Small Reactors without On-site Refuelling: Neutronic Characteristics, Emergency Planning and Development Scenarios

Small reactors without on-site refuelling have a capability to operate without reloading or shuffling of fuel in their cores for reasonably long periods of time consistent with plant economy and considerations of energy security, with no fresh or spent fuel being stored at the site during reactor operation. In 2009, more than 25 design concepts of such reactors were analyzed or developed in IAEA Member States, representing both developed and developing countries. Small reactors without on-site refuelling are being developed for several reactor lines, including water cooled reactors, sodium cooled fast reactors, lead and lead bismuth cooled reactors, and also include some non-conventional concepts. To further research and development (R&D) in the areas mentioned above and several others, and to facilitate progress in Member States in design and technology development for small reactors without on-site refueling, the IAEA has conducted a dedicated Coordinated Research Project (CRP) entitled ‘Small Reactors without On-site Refuelling’ (CRPi25001). The project started late in 2004 and, after a review in 2008, was extended for one more year to be ended in 2009. The project has created a network of 18 research institutions from 10 Member States, representing both developed and developing countries. The objective of this report is to document reference points and conclusions achieved through coordinated research conducted within the CRP on ‘Small Reactors without On-site Refuelling’ and to suggest R&D activities to be furthered after the CRP completion. Being documented, the outputs of this CRP may foster further R&D and increase the capability of Member States to achieve progress in development and deployment of small reactors without on-site refuelling

Small reactors without on-site refuelling : neutronic characteristics, emergency planning and development scenarios : final report of an IAEA coordinated research project

Lietuvos energetikos institutas, [email protected] energetikos institutas, [email protected] energetikos institutas, [email protected]

General anaesthesia versus local anaesthesia for carotid surgery (GALA): a multicentre, randomised controlled trial

Background: The effect of carotid endarterectomy in lowering the risk of stroke ipsilateral to severe atherosclerotic carotid-artery stenosis is offset by complications during or soon after surgery. We compared surgery under general anaesthesia with that under local anaesthesia because prediction and avoidance of perioperative strokes might be easier under local anaesthesia than under general anaesthesia. Methods: We undertook a parallel group, multicentre, randomised controlled trial of 3526 patients with symptomatic or asymptomatic carotid stenosis from 95 centres in 24 countries. Participants were randomly assigned to surgery under general (n=1753) or local (n=1773) anaesthesia between June, 1999 and October, 2007. The primary outcome was the proportion of patients with stroke (including retinal infarction), myocardial infarction, or death between randomisation and 30 days after surgery. Analysis was by intention to treat. The trial is registered with Current Control Trials number ISRCTN00525237. Findings: A primary outcome occurred in 84 (4·8%) patients assigned to surgery under general anaesthesia and 80 (4·5%) of those assigned to surgery under local anaesthesia; three events per 1000 treated were prevented with local anaesthesia (95% CI -11 to 17; risk ratio [RR] 0·94 [95% CI 0·70 to 1·27]). The two groups did not significantly differ for quality of life, length of hospital stay, or the primary outcome in the prespecified subgroups of age, contralateral carotid occlusion, and baseline surgical risk. Interpretation: We have not shown a definite difference in outcomes between general and local anaesthesia for carotid surgery. The anaesthetist and surgeon, in consultation with the patient, should decide which anaesthetic technique to use on an individual basis. Funding: The Health Foundation (UK) and European Society of Vascular Surgery. © 2008 Elsevier Ltd. All rights reserved

General anaesthesia versus local anaesthesia for carotid surgery (GALA): a multicentre, randomised controlled trial

BACKGROUND: The effect of carotid endarterectomy in lowering the risk of stroke ipsilateral to severe atherosclerotic carotid-artery stenosis is offset by complications during or soon after surgery. We compared surgery under general anaesthesia with that under local anaesthesia because prediction and avoidance of perioperative strokes might be easier under local anaesthesia than under general anaesthesia. METHODS: We undertook a parallel group, multicentre, randomised controlled trial of 3526 patients with symptomatic or asymptomatic carotid stenosis from 95 centres in 24 countries. Participants were randomly assigned to surgery under general (n=1753) or local (n=1773) anaesthesia between June, 1999 and October, 2007. The primary outcome was the proportion of patients with stroke (including retinal infarction), myocardial infarction, or death between randomisation and 30 days after surgery. Analysis was by intention to treat. The trial is registered with Current Control Trials number ISRCTN00525237. FINDINGS: A primary outcome occurred in 84 (4.8%) patients assigned to surgery under general anaesthesia and 80 (4.5%) of those assigned to surgery under local anaesthesia; three events per 1000 treated were prevented with local anaesthesia (95% CI -11 to 17; risk ratio [RR] 0.94 [95% CI 0.70 to 1.27]). The two groups did not significantly differ for quality of life, length of hospital stay, or the primary outcome in the prespecified subgroups of age, contralateral carotid occlusion, and baseline surgical risk. INTERPRETATION: We have not shown a definite difference in outcomes between general and local anaesthesia for carotid surgery. The anaesthetist and surgeon, in consultation with the patient, should decide which anaesthetic technique to use on an individual basis. FUNDING: The Health Foundation (UK) and European Society of Vascular Surgery