Research and development on the application of advanced control technologies to advanced nuclear reactor systems: A US national perspective

Control system designs for nuclear power plants are becoming more advanced through the use of digital technology and automation. This evolution is taking place because of: (1) the limitations in analog based control system performance and maintenance and availability and (2) the promise of significant improvement in plant operation and availability due to advances in digital and other control technologies. Digital retrofits of control systems in US nuclear plants are occurring now. Designs of control and protection systems for advanced LWRs are based on digital technology. The use of small inexpensive, fast, large-capacity computers in these designs is the first step of an evolutionary process described in this paper. Under the sponsorship of the US Department of Energy (DOE), Oak Ridge National Laboratory, Argonne National Laboratory, GE Nuclear Energy and several universities are performing research and development in the application of advances in control theory, software engineering, advanced computer architectures, artificial intelligence, and man-machine interface analysis to control system design. The target plant concept for the work described in this paper is the Power Reactor Inherently Safe Module reactor (PRISM), an advanced modular liquid metal reactor concept. This and other reactor designs which provide strong passive responses to operational upsets or accidents afford good opportunities to apply these advances in control technology. 18 refs., 5 figs

A retrospective propensity-score-matched cohort study of the impact of procalcitonin testing on antibiotic use in hospitalized patients during the first wave of COVID-19

Background Procalcitonin (PCT) is a blood marker used to help diagnose bacterial infections and guide antibiotic treatment. PCT testing was widely used/adopted during the COVID-19 pandemic in the UK. Objectives Primary: to measure the difference in length of early (during first 7 days) antibiotic prescribing between patients with COVID-19 who did/did not have baseline PCT testing during the first wave of the pandemic. Secondary: to measure differences in length of hospital/ICU stay, mortality, total days of antibiotic prescribing and resistant bacterial infections between these groups. Methods Multi-centre, retrospective, observational, cohort study using patient-level clinical data from acute hospital Trusts/Health Boards in England/Wales. Inclusion: patients ≥16 years, admitted to participating Trusts/Health Boards and with a confirmed positive COVID-19 test between 1 February 2020 and 30 June 2020. Results Data from 5960 patients were analysed: 1548 (26.0%) had a baseline PCT test and 4412 (74.0%) did not. Using propensity-score matching, baseline PCT testing was associated with an average reduction in early antibiotic prescribing of 0.43 days [95% confidence interval (CI): 0.22–0.64 days, P < 0.001) and of 0.72 days (95% CI: 0.06–1.38 days, P = 0.03] in total antibiotic prescribing. Baseline PCT testing was not associated with increased mortality or hospital/ICU length of stay or with the rate of antimicrobial-resistant secondary bacterial infections. Conclusions Baseline PCT testing appears to have been an effective antimicrobial stewardship tool early in the pandemic: it reduced antibiotic prescribing without evidence of harm. Our study highlights the need for embedded, rapid evaluations of infection diagnostics in the National Health Service so that even in challenging circumstances, introduction into clinical practice is supported by evidence for clinical utility