Occupational Electromagnetic Fields exposure in Magnetic Resonance Imaging systems – Preliminary results for the RF harmonic content

PurposeEuropean legislation concerning the protection of workers from exposure to Electromagnetic Fields (EMF) was recently (26.6.2013) completed by Directive 2013/35/ΕU. This Directive is a specific one of the framework Directive 89/391/EEC and part of the overall legislation for Occupational Health and Safety (OHS). Magnetic Resonance Imaging (MRI) systems have played a key role, both in the postponement of the former 2004/40 EMF Directive and in the formation of the latest limits adopted by the new Directive. On the other hand, MRI systems are associated with the exposure of personnel to EMF of various frequencies and modulations, arousing peculiar safety issues. Therefore, we will try to acquire the highly important knowledge of the exact occupational exposure levels, in all working scenarios and practices.MethodsDifferent MRI systems (1.5 and 3 T) have been chosen for a variety of measurements in order to assess occupational exposure compared to the limits (ALs) of the Directive and to the main OHS principles. Gradient function of MRI systems results in low frequency exposure, while high frequency exposure comes from the application of the RF excitation frequency.ResultsIn most of the cases the RMS and peak value measurements do not exceed the corresponding ALs, apart from a few specific hot spots, manageable through OHS principles.DiscussionComplete occupational exposure results can form the basis for dealing with multiple exposures present in MRI systems. Peculiar RF harmonic components, of no safety concern, were detected. Their origin is under examination.     

Regulation of herbal medicinal products in the EU: an up-to-date scientific review

A new European legislation on herbal medicinal products (HMPs) was developed, in order to harmonise the use of HMPs in the 28 member states of the European Union, according to Directive 2004/24/EC which amended the basic legislation laid down in Directive 2001/83/EC. The objective of this legislation was to ensure the future existence of such products and to consider particular characteristics during the assessment of their quality, efficacy and safety, having defined two categories for herbal medicines: (a) well-established use HMPs, which can be granted a marketing authorisation; and (b) traditional herbal medicinal products which can be granted a registration based on their long-standing safe and efficient use. The Committee on Herbal Medicinal Products was established at the European Medicines Agency in 2004, in order mainly to provide community monographs and list entries on herbal substances and preparations. 120 monographs have been published since then, which offer a scientific and regulatory standard for their safety and efficacy, during their use as medicinal products. The HMPs can be placed in the market after quality, efficacy, and safety have been assessed according to the provisions of the legislation (Directive 2004/24/EC and Directive 2001/83/EC), with adequate labeling information to patients and health care professionals, distinguishing them from other product categories containing herbs like: foods, food supplements, medical devices and cosmetics.     

EFOMP survey results on national radiotherapy dosimetry audits

PurposeThe Council Directive 2013/58/EURATOM entered into force in 2014, and its transposition into national legislations became applicable in 2018. The Council Directive 2013/58/EURATOM strengthened the importance of clinical audits, and stated that Member States should ensure dosimetry audit compliance in accordance with national procedures. Therefore, the purpose of this work was to picture the status of the implementation of dosimetry audits in European countries. Methods: A questionnaire was designed to describe dosimetry audit standards in radiotherapy across European countries. The questionnaire was sent to 33 EFOMP National Member Organizations (NMO). Results: Nineteen NMOs responded to the survey (14 EU members). For 58% of the participating countries national regulations required dosimetry audits in radiotherapy departments. In 37% of the participating countries there were implemented regulations for independent/secondary dose verification, and in 21% of the participating countries similar procedures for dose verification were already implemented although not regulated by law. In 42% of the participating countries there were implemented mechanisms to review updates and advances in the field of radiotherapy.ConclusionsThe transposition and further implementation of the Council Directive 2013/59/EURATOM was scarce, leading to heterogeneities in national policies about dosimetry audits.     

EFOMP policy statement 16: The role and competences of medical physicists and medical physics experts under 2013/59/EURATOM

On 5 December 2013 the European Council promulgated Directive 2013/59/EURATOM. This Directive is important for Medical Physicists and Medical Physics Experts as it puts the profession on solid foundations and describes it more comprehensively. Much commentary regarding the role and competences has been developed in the context of the European Commission project “European Guidelines on the Medical Physics Expert” published as Radiation Protection Report RP174. The guidelines elaborate on the role and responsibilities under 2013/59/EURATOM in terms of a mission statement and competence profile in the specialty areas of Medical Physics relating to medical radiological services, namely Diagnostic and Interventional Radiology, Radiation Oncology and Nuclear Medicine. The present policy statement summarises the provisions of Directive 2013/59/EURATOM regarding the role and competences, reiterates the results of the European Guidelines on the Medical Physics Expert document relating to role and competences of the profession and provides additional commentary regarding further issues arising following the publication of the RP174 guidelines.     

Patient dose monitoring systems: A new way of managing patient dose and quality in the radiology department

PurposeDue to the upcoming European Directive (2013/59/EURATOM) and the increased focus on patient safety in international guidelines and regulations, Patient Dose Monitoring Systems, also called Dose Management Systems (DMS), are introduced in medical imaging departments. This article focusses on the requirements for a DMS, its benefits and the necessary implementation steps.MethodThe implementation of a DMS can be perceived as a lengthy, yet worthy, procedure: users have to select the appropriate system for their applications, prepare data collection, validate, perform configuration, and start using the results in quality improvement projects.ResultsA state of the art DMS improves the quality of service, ensures patient safety and optimizes the efficiency of the department. The gain is multifaceted: the initial goal is compliance monitoring against diagnostic reference levels. At a higher level, the user gets an overview of the performance of the devices or centers that are under his supervision. Error identification, generation of alerts and workflow analysis are additional benefits. It can also enable a more patient-centric approach with personalized dosimetry. Skin dose, size-specific dose estimates and organ doses can be calculated and evaluated per patient.ConclusionA DMS is a powerful tool and essential for improved quality and patient care in a radiology department. It can be configured to the needs of medical physicists, radiologists, technologists, even for the management of the hospital. Collaboration between all health professionals and stakeholders, input-output validation and communication of findings are key points in the process of a DMS implementation.     

Comparative LCA of concrete with recycled aggregates: a circular economy mindset in Europe

Purpose

Construction and demolition waste (C&DW) is the largest waste stream in the European Union (EU) and all over the world. Proper management of C&DW and recycled materials—including the correct handling of hazardous waste—can have major benefits in terms of sustainability and the quality of life. The Waste Framework Directive 2008/98/EC aims to have 70% of C&DW recycled by 2020. However, except for a few EU countries, only about 50% of C&DW is currently being recycled. In the present research, the environmental impact of concrete with recycled aggregates and with geopolymer mixtures is analysed. The aim of the present research is to propose a comparative LCA of concrete with recycled aggregates in the context of European politics.

Methods

Life cycle assessment (LCA) methodology is applied using Simapro© software. A cradle to grave analysis is carried out. The results are analysed based on the database Ecoinvent 3.3 and Impact 2002+.

Results

Results show that the concrete with 25% recycled aggregates is the best solution from an environmental point of view. Furthermore, geopolymer mixtures could be a valid alternative to reduce the phenomenon of “global warming”; however, the production of sodium silicate and sodium hydroxide has a great environmental impact.

Conclusions

A possible future implementation of the present study is certainly to carry out an overall assessment and to determine the most cost-effective option among the different competing alternatives through the life cycle cost analysis.

     

Validation of the MC-GPU Monte Carlo code against the PENELOPE/penEasy code system and benchmarking against experimental conditions for typical radiation qualities and setups in interventional radiology and cardiology

IntroductionInterventional procedures are associated with potentially high radiation doses to the skin. The 2013/59/EURATOM Directive establishes that the equipment used for interventional radiology must have a device or a feature informing the practitioner of relevant parameters for assessing patient dose at the end of the procedure. Monte Carlo codes of radiation transport are considered to be one of the most reliable tools available to assess doses. However, they are usually too time consuming for use in clinical practice. This work presents the validation of the fast Monte Carlo code MC-GPU for application in interventional radiology.MethodologiesMC-GPU calculations were compared against the well-validated Monte Carlo simulation code PENELOPE/penEasy by simulating the organ dose distribution in a voxelized anthropomorphic phantom. In a second phase, the code was compared against thermoluminescent measurements performed on slab phantoms, both in a calibration laboratory and at a hospital.ResultsThe results obtained from the two simulation codes show very good agreement, differences in the output were within 1%, whereas the calculation time on the MC-GPU was 2500 times shorter. Comparison with measurements is of the order of 10%, within the associated uncertainty.ConclusionsIt has been verified that MC-GPU provides good estimates of the dose when compared to PENELOPE program. It is also shown that it presents very good performance when assessing organ doses in very short times, less than one minute, in real clinical set-ups. Future steps would be to simulate complex procedures with several projections.     

Comparison of Different Standard Methods to Evaluate the Total Concentrations of Heavy Metals in Waste Rock

The mining industry is a very rapidly increasing production sector in Finland. Many new mines have been opened recently and others are in the planning phase. Mining legislation has been recently revised and compilation of an ID-directive (Industrial Emission Directive, 2010) required to implement environmental law revision is in progress. The aim of this study was to compare different digestion methods recommended by the Finnish Environmental Administration for threshold and guideline value determinations in the Finnish PIMA Decree (214/2007) and Government Decree (591/2006) concerning recovery of certain wastes in earth construction. Altogether six methods were tested, of which five were microwave-assisted acid digestion methods: ISO 11466, EPA Method 3051A (aqua region), EPA Method 3051A (HNO₃), EPA Method 3051A (HNO₃/HCl), and SFS-EN 13656, while one was a fusion method with lithium tetraborate (ASTM C 1391 - 95). The results showed that concentrations of heavy metals (As, Cd, Co, Cu, Ni, Pb, Sb, V, and Zn) can be determined reproducibly with standard methods, but the chemical method used can have a significant impact on the results. This conclusion is very important, because the measured heavy metal values can affect the classification and processing of waste materials, and thereby can significantly impact the cost of treatment.     

Extended Producer Responsibility for Waste Electronics: An Example of Printer Recycling in the United Kingdom

In February 2003, European Union (EU) policy makers implemented a Directive that will make producers responsible for waste electrical and electronic equipment at end-of-life (known as the "WEEE" Directive). Under this new legislation, producers are required to organize and finance the take-back, treatment, and recycling of WEEE and achieve mass-based recycling and recovery targets. This legislation is part of a growing trend of extended producer responsibility for waste, which has the potential to shift the world's economies toward more circular patterns of resource use and recycling. This study uses life-cycle assessment and costing to investigate the possible environmental effects of the WEEE Directive, based on an example of printer recycling in the United Kingdom.
For a total of four waste management scenarios and nine environmental impact categories investigated in this study, results varied, with no scenario emerging as best or worst overall compared to landfilling. The level of environmental impact depended on the type of material and waste management processes involved. Additionally, under the broad mass-based targets of the WEEE Directive, the pattern of relationships between recycling rates, environmental impacts, and treatment and recycling costs may lead to unplanned and unwanted results. Contrary to original EU assumptions, the use of mass-based targets may not ensure that producers adapt the design of their products as intended under producer responsibility.
It is concluded that the EU should revise the scope of consideration of the WEEE Directive to ensure its life-cycle impacts are addressed. In particular, specific environmental objectives and operating standards for treatment and recycling processes should be investigated as an alternative to mass-based recycling and recovery targets.     

Occupational exposure to electromagnetic fields. The situation in Greece

PurposeThe management of the occupational exposure to electromagnetic fields (EMF), an Occupational Health and Safety (OHS) issue of great scientific, social and economic significance, was under intense negotiations at European level over the last twenty years; the Directive 2013/35/EU is the new legislative tool. The presented study deals with the practical aspects of the Directive’s implementation.MethodsThe appropriate, extensive measurements and the overall EMF exposure assessments (i.e. exposure mapping, identification of hot spots, proposition of solutions) were conducted in specific workplaces, including power production, railway, broadcasting, clinical Magnetic Resonance Imaging (MRI) systems, industrial and research sites, as well as common office workplaces.ResultsThe vast majority of the performed EMF assessments did not reveal occupational overexposures; moreover in most of the cases, even the general public exposure limits (in the above occupational areas) were not exceeded. The very few localized overexposures detected, were manageable on the basis of the technical and organizational OHS principles.On the contrary, the maintenance procedures of the EMF emitting equipment, as recorded in this survey, presented overexposures revealing a challenging field.ConclusionsThis study lays a firm basis for the clarification of the occupational EMF environment, where potential exposures might be high. The proper risk assessment demands precise exposure identification and deep understanding of the EMF nature and hazards. Misconceptions range from the common exposure overestimation to the rarer case of the maintenance hazards underestimation, while attention is needed concerning the proper application of the complex limiting system of the Directive.     

Simulation of Diffusive Transport of Radionuclides in the Soil of a Radioactive Waste Disposal Site

The diffusive transport of ¹³⁷Cs, ⁹⁰Sr, and ⁶⁰Co in the clay of a radioactive waste disposal site at PINSTECH was studied to assess the safety of the underlying permeable zone against the release of these radionuclides from buried waste containers in the clay. Diffusion coefficients of these radionuclides were estimated by reservoir to sediment diffusion method via their stable counterparts in a laboratory experiment. A curve-fitting procedure was applied on the measured concentration-time profiles of the reservoir using the one-dimensional solute transport equation with a nonlinear least squares technique. Distribution coefficients were determined in laboratory batch experiments. Diffusive transport simulations were performed with the estimated values of diffusion coefficients and distribution coefficients using the one-dimensional solute transport equation describing Fickian diffusion, equilibrium adsorption, and radioactive decay. The transport simulation results showed that ¹³⁷Cs, ⁹⁰Sr, and ⁶⁰Co will transport distances of 4.33, 3.77, and 1.51 meters, respectively, in the clay before their activity concentrations will drop to clearance levels set by the International Atomic Energy Agency (IAEA), below which the waste is treated as non-radioactive. This showed that concentrations more than clearance levels will not be able to transport to the permeable zone at a minimum depth of seven meters from the ground surface if the waste containers are disposed in a trench below which a clay layer with a thickness of 4.33 meters or more exists.     

The European Federation of Organisations for Medical Physics Policy Statement No. 10.1: Recommended Guidelines on National Schemes for Continuing Professional Development of Medical Physicists

Continuing Professional Development (CPD) is vital to the medical physics profession if it is to embrace the pace of change occurring in medical practice. As CPD is the planned acquisition of knowledge, experience and skills required for professional practice throughout one's working life it promotes excellence and protects the profession and public against incompetence. Furthermore, CPD is a recommended prerequisite of registration schemes (Caruana et al. 2014 [1]; [2]) and is implied in the Council Directive 2013/59/EURATOM (EU BSS) [3] and the International Basic Safety Standards (BSS) [4]. It is to be noted that currently not all national registration schemes require CPD to maintain the registration status necessary to practise medical physics. Such schemes should consider adopting CPD as a prerequisite for renewing registration after a set period of time.This EFOMP Policy Statement, which is an amalgamation and an update of the EFOMP Policy Statements No. 8 and No. 10, presents guidelines for the establishment of national schemes for CPD and activities that should be considered for CPD.     

医疗损害赔偿立法存在的问题与完善建议

《中华人民共和国侵权责任法》虽然用专章规定医疗损害责任，但对医疗损害赔偿没有作出专门性规定，不能完全解决在司法实践中涌现的诸多医疗损害赔偿问题。拟从医学与法学理论及实践相结合角度，同时借鉴有关国家和地区医疗损害赔偿相关经验，对医疗损害赔偿立法存在的问题及完善进行分析、探讨。     

Niche Partitioning of Microbial Communities at an Ancient Vitrified Hillfort: Implications for Vitrified Radioactive Waste Disposal

Abstract

Because microbes cannot be eliminated from radioactive waste disposal facilities, the consequences of bio-colonization must be understood. At a pre-Viking era vitrified hillfort, Broborg, Sweden, anthropogenic glass has been subjected to bio-colonization for over 1,500?years. Broborg is used as a habitat analogue for disposed radioactive waste glass to inform how microbial processes might influence long-term glass durability. Electron microscopy and DNA sequencing of surficial material from the Broborg vitrified wall, adjacent soil, and general topsoil show that the ancient glass supports a niche microbial community of bacteria, fungi, and protists potentially involved in glass alteration. Communities associated with the vitrified wall are distinct and less diverse than soil communities. The vitrified niche of the wall and adjacent soil are dominated by lichens, lichen-associated microbes, and other epilithic, endolithic, and epigeic organisms. These organisms exhibit potential bio-corrosive properties, including silicate dissolution, extraction of essential elements, and secretion of geochemically reactive organic acids, that could be detrimental to glass durability. However, long-term biofilms can also possess a homeostatic function that could limit glass alteration. This study documents potential impacts that microbial colonization and niche partitioning can have on glass alteration, and subsequent release of radionuclides from a disposal facility for vitrified radioactive waste.     

Manganese metabolism is impaired in the Belgrade laboratory rat

Homozygous Belgrade rats have a hypochromic anaemia due to impaired iron transport across the cell membrane of immature erythroid cells. This study aimed at investigating whether there are also abnormalities of Mn metabolism in erythroid and other types of cells. The experiments were performed with homozygous (b/b) and heterozygous (+/b) Belgrade rats and Wistar rats and included measurements of Mn uptake by reticulocytes in vitro, Mn absorption from in situ closed loops of the duodenum, and plasma clearance and uptake by several organs after intravenous injection of radioactive Mn bound to transferrin (Tf ) or mixed with serum. Similar measurements were made with ⁵⁹Fe-labelled Fe in several of the experiments. Mn uptake by reticulocytes and absorption from the duodenum was impaired in b/b rats compared with +/b or Wistar rats. The plasma clearance of Mn-Tf was much slower than Mn-serum, but both were faster than the clearance of Fe-Tf. Uptake of ⁵⁴Mn by the kidneys, brain and femurs was less in b/b than Wistar or +/b rats, but uptake by the liver was greater in b/b rats. Similar differences were found for ⁵⁹Fe uptake by kidneys, brain and femurs but ⁵⁹Fe uptake by the liver was also impaired in the liver. It is concluded that the genetic abnormality present in b/b rats affects Mn metabolism as well as Fe metabolism and that Mn and Fe share similar transport mechanisms in the cells of erythroid tissue, duodenal mucosa, kidney and blood-brain barrier. Accepted: 20 February 1997     

A new bisphosphonate-containing <Superscript>99m</Superscript>Tc(I) tricarbonyl complex potentially useful as bone-seeking agent: synthesis and biological evaluation

Aiming to develop new bone-seeking radiotracers based on the organometallic core fac-[^99mTc(CO)₃]⁺ with improved radiochemical and biological properties, we have prepared new conjugates with phosphonate pendant groups. The conjugates comprise a chelating unit for metal coordination, which corresponds to a pyrazolyl-containing backbone (pz) with a N,N,N donor-atom set, and a pendant diethyl phosphonate (pz-MPOEt), phosphonic acid (pz-MPOH) or a bisphosphonic acid (pz-BPOH) group for bone targeting. Reactions of the conjugates with the precursor [^99mTc(H₂O)₃(CO)₃]⁺ yielded (mote than 95%) the single and well-defined radioactive species [^99mTc(CO)₃(κ³-pz-MPOEt)]⁺ (1a), [^99mTc(CO)₃(κ³-pz-MPOH]⁺ (2a) and [^99mTc(CO)₃(κ³-pz-BPOH)]⁺ (3a), which were characterized by reversed-phase high-performance liquid chromatography . The corresponding Re surrogates (1–3), characterized by the usual analytical techniques, including X-ray diffraction analysis in the case of 1, allowed for macroscopic identification of the radioactive conjugates. These radioactive complexes revealed high stability both in vitro (phosphate-buffered saline solution and human plasma) and in vivo, without any measurable decomposition. Biodistribution studies of the complexes in mice indicated a fast rate of blood clearance and high rate of total radioactivity excretion, occurring primarily through the renal–urinary pathway in the case of complex 3a. Despite presenting moderate bone uptake (3.04 ± 0.47% injected dose per gram of organ, 4 h after injection), the high stability presented by 3a and its adequate in vivo pharmacokinetics encourages the search for new ligands with the same chelating unit and different bisphosphonic acid pendant arms.     

European Federation of Organisations for Medical Physics (EFOMP) Policy Statement 12.1: Recommendations on Medical Physics Education and Training in Europe 2014

In 2010, EFOMP issued Policy Statement No. 12: “The present status of Medical Physics Education and Training in Europe. New perspectives and EFOMP recommendations” to be applied to education and training in Medical Physics within the context of the developments in the European Higher Education Area arising from the Bologna Declaration and with a view to facilitate the free movement of Medical Physics professionals within Europe. Concurrently, new recommendations regarding qualifications frameworks were published by the European Parliament and Council which introduced new terminology and a new qualifications framework – the European Qualifications Framework (EQF) for lifelong learning. In addition, a new European directive involving the medical use of ionizing radiations and set to replace previous directives in this area was in the process of development. This has now been realized as Council Directive 2013/59/Euratom of 5 December 2013 which has repealed directive 97/43/Euratom. In this regard, a new document was developed in the context of the EC financed project "European Guidelines on the Medical Physics Expert" and published as RP174. Among other items, these guidelines refer to the mission statement, key activities, qualification framework and curricula for the specialty areas of Medical Physics relating to radiological devices and protection from ionizing radiation. These developments have made necessary an update of PS12; this policy statement provides the necessary update.     

New Tools for Weight-Loss Therapy Enable a More Robust Medical Model for Obesity Treatment: Rationale for a Complications-Centric Approach

ObjectiveRecent advances in lifestyle intervention programs, pharmacotherapy, and bariatric surgery have enabled the development of medical models for the treatment of obesity. Regarding pharmacotherapy, in 2012 the U.S. Food and Drug Administration approved two new effective and safe weight-loss medications, phentermine/ topiramate extended release and lorcaserin, which has greatly augmented options for medically assisted weight loss.MethodsThe rationale for advantages of a complications-centric medical model over current body mass index (BMI)-centric indications for therapy is examined.ResultsCurrently, the baseline BMI level is the principle determinant of indications for obesity treatment using medication and surgery. However, the BMI-centric approach fails to target therapy to those obese patients who will benefit most from weight loss. In contrast, a complications-centric medical model is proposed that will earmark the modality and intensity of the therapeutic intervention based on the presence and severity of complications that can be ameliorated by weight loss.ConclusionThe complications-centric approach to “medicalizing” obesity care employs weight loss primarily as a tool to treat obesity-related complications and promotes the optimization of health outcomes, the benefit/risk ratio, and the cost-effectiveness of therapy. (Endocr Pract. 2013;19:864-874)     

基于荧光染料Cy5.5标记的引物延伸法鉴定细菌RNA剪切加工位点

【背景】传统引物延伸法常与放射性标记结合使用,但由于放射性元素半衰期短、危害人体健康及严格的操作要求等限制了其在一般实验室的广泛使用。因此,开发新型非放射性引物延伸法成为当前研究的热点。【目的】建立非放射性的引物延伸法,并利用该方法实现对细菌RNA剪切加工位点的鉴定。【方法】将包含RNA剪切位点的序列克隆至双荧光报告系统,然后利用荧光染料Cy5.5标记的特异性靶向mcherry寡核苷酸引物进行延伸,并辅以Northern blotting、RT-qPCR等技术,确定RNA剪切加工的精确位点。【结果】鉴定了来自解纤维梭菌cip-cel mRNA中的2个剪切加工位点均位于颈环结构下游的单链区域,且在剪切位点附近未发现保守序列。【结论】基于Cy5.5标记的引物延伸法能够精确鉴定RNA剪切加工位点,且与传统的放射性引物延伸法相比,该方法具有更高的安全性和更快的检测速度,能够满足一般实验室的实验要求。