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Complex metal hydrides are a fascinating and continuously expanding class of materials with many properties relevant for solid-state hydrogen and ammonia storage and solid-state electrolytes. The crystal structures are often investigated using powder X-ray diffraction (PXD), which can be ambiguous. Here, we revisit the crystal structure of Y(11BD4)3·3ND3 with the use of neutron diffraction, which, in comparison to previous PXD studies, provides accurate information about the D positions in the compound. Upon cooling to 10 K, the compound underwent a polymorphic transition, and a new monoclinic low-temperature polymorph denoted as α-Y(11BD4)3·3ND3 was discovered. Furthermore, the series of Y(11BH4)3·xNH3 (x = 0, 3, and 7) were also investigated with inelastic neutron scattering and infrared spectroscopy techniques, which provided information of the local coordination environment of the 11BH4- and NH3 groups and unique insights into the hydrogen dynamics. Partial deuteration using ND3 in Y(11BH4)3·xND3 (x = 3 and 7) allowed for an unambiguous assignment of the vibrational bands corresponding to the NH3 and 11BH4- in Y(11BH4)3·xNH3, due to the much larger neutron scattering cross section of H compared to D. The vibrational spectra of Y(11BH4)3·xNH3 could roughly be divided into three regions: (i) below 55 meV, containing mainly 11BH4- librational motions, (ii) 55-130 meV, containing mainly NH3 librational motions, and (iii) above 130 meV, containing 11B-H and N-H bending and stretching motions.

Background Alzheimer’s disease (AD) is the most common form of age-related neurodegenerative diseases. Cerebral deposition of Aβ peptides, especially Aβ42, is considered the major neuropathological hallmark of AD and the putative cause of AD-related neurotoxicity. Aβ peptides are produced by sequential proteolytic processing of APP, with β-secretase (BACE) being the initiating enzyme. Therefore, BACE has been considered an attractive therapeutic target in AD research and several BACE inhibitors have been tested in clinical trials, but so far, all have had negative outcomes or even led to worsening of cognitive function. AD can be triggered by Aβ years before the first symptoms appear and one reason for the failures could be that the clinical trials were initiated too late in the disease process. Another possible explanation could be that BACE inhibition alters physiological APP processing in a manner that impairs synaptic function, causing cognitive deterioration. Methods The aim of this study was to investigate if partial BACE inhibition, mimicking the putative protective effect of the Icelandic mutation in the APP gene, could reduce Aβ generation without affecting synaptic transmission. To investigate this, we used an optical electrophysiology platform, in which effects of compounds on synaptic transmission in cultured neurons can be monitored. We employed this method on primary cortical rat neuronal cultures treated with three different BACE inhibitors (BACE inhibitor IV, LY2886721, and lanabecestat) and monitored Aβ secretion into the cell media. Results We found that all three BACE inhibitors tested decreased synaptic transmission at concentrations leading to significantly reduced Aβ secretion. However, low-dose BACE inhibition, resulting in less than a 50% decrease in Aβ secretion, did not affect synaptic transmission for any of the inhibitors tested. Conclusion Our results indicate that Aβ production can be reduced by up to 50%, a level of reduction of relevance to the protective effect of the Icelandic mutation, without causing synaptic dysfunction. We therefore suggest that future clinical trials aimed at prevention of Aβ build-up in the brain should aim for a moderate CNS exposure of BACE inhibitors to avoid side effects on synaptic function.

99mTc-Sestamibi Single Photon Emission Computed Tomography/Computed Tomography (SPECT/CT) contributes to the non-invasive differentiation of renal oncocytoma (RO) from renal cell carcinoma (RCC) by characterising renal tumours as Sestamibi positive or Sestamibi negative regarding their 99mTc-Sestamibi uptake compared to the non-tumoral renal parenchyma. To determine whether 99mTc- Sestamibi uptake in renal tumour and the non-tumoral renal parenchyma measured using Standard Uptake Value (SUV) SPECT, has a beneficial role in differentiating RO from RCC. Fifty-seven renal tumours from 52 patients were evaluated. In addition to visual evaluation of 99mTc-Sestamibi uptake, SUVmax measurements were performed in the renal tumour and the ipsilateral non-tumoral renal parenchyma. Analysis of the area under the receiver operating characteristic curve identified an optimal cut-off value for detecting RO, based on the relative ratio of 99mTc- Sestamibi uptake. Semiquantitative evaluation of 99mTc-Sestamibi uptake did not improve the performance of 99mTc- Sestamibi SPECT/CT in detecting RO. 99mTc- Sestamibi SPECT/CT identifies a group of mostly indolent Sestamibi-positive tumours with low malignant potential containing RO, Low-Grade Oncocytic Tumours, Hybrid Oncocytic Tumours, and a subset of chromophobe RCCs. The imaging limitations for accurate differentiation of Sestamibi-positive renal tumours mirror the recognised diagnostic complexities of the histopathologic evaluation of oncocytic neoplasia. Patients with Sestamibi-positive renal tumours could be better suited for biopsy and follow-up, according to the current active surveillance protocols.

Background: Patients with preoperative dual antiplatelet therapy prior to coronary artery bypass surgery are at risk of bleeding and blood component transfusion. We hypothesise that an optimised cardiopulmonary bypass strategy reduces postoperative blood loss and transfusions. Methods: In total, 60 patients admitted for coronary artery bypass grafting with ticagrelor and aspirin medication withdrawn ® heparin-coated circuit with low systemic heparinisation (activated clotting time ® coated open circuit, full systemic heparinisation (activated clotting time > 480 seconds) and conventional cardiotomy suction. This perfusion strategy was evaluated by the chest drain volume after 24 hours, perioperative haemoglobin and platelet loss accompanied by global coagulation assessments. Results: Patients in the study group demonstrated significantly better outcomes signified by lower blood loss 554 ± 224 versus 1,100 ± 989 mL (p 9/L (p = 0.001). Indices of rotational thromboelastometry indicated shorter clotting times within the internal and external pathways. Adenosine diphosphate activated platelet function was within normal range based on Multiplate® aggregometry, while ROTEM® platelet analyses indicated inhibited function both preoperatively and post-bypass. Platelet inhibition by aspirin was verified throughout the perioperative period. Platelet function showed no intergroup differences. Conclusion: A stringent perfusion strategy reduced blood loss and transfusions in dual antiplatelet therapy patients requiring urgent surgery.

Background: 99mTc-Sestamibi Single Photon Emission Computed Tomography/Computed Tomography (SPECT/CT) contributes to the non-invasive differentiation of renal oncocytoma (RO) from renal cell carcinoma (RCC). We investigated whether standard uptake value (SUV) SPECT, has a beneficial role in differentiating renal oncocytoma (RO) from renal cell carcinoma (RCC) besides visual assessment. As a secondary aim, we evaluated the mitochondrial content of 19 oncocytic tumours arranged in a tissue microarray, by immunohistochemistry, using succinate dehydrogenase complex subunit B (SDHB) protein expression. In addition to visual evaluation of 99mTc-Sestamibi uptake by characterizing renal tumours as Sestamibi positive or Sestamibi negative regarding their uptake compared to the non-tumoral renal parenchyma, SUVmean and SUVmax measurements were performed in the renal tumour and the non-tumoral renal parenchyma. Intra Class Correlation calculated to assess the intra-reader reliability of SUV measurements. ROC-analysis demonstrated an optimal cut off SUV value that differentiates RO from RCC. SDHB score was analysed using Cochran–Armitage test for trend.Results: 57 renal tumours from 52 patients were evaluated. Visual evaluation of 99mTc-Sestamibi SPECT/CT examination resulted in a sensitivity of 83%, whereas quantitative evaluation showed a sensitivity of 64% regarding the differential of RO from RCC. A significant trend (p=0,0328) of increased SDHB score found in the Sestamibi positive group.Conclusion: Quantitative evaluation with SUV SPECT measurements did not improve the performance of 99mTc-Sestamibi SPECT/CT in differentiating RO from RCC. 99mTc- Sestamibi SPECT/CT identified a larger Sestamibi-positive tumour group containing RO, Hybrid Oncocytic Chromophobe Tumours and the majority of chromophobe RCCs. Thus, Sestamibi-negative renal tumours, that are possibly malignant, should be considered for surgery. Patients with Sestamibi-positive tumours can be suited for biopsy and follow up according to active surveillance protocols. Low Grade Oncoytic Tumour, a provisional renal entity with no proven recurrence or metastatic potential, appears to be positive on 99mTc- Sestamibi SPECT/CT examination.

A reduction in the global burden of malaria over the past two decades has encouraged efforts for regional malaria elimination. Despite the need to target all Plasmodium species, current focus is mainly directed towards Plasmodium falciparum, and to a lesser extent P. vivax. There is a substantial lack of data on both global and local transmission patterns of the neglected malaria parasites P. malariae and P. ovale spp. We used a species-specific real-time PCR assay targeting the Plasmodium 18s rRNA gene to evaluate temporal trends in the prevalence of all human malaria parasites over a 22-year period in a rural village in Tanzania.We tested 2897 blood samples collected in five cross-sectional surveys conducted between 1994 and 2016. Infections with P. falciparum, P. malariae, and P. ovale spp. were detected throughout the study period, while P. vivax was not detected. Between 1994 and 2010, we found a more than 90% reduction in the odds of infection with all detected species. The odds of P. falciparum infection was further reduced in 2016, while the odds of P. malariae and P. ovale spp. infection increased 2- and 6-fold, respectively, compared to 2010. In 2016, non-falciparum species occurred more often as mono-infections. The results demonstrate the persistent transmission of P. ovale spp., and to a lesser extent P. malariae despite a continued decline in P. falciparum transmission. This illustrates that the transmission patterns of the non-falciparum species do not necessarily follow those of P. falciparum, stressing the need for attention towards non-falciparum malaria in Africa. Malaria elimination will require a better understanding of the epidemiology of P. malariae and P. ovale spp. and improved tools for monitoring the transmission of all Plasmodium species, with a particular focus towards identifying asymptomatic carriers of infection and designing appropriate interventions to enhance malaria control., Author summary The reduction in the global burden of malaria has encouraged efforts for elimination. Attempts to control and monitor transmission have mainly focused on the predominant malaria parasites Plasmodium falciparum and P. vivax. However, eliminating malaria requires the elimination of all human malaria parasites and limited interest has been directed towards estimating the disease burden attributable to the neglected malaria parasites P. ovale spp. and P. malariae. The authors used molecular methods to analyse 2897 blood samples collected in five cross-sectional surveys over a period of 22 years, and described the transmission patterns of all human malaria parasites in a Tanzanian village. They demonstrate a persistent transmission of P. malariae and P. ovale spp. despite a substantial reduction in transmission of P. falciparum, highlighting the need for more attention towards non-falciparum malaria. The authors discuss the implications of these findings in the context of current efforts for regional malaria elimination.

Quantification tools for SPECT/CT are a field of ongoing research among hybrid imaging techniques. A recent multicenter study evaluating SUV SPECT software on phantoms showed that quantitative SPECT/CT is reproducible in Hybrid Viewer software. The aim of our study was to evaluate the intra- and interobserver agreement of quantitative SUV SPECT measurements in clinical settings for patients with solid renal tumors. Methods: The evaluation was part of a study that examined the role of 99mTc-sestamibi SPECT/CT in the characterization of solid kidney tumors and the differentiation of renal oncocytomas from renal cell carcinomas. Quantitative evaluation of SUV measurements was performed in Hybrid Viewer PDR, version 2.5. Forty-eight renal lesions were identified and examined twice by 2 independent readers. The agreement of the SUV measurements, concerning renal tumors and adjacent renal parenchyma, was evaluated using the intraclass correlation coefficient (ICC). Results: ICC for SUVmax measurements by the same reader was 97%-99% for solid renal tumors and 92%-98% for ipsilateral healthy renal parenchyma. ICC for SUVmax measurements between readers was 87%-89% for solid renal tumors and 72%-73% for ipsilateral healthy renal parenchyma. Estimated ICC for SUVmean measurements of solid renal tumors was 95%-98% for the same reader and 86%-89% between readers. Similar results were found for SUVpeak measurements. Conclusion: The high ICCs indicate a strong agreement among SUV measurements for patients with solid renal lesions undergoing 99mTc-sestamibi SPECT/CT, not only for measurements by the same reader but also for measurements between 2 different readers.

Many countries using sensitive screening methods for detection of carriage of methicillin-resistant Staphylococcus aureus (MRSA) have a sustained low incidence of MRSA infections. For diagnostic laboratories with high sample volumes, MRSA screening requires stability, low maintenance and high performance at a low cost. Herein we designed oligonucleotides for a new nuc targeted hydrolysis probe PCR to replace the standard in-house nuc SybrGreen PCR assay. This new, more time-efficient, PCR assay resulted in a 40% increase in daily sample capacity, with maintained high specificity and sensitivity. The assay was also able to detect Staphylococcus aureus clonal cluster 75 (CC75) lineage strains, recently re-classified as Staphylococcus argenteus, with a sensitivity considerably increased compared to our previous assay. While awaiting consensus if the CC75 lineage of S. aureus should be considered as S. argenteus, and whether methicillin-resistant S. argenteus should be included in the MRSA definition, many diagnostic laboratories need to update their MRSA assay sensitivity/specificity towards this lineage/species. The MRSA screening assay presented in this manuscript is comprised of nuc oligonucleotides separately targeting S. aureus and CC75 lineage strains/S. argenteus, thus providing high user flexibility for the detection of CC75 lineage strains/S. argenteus.

Purpose: During the first part of the 20th century, Ra-226 was the most used radionuclide for brachytherapy. Retrospective accurate dosimetry, coupled with patient follow up, is important for advan ...

Background: The majority (70%) of cardiac arrests in Sweden are experienced in the patient’s home. In these situations, the ambulance nurses may encounter several ethical dilemmas. Aim: The aim was to investigate Swedish specialist ambulance nurses’ experiences of ethical dilemmas associated with cardiac arrest situations in adult patients’ homes. Methods: Nine interviews were conducted with specialist ambulance nurses at four different ambulance stations in the southeast region of Sweden. Data were analysed using content analysis. Ethical considerations: Ethical principles mandated by the Swedish Research Council were carefully followed during the whole process. Findings: Two main themes with six sub-themes were identified: The scene – creating a sheltered space for caring and Ethical decision-making. The results showed that ethical dilemmas might occur when trying to create a sheltered space to preserve the patients’ integrity and dignity. A dilemma could be whether or not to invite significant others to be present during the medical treatment. Ethical decision-making was dependent on good communication and ethical reasoning among all parties. In certain situations, decisions were made not to commence or to terminate care despite guidelines. The decision was guided by combining the medical/nursing perspectives and ethical competence with respect to the human being’s dignity and a will to do good for the patient. The nurses followed the voice of their heart and had the courage to be truly human. Conclusion: The ambulance nurses were guided by their ethos, including the basic motive to care for the patient, to alleviate suffering, to confirm the patient’s dignity and to serve life and health.

Background Despite the progress in the quality of multiphasic CT and MRI scans, it is still difficult to fully characterize a solid kidney lesion. Approximately 10% of all solid renal tumours turn out to be oncocytomas. In actual clinical practice, this is verified only following unnecessary surgery or a renal biopsy/ablation. The objective of our pilot study examines whether 99mTc-sestamibi SPECT/CT can play a crucial role in the characterization of solid renal neoplasms and the differentiation of oncocytomas from renal cell carcinomas. The study included 27 patients identified with 31 solid renal lesions. All patients were discussed in a multidisciplinary conference, and a decision for surgery or biopsy was taken. Prior to invasive procedures, patients underwent a SPECT/CT with 99mTc-sestamibi. Visual evaluation was performed, and any focal 99mTc-sestamibi uptake detected on SPECT in the localisation of tumour was considered as positive. Results Eleven out of 12 oncocytomas (91.6%) displayed positive uptake of 99mTc-sestamibi. Three hybrid tumours (mixed-type oncocytoma and chromophobe renal cancer) were positive on SPECT/CT. One papillary renal cell carcinoma had a slight uptake of 99mTc-sestamibi. The remaining 11 renal cell carcinomas were sestamibi negative. Conclusions Differentiation of benign renal oncocytomas from renal cell carcinomas seems very promising on 99mTc-sestamibi SPECT/CT examination. Additional supplement to visual evaluation, i.e. quantitative tools, should be sought for an accurate estimate of biological behaviour and hence a secure diagnosis.

Dosimetric accuracy of radiation treatment planning in brachytherapy depends on knowledge of tissue composition. It has been speculated that soft tissues can be decomposed to water, lipid and protein. The aim of our work is to evaluate the accuracy of such tissue decomposition. Selected abdominal soft tissues, whose average elemental compositions were taken from literature, were decomposed using dual energy computed tomography to water, lipid and protein via the three-material decomposition method. The quality of the decomposition was assessed using relative differences between (i) mass energy absorption and (ii) mass energy attenuation coefficients of the analyzed and approximated tissues. It was found that the relative differences were less than 2% for photon energies larger than 10 keV. The differences were notably smaller than the ones for water as the transport and dose scoring medium. The choice of the water, protein and lipid triplet resulted in negative elemental mass fractions for some analyzed tissues. As negative elemental mass fractions cannot be used in general purpose particle transport computer codes using the Monte Carlo method, other triplets should be used for the decomposition. These triplets may further improve the accuracy of the approximation as the differences were mainly caused by the lack of high-Z materials in the water, protein and lipid triplet. Funding Agencies|Swedish Cancer Society (Cancerfonden)|100 512

Background Despite the progress in the quality of multiphasic CT and MRI scans, it is still difficult to fully characterize a solid kidney lesion. Approximately 10% of all solid renal tumours turn out to be oncocytomas. In actual clinical practice, this is verified only following unnecessary surgery or a renal biopsy/ablation. The objective of our pilot study examines whether 99mTc-sestamibi SPECT/CT can play a crucial role in the characterization of solid renal neoplasms and the differentiation of oncocytomas from renal cell carcinomas. The study included 27 patients identified with 31 solid renal lesions. All patients were discussed in a multidisciplinary conference, and a decision for surgery or biopsy was taken. Prior to invasive procedures, patients underwent a SPECT/CT with 99mTc-sestamibi. Visual evaluation was performed, and any focal 99mTc-sestamibi uptake detected on SPECT in the localisation of tumour was considered as positive. Results Eleven out of 12 oncocytomas (91.6%) displayed positive uptake of 99mTc-sestamibi. Three hybrid tumours (mixed-type oncocytoma and chromophobe renal cancer) were positive on SPECT/CT. One papillary renal cell carcinoma had a slight uptake of 99mTc-sestamibi. The remaining 11 renal cell carcinomas were sestamibi negative. Conclusions Differentiation of benign renal oncocytomas from renal cell carcinomas seems very promising on 99mTc-sestamibi SPECT/CT examination. Additional supplement to visual evaluation, i.e. quantitative tools, should be sought for an accurate estimate of biological behaviour and hence a secure diagnosis.

The electrical disturbance in Forsmark 2006 [3] led to increased attention being paid to the power supplies of nuclear power plants and their role in safety system reliability, both nationally and internationally. Since then numerous disturbances similar in nature have occurred in the electrical power supply which raises questions whether best available technology (BAT) has been utilised in the design and analysis of the electrical power supply of the safety functions of nuclear facilities. On repeated occasions this type of disturbances has had an impact on redundant parts of several safety systems due to functional dependencies between these. The frequency of these occurrences has been unexpected. The Swedish Radiation Safety Authority (SSM) has decided to write this document to clarify the regulators position on this issue. The document is also intended to support SSM:s assessments and evaluations of the Licensees efforts regarding degraded power supplies. An assessment of nuclear power plant electrical power systems is necessary in the light of the past years’ operational experience [1–7], where disturbances in the electrical power supply on repeated occasions have caused a power supply with degradation severe enough to challenge plant safety. As the potential consequences of such a degraded power supply can be severe it must be proven that the frequency of such occurrences is tolerably low. Furthermore, it is important to consider experiences from known situations with degraded power supplies, to enable a reasonable approach to identify and take counter-measures based on the root-cause and ensure utilisation of best available technology. A sufficient approach to enable prevention, protection and mitigation against this type of disturbances has been difficult to identify. Actual events and conditions causing a degraded power supply have often been complex in nature and difficult to anticipate, wherefore events and conditions which has not yet occurred are difficult to foresee. For this reason it is deemed most effective to identify and implement proportional measures that enhances the independence of the power supplies, such that a degraded power supply with a higher reliability is prevented from propagating to multiple parts of the safety systems. In this memorandum, SSM describes a state-based approach to analysing electrical power system functionality in different states of degraded power supply. The approach is intended to identify potential design weaknesses and measures to enhance robustness. Such an approach is viewed as more favourable in facilitating the identification of such measures, which may otherwise be neglected due to an estimated low frequency of occurrence, or missed due to incomplete identification of possible events and conditions. Furthermore this document describes how an assessment of electrical power system design can be performed, where the lowest common denominator from operational experience e.g. [1–7] is identified and counteracted. Actual occurrences of degraded power supplies, which all have been “unknown during the event identification process” but “well-known electrical phenomena”, can be described as unidentified degrading conductive disturbances.

In parallel to the increased utilization of cross-sectional imaging, the incidence of small renal masses has steadily risen in recent years. At the present time, anatomical imaging techniques are limited in their ability to differentiate benign from malignant renal masses. Moreover, renal mass biopsy has a high non-diagnostic rate, poor negative-predictive ability, and carries potential risks as well as substantial costs. As a result, benign renal masses are often unnecessarily resected for the false presumption of cancer. (99m)Tc-sestamibi single photon emission computed tomography/computed tomography (SPECT/CT) is a molecular imaging test that allows for the differentiation of benign renal oncocytomas and hybrid oncocytomic/chromophobe tumours apart from malignant renal cell carcinomas on the basis of differences in mitochondrial content as well as multidrug resistant pump expression. Herein, we review the principles of (99m)Tc-sestamibi SPECT/CT administration and image interpretation for the purpose of renal mass characterization.

We present an experimental system that allows visualization of conformational changes in membrane proteins at the single-molecule level. The target membrane protein is reconstituted in a giant liposome for independent control of the aqueous environments on the two sides of the membrane. For direct observation of conformational changes, an extra-liposomal site(s) of the target protein is bound to a glass surface, and a probe that is easily visible under a microscope, such as a micron-sized plastic bead, is attached to another site on the intra-liposomal side. A conformational change, or an angular motion in the tiny protein molecule, would manifest as a visible motion of the probe. The attachment of the protein on the glass surface also immobilizes the liposome, greatly facilitating its manipulation such as the probe injection. As a model system, we reconstituted ATP synthase (FOF1) in liposomes tens of mu m in size, attached the protein specifically to a glass surface, and demonstrated its ATP-driven rotation in the membrane through the motion of a submicron bead. (c) 2009 Elsevier B.V. All rights reserved.

Nanotechnologies have potential to be used in transformer industry in enhancing material properties which may lead to a compact design of transformer and reduced manufacturing cost. Effect of adding different nanoparticles such as titania, silica, nano-diamond, etc. has been studied in literatures. In this paper, nano-ceria particles have been successfully added into transformer mineral oil with different content. The suspension is very stable and no segmentation can be observed over several months. The ceria nanoparticles are commercially available, which have a quite narrow size distribution. UV-Vis, TGA and FT-IR are used to characterize the ceria nanofluids. The water content of the ceria nanofluids has been measured by Karl Fisher titration, which is important for the breakdown strength of transformer oil. AC voltage breakdown and lightning impulse voltage breakdown measurements have been performed on the ceria nanofluids. An enhancement of 15% on AC breakdown voltage has been observed on ceria nanofluids with some content compared to reference transformer oil. On the other hand, no clear difference on the lightning impulse breakdown voltage is observed between the ceria nanofluids and reference transformer oil.

Background The Stockholm Hemangioma Cohort is important for evaluation of late effects after exposure to ionizing radiation during childhood. Dose estimates in this cohort were based on both measurements and calculations using an old treatment planning system. Methods We compare previously published and calculated dose estimates with new ones, obtained by Monte Carlo simulations, which mimic the hemangioma treatments with 226 Ra needles and tubes. The distances between the 226 Ra sources and the thyroid and breasts, respectively, were reassessed. Result The Monte Carlo calculations showed significantly lower dose values than those obtained earlier. The differences depended both on the modeling of the sources and on further individualized distances from the sources. The mean value of the new calculated doses was 25% of the old breast doses and 46% of the old thyroid doses. Conclusion New dosimetry for hemangioma treatments gives significantly lower organ doses for the few cases receiving the highest absorbed dose values. This implies that radiation risk estimates will increase and have to be recalculated. For retrospective studies it is now possible to calculate organ doses from radium treatments using modern treatment planning systems by modeling the source geometry carefully and apply the TG-43 formalism. It is important to be aware of the large uncertainties in calculated absorbed dose values.