Strong disorder renormalization group study of aperiodic quantum Ising chains

We employ an adaptation of a strong-disorder renormalization-group technique in order to analyze the ferro-paramagnetic quantum phase transition of Ising chains with aperiodic but deterministic couplings under the action of a transverse field. In the presence of marginal or relevant geometric fluctuations induced by aperiodicity, for which the critical behavior is expected to depart from the Onsager universality class, we derive analytical and asymptotically exact expressions for various critical exponents (including the correlation-length and the magnetization exponents, which are not easily obtainable by other methods), and shed light onto the nature of the ground state structures in the neighborhood of the critical point. The main results obtained by this approach are confirmed by finite-size scaling analyses of numerical calculations based on the free-fermion method

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

HEATSTORE SWITZERLAND: New Opportunities of Geothermal District Heating Network Sustainable Growth by High Temperature Aquifer Thermal Energy Storage Development

HEATSTORE is a GEOTHERMICA ERA-NET co-funded project, aiming at developing High Temperature (~25°C to ~90°C) Underground Thermal Energy Storage (HT-UTES) technologies by lowering the cost, reducing risks, improving the performance, and optimizing the district heating network demand side management at 6 new pilot and demonstration sites, two of which are in Switzerland, plus 8 case studies. The European HEATSTORE consortium includes 24 contributing partners from 9 countries, composing a mix of scientific research institutes and private companies. The Swiss consortium, developing HEATSTORE in Switzerland, involves of two industrial partners (Services Industriels de Geneva - SIG and Energie Wasser Bern - EWB) and four academic partners (Universities of Geneva, Bern, Neuchâtel and ETH Zurich), with support from the Swiss Federal Office of Energy. The aims are to develop two demonstration projects for High Temperature Aquifer Thermal Energy Storage (HT-ATES) in the cantons of Geneva and Bern such that industrial waste heat can be converted into a resource. This paper presents the results of the first year of activities in the Swiss projects. The activities planned cover subsurface characterization, energy system analysis, surface implementation design, legal framework improvement and business modelling to ensure the sustainability of the projects. This approach is supported by large industrial investments for subsurface characterization. Two wells, down to 1200m below surface level (bsl) are being drilled in the Geneva area to tap potential targets in the carbonate Mesozoic units and at least three additional wells, down to 500m bsl will target the Molasse sediments in the Bern area next year. These wells allow subsurface exploration and characterization and will provide data, used for detailed THMC modelling to assess the thermal energy storage potential at the two sites in Switzerland. The results of such numerical modelling are combined with energy system analysis to quantify the waste heat availability and heat demand and hence optimize the production and injection operations. The outcomes of the coupled assessments will aid in designing the integration of the new installations into the districtheating network. Legal framework improvements, based on complete technical evaluation and on the best-practice sharing with the other European partners, will be an enabling tool to accelerate the implementation of the HT-ATES systems, while business modelling helps calibrate the economic feasibility of the projects and helps industrial partners to plan future investments