Underpinning the use of indium as a neutron absorbing additive in zirconolite by X-ray absorption spectroscopy.

Indium (In) is a neutron absorbing additive that could feasibly be used to mitigate criticality in ceramic wasteforms containing Pu in the immobilised form, for which zirconolite (nominally CaZrTi2O7) is a candidate host phase. Herein, the solid solutions Ca1-xZr1-xIn2xTi2O7 (0.10 ≤ x ≤ 1.00; air synthesis) and Ca1-xUxZrTi2-2xIn2xO7 (x = 0.05, 0.10; air and argon synthesis) were investigated by conventional solid state sintering at a temperature of 1350 °C maintained for 20 h, with a view to characterise In3+ substitution behaviour in the zirconolite phase across the Ca2+, Zr4+ and Ti4+ sites. When targeting Ca1-xZr1-xIn2xTi2O7, single phase zirconolite-2M was formed at In concentrations of 0.10 ≤ x ≤ 0.20; beyond x ≥ 0.20, a number of secondary In-containing phases were stabilised. Zirconolite-2M remained a constituent of the phase assemblage up to a concentration of x = 0.80, albeit at relatively low concentration beyond x ≥ 0.40. It was not possible to synthesise the In2Ti2O7 end member compound using a solid state route. Analysis of the In K-edge XANES spectra in the single phase zirconolite-2M compounds confirmed that the In inventory was speciated as trivalent In3+, consistent with targeted oxidation state. However, fitting of the EXAFS region using the zirconolite-2M structural model was consistent with In3+ cations accommodated within the Ti4+ site, contrary to the targeted substitution scheme. When deploying U as a surrogate for immobilised Pu in the Ca1-xUxZrTi2-2xIn2xO7 solid solution, it was demonstrated that, for both x = 0.05 and 0.10, In3+ was successfully able to stabilise zirconolite-2M when U was distributed predominantly as both U4+ and average U5+, when synthesised under argon and air, respectively, determined by U L3-edge XANES analysis.

Optimization of Magnesium Potassium Phosphate Cements Using Ultrafine Fly Ash and Fly Ash.

The effect of ultrafine fly ash (UFA) and fly ash (FA) on the physical properties, phase assemblage, and microstructure of magnesium potassium phosphate cement (MKPC) was investigated. This study revealed that the UFA addition does not affect the calorimetry hydration peak associated with MKPC formation when normalized to the reactive components (MgO and KH2PO4). However, there is an indication that greater UFA additions lead to an increased reaction duration, suggesting the potential formation of secondary reaction products. The addition of a UFA:FA blend can delay the hydration and the setting time of MKPC, enhancing workability. MgKPO4·6H2O was the main crystalline phase observed in all systems; however, at low replacement levels in the UFA-only system (<30 wt %), Mg2KH(PO4)2·15H2O was also observed by XRD, SEM/EDS, TGA, and NMR (31P MAS, 1H-31P CP MAS). Detailed SEM/EDS and MAS NMR investigations (27Al, 29Si, 31P) demonstrated that the role of UFA and UFA:FA was mainly as a filler and diluent. Overall, the optimized formulation was determined to contain 40 wt % fly ash (10 wt % UFA and 30 wt % FA (U10F30)), which achieved the highest compressive strength and fluidity and produced a dense microstructure.

Phase Evolution in the CaZrTi2O7-Dy2Ti2O7 System: A Potential Host Phase for Minor Actinide Immobilization.

Zirconolite is considered to be a suitable wasteform material for the immobilization of Pu and other minor actinide species produced through advanced nuclear separations. Here, we present a comprehensive investigation of Dy3+ incorporation within the self-charge balancing zirconolite Ca1-xZr1-xDy2xTi2O7 solid solution, with the view to simulate trivalent minor actinide immobilization. Compositions in the substitution range 0.10 ≤ x ≤ 1.00 (Δx = 0.10) were fabricated by a conventional mixed oxide synthesis, with a two-step sintering regime at 1400 °C in air for 48 h. Three distinct coexisting phase fields were identified, with single-phase zirconolite-2M identified only for x = 0.10. A structural transformation from zirconolite-2M to zirconolite-4M occurred in the range 0.20 ≤ x ≤ 0.30, while a mixed-phase assemblage of zirconolite-4M and cubic pyrochlore was evident at Dy concentrations 0.40 ≤ x ≤ 0.50. Compositions for which x ≥ 0.60 were consistent with single-phase pyrochlore. The formation of zirconolite-4M and pyrochlore polytype phases, with increasing Dy content, was confirmed by high-resolution transmission electron microscopy, coupled with selected area electron diffraction. Analysis of the Dy L3-edge XANES region confirmed that Dy was present uniformly as Dy3+, remaining analogous to Am3+. Fitting of the EXAFS region was consistent with Dy3+ cations distributed across both Ca2+ and Zr4+ sites in both zirconolite-2M and 4M, in agreement with the targeted self-compensating substitution scheme, whereas Dy3+ was 8-fold coordinated in the pyrochlore structure. The observed phase fields were contextualized within the existing literature, demonstrating that phase transitions in CaZrTi2O7-REE3+Ti2O7 binary solid solutions are fundamentally controlled by the ratio of ionic radius of REE3+ cations.

Thermal treatment of Cs-exchanged chabazite by hot isostatic pressing to support decommissioning of Fukushima Daiichi Nuclear Power Plant.

Ion exchange materials are used widely for the removal of radionuclides from contaminated water at nuclear licensed sites, during normal operating procedures, decommissioning and in accident clean-up, such as the ongoing recovery operation at the Fukushima Daiichi nuclear power plant. Framework silicate inorganic ion exchange materials, such as chabazite ((Na0.14K1.03Ca1.00Mg0.17)[Al3.36Si8.53O24]•9.7H2O), have shown particular selectivity towards 137Cs uptake, but their safe storage poses a number challenges requiring conditioning into passively safe waste packages of minimal volume. We demonstrate the transformation of Cs-exchanged chabazite into a glass-ceramic wasteform by hot isostatic pressing to produce a durable consolidated monolith. The application of heat and pressure resulted in the collapse of the chabazite framework, forming crystalline Cs-substituted leucite (Cs0.15(3)K0.57(4)Al0.90(4)Si2.24(5)O6) incorporated within a K2O-CaO-MgO-Al2O3-SiO2 glass. The Cs partitioned preferentially into the Cs/K-feldspar which incorporated ~77% of the Cs2O inventory. Analysis of the chemical durability of the glass-ceramic wasteform revealed that the Cs release rates were comparable or lower than those reported for vitrified high level and intermediate level wastes. Overall, hot isostatic pressing was demonstrated to be an effective processing technology for conditioning spent inorganic ion exchange materials by yielding durable and passively safe wasteforms.

Characterization of and Structural Insight into Struvite-K, MgKPO4·6H2O, an Analogue of Struvite.

Struvite-K (MgKPO4·6H2O) is a magnesium potassium phosphate mineral with naturally cementitious properties, which is finding increasing usage as an inorganic cement for niche applications including nuclear waste management and rapid road repair. Struvite-K is also of interest in sustainable phosphate recovery from wastewater and, as such, a detailed knowledge of the crystal chemistry and high-temperature behavior is required to support further laboratory investigations and industrial applications. In this study, the local chemical environments of synthetic struvite-K were investigated using high-field solid-state 25Mg and 39K MAS NMR techniques, alongside 31P MAS NMR and thermal analysis. A single resonance was present in each of the 25Mg and 39K MAS NMR spectra, reported here for the first time alongside the experimental and calculated isotropic chemical shifts, which were comparable to the available data for isostructural struvite (MgNH4PO4·6H2O). An in situ high-temperature XRD analysis of struvite-K revealed the presence of a crystalline-amorphous-crystalline transition that occurred between 30 and 350 °C, following the single dehydration step of struvite-K. Between 50 and 300 °C, struvite-K dehydration yielded a transient disordered (amorphous) phase identified here for the first time, denoted δ-MgKPO4. At 350 °C, recrystallization was observed, yielding ß-MgKPO4, commensurate with an endothermic DTA event. A subsequent phase transition to γ-MgKPO4 was observed on further heating, which reversed on cooling, resulting in the α-MgKPO4 structure stabilized at room temperature. This behavior was dissimilar from that of struvite exposed to high temperature, where NH4 liberation occurs at temperatures >50 °C, indicating that struvite-K could potentially withstand high temperatures via a transition to MgKPO4.

Characterisation and disposability assessment of multi-waste stream in-container vitrified products for higher activity radioactive waste.

Materials from GeoMelt® In-Container Vitrification (ICV)™ of simulant UK nuclear wastes were characterised to understand the partitioning of elements, including inactive surrogates for radionuclide species of interest, within the heterogeneous products. Aqueous durability analysis was performed to assess the potential disposability of the resulting wasteforms. The vitrification trial aimed to immobilise a variety of simulant legacy waste streams representative of decommissioning operations in the UK, including plutonium contaminated material, Magnox sludges and ion-exchange materials, which were vitrified upon the addition of glass forming additives. Two trials with different wastes were characterised, with the resultant vitreous wasteforms comprising olivine and pyroxene crystalline minerals within glassy matrices. Plutonium surrogate elements were immobilised within the glassy fraction rather than partitioning into crystalline phases. All vitrified products exhibited comparable or improved durability to existing UK high level waste vitrified nuclear wasteforms over a 28 day period.

Exploiting in-situ solid-state NMR spectroscopy to probe the early stages of hydration of calcium aluminate cement.

We report a high-field in-situ solid-state NMR study of the hydration of CaAl2O4 (the most important hydraulic phase in calcium aluminate cement), based on time-resolved measurements of solid-state 27Al NMR spectra during the early stages of the reaction. A variant of the CLASSIC NMR methodology, involving alternate recording of direct-excitation and MQMAS 27Al NMR spectra, was used to monitor the 27Al species present in both the solid and liquid phases as a function of time. Our results provide quantitative information on the changes in the relative amounts of 27Al sites with tetrahedral coordination (the anhydrous reactant phase) and octahedral coordination (the hydrated product phases) as a function of time, and reveal significantly different kinetic and mechanistic behaviour of the hydration reaction at the different temperatures (20 °C and 60 °C) studied.

Current controversies in early-stage melanoma: Questions on incidence, screening, and histologic regression.

In the first article in this continuing medical education series we review controversies and uncertainties relating to the epidemiology and initial diagnosis of localized cutaneous melanoma (ie, stage 0, I, or II). Many of these issues are unsettled because of conflicting evidence. Melanoma incidence appears to be increasing, yet its basis has not been fully explained. Despite the advantages of early detection, the US Preventive Services Task Force does not recommend skin screening for the general population. Occasionally, biopsy specimens of melanoma will show histologic regression, but the prognostic importance of this phenomenon is uncertain. Some practitioners recommend obtaining a sentinel lymph node biopsy specimen for thin melanomas showing regression, although this histologic finding is not part of the staging system for thin melanomas. Our goal is to provide the clinician who cares for patients with (or at risk for) melanoma with up-to-date contextual knowledge to appreciate the multiple sides of each controversy so that they will be better informed to discuss these issues with their patients and their families.

Use of an Interdisciplinary Student Medical Innovation and Entrepreneurship Program to Create Affordable Global Health Care Solutions.

BACKGROUND: Bench to Bedside is a 7-month-long medical innovation and entrepreneurship program at the University of Utah in which teams comprising students from various disciplines work together to identify health care problems and develop novel technology solutions. Student teams are provided a small prototyping budget, access to device development workshops, prototyping facilities, and expert faculty and industry mentors. Teams then compete for seed funding at the Bench to Bedside competition at the end of the program. In 2014, we created global health-specific resources, mentorship, guidance, and award incentives as a means to drive global health technology development in the program and then studied our impact after 6 years. METHODS: We reviewed program data collected continuously between 2011 and 2018 to evaluate the impact of global health incentive initiatives on the development of global health-related technologies. We quantified the number of global health teams based on both team-declared data and objective evaluation of each competing technology. RESULTS: The initiation of global health technology incentives was associated with an annual overall doubling of teams pursuing the development of global health-related technologies from an average of 11.4% to 24.8% ( P = .003). CONCLUSIONS: A student medical technology innovation program designed to address global health needs is an effective means of generating new solutions to improve global health care. The use of global health-specific awards and mentors raised awareness of the need for affordable global solutions and incentivized teams to pursue development.

Blast furnace slag-Mg(OH)2 cements activated by sodium carbonate.

The structural evolution of a sodium carbonate activated slag cement blended with varying quantities of Mg(OH)2 was assessed. The main reaction products of these blended cements were a calcium-sodium aluminosilicate hydrate type gel, an Mg-Al layered double hydroxide with a hydrotalcite type structure, calcite, and a hydrous calcium aluminate phase (tentatively identified as a carbonate-containing AFm structure), in proportions which varied with Na2O/slag ratios. Particles of Mg(OH)2 do not chemically react within these cements. Instead, Mg(OH)2 acts as a filler accelerating the hardening of sodium carbonate activated slags. Although increased Mg(OH)2 replacement reduced the compressive strength of these cements, pastes with 50 wt% Mg(OH)2 still reached strengths of ∼21 MPa. The chemical and mechanical characteristics of sodium carbonate activated slag/Mg(OH)2 cements makes them a potentially suitable matrix for encapsulation of high loadings of Mg(OH)2-bearing wastes such as Magnox sludge.

Risk factors for development of melanoma brain metastasis and disease progression: a single-center retrospective analysis.

Melanoma metastasis to the brain is associated with a poor prognosis. We sought to determine patient demographics and primary tumor factors associated with the development of brain metastasis (BM) and survival. We also investigated whether the BM detection setting (routine screening vs. symptomatic presentation) affected clinical outcomes. A database of melanoma patients seen from 1999 to 2015 at our institution was reviewed to identify patients who developed BM. Patients with BM were matched by initial stage with patients who did not develop BM as a control group. Patient demographics, primary tumor characteristics, and clinical outcomes were analyzed. A total of 123 patients with BM were matched by initial presenting stage to 237 patients without BM. The characteristics of the primary melanoma tumor associated with BM development included location on the scalp (P=0.030), nodular histologic type (P=0.020), and Breslow depth more than 4 mm (P=0.048), whereas location on the leg was associated with decreased BM risk (P=0.006). In patients with BM, time to first recurrence for melanomas of the scalp was significantly shorter (10.8 vs. 24.8 months, P=0.007) than nonscalp head and neck tumors. Patient stage, tumor depth, nodular type, and ulceration were also associated with worse clinical outcomes. There were no differences in the clinical outcomes between patients whose BM were detected upon routine screening versus those detected upon symptomatic presentation. In summary, factors predictive of development of BM included primary scalp location, nodular type, and depth. In BM patients, scalp location, stage, tumor depth, nodular type, and ulceration, but not detection setting, were associated with worse clinical outcomes.

Histiocytic sarcoma with secondary involvement of the skin and expression of CD1a: evidence of indeterminate cell differentiation?

BACKGROUND: Histiocytic sarcoma is an exceedingly rare malignant neoplasm composed of cells with a monocyte/macrophage phenotype. In the current nosology of histiocytic neoplasms, histiocytic sarcoma is separate from indeterminate cell histiocytosis, a generally benign disorder characterized by proliferation of a CD1a+ and S-100+ population of cells lacking Birbeck granules usually limited to the skin. METHODS: We present a case of histiocytic sarcoma in a 64-year-old man presenting as a peritonsillar mass and secondarily involving the skin. RESULTS: The malignant cells in the extracutaneous foci of disease expressed macrophage-associated antigens including S-100 but were CD1a-. The malignant cells in the skin coexpressed CD1a and S-100 but lacked ultrastructural features of Langerhans cells, findings indicative of indeterminate cells. CONCLUSIONS: We discuss the clinical and histopathologic differential diagnosis in association with prior reported cases of histiocytic sarcoma, particularly in cases involving the skin and cases expressing the Langerhans cell-associated antigen CD1a.

Ewing sarcoma/peripheral primitive neuroectodermal tumor: adult abdominal tumors with an Ewing sarcoma gene rearrangement demonstrated by fluorescence in situ hybridization in paraffin sections.

The differential diagnosis of small round cell tumors is exhaustive and requires ancillary studies. Relatively recently, fluorescence in situ hybridization (FISH) using probes for specific gene rearrangements has gained wide acceptance. This technique is particularly useful in the differential diagnosis of Ewing sarcoma/primitive neuroectodermal tumor (ES/PNET) and desmoplastic small round-cell tumor (DSRCT). In ES/PNET, the EWS gene is juxtaposed to the FLI-1 gene in 85% of cases and to the ERG gene in another 7% of cases; the EWS gene is juxtaposed to the WTI gene in DSRCT. Documentation of the EWS gene rearrangements in EWS/PNET has previously been demonstrated in frozen tissue. We report 2 unusual cases of EWS/PNET diagnosed in abdominal tumors in adults. Although the immunohistochemical results supported a diagnosis of ES/PNET, 1 case morphologically resembled DSRCT. The diagnosis in these 2 cases was confirmed by the FISH demonstration of EWS/FLI-1 gene fusion in paraffin-embedded tissue. Thus, the usefulness of FISH demonstration of an EWS gene rearrangement with these specific probes in such unusual cases is supported and is demonstrated in paraffin-embedded tissue.

Extranodal posttransplant plasmacytic hyperplasia with subsequent posttransplant plasmacytic malignancy: six-year interval case report and review of the literature.

Posttransplant lymphoproliferative disorders (PTLDs) represent a morphologic, immunophenotypic, and genotypic spectrum of disease. Most recently, Knowles et al divided PTLDs into 3 distinct categories: (1) plasmacytic hyperplasia, (2) polymorphic B-cell hyperplasia and polymorphic B-cell lymphoma, and (3) immunoblastic lymphoma and multiple myeloma. Although one form of PTLD may progress to another form, only 1 previous case has been reported in which multiple myeloma developed 14 months after an original diagnosis of plasmacytic hyperplasia. The type of solid organ transplant was not specified in that case. We report a post--cardiac transplant plasmacytic hyperplasia developing 7 years posttransplant. Six years subsequent to the plasmacytic hyperplasia, the patient developed a posttransplant plasmacytic malignancy, supported by morphology, flow cytometric immunophenotyping, and genotypic studies. Since we have no data to support disseminated bony disease or an abnormal serum protein, we have not used the term "multiple myeloma" for this case.

Flow cytometric immunophenotyping in posttransplant lymphoproliferative disorders.

We studied the flow cytometric immunophenotyping (FCI) and genotypic data of 11 specimens from 10 transplant recipients and categorized them based on a scheme for posttransplant lymphoproliferative disorders (PTLDs). Specimens had been analyzed by polymerase chain reaction and/or Southern blot for T-cell and B-cell (immunoglobulin heavy chain and light chain genes) gene rearrangements (BGR). The categories for PTLDs were as follows: 1, 1; 2, 6; and 3, 4. The plasmacytic and polymorphic B-cell hyperplasias (PBCHs) revealed no monoclonal/aberrant cells by FCI or genotypic studies (GS). Three of 4 polymorphic B-cell lymphomas (PBCLs) revealed monoclonal or aberrant (no surface light chain) B cells by FCI; 1 of 3 revealed a BGR. However, the 1 case with no monoclonal/aberrant B cells by FCI revealed a BGR. Both immunoblastic lymphomas revealed monoclonal or aberrant B cells by FCI; 1 revealed a BGR. Both multiple myelomas revealed monoclonal plasma cells by FCI; 1 revealed a BGR. In the 4 PTLDs with monoclonal/aberrant B cells by FCI and no clonality detected by GS, the GS were performed on fresh and paraffin-embedded tissue samples. FCI of the plasmacytic and PBCHs supported no clonal process by GS. FCI defined a clonal process in 2 PBCLs, I immunoblastic lymphoma, and 1 multiple myeloma that were negative by GS. However, 1 PBCL that was polyclonal by FCI was monoclonal by GS. Thus, FCI is useful for identifying a clonal process in PTLDs with negative results by GS; FCI and GS should be performed routinely in PTLDs to detect a clonal process.