An overview of solvent extraction processes developed in Europe for advanced nuclear fuel recycling, Part 2 — homogeneous recycling

The hydrometallurgical separation concepts for the recycling of irradiated nuclear fuels developed in Europe are presented and discussed. Whilst Part 1 of the review focused on concepts for heterogeneous recycling of minor actinides, this article focuses on group recycling of transuranic actinides, which would support homogeneous recycling scenarios. Most of these concepts were developed within European collaborative projects and involve solvent extraction processes separating all the actinides (U-Cm) in two cycles. The first cycle uses a monoamide extractant to recover uranium leaving all the transuranic actinides in the aqueous raffinate with the fission products. The second cycle aims for a group recovery of the transuranium elements and several strategies have been proposed for this stage. In this review article, the various solvent extraction processes are summarised and the key features of the process schemes are compared

Comparison of the Airtraq® and Truview® laryngoscopes to the Macintosh laryngoscope for use by Advanced Paramedics in easy and simulated difficult intubation in manikins

<p>Abstract</p> <p>Background</p> <p>Paramedics are frequently required to perform tracheal intubation, a potentially life-saving manoeuvre in severely ill patients, in the prehospital setting. However, direct laryngoscopy is often more difficult in this environment, and failed tracheal intubation constitutes an important cause of morbidity. Novel indirect laryngoscopes, such as the Airtraq^®and Truview^®laryngoscopes may reduce this risk.</p> <p>Methods</p> <p>We compared the efficacy of these devices to the Macintosh laryngoscope when used by 21 Paramedics proficient in direct laryngoscopy, in a randomized, controlled, manikin study. Following brief didactic instruction with the Airtraq^®and Truview^®laryngoscopes, each participant took turns performing laryngoscopy and intubation with each device, in an easy intubation scenario and following placement of a hard cervical collar, in a SimMan^®manikin.</p> <p>Results</p> <p>The Airtraq^®reduced the number of optimization manoeuvres and reduced the potential for dental trauma when compared to the Macintosh, in both the normal and simulated difficult intubation scenarios. In contrast, the Truview^®increased the duration of intubation attempts, and required a greater number of optimization manoeuvres, compared to both the Macintosh and Airtraq^®devices.</p> <p>Conclusion</p> <p>The Airtraq^®laryngoscope performed more favourably than the Macintosh and Truview^®devices when used by Paramedics in this manikin study. Further studies are required to extend these findings to the clinical setting.</p

Comparison of the Airtraq® and Truview® laryngoscopes to the Macintosh laryngoscope for use by Advanced Paramedics in easy and simulated difficult intubation in manikins

<p>Abstract</p> <p>Background</p> <p>Paramedics are frequently required to perform tracheal intubation, a potentially life-saving manoeuvre in severely ill patients, in the prehospital setting. However, direct laryngoscopy is often more difficult in this environment, and failed tracheal intubation constitutes an important cause of morbidity. Novel indirect laryngoscopes, such as the Airtraq^®and Truview^®laryngoscopes may reduce this risk.</p> <p>Methods</p> <p>We compared the efficacy of these devices to the Macintosh laryngoscope when used by 21 Paramedics proficient in direct laryngoscopy, in a randomized, controlled, manikin study. Following brief didactic instruction with the Airtraq^®and Truview^®laryngoscopes, each participant took turns performing laryngoscopy and intubation with each device, in an easy intubation scenario and following placement of a hard cervical collar, in a SimMan^®manikin.</p> <p>Results</p> <p>The Airtraq^®reduced the number of optimization manoeuvres and reduced the potential for dental trauma when compared to the Macintosh, in both the normal and simulated difficult intubation scenarios. In contrast, the Truview^®increased the duration of intubation attempts, and required a greater number of optimization manoeuvres, compared to both the Macintosh and Airtraq^®devices.</p> <p>Conclusion</p> <p>The Airtraq^®laryngoscope performed more favourably than the Macintosh and Truview^®devices when used by Paramedics in this manikin study. Further studies are required to extend these findings to the clinical setting.</p

A 60-million-year Cenozoic history of western Amazonian ecosystems in Contamana, eastern Peru

Weprovide a synopsis of ~60million years of life history in Neotropical lowlands, based on a comprehensive survey of the Cenozoic deposits along the Quebrada Cachiyacu near Contamana in PeruvianAmazonia. The 34 fossilbearing localities identified have yielded a diversity of fossil remains, including vertebrates,mollusks, arthropods, plant fossils, and microorganisms, ranging from the early Paleocene to the lateMiocene–?Pliocene (N20 successive levels). This Cenozoic series includes the base of the Huchpayacu Formation (Fm.; early Paleocene; lacustrine/ fluvial environments; charophyte-dominated assemblage), the Pozo Fm. (middle + ?late Eocene; marine then freshwater environments; most diversified biomes), and complete sections for the Chambira Fm. (late Oligocene–late early Miocene; freshwater environments; vertebrate-dominated faunas), the Pebas Fm. (late early to early late Miocene; freshwater environments with an increasing marine influence; excellent fossil record), and Ipururo Fm. (late Miocene–?Pliocene; fully fluvial environments; virtually no fossils preserved). At least 485 fossil species are recognized in the Contamana area (~250 ‘plants’, ~212 animals, and 23 foraminifera). Based on taxonomic lists from each stratigraphic interval, high-level taxonomic diversity remained fairly constant throughout themiddle Eocene–Miocene interval (8-12 classes), ordinal diversity fluctuated to a greater degree, and family/species diversity generally declined, with a drastic drop in the early Miocene. The Paleocene–?Pliocene fossil assemblages from Contamana attest at least to four biogeographic histories inherited from (i) Mesozoic Gondwanan times, (ii) the Panamerican realm prior to (iii) the time of South America’s Cenozoic “splendid isolation”, and (iv) Neotropical ecosystems in the Americas. No direct evidence of any North American terrestrial immigrant has yet been recognized in the Miocene record at Contamana.Facultad de Ciencias Naturales y Muse

The management of acute venous thromboembolism in clinical practice. Results from the European PREFER in VTE Registry

Venous thromboembolism (VTE) is a significant cause of morbidity and mortality in Europe. Data from real-world registries are necessary, as clinical trials do not represent the full spectrum of VTE patients seen in clinical practice. We aimed to document the epidemiology, management and outcomes of VTE using data from a large, observational database. PREFER in VTE was an international, non-interventional disease registry conducted between January 2013 and July 2015 in primary and secondary care across seven European countries. Consecutive patients with acute VTE were documented and followed up over 12 months. PREFER in VTE included 3,455 patients with a mean age of 60.8 ± 17.0 years. Overall, 53.0 % were male. The majority of patients were assessed in the hospital setting as inpatients or outpatients (78.5 %). The diagnosis was deep-vein thrombosis (DVT) in 59.5 % and pulmonary embolism (PE) in 40.5 %. The most common comorbidities were the various types of cardiovascular disease (excluding hypertension; 45.5 %), hypertension (42.3 %) and dyslipidaemia (21.1 %). Following the index VTE, a large proportion of patients received initial therapy with heparin (73.2 %), almost half received a vitamin K antagonist (48.7 %) and nearly a quarter received a DOAC (24.5 %). Almost a quarter of all presentations were for recurrent VTE, with &gt;80 % of previous episodes having occurred more than 12 months prior to baseline. In conclusion, PREFER in VTE has provided contemporary insights into VTE patients and their real-world management, including their baseline characteristics, risk factors, disease history, symptoms and signs, initial therapy and outcomes

Subclonal diversification of primary breast cancer revealed by multiregion sequencing.

The sequencing of cancer genomes may enable tailoring of therapeutics to the underlying biological abnormalities driving a particular patient's tumor. However, sequencing-based strategies rely heavily on representative sampling of tumors. To understand the subclonal structure of primary breast cancer, we applied whole-genome and targeted sequencing to multiple samples from each of 50 patients' tumors (303 samples in total). The extent of subclonal diversification varied among cases and followed spatial patterns. No strict temporal order was evident, with point mutations and rearrangements affecting the most common breast cancer genes, including PIK3CA, TP53, PTEN, BRCA2 and MYC, occurring early in some tumors and late in others. In 13 out of 50 cancers, potentially targetable mutations were subclonal. Landmarks of disease progression, such as resistance to chemotherapy and the acquisition of invasive or metastatic potential, arose within detectable subclones of antecedent lesions. These findings highlight the importance of including analyses of subclonal structure and tumor evolution in clinical trials of primary breast cancer