The use of stimulation of peripheral nerves to test or treat various medical disorders has been prevalent for a long time. Over the last few years, there has been growing evidence for the use of peripheral nerve stimulation (PNS) for treating a myriad of chronic pain conditions such as limb mononeuropathies, nerve entrapments, peripheral nerve injuries, phantom limb pain, complex regional pain syndrome, back pain, and even fibromyalgia. The ease of placement of a minimally invasive electrode via percutaneous approach in the close vicinity of the nerve and the ability to target various nerves have led to its widespread use and compliance. While most of the mechanism behind its role in neuromodulation is largely unknown, the gate control theory proposed by Melzack and Wall in the 1960s has been the mainstay for understanding its mechanism of action. In this review article, the authors performed a literature review to discuss the mechanism of action of PNS and discuss its safety and usefulness in treating chronic pain. The authors also discuss current PNS devices available in the market today.

This M3FT-19IN030205042 milestone report presents the current status on investigations related to the development of HALEU transportation capabilities in the U.S. The report initially reviews potential short-term HALEU production options and describes an expected HALEU composition. It then discusses the regulatory bases for HALEU transportation and identifies two compliant packaging designs: (1) the TN Americas TN-LC and (2) the NAC International OPTIMUS™-L. To modify these designs for HALEU transportation, an inner canister concept, and modular metal and foam basket concepts were developed, and this is described in the report. The expected activity, criticality tendency, radiation level, and decay heat of the package content are evaluated considering the specific system characteristics.Based on the results of the investigations, the research team consisting of INL, PNNL, and ORNL staff concluded that, given the anticipated source material composition, the OPTIMUS™-L, or a comparable design, is the preferred candidate. This is due to its larger HALEU payload per LWT, lighter weight, and simpler handling procedures compared to the TN-LC. Thus, ongoing research efforts for the scope of this project will focus on more thorough evaluations of the OPTIMUS™-L packaging for HALEU transportation. A tentative timeline is presented for the remaining work that is planned for FY 2020. The goal is the development of F&Rs that provide guidance to a potential HALEU transportation package vendor on critical specifications by August 2020.

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