50 research outputs found
CFD ANALYSES OF THE TN-24P PWR SPENT FUEL STORAGE CASK
ABSTRACT Dry storage casks are used to store spent nuclear fuel after removal from the reactor spent fuel pool. Even prior to the Fukushima earthquake of March 2011, dry storage of spent fuel was receiving increased attention as many reactor spent fuel pools near their capacity. Many different types of cask designs are used, and one representative design is the TN-24P spent fuel cask, a nonventilated steel cask with a shielded exterior shell and lid. The cask is typically filled with an inert gas such as helium, argon or nitrogen. In this paper, Computational Fluid Dynamics (CFD) calculation results for the thermal performance of the TN-24P cask using the commercial CFD software STAR-CCM+ are presented. Initial calculations employ a common approach of treating the fuel assemblies as conducting porous media with calibrated volume-averaged properties, and comparison to existing measured temperature data shows good agreement. One of the fuel assemblies is then replaced with a more accurate representation that includes the full geometric detail of the fuel rods, guide tubes, spacer grids and end fittings (flow nozzles), and the results shown are consistent with the initial analysis, but without the need for the assumptions inherent in the porous media approach. This hybrid modeling approach also permits the direct determination of important results, such as the precise location of peak fuel cladding temperatures (PCTs), which is not possible using the more traditional porous media approach
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Spent Fuel Transportation Package Response to the Baltimore Tunnel Fire Scenario
On July 18, 2001, a freight train carrying hazardous (non-nuclear) materials derailed and caught fire while passing through the Howard Street railroad tunnel in downtown Baltimore, Maryland. The United States Nuclear Regulatory Commission (USNRC), one of the agencies responsible for ensuring the safe transportation of radioactive materials in the United States, undertook an investigation of the train derailment and fire to determine the possible regulatory implications of this particular event for the transportation of spent nuclear fuel by railroad. Shortly after the accident occurred, the USNRC met with the National Transportation Safety Board (NTSB, the U.S. agency responsible for determining the cause of transportation accidents), to discuss the details of the accident and the ensuing fire. Following these discussions, the USNRC assembled a team of experts from the National Institute of Standards and Technology (NIST), the Center for Nuclear Waste Regulatory Analyses (CNWRA), and Pacific Northwest National Laboratory (PNNL) to determine the thermal conditions that existed in the Howard Street tunnel fire and analyze the effects of this fire on various spent fuel transportation package designs. The Fire Dynamics Simulator (FDS) code, developed by NIST, was used to determine the thermal environment present in the Howard Street tunnel during the fire. The FDS results were used as boundary conditions in the COBRA-SFS and ANSYS® computer codes to evaluate the thermal performance of different package designs. The staff concluded that larger transportation packages resembling the HOLTEC Model No. HI STAR 100 and TransNuclear Model No. TN-68 would withstand a fire with thermal conditions similar to those that existed in the Baltimore tunnel fire event with only minor damage to peripheral components. This is due to their sizable thermal inertia and design specifications in compliance with currently imposed regulatory requirements. The staff also concluded that some components of smaller transportation packages resembling the NAC Model No. LWT, despite placement within an ISO container, could degrade. USNRC staff evaluated the radiological consequences of the package responses to the Baltimore tunnel fire. Though components in some packages heated up beyond their service temperatures, the staff determined that there would be no significant dose as a result of the fire for any of these and similar packages
Prognostic model to predict postoperative acute kidney injury in patients undergoing major gastrointestinal surgery based on a national prospective observational cohort study.
Background: Acute illness, existing co-morbidities and surgical stress response can all contribute to postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. The aim of this study was prospectively to develop a pragmatic prognostic model to stratify patients according to risk of developing AKI after major gastrointestinal surgery. Methods: This prospective multicentre cohort study included consecutive adults undergoing elective or emergency gastrointestinal resection, liver resection or stoma reversal in 2-week blocks over a continuous 3-month period. The primary outcome was the rate of AKI within 7 days of surgery. Bootstrap stability was used to select clinically plausible risk factors into the model. Internal model validation was carried out by bootstrap validation. Results: A total of 4544 patients were included across 173 centres in the UK and Ireland. The overall rate of AKI was 14·2 per cent (646 of 4544) and the 30-day mortality rate was 1·8 per cent (84 of 4544). Stage 1 AKI was significantly associated with 30-day mortality (unadjusted odds ratio 7·61, 95 per cent c.i. 4·49 to 12·90; P < 0·001), with increasing odds of death with each AKI stage. Six variables were selected for inclusion in the prognostic model: age, sex, ASA grade, preoperative estimated glomerular filtration rate, planned open surgery and preoperative use of either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker. Internal validation demonstrated good model discrimination (c-statistic 0·65). Discussion: Following major gastrointestinal surgery, AKI occurred in one in seven patients. This preoperative prognostic model identified patients at high risk of postoperative AKI. Validation in an independent data set is required to ensure generalizability
The development and validation of a scoring tool to predict the operative duration of elective laparoscopic cholecystectomy
Background: The ability to accurately predict operative duration has the potential to optimise theatre efficiency and utilisation, thus reducing costs and increasing staff and patient satisfaction. With laparoscopic cholecystectomy being one of the most commonly performed procedures worldwide, a tool to predict operative duration could be extremely beneficial to healthcare organisations.
Methods: Data collected from the CholeS study on patients undergoing cholecystectomy in UK and Irish hospitals between 04/2014 and 05/2014 were used to study operative duration. A multivariable binary logistic regression model was produced in order to identify significant independent predictors of long (> 90 min) operations. The resulting model was converted to a risk score, which was subsequently validated on second cohort of patients using ROC curves.
Results: After exclusions, data were available for 7227 patients in the derivation (CholeS) cohort. The median operative duration was 60 min (interquartile range 45–85), with 17.7% of operations lasting longer than 90 min. Ten factors were found to be significant independent predictors of operative durations > 90 min, including ASA, age, previous surgical admissions, BMI, gallbladder wall thickness and CBD diameter. A risk score was then produced from these factors, and applied to a cohort of 2405 patients from a tertiary centre for external validation. This returned an area under the ROC curve of 0.708 (SE = 0.013, p 90 min increasing more than eightfold from 5.1 to 41.8% in the extremes of the score.
Conclusion: The scoring tool produced in this study was found to be significantly predictive of long operative durations on validation in an external cohort. As such, the tool may have the potential to enable organisations to better organise theatre lists and deliver greater efficiencies in care
Hyperoxemia and excess oxygen use in early acute respiratory distress syndrome : Insights from the LUNG SAFE study
Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Concerns exist regarding the prevalence and impact of unnecessary oxygen use in patients with acute respiratory distress syndrome (ARDS). We examined this issue in patients with ARDS enrolled in the Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study. Methods: In this secondary analysis of the LUNG SAFE study, we wished to determine the prevalence and the outcomes associated with hyperoxemia on day 1, sustained hyperoxemia, and excessive oxygen use in patients with early ARDS. Patients who fulfilled criteria of ARDS on day 1 and day 2 of acute hypoxemic respiratory failure were categorized based on the presence of hyperoxemia (PaO2 > 100 mmHg) on day 1, sustained (i.e., present on day 1 and day 2) hyperoxemia, or excessive oxygen use (FIO2 ≥ 0.60 during hyperoxemia). Results: Of 2005 patients that met the inclusion criteria, 131 (6.5%) were hypoxemic (PaO2 < 55 mmHg), 607 (30%) had hyperoxemia on day 1, and 250 (12%) had sustained hyperoxemia. Excess FIO2 use occurred in 400 (66%) out of 607 patients with hyperoxemia. Excess FIO2 use decreased from day 1 to day 2 of ARDS, with most hyperoxemic patients on day 2 receiving relatively low FIO2. Multivariate analyses found no independent relationship between day 1 hyperoxemia, sustained hyperoxemia, or excess FIO2 use and adverse clinical outcomes. Mortality was 42% in patients with excess FIO2 use, compared to 39% in a propensity-matched sample of normoxemic (PaO2 55-100 mmHg) patients (P = 0.47). Conclusions: Hyperoxemia and excess oxygen use are both prevalent in early ARDS but are most often non-sustained. No relationship was found between hyperoxemia or excessive oxygen use and patient outcome in this cohort. Trial registration: LUNG-SAFE is registered with ClinicalTrials.gov, NCT02010073publishersversionPeer reviewe
Mitochondrial Role in Oncogenesis and Potential Chemotherapeutic Strategy of Mitochondrial Infusion in Breast Cancer
Triple negative breast cancer (TNBC) is one of the most aggressive cancers diagnosed amongst women with a high rate of treatment failure and a poor prognosis. Mitochondria have been found to be key players in oncogenesis and tumor progression by mechanisms such as altered metabolism, reactive oxygen species (ROS) production and evasion of apoptosis. Therefore, mitochondrial infusion is an area of interest for cancer treatment. Studies in vitro and in vivo demonstrate mitochondrial-mediated reduction in glycolysis, enhancement of oxidative phosphorylation (OXPHOS), reduction in proliferation, and an enhancement of apoptosis as effective anti-tumor therapies. This review focuses on mitochondrial dysregulation and infusion in malignancies, such as TNBC
Consensus Report by the Pediatric Acute Lung Injury and Sepsis Investigators and Pediatric Blood and Marrow Transplantation Consortium Joint Working Committees on Supportive Care Guidelines for Management of Veno-Occlusive Disease in Children and Adolescents, Part 3: Focus on Cardiorespiratory Dysfunction, Infections, Liver Dysfunction, and Delirium
Some patients with veno-occlusive disease (VOD) have multiorgan dysfunction, and multiple teams are involved in their daily care in the pediatric intensive care unit. Cardiorespiratory dysfunction is critical in these patients, requiring immediate action. The decision of whether to use a noninvasive or an invasive ventilation strategy may be difficult in the setting of mucositis or other comorbidities in patients with VOD. Similarly, monitoring of organ functions may be very challenging in these patients, who may have fulminant hepatic failure with or without hepatic encephalopathy complicated by delirium and/or infections. In this final guideline of our series on supportive care in patients with VOD, we address some of these questions and provide evidence-based recommendations on behalf of the Pediatric Acute Lung Injury and Sepsis Investigators and Pediatric Blood and Marrow Transplantation Consortium Joint Working Committees