Experimental Characterization of a Passive Emergency Heat Removal System for a GenIII + Reactor

Among the several types of passive safety systems adopted in new generation reactor designs, the experimental investigation of a closed loop, two-phase flow, natural circulation system is depicted. Emergency Heat Removal Systems (EHRSs) based on this solution are envisaged as safety-engineered features for advanced nuclear reactors, as in the IRIS reactor. An experimental facility simulating one EHRS-like loop has been built and operated at SIET labs in Piacenza (Italy). The facility is a natural circulation, sliding pressure, and electrically heated loop, with a helical coil steam generator as a heat source and a horizontal tube pool condenser as a heat sink. A steady-state analysis is provided to characterize the system behaviour and its key parameters. Because of the loop limited volume, oscillations of the main parameters (temperatures, flowrate, pressure) may be expected. The oscillating phenomena detected during the experimental campaign are discussed; a reasonable explanation is at last proposed

On Density Wave Instability Phenomena – Modelling and Experimental Investigation

Density Wave Oscillations (DWOs) are dealt with in this work as the most representative instabilities frequently encountered in the boiling systems. This dynamic type instability mode – resulting from multiple feedback effects between the flow rate, the vapour generation rate and the pressure drops in the boiling channel – constitutes an issue of special interest for the design of industrial systems and equipments involving vapour generation. The chapter is structured as follows. Physical insight into the distinctive features leading to DWO mechanism is provided in Section 2. Modelling and experimental investigations on instability phenomena available from the open literature are described in Section 3. Section 4 and 5 present the analytical modelling developed in this work for DWO theoretical predictions, whereas numerical modelling (using RELAP5 and COMSOL codes) is briefly discussed in Section 6. Modelling efforts start necessarily from the simplifying and sound case of straight vertical tube geometry, which is referenced for validating the whole modelling tools. Description of the experimental campaign for DWO characterization in helical coil tubes is shortly presented in Section 7. The peculiar influence of the helical shape on the instability occurrence is examined in Section 8. Suited modifications of the models are introduced in order to simulate the experimental results

Revising the Emergency Management Requirements for new generation reactors

The paper presents the application of a new risk-informed methodology for the identification of the Emergency Management Requirements (EMR) to a Generation II, Large size Reactor and a Generation III+ Small Modular Reactor. The results obtained in this test case demonstrate that the actual EMR is conservative, as expected, for the GenII reactor, while the new methodology could be applied for the definition of EMRs for the new generation Nuclear Power Plants, with a possible reduction of the emergency area without loss of safety level. By adopting both probabilistic and deterministic approaches, the study addresses possible accidents and corresponding release scenarios for the two types of reactor, calculates the areas where the accidents have an impact on the population and defines the new EMR considering the health effects on the population

A Feasibility Study of an Integral PWR for Space Applications

Fission space power systems are well suited to provide safe, reliable, economic and robust energy sources, in the order of 100 KWe. A preliminary feasibility study of a nuclear fission reactor is here presented with the following requirements: i) high reliability, ii) R&D program of moderate cost, iii) to be deployed within a reasonable period of time (e.g. 2015), iv) to be operated and controlled for a long time (10 years) without human intervention, v) possibly to be also used as a byproduct for some particular terrestrial application (or at least to share common technologies), vi) to start with stationary application. The driving idea is to extend as much as possible the PWR technology, by recurring to an integral type reactor. Two options are evaluated for the electricity production: a Rankine steam cycle and a Rankine organic fluid cycle. The neutronics calculation is based on WIMS code benchmarked with MCNP code. The reactivity control is envisaged by changing the core geometry. The resulting system appears viable and of reasonable size, well fit to the present space vector capabilities. Finally, a set of R&D needs has been identified: cold well, small steam turbines, fluid leakage control, pumps, shielding, steam generator in low-gravity conditions, self pressurizer, control system. A R&D program of reasonable extent may yield the needed answers, and some demanding researches are of interest for the new generation Light Water Reactors

Cogeneration: An option to facilitate load following in Small Modular Reactors

Nuclear Power Plants (NPPs) have been historically deployed to cover the base-load of the electricity demand. Nowadays some NPPs might perform daily load cycling operation (i.e. load following) between 50% and 100% of their rated power. With respect to the insertion of control rods or comparable action to reduce the nuclear power generation, a more efficient alternative might be the “Load Following by Cogeneration”, i.e. diverting the excess of power, respect to the electricity demand, to an auxiliary system. A suitable cogeneration system needs: 1. To have a demand of electricity and/or heat in the region of 500 MWe–1.5 GWt; 2. To meet a significant market demand; 3. To have access to adequate input to process; 4. To be flexible: cogeneration might operate at full load during the night when the request of electricity is low, and be turned off during the daytime. From the economic standpoint, it is essential that the investment in the auxiliary system is profitable. This paper provides a techno-economic assessment of systems potentially suitable for coupling with a NPP for load following. The results show that district heating, desalination and hydrogen might be technically and economically feasible

The NorthStar Ambulatory Assessment in Duchenne muscular dystrophy:Considerations for the design of clinical trials

Objective: With the emergence of experimental therapies for Duchenne muscular dystrophy (DMD), it is fundamental to understand the natural history of this disorder to properly design clinical trials. The aims of this study were to assess the effects produced on motor function by different DMD genotypes and early initiation of glucocorticoids. Methods: Through the NorthStar Network, standardised clinical data including the NorthStar Ambulatory Assessment score (NSAA) on 513 ambulant UK boys with DMD were analysed from 2004 to 2012. For the analysis of the genetic subpopulation, we also included data from 172 Italian boys with DMD. NSAA raw scores were converted into linear scores. Results: On the linearised NSAA, we observed an average decline of 8 units/year (4 units on raw NSAA analysis) after age 7. The median age at loss of ambulation (LOA) was 13 years (95% CI 12.1 to 13.5); 2 years prior to LOA, the estimated mean linearised NSAA score was 42/100 (13/34 raw scale). Starting glucocorticoids between 3 and 5 years conferred an additional gain in motor function of 3 units/year (1.3 raw units) up to age 7. When analysing the effect of genotype in the UK and Italian cumulative cohorts, individuals with deletions amenable to exons 44 and 46 skipping declined at a slower rate over 2 years (9 units (4 raw units), p<0.001), while 53 and 51 skippable deletions showed a faster decline of 14 (4.5; p<0.001) and 5 linearised units (2.4 NSAA units; p=0.02), respectively. Conclusions: Our study provides a novel insight on the current natural history of DMD, which will be instrumental for the design of future clinical trials

Why Are Outcomes Different for Registry Patients Enrolled Prospectively and Retrospectively? Insights from the Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF).

Background: Retrospective and prospective observational studies are designed to reflect real-world evidence on clinical practice, but can yield conflicting results. The GARFIELD-AF Registry includes both methods of enrolment and allows analysis of differences in patient characteristics and outcomes that may result. Methods and Results: Patients with atrial fibrillation (AF) and ≥1 risk factor for stroke at diagnosis of AF were recruited either retrospectively (n = 5069) or prospectively (n = 5501) from 19 countries and then followed prospectively. The retrospectively enrolled cohort comprised patients with established AF (for a least 6, and up to 24 months before enrolment), who were identified retrospectively (and baseline and partial follow-up data were collected from the emedical records) and then followed prospectively between 0-18 months (such that the total time of follow-up was 24 months; data collection Dec-2009 and Oct-2010). In the prospectively enrolled cohort, patients with newly diagnosed AF (≤6 weeks after diagnosis) were recruited between Mar-2010 and Oct-2011 and were followed for 24 months after enrolment. Differences between the cohorts were observed in clinical characteristics, including type of AF, stroke prevention strategies, and event rates. More patients in the retrospectively identified cohort received vitamin K antagonists (62.1% vs. 53.2%) and fewer received non-vitamin K oral anticoagulants (1.8% vs . 4.2%). All-cause mortality rates per 100 person-years during the prospective follow-up (starting the first study visit up to 1 year) were significantly lower in the retrospective than prospectively identified cohort (3.04 [95% CI 2.51 to 3.67] vs . 4.05 [95% CI 3.53 to 4.63]; p = 0.016). Conclusions: Interpretations of data from registries that aim to evaluate the characteristics and outcomes of patients with AF must take account of differences in registry design and the impact of recall bias and survivorship bias that is incurred with retrospective enrolment. Clinical Trial Registration: - URL: http://www.clinicaltrials.gov . Unique identifier for GARFIELD-AF (NCT01090362)

Improved risk stratification of patients with atrial fibrillation: an integrated GARFIELD-AF tool for the prediction of mortality, stroke and bleed in patients with and without anticoagulation.

OBJECTIVES: To provide an accurate, web-based tool for stratifying patients with atrial fibrillation to facilitate decisions on the potential benefits/risks of anticoagulation, based on mortality, stroke and bleeding risks. DESIGN: The new tool was developed, using stepwise regression, for all and then applied to lower risk patients. C-statistics were compared with CHA2DS2-VASc using 30-fold cross-validation to control for overfitting. External validation was undertaken in an independent dataset, Outcome Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF). PARTICIPANTS: Data from 39 898 patients enrolled in the prospective GARFIELD-AF registry provided the basis for deriving and validating an integrated risk tool to predict stroke risk, mortality and bleeding risk. RESULTS: The discriminatory value of the GARFIELD-AF risk model was superior to CHA2DS2-VASc for patients with or without anticoagulation. C-statistics (95% CI) for all-cause mortality, ischaemic stroke/systemic embolism and haemorrhagic stroke/major bleeding (treated patients) were: 0.77 (0.76 to 0.78), 0.69 (0.67 to 0.71) and 0.66 (0.62 to 0.69), respectively, for the GARFIELD-AF risk models, and 0.66 (0.64-0.67), 0.64 (0.61-0.66) and 0.64 (0.61-0.68), respectively, for CHA2DS2-VASc (or HAS-BLED for bleeding). In very low to low risk patients (CHA2DS2-VASc 0 or 1 (men) and 1 or 2 (women)), the CHA2DS2-VASc and HAS-BLED (for bleeding) scores offered weak discriminatory value for mortality, stroke/systemic embolism and major bleeding. C-statistics for the GARFIELD-AF risk tool were 0.69 (0.64 to 0.75), 0.65 (0.56 to 0.73) and 0.60 (0.47 to 0.73) for each end point, respectively, versus 0.50 (0.45 to 0.55), 0.59 (0.50 to 0.67) and 0.55 (0.53 to 0.56) for CHA2DS2-VASc (or HAS-BLED for bleeding). Upon validation in the ORBIT-AF population, C-statistics showed that the GARFIELD-AF risk tool was effective for predicting 1-year all-cause mortality using the full and simplified model for all-cause mortality: C-statistics 0.75 (0.73 to 0.77) and 0.75 (0.73 to 0.77), respectively, and for predicting for any stroke or systemic embolism over 1 year, C-statistics 0.68 (0.62 to 0.74). CONCLUSIONS: Performance of the GARFIELD-AF risk tool was superior to CHA2DS2-VASc in predicting stroke and mortality and superior to HAS-BLED for bleeding, overall and in lower risk patients. The GARFIELD-AF tool has the potential for incorporation in routine electronic systems, and for the first time, permits simultaneous evaluation of ischaemic stroke, mortality and bleeding risks. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier for GARFIELD-AF (NCT01090362) and for ORBIT-AF (NCT01165710)

Two-year outcomes of patients with newly diagnosed atrial fibrillation: results from GARFIELD-AF.

AIMS: The relationship between outcomes and time after diagnosis for patients with non-valvular atrial fibrillation (NVAF) is poorly defined, especially beyond the first year. METHODS AND RESULTS: GARFIELD-AF is an ongoing, global observational study of adults with newly diagnosed NVAF. Two-year outcomes of 17 162 patients prospectively enrolled in GARFIELD-AF were analysed in light of baseline characteristics, risk profiles for stroke/systemic embolism (SE), and antithrombotic therapy. The mean (standard deviation) age was 69.8 (11.4) years, 43.8% were women, and the mean CHA2DS2-VASc score was 3.3 (1.6); 60.8% of patients were prescribed anticoagulant therapy with/without antiplatelet (AP) therapy, 27.4% AP monotherapy, and 11.8% no antithrombotic therapy. At 2-year follow-up, all-cause mortality, stroke/SE, and major bleeding had occurred at a rate (95% confidence interval) of 3.83 (3.62; 4.05), 1.25 (1.13; 1.38), and 0.70 (0.62; 0.81) per 100 person-years, respectively. Rates for all three major events were highest during the first 4 months. Congestive heart failure, acute coronary syndromes, sudden/unwitnessed death, malignancy, respiratory failure, and infection/sepsis accounted for 65% of all known causes of death and strokes for <10%. Anticoagulant treatment was associated with a 35% lower risk of death. CONCLUSION: The most frequent of the three major outcome measures was death, whose most common causes are not known to be significantly influenced by anticoagulation. This suggests that a more comprehensive approach to the management of NVAF may be needed to improve outcome. This could include, in addition to anticoagulation, interventions targeting modifiable, cause-specific risk factors for death. CLINICAL TRIAL REGISTRATION: http://www.clinicaltrials.gov. Unique identifier: NCT01090362