Iodine-131 in Household waste - a pilot study

Werknemers in de thuis- en verpleegzorg en vuilnisophalers komen soms zonder dat te weten in aanraking met de radioactieve stof jodium-131. Toch is het niet aannemelijk dat zij aan een te hoge stralingsdosis blootstaan. Voorwaarde is, dat ze de normale hygienische voorschriften naleven. Dit blijkt uit verkennend onderzoek van het RIVM. Aanleiding is een tiental stralingsmeldingen bij een afvalverbrandingsinstallatie voor huishoudelijk afval in Dordrecht tussen april 2008 en april 2009. De straling was afkomstig van jodium-131 in incontinentiemateriaal en ander afval van patienten die met deze radioactieve stof zijn behandeld wegens een schildklierafwijking. Voor het onderzoek zijn vijf ziekenhuizen bezocht en zijn gegevens van de VROM-Inspectie gebruikt. Op basis hiervan heeft het RIVM scenario's opgesteld waarmee dosisschattingen voor werknemers zijn gemaakt. Deze schattingen zijn gebaseerd op de veronderstelling dat de hoeveelheid jodium-131 in incontinentiemateriaal niet groter is dan tot nu toe in het huishoudelijk afval is waargenomen. Er zijn twee mogelijke verklaringen voor de aanwezigheid van jodium-131 in het incontinentiemateriaal. Incontinente patienten mogen in Nederland niet poliklinisch met jodium-131 worden behandeld, maar in de praktijk gebeurt dat toch. De eerste 24 uur na de behandeling bevat de urine van deze patienten relatief veel van deze radioactieve stof. Een tweede verklaring zou kunnen zijn dat patienten die met een hoge dosering zijn behandeld, in sommige ziekenhuizen vaker vervroegd worden ontslagen. In Duitsland is poliklinische behandeling met jodium-131 niet toegestaan. Gezien de beperkte risico's lijkt een dergelijk totaalverbod in Nederland niet te rechtvaardigen. Om de risico's voor derden laag te houden, zou men bij incontinente patienten terughoudend moeten zijn met poliklinische behandeling en vervroegd ontslag.Workers in homecare and nursing homes are occasionally exposed to the radioactive drug iodine-131. Still, it is unlikely that dose limits are exceeded, provided that sanitary procedures are followed. This is shown in a pilot study by RIVM carried out after a number of radiation alerts at the household waste incinerator in Dordrecht between April 2008 and April 2009. The radiation originated from iodine-131 in diapers and similar waste from patients that had been treated for thyroid disorders. For this pilot study, five hospitals have been visited, and data were obtained from the environmental inspectorate. Based on this, scenarios were drawn up and dose estimates were made for workers. Two explanations are given for the unexpected presence of iodine-131 in household waste. First iodine-131 therapy is not allowed for outpatients if they are incontinent, but it is still done. Second, early release of patients treated with high doses may occur more often in some hospitals. In Germany, iodine therapy of outpatients is not allowed at all. In view of the limited risks, such a total ban seems unjustifiable in the Netherlands. To keep the risks for others to a minimum, hospitals should exercise restraint on sending incontinent patients home early.VRO

Prospects of germline nuclear transfer in women with diminished ovarian reserve

Diminished ovarian reserve (DOR) is associated with a reduced quantity and quality of the retrieved oocytes, usually leading to poor reproductive outcomes which remain a great challenge for assisted reproduction technology (ART). Women with DOR often have to seek for oocyte donation, precluding genetically related offspring. Germline nuclear transfer (NT) is a novel technology in ART that involves the transfer of the nuclear genome from an affected oocyte/zygote of the patient to the cytoplast of an enucleated donor oocyte/zygote. Therefore, it offers opportunities for the generation of genetically related embryos. Currently, although NT is clinically applied only in women with serious mitochondrial DNA disorders, this technology has also been proposed to overcome certain forms of female infertility, such as advanced maternal age and embryo developmental arrest. In this review, we are proposing the NT technology as a future treatment option for DOR patients. Strikingly, the application of different NT strategies will result in an increase of the total number of available reconstituted embryos for DOR patients

The Influence of Oral Health Factors on the Quality of Life in Older People: A Systematic Review

Background and Objectives: The number of people aged 65 years or older is growing substantially. As a result of increased health burden and tooth retention, more oral health problems are expected in this age group. A poor oral health-related quality of life (OHQoL) can compromise a person’s psychological state, social relationships, personal beliefs, and physical health. The aim of this systematic review was to identify oral health factors associated with OHQoL in people aged 65 years or older and to give a comprehensive overview of the body of literature for each oral health factor separately. // Research Design and Methods: A comprehensive search was performed in five databases. The following terms were used as index terms or free-text words: “Oral Health,” “Quality of Life,” “Older People.” Two researchers independently assessed studies for eligibility based on predefined criteria. // Results: Of 3,702 references retrieved from the databases, 68 studies were eligible and included (9 randomized clinical trials, 6 cohort studies, and 53 cross-sectional studies). All results were reported descriptively. OHQoL in people aged 65 years or older is positively associated with higher number of teeth, higher number of occluding pairs, implant-retained overdentures, and the shortened dental arch concept and negatively associated with xerostomia, orofacial pain, and poor chewing ability. In the current literature, there is no consensus on the association between edentulism, caries, and periodontal conditions and OHQoL. // Discussion and Implications: Having a functional dentition (either natural or prosthetic) is important for a good OHQoL, whereas painful or functional complaints are associated with impaired OHQoL

Safety risks among frail older people living at home in the Netherlands:A cross‐sectional study in a routine primary care sample

Frail older people face a range of problems and risks that could undermine their ability to live safely at home. A comprehensive overview of these risks, from a multidimensional perspective, is currently lacking. This study aims to examine the prevalence of risks in multiple domains of life among frail older people living at home. We used cross‐sectional data from 824 people aged 65 years and older, who received a comprehensive geriatric assessment (the interRAI Home Care [interRAI‐HC]) between 2014 and 2018, as part of routine care from 25 general practices in the region of West‐Friesland, the Netherlands. The interRAI‐HC identifies amenable risks related to people's clinical conditions, functioning, lifestyle and behaviour, and social and physical environment. Descriptive statistics were used to examine population characteristics (age, gender, marital status, living arrangements and presence of chronic conditions) and prevalence of risks. Most common risks were related to people's clinical conditions (i.e cardio‐respiratory health, urinary incontinence, pain), functioning (i.e. limitations in instrumental activities of daily living and mood) and social environment (i.e. limitations in informal care and social functioning). More than 80% of frail older people faced multiple risks, and often on multiple domains of life simultaneously. People experiencing multiple risks per person, and on multiple domains simultaneously, were more often widowed and living alone. The multidimensional character of risks among frail older people living at home implies that an integrated approach to care, comprising both health and social care, is necessary. Insight in the prevalence of these risks can give direction to care allocation decisions

Replicate Periodic Windows in the Parameter Space of Driven Oscillators

In the bi-dimensional parameter space of driven oscillators, shrimp-shaped periodic windows are immersed in chaotic regions. For two of these oscillators, namely, Duffing and Josephson junction, we show that a weak harmonic perturbation replicates these periodic windows giving rise to parameter regions correspondent to periodic orbits. The new windows are composed of parameters whose periodic orbits have periodicity and pattern similar to stable and unstable periodic orbits already existent for the unperturbed oscillator. These features indicate that the reported replicate periodic windows are associated with chaos control of the considered oscillators

DICER1 RNase IIIb domain mutations are infrequent in testicular germ cell tumours

Background: Testicular Germ Cell Tumours (TGCT) are the most frequently occurring malignancy in males from 15-45 years of age. They are derived from germ cells unable to undergo physiological maturation, although the genetic basis for this is poorly understood. A recent report showed that mutations in the RNase IIIb domain of DICER1, a micro-RNA (miRNA) processing enzyme, are common in non-epithelial ovarian cancers. DICER1 mutations were found in 60% of Sertoli-Leydig cell tumours, clustering in four codons encoding metal-binding sites. Additional analysis of 14 TGCT DNA samples identified one case that also contained a mutation at one of these sites. Findings. A number of previous studies have shown that DICER1 mutations are found in Q) within the RNase IIIb domain in one TGCT sample, which was predicted to disturb DICER1 function. Conclusion: Overall our findings suggest a mutation frequency in TGCTs of ∼1%. We conclude therefore that hot-spot mutations, frequently seen in Sertoli-Leydig cell tumours, are not common in TGCTs

The early evolution of young massive clusters: The kinematic history of NGC6611 / M16

In the first few Myr the massive stars dynamically interact, produce runaways and affect the initial binary population. Observing and interpreting the dynamics of young massive clusters is key to our understanding of the star formation process and predicting the outcome of stellar evolution. We have studied NGC6611 in the Eagle Nebula (M16), a young massive cluster hosting 19 O stars. We used Gaia EDR3 data to determine the membership, age, cluster dynamics and the kinematics of the massive stars including runaways. The membership analysis yields 137 members located at a mean distance of 1706 $\pm$ 7 pc. The colour - absolute magnitude diagram reveals a blue and a red population of pre-main-sequence stars, consistent with two distinct populations of stars. In line with earlier studies, the youngest population has a mean extinction $A_V$ = 3.6 $\pm$ 0.1 mag and an age = 1.3 $\pm$ 0.2 Myr, while the older population of stars has a mean extinction $A_V$ = 2.0 $\pm$ 0.1 mag and an age = 7.5 $\pm$ 0.4 Myr. The latter population is more spatially extended than the younger generation of stars. We argue that most of the OB stars belong to the younger population. We identify 8 runaways originating from the center of NGC6611, consistent with the dynamical ejection scenario. We show that ~ 50% of the O stars have velocities comparable to or greater than the escape velocity. These O stars can be traced back to the center of NGC6611 with kinematic ages ranging from 0 to 2 Myr. This suggests that dynamical interactions played an important role in the early evolution of NGC6611, which is surprising considering the low current stellar density. Comparing this to simulations of young massive clusters, the required initial radius of 0.1-0.5 pc is not consistent with that of NGC6611. The O stars could have initially formed in wide binaries and possibly harden through dynamical interactions.Comment: replaced with accepted version to A&A. 28 pages, 15 figure