Winding Pack Research Articles

Topical tranexemic acid reduces intra-operative blood loss and transfusion requirements in spinal deformity correction in patients with adolescent idiopathic scoliosis.

To evaluate the effectiveness of the use of topical tranexamic acid (tTXA) in spinal deformity correction in AIS patients METHODS: Sixty consecutive operative AIS patients were reviewed from a single institution and divided into two groups with similar demographics. Standardized peri-operative blood salvage techniques were utilized in all 60 patients. In the latter 30 patients, tTXA soaked sponges (1g mixed in 500ml Normal Saline) was utilised for wound packing during the entire surgical procedure compared to dry sponges as used in the former 30 patients. Both the groups were compared for the magnitude of deformity corrected, EBL per level fused, total EBL, blood transfused, drain output and peri-operative events. Sixty AIS patients (mean age 14.4 yrs, 43 females, mean BMI 21.5, mean levels 10.7) were included. Both groups achieved similar change in Coronal Cobb correction. The EBVL (Estimated blood volume loss) % lost in the topical TXA group was 38% less than the control group (11.2 vs. 18.3%, p = 0.006). Similarly, the EBL/level was significantly lower in the topical TXA group (41 ± 30ml vs. 57 ± 26ml, p = 0.03). Three of 30 patients in the control group required at least 1 unit of blood transfusion, whereas only 1 patient in the topical TXA group required transfusion (10 vs. 3.3%, p = 0.001). No differences were noted in post-operative drain output, change in hemoglobin levels, and peri-operative complication rates. When used as an adjunct to the conventional blood salvage techniques in spinal deformity correction procedures, the use of tTXA resulted in reduced operative blood loss, and blood transfusion requirements.

Alternative PF Coil Winding Pack Design for the EU DEMO

The EUROfusion DEMO machine is at its pre-conceptual stage. The design of the magnet system for this machine is being developed in collaboration with several European research centers. The Poloidal Field (PF) coils proposed by the Swiss Plasma Center (SPC) use a multiple-in-hand Pancake winding technique. A design based on updated plasma scenarios (2018) was recently proposed. The Winding Pack (WP) aspect ratio was kept close to one, similar to the baseline design in the EUROfusion 2018 DEMO baseline document. In this publication, we study the effects of changing WP aspect ratio. A vertically elongated WP cross-section is beneficial in the reduction of the peak magnetic field at WP cross-section, the machine radial extent, and the hydraulic lengths. However, it increases the bending stress on the WP. An updated PF design is presented. The dimensioning and allocation of materials is based on 3-dimensional electromagnetic calculations. Mechanical performance is evaluated against both dynamic fatigue stress and static stresses. The static stresses are evaluated through 3-dimensional finite element simulations to take into account also the ripple effect of TF coils and increase in bending stresses due to the elongation of the WP cross-section. The thermal-hydraulic analysis verifies a temperature margin of 1.5 K and confirms sufficient coolant flow for the prescribed pressure drop. The quench analysis determines the hot-spot temperatures during various quench scenarios.

Treatments for Periductal Mastitis: Systematic Review and Meta-Analysis

Introduction: Periductal mastitis (PDM) is a complex benign breast disease with a prolonged course and a high risk of recurrence after treatment. There are many available treatments for PDM, but none is widely accepted. This study aims to evaluate the various treatment failure rates (TFR) of different invasive treatment measures by looking at recurrence and persistence after treatment. In this way, it sets out to inform better clinical decisions in the treatment of PDM. Methods: We searched PubMed, Embase, and Cochrane Library databases for eligible studies about different treatment regimens provided to PDM patients that had been published before October 1, 2019. We included original studies written in English that reported the recurrence and/or persistence rates of each therapy. Outcomes were presented as pooled TFR and 95% CI for the TFR. Results: We included 27 eligible studies involving 1,066 patients in this study. We summarized 4 groups and 10 subgroups of PDM treatments, according to the published studies. Patients treated minimally invasively (group 1) were subdivided into 3 subgroups and pooled TFR were calculated as follows: incision and drainage (n = 73; TFR = 75.6%; 95% CI 27.3–100%), incision alone (n = 74; TFR = 20.1%; 95% CI 0–59.9%), and breast duct irrigation (n = 123; TFR = 19.4%; 95% CI 0–65.0%). Patients treated with a minor excision (excision of the infected tissue and related duct; group 2) were divided into 4 subgroups and pooled TFR were calculated as follows: wound packing alone (n = 127; TFR = 2.1%; 95% CI 0–5.2%), primary closure alone (n = 66; TFR = 37.1%; 95% CI 9.5–64.8%), primary closure under antibiotic treatment cover (n = 55; TFR = 4.8%; 95% CI 0–11.4%) , and additional nipple part removal (n = 232; TFR = 9.6%; 95% CI 5.8–13.4%). Patients treated with a major excision (excision of the infected tissue and the major duct; group 3) included the following 2 subgroups: patients treated with a circumareolar incision (n = 142; TFR = 7.5%; 95% CI 0.4–14.7%) and patients treated with a radial incision of the breast (n = 78; TFR = 0.6%; 95% CI 0–3.6%). Group 4 contained patients receiving different major plastic surgeries. The pooled TFR of this group (n = 86) was 3.4% (95% CI 0–7.5%). Conclusion: Breast duct irrigation, which is the most minimally invasive of all of the treatment options, seemed to yield good outcomes and may be the first-line treatment for PDM patients. Minor excision methods, except for primary closure alone, might be enough for most PDM patients. Major excision, especially with radial incision, was a highly effective salvage therapy. The major plastic surgery technique was also acceptable as an alternative treatment for patients with large lesions and concerns about breast appearance. Incision and drainage and minor excision with primary closure alone should be avoided for PDM patients. Further research is still needed to better understand the etiology and pathogenesis of PDM and explore more effective treatments for this disease.

The Addition of High-Technology Into the Stop the Bleed Program Among School Personnel Improves Short-Term Skill Application, Not Long-Term Retention.

The Stop the Bleed (STB) program trains the general public on identifying and treating life-threatening bleeding. Data on efficacy and retention of skills taught through this program are limited, with the role of high-technology modalities to augment the program, such as simulation and feedback devices, untested. A convenience sample of 66 school personnel participated in an open-label observational study from January to August 2019. The control group received the standard bleeding control course, while the intervention group received the bleeding control course with addition of a simulation and a feedback device for wound packing. Assessment was performed by STB instructors using performance metrics from prior studies as well as a feedback device. Retention testing was performed 2 to 8 months after intervention. The study was approved by the hospital's institutional review board. The intervention group performed better than the control group on correct tourniquet application [90.3% vs. 71.0%; odds ratio (OR) = 11.28; P = 0.015; 95% confidence interval (CI) = 1.86 to 104.67] wound packing scores (59.5% vs. 29.6%; OR = 0.33; P = 0.007; 95% CI = 9.36 to 56.00) and were more likely to assess their safety (OR = 5.49; P = 0.034; 95% CI = 1.28 to 27.66), and reported higher comfort scores on stepping into an emergency scenario (OR = 11.19; P = 0.004; 95% CI = 2.51 to 63.11), wound packing (OR = 5.16; P = 0.025; 95% CI = 1.35 to 22.46), and using a tourniquet (OR = 11.41; P = 0.003; 95% CI = 2.57 to 67.59). Thirty-one participants (46.9%) were assessed again at retention 2 to 8 months later where scores for tourniquet placement and wound packing were not significantly different in the two groups. Augmenting STB with simulation and feedback improved both self-reported comfort level and skill set of participants, but the retention of skills was poor in both groups.

Abstract PS15-03: Breast complications in patients who received intraoperative radiation therapy compared to other forms of radiation therapy following breast conserving surgery

Abstract Introduction: Intraoperative radiation therapy (IORT) is a convenient treatment option for appropriate women with early stage breast cancer. Some patients undergoing IORT also need adjuvant whole breast radiation therapy due to adverse final pathologic features. Although there are various reports of the complication rates with patients undergoing IORT, comparisons with patients undergoing other forms of radiation therapy such as whole breast or accelerated partial breast radiation are sparse. Methods: A total of 293 patients underwent breast conserving surgery at the study institution between January 2016 and December 2019 for either ductal carcinoma in situ (DCIS) or invasive breast cancer. Three patients had bilateral breast cancer and one patient had a local recurrence having refused adjuvant treatment following breast conserving surgery, for a total of 297 treated breasts. 124 received whole breast radiation therapy, 70 did not receive radiation therapy, 47 received IORT alone, 15 received IORT and whole breast radiation therapy, 30 received accelerated partial breast radiation using external beam radiation (APBI-EB), and 9 received Ir-192 based high dose rate accelerated partial breast radiation (APBI-HDR). One patient with bilateral breast cancer did not complete whole breast radiation therapy to either breast. Complications included cellulitis, wound drainage, symptomatic seroma, delayed wound healing, and wet desquamation. Interventions included observation, antibiotics, wound packing, debridement, fluid aspiration, hydrogel dressings, and wound vacuums. Results: For the entire group, the incidence of wound complications was 20%. The risk of complications was 27.4% for those undergoing IORT (with or without whole breast radiation) compared to 18.3% for those not receiving IORT, which was not statistically different at the 5% significance level. For those who received both IORT and whole breast radiation, however, the proportion having complication was 53.3% versus 18.4% in the other groups. The difference was significant with a p-value 0.0032. Conclusion: Patients who undergo both IORT and whole breast radiation have an increased risk for wound complications. Citation Format: James Wheeler, Houman Vaghefi, Laura Morris, Fang Liu, Irina Sparks, Fiona Denham, Leonard Henry, Ashley Hardy, Meghan Schrock, Vanessa DePue, Leon Coody. Breast complications in patients who received intraoperative radiation therapy compared to other forms of radiation therapy following breast conserving surgery [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS15-03.

Norwegian Emergency Medicine Systems' Training and Equipment for Penetrating Injuries: A National Survey-Based Study.

Recent terror attacks led the Norwegian government to develop a procedure for emergency and law enforcement services cooperation during Active Violent Incidents (AVI, abbreviated PLIVO in Norwegian). To address further national initiatives to improve preparedness for mass casualty events and penetrating injuries among emergency medical services (EMS) in Norway, training and equipment status were mapped. All EMS regions in Norway were invited to participate in an electronic nation-wide survey about practical medical training in PLIVO scenario training and specific training in hemorrhage control and penetrating injuries. Ninety percent (842/938) had attended at least 1 PLIVO training scenario. Of these, 76% (642/938) reported only evacuation training during the exercise, while only 20% (168/938) had practiced hemorrhage control. Eighty-one percent (760/938) respondents reported that they were equipped with tourniquets and 91% (853/938) were equipped with gauze to pack wounds. However, only 52% (487/938) and 48% (450/938) reported practical training in tourniquet application and wound packing, respectively, while 30% (280/938) reported that they had no training or only theoretical education in tourniquet application. Supervised practical training on penetrating thoracic injuries was reported by <20%, and <50% reported practical training in needle decompression of a tension pneumothorax. Enhanced focus on training in hemorrhage control and penetrating injuries is needed. This supports the recent decision from the Norwegian government to strengthen the training for EMS in AVI (PLIVO) exercises, by focusing on medical procedures in addition to evacuation training. Although the estimated response rate is 17%, we believe the large number of respondents still make the results valuable.

Magnetostructural assessment of DEMO TF coils with ENEA Winding Pack configuration

The present paper deals with a multiphysics study of the DEMO Toroidal Field (TF) coils with Winding Pack (WP) layout proposed by the Italian agency ENEA. The latest WP configuration, so far designed adopting the Wind&React technique, is composed of 202 Nb3Sn rectangular conductors, with steel jacket thickness progressively increased from the plasma-facing side, arranged in 6 double layers. Each conductor is designed to carry an operative current of 73.4 kA (14.8 MAt for one TF coil) and to ensure the requirement of 12 T of magnetic peak field. The electromagnetic (EM) Lorentz forces have been preliminary evaluated with a magnetostatic 3D analysis at different instants of plasma scenario and then used to perform the 3D structural assessment of the TF coil. For both models (i.e., electromagnetic and mechanical), the WP has been represented as a homogenized material with the cyclic symmetry boundary conditions, allowing to reduce the computational effort. In the structural model, a preliminary design of outer inter-coil structures and gravity support have been included allowing them to identify critical locations in a reliable way. In addition to the EM loads at different plasma scenario instants also the cooling down has been considered as loading condition. The stress assessment on the steel Casing was performed, exploiting the stress linearization along several paths chosen in the most critical locations.

CAD model update on as-built geometries with morphing technique: ITER winding pack

CAD and CAE model update on manufactured shapes is a key process in the industry 4.0, where design, manufacturing and maintenance are integrated elements. Digital Twin models, together with Reverse Engineering (RE) techniques, allow tracking components performances during production and verifying the compliance with design requirements during the component lifetime. The need to have RE processes with a small impact on the production is driving the development of these models towards numerical techniques with fast computing performances. In this context, morphing techniques, largely deployed in the field of CAE models update, represent a valuable alternative to conventional RE techniques, because of their reduced computational time and capability to preserve the initial topology of the model. In the work presented in this paper, Radial Basis Function morphing technique has been used for the update of ITER Winding Pack CAD model on scan data acquired from the manufactured component.

Optimized finite-build stellarator coils using automatic differentiation

A new stellarator coil design code is introduced that optimizes the position and winding pack orientation of finite-build coils. The new code, called flexible optimized curves in space using automatic differentiation (AD) and finite build (FOCUSADD), performs gradient-based optimization in a high-dimensional, non-convex space. The derivatives with respect to parameters of finite-build coils are easily and efficiently computed using AD. FOCUSADD parametrizes coil positions in free space using a Fourier series and uses a multi-filament approximation to the coil winding pack. The orientation of the winding pack is parametrized with a Fourier series and can be optimized as well. Optimized finite-build coils for a Wendelstein 7-X (W7-X)-like stellarator are found, and compared with filamentary coil results. The final positions of optimized finite-build W7-X-like coils are shifted, on average, by approximately 2.5 mm relative to optimized filamentary coils. These results suggest that finite-build effects should be accounted for in the optimization of stellarators with low coil tolerances.

Time-Dependent Thermo-Electro-Magneto-Mechanical Analysis of the TF Coil in Damavand Upgrade Tokamak With Longer Pulse Operation

To reach a more efficient plasma operation, a new configuration is planned for Damavand tokamak toward a longer pulse scenario. The current pulses in the magnetic system will be ten-times extended. This introduces major thermal impacts on the toroidal field (TF) coils due to Joule heating in addition to electromagnetic loads. Each TF coil consists of a winding pack (WP) with epoxy-impregnated glass-mica tape enclosed in an aluminum case. In this work, the combined thermo-electro-magneto-mechanical behavior of the TF coil components is investigated in the long pulse operation. A computational fluid dynamics (CFD) model has been involved to simulate a water cooling in the TF coil using COMSOL. Therefore, the study involves various analyses on the Lorentz force density, thermal load due to the Joule heat, stabilized temperature, heat dissipation, stresses and strains, and TF deviation in vacuum vessel due to the TF coil deformation. Every shot introduces a rise in the temperature of the coil. Thus, depending on the cooling conditions, in a series of consecutive shots, the temperature reaches a limit which is crucial for the mechanical analysis. As a result, although the thermal stress on the WP is highly increased in every long pulse, the total stress (i.e., combined thermal-magnetic stress) decreases compared to the value in the presently short pulse operation. The total stress in the WP can be lower than its magnetic stress due to an increase in elasticity of the coil during the longer pulses, while this result is the opposite for the casing and the epoxy resin.

Removal of the Prehospital Tourniquet in the Emergency Department.

Life-threatening hemorrhage from extremity injuries can be effectively controlled in the prehospital environment through direct pressure, wound packing, and the use of tourniquets. Early tourniquet application has been prioritized for rapid control of severe extremity hemorrhage and is a cornerstone of prehospital trauma resuscitation guidelines. Emergency physicians must be knowledgeable regarding the initial assessment and appropriate management of patients who present with a prehospital tourniquet in place. An interdisciplinary group of experts including emergency physicians, trauma surgeons, and tactical and Emergency Medical Services physicians collaborated to develop a stepwise approach to the assessment and removal (discontinuation) of an extremity tourniquet in the emergency department after being placed in the prehospital setting. We have developed a best-practices guideline to serve as a resource to aid the emergency physician in how to safely remove a tourniquet. The guideline contains five steps that include: 1) Determine how long the tourniquet has been in place; 2) Evaluate for contraindications to tourniquet removal; 3) Prepare for tourniquet removal; 4) Release the tourniquet; and 5) Monitor and reassess the patient. These steps outlined will help emergency medicine clinicians appropriately evaluate and manage patients presenting with tourniquets in place. Tourniquet removal should be performed in a systematic manner with plans in place to immediately address complications.

Development of Gap-filling Impregnation Method of ITER TF Coils

The ITER Toroidal Field (TF) coil is composed of a Winding Pack (WP) and a TF coil case (TFCC). In the manufacturing of a TF coil, the gap between the WP and the TFCC is filled with radiation resistant Triglycidyl-p-aminophenol (TGPAP) resin. Vacuum Pressure Impregnation (VPI) is adopted. The selected resin system displayed two potential problems: high viscosity and cracking after cure. A series of production optimizations have been performed to develop techniques to apply the selected resin for the TF coil production: crack countermeasure, narrow gap injection, and pressure control. For crack countermeasure, the addition of fiberglass tape or sheet layer was found to be effective in preventing fragmentation of cracked resin. Since the cracked resin would not harm the TF coil quality as long as it stays in the original position, addition of confining fiberglass layers solves the problem. In narrow gap qualification tests, resin injection into a 2 mm wide space was observed with proper selection of fiberglass layer addition conditions. The pressure qualification test showed that resin cured without additional pressurization can satisfy the compression strength requirements. From those results, techniques for the TF coil production have been developed, and with the implementation of those techniques the gap-filling of the first TF coil in Japan was successfully completed in 2019. Since then, two more TF coils have completed the gap-filling process with some improvements.

Development of ITER TF Coil Assembly Technique, Integration of Winding Pack into Coil Case

Development of ITER TF Coil Assembly Technique, Integration of Winding Pack into Coil Case

Quench analysis of the DEMO CS1 coil

The European DEMOnstration Fusion Power Plant (EU-DEMO) is being designed as an intermediary stage between the ITER experimental reactor and future commercial fusion power plants. The EU-DEMO is based on the tokamak concept with a fully superconducting magnet system. The Central Solenoid (CS) of the EU-DEMO will consist of five modules, namely: CSU3, CSU2, CS1, CSL2 and CSL3, located vertically one above the other. The central CS1 module will be subjected to the most demanding operating conditions (the highest magnetic field and mechanical loads). Two concepts of the CS1 winding pack (WP) are being designed by CEA IRFM (France) and EPFL-SPC (Switzerland) teams. The pancake wound WP proposed by CEA is based on Wind & React Nb3Sn Cable-in-Conduit Conductor, whereas the hybrid WP developed by EPFL-SPC consist of 10 sub-coils, layer-wound using: HTS (RE-123), React & Wind Nb3Sn and NbTi conductors in the high, medium and low field sections, respectively. Each design iteration undergoes comprehensive electromagnetic, mechanical and thermal-hydraulic analyses aimed at verification if it fulfils the design performance criteria. Our present work is focused on the quench analysis of all the hybrid CS1 sub-coils, aimed at the assessment of the maximum hot-spot temperature. The analysis, based on the iteration of the hybrid design proposed in 2017, is performed using the THEA CryoSoft code. We assume that quench is initiated at the beginning of premagnetization phase and include in our model the realistic magnetic field distribution along each conductor computed with 2D axi-symmetrical finite element model in ANSYS. We study the effect of taking into account heat transfer between neighbouring turns and heat generation due to AC losses during the fast discharge on the value of the hot spot temperature.

Primary Closure of Abscesses Versus Conventional Incision and Drainage

Objective: To determine reliability of primary closure of abscesses verses conventional incision and drainage. Study Design: Comparative study. Settings: DHQ Hospital, Independent University Hospital Faisalabad-Pakistan. Duration: Two years, 2017 to 2019. Conventional incision and drainage with wound packing is still being widely practiced despite innovative broad spectrum antibiotic coverage availability. The purposes of innovative primary closure procedure after incision and drainage and meticulous wound cleansing with normal saline covered by broad-spectrum prophylactic and post-operative antibiotics is to reduce morbidity and cost related to the more conventional procedure. Methodology: Comparison of two procedures that i.e. conventional incision and drainage with wound packing and incision and drainage with primary closure. The results were observed in patients including author's recent practice undergoing primary closure after incision and drainage from December 2017 to July 2019. The data was collected from DHQ Hospital, Independent University Hospital Faisalabad from year 2017 to 2019. Group 1 included patients with primary closure and group 2 included patients undergoing conventional incision and drainage. Results: Results of both procedures were compared in terms of morbidity i.e. recurrence, wound infection, cost and final scar results. In group 1 recurrence was observed in one patient (2%). It was observed that post-operative wound infection occurred in two patients (4%) that settled with antibiotic cover. Lesser number of average hospitals stay which the author found to be just 0- 1 day. The healing time was observed to be 7-10 days. In the group 2, there was no difference in recurrence of abscess which was found to be 2%-3%. The wound infection was observed 4% which was like group 1. On the other hand, the patients had to stay hospital for 4-5 days. Daily painful dressings requiring I.V analgesia and psychological trauma related to open wound. The average healing time was extended to of 4-6 weeks. Conclusion: Primary closure of abscesses versus conventional incision and drainage is more beneficent.

Progress on European ITER Toroidal Field Coil Procurement: Cold Test and Insertion Work Package

The plasma confinement of the International Tokamak Experimental Reactor (ITER) is provided by the magnetic field generated by 18 toroidal field coils. Fusion for Energy (F4E), the European Domestic Agency for ITER, is responsible for the supply of 10 TFC to ITER project. Their procurement has been divided into three main work packages: I) the production of the radial plates, structural stainless steel components housing the Nb3Sn conductors, II) the manufacture of 10 Winding Packs (WP) and III) the cold test of 10 WP plus their insertion into the Coil Cases. This article gives an update of the status of the production of the third and last work package performed under the framework of an F4E contract assigned to SIMIC SpA, an Italian company. In particular, the details of the WP thermal cycle, the insertion of the firsts TF coil in their coil cases, the closure weld, the gap filling and the machining strategy adopted to optimize the final TF coil shape optimized to minimize the field errors are presented.

Comparison of FEM Predicted and Measured Values of the ITER TF Coil Closure Welding Distortion

The ITER reactor relies in magnetic confinement of hot plasma. The main driver for the confinement is played by the Toroidal Field Coils. These magnets are composed by a Winding Pack, made of Nb3Sn superconductors, and a surrounding stainless steel structure or Coil Case which is closed by welding once the Winding Pack is inserted. The closure GTAW weld of the cases includes about 70m of weld ranging from 40 to 120 mm. Due to the tight tolerances that have to be respected on the final Toroidal Field Coils, a mechanical quasi-static Finite Element Model has been developed using ANSYS software by Enginsoft and SIMIC, under the work frame of a Fusion for Energy contract, to predict the welding distortion by simulating different welding scenarios and to confirm the definition of the required extra-material in the Toroidal Field Coil Cases. The FEM model was firstly benchmarked with validation coupons, then verified and fine-tuned with four 1:1 scaled Toroidal Field Coil Case cross section mock ups. Finally, a full Finite Element Model has been developed in order to predict the deformation of the cases during the welding process. The first Toroidal Field Coil has been welded during the first half of 2019. In this paper, a comparison between the deformation predicted by Finite Element Model and direct dimensional measurements of the distortions carried out during the welding process is presented.

Preliminary Design of DEMO PF Coils Based on EU DEMO 2018 Baseline

The dimensioning of Winding Packs and allocation of materials in DEMO PF coils is proposed based on the requirements defined by the EUROfusion 2018 DEMO baseline. The coils are pancake-wound and use two types of forced flow cable-in-conduit conductors. The conductor which uses NbTi has a high void fraction but has no separated low-impedance cooling channel. On the other hand, the conductor made using Nb3Sn has a separated low-impedance cooling channel and therefore low void fraction in the remaining cable space. Both the conductors have a rectangular cross-section. The design addresses the dimensioning of the Winding Pack (WP) based on the electromagnetic field calculations and stress analysis. The amount of superconductor, copper, and cable void fraction in the conductor are determined by the coil current, magnetic field and assumed temperature margin. The amount of structural material in the conductor jacket depends mainly on the fatigue stress corresponding to the pulsed operation of these coils. For PF1 and PF6 coils, the comparison of NbTi and Nb3Sn design options suggest a more efficient allocation of structural and superconducting material in the latter case. The WP dimensions do not significantly depend on the winding technique (pancake vs layer winding).

Hemorrhage control, a fundamental skill: A review of direct pressure, dressings, wound packing and bandages for life-saving

Hemorrhage control, a fundamental skill: A review of direct pressure, dressings, wound packing and bandages for life-saving

20 kW laser welding applied on the international thermonuclear experimental reactor correction coil case welding

International thermonuclear experimental reactor correction coil cases are made of heavy, thick, high strength, and high toughness austenitic stainless steel 316LN. The BTCC (bottom and top correction coils) case has the dimension of 2.5 × 7 m2 and cross section of 239.8 × 146.7 mm2, side correction coil case has the dimension of 7.2 × 7.6 m2 and cross section of 147.8 × 168 mm2, and they will be closure welded after winding pack insertion. The 20 mm welding depth, dozens of meter of welding length, strict welding requirements, large size, and complex configuration bring a big challenge to this closure welding work. 20 kW high power laser welding is selected as the main welding method because of the advantage of potential welding deformation control and its penetrating ability and cracking resistance. The welding parameter is developed that can cover the assembly gap from 0 to 0.5 mm with a good welding quality. A special test coupon is designed for the welding procedure qualification, and related tests are carried out to qualify the joint properties of bend, tensile, and impact. Finally, a full-scale BTCC case is welded. After welding, ultrasonic testing confirms that almost all welds satisfy the weld seam quality requirement. The recorded temperatures less than 250° indicate that the temperature induced by welding will not harm the internal winding pack. The dimensional deviation of the inner face is less than 4 mm and also satisfies the tolerance requirement of ±2 mm for the BTCC case.