Physical activity monitoring in Europe : the European physical activity surveillance system (EUPASS) approach and indicator testing.

Objectives: The main objective of this paper is to describe the approach and specific findings of the European Physical Activity Surveillance System (EUPASS) research project. In particular, the analysis presented aims at testing the reliability, comparability and predictive power of different sets of physical activity (PA) indicators. Design: First, a panel study based on computer-aided telephone interview (CATI) was designed to report PA data of a representative, selected group of about 100 persons per country at three points in time. Second, a CATI time series survey was carried out with the goal of realising about 100 interviews per month over six consecutive months. Setting: The project was carried out in eight European countries to support the development of the European Union's (EU) Health Monitoring Programme. Subjects: Random population samples (subjects aged 18 years and older) were drawn from each participating country. Results: While many PA indicators used in EU countries to date as well as the psychosocial and environmental measures tested in the present study had acceptable to good reliability coefficients, the test–retest reliability scores of the International Physical Activity Questionnaire (IPAQ) version tested (the short (last 7 days) telephone interview IPAQ; IPAQ-S7T) were rather low. The comparability between extant national PA items and the IPAQ-S7T was low for all countries. The strongest predictors of perceived health were the psychosocial and environmental PA indicators. Conclusions: According to the results of the present study, more research is needed to further investigate and improve the quality of the IPAQ. In addition, the specific predictive power of the tested psychosocial and environmental PA indicators on perceived health should be of particular interest for designing health surveillance activities in the future

Computer Code System V. S. O. P. (99/11) Update 2011 of V.S.O.P(99)-Version 2009 CODE MANUAL

V.S.O.P. is a computer code system for the comprehensive numerical simulation of the physics of thermal reactors. The application of the code implies processing of cross sections, the set-up of the reactor and of the fuel element, neutron spectrum evaluation, neutron diffusion calculation, fuel burnup, fuel shuffling, reactor control, and thermal hydraulics of steady states and transients. The neutronics calculations can be performed in up to three dimensions. Thermal hydraulics is restricted to gas-cooled reactors in two spatial dimensions. Evaluation of fuel cycle costs over the reactor life time is made using the present worth method. A broad description of the features of the code has been published in Ref. /1/

Study on temperature coefficients of actinide burning HTGRs

HTGRs have the potential to achieve a high transmutation ratio, burning transuranium isotopes. The main reason is the large burnup, which is achieved by the fuel in the form of coated particles. In view of inherent safety features temperature coefficients have been studied for HTGR-fuel containing Pu and Minor Actinides in various fuel specifications in each case aiming at a high Pu burning ratio. The performed cell bumup calculations indicate, that HTGRs have the potential to achieve a high transmutation potential. In view of the temperature coefficients U$^{238}$ as breed material has an advantage compared to Th$^{232}$, maintaining a negative temperature coefficient even at a very high fuel burnup. In order to maximize the yearly depletion rate of Pu, small amounts should be loaded to the fuel elements without U. For utilizing Pu effectively, i.e. to achieve a long burnup cycle and a high burnup of the Pu loaded to the fuel elements, a high heavy metal loading including U as breed material is adequate

CIX - A Detector for Spectral Enhanced X-ray Imaging by Simultaneous Counting and Integrating

A hybrid pixel detector based on the concept of simultaneous charge integration and photon counting will be presented. The second generation of a counting and integrating X-ray prototype CMOS chip (CIX) has been operated with different direct converting sensor materials (CdZnTe and CdTe) bump bonded to its 8x8 pixel matrix. Photon counting devices give excellent results for low to medium X-ray fluxes but saturate at high rates while charge integration allows the detection of very high fluxes but is limited at low rates by the finite signal to noise ratio. The combination of both signal processing concepts therefore extends the resolvable dynamic range of the X-ray detector. In addition, for a large region of the dynamic range, where counter and integrator operate simultaneously, the mean energy of the detected X-ray spectrum can be calculated. This spectral information can be used to enhance the contrast of the X-ray image. The advantages of the counting and integrating signal processing concept and the performance of the imaging system will be reviewed. The properties of the system with respect to dynamic range and sensor response will be discussed and examples of imaging with additional spectral information will be presented.Comment: 12 pages, 14 figures, SPIE Medical Imaging Conference, San Diego, 200

Zur selbsttätig sicheren Begrenzung von nuklearer Leistung und Brennstofftemperatur in innovativen Kernreaktoren

Nuclear energy probably will not contribute significantly to the future worldwide energysupply until it can be made catastrophefree. Therefore it has to be shown, that theconsequences of even largest accidents will have no major impact to the environmentof a power plant.In this paper one of the basic conditions for such a nuclear technology is discussed.Using mainly the modular pebble-bed high-temperature reactor as an example, thedesign principles, analytical methods and the level of knowledge as given today incontrolling reactivity accidents by inherent safety features of innovative nuclear reactorsare described. Complementary possibilities are shown to reach this goal with systems ofdifferent types of construction . Questions open today and resulting requirements forfuture activities are discussed .Today's knowledge credibly supports the possibility of a catastrophefree nucleartechnology with respect to reactivity event

Quality of life and clinical outcomes in rectal cancer patients treated on a 1.5T MR-Linac within the MOMENTUM study

Background and purpose: This study assessed quality of life (QoL) and clinical outcomes in rectal cancer patients treated with magnetic resonance (MR) guided short-course radiation therapy (SCRT) on a 1.5 Tesla (T) MR-Linac during the first 12 months after treatment. Materials and methods: Rectal cancer patients treated with 25 Gy SCRT in five fractions with curative intent in the Netherlands (2019–2022) were identified in MOMENTUM (NCT04075305). Toxicity (CTCAE v5) and QoL (EORTC QLQ-C30 and -CR29) was primarily analyzed in patients without metastatic disease (M0) and no other therapies after SCRT. Patients who underwent tumor resection were censored from surgery. A generalized linear mixed-model was used to investigate clinically meaningful (≥10) and significant (P < 0.05) QoL changes. Clinical and pathological complete response (cCR and pCR) rates were calculated in patients in whom response was documented. Results: A total of 172 patients were included, of whom 112 patients were primarily analyzed. Acute and late radiation-induced high-grade toxicity were reported in one patient, respectively. CCR was observed in 8/64 patients (13 %), 14/37 patients (38 %) and 13/16 patients (91 %) at three, six and twelve months; pCR was observed in 3/69 (4 %) patients. After 12 months, diarrhea (mean difference [MD] −17.4 [95 % confidence interval [CI] −31.2 to −3.7]), blood and mucus in stool (MD −31.1 [95 % CI −46.4 to −15.8]), and anxiety (MD –22.4 [95 % CI −34.0 to −10.9]) were improved. Conclusion: High-field MR-guided SCRT for the treatment of patients with rectal cancer is associated with improved disease-related symptom management and functioning one year after treatment

Effect of a prediction tool and communication skills training on communication of treatment outcomes: a multicenter stepped wedge clinical trial (the SOURCE trial)

Background: For cancer patients to effectively engage in decision making, they require comprehensive and understandable information regarding treatment options and their associated outcomes. We developed an online prediction tool and supporting communication skills training to assist healthcare providers (HCPs) in this complex task. This study aims to assess the impact of this combined intervention (prediction tool and training) on the communication practices of HCPs when discussing treatment options. Methods: We conducted a multicenter intervention trial using a pragmatic stepped wedge design (NCT04232735). Standardized Patient Assessments (simulated consultations) using cases of esophageal and gastric cancer patients, were performed before and after the combined intervention (March 2020 to July 2022). Audio recordings were analyzed using an observational coding scale, rating all utterances of treatment outcome information on the primary outcome–precision of provided outcome information–and on secondary outcomes–such as: personalization, tailoring and use of visualizations. Pre vs. post measurements were compared in order to assess the effect of the intervention. Findings: 31 HCPs of 11 different centers in the Netherlands participated. The tool and training significantly affected the precision of the overall communicated treatment outcome information (p = 0.001, median difference 6.93, IQR (−0.32 to 12.44)). In the curative setting, survival information was significantly more precise after the intervention (p = 0.029). In the palliative setting, information about side effects was more precise (p < 0.001). Interpretation: A prediction tool and communication skills training for HCPs improves the precision of treatment information on outcomes in simulated consultations. The next step is to examine the effect of such interventions on communication in clinical practice and on patient-reported outcomes. Funding: Financial support for this study was provided entirely by a grant from the Dutch Cancer Society (UVA 2014-7000)

Physical activity as a possible mechanism behind the relationship between green space and health: A multilevel analysis

Background: The aim of this study was to investigate whether physical activity (in general, and more specifically, walking and cycling during leisure time and for commuting purposes, sports and gardening) is an underlying mechanism in the relationship between the amount of green space in people's direct living environment and self-perceived health. To study this, we first investigated whether the amount of green space in the living environment is related to the level of physical activity. When an association between green space and physical activity was found, we analysed whether this could explain the relationship between green space and health. Methods: The study includes 4.899 Dutch people who were interviewed about physical activity, self-perceived health and demographic and socioeconomic background. The amount of green space within a one-kilometre and a three-kilometre radius around the postal code coordinates was calculated for each individual. Multivariate multilevel analyses and multilevel logistic regression analyses were performed at two levels and with controls for socio-demographic characteristics and urbanicity. Results: No relationship was found between the amount of green space in the living environment and whether or not people meet the Dutch public health recommendations for physical activity, sports and walking for commuting purposes. People with more green space in their living environment walked and cycled less often and fewer minutes during leisure time; people with more green space garden more often and spend more time on gardening. Furthermore, if people cycle for commuting purposes they spend more time on this if they live in a greener living environment. Whether or not people garden, the time spent on gardening and time spent on cycling for commuting purposes did not explain the relationship between green space and health. Conclusion: Our study indicates that the amount of green space in the living environment is scarcely related to the level of physical activity. Furthermore, the amount of physical activity undertaken in greener living environments does not explain the relationship between green space and health.

CMS physics technical design report : Addendum on high density QCD with heavy ions

Peer reviewe