77 research outputs found
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Influence of irradiation on the tensile properties of austenitic stainless steel weldments
Weldments in the first wall and front sections of the blanket of a fusion reactor will be exposed to approximately the same operating conditions as will the base metal. Thus the irradiation response of weld metal, of the weld heat affected zones in the base metal, and of the base metal are all of equal concern. Austenitic stainless steels will most likely be joined by a gas tungsten arc welding process. Welds have been made by this process between sections of 6-mm-thick (0.25 in.) base plate of type 316 in the 20%-cold-worked condition, with either type 316 or 16-8-2 stainless steel filler metal. Rod tensile specimens were cut through the welds, containing weld meta in the central gage portion. Weld-contaning tensile specimens have been irradiated in HFIR at 55/sup 0/C and throughout the temperature range 280 to 620/sup 0/C. The neutron fluences ranged from 0.5 to 1.6 x 10/sup 26/ n/m/sup 2/ (> 0.1 MeV). The corresponding displacement damage levels range from 4.5 to 12.1 dpa, and the helium generation from the thermal neutron captures in nickel resulted in 100 to 550 at. ppM He
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Behavior of Type 316 stainless steel under simulated fusion reactor irradiation
Fusion reactor irradiation response in alloys containing nickel can be simulated in thermal-spectrum fission reactors, where displacement damage is produced by the high-energy neutrons and helium is produced by the capture of two thermal neutrons in the reactions: /sup 58/Ni + n ..-->.. /sup 59/Ni + ..gamma..; /sup 59/Ni + n ..-->.. /sup 56/Fe + ..cap alpha... Examination of type 316 stainless steel specimens irradiated in HFIR has shown that swelling due to cavity formation and degradation of mechanical properties are more severe than can be predicted from fast reactor irradiations, where the helium contents produced are far too low to simulate fusion reactor service. Swelling values are greater and the temperature dependence of swelling is different than in the fast reactor case
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Overview of the US Magnetic Fusion Energy Program
Since the 1988 Symposium on Fusion Technology, steady progress has been made in the US Magnetic Fusion Energy Program. The large US tokamaks have reached new levels of plasma performance with associated improvements in the understanding of transport. The technology support for ongoing and future devices is similarly advancing with notable advances in magnetic, rf heating tubes, pellet injector, plasma interactive materials, tritium handling, structural materials, and system studies. Currently, a high level DOE review of the program is underway to provide recommendations for a strategic plan
Prognostic model to predict postoperative acute kidney injury in patients undergoing major gastrointestinal surgery based on a national prospective observational cohort study.
Background: Acute illness, existing co-morbidities and surgical stress response can all contribute to postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. The aim of this study was prospectively to develop a pragmatic prognostic model to stratify patients according to risk of developing AKI after major gastrointestinal surgery. Methods: This prospective multicentre cohort study included consecutive adults undergoing elective or emergency gastrointestinal resection, liver resection or stoma reversal in 2-week blocks over a continuous 3-month period. The primary outcome was the rate of AKI within 7 days of surgery. Bootstrap stability was used to select clinically plausible risk factors into the model. Internal model validation was carried out by bootstrap validation. Results: A total of 4544 patients were included across 173 centres in the UK and Ireland. The overall rate of AKI was 14·2 per cent (646 of 4544) and the 30-day mortality rate was 1·8 per cent (84 of 4544). Stage 1 AKI was significantly associated with 30-day mortality (unadjusted odds ratio 7·61, 95 per cent c.i. 4·49 to 12·90; P < 0·001), with increasing odds of death with each AKI stage. Six variables were selected for inclusion in the prognostic model: age, sex, ASA grade, preoperative estimated glomerular filtration rate, planned open surgery and preoperative use of either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker. Internal validation demonstrated good model discrimination (c-statistic 0·65). Discussion: Following major gastrointestinal surgery, AKI occurred in one in seven patients. This preoperative prognostic model identified patients at high risk of postoperative AKI. Validation in an independent data set is required to ensure generalizability
Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial
Background:
Many patients with COVID-19 have been treated with plasma containing anti-SARS-CoV-2 antibodies. We aimed to evaluate the safety and efficacy of convalescent plasma therapy in patients admitted to hospital with COVID-19.
Methods:
This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]) is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. The trial is underway at 177 NHS hospitals from across the UK. Eligible and consenting patients were randomly assigned (1:1) to receive either usual care alone (usual care group) or usual care plus high-titre convalescent plasma (convalescent plasma group). The primary outcome was 28-day mortality, analysed on an intention-to-treat basis. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936.
Findings:
Between May 28, 2020, and Jan 15, 2021, 11558 (71%) of 16287 patients enrolled in RECOVERY were eligible to receive convalescent plasma and were assigned to either the convalescent plasma group or the usual care group. There was no significant difference in 28-day mortality between the two groups: 1399 (24%) of 5795 patients in the convalescent plasma group and 1408 (24%) of 5763 patients in the usual care group died within 28 days (rate ratio 1·00, 95% CI 0·93–1·07; p=0·95). The 28-day mortality rate ratio was similar in all prespecified subgroups of patients, including in those patients without detectable SARS-CoV-2 antibodies at randomisation. Allocation to convalescent plasma had no significant effect on the proportion of patients discharged from hospital within 28 days (3832 [66%] patients in the convalescent plasma group vs 3822 [66%] patients in the usual care group; rate ratio 0·99, 95% CI 0·94–1·03; p=0·57). Among those not on invasive mechanical ventilation at randomisation, there was no significant difference in the proportion of patients meeting the composite endpoint of progression to invasive mechanical ventilation or death (1568 [29%] of 5493 patients in the convalescent plasma group vs 1568 [29%] of 5448 patients in the usual care group; rate ratio 0·99, 95% CI 0·93–1·05; p=0·79).
Interpretation:
In patients hospitalised with COVID-19, high-titre convalescent plasma did not improve survival or other prespecified clinical outcomes.
Funding:
UK Research and Innovation (Medical Research Council) and National Institute of Health Research
Tocilizumab in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial
Background:
In this study, we aimed to evaluate the effects of tocilizumab in adult patients admitted to hospital with COVID-19 with both hypoxia and systemic inflammation.
Methods:
This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. Those trial participants with hypoxia (oxygen saturation <92% on air or requiring oxygen therapy) and evidence of systemic inflammation (C-reactive protein ≥75 mg/L) were eligible for random assignment in a 1:1 ratio to usual standard of care alone versus usual standard of care plus tocilizumab at a dose of 400 mg–800 mg (depending on weight) given intravenously. A second dose could be given 12–24 h later if the patient's condition had not improved. The primary outcome was 28-day mortality, assessed in the intention-to-treat population. The trial is registered with ISRCTN (50189673) and ClinicalTrials.gov (NCT04381936).
Findings:
Between April 23, 2020, and Jan 24, 2021, 4116 adults of 21 550 patients enrolled into the RECOVERY trial were included in the assessment of tocilizumab, including 3385 (82%) patients receiving systemic corticosteroids. Overall, 621 (31%) of the 2022 patients allocated tocilizumab and 729 (35%) of the 2094 patients allocated to usual care died within 28 days (rate ratio 0·85; 95% CI 0·76–0·94; p=0·0028). Consistent results were seen in all prespecified subgroups of patients, including those receiving systemic corticosteroids. Patients allocated to tocilizumab were more likely to be discharged from hospital within 28 days (57% vs 50%; rate ratio 1·22; 1·12–1·33; p<0·0001). Among those not receiving invasive mechanical ventilation at baseline, patients allocated tocilizumab were less likely to reach the composite endpoint of invasive mechanical ventilation or death (35% vs 42%; risk ratio 0·84; 95% CI 0·77–0·92; p<0·0001).
Interpretation:
In hospitalised COVID-19 patients with hypoxia and systemic inflammation, tocilizumab improved survival and other clinical outcomes. These benefits were seen regardless of the amount of respiratory support and were additional to the benefits of systemic corticosteroids.
Funding:
UK Research and Innovation (Medical Research Council) and National Institute of Health Research
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Influence of neutron irradiation at 55/sup 0/C on the properties of austenitic stainless steels
Types 316 and 316 + 0.23 wt % Ti stainless steels and 16-8-2 weldment were irradiated in HFIR at 55/sup 0/C to fluences up to 1.35 x 10/sup 26/ neutrons/m/sup 2/ (< 0.1 MeV), which produced up to 10.5 dpa and 520 at. ppM He. Examination showed no swelling, no cavities, no precipitates, but a high concentration of dislocations. Tensile tests showed large increases in the 35/sup 0/C strength properties, with the weldments the weakest of the materials. The ductility of all materials was reduced by the irradiation, the uniform elongation to only 0.4% in the cold-worked material. Tests at temperatures above the irradiation temperature showed an approach to unirradiated properties as the temperature was increased from 200 to 600/sup 0/C. Helium embrittlement at 700/sup 0/C severely reduced elongation
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