Dose equivalent consideration from neutron contamination in modified radiotherapy vault: a Monte Carlo study.

Laminated barriers incorporating metal sheets provide effective protection for space-restricted radiotherapy centers. This study aimed to assess photoneutron contamination in smaller vaults protected by different compositions of multilayer barriers during simulated pelvic radiotherapy with 18 MV photon beams. Monte Carlo Simulations of 18 MV LINAC (Varian 2100 C/D) and Medical Internal Radiation Dose (MIRD) phantom were used to assess photoneutron contamination within reconstructed vaults incorporating different combinations of metal sheet and borated polyethylene (BPE) during pelvic radiotherapy. The findings highlight a 3.27 and 2.91 times increase in ambient neutron doseHn*(10) along the maze of reconstructed vaults that use lead and steel sheets, respectively, compared to concrete. TheHn*(10) outside the treatment room increased after incorporating a metal sheet, but it remained within the permissible limit of 20µSv/week for uncontrolled areas adjacent to the LINAC bunker, even with a workload of 1000Gy/week. Neutron equivalent doses in the patient's organs ranged from 0.22 to 0.96 mSv Gy-1. There is no notable distinction in the organ's neutron equivalent dose, fatal cancer risk, secondary radiation-induced cancer risk, and cancer mortality for various laminated barrier compositions. Furthermore, the use of metal sheets for vault wall reconstruction keeps the variation in cancer risk induced by photoneutrons below 6%, while risks of fatal cancer and cancer mortality vary less than 11%. While the metal portion of the laminated barrier raises the neutron dose, the addition of a BPE plate reduces concerns of increased effective dose and secondary malignancy risk.

Mechanochemical recycling of cellulose multilayer carton packages to produce micro and nanocellulose from the perspective of techno-economic and environmental analysis.

Despite being composed of recyclable materials, the main technological challenge of multilayer carton packs involves the efficient decompatibilization of the cellulosic, polymeric, and metallic phases. Here, a simple two-step mechanochemical process is described that uses only aqueous media and mechanical force to promote phase separation in order to fully recycle multi-layer carton packaging. The first step produces value-added micro- and nanocellulose, while in the second step, aluminum is extracted, forming precipitated aluminum and aluminum oxyhydroxides. Solid polyethylene (PE) remains with a degree of purity defined by the process efficiency. The results show that cellulose is efficiently extracted and converted into micro- and nanocellulose after 15 min of milling. In the second stage, approximately 90% of the aluminum is extracted from the PE after 15 min of milling. Due to the separation and drying medium conditions, the finely divided particles of extracted aluminum also have oxyhydroxides in their composition. It is believed that a passivation layer forms on the metallic aluminum particle. The techno-economic analysis revealed a positive net present value (NPV) of $17.5 million, with a minimum selling price of 1.62 USD/kg of cellulose. The environmental analysis concluded that most of the environmental impact of the process is associated with the entry of carton packages into the system, incorporating a small environmental load related to the industrial process. The results indicate a promising option toward a circular economy and carbon neutrality.

Interaction of fluorene and its analogs with high-density polyethylene microplastics: An assessment of the adsorption mechanism to establish the effects of heteroatoms in the molecule.

The threat of microplastics (MP) pollution in aquatic ecosystems can be even more severe for they are able to interact with organic pollutants that can migrate to adjacent environments. The presence of heteroatoms in organic pollutants can directly influence adsorption onto MP. This research evaluated the adsorption of fluorene (FLN) and its heteroatom analogs dibenzothiophene (DBT), dibenzofuran (DBF) and carbazole (CBZ) onto high-density polyethylene (HDPE) MP from residual (HDPEres) and commercial (HDPEcom) sources. The Langmuir isotherm showed a better fit, while DBT showed higher maximum adsorption capacity (19.2 and 15.8 µmol g-1) followed by FLN (13.4 and 11.7 µmol g-1), and DBF (13.5 and 10.3 µmol g-1) to the HDPEcom and HDPEres, respectively, which indicates a direct correlation with the hydrophobicity of the molecules determined by Log Kow. In contrast, CBZ showed no significant interaction with MP, due to their polar characteristic, thus, no kinetic and thermodynamic parameters could be determined. The adsorption process of all PAH was determined to be exothermic and spontaneous, with low temperatures favoring the process. The pseudo-second-order kinetic models have fitted to the adsorption onto both HDPE; intraparticle diffusion was also observed. Computational studies, physical characterization techniques and batch adsorption experiments demonstrated that the mechanism is governed by hydrophobic interactions, with van der Waals forces as a secondary effect in the adsorption of FLN, DBT and DBF onto HDPEres and HDPEcom. Thus, allowing a deeper understanding of the interactions between HDPE MP and FLN as well with its derivatives.

Water-Tree Resistability of UV-XLPE from Hydrophilicity of Auxiliary Crosslinkers.

The water-resistant characteristics of ultraviolet crosslinked polyethylene (UV-XLPE) are investigated specially for the dependence on the hydrophilicities of auxiliary crosslinkers, which is significant to develop high-voltage insulating cable materials. As auxiliary crosslinking agents of polyethylene, triallyl isocyanurate (TAIC), trimethylolpropane trimethacrylate (TMPTMA), and N,N'-m-phenylenedimaleimide (HAV2) are individually adopted to prepared XLPE materials with the UV-initiation crosslinking technique, for the study of water-tree resistance through the accelerating aging experiments with water blade electrode. The stress-strain characteristics and dynamic viscoelastic properties of UV-XLPE are tested by the electronic tension machine and dynamic thermomechanical analyzer. Monte Carlo molecular simulation is used to calculate the interaction parameters and mixing energy of crosslinker/water binary systems to analyze the compatibility between water and crosslinker molecules. Water-tree experiments verify that XLPE-TAIC represents the highest ability to inhibit the growth of water-trees, while XLPE-HAV2 shows the lowest resistance to water-trees. The stress-strain and viscoelastic properties show that the concentration of molecular chains connecting the adjacent lamellae in amorphous phase of XLPE-HAV2 is significantly higher than that of XLPE-TAIC and XLPE-TMPTMA. The molecular simulation results demonstrate that TAIC/water and TMPTMA/water binary systems possess a higher hydrophilicity than that of HAV2/water, as manifested by their lower interaction parameters and mixing free energies. The auxiliary crosslinkers can not only increase the molecular density of amorphous polyethylene between lamellae to inhibit water-tree growth, but also prevent water molecules at insulation defects from agglomerating into micro-water beads by increasing the hydrophilicity of auxiliary crosslinkers, which will evidently reduce the damage of micro-water beads on the amorphous phase in UV-XLPE. The better compatibility of TAIC and water molecules is the dominant reason accounting for the excellent water resistance of XLPE-TAIC.

The Role of Crosslinked Polyethylene in Reducing Aggregated Costs of Total Hip Arthroplasty in the United States.

BACKGROUND: Widespread adoption of crosslinked polyethylene for the acetabular articular surface for total hip arthroplasty has substantially reduced revision rates and dislocation rates. We aim to provide estimates of the resulting magnitude of the annual reduction in aggregated costs of total hip arthroplasty surgery in the United States. METHODS: After we obtained, from the literature, the contrasting mid-term rates of revisions and dislocations of total hip arthroplasty using conventional polyethylene vs those using crosslinked polyethylene, specifically from only registry studies and prospective, randomized controlled studies, we multiplied these incidence figures by the cost estimates of these failures to generate approximations of the cost savings in the United States from the use of crosslinked polyethylene. RESULTS: The estimates suggest that in the United States these savings might be one billion dollars per annual cohort over a 15-year duration. CONCLUSION: The use of crosslinked polyethylene has reduced substantially the overall costs of total hip arthroplasty surgery in the United States.

Label-free detection of pepsinogen 1 and 2 by polyethylene coating Lamb microfluidic device.

Early screening of gastric cancer is a critical importance for the improvement of patients' survival rate. Here, a polyethylene coating Lamb (PE-Lamb) microfluidic device with immune layer for gastric cancer label-free detection was constructed. Two serum pepsinogen 1 (PG1) and pepsinogen 2 (PG2) biomarkers were applied to screen and predict the appearance of gastric cancer. Compared with enzyme-linked immunosorbent assay (ELISA), this method achieved a higher sensitivity and less time (40 min vs 120 min). The limit of detections (LOD) were reached 60 pg/mL for PG1 and 30 pg/mL for PG2, which have two orders of magnitude lower than traditional ELISA. The linearity coefficient indexes (R2) for PG1 and PG2 were 0.992 and 0.953 respectively, which is similar to that of ELISA. In addition, PG1 and PG2 mixed antigens sample with human serum was detected by PE-Lamb approach, and the frequency response showed high reproducibility and specificity. The results indicate that PE-lamb diagnostic technique is a novel and promising method for high-throughput screening and early diagnosis of gastric cancer.

In vitro assessment of the influence of intravenous extension set materials on insulin aspart drug delivery.

Insulin is a frequently prescribed drug in hospitals and is usually administered by syringe pumps with an extension line which can be made of various materials. Two insulin solutions were studied: an insulin analogue, Novorapid® which contains insulin aspart and two phenolic preservatives (e.g. phenol and metacresol) and Umuline rapide® with human insulin and metacresol as preservative. Some studies have indicated interactions between insulin, polyvinyl chloride (PVC) and polyethylene (PE). The aim of this work was to study such interactions between Novorapid® or Umuline rapide® and infusion extension line materials (PVC, PE and coextruded (PE/PVC)). Insulin solution at 1 IU/mL was infused at 2 mL/h over 24 hours with 16 different extension lines (8 in PVC, 3 in PE and 5 in PE/PVC). Ultra-Fast Liquid Chromatography with diode array detection (UFLC-DAD) was performed to quantify insulin (human and aspart) and preservatives (metacresol and phenol). Limited human insulin sorption was observed thirty minutes after the onset of infusion: 24.3 ± 12.9%, 3.1 ± 1.6% and 18.6 ± 10.0% for PVC, PE and PE/PVC respectively. With insulin aspart, sorption of about 5% was observed at the onset of infusion for all materials. However, there were interactions between phenol and especially metacresol with PVC, but no interactions with PE and PE/PVC. This study shows that insulin interacts with PVC, PE and PE/PVC at the onset of infusion. It also demonstrates that insulin preservatives interact with PVC, which may result in problems of insulin conservation and conformation. Some more studies are required to understand the clinical impact of the latter during infusion.

Isolated Polyethylene Exchange With Increased Constraint Is Comparable to Component Revision TKA for Instability in Properly Selected Patients.

BACKGROUND: Symptomatic instability following total knee arthroplasty (TKA) is a leading cause of early failure. Most reports recommend component revision as the preferred treatment because of poor outcomes and high failure rates with isolated tibial polyethylene insert exchange (ITPIE). However, these ideas have not been tested in modern implant systems that allow insert constraint to be increased. METHODS: We retrospectively reviewed 90 consecutive patients with minimum 2-year (mean 3.7 years) follow-up who underwent revision TKA for instability at a single institution. Mean age was 62.0 years (range, 41 to 83 years), and 73% of patients were women. Forty percent of patients were treated with ITPIE when standardized preoperative and intraoperative criteria were met; 60% underwent revision of one or both components when these criteria were not met. RESULTS: Patients experienced significant improvements in Knee Society (KS) knee (48.4 to 82.6; P < .001) and function (49.0 to 81.0; P < .001) scores. There were no significant differences in improvements in KS knee scores (38.1 vs 33.1; P = .18), KS function scores (36.0 vs 34.0; P = .63), or arc of motion (5° vs 6°; P = .88) between those treated with ITPIE and component revision. Failure rates were 19.4% in the ITPIE group vs 18.5% in the component revision group (odds ratio, 1.06; P = .91). Re-revision rates were significantly lower (6.3% vs 30.8%; odds ratio, 0.15; P = .004) when polyethylene insert constraint was increased. CONCLUSION: In selected patients, ITPIE is not inferior to component revision at addressing symptomatic instability following TKA. Degree of constraint should be increased whenever possible during revision surgery for instability.

Development and blood compatibility assessment of electrospun polyvinyl alcohol blended with metallocene polyethylene and plectranthus amboinicus (PVA/mPE/PA) for bone tissue engineering.

INTRODUCTION: Currently, the design of extracellular matrix (ECM) with nanoscale properties in bone tissue engineering is challenging. For bone tissue engineering, the ECM must have certain properties such as being nontoxic, highly porous, and should not cause foreign body reactions. MATERIALS AND METHODS: In this study, the hybrid scaffold based on polyvinyl alcohol (PVA) blended with metallocene polyethylene (mPE) and plectranthus amboinicus (PA) was fabricated for bone tissue engineering via electrospinning. The fabricated hybrid nanocomposites were characterized by scanning electron microscopy (SEM), Fourier transform and infrared spectroscopy (FTIR), thermogravimetric analysis (TGA), contact angle measurement, and atomic force microscopy (AFM). Furthermore, activated partial thromboplastin time (APTT), prothrombin time (PT), and hemolytic assays were used to investigate the blood compatibility of the prepared hybrid nanocomposites. RESULTS: The prepared hybrid nanocomposites showed reduced fiber diameter (238±45 nm) and also increased porosity (87%) with decreased pore diameter (340±86 nm) compared with pure PVA. The interactions between PVA, mPE, and PA were identified by the formation of the additional peaks as revealed in FTIR. Furthermore, the prepared hybrid nanocomposites showed a decreased contact angle of 51°±1.32° indicating a hydrophilic nature and exhibited lower thermal stability compared to pristine PVA. Moreover, the mechanical results revealed that the electrospun scaffold showed an improved tensile strength of 3.55±0.29 MPa compared with the pristine PVA (1.8±0.52 MPa). The prepared hybrid nanocomposites showed delayed blood clotting as noted in APTT and PT assays indicating better blood compatibility. Moreover, the hemolysis assay revealed that the hybrid nanocomposites exhibited a low hemolytic index of 0.6% compared with pure PVA, which was 1.6% suggesting the safety of the developed nanocomposite to red blood cells (RBCs). CONCLUSION: The prepared nanocomposites exhibited better physico-chemical properties, sufficient porosity, mechanical strength, and blood compatibility, which favors it as a valuable candidate in bone tissue engineering for repairing the bone defects.

Cost Analysis of All-Polyethylene Compared to Metal-Backed Implants in Total Knee Arthroplasty.

INTRODUCTION: The growing trends of total knee arthroplasty (TKA) foreshadow an inevitable increase in the financial burden on healthcare expenditure estimated to almost nine billion dollars annually. This study aims to demonstrate the potential savings when using all-polyethylene (AP) compared to metal-backed (MB) tibial components and describes the cost variability amongst three major commercially available implants. MATERIALS AND METHODS: The cost of AP versus MB implants was analyzed using a large nationwide database, Emergency Care Research Institute (ECRI). Cost of femoral components and patellar buttons were excluded. The three manufacturers included in the study were DePuy, Smith&Nephew, and Stryker (Zimmer data was not available for analysis). RESULTS: Our results show that AP components were significantly less costly in comparison to other manufacturers, and the average AP price was $1,009. The average MB (baseplate plus liner) price was $2,054 (p<0.01). Analysis of variance (ANOVA) of the means of the AP components showed no significant difference in prices among the three studied manufacturers (p=0.946). DISCUSSION: Our results demonstrate that, regardless of the manufacturing company, AP tibial components are significantly cheaper than their MB counterparts. A literature review revealed that, when indicated, AP implants are not inferior to MB in terms of survivorship or outcome. The average savings was more than $1,000 per TKA when multiplied even by a small portion of the large volume of TKAs completed annually. This can translate into millions of dollars in savings in healthcare expenditures. With the impending legislation of the bundled-payment initiative, orthopaedic surgeons should be aware of less costly implant options that can positively impact outcomes and/or quality of care.

Toxicity assessment of the extractables from multi-layer coextrusion poly ethylene bags exposed to pH=5 solution containing 4% benzyl alcohol and 0.1 M sodium acetate.

A non-target analysis was developed for the analysis of extractables from multi-layer coextrusion bags exposed to 4% benzyl alcohol solution and 0.1 M sodium acetate at pH = 5 for defined periods (15 day, 45 day and 90 day) according to manufacturer instructions based on the ultra-performance liquid chromatography (UPLC) quadrupole-time of flight mass spectrometry (Q-TOF MS). In order to confirm the extractables, principal component analysis (PCA) was used to indicate the differences among samples of different periods. Then, the extractables were identified based on searching the self-built library or online searching. The total content of extractables of 90 day samples was 589.78 µg/L, and the content was in the range of acceptable levels for pharmaceutical manufacturers. The risk assessment of the extractables were evaluated by Toxtree and T.E.S.T. software to avoid the animals bioexperiment.

ENERGY RESPONSE OF FLUORESCENT NUCLEAR TRACK DETECTORS OF VARIOUS COLORATIONS TO MONOENERGETIC NEUTRONS.

The neutron-energy dependence of the track-counting sensitivity of fluorescent nuclear track detectors (FNTDs) at two ranges of Mg doping, resulting in different crystal colorations, was investigated. The performance of FNTDs was studied with the following converters: Li-glass for thermal to intermediate-energy neutrons, polyethylene for fast neutrons, and polytetrafluoroethylene (Teflon™) for photon- and radon-background subtraction. The irradiations with monoenergetic neutrons were performed at the National Physics Laboratory (NPL), UK. The energy range was varied from 144 keV to 16.5 MeV in the personal dose equivalent range from 1 to 3 mSv. Monte Carlo simulations were performed to model the response of FNTDs to monoenergetic neutrons. A good agreement with the experimental data was observed suggesting the development of a basic model for future MC studies. Further work will focus on increasing FNTD sensitivity to low-energy neutrons and developing a faster imaging technique for scanning larger areas to improve counting statistics.

Micro X-Ray Computed Tomography Mass Loss Assessment of Different UHMWPE: A Hip Joint Simulator Study on Standard vs. Cross-Linked Polyethylene.

More than 60.000 hip arthroplasty are performed every year in Italy. Although Ultra-High-Molecular-Weight-Polyethylene remains the most used material as acetabular cup, wear of this material induces over time in vivo a foreign-body response and consequently osteolysis, pain, and the need of implant revision. Furthermore, oxidative wear of the polyethylene provoke several and severe failures. To solve these problems, highly cross-linked polyethylene and Vitamin-E-stabilized polyethylene were introduced in the last years. In in vitro experiments, various efforts have been made to compare the wear behavior of standard PE and vitamin-E infused liners. In this study we compared the in vitro wear behavior of two different configurations of cross-linked polyethylene (with and without the add of Vitamin E) vs. the standard polyethylene acetabular cups. The aim of the present study was to validate a micro X-ray computed tomography technique to assess the wear of different commercially available, polyethylene's acetabular cups after wear simulation; in particular, the gravimetric method was used to provide reference wear values. The agreement between the two methods is documented in this paper.

Drug product immobilization in recycled polyethylene/polypropylene reclaimed from municipal solid waste: experimental and numerical assessment.

Recently, there has been a growing interest in identifying suitable routes for the disposal of pharmaceutical wastes. This study investigates the potential of matrix materials composed of recycled polyethylene/polypropylene reclaimed from municipal solid wastes at immobilizing pharmaceutical solid wastes. Diclofenac (DF) drug product was embedded in boards of recycled plastic material, and leaching in water was assessed at various temperatures. DF concentrations were determined by high-performance liquid chromatography and revealed a maximum leachable fraction of 4% under accelerated conditions of 70°C, and less than 0.3% following 39 days of exposure at 20°C. The Ensemble Kalman Filter was employed to characterize the leaching behavior of DF. The filter verified the occurrence of leaching through diffusion, and was successful in predicting the leaching behavior of DF at 50°C and 70°C.

Improving rice production sustainability by reducing water demand and greenhouse gas emissions with biodegradable films.

In China, rice production is facing unprecedented challenges, including the increasing demand, looming water crisis and on-going climate change. Thus, producing more rice at lower environmental cost is required for future development, i.e., the use of less water and the production of fewer greenhouse gas (GHG) per unit of rice. Ground cover rice production systems (GCRPSs) could potentially address these concerns, although no studies have systematically and simultaneously evaluated the benefits of GCRPS regarding yields and considering water use and GHG emissions. This study reports the results of a 2-year study comparing conventional paddy and various GCRPS practices. Relative to conventional paddy, GCRPSs had greater rice yields and nitrogen use efficiencies (8.5% and 70%, respectively), required less irrigation (-64%) and resulted in less total CH4 and N2O emissions (-54%). On average, annual emission factors of N2O were 1.67% and 2.00% for conventional paddy and GCRPS, respectively. A cost-benefit analysis considering yields, GHG emissions, water demand and labor and mulching costs indicated GCRPSs are an environmentally and economically profitable technology. Furthermore, substituting the polyethylene film with a biodegradable film resulted in comparable benefits of yield and climate. Overall, GCRPSs, particularly with biodegradable films, provide a promising solution for farmers to secure or even increase yields while reducing the environmental footprint.

Use of low density polyethylene membranes for assessment of genotoxicity of PAHs in the Seine River.

The genotoxicity of river water dissolved contaminants is usually estimated after grab sampling of river water. Water contamination can now be obtained with passive samplers that allow a time-integrated sampling of contaminants. Since it was verified that low density polyethylene membranes (LDPE) accumulate labile hydrophobic compounds, their use was proposed as a passive sampler. This study was designed to test the applicability of passive sampling for combined chemical and genotoxicity measurements. The LDPE extracts were tested with the umu test (TA1535/pSK1002 ± S9) and the Ames assay (TA98, TA100 and YG1041 ± S9). We describe here this new protocol and its application in two field studies on four sites of the Seine River. Field LDPE extracts were negative with the YG1041 and TA100 and weakly positive with the TA98 + S9 and Umu test. Concentrations of labile mutagenic PAHs were higher upstream of Paris than downstream of Paris. Improvement of the method is needed to determine the genotoxicity of low concentrations of labile dissolved organic contaminants.

Sakacin-A antimicrobial packaging for decreasing Listeria contamination in thin-cut meat: preliminary assessment.

BACKGROUND: Minimally processed ready-to-eat products are considered a high-risk food because of the possibility of contamination with pathogenic bacteria, including Listeria monocytogenes from the animal reservoir, and the minimal processing they undergo. In this study, a sakacin-A anti-Listeria active package was developed and tested on thin-cut veal meat slices (carpaccio). RESULTS: Enriched food-grade sakacin-A was obtained from a cell-free supernatant of a Lactobacillus sakei culture and applied (0.63 mg cm-2 ) onto the surface of polyethylene-coated paper sheets to obtain an active antimicrobial package. The coating retained antimicrobial features, indicating that the process did not affect sakacin-A functionality, as evidenced in tests carried out in vitro. Thin-cut veal meat slices inoculated with Listeria innocua (a surrogate of pathogenic L. monocytogenes) were laid on active paper sheets. After 48 h incubation at 4 °C, the Listeria population was found to be 1.5 log units lower with respect to controls (3.05 vs 4.46 log colony-forming units (CFU) g-1 ). CONCLUSION: This study demonstrates the possibility of using an antimicrobial coating containing sakacin-A to inhibit or decrease the Listeria population in ready-to-eat products, thus lowering the risk of food-related diseases. © 2016 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

Characteristics of Protons Exiting from a Polyethylene Converter Irradiated by Neutrons with Energies between 1 keV and 10 MeV.

Monte Carlo method has been used to determine the efficiency for proton production and to study the energy and angular distributions of the generated protons. The ENDF library of cross sections is used to simulate the interactions between the neutrons and the atoms in a polyethylene (PE) layer, while the ranges of protons with different energies in PE are determined using the Stopping and Range of Ions in Matter (SRIM) computer code. The efficiency of proton production increases with the PE layer thickness. However the proton escaping from a certain polyethylene volume is highly dependent on the neutron energy and target thickness, except for a very thin PE layer. The energy and angular distributions of protons are also estimated in the present paper, showing that, for the range of energy and thickness considered, the proton flux escaping is dependent on the PE layer thickness, with the presence of an optimal thickness for a fixed primary neutron energy.

INVESTIGATION OF THE EXTENDED RANGE REM-COUNTER SMARTREM-LINUS IN REFERENCE AND WORKPLACE FIELDS EXPECTED AROUND HIGH-ENERGY ACCELERATORS.

Radiation survey instrumentation is adequate for the use around high-energy accelerators if capable to measure the dose arising from neutrons with energies ranging from thermal up to a few gigaelectronvolts. The SmartREM-LINUS is a commercial extended range rem-counter, consisting of a central (3)He-proportional counter surrounded by a spherical moderator made of borated polyethylene with an internal shield made of lead. The dose rate indicated by the SmartREM-LINUS was investigated for two different irradiation conditions. The linearity and the angular dependence of the indicated dose rate were investigated using reference neutron fields produced by (241)AmBe and (252)Cf. Additional measurements were performed in two different workplace fields with a component of neutrons with energies >20 MeV, namely the CERN-EU high-energy reference field and near the beam dump of the SwissFEL injector test facility. The measured dose rates were compared to a commercial rem-counter (WENDI2) and the results of Monte Carlo simulations.

Assessment of Damage on a Dual Mobility Acetabular System.

BACKGROUND: Dual mobility designs were introduced to increase stability and reduce the risk of dislocation, both being common reasons for surgical revision after total hip arthroplasty. The in vivo behavior of dual mobility constructs remains unclear, and to our knowledge, no data have been published describing in vivo surface damage to the polyethylene bearing surfaces. METHODS: We used surface damage assessed on the inner and outer polyethylene bearing surfaces in 33 short-term retrieved dual mobility liners as evidence of relative motion at the 2 bearings. A lever out test was performed to determine the force required for dislocation of the cobalt-chromium femoral head from the polyethylene liner. RESULTS: Both bearings showed damage; however, the inner polyethylene bearings had higher damage scores, lower prevalence of remaining machining marks, and higher incidence of concentric wear, all consistent with more motion at the inner polyethylene bearing. The inner polyethylene bearings also had a higher occurrence of embedded titanium debris. The damage sustained in vivo was insufficient to lead to intraprosthetic dislocation in any of the retrieved components. Lever out tests of 12 retrievals had a mean dislocation load of 261 ± 52 N, which was unrelated to the length of implantation. CONCLUSION: Our short-term retrieval data of 33 highly cross-linked polyethylene dual mobility components suggest that although motion occurs at both bearing articulations, the motion of the femoral head against the inner polyethylene bearing dominates. Although damage was not severe enough to lead to intraprosthetic dislocation, failure may occur long term and should be assessed in future studies.