International External Validation Study of the 2014 European Society of Cardiology Guidelines on Sudden Cardiac Death Prevention in Hypertrophic Cardiomyopathy (EVIDENCE-HCM).

BACKGROUND: Identification of people with hypertrophic cardiomyopathy (HCM) who are at risk of sudden cardiac death (SCD) and require a prophylactic implantable cardioverter defibrillator is challenging. In 2014, the European Society of Cardiology proposed a new risk stratification method based on a risk prediction model (HCM Risk-SCD) that estimates the 5-year risk of SCD. The aim was to externally validate the 2014 European Society of Cardiology recommendations in a geographically diverse cohort of patients recruited from the United States, Europe, the Middle East, and Asia. METHODS: This was an observational, retrospective, longitudinal cohort study. RESULTS: The cohort consisted of 3703 patients. Seventy three (2%) patients reached the SCD end point within 5 years of follow-up (5-year incidence, 2.4% [95% confidence interval {CI}, 1.9–3.0]). The validation study revealed a calibration slope of 1.02 (95% CI, 0.93–1.12), C-index of 0.70 (95% CI, 0.68–0.72), and D-statistic of 1.17 (95% CI, 1.05–1.29). In a complete case analysis (n= 2147; 44 SCD end points at 5 years), patients with a predicted 5-year risk of <4% (n=1524; 71%) had an observed 5-year SCD incidence of 1.4% (95% CI, 0.8–2.2); patients with a predicted risk of ≥6% (n=297; 14%) had an observed SCD incidence of 8.9% (95% CI, 5.96–13.1) at 5 years. For every 13 (297/23) implantable cardioverter defibrillator implantations in patients with an estimated 5-year SCD risk ≥6%, 1 patient can potentially be saved from SCD. CONCLUSIONS: This study confirms that the HCM Risk-SCD model provides accurate prognostic information that can be used to target implantable cardioverter defibrillator therapy in patients at the highest risk of SCD.post-print846 K

Building an end user focused THz based ultra high bandwidth wireless access network: The TERAPOD approach

The TERAPOD project aims to investigate and demonstrate the feasibility of ultra high bandwidth wireless access networks operating in the Terahertz (THz) band. The proposed TERAPOD THz communication system will be developed, driven by end user usage scenario requirements and will be demonstrated within a first adopter operational setting of a Data Centre. In this article, we define the full communications stack approach that will be taken in TERAPOD, highlighting the specific challenges and aimed innovations that are targeted

The frontiers of participatory public engagement

Currently missing from critical literature on public engagement with academic research is a public-centric analysis of the wider contemporary context of developments in the field of public engagement and participation. Drawing on three differently useful strands of the existing theoretical literature on the public, this article compares a diverse sample of 100 participatory public engagement initiatives in order to first, analyse a selection of the myriad ways that the public is being constituted and supported across this contemporary field and second, identify what socio-cultural researchers might learn from these developments. Emerging from this research is a preliminary map of the field of public engagement and participation. This map highlights relationships and divergences that exist among diverse forms of practice and brings into clearer view a set of tensions between different contemporary approaches to public engagement and participation. Two ‘frontiers’ of participatory public engagement that socio-cultural researchers should attend are also identified. At the first, scholars need to be critical regarding the particular versions of the public that their preferred approach to engagement and participation supports and concerning how their specific identifications with the public relate to those being addressed across the wider field. At the second frontier, researchers need to consider the possibilities for political intervention that public engagement and participation practice could open out, both in the settings they are already working and also in the much broader, rapidly developing and increasingly complicated contemporary field of public engagement and participation that this article explores

Nonlinear vertical oscillations of a particle in a sheath of a rf discharge

A new simple method to measure the spatial distribution of the electric field in the plasma sheath is proposed. The method is based on the experimental investigation of vertical oscillations of a single particle in the sheath of a low-pressure radio-frequency discharge. It is shown that the oscillations become strongly nonlinear and secondary harmonics are generated as the amplitude increases. The theory of anharmonic oscillations provides a good qualitative description of the data and gives estimates for the first two anharmonic terms in an expansion of the sheath potential around the particle equilibrium.Comment: 11 pages, 4 figure

Retarding field energy analyser ion current calibration and transmission

International audienceAccurate measurement of ion current density and ion energy distributions (IED) is often critical for plasma processes in both industrial and research settings. Retarding field energy analyzers (RFEA) have been used to measure IEDs because they are considered accurate, relatively simple and cost effective. However, their usage for critical measurement of ion current density is less common due to difficulties in estimating the proportion of incident ion current reaching the current collector through the RFEA retarding grids. In this paper an RFEA has been calibrated to measure ion current density from an ion beam at pressures ranging from 0.5 to 50.0 mTorr. A unique method is presented where the currents generated at each of the retarding grids and the RFEA upper face are measured separately, allowing the reduction in ion current to be monitored and accounted for at each stage of ion transit to the collector. From these I-V measurements a physical model is described. Subsequently, a mathematical description is extracted which includes parameters to account for grid transmissions, upper face secondary electron emission and collisionality. Pressure-dependant calibration factors can be calculated from least mean square best fits of the collector current to the model allowing quantitative measurement of ion current density

Controlled microdroplet transport in an atmospheric pressure microplasma

We report the controlled injection of near-isolated micron-sized liquid droplets into a low temperature He-Ne steady-state rf plasma at atmospheric pressure. The H2O droplet stream is constrained within a 2 mm diameter quartz tube. Imaging at the tube exit indicates a log-normal droplet size distribution with an initial count mean diameter of 15 micrometers falling to 13 micrometers with plasma exposure. The radial velocity profile is approximately parabolic indicating near laminar flow conditions with the majority of droplets travelling at >75% of the local gas speed and having a plasma transit time of < 100 microseconds. The maximum gas temperature, determined from nitrogen spectral lines, was below 400 K and the observed droplet size reduction implies additional factors beyond standard evaporation, including charge and surface chemistry effects. The successful demonstration of controlled microdroplet streams opens up possibilities for gas-phase microreactors and remote delivery of active species for plasma medicine

Caries associated with orthodontic care part 2: management

It is recognized that wearing an orthodontic appliance increases the caries risk of the individual. The prevalence of demineralization has been reported to be as high as 73%. When demineralization occurs a number of treatments exist: fluoride application, acid microabrasion, casein phosphopeptide-amorphous calcium phosphate (CCP-ACP), resin infiltration and self-assembling peptides. Of these, topical fluoride has the most evidence to support its use. CPD/Clinical Relevance: Demineralization is the most common complication of orthodontic care. The clinician should understand how to manage this when it occurs

Insights from 20 years of temperature parallel measurements in Mauritius around the turn of the 20th century

There is considerable import in creating more complete, better understood holdings of early meteorolog- ical data. Such data permit an improved understanding of climate variability and long-term changes. Early records are particularly incomplete in the tropics, with implications for estimates of global and regional temperature. There is also a relatively low level of scientific understanding of how these early measurements were made and, as a result, of their ho- mogeneity and comparability to more modern techniques and measurements. Herein we describe and analyse a newly rescued set of long-term, up to six-way parallel measure- ments undertaken over 1884–1903 in Mauritius, an island situated in the southern Indian Ocean. Data include (i) mea- surements from a well-ventilated room, (ii) a shaded thermo- graph, (iii) instruments housed in a manner broadly equiv- alent to a modern Stevenson screen, (iv) a set of measure- ments by a hygrometer mounted in a Stevenson screen, and for a much shorter period (v) two additional Stevenson screen configurations. All measurements were undertaken within an ∼ 80 m radius of each other. To our knowledge this is the first such multidecadal multi-instrument assessment of meteoro- logical instrument transition impacts ever undertaken, pro- viding potentially unique insights. The intercomparison also considers the impact of different ways of deriving daily and monthly averages. The long-term comparison is sufficient to robustly characterize systematic offsets between all the in- struments and seasonally varying impacts. Differences be- tween all techniques range from tenths of a degree Celsius to more than 1 ◦C and are considerably larger for maximum and minimum temperatures than for means or averages. System- atic differences of several tenths of a degree Celsius also exist for the different ways of deriving average and mean tempera- tures. All differences, except two average temperature series pairs, are significant at the 0.01 level using a paired t test. Given that all thermometers were regularly calibrated against a primary Kew standard thermometer maintained by the ob- servatory, this analysis highlights significant impacts of in- strument exposure, housing, siting, and measurement prac- tices in early meteorological records. These results reaffirm the importance of thoroughly assessing the homogeneity of early meteorological records