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We provide an assessment of the Infinity Two fusion pilot plant (FPP) baseline plasma physics design. Infinity Two is a four-field period, aspect ratio $A = 10$, quasi-isodynamic stellarator with improved confinement appealing to a max-$J$ approach, elevated plasma density and high magnetic fields ($ \langle B\rangle = 9$ T). Here $J$ denotes the second adiabatic invariant. At the envisioned operating point ($800$ MW deuterium-tritium (DT) fusion), the configuration has robust magnetic surfaces based on magnetohydrodynamic (MHD) equilibrium calculations and is stable to both local and global MHD instabilities. The configuration has excellent confinement properties with small neoclassical transport and low bootstrap current ($|I_{bootstrap}| \sim 2$ kA). Calculations of collisional alpha-particle confinement in a DT FPP scenario show small energy losses to the first wall (${\lt}1.5 \,\%$) and stable energetic particle/Alfvén eigenmodes at high ion density. Low turbulent transport is produced using a combination of density profile control consistent with pellet fueling and reduced stiffness to turbulent transport via three-dimensional shaping. Transport simulations with the T3D-GX-SFINCS code suite with self-consistent turbulent and neoclassical transport predict that the DT fusion power$P_{{fus}}=800$ MW operating point is attainable with high fusion gain ($Q=40$) at volume-averaged electron densities $n_e\approx 2 \times 10^{20}$ m$^{-3}$, below the Sudo density limit. Additional transport calculations show that an ignited ($Q=\infty$) solution is available at slightly higher density ($2.2 \times 10^{20}$ m$^{-3}$) with $P_{{fus}}=1.5$ GW. The magnetic configuration is defined by a magnetic coil set with sufficient room for an island divertor, shielding and blanket solutions with tritium breeding ratios (TBR) above unity. An optimistic estimate for the gas-cooled solid breeder designed helium-cooled pebble bed is TBR $\sim 1.3$. Infinity Two satisfies the physics requirements of a stellarator fusion pilot plant.
Congenital airway obstruction is rare but potentially fatal. We developed a complex airways interventional delivery team to manage such cases. Antenatal imaging detects airway compromise at an early stage and facilitates the planning of delivery procedures (‘ex utero intrapartum treatment’ and ‘operation on placental support’) which maintain feto-placental circulation whilst an airway is secured.
Method:
A retrospective review was performed of cases in which ENT input was required at birth for airway obstruction.
Results:
Four neonates were delivered before implementation of the service: two were intubated and another two underwent tracheostomy but died in the peri-natal period. Seven neonates were delivered after implementation of the service: six were intubated and one underwent immediate tracheostomy. Five subsequently underwent tracheostomy (three have since been decannulated). One child with multiple congenital anomalies died due to respiratory failure. Airway obstruction was caused by lymphatic malformation, teratoma, costo-craniomandibular syndrome and choristoma.
Conclusion:
In the absence of other anomalies, interventional airway delivery led to reduced mortality and improved outcomes.
This study aimed to evaluate the prevalence of normal variations of temporal bone anatomy on high-resolution computed tomography imaging and report their clinical importance.
Methods:
A retrospective review was conducted of high-resolution temporal bone computed tomography imaging performed at NHS Greater Glasgow and Clyde over an eight-year period. The presence of five variants was determined. These variants were: a high dehiscent jugular bulb, an anteriorly located sigmoid sinus, a deep sinus tympani, an enlarged cochlear aqueduct and a large internal auditory meatus.
Results:
A total of 339 temporal bones were examined. The incidences of a high dehiscent jugular bulb, anteriorly located sigmoid sinus, deep sinus tympani, enlarged cochlear aqueduct and an enlarged internal auditory meatus were 2.76 per cent, 2.94 per cent, 5.01 per cent, 0.58 per cent and 1.76 per cent respectively.
Conclusion:
Anatomical variations of the temporal bone are not uncommon and it is important for the investigating otologist to be aware of such variations prior to undertaking surgery.
To review outcomes following paediatric cholesteatoma surgery performed between 1999 and 2009 in a tertiary paediatric ENT unit.
Study design:
Retrospective case note review.
Results:
A total of 137 mastoid procedures were recorded. Fifty-four per cent of children were observed to have disease involving the entire middle-ear cleft and mastoid complex. The revision rate was 25 per cent. Time to recurrence was one to three years in 17 patients, three to six years in five patients, and six to nine years in three cases. Eight of 25 revision cases demonstrated spontaneous improvement in air conduction thresholds following primary surgery. A high facial ridge and inadequate meatoplasty correlated highly with disease recurrence.
Conclusion:
Children tend to present with aggressive disease. Disease extent and ossicular chain involvement are associated with a higher risk of recurrent disease. Spontaneous improvement in hearing thresholds following cholesteatoma surgery should alert the clinician to recurrent disease.
A case of stridor is described which was due to the presence of a foreign body in the larynx of an infant. Following partial removal, compression of the right main bronchus was detected because of continuing low arterial oxygen saturation. The use of pulse oximetry allowed this complication to be identified, and the advantages of this method of monitoring are discussed.
An unusual case of symptomatic enlargement of the hyoid bone is reported. The patient's main complaint was of pain on swallowing and opening of the jaw.
Partial excision of the greater cornu of the hyoid on each side, resulted in a complete remission of the symptoms.
In the perovskite-related La/Ba/Cu oxide system, the lanthanum ions can substitute on the barium sites due to a close match in the ionic radius of the two. Thus it is possible to make a solid solution La1+xBa2-xCu3Oy where O ∼ x ≤ 0.5 and y ∼ 7. For the Ba-rich end member composition (x ∼ 0). the structure is orthorhombic. but as the La content increases and La begins to substitute on the Ba sites (disordered), the crystal symmetry changes from orthorhombic to tetragonal. In addition, the superconducting properties vary with increasing La content. In particular, the superconducting onset temperature is found to decrease linearly from 80 to 45 K over the compositional (x) range 0.0 → 0.375. In the La-rich limit (x = 0.5). 1/4 of the Ba atoms are replaced by La and superconductivity is lost. A correlation between oxygen ordering (annealing) and high Tc is observed for orthorhombic LaBa2Cu3Oy and inferred in the case of tetragonal La1.25Ba1.75Cu3Oy.
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