Antineutrino emission and gamma background characteristics from a thermal research reactor

The detailed understanding of the antineutrino emission from research reactors is mandatory for any high sensitivity experiments either for fundamental or applied neutrino physics, as well as a good control of the gamma and neutron backgrounds induced by the reactor operation. In this article, the antineutrino emission associated to a thermal research reactor: the OSIRIS reactor located in Saclay, France, is computed in a first part. The calculation is performed with the summation method, which sums all the contributions of the beta decay branches of the fission products, coupled for the first time with a complete core model of the OSIRIS reactor core. The MCNP Utility for Reactor Evolution code was used, allowing to take into account the contributions of all beta decayers in-core. This calculation is representative of the isotopic contributions to the antineutrino flux which can be found at research reactors with a standard 19.75\% enrichment in $^{235}$U. In addition, the required off-equilibrium corrections to be applied to converted antineutrino energy spectra of uranium and plutonium isotopes are provided. In a second part, the gamma energy spectrum emitted at the core level is provided and could be used as an input in the simulation of any reactor antineutrino detector installed at such research facilities. Furthermore, a simulation of the core surrounded by the pool and the concrete shielding of the reactor has been developed in order to propagate the emitted gamma rays and neutrons from the core. The origin of these gamma rays and neutrons is discussed and the associated energy spectrum of the photons transported after the concrete walls is displayed.Comment: 14 pages, 11 figures, Data in Appendix A and B (13 pages

Evaluer la spécificité d'un centre hospitalo-universitaire: exemple du recours à la colonoscopie (enquête EPAGE) = [Estimating the specificity of a University Hospital Centre: example of the colonoscopy (EPAGE survey)]

Objectif: La spécificité d'un hôpital universitaire est le plus souvent abordée sous l'angle de la charge d'enseignement et de recherche. L'enquête EPAGE, outil d'aide à la décision accessible sur Internet, nous a permis de comparer le recours à un acte courant, la colonoscopie, au CHU de Clermont-Ferrand et au CH de Moulins. L'objectif a été de mettre en évidence des différences de pratique de soins entre ces 2 centres proches géographiquement, qui traduiraient une spécificité hospitalo-universitaire non prise en compte dans le mode de financement de l'hôpital. Méthode Les données sont tirées de l'étude EPAGE, étude multicentrique prospective associant 21 centres euro-canadiens. Le recueil des données au CHU de Clermont-Ferrand s'est fait sur 2 périodes : de décembre 2000 à mars 2001, puis de décembre 2001 à février 2002, et au CH de Moulins de décembre 2000 à fin novembre 2001. Pour cet article, seuls les caractéristiques des patients, les indications de colonoscopie et le taux d'opportunité ont été analysés. Une comparaison des catégories de patients des 2 centres a été réalisée en fonction de leur classe GHM (groupe homogène de malades) permettant ainsi de calculer la moyenne de points ISA (indice synthétique d'activité) des 2 centres. Résultats 221 cas de colonoscopies pratiquées au CHU et 292 au CH ont été inclus dans l'étude. Aucune différence statistiquement significative n'est trouvée pour les motifs de recours à la colonoscopie, en ce qui concerne les indications cotées par le site EPAGE. Les indications non répertoriées sont de 18 % au CHU contre 4,8 % au CH (p &lt; 1.10-6). À partir de la nomenclature GHM, le calcul de la moyenne de points ISA au CHU par patient est de 1161 contre 1147 : écart non significatif de 1,2 % en faveur du CHU. Discussion ? Conclusion La différence de motifs de recours à la colonoscopie trouvée entre les 2 centres relève de situations rares, complexes ou très innovantes. Ceci illustre le rôle de centre de référence régional d'un CHU, aspect spécifique fortement sous-estimé par la mesure du case-mix, à partir des GHM. Il reste à étudier quels systèmes de financement et/ou d'information pourraient remédier à l'apparente sous-estimation actuelle du mode de financement. [auteurs]]]> oai:serval.unil.ch:BIB_74D2C2162DD1 2022-05-07T01:20:34Z <oai_dc:dc xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:xs="http://www.w3.org/2001/XMLSchema" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd"> https://serval.unil.ch/notice/serval:BIB_74D2C2162DD1 Der akute anale Schmerz [Acute anal pain]. info:doi:10.1024/0040-5930/a000424 info:eu-repo/semantics/altIdentifier/doi/10.1024/0040-5930/a000424 info:eu-repo/semantics/altIdentifier/pmid/23798022 Pittet, O. Demartines, N. Hahnloser, D. info:eu-repo/semantics/review article 2013 Therapeutische Umschau. Revue Thérapeutique, vol. 70, no. 7, pp. 399-402 info:eu-repo/semantics/altIdentifier/pissn/0040-5930 urn:issn:0040-5930 <![CDATA[Acute anal pain is a common proctological problem. A detailed history together with the clinical examination are crucial for the diagnosis. An acute perianal vein thrombosis can be successfully excised within the first 72 hours. Acute anal fissures are best treated conservatively using stool regulation and topical medications reducing the sphincter spasm. A chronic anal fissure needs surgery. Perianal abscesses can very often be incised and drained in local anesthesia. Proctalgia fugax and the levator ani syndrome are exclusion diagnoses and are treated symptomatically

The Role of Whole Blood Impedance Aggregometry and Its Utilisation in the Diagnosis and Prognosis of Patients with Systemic Inflammatory Response Syndrome and Sepsis in Acute Critical Illness

Objective: To assess the prognostic and diagnostic value of whole blood impedance aggregometry in patients with sepsis and SIRS and to compare with whole blood parameters (platelet count, haemoglobin, haematocrit and white cell count). Methods: We performed an observational, prospective study in the acute setting. Platelet function was determined using whole blood impedance aggregometry (multiplate) on admission to the Emergency Department or Intensive Care Unit and at 6 and 24 hours post admission. Platelet count, haemoglobin, haematocrit and white cell count were also determined. Results: 106 adult patients that met SIRS and sepsis criteria were included. Platelet aggregation was significantly reduced in patients with severe sepsis/septic shock when compared to SIRS/uncomplicated sepsis (ADP: 90.7±37.6 vs 61.4±40.6; p<0.001, Arachadonic Acid 99.9±48.3 vs 66.3±50.2; p = 0.001, Collagen 102.6±33.0 vs 79.1±38.8; p = 0.001; SD ± mean)). Furthermore platelet aggregation was significantly reduced in the 28 day mortality group when compared with the survival group (Arachadonic Acid 58.8±47.7 vs 91.1±50.9; p<0.05, Collagen 36.6±36.6 vs 98.0±35.1; p = 0.001; SD ± mean)). However haemoglobin, haematocrit and platelet count were more effective at distinguishing between subgroups and were equally effective indicators of prognosis. Significant positive correlations were observed between whole blood impedance aggregometry and platelet count (ADP 0.588 p<0.0001, Arachadonic Acid 0.611 p<0.0001, Collagen 0.599 p<0.0001 (Pearson correlation)). Conclusions: Reduced platelet aggregometry responses were not only significantly associated with morbidity and mortality in sepsis and SIRS patients, but also correlated with the different pathological groups. Whole blood aggregometry significantly correlated with platelet count, however, when we adjust for the different groups we investigated, the effect of platelet count appears to be non-significant

Senior-COVID-Rea Cohort Study: A Geriatric Prediction Model of 30-day Mortality in Patients Aged over 60 Years in ICU for Severe COVID-19

International audienceThe SARS-COV2 pandemic induces tensions on health systems and ethical dilemmas. Practitioners need help tools to define patients not candidate for ICU admission. A multicentre observational study was performed to evaluate the impact of age and geriatric parameters on 30-day mortality in patients aged ≥60 years of age. Patients or next of kin were asked to answer a phone questionnaire assessing geriatric covariates 1 month before ICU admission. Among 290 screened patients, 231 were included between March 7 and May 7, 2020. In univariate, factors associated with lower 30-day survival were: age (per 10 years increase; OR 3.43, [95%CI: 2.13-5.53]), ≥3 CIRS-G grade ≥2 comorbidities (OR 2.49 [95%CI: 1.36-4.56]), impaired ADL, (OR 4.86 [95%CI: 2.44-9.72]), impaired IADL8 (OR 6.33 [95%CI: 3.31-12.10], p\textless0.001), frailty according to the Fried score (OR 4.33 [95%CI: 2.03-9.24]) or the CFS ≥5 (OR 3.79 [95%CI: 1.76-8.15]), 6-month fall history (OR 3.46 [95%CI: 1.58-7.63]). The final multivariate model included age (per 10 years increase; 2.94 [95%CI:1.78-5.04], p\textless0.001) and impaired IADL8 (OR 5.69 [95%CI: 2.90-11.47], p\textless0.001)). Considered as continuous variables, the model led to an AUC of 0.78 [95% CI: 0.72, 0.85]. Age and IADL8 provide independent prognostic factors for 30-day mortality in the considered population. Considering a risk of death exceeding 80% (82.6% [95%CI: 61.2% - 95.0%]), patients aged over 80 years with at least 1 IADL impairment appear as poor candidates for ICU admission

Intensive care-related loss of quality of life and autonomy at 6 months post-discharge: Does COVID-19 really make things worse?

International audienceOBJECTIVE: To compare old patients hospitalized in ICU for respiratory distress due to COVID-19 with old patients hospitalized in ICU for a non-COVID-19-related reason in terms of autonomy and quality of life. DESIGN: Comparison of two prospective multi-centric studies. SETTING: This study was based on two prospective multi-centric studies, the Senior-COVID-Rea cohort (COVID-19-diagnosed ICU-admitted patients aged over 60) and the FRAGIREA cohort (ICU-admitted patients aged over 70). PATIENTS: We included herein the patients from both cohorts who had been evaluated at day 180 after admission (ADL score and quality of life). INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: A total of 93 COVID-19 patients and 185 control-ICU patients were included. Both groups were not balanced on age, body mass index, mechanical ventilation, length of ICU stay, and ADL and SAPS II scores. We modeled with ordered logistic regression the influence of COVID-19 on the quality of life and the ADL score. After adjustment on these factors, we observed COVID-19 patients were less likely to have a loss of usual activities (aOR [95% CI] 0.47 [0.23; 0.94]), a loss of mobility (aOR [95% CI] 0.30 [0.14; 0.63]), and a loss of ADL score (aOR [95% CI] 0.30 [0.14; 0.63]). On day 180, 52 (56%) COVID-19 patients presented signs of dyspnea, 37 (40%) still used analgesics, 17 (18%) used anxiolytics, and 14 (13%) used antidepressant. CONCLUSIONS: COVID-19-related ICU stay was not associated with a lower quality of life or lower autonomy compared to non-COVID-19-related ICU stay

Prognosis of Old Intensive Care COVID-19 Patients at a Glance: The Senior COVID Study

International audienceOBJECTIVE: Admission in the intensive care unit of the old patient with coronavirus disease 19 raises an ethical question concerning the scarce resources and their short-term mortality. METHODS: Patients aged over 60 from 7 different intensive care units admitted between March 1, 2020 and May 6, 2020, with a diagnosis of coronavirus disease 19 were included in the cohort. Twenty variables were collected during the admission, such as age, severity (Simplified Acute Physiology Score [SAPS] II), several data on physiological status before intensive care unit comorbidities, evaluation of autonomy, frailty, and biological variables. The objective was to model the 30-day mortality with relevant variables, compute their odds ratio associated with their 95% CI, and produce a nomogram to easily estimate and communicate the 30-day mortality. The performance of the model was estimated with the area under the receiving operating curve. RESULTS: We included 231 patients, among them 60 (26.0%) patients have died on the 30th day. The relevant variables selected to explain the 30-day mortality were Instrumental Activities of Daily Living (IADL) score (0.82 [0.71-0.94]), age 1.12 (1.07-1.18), SAPS II 1.05 (1.02-1.08), and dementia 6.22 (1.00-38.58). A nomogram was computed to visually represent the final model. Area under the receiving operating curve was at 0.833 (0.776-0.889). CONCLUSIONS: Age, autonomy, dementia, and severity at admission were important predictive variables for the 30-day mortality status, and the nomogram could help the physician in the decision-making process and the communication with the family