The current wave of small modular reactor (SMR) designs all have the goal of reducing the cost of management and operations. By optimizing the system, the goal is to make these power plants safer, cheaper to operate and maintain, and more secure. In particular, the reduction in plant staffing can result in significant cost savings. The introduction of advanced reactor designs and increased use of advanced automation technologies in existing nuclear power plants will likely change the roles, responsibilities, composition, and size of the crews required to control plant operations. Similarly, certain security staffing requirements for traditional operational nuclear power plants may not be appropriate or necessary for SMRs due to the simpler, safer and more automated design characteristics of SMRs. As a first step in a process to identify where regulatory requirements may be met with reduced staffing and therefore lower cost, this report identifies the regulatory requirements and associated guidance utilized in the licensing of existing reactors. The potential applicability of these regulations to advanced SMR designs is identified taking into account the unique features of these types of reactors.
Background:
A group of experts from different disciplines was convened to develop guidelines for the management of upper visual field impairments related to eyelid ptosis and dermatochalasis. The goal was to provide evidence-based recommendations to improve patient care.
Methods:
A multidisciplinary group of experts representing their specialty organizations was selected. A systematic literature review was performed including topics regarding documentation of the underlying cause for visual field impairment, selection of an appropriate surgical repair, assessment of the type of anesthesia, the use of adjunctive brow procedures, and follow-up assessments. The Grading of Recommendations, Assessment, Development, and Evaluation methodology process was used to evaluate the relevant studies. Clinical practice recommendations were developed using BRIDGE-Wiz (Building Recommendations In a Developers’ Guideline Editor) software.
Results:
Each topic area was assessed. A clinical recommendation was made, and the relevant literature was discussed.
Conclusions:
The review of the literature revealed varied complication rates and diverse treatment modalities for the correction of upper visual field deficit. Strong recommendations could not be made in most topic areas because of a paucity of methodologically sound studies in the literature. More rigorously designed studies are needed to measure outcomes of interest, with fewer sources of potential error or bias.
CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, V.
This report gives an overview of expected design characteristics, concepts, and procedures for small modular reactors. The purpose of this report is to provide those who are interested in reducing the cost and improving the safety of advanced nuclear power plants with a generic design that possesses enough detail in a non-sensitive manner to give merit to their conclusions. The report is focused on light water reactor technology, but does add details on what could be different in a more advanced design (see Appendix). Numerous reactor and facility concepts were used for inspiration (documented in the bibliography). The final design described here is conceptual and does not reflect any proposed concept or subsystems , thus any details given here are only relevant within this report. This report does not include any design or engineering calculations.
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