Design study of benchmark experiment for large-angle scattering cross section for non-solid target with 14 MeV neutron

Accuracy of large-angle scattering cross section in nuclear data has a large contribution on precision of neutron transport calculation in fusion reactor design. In the previous research, benchmark experiments for a solid target were carried out, however, non-solid targets, which are enclosed in a container, could not be dealt with. This is because we were not able to remove the effect due to existence of the container in the previous method. In this study, we performed design study of advanced benchmark experiment for large-angle scattering cross section especially for a non-solid target in a container. In addition, we also carried out benchmark experiments for silicon, which is important for the fusion reactor, however, is one of the elements that are difficult to obtain a solid target. In conclusion, we successfully developed an advanced benchmark experimental method for non-solid targets and verified it numerically by Monte Carlo calculation. In addition, we also found experimentally that large-angle scattering cross section of silicon is underestimated in JENDL-4, ENDF-B/VIII and JEFF-3.3

A benchmark study of large-angle neutron scattering cross section of tungsten using two shadow bars technique at 14 MeV

In fusion reactor design, neutron leaks intensively from blanket material through a gap. In this streaming phenomenon, backscattering cross section is known to be very crucial. In the present study, the author's team carried out a new experiment for benchmarking the large angle scattering cross section of tungsten using a DT neutron source of OKTAVIAN facility, Osaka University, Japan. Tungsten-containing material is under consideration as the radiation shield in a fusion reactor. The experimental geometry consists of a DT neutron source, two shadow bars, niobium foil, and a tungsten target. Four irradiations were performed at a neutron energy of 14 MeV using DT neutrons to extract only the contribution of large angle scattering cross section. By using two shadow bars, room return contribution was effectively suppressed. Consequently, only backscattering neutrons were measured by using a niobium foil. In the present benchmark study, obtained experimental data were compared with numerical calculations by MCNP6 using various nuclear data libraries, including JENDL-4.0, JENDL-5, JEFF-3.3, and ENDF/B-VIII

Association between brain imaging biomarkers and continuous glucose monitoring-derived glycemic control indices in Japanese patients with type 2 diabetes mellitus

Introduction Although type 2 diabetes mellitus (T2DM) is associated with alterations in brain structure, the relationship between glycemic control indices and brain imaging markers remains unclear. This study aimed to investigate the association between continuous glucose monitoring (CGM)-derived glycemic control indices and brain imaging biomarkers assessed by MRI.Research design and methods This cross-sectional study included 150 patients with T2DM. The severity of cerebral white matter lesions (WMLs) was assessed using MRI for deep and subcortical white matter and periventricular hyperintensities. The degree of medial temporal lobe atrophy (MTA) was assessed using voxel-based morphometry. Each participant wore a retrospective CGM for 14 consecutive days, and glycemic control indices, such as time in range (TIR) and glycemia risk index (GRI), were calculated.Results The proportion of patients with severe WMLs showed a decreasing trend with increasing TIR (P for trend=0.006). The proportion of patients with severe WMLs showed an increasing trend with worsening GRI (P for trend=0.011). In contrast, no significant association was observed between the degree of MTA and CGM-derived glycemic control indices, including TIR (P for trend=0.325) and GRI (P for trend=0.447).Conclusions The findings of this study indicate that the severity of WMLs is associated with TIR and GRI, which are indices of the quality of glycemic control.Trial registration number UMIN000032143

Safety and efficacy of eculizumab in anti-acetylcholine receptor antibody-positive refractory generalised myasthenia gravis (REGAIN): a phase 3, randomised, double-blind, placebo-controlled, multicentre study

Background Complement is likely to have a role in refractory generalised myasthenia gravis, but no approved therapies specifically target this system. Results from a phase 2 study suggested that eculizumab, a terminal complement inhibitor, produced clinically meaningful improvements in patients with anti-acetylcholine receptor antibody-positive refractory generalised myasthenia gravis. We further assessed the efficacy and safety of eculizumab in this patient population in a phase 3 trial. Methods We did a phase 3, randomised, double-blind, placebo-controlled, multicentre study (REGAIN) in 76 hospitals and specialised clinics in 17 countries across North America, Latin America, Europe, and Asia. Eligible patients were aged at least 18 years, with a Myasthenia Gravis-Activities of Daily Living (MG-ADL) score of 6 or more, Myasthenia Gravis Foundation of America (MGFA) class II\ue2\u80\u93IV disease, vaccination against Neisseria meningitides, and previous treatment with at least two immunosuppressive therapies or one immunosuppressive therapy and chronic intravenous immunoglobulin or plasma exchange for 12 months without symptom control. Patients with a history of thymoma or thymic neoplasms, thymectomy within 12 months before screening, or use of intravenous immunoglobulin or plasma exchange within 4 weeks before randomisation, or rituximab within 6 months before screening, were excluded. We randomly assigned participants (1:1) to either intravenous eculizumab or intravenous matched placebo for 26 weeks. Dosing for eculizumab was 900 mg on day 1 and at weeks 1, 2, and 3; 1200 mg at week 4; and 1200 mg given every second week thereafter as maintenance dosing. Randomisation was done centrally with an interactive voice or web-response system with patients stratified to one of four groups based on MGFA disease classification. Where possible, patients were maintained on existing myasthenia gravis therapies and rescue medication was allowed at the study physician's discretion. Patients, investigators, staff, and outcome assessors were masked to treatment assignment. The primary efficacy endpoint was the change from baseline to week 26 in MG-ADL total score measured by worst-rank ANCOVA. The efficacy population set was defined as all patients randomly assigned to treatment groups who received at least one dose of study drug, had a valid baseline MG-ADL assessment, and at least one post-baseline MG-ADL assessment. The safety analyses included all randomly assigned patients who received eculizumab or placebo. This trial is registered with ClinicalTrials.gov, number NCT01997229. Findings Between April 30, 2014, and Feb 19, 2016, we randomly assigned and treated 125 patients, 62 with eculizumab and 63 with placebo. The primary analysis showed no significant difference between eculizumab and placebo (least-squares mean rank 56\uc2\ub76 [SEM 4\uc2\ub75] vs 68\uc2\ub73 [4\uc2\ub75]; rank-based treatment difference \ue2\u88\u9211\uc2\ub77, 95% CI \ue2\u88\u9224\uc2\ub73 to 0\uc2\ub796; p=0\uc2\ub70698). No deaths or cases of meningococcal infection occurred during the study. The most common adverse events in both groups were headache and upper respiratory tract infection (ten [16%] for both events in the eculizumab group and 12 [19%] for both in the placebo group). Myasthenia gravis exacerbations were reported by six (10%) patients in the eculizumab group and 15 (24%) in the placebo group. Six (10%) patients in the eculizumab group and 12 (19%) in the placebo group required rescue therapy. Interpretation The change in the MG-ADL score was not statistically significant between eculizumab and placebo, as measured by the worst-rank analysis. Eculizumab was well tolerated. The use of a worst-rank analytical approach proved to be an important limitation of this study since the secondary and sensitivity analyses results were inconsistent with the primary endpoint result; further research into the role of complement is needed. Funding Alexion Pharmaceuticals