Assessment of ITER radiation environment during the remote-handling operation of In-Vessel components with D1SUNED.

During ITER operational life, a remote-handled cask will be used to transfer In-Vessel components to the Hot Cell for maintenance, storage and decommissioning purposes. Due to the distribution of penetrations for system allocation in the facility, the radiation field of each transfer operation presents a high spatial variability; all operations must be studied independently for workers and electronics protection. In this paper, we present a fully representative approach to describe the radiation environment during the complete remote-handling scenario of In-Vessel components in the ITER facility. The impact of all relevant radiation sources during different stages of the operation is addressed. As-built structures and 2020 baseline designs are considered to produce the most detailed neutronics model of the Tokamak Complex, the 400,000-tonne civil structure hosting the tokamak, up to date. Novel capabilities of the D1SUNED code have allowed to compute the integral dose, the dose rate and the photon-induced neutron flux of both moving and static radiation sources. Time bins are included in the simulations to compute the dose rate caused by In-Vessel components at all positions along the transfer. The time evolution of the dose rate is built in video format with a 1-m resolution, especially valuable for hot-spots identification.

Capillary rise dynamics of aqueous glycerol solutions in glass capillaries: a critical examination of the Washburn equation.

The classic description of capillary rise given by the Washburn equation was recently questioned in the light of experimental evidence for a velocity dependent dynamic contact angle at a moving contact line. We present a systematic investigation of the capillary rise dynamics of glycerol and aqueous glycerol solutions in vertical glass capillaries of various radii. For pure glycerol, the results of our experiments are in almost perfect agreement with the predictions of the Washburn equation using independently measured values for the liquid and capillary parameters. For aqueous glycerol solutions we observe discrepancies between the theoretical expectations and the experimental results, which are increasing with the water content of the solution. A thorough analysis, combined with scaling arguments, allows us to conclude that dynamic contact angle effects alone cannot provide a consistent explanation for these discrepancies. Rather, they can be perfectly accounted for if the mixture flowing in the capillary would have an effective, increased viscosity (in respect to the nominal value). We suggest and briefly discuss various mechanisms that could contribute to this observed behavior.

Geographical distribution of salmonid alphavirus subtypes in marine farmed Atlantic salmon, Salmo salar L., in Scotland and Ireland.

Sequence data from salmonid alphavirus (SAV) strains obtained from farmed marine Atlantic salmon, Salmo salar L. , over a 20-year period between 1991 and 2011 was reviewed to examine the geographical distribution of the genetically defined SAV subtypes in twelve regions across Ireland and Scotland. Of 160 different Atlantic salmon SAV strains examined, 62 belonged to subtype 1, 28 to subtype 2, 34 to subtype 4, 35 to subtype 5 and 1 to subtype 6. SAV subtypes 1, 4 and 6 were found in Ireland, while subtypes 1, 2, 4 and 5 were found in Scotland. In the majority of regions, there was a clear clustering of subtypes, with SAV subtype 1 being the dominant subtype in Ireland overall, as well as in Argyll and Bute in Scotland. SAV subtype 2 predominated in the Shetland and Orkney Islands. The emergence in Atlantic salmon of subtype 2 strains typically associated with sleeping disease in rainbow trout in Argyll and Bute, strongly suggesting transmission of infection between these species, was noted for the first time. SAV subtype 4 was the most common subtype found in the southern Western Isles, while SAV subtype 5 predominated in the northern Western Isles and north-west mainland Scotland. No single strain was dominant on sites in the western Highlands, with a number of sites in this region in particular having more than one subtype detected in different submissions. The significance of these results in relation to aspects of the epidemiology of infection, including transmission, biosecurity and wildlife reservoirs are discussed and knowledge gaps identified.

Flujo retrógrado diastólico. Comunicación preliminar / Diastolic retrograde arterial flow: preliminary report

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[Diastolic retrograde arterial flow: preliminary report]. / Flujo retrógrado diastólico. Comunicación preliminar.

OBJECTIVE: Holodiastolic arterial blood flow is associated with pathological conditions. Nevertheless, we have observed that lifting the arm at an angle greater than the horizontal causes holodiastolic arterial blood flow in the brachial artery in normal patients. Thus, we decided to assess the frequency and characteristics of this phenomenon. MATERIAL AND METHODS: Ten volunteers (7 women) aged 43 ± 17 years participated in the study. We used an ultrasound scanner with a 12 MHz probe to analyze the brachial artery. The examination included: a) Baseline measurements in the supine position; b) measurements during three minutes with the arm raised, and c) a measurement sixty seconds after lowering the arm to the supine position in which the baseline measurements had been obtained. RESULTS: We observed mid- and end-diastolic retrograde flow in 8/10 patients when their arms were raised. No mid- or end-diastolic retrograde flow was observed in the baseline measurements or after the arm was lowered to the supine position (p=0.0007). The minimum diastolic velocity was significantly higher in the measurements obtained with the arm raised than in the supine position before or after arm raising (-13.5 ± 4.9 cm/s vs. -2.38 ± 7.5 cm/s, p<0.05 and -13.5 ± 4.9 cm/s vs. -4.6 ± 5.2 cm/s, p<0.05, respectively). The modified resistance index was significantly higher when the arm was raised (1.20 ± 0.07 vs. 1.04 ± 0.15; p<0.05); moreover, the modified resistance index was significantly lower in the measurements obtained after the arm was lowered than in the baseline measurements (1.20 ± 0.07 vs 1.07 ± 0.08; p<0.05). CONCLUSION: We conclude that holodiastolic reflux occurs in healthy patients. This physiological phenomenon merits further investigation and can help elucidate previous observations in different pathological conditions.

Extended major histocompatibility complex haplotypes, ancestry and acute kidney transplant rejection in Mexicans.

INTRODUCTION: Extended major histocompatibility complex (MHC) haplotypes are associated with several autoimmune diseases, and these appear to depend on ancestry. OBJECTIVE: To evaluate the association of extended MHC gene frequencies, ancestry, and acute rejection. MATERIAL AND METHODS: 127 living kidney transplant recipients who underwent kidney transplantation in Mexico City between January 2004 and October 2007 with follow up until October 2008. The primary outcome was biopsy proven acute rejection. Ancestry was considered as either Amerindian or admixtures with Caucasian, African or Oriental genes. Allele and haplotype frequencies were estimated for HLA A, B and DR loci. Hardy Weinberg (HW) and delta values were analyzed to test for linkage disequilibrium (LD). RESULTS: There were no significant differences in the baseline characteristics between groups. 50% were men, and 28, 61 and 10% of the patients shared zero, one or two haplotypes, respectively. The whole population was Hispanic and born in Mexico. Median PRA was 0%. Allelic variance in all MCH loci was in HW equilibrium, 14% developed acute rejection. There was a high frequency of Amerindian haplotypes; admixture genes and LD were higher in the group with acute rejection. When compared to the group without acute rejection, the haplotype A1*B8*DR3 was more frequent in donors in whom their recipients had acute rejection (p = 0.008), while A28*B39*DR4 was more common in the recipients with acute rejection (p = 0.003). Multivariate Cox regression models did not attenuate these associations. CONCLUSIONS: Ancestry and LD may be associated with risk of acute rejection and may therefore be useful in directing immunosuppression.

Biofilm formation on enteral feeding tubes by Cronobacter sakazakii, Salmonella serovars and other Enterobacteriaceae.

WHO (2007) recommended that to reduce microbial risks, powdered infant formula should be reconstituted with water at temperatures >70 degrees C, and that such feeds should be used within 2h of preparation. However, this recommendation does not consider the use of enteral feeding tubes which can be in place for more than 48h and can be loci for bacterial attachment. This study determined the extent to which 29 strains of Cronobacter sakazakii, Salmonella serovars, other Enterobacteriaceae and Acinetobacter spp. can adhere and grow on enteral feeding tubes composed of polyvinyl chloride and polyurethane. The study also included silver-impregnated tubing which was expected to have antibacterial activity. Bacterial biofilm formation by members of the Enterobacteriaceae was ca. 10(5)-10(6) cfu/cm after 24h. Negligible biofilm was detected for Acinetobacter gensp. 13; ca. 10 cfu/cm, whereas Cr. sakazakii strain ATCC 12868 had the highest biofilm cell density of 10(7) cfu/cm. Biofilm formation did not correlate with capsule production, and was not inhibited on silver-impregnated tubing. Bacteria grew in the tube lumen to cell densities of 10(7)cfu/ml within 8h, and 10(9)cfu/ml within 24h. It is plausible that in vivo the biofilm will both inoculate subsequent routine feeds and as the biofilm ages, clumps of cells will be shed which may survive passage through the neonate's stomach. Therefore biofilm formation on enteral feeding tubes constitutes a risk factor for susceptible neonates.

Benchmarking of Monte Carlo based shutdown dose rate calculations for applications to JET.

The calculation of dose rates after shutdown is an important issue for operating nuclear reactors. A validated computational tool is needed for reliable dose rate calculations. In fusion reactors neutrons induce high levels of radioactivity and presumably high doses. The complex geometries of the devices require the use of sophisticated geometry modelling and computational tools for transport calculations. Simple rule of thumb laws do not always apply well. Two computational procedures have been developed recently and applied to fusion machines. Comparisons between the two methods showed some inherent discrepancies when applied to calculation for the ITER while good agreement was found for a 14 MeV point source neutron benchmark experiment. Further benchmarks were considered necessary to investigate in more detail the reasons for the different results in different cases. In this frame the application to the Joint European Torus JET machine has been considered as a useful benchmark exercise. In a first calculational benchmark with a representative D-T irradiation history of JET the two methods differed by no more than 25%. In another, more realistic benchmark exercise, which is the subject of this paper, the real irradiation history of D-T and D-D campaigns conducted at JET in 1997-98 were used to calculate the shut-down doses at different locations, irradiation and decay times. Experimental dose data recorded at JET for the same conditions offer the possibility to check the prediction capability of the calculations and thus show the applicability (and the constraints) of the procedures and data to the rather complex shutdown dose rate analysis of real fusion devices. Calculation results obtained by the two methods are reported below, comparison with experimental results give discrepancies ranging between 2 and 10. The reasons of that can be ascribed to the high uncertainty on the experimental data and the unsatisfactory JET model used in the calculation. A new dedicated JET benchmark experiment will be performed trying to solve these issues.

A comparative study on attitudes, mental health and job stress amongst GPs participating, or not, in a rural out-of-hours co-operative.

OBJECTIVES: To test the study hypothesis that GPs participating in co-operatives will have more positive attitudes towards co-operatives, better mental health and less stress than GPs using traditional out-of-hours arrangements. METHODS: A comparative questionnaire study was conducted amongst GPs, participating, or not, in an out-of-hours, largely rural, co-operative ('NoWDOC') which had been established one year previously. The general attitudes of GPs towards out-of-hours work were obtained together with responses to the General Health Questionnaire-12 (mental health) and Stress Arousal Checklist (job stress). RESULTS: Eighty-nine of 120 eligible practitioners responded (74%). The mean GHQ scores for GPs in NoWDOC was 10.2 [standard deviation (SD) 3.9] compared to a score of 11.3 (SD 4.5) for those not participating (t = -1.18; P = 0.24). The overall mean stress score for members of NoWDOC was 3.8 (SD 2.6) compared to 3.4 (SD 2.7) for non-NoWDOC (t = 0.59; P = 0.55). The overall mean arousal score for NoWDOC GPs was 5.2 (SD 2.0) compared to 5.5 (SD 2.9) for non-NoWDOC GPs (t = -0.68; P = 0.50). Multiple regression analyses suggested that the independent variables (partnership arrangements, age, working hours and membership of NoWDOC) did not account for any of the variability in the GHQ score but a significant amount of variability in stress and arousal scores. CONCLUSIONS: The anticipated differences in mental health and job stress among participating GPs were not shown. As the new generation of GPs resemble the NoWDOC participants in their preferences for multi-partner practices with limited out-of-hours care provision, clarification of these findings is important.

Pseudomonas aeruginosa cells adapted to benzalkonium chloride show resistance to other membrane-active agents but not to clinically relevant antibiotics.

Our objective was to determine whether strains of Pseudomonas aeruginosa can adapt to growth in increasing concentrations of the disinfectant benzalkonium chloride (BKC), and whether co-resistance to clinically relevant antimicrobial agents occurs. Attempts were made to determine what phenotypic alterations accompanied resistance and whether these explained the mechanism of resistance. Strains were serially passaged in increasing concentrations of BKC in static nutrient broth cultures. Serotyping and genotyping were used to determine purity of the cultures. Two strains were examined for cross-resistance to other disinfectants and antibiotics by broth dilution MIC determination. Alterations in outer membrane proteins and lipopolysaccharide (LPS) expressed were examined by SDS-PAGE. Cell surface hydrophobicity and charge, uptake of disinfectant and proportion of specific fatty acid content of outer and cytoplasmic membranes were determined. Two P. aeruginosa strains showed a stable increase in resistance to BKC. Co-resistance to other quaternary ammonium compounds was observed in both strains; chloramphenicol and polymyxin B resistance were observed in one and a reduction in resistance to tobramycin observed in the other. However, no increased resistance to other biocides (chlorhexidine, triclosan, thymol) or antibiotics (ceftazidime, imipenem, ciprofloxacin, tobramycin) was detected. Characteristics accompanying resistance included alterations in outer membrane proteins, uptake of BKC, cell surface charge and hydrophobicity, and fatty acid content of the cytoplasmic membrane, although no evidence was found for alterations in LPS. Each of the two strains had different alterations in phenotype, indicating that such adaptation is unique to each strain of P. aeruginosa and does not result from a single mechanism shared by the whole species.

Arguments at cross-purposes: moral epistemology and medical ethics.

Different beliefs about the nature and justification of bioethics may reflect different assumptions in moral epistemology. Two alternative views (put forward by David Seedhouse and Michael H Kottow) are analysed and some speculative conclusions formed. The foundational questions raised here are by no means settled and deserve further attention.

Survivors of childhood abuse: their reported experiences with professional help.

This article analyzes the self-reports of 384 adults who responded to a survey of people abused physically, sexually, or emotionally by family members in childhood. Most of the respondents sought help as adults from social workers and other mental health professionals for the long-term effects of their abusive experiences. This article analyses the reports of their help-seeking experiences against a backdrop of the reports of clinicians and researchers on working with survivors, as reported in the literature. Although survivors of childhood abuse often are described as having difficulty relating to professionals, these respondents persisted in seeking help and tended to report at least one experience with professional services that was very helpful. Their self-esteem and family functioning in adulthood was associated with having had a very helpful professional or service provider. The findings describe the responses most valued by survivors, as well as their views of the limitations of available services.

Epidemiology of behavioral dependence: literature review and results of original studies.

The extension of the definition of dependence leads to the consideration of some impulsive disorders as a form of dependence disorder. This pathological condition is characterized by the repetitive occurrence of impulsive and uncontrolled behaviors. Other clinical characteristics are failure to resist an impulse, drive or temptation to perform some act harmful to oneself and/or others, an increasing sense of tension or excitement before acting out, and a sense of pleasure, gratification or release at the time of the behavior or shortly thereafter. Behavioral dependences most often described are pathological gambling, kleptomania, trichotillomania and compulsive buying. Studies using a specific assessment scale, the South Oaks Gambling Screen, distinguished problem gambling from pathological gambling. Social gamblers spend 5% of their money and pathological gamblers 14 to 45%. Prevalence of 'problem gambling' is 4% and pathological gambling 2%. Several studies have suggested that the incidence of pathological gambling is eight to ten times greater in alcohol-dependent patients than in the general population. No systematic study has assessed the prevalence of kleptomania. Data come from case reports. Among subjects arrested after a theft, prevalence of kleptomania varied between 0 and 24%. Trichotillomania prevalence rate is 0.6% among students. Studies using less restrictive diagnostic criteria found a prevalence rate of 3.4% in women and 1.5% in men. The disorder is often unrecognized; 40% of the cases are not diagnosed and 58% of the patients have never been treated. Prevalence studies of compulsive buying found a rate between 1 and 6% in the general population. Compulsive buying is significantly more frequent among women (90% of the cases). Study of family history of compulsive buyers showed a high frequency of alcohol-dependence disorder (20%) and depression (18%). In all cases of behavioral dependence disorders, a high level of impulsivity and sensation-seeking could determine an increased risk.

Responding to children's disclosure of familial abuse: what survivors tell us.

This study is based on the reports of 384 adults who were abused physically, sexually, and/or emotionally in childhood by family members. It describes the survivors' attempts, as children, to get help by disclosing the abuse to someone who might intervene; those who did not disclose explain their reasons. The results indicate that disclosure usually did not bring an end to the abuse, and that little action was taken to control the perpetrator, even after disclosure took place. The responses received by the children to their disclosure are linked to their levels of self-esteem and family functioning as adults.

Three-dimensional modeling of biopsy protocols for localized prostate cancer.

Prostate cancer is the most common malignant tumor in American men, yet only a small percentage of men will develop clinically significant disease. Needle core biopsies are used to confirm the presence of cancer prior to surgery. While needle core biopsies have shown some ability to predict tumor volume and grade in prostatectomy specimens, for the individual patient they are neither sensitive nor specific enough to guide therapy. In this paper, we describe a system for simulating needle biopsies on three-dimensional models of cancerous prostates reconstructed from serial sections. First we segment the serial sections, delineating tumors and landmarks. Next, we register the sections using a color-merging scheme, and reconstruct the three-dimensional model using modified-shape-based interpolation. The resulting volume can be rendered, and simulated needle core biopsies can be taken from the reconstructed model. We use our system to simulate two different biopsy protocols on a reconstructed prostate specimen.

Endotracheal reintubation: a closer look at a preventable condition.

We designed a prospective study of endotracheal intubations and reintubations in our inner city Level 1 Trauma Center, to determine the frequency and causes of reintubation and evaluate the impact of an educational intervention aimed at minimizing unplanned extubations (UEs). After an initial 3-month phase, efforts were instituted to educate healthcare providers to the causes of reintubation noted. An identical 3-month period was then studied to evaluate the efficacy of the interventions. There were 862 patients, all adults, in the initial phase of the study, with 40 reintubation events in 22 patients; of the 808 in the second phase, there were 16 reintubations in 13 patients. The reintubation rate decreased from 4.4% to 1.9% (p = 0.005). Reintubations after UEs decreased from 14% to 5.2% (rate ratio, 0.374; 95% confidence interval = 0.141, 0.990). Multiple reintubation events decreased from 45% to 18.8% (p = 0.07). Increased provider education and protocol changes were associated with lower reintubation rates.