhibiting excessive soft tissue fibrosis. This is followed by a stretching and strengthening program. Upon the completion of 6 wk of ASTM therapy, the athlete had no pain and had regained full range of motion and function. This case report is an example of how a noninvasive augmented form of soft tissue mobilization (ASTM) demonstrated impressive clinical results in treating a condition caused by connective tissue fibrosis.

Purpose: The purpose of this study was to develop and determine the efficacy of a middle digit isokinetic eccentric strength dynamometer (MDD) in two groups of subjects. Methods: The first group was composed of individuals without physician diagnosed lateral epicondylitis (13 males and 14 females), and the second group was composed of individuals who had physician diagnosed lateral epicondylitis (13 males and 14 females). A middle digital extension isokinetic dynamometer measured eccentric isokinetic torque, work, power, and angle at peak torque of the third finger. Results : Test-retest correlation values ranged from 0.83 to 0.45. ANOVA indicated a significant difference in work, power, and angle at peak torque were indicated between the two subject groups. Conclusion: The middle digital extension isokinetic dynamometer appears to provide an acceptable means of evaluating effects of lateral epicondylitis therapy.

Augmented Soft Tissue Mobilization (ASTM) is a new non-invasive soft tissue mobilization technique which has been used successfully to treat a variety of musculoskeletal disorders. The purpose of this study was to determine the effects of ASTM therapy on the morphological and functional characteristics of enzyme induced injured rat Achilles tendons. Four groups of five rats were allocated as follows: (A) control, (B) tendinitis, (C) tendinitis plus ASTM, and (D) ASTM alone. Collagenase injury was induced, and the surgical site was allowed to heal for 3 wk. ASTM was performed on the Achilles tendon of groups C and D for 3 min on postoperative days 21, 25, 29, and 33 for a total of four treatments. Gait data were gathered prior to each treatment. The Achilles tendons of each group were harvested 1 wk after the last treatment. Specimens were prepared for light and electron microscopy, and immunostaining for type I and type III collagen and fibronectin was performed. Light microscopy showed increased fibroblast proliferation in the tendinitis plus ASTM treatment group. Although healing in rats may not translate directly to healing in humans, the findings of this study suggest that ASTM may promote healing via increased fibroblast recruitment.

Feeding rations supplemented with fats may provide an opportunity to manipulate the health and performance of dairy cows; however, the relative effects of specific fats, such as trans fatty acids (TFA), are poorly understood. The objective of this study was to investigate the effects of a ration supplemented with TFA on the fatty acid (FA) profile of peripheral blood mononuclear cells (PBMC), plasma lipids, and milk; the gene expression of inflammatory markers; production of acute phase proteins; and production performance in early lactating dairy cows. Trans fat was fed at 0, 1.5, and 3% of dry matter, replacing (1:1 wt:wt) saturated fatty acids (SFA). Multiparous lactating Holstein cows at 7 d in milk (n=12) were randomly assigned to a treatment sequence in a 3 × 3 balanced Latin square design; each period lasted 14 d. Milk and heparinized blood were collected on d 0 (pretreatment) and on d 10 and 14 of each period. Plasma was collected and solid-phase extraction was used to isolate plasma phospholipids and nonesterified fatty acids. Additionally, PBMC were isolated for FA analysis and gene expression analysis by reverse transcription-PCR using bovine RPS9 as the endogenous control. The FA composition of PBMC, plasma lipid fractions, and milk were analyzed by gas chromatography. Data were analyzed using the MIXED procedure (SAS Institute Inc., Cary, NC). As dietary TFA increased, the percentage of some 18:1 trans isomers increased in PBMC, plasma lipids, and milk. Dietary TFA had no detectable effect on mRNA expression of proinflammatory TNFα or IL6. Expression of IL1β and ICAM1 decreased with increasing TFA. In addition, supplementation of TFA did not affect percentages of milk fat, protein, lactose, or solids-not-fat, or somatic cell count. Overall, dietary TFA increased the trans FA present in PBMC, plasma lipids, and milk; however, dietary TFA decreased PBMC expression of some of the proinflammatory markers tested at the mRNA level compared with SFA in early lactating dairy cows. Together, these findings provide evidence that over short period of times, dietary TFA might be slightly less immune-stimulatory than dietary SFA.

Field reversed configurations (FRCs) with high confinement are obtained in the C-2 device by combining plasma gun edge biasing and neutral beam injection. The plasma gun creates an inward radial electric field that counters the usual FRC spin-up. The $n=2$ rotational instability is stabilized without applying quadrupole magnetic fields. The FRCs are nearly axisymmetric, which enables fast ion confinement. The plasma gun also produces $E\ifmmode\times\else\texttimes\fi{}B$ shear in the FRC edge layer, which may explain the observed improved particle transport. The FRC confinement times are improved by factors 2 to 4, and the plasma lifetimes are extended from 1 to up to 4 ms.

One of the key challenges in designing the next generation tokamaks is the development of plasma facing components (PFC`s) that can withstand the severe environmental conditions at the plasma edge. The most intensely loaded element of the PFC`s is the divertor. The divertor must handle high fluxes of energetic plasma particles and electromagnetic radiation without excessive impurity build-up in the plasma core. It must also remove helium ash while recirculating a large fraction of the unburned hydrogen fuel so that vacuum pumping requirements are not excessive. The gas-dynamic mode of divertor operation proposed for ITER expands the divertor design window to include several alternate heat sink and armor materials that were not feasible for the previous high recycling divertor approach. In particular, beryllium armor can now be considered with copper, niobium or vanadium structural materials cooled by liquid metal or possibly helium in addition to water. This paper presents some of the results achieved under ongoing ITER Plasma Facing Components research and development tasks. The overall effort involves U.S. industry, universities and national laboratories and is directed towards developing and/or testing: (1) ductile beryllium and beryllium joining techniques; (2) prototype divertor component design, fabrication and testing; (3) fiber-reinforced composites for more » beryllium and carbon; (4) beryllium plasma spray processes; (5) compliant layers for PFC armor attachment; (6) sacrificial armor layers for the divertor end-plates; and (7) tritium permeation and inventory in proposed PFC materials and components. The paper focuses on work being conducted by the industrial support team consisting of McDonnell Douglas Aerospace, Ebasco, General Atomics, Rocketdyne, University of Illinois and Westinghouse. « less

The objective of this article has been to focus on the more common infectious diseases that the physician caring for athletes may encounter in the office practice of sports medicine. Clearly the physician plays a critical role in treatment and prevention through early recognition and intervention when appropriate. Fortunately, being a fairly young, healthy athletic population, these patients respond well to treatment. It is critical that physicians caring for athletes take an active role to educate and counsel their patients on appropriate preventive measures and give clear return to participation recommendations. Advice should be based on consideration of each athlete's unique situation as well as up-to-date knowledge concerning the particular infectious disease process involved and appropriate treatment options.

Somatic cell count (SCC) is a widely used marker of udder health and a predictor of inflammation caused by an immune response. The objective of this study was to determine whether selected measures of mammary gland health as well as milk fatty acid profile were altered by an increase in milking frequency using a unilateral frequent milking (UFM) model. Holstein cows at parturition were assigned to UFM, in which the left udder half of each cow was milked four-times daily (4X) and the right udder half was milked twice daily (2X) for the first 21 days in milk (DIM). Milk yields from each udder half were measured from 1–21 DIM and samples were collected on days 3, 7, 10, 14 and 21 for determination of SCC and milk composition. Flow cytometric analysis with bovine monoclonal antibodies was used to identify milk immune cell populations and milk fatty acid (FA) composition was determined using gas chromatography. Gene expression analysis was used to determine whether there was an alteration in mRNA expression of genes involved in milk fat production including lipoprotein lipase (LPL) and FA-binding protein 3 (FABP3) with ribosomal protein S9 (RPS9) as a house-keeping gene. No difference was detected for milk SCC or cell populations between the udder halves milked 4X as compared with the udder halves milked 2X. In addition, no difference was detected for any FA in milk from the udder half milked 4X as compared with the udder half milked 2X. Overall, using a UFM model, increased milking frequency for the first 21 DIM did not affect selected measures of mammary gland health or milk FA, but was associated with greater milk yield, milk fat percent and yield, and milk protein and lactose yields.

A high temperature field reversed configuration (FRC) has been produced in the newly built, world’s largest compact toroid (CT) facility, C-2, by colliding and merging two high-β CTs produced using the advanced field-reversed θ-pinch technology. This long-lived, stable merged state exhibits the following key properties: (1) apparent increase in the poloidal flux from the first pass to the final merged state, (2) significantly improved confinement compared to conventional θ-pinch FRCs with flux decay rates approaching classical values in some cases, (3) strong conversion from kinetic energy into thermal energy with total temperature (Te + Ti) exceeding 0.5 keV, predominantly into the ion channel. Detailed modeling using a new 2-D resistive magnetohydrodynamic (MHD) code, LamyRidge, has demonstrated, for the first time, the formation, translation, and merging/reconnection dynamics of such extremely high-β plasmas.

The Tokamak Physics Experiment is designed to develop the scientific basis for a compact and continuously operating tokamak fusion reactor. It is based on an emerging class of tokamak operating modes, characterized by beta limits well in excess of the Troyon limit, confinement scaling well in excess of H-mode, and bootstrap current fractions approaching unity. Such modes are attainable through the use of advanced, steady state plasma controls including strong shaping, current profile control, and active particle recycling control. Key design features of the TPX are superconducting toroidal and poloidal field coils; actively-cooled plasma-facing components; a flexible heating and current drive system; and a spacious divertor for flexibility. Substantial deuterium plasma operation is made possible with an in-vessel remote maintenance system, a lowactivation titanium vacuum vessel, and shielding of ex-vessel components. The facility will be constructed as a national project with substantial participation by U.S. industry. Operation will begin with first plasma in the year 2000.

An advanced electromagnetic gun (AEMG) barrel was developed for the US Air Force Wright Laboratory (Armament Directorate) to repetitively accelerate large mass projectiles. The AEMG barrel used 5-m rails, had a 50-mm square bore, and was designed to operate at a peak current of 1.5 MA (bore pressure 25 ksi). Key technical achievements included (1) an efficient barrel containment structure that weighs approximately 25% of a similarly rated clamped barrel; (2) an insulator material that retains surface resistivity after repeated firings; and (3) a high-velocity water cooling system designed to remove a peak heat flux of 5 MJ/m/sup 2/ per shot. A 2-m prototype of the AEMG barrel was tested in a 4-MJ electromagnetic launcher test facility. >

A hot stable field-reversed configuration (FRC) has been produced in the C-2 experiment by colliding and merging two high-β plasmoids preformed by the dynamic version of field-reversed θ-pinch technology. The merging process exhibits the highest poloidal flux amplification obtained in a magnetic confinement system (over tenfold increase). Most of the kinetic energy is converted into thermal energy with total temperature (T{i}+T{e}) exceeding 0.5 keV. The final FRC state exhibits a record FRC lifetime with flux confinement approaching classical values. These findings should have significant implications for fusion research and the physics of magnetic reconnection.

Insufficient estrogen can cause osteoporosis in young female athletes, like the 17-year-old runner described here, as well as in postmenopausal women, whose management is also detailed. The most common technique for diagnosis is dual-energy x-ray absorptiometry. Prevention and treatment depend on a woman's age but may include increased calcium intake, weight gain, weight-bearing and resistance exercise, and estrogen replacement therapy. Alendronate and/or calcitonin may be used as alternatives to estrogen therapy.

A cryocondensation pump was designed for the baffle chamber of General Atomics DIII-D tokamak and will be installed in the fall of 1992. The purpose of the pump is to study plasma density control by pumping the divertor. The pump is toroidally continuous, approximately 10 m long and located in the lower outer corner of the vacuum chamber of the machine. It consists of a 1 m{sup 2} liquid helium-cooled surface surrounded by a liquid nitrogen-cooled shield to limit the heat load on the helium-cooled surface. The liquid nitrogen-cooled surface is surrounded by a radiation/particle shield to prevent energetic particles from impacting and releasing condensed water molecules. A thermal enhancement coating was applied to the nitrogen shell to lower the maximum temperature of the shell. The coating is non-continuous to keep the toroidal electrical resistance high. The whole pump is supported off the water-cooled vacuum vessel wall. Supports for the pump were designed to accommodate the thermal differences between the 4 K helium surface, the 77 K nitrogen shells, and the 300 K vacuum vessel supporting the pump and to provide a low heat leak structural support. Disruption loading on the pump was analyzed and a finite element structural analysismore » of the pump was completed. A testing program was completed to evaluate coating techniques to enhance heat transfer and emissivity of the various surfaces. Fabrication tests were performed to determine the best method of attaching the liquid nitrogen flow tubes to their shield surfaces and to determine the best alternative to fabricating the different shells of the pump. A prototype sector of the pump was built to verify fabrication and assembly techniques.« less

Introduction. Patients with chronic lateral elbow (LE) tendinopathy, commonly known as tennis elbow, often experience prolonged symptoms and frequent relapses. Astym treatment, evidenced in animal studies to promote the healing and regeneration of soft tissues, is hypothesized to improve outcomes in LE tendinopathy patients. This study had two objectives: (1) to compare the efficacy of Astym treatment to an evidence-based eccentric exercise program (EE) for patients with chronic LE tendinopathy, and (2) to quantify outcomes of subjects non-responsive to EE who were subsequently treated with Astym treatment. Study Design. Prospective, two group, parallel, randomized controlled trial completed at a large orthopedic center in Indiana. Inclusion criteria: age range of 18–65 years old, with clinical indications of LE tendinopathy greater than 12 weeks, with no recent corticosteriod injection or disease altering comorbidities. Methods. Subjects with chronic LE tendinopathy (107 subjects with 113 affected elbows) were randomly assigned using computer-generated random number tables to 4 weeks of Astym treatment (57 elbows) or EE treatment (56 elbows). Data collected at baseline, 4, 8, 12 weeks, 6 and 12 months. Primary outcome measure: DASH; secondary outcome measures: pain with activity, maximum grip strength and function. The treating physicians and the rater were blinded; subjects and treating clinicians could not be blinded due to the nature of the treatments. Results. Resolution response rates were 78.3% for the Astym group and 40.9% for the EE group. Astym subjects showed greater gains in DASH scores (p = 0.047) and in maximum grip strength (p = 0.008) than EE subjects. Astym therapy also resolved 20/21 (95.7%) of the EE non-responders, who showed improvements in DASH scores (p < 0.005), pain with activity (p = 0.002), and function (p = 0.004) following Astym treatment. Gains continued at 6 and 12 months. No adverse effects were reported. Conclusion. This study suggests Astym therapy is an effective treatment option for patients with LE tendinopathy, as an initial treatment, and after an eccentric exercise program has failed. Registration/Funding. Ball Memorial Hospital provided limited funding. Trial registration was not required by FDAAA 801. Known about the Subject. Under the new paradigm of degenerative tendinopathy, eccentric exercise (EE) is emerging as a first line conservative treatment for LE tendinopathy. EE and Astym treatment are among the few treatment options aiming to improve the degenerative pathophysiology of the tendon. In this trial, Astym therapy, which has shown success in the treatment of tendinopathy, is compared to EE, which has also shown success in the treatment of tendinopathy. Clinical Relevance. There is a need for more effective, conservative treatment options. Based on the current efficacy study, Astym therapy appears to be a promising, non-invasive treatment option.

Conventional field-reversed configurations (FRCs), high-beta, prolate compact toroids embedded in poloidal magnetic fields, face notable stability and confinement concerns. These can be ameliorated by various control techniques, such as introducing a significant fast ion population. Indeed, adding neutral beam injection into the FRC over the past half-decade has contributed to striking improvements in confinement and stability. Further, the addition of electrically biased plasma guns at the ends, magnetic end plugs, and advanced surface conditioning led to dramatic reductions in turbulence-driven losses and greatly improved stability. Together, these enabled the build-up of a well-confined and dominant fast-ion population. Under such conditions, highly reproducible, macroscopically stable hot FRCs (with total plasma temperature of ∼1 keV) with record lifetimes were achieved. These accomplishments point to the prospect of advanced, beam-driven FRCs as an intriguing path toward fusion reactors. This paper reviews key results and presents context for further interpretation.

Epilepsy is a common disease found in 2% of the population, affecting both young and old. Unfortunately, epileptics have previously been discouraged from participation in physical activity and sports for fear of inducing seizures or increasing seizure frequency. Despite a shift in medical recommendations toward encouraging rather than restricting participation, the stigma remains and epileptics continue to be less active than the general population. This results in increased body mass index, decreased aerobic endurance, poorer self-esteem, and higher levels of anxiety and depression. Although there are rare cases of exercise-induced seizures, studies have shown that physical activity can decrease seizure frequency, as well as lead to improved cardiovascular and psychologic health. The majority of sports are safe for epileptics to participate in with special attention to adequate seizure control, close monitoring of medications, and preparation of family, coaches, or trainers. Contact sports including football, hockey, and soccer have not been shown to induce seizures, and epileptics should not be precluded from participation. Water sports and swimming are felt to be safe if seizures are well controlled and direct supervision is present. Additional care must be taken in sports involving heights such as gymnastics, harnessed rock climbing, or horseback riding. Sports such as hang-gliding, scuba diving, or free climbing are not recommended, given the risk of severe injury or death, if a seizure were to occur during the activity. This article reviews the risks and benefits of physical activity in epileptics, discusses sports in which epileptics may participate, and addresses how to decrease possible risks for injury.

A common disorder encountered by healthcare specialists is carpal tunnel syndrome (CTS). CTS is a neuropathy disorder caused by compression on the median nerve.Currently, there are several treatment methods for CTS such as: (1) non-steroidal anti-inflammatory drugs (NSAIDs); (2) injection of medications; (3) immobilization by splinting; (4) rehabilitation modalities (therapeutic ultrasound, ASTM AdvantEDGE, stretching and strengthening); and (5) surgery by carpal tunnel release.While NSAIDs, injections, and splinting have shown promise in relieving symptoms, long-term outcomes have been poor.This article provides a background in current treatment methods and an insight into the focal point of the future.

The KSTAR (Korea Superconducting Tokamak Advanced Research) project is the major effort of the Korean National Fusion Program to design, construct, and operate a steady-state-capable superconducting tokamak. The project is led by Korea Basic Science Institute and shared by national laboratories, universities, and industry along with international collaboration. It is in the conceptual design phase and aims for the first plasma by mid 2002. The key design features of KSTAR are: major radius 1.8 m, minor radius 0.5 m, toroidal field 3.5 T, plasma current 2 MA, and flexible plasma shaping (elongation 2.0; triangularity 0.8; double-null poloidal divertor). Both the toroidal and the poloidal field magnets are superconducting coils. The device is configured to be initially capable of 20 s pulse operation and then to be upgraded for operation up to 300 s with non-inductive current drive. The auxiliary heating and current drive system consists of neutral beam, ICRF, lower hybrid, and ECRF. Deuterium operation is planned with a full radiation shielding.

Cumulative Trauma Disorders (CTDs) is the latest four-letter word for employees and employers. The purpose of this pilot study was to test the efficacy and cost effectiveness of ASTM, previously executed with Division I college athletes, in a work-related population. ASTM uses specially designed instruments to assist clinicians in rapid localization and effective treatment of soft tissue fibrosis/scar tissue. The protocol includes a flexibility and functional program that helps the worker adapt to the demands of the job. Physical and occupational therapists in both an outpatient clinic, and an industrial on-site setting, utilized ASTM. ASTM was considered successful, with symptoms resolved in over 70 percent of the patients. ASTM demonstrated impressive results in both settings and decreased medical and non-medical expenditures.

Many similarities can be drawn between the athletic and industrial population. It is time for a shift in the approach toward injured workers utilizing a sports medicine perspective. We must think of workers as industrial athletes and recognize that the sports medicine model can be appropriately adapted to the injured worker. This model includes prevention, early intervention/identification, training and conditioning, and progressive treatment. Sports medicine rehabilitation concepts include treating the entire kinetic chain that is associated with a specific injury and the SAID principle (Specific Adaptations to Imposed Demands).

Tendinitis has dramatically risen over the last few years. Some instances of tendinitis are resistant to traditional management aimed at decreasing the inflammatory process leaving clinicians to wonder whether or not they are truly dealing with an inflammatory condition. An understanding is essential for the appropriate clinical management of tendon disorders. The focus of this article will be to review tendon injuries, their healing, and to present an illustrative case treated successfully with an innovative form of treatment.

Summary form only given, as follows. The tank waste at the Hanford Nuclear Reservation is the worst environmental cleanup problem in the United States. Separation of radionuclides from the waste has proved intractable by standard chemical means. Low pressure plasmas offer a way around this problem since the waste molecules are fully dissociated and consequently the rate of chemical reactions is small. Archimedes Technology Group in San Diego, CA is developing a patented new plasma technology that separates the radionuclides from the waste by mass. This technique has the potential to greatly reduce the amount of waste since 99.9% of the radioactivity comes from atoms above mass 89 while 95% of the total atoms are below mass 60. The technique is fundamentally different than the plasma centrifuge concept developed for isotope separation. Rather than relying on an equilibrium mass distribution, it works by establishing a "low-pass filter". Ions heavier than a certain "cut-off mass" are expelled from the plasma. This talk will focus on the plasma physics bases for establishing the cut-off mass and the fundamental constraints on the plasma parameters.

A 1000 keV, 5 MW, 1000 s neutral beam injector based on negative ions is being developed in the Budker Institute of Nuclear Physics, Novosibirsk in collaboration with Tri Alpha Energy, Inc. The innovative design of the injector features the spatially separated ion source and an electrostatic accelerator. Plasma or photon neutralizer and energy recuperation of the remaining ion species is employed in the injector to provide an overall energy efficiency of the system as high as 80%. A test stand for the beam acceleration is now under construction. A prototype of the negative ion beam source has been fabricated and installed at the test stand. The prototype ion source is designed to produce 120 keV, 1.5 A beam.

Lateral epicondylitis is a common problem among physically active individuals. One of the most important roles of the clinician is to provide the most effective rehabilitation intervention for the injured athlete and the physically active individual. Over 40 different treatment methods for lateral epicondylitis have been reported in the literature. Initially, lateral epicondylitis can be treated with rest, ice, tennis brace and/or injections. Injections are one of the most popular methods utilised, with a high success rate. However, when the condition is chronic or not responding to initial treatment, physical therapy is initiated. Common rehabilitation modalities utilised are ultrasound, phonophoresis, electrical stimulation, manipulation, soft tissue mobilisation, neural tension, friction massage, augmented soft tissue mobilisation (ASTM) and stretching and strengthening exercise. ASTM is becoming a more popular modality due to the detection of changes in the soft tissue texture as the patient progresses through the rehabilitation process. Other new modalities include laser and acupuncture. As a last resort for chronic or resistant cases, lateral epicondylitis may undergo surgery. Scientific research has found that all these methods have been inconsistently effective in treating lateral epicondylitis. Therefore, further research efforts are needed to determine which method is more effective.

Upper respiratory illness may cause more disability among athletes than all other diseases combined. This paper presents the essential epidemiology, risks of infection, and transmission features of upper respiratory illness. Those who provide health care for athletes must understand the subsequent implications of an upper respiratory illness on sport performance and should be familiar with participation and clinical management guidelines for athletes with an upper respiratory illness. The literature suggests that regular, rigorous exercise increases both the incidence and severity of upper respiratory illness, yet the immune system appears to have a distinct level at which moderate exercise promotes optimum health. Although research indicates that upper respiratory illness infections are surprisingly reluctant transmitters, upper respiratory illness transmission may escalate during winter sports seasons. The impact of upper respiratory illness on selected pulmonary, cardiac, and skeletal muscle functions may lead to illness complications in athletes, and sport performance during illness may also decline. Athletes should monitor symptoms, adjust training schedules, and rest during an upper respiratory illness.

Electron cyclotron heating (ECH) has been demonstrated to be effective at heating tokamak plasmas in DIII‐D and other tokamaks. Extension of these results to higher frequency and higher power in DIII‐D is planned using 110 GHz outside launch X‐mode at the second harmonic. A 2 MW system constructed from four modules, each using a Varian 0.5 MW 110 GHz gyrotron, is scheduled to be completed by May 1992; construction of a complete 0.5 MW module is complete and is in checkout. The results of the engineering test will be reported. A unique feature of this design is the use of strongly guided HE11 modes to transmit the power over the long distances required. The choice of a strongly guided HE11 mode for transmitting the ECH power was influenced by the compact waveguide, the non‐critical alignment which allows waveguide flex, the ability to use mode selective directional couplers, and finally, continuous curvature bends can be used since there are no trapped modes. The waveguide is evacuated to handle the requir...

Due to the tremendous addition of work related injuries attributing to lost productivity and workdays, billions of dollars are being spent for treatment of these problems that result in less than optimal outcomes. Clinicians who care for injured workers continually search for enhanced innovative approaches to treatment that will result in improved outcomes, reduced time away from work, and improved patient satisfaction. Unfortunately, patients are still being treated with conventional methods developed 20–30 years ago. These methods are often shown to be ineffective in terms of returning the injured workers to their original jobs without restrictions. Despite what is considered to be the definitive treatment, workers are often left with considerable impairment, and are unable to return to their original job. It is time for a conceptual shift in the treatment of these debilitating, and …