Design, Fabrication and Testing of a Superconducting Fault Current Limiter (SFCL)

The purpose of this project was to conduct R&D on specified components and provide technical design support to a SuperPower team developing a high temperature superconducting Fault Current Limiter (SFCL). ORNL teamed with SuperPower, Inc. on a Superconductivity Partnerships with Industry (SPI) proposal for the SFCL that was submitted to DOE and approved in FY 2003. A contract between DOE and SuperPower, Inc. was signed on July 14, 2003 to design, fabricate and test the SFCL. This device employs high temperature superconducting (HTS) elements and SuperPower's proprietary technology. The program goal was to demonstrate a device that will address a broad range of the utility applications and meet utility industry requirements. This DOE-sponsored Superconductivity Partnership with Industry project would positively impact electric power transmission reliability and security by introducing a new element in the grid that can significantly mitigate fault currents and provide lower cost solutions for grid protection. The project will conduct R&D on specified components and provide technical design support to a SuperPower-led team developing a SFCL as detailed in tasks 1-5 below. Note the SuperPower scope over the broad SPI project is much larger than that shown below which indicates only the SuperPower tasks that are complementary to the ORNL tasks. SuperPower is the Project Manager for the SFCL program, and is responsible for completion of the project on schedule and budget. The scope of work for ORNL is to provide R&D support for the SFCL in the following four broad areas: (1) Assist with high voltage subsystem R&D, design, fabrication and testing including characterization of the general dielectric performance of LN2 and component materials; (2) Consult on cryogenic subsystem R&D, design, fabrication and testing; (3) Participate in project conceptual and detailed design reviews; and (4) Guide commercialization by participation on the Technical Advisory Board (TAB). SuperPower's in-kind work for the SFCL will be provided in the following areas: (1) Work with ORNL to develop suitable test platforms for the evaluation of subsystems and components; (2) Provide cryogenic and high voltage subsystem designs for evaluation; (3) Lead the development of the test plans associated with the subsystem and components and participate in test programs at ORNL; and (4) Based on the test results, finalize the subsystem and component designs and incorporate into the respective SFCL prototypes

Characterization of edge damage induced on REBCO superconducting tape by mechanical slitting

Rare-earth barium-copper-oxide (REBCO) superconductors are high-field superconductors fabricated in a tape geometry that can be utilized in magnet applications well in excess of 20 T. Due to the multilayer architecture of the tape, delamination is one cause of mechanical failure in REBCO tapes. During a mechanical slitting step in the manufacturing process, edge cracks can be introduced into the tape. These cracks are thought to be potential initiation sites for crack propagation in the tapes when subjected to stresses in the fabrication and operation of magnet systems. We sought to understand which layers were the mechanically weakest by locating the crack initiation layer and identifying the geometrical conditions of the slitter that promoted or suppressed crack formation. The described cracking was investigated by selectively etching and characterizing each layer with scanning electron microscopy, laser confocal microscopy, and digital image analysis. Our analysis showed that the average crack lengths in the REBCO, LaMnO3 (LMO) and Al2O3 layers were 34 μm, 28 μm, and 15 μm, respectively. The total number of cracks measured in 30mmof wire length was between 3000 and 5700 depending on the layer and their crack densities were 102 cracks mm-1 for REBCO, 108 cracks mm-1 for LMO, and 183 cracks mm-1 for Al2O3. These results indicated that there are separate crack initiation mechanisms for the REBCO and the LMO layers, as detailed in the paper. With a better understanding of the crack growth behavior exhibited by REBCO tapes, the fabrication process can be improved to provide a more mechanically stable and cost-effective superconductor

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Anisotropy dominated radio frequency vortex dynamics in Bi<SUB>2</SUB>Sr<SUB>2</SUB>CaCu<SUB>2</SUB>O<SUB>8</SUB> thick film on silver tapes

Vortex dynamics at radio frequency (rf) is studied in flexible tape samples of Bi2Sr2CaCu2O8 superconductor as functions of dc magnetic field, temperature and orientation between the field and plane of the tape. The rf response in the geometry when the dc field is perpendicular to the tape suggests two distinct regimes of vortex dynamics, one corresponding to a moderately pinned three-dimensional vortex solid and the other a liquid of two-dimensional vortices. The rf penetration depth in the 3D pinned phase is analyzed in the framework of the theories of single vortex pinning and the behaviour of pinning force constant kp is discussed. In the vortex solid phase we see evidence of flux lock-in between the CuO2 planes. The angle dependent response in the liquid state scales with the component of dc field parallel to c-axis. The scaling analysis shows some renormalization of the anisotropy due to non-zero deviations from a perfect alignment of the grains parallel to the plane of the tape

Thigh-length compression stockings and DVT after stroke

Controversy exists as to whether neoadjuvant chemotherapy improves survival in patients with invasive bladder cancer, despite randomised controlled trials of more than 3000 patients. We undertook a systematic review and meta-analysis to assess the effect of such treatment on survival in patients with this disease

Azithromycin in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Background Azithromycin has been proposed as a treatment for COVID-19 on the basis of its immunomodulatory actions. We aimed to evaluate the safety and efficacy of azithromycin in patients admitted to hospital with COVID-19. Methods In this randomised, controlled, open-label, adaptive platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), several possible treatments were compared with usual care in patients admitted to hospital with COVID-19 in the UK. The trial is underway at 176 hospitals in the UK. Eligible and consenting patients were randomly allocated to either usual standard of care alone or usual standard of care plus azithromycin 500 mg once per day by mouth or intravenously for 10 days or until discharge (or allocation to one of the other RECOVERY treatment groups). Patients were assigned via web-based simple (unstratified) randomisation with allocation concealment and were twice as likely to be randomly assigned to usual care than to any of the active treatment groups. Participants and local study staff were not masked to the allocated treatment, but all others involved in the trial were masked to the outcome data during the trial. The primary outcome was 28-day all-cause mortality, assessed in the intention-to-treat population. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936. Findings Between April 7 and Nov 27, 2020, of 16 442 patients enrolled in the RECOVERY trial, 9433 (57%) were eligible and 7763 were included in the assessment of azithromycin. The mean age of these study participants was 65·3 years (SD 15·7) and approximately a third were women (2944 [38%] of 7763). 2582 patients were randomly allocated to receive azithromycin and 5181 patients were randomly allocated to usual care alone. Overall, 561 (22%) patients allocated to azithromycin and 1162 (22%) patients allocated to usual care died within 28 days (rate ratio 0·97, 95% CI 0·87–1·07; p=0·50). No significant difference was seen in duration of hospital stay (median 10 days [IQR 5 to >28] vs 11 days [5 to >28]) or the proportion of patients discharged from hospital alive within 28 days (rate ratio 1·04, 95% CI 0·98–1·10; p=0·19). Among those not on invasive mechanical ventilation at baseline, no significant difference was seen in the proportion meeting the composite endpoint of invasive mechanical ventilation or death (risk ratio 0·95, 95% CI 0·87–1·03; p=0·24). Interpretation In patients admitted to hospital with COVID-19, azithromycin did not improve survival or other prespecified clinical outcomes. Azithromycin use in patients admitted to hospital with COVID-19 should be restricted to patients in whom there is a clear antimicrobial indication. Funding UK Research and Innovation (Medical Research Council) and National Institute of Health Research

Whole-genome sequencing reveals host factors underlying critical COVID-19

Altres ajuts: Department of Health and Social Care (DHSC); Illumina; LifeArc; Medical Research Council (MRC); UKRI; Sepsis Research (the Fiona Elizabeth Agnew Trust); the Intensive Care Society, Wellcome Trust Senior Research Fellowship (223164/Z/21/Z); BBSRC Institute Program Support Grant to the Roslin Institute (BBS/E/D/20002172, BBS/E/D/10002070, BBS/E/D/30002275); UKRI grants (MC_PC_20004, MC_PC_19025, MC_PC_1905, MRNO2995X/1); UK Research and Innovation (MC_PC_20029); the Wellcome PhD training fellowship for clinicians (204979/Z/16/Z); the Edinburgh Clinical Academic Track (ECAT) programme; the National Institute for Health Research, the Wellcome Trust; the MRC; Cancer Research UK; the DHSC; NHS England; the Smilow family; the National Center for Advancing Translational Sciences of the National Institutes of Health (CTSA award number UL1TR001878); the Perelman School of Medicine at the University of Pennsylvania; National Institute on Aging (NIA U01AG009740); the National Institute on Aging (RC2 AG036495, RC4 AG039029); the Common Fund of the Office of the Director of the National Institutes of Health; NCI; NHGRI; NHLBI; NIDA; NIMH; NINDS.Critical COVID-19 is caused by immune-mediated inflammatory lung injury. Host genetic variation influences the development of illness requiring critical care or hospitalization after infection with SARS-CoV-2. The GenOMICC (Genetics of Mortality in Critical Care) study enables the comparison of genomes from individuals who are critically ill with those of population controls to find underlying disease mechanisms. Here we use whole-genome sequencing in 7,491 critically ill individuals compared with 48,400 controls to discover and replicate 23 independent variants that significantly predispose to critical COVID-19. We identify 16 new independent associations, including variants within genes that are involved in interferon signalling (IL10RB and PLSCR1), leucocyte differentiation (BCL11A) and blood-type antigen secretor status (FUT2). Using transcriptome-wide association and colocalization to infer the effect of gene expression on disease severity, we find evidence that implicates multiple genes-including reduced expression of a membrane flippase (ATP11A), and increased expression of a mucin (MUC1)-in critical disease. Mendelian randomization provides evidence in support of causal roles for myeloid cell adhesion molecules (SELE, ICAM5 and CD209) and the coagulation factor F8, all of which are potentially druggable targets. Our results are broadly consistent with a multi-component model of COVID-19 pathophysiology, in which at least two distinct mechanisms can predispose to life-threatening disease: failure to control viral replication; or an enhanced tendency towards pulmonary inflammation and intravascular coagulation. We show that comparison between cases of critical illness and population controls is highly efficient for the detection of therapeutically relevant mechanisms of disease