Joint Assessment of ETRR-2 Research Reactor Operations Program, Capabilities, and Facilities

A joint assessment meeting was conducted at the Egyptian Atomic Energy Agency (EAEA) followed by a tour of Egyptian Second Research Reactor (ETRR-2) on March 22 and 23, 2006. The purpose of the visit was to evaluate the capabilities of the new research reactor and its operations under Action Sheet 4 between the U.S. DOE and the EAEA, ''Research Reactor Operation'', and Action Sheet 6, ''Technical assistance in The Production of Radioisotopes''. Preliminary Recommendations of the joint assessment are as follows: (1) ETRR-2 utilization should be increased by encouraging frequent and sustained operations. This can be accomplished in part by (a) Improving the supply-chain management for fresh reactor fuel and alleviating the perception that the existing fuel inventory should be conserved due to unreliable fuel supply; and (b) Promulgating a policy for sample irradiation priority that encourages the use of the reactor and does not leave the decision of when to operate entirely at the discretion of reactor operations staff. (2) Each experimental facility in operation or built for a single purpose should be reevaluated to focus on those that most meet the goals of the EAEA strategic business plan. Temporary or long-term elimination of some experimental programs might be necessary to provide more focused utilization. There may be instances of emerging reactor applications for which no experimental facility is yet designed or envisioned. In some cases, an experimental facility may have a more beneficial use than the purpose for which it was originally designed. For example, (a) An effective Boron Neutron Capture Therapy (BNCT) program requires nearby high quality medical facilities. These facilities are not available and are unlikely to be constructed near the Inshas site. Further, the BNCT facility is not correctly designed for advanced research and therapy programs using epithermal neutrons. (b) The ETRR-2 is frequently operated to provide color-enhanced gemstones but is operated infrequently for radioisotope production. Because the two irradiation programs compete by utilizing the same core locations, the issues should be resolved at a high level. (c) Cobalt-60 production uses the most valuable irradiation location in the ETRR-2 (the high neutron density flux-trap), but there seems to be no potential customer for the Co-60. Further, the low number of hours the reactor is operated per week precludes ever producing a marketable specific activity of Co-60. Accordingly, Co-60 production should be reevaluated. (d) ETRR-2 staff would benefit from additional training to successfully design new experiment facilities and utilize existing facilities more effectively. This training can include IAEA Fellowships, as well as topical DOE Sister Laboratory visits to gain experience using equipment and research tools at other research reactor facilities

An active inference model of car following: Advantages and applications

Driver process models play a central role in the testing, verification, and development of automated and autonomous vehicle technologies. Prior models developed from control theory and physics-based rules are limited in automated vehicle applications due to their restricted behavioral repertoire. Data-driven machine learning models are more capable than rule-based models but are limited by the need for large training datasets and their lack of interpretability, i.e., an understandable link between input data and output behaviors. We propose a novel car following modeling approach using active inference, which has comparable behavioral flexibility to data-driven models while maintaining interpretability. We assessed the proposed model, the Active Inference Driving Agent (AIDA), through a benchmark analysis against the rule-based Intelligent Driver Model, and two neural network Behavior Cloning models. The models were trained and tested on a real-world driving dataset using a consistent process. The testing results showed that the AIDA predicted driving controls significantly better than the rule-based Intelligent Driver Model and had similar accuracy to the data-driven neural network models in three out of four evaluations. Subsequent interpretability analyses illustrated that the AIDA's learned distributions were consistent with driver behavior theory and that visualizations of the distributions could be used to directly comprehend the model's decision making process and correct model errors attributable to limited training data. The results indicate that the AIDA is a promising alternative to black-box data-driven models and suggest a need for further research focused on modeling driving style and model training with more diverse datasets

Engineering the growth of germanium nanowires by tuning the supersaturation of Au/Ge binary alloy catalysts

The synthesis of Ge nanowires with very high-aspect ratios (greater than 1000) and uniform crystal growth directions is highly desirable, not only for investigating the fundamental properties of nanoscale materials but also for fabricating integrated functional nanodevices. In this article, we present a unique approach for manipulating the supersaturation, and thus the growth kinetics, of Ge nanowires using Au/Ge bilayer films. Ge nanowires were synthesized on substrates consisting of two parts: a Au film on one-half of a Si substrate and a Au/Ge bilayer film on the other half of the substrate. Upon annealing the substrate, Au and Au/Ge binary alloy catalysts were formed on both the Au and Au/Ge-sides of the substrates, respectively, under identical conditions. The mean lengths of Ge nanowires produced were found to be significantly longer on the Au/Ge bilayer side of the substrate compared to the Au-coated side, as a result of a reduced incubation time for nucleation on the bilayer side. The mean length and growth rate on the bilayer side (with a 1 nm Ge film) was found to be 5.5 ± 2.3 μm and 3.7 × 10–3 μm s–1, respectively, and 2.7 ± 0.8 μm and 1.8 × 10–3 μm s–1 for the Au film. Additionally, the lengths and growth rates of the nanowires further increased as the thickness of the Ge layer in the Au/Ge bilayer was increased. In-situ TEM experiments were performed to probe the kinetics of Ge nanowire growth from the Au/Ge bilayer substrates. Diffraction contrast during in situ heating of the bilayer films clarified the fact that thinner Ge films, that is, lower Ge concentration, take longer to alloy with Au than thicker films. Phase separation was also more significant for thicker Ge films upon cooling. The use of binary alloy catalyst particles, instead of the more commonly used elementary metal catalyst, enabled the supersaturation of Ge during nanowire growth to be readily tailored, offering a unique approach to producing very long high aspect ratio nanowires

AMMECR1: a single point mutation causes developmental delay, midface hypoplasia and elliptocytosis

Background: Deletions in the Xq22.3–Xq23 region, inclusive of COL4A5, have been associated with a contiguous gene deletion syndrome characterised by Alport syndrome with intellectual disability (Mental retardation), Midface hypoplasia and Elliptocytosis (AMME). The extrarenal biological and clinical significance of neighbouring genes to the Alport locus has been largely speculative. We sought to discover a genetic cause for two half-brothers presenting with nephrocalcinosis, early speech and language delay and midface hypoplasia with submucous cleft palate and bifid uvula.Methods: Whole exome sequencing was undertaken on maternal half-siblings. In-house genomic analysis included extraction of all shared variants on the X chromosome in keeping with X-linked inheritance. Patient-specific mutants were transfected into three cell lines and microscopically visualised to assess the nuclear expression pattern of the mutant protein.Results: In the affected half-brothers, we identified a hemizygous novel non-synonymous variant of unknown significance in AMMECR1 (c.G530A; p.G177D), a gene residing in the AMME disease locus. Transfected cell lines with the p.G177D mutation showed aberrant nuclear localisation patterns when compared with the wild type. Blood films revealed the presence of elliptocytes in the older brother.Conclusions: Our study shows that a single missense mutation in AMMECR1 causes a phenotype of midface hypoplasia, mild intellectual disability and the presence of elliptocytes, previously reported as part of a contiguous gene deletion syndrome. Functional analysis confirms mutant-specific protein dysfunction. We conclude that AMMECR1 is a critical gene in the pathogenesis of AMME, causing midface hypoplasia and elliptocytosis and contributing to early speech and language delay, infantile hypotonia and hearing loss, and may play a role in dysmorphism, nephrocalcinosis and submucous cleft palate.<br/

East Midlands Research into Ageing Network (EMRAN) Discussion Paper Series

Academic geriatric medicine in Leicester . There has never been a better time to consider joining us. We have recently appointed a Professor in Geriatric Medicine, alongside Tom Robinson in stroke and Victoria Haunton, who has just joined as a Senior Lecturer in Geriatric Medicine. We have fantastic opportunities to support students in their academic pursuits through a well-established intercalated BSc programme, and routes on through such as ACF posts, and a successful track-record in delivering higher degrees leading to ACL post. We collaborate strongly with Health Sciences, including academic primary care. See below for more detail on our existing academic set-up. Leicester Academy for the Study of Ageing We are also collaborating on a grander scale, through a joint academic venture focusing on ageing, the ‘Leicester Academy for the Study of Ageing’ (LASA), which involves the local health service providers (acute and community), De Montfort University; University of Leicester; Leicester City Council; Leicestershire County Council and Leicester Age UK. Professors Jayne Brown and Simon Conroy jointly Chair LASA and have recently been joined by two further Chairs, Professors Kay de Vries and Bertha Ochieng. Karen Harrison Dening has also recently been appointed an Honorary Chair. LASA aims to improve outcomes for older people and those that care for them that takes a person-centred, whole system perspective. Our research will take a global perspective, but will seek to maximise benefits for the people of Leicester, Leicestershire and Rutland, including building capacity. We are undertaking applied, translational, interdisciplinary research, focused on older people, which will deliver research outcomes that address domains from: physical/medical; functional ability, cognitive/psychological; social or environmental factors. LASA also seeks to support commissioners and providers alike for advice on how to improve care for older people, whether by research, education or service delivery. Examples of recent research projects include: ‘Local History Café’ project specifically undertaking an evaluation on loneliness and social isolation; ‘Better Visits’ project focused on improving visiting for family members of people with dementia resident in care homes; and a study on health issues for older LGBT people in Leicester. Clinical Geriatric Medicine in Leicester We have developed a service which recognises the complexity of managing frail older people at the interface (acute care, emergency care and links with community services). There are presently 17 consultant geriatricians supported by existing multidisciplinary teams, including the largest complement of Advance Nurse Practitioners in the country. Together we deliver Comprehensive Geriatric Assessment to frail older people with urgent care needs in acute and community settings. The acute and emergency frailty units – Leicester Royal Infirmary This development aims at delivering Comprehensive Geriatric Assessment to frail older people in the acute setting. Patients are screened for frailty in the Emergency Department and then undergo a multidisciplinary assessment including a consultant geriatrician, before being triaged to the most appropriate setting. This might include admission to in-patient care in the acute or community setting, intermediate care (residential or home based), or occasionally other specialist care (e.g. cardiorespiratory). Our new emergency department is the county’s first frail friendly build and includes fantastic facilities aimed at promoting early recovering and reducing the risk of hospital associated harms. There is also a daily liaison service jointly run with the psychogeriatricians (FOPAL); we have been examining geriatric outreach to oncology and surgery as part of an NIHR funded study. We are home to the Acute Frailty Network, and those interested in service developments at the national scale would be welcome to get involved. Orthogeriatrics There are now dedicated hip fracture wards and joint care with anaesthetists, orthopaedic surgeons and geriatricians. There are also consultants in metabolic bone disease that run clinics. Community work Community work will consist of reviewing patients in clinic who have been triaged to return to the community setting following an acute assessment described above. Additionally, primary care colleagues refer to outpatients for sub-acute reviews. You will work closely with local GPs with support from consultants to deliver post-acute, subacute, intermediate and rehabilitation care services. Stroke Medicine 24/7 thrombolysis and TIA services. The latter is considered one of the best in the UK and along with the high standard of vascular surgery locally means one of the best performances regarding carotid intervention

General practitioner workforce planning: assessment of four policy directions

<p>Abstract</p> <p>Background</p> <p>Estimating the supply of GPs into the future is important in forecasting shortages. The lengthy training process for medicine means that adjusting supply to meet demand in a timely fashion is problematic. This study uses Ireland as a case study to determine the future demand and supply of GPs and to assess the potential impact of several possible interventions to address future shortages.</p> <p>Methods</p> <p>Demand was estimated by applying GP visit rates by age and sex to national population projections. Supply was modelled using a range of parameters derived from two national surveys of GPs. A stochastic modelling approach was adopted to determine the probable future supply of GPs. Four policy interventions were tested: increasing vocational training places; recruiting GPs from abroad; incentivising later retirement; increasing nurse substitution to enable practice nurses to deliver more services.</p> <p>Results</p> <p>Relative to most other European countries, Ireland has few GPs per capita. Ireland has an ageing population and demand is estimated to increase by 19% by 2021. Without intervention, the supply of GPs will be 5.7% less than required in 2021. Increasing training places will enable supply to meet demand but only after 2019. Recruiting GPs from overseas will enable supply to meet demand continuously if the number recruited is approximately 0.8 per cent of the current workforce per annum. Later retirement has only a short-term impact. Nurse substitution can enable supply to meet demand but only if large numbers of practice nurses are recruited and allowed to deliver a wide range of GP services.</p> <p>Conclusions</p> <p>A significant shortfall in GP supply is predicted for Ireland unless recruitment is increased. The shortfall will have numerous knock-on effects including price increases, longer waiting lists and an increased burden on hospitals. Increasing training places will not provide an adequate response to future shortages. Foreign recruitment has ethical considerations but may provide a rapid and effective response. Increased nurse substitution appears to offer the best long-term prospects of addressing GP shortages and presents the opportunity to reshape general practice to meet the demands of the future.</p

APRIL is a novel clinical chemo-resistance biomarker in colorectal adenocarcinoma identified by gene expression profiling

<p>Abstract</p> <p>Background</p> <p>5-Fluorouracil(5FU) and oral analogues, such as capecitabine, remain one of the most useful agents for the treatment of colorectal adenocarcinoma. Low toxicity and convenience of administration facilitate use, however clinical resistance is a major limitation. Investigation has failed to fully explain the molecular mechanisms of resistance and no clinically useful predictive biomarkers for 5FU resistance have been identified. We investigated the molecular mechanisms of clinical 5FU resistance in colorectal adenocarcinoma patients in a prospective biomarker discovery project utilising gene expression profiling. The aim was to identify novel 5FU resistance mechanisms and qualify these as candidate biomarkers and therapeutic targets.</p> <p>Methods</p> <p>Putative treatment specific gene expression changes were identified in a transcriptomics study of rectal adenocarcinomas, biopsied and profiled before and after pre-operative short-course radiotherapy or 5FU based chemo-radiotherapy, using microarrays. Tumour from untreated controls at diagnosis and resection identified treatment-independent gene expression changes. Candidate 5FU chemo-resistant genes were identified by comparison of gene expression data sets from these clinical specimens with gene expression signatures from our previous studies of colorectal cancer cell lines, where parental and daughter lines resistant to 5FU were compared. A colorectal adenocarcinoma tissue microarray (n = 234, resected tumours) was used as an independent set to qualify candidates thus identified.</p> <p>Results</p> <p>APRIL/TNFSF13 mRNA was significantly upregulated following 5FU based concurrent chemo-radiotherapy and in 5FU resistant colorectal adenocarcinoma cell lines but not in radiotherapy alone treated colorectal adenocarcinomas. Consistent withAPRIL's known function as an autocrine or paracrine secreted molecule, stromal but not tumour cell protein expression by immunohistochemistry was correlated with poor prognosis (p = 0.019) in the independent set. Stratified analysis revealed that protein expression of APRIL in the tumour stroma is associated with survival in adjuvant 5FU treated patients only (n = 103, p < 0.001), and is independently predictive of lack of clinical benefit from adjuvant 5FU [HR 6.25 (95%CI 1.48-26.32), p = 0.013].</p> <p>Conclusions</p> <p>A combined investigative model, analysing the transcriptional response in clinical tumour specimens and cancers cell lines, has identified APRIL, a novel chemo-resistance biomarker with independent predictive impact in 5FU-treated CRC patients, that may represent a target for novel therapeutics.</p

Municipal solid waste management under Covid-19: Challenges and recommendations

Covid-19 is proving to be an unprecedented disaster for human health, social contacts and the economy worldwide. It is evident that SARS-CoV-2 may spread through municipal solid waste (MSW), if collected, bagged, handled, transported or disposed of inappropriately. Under the stress placed by the current pandemic on the sanitary performance across all MSW management (MSWM) chains, this industry needs to re-examine its infrastructure resilience with respect to all processes, from waste identification, classification, collection, separation, storage, transportation, recycling, treatment and disposal. The current paper provides an overview of the severe challenges placed by Covid-19 onto MSW systems, highlighting the essential role of waste management in public health protection during the ongoing pandemic. It also discusses the measures issued by various international organisations and countries for the protection of MSWM employees (MSWEs), identifying gaps, especially for developing countries, where personal protection equipment and clear guidelines to MSWEs may not have been provided, and the general public may not be well informed. In countries with high recycling rates of MSW, the need to protect MSWEs' health has affected the supply stream of the recycling industry. The article concludes with recommendations for the MSW industry operating under public health crisis conditions