AION: An Atom Interferometer Observatory and Network

We outline the experimental concept and key scientific capabilities of AION (Atom Interferometer Observatory and Network), a proposed UK-based experimental programme using cold strontium atoms to search for ultra-light dark matter, to explore gravitational waves in the mid-frequency range between the peak sensitivities of the LISA and LIGO/Virgo/ KAGRA/INDIGO/Einstein Telescope/Cosmic Explorer experiments, and to probe other frontiers in fundamental physics. AION would complement other planned searches for dark matter, as well as probe mergers involving intermediate mass black holes and explore early universe cosmology. AION would share many technical features with the MAGIS experimental programme in the US, and synergies would flow from operating AION in a network with this experiment, as well as with other atom interferometer experiments such as MIGA, ZAIGA and ELGAR. Operating AION in a network with other gravitational wave detectors such as LIGO, Virgo and LISA would also offer many synergies

Centralised Design and Production of the Ultra-High Vacuum and Laser-Stabilisation Systems for the AION Ultra-Cold Strontium Laboratories

This paper outlines the centralised design and production of the Ultra-High-Vacuum sidearm and Laser-Stabilisation systems for the AION Ultra-Cold Strontium Laboratories. Commissioning data on the residual gas and steady-state pressures in the sidearm chambers, on magnetic field quality, on laser stabilisation, and on the loading rate for the 3D Magneto-Optical Trap are presented. Streamlining the design and production of the sidearm and laser stabilisation systems enabled the AION Collaboration to build and equip in parallel five state-of-the-art Ultra-Cold Strontium Laboratories within 24 months by leveraging key expertise in the collaboration. This approach could serve as a model for the development and construction of other cold atom experiments, such as atomic clock experiments and neutral atom quantum computing systems, by establishing dedicated design and production units at national laboratories.Comment: 27 pages, 21 figure

Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700

Efficacy of self-monitored blood pressure, with or without telemonitoring, for titration of antihypertensive medication (TASMINH4): an unmasked randomised controlled trial.

BACKGROUND: Studies evaluating titration of antihypertensive medication using self-monitoring give contradictory findings and the precise place of telemonitoring over self-monitoring alone is unclear. The TASMINH4 trial aimed to assess the efficacy of self-monitored blood pressure, with or without telemonitoring, for antihypertensive titration in primary care, compared with usual care. METHODS: This study was a parallel randomised controlled trial done in 142 general practices in the UK, and included hypertensive patients older than 35 years, with blood pressure higher than 140/90 mm Hg, who were willing to self-monitor their blood pressure. Patients were randomly assigned (1:1:1) to self-monitoring blood pressure (self-montoring group), to self-monitoring blood pressure with telemonitoring (telemonitoring group), or to usual care (clinic blood pressure; usual care group). Randomisation was by a secure web-based system. Neither participants nor investigators were masked to group assignment. The primary outcome was clinic measured systolic blood pressure at 12 months from randomisation. Primary analysis was of available cases. The trial is registered with ISRCTN, number ISRCTN 83571366. FINDINGS: 1182 participants were randomly assigned to the self-monitoring group (n=395), the telemonitoring group (n=393), or the usual care group (n=394), of whom 1003 (85%) were included in the primary analysis. After 12 months, systolic blood pressure was lower in both intervention groups compared with usual care (self-monitoring, 137·0 [SD 16·7] mm Hg and telemonitoring, 136·0 [16·1] mm Hg vs usual care, 140·4 [16·5]; adjusted mean differences vs usual care: self-monitoring alone, -3·5 mm Hg [95% CI -5·8 to -1·2]; telemonitoring, -4·7 mm Hg [-7·0 to -2·4]). No difference between the self-monitoring and telemonitoring groups was recorded (adjusted mean difference -1·2 mm Hg [95% CI -3·5 to 1·2]). Results were similar in sensitivity analyses including multiple imputation. Adverse events were similar between all three groups. INTERPRETATION: Self-monitoring, with or without telemonitoring, when used by general practitioners to titrate antihypertensive medication in individuals with poorly controlled blood pressure, leads to significantly lower blood pressure than titration guided by clinic readings. With most general practitioners and many patients using self-monitoring, it could become the cornerstone of hypertension management in primary care. FUNDING: National Institute for Health Research via Programme Grant for Applied Health Research (RP-PG-1209-10051), Professorship to RJM (NIHR-RP-R2-12-015), Oxford Collaboration for Leadership in Applied Health Research and Care, and Omron Healthcare UK

A versatile and reliably re-usable ultra-high vacuum viewport

We present a viewport for use in ultrahigh vacuum (UHV) based upon the preflattened solder seal design presented in earlier work [ Cox et al., Rev. Sci. Instrum. 74, 3185 (2003) ]. The design features significant modifications to improve long term performance. The windows have been leak tested to less than 10−10 atm cm3/s. From atom number measurements in an optical dipole trap loaded from a vapor cell magneto-optical trap inside a vacuum chamber accommodating these viewports, we measure a trap lifetime of 9.5 s suggesting a pressure of around 10−10 Torr limited by background rubidium vapor pressure. We also present a simplified design where the UHV seal is made directly to a vacuum pipe