New approach to the conceptual design of STUMM: A module dedicated to the monitoring of neutron and gamma radiation fields generated in IFMIF-DONES

International Fusion Materials Irradiation Facility — DEMOsingle bondOriented Neutron Source (IFMIF-DONES) is a planned powerful neutron source, which will generate an intense flux of neutrons (up to ∼1015n/s/cm2) with a fusion-relevant energy spectrum. It will be an accelerator source based on deuteron beam - lithium target reactions. The engineering design of IFMIF-DONES is elaborated in the frame of the Early Neutron Source work package of the EUROfusion consortium. The facility will be dedicated to the irradiation of suitable structural materials planned for the construction of future fusion reactors such as DEMO (Demonstration Fusion Power Plant). Start-up Monitoring Module (STUMM) is designed to monitor radiation and thermal conditions during the commissioning phase of IFMIF-DONES, characterize the produced neutron flux and validate neutronic modeling of the facility. The conceptual design of STUMM is prepared by a team of physicists and engineers from the Institute of Nuclear Physics Polish Academy of Sciences (IFJ PAN) and the National Centre for Nuclear Research (NCBJ), Poland. This paper presents the concept of STUMM, the proposed design of the module, and selected measuring systems

Extracorporeal membrane oxygenation support in COVID-19: an international cohort study of the Extracorporeal Life Support Organization registry

Background: Multiple major health organisations recommend the use of extracorporeal membrane oxygenation (ECMO) support for COVID-19-related acute hypoxaemic respiratory failure. However, initial reports of ECMO use in patients with COVID-19 described very high mortality and there have been no large, international cohort studies of ECMO for COVID-19 reported to date. Methods: We used data from the Extracorporeal Life Support Organization (ELSO) Registry to characterise the epidemiology, hospital course, and outcomes of patients aged 16 years or older with confirmed COVID-19 who had ECMO support initiated between Jan 16 and May 1, 2020, at 213 hospitals in 36 countries. The primary outcome was in-hospital death in a time-to-event analysis assessed at 90 days after ECMO initiation. We applied a multivariable Cox model to examine whether patient and hospital factors were associated with in-hospital mortality. Findings: Data for 1035 patients with COVID-19 who received ECMO support were included in this study. Of these, 67 (6%) remained hospitalised, 311 (30%) were discharged home or to an acute rehabilitation centre, 101 (10%) were discharged to a long-term acute care centre or unspecified location, 176 (17%) were discharged to another hospital, and 380 (37%) died. The estimated cumulative incidence of in-hospital mortality 90 days after the initiation of ECMO was 37·4% (95% CI 34·4–40·4). Mortality was 39% (380 of 968) in patients with a final disposition of death or hospital discharge. The use of ECMO for circulatory support was independently associated with higher in-hospital mortality (hazard ratio 1·89, 95% CI 1·20–2·97). In the subset of patients with COVID-19 receiving respiratory (venovenous) ECMO and characterised as having acute respiratory distress syndrome, the estimated cumulative incidence of in-hospital mortality 90 days after the initiation of ECMO was 38·0% (95% CI 34·6–41·5). Interpretation: In patients with COVID-19 who received ECMO, both estimated mortality 90 days after ECMO and mortality in those with a final disposition of death or discharge were less than 40%. These data from 213 hospitals worldwide provide a generalisable estimate of ECMO mortality in the setting of COVID-19. Funding: None