Personnel dose equivalent monitoring at SLAC using lithium-fluoride TLD's (thermoluminescent dosimeters)

TLD's replaced film badges in the early 1970's for all dose equivalent monitoring, both neutron and photon, and for all locations at SLAC. The photon TLD's, composed of Li-7 loaded teflon discs, are calibrated using conventional gamma-ray sources; i.e., Co-60, Cs-137, etc. For these TLD's a nominal value of 1 nC/mrem is used, and is independent of source energy for 100 keV to 3 MeV. Since measured dose equivalents at SLAC are only a small fraction of the allowable levels, it was not deemed necessary to develop neutron dosimeters which would measure dose equivalent accurately for all possible neutron spectra. Today, wallet TLD's, composed of pairs of Li-7 and Li-6 discs, are used, with the Li-6 measuring only thermal neutrons; i.e., they aren't moderated in any way to make them sensitive to neutrons with energies greater than thermal. The assumption is made that there is a correlation between thermal neutron fluences and fast neutron fluences around the research area where almost all neutron doses (exclusive of sealed sources) are received. The calibration factor for these Li-6 TLD's is 1 nC/mrem of fast neutrons. The method of determining the validity of this calibration is the subject of this note. 4 refs., 9 figs., 1 tab

Cardiorenal end points in a trial of aliskiren for type 2 diabetes.

Background This study was undertaken to determine whether use of the direct renin inhibitor aliskiren would reduce cardiovascular and renal events in patients with type 2 dia- betes and chronic kidney disease, cardiovascular disease, or both. Methods In a double-blind fashion, we randomly assigned 8561 patients to aliskiren (300 mg daily) or placebo as an adjunct to an angiotensin-converting\u2013enzyme inhibitor or an angiotensin-receptor blocker. The primary end point was a composite of the time to cardiovascular death or a first occurrence of cardiac arrest with resuscitation; nonfatal myocardial infarction; nonfatal stroke; unplanned hospitalization for heart failure; end-stage renal disease, death attributable to kidney failure, or the need for renal-replacement therapy with no dialysis or transplantation available or initiated; or doubling of the baseline serum creatinine level. Results The trial was stopped prematurely after the second interim efficacy analysis. After a median follow-up of 32.9 months, the primary end point had occurred in 783 patients (18.3%) assigned to aliskiren as compared with 732 (17.1%) assigned to placebo (hazard ratio, 1.08; 95% confidence interval [CI], 0.98 to 1.20; P=0.12). Effects on secondary renal end points were similar. Systolic and diastolic blood pres- sures were lower with aliskiren (between-group differences, 1.3 and 0.6 mm Hg, respectively) and the mean reduction in the urinary albumin-to-creatinine ratio was greater (between-group difference, 14 percentage points; 95% CI, 11 to 17). The proportion of patients with hyperkalemia (serum potassium level, 656 mmol per liter) was significantly higher in the aliskiren group than in the placebo group (11.2% vs. 7.2%), as was the proportion with reported hypotension (12.1% vs. 8.3%) (P<0.001 for both comparisons). Conclusions The addition of aliskiren to standard therapy with renin\u2013angiotensin system block- ade in patients with type 2 diabetes who are at high risk for cardiovascular and renal events is not supported by these data and may even be harmful