Life-Cycle Cost and Risk Analysis of Alternative Configurations for Shipping Low-Level Radioactive Waste to the Nevada Test Site

The Nevada Test Site (NTS) is a major receiver of low-level radioactive waste (LLW) for disposal. Currently, all LLW received at NTS is shipped by truck. The trucks use highway routes to NTS that pass through the Las Vegas Valley and over Hoover Dam, which is a concern of local stakeholder groups in the State of Nevada. Rail service offers the opportunity to reduce transportation risks and costs, according to the Waste Management Programmatic Environmental Impact Statement (WM-PEIS). However, NTS and some DOE LLW generator sites are not served with direct rail service so intermodal transport is under consideration. Intermodal transport involves transport via two modes, in this case truck and rail, from the generator sites to NTS. LLW shipping containers would be transferred between trucks and railcars at intermodal transfer points near the LLW generator sites, NTS, or both. An Environmental Assessment (EA)for Intermodal Transportation of Low-Level Radioactive Waste to the Nevada Test Site (referred to as the NTSIntermodal -M) has been prepared to determine whether there are environmental impacts to alterations to the current truck routing or use of intermodal facilities within the State of Nevada. However, an analysis of the potential impacts outside the State of Nevada are not addressed in the NTS Intermodal EA. This study examines the rest of the transportation network between LLW generator sites and the NTS and evaluates the costs, risks, and feasibility of integrating intermodal shipments into the LLW transportation system. This study evaluates alternative transportation system configurations for NTS approved and potential generators based on complex-wide LLW load information. Technical judgments relative to the availability of DOE LLW generators to ship from their sites by rail were developed. Public and worker risk and life-cycle cost components are quantified. The study identifies and evaluates alternative scenarios that increase the use of rail (intermodal where needed) to transport LLW from generator sites to NTS

Effect of a low fat versus a low carbohydrate weight loss dietary intervention on biomarkers of long term survival in breast cancer patients ('CHOICE'): study protocol

<p>Abstract</p> <p>Background</p> <p>Weight loss in overweight or obese breast cancer patients is associated with an improved prognosis for long term survival. However, it is not clear whether the macronutrient composition of the chosen weight loss dietary plan imparts further prognostic benefit. A study protocol is presented for a dietary intervention to investigate the effects of weight loss dietary patterns that vary markedly in fat and carbohydrate contents on biomarkers of exposure to metabolic processes that may promote tumorigenesis and that are predictive of long term survival. The study will also determine how much weight must be lost for biomarkers to change in a favorable direction.</p> <p>Methods/Design</p> <p>Approximately 370 overweight or obese postmenopausal breast cancer survivors (body mass index: 25.0 to 34.9 kg/m²) will be accrued and assigned to one of two weight loss intervention programs or a non-intervention control group. The dietary intervention is implemented in a free living population to test the two extremes of popular weight loss dietary patterns: a high carbohydrate, low fat diet versus a low carbohydrate, high fat diet. The effects of these dietary patterns on biomarkers for glucose homeostasis, chronic inflammation, cellular oxidation, and steroid sex hormone metabolism will be measured. Participants will attend 3 screening and dietary education visits, and 7 monthly one-on-one dietary counseling and clinical data measurement visits in addition to 5 group visits in the intervention arms. Participants in the control arm will attend two clinical data measurement visits at baseline and 6 months. The primary outcome is high sensitivity C-reactive protein. Secondary outcomes include interleukin-6, tumor necrosis factor-α, insulin-like growth factor-1 (IGF), IGF binding protein-3, 8-isoprostane-F2-alpha, estrone, estradiol, progesterone, sex hormone binding globulin, adiponectin, and leptin.</p> <p>Discussion</p> <p>While clinical data indicate that excess weight for height is associated with poor prognosis for long term survival, little attention is paid to weight control in the clinical management of breast cancer. This study will provide information that can be used to answer important patient questions about the effects of dietary pattern and magnitude of weight loss on long term survival following breast cancer treatment.</p> <p>Clinical Trial Registration</p> <p>CA125243</p

DEXA measures of body fat percentage and acute phase proteins among breast cancer survivors: a Cross-Sectional Analysis

<p>Abstract</p> <p>Background</p> <p>C-reactive protein (CRP) and Serum amyloid A protein (SAA) increases with systemic inflammation and are related to worse survival for breast cancer survivors. This study examines the association between percent body fat and SAA and CRP and the potential interaction with NSAID use and weight change.</p> <p>Methods</p> <p>Participants included 134 non-Hispanic white and Hispanic breast cancer survivors from the Health, Eating, Activity, and Lifestyle Study. Body fat percentage, measured with Dual Energy X-ray Absorptiometer (DEXA), and circulating levels of CRP and SAA were obtained 30 months after breast cancer diagnosis.</p> <p>Results</p> <p>Circulating concentrations of CRP and SAA were associated with increased adiposity as measured by DEXA after adjustment for age at 24-months, race/ethnicity, dietary energy intake, weight change, and NSAID use. Survivors with higher body fat ≥35% had significantly higher concentrations of CRP (2.01 mg/l vs. 0.85 mg/l) and SAA (6.21 mg/l vs. 4.21 mg/l) compared to non-obese (body fat < 35%). Women who had gained more than 5% of their body weight since breast cancer diagnosis had non-statistically significant higher geometric mean levels of CRP and SAA. Mean levels of CRP and SAA were higher among obese women who were non-users of NSAIDs compared to current users; the association with SAA reached statistical significance (Mean SAA = 7.24, 95%CI 6.13-8.56 for non-NSAID; vs. 4.87; 95%CI 3.95-6.0 for NSAID users respectively).</p> <p>Conclusions</p> <p>Breast cancer survivors with higher body fat had higher mean concentrations of CRP and SAA than women with lower body fat. Further assessment of NSAID use and weight control in reducing circulating inflammatory markers among survivors may be worthwhile to investigate in randomized intervention trials as higher inflammatory markers are associated with worse survival.</p