Extensional and Intensional Strategies

This paper is a contribution to the theoretical foundations of strategies. We first present a general definition of abstract strategies which is extensional in the sense that a strategy is defined explicitly as a set of derivations of an abstract reduction system. We then move to a more intensional definition supporting the abstract view but more operational in the sense that it describes a means for determining such a set. We characterize the class of extensional strategies that can be defined intensionally. We also give some hints towards a logical characterization of intensional strategies and propose a few challenging perspectives

EuReCa ONE—27 Nations, ONE Europe, ONE Registry A prospective one month analysis of out-of-hospital cardiac arrest outcomes in 27 countries in Europe

AbstractIntroductionThe aim of the EuReCa ONE study was to determine the incidence, process, and outcome for out of hospital cardiac arrest (OHCA) throughout Europe.MethodsThis was an international, prospective, multi-centre one-month study. Patients who suffered an OHCA during October 2014 who were attended and/or treated by an Emergency Medical Service (EMS) were eligible for inclusion in the study. Data were extracted from national, regional or local registries.ResultsData on 10,682 confirmed OHCAs from 248 regions in 27 countries, covering an estimated population of 174 million. In 7146 (66%) cases, CPR was started by a bystander or by the EMS. The incidence of CPR attempts ranged from 19.0 to 104.0 per 100,000 population per year. 1735 had ROSC on arrival at hospital (25.2%), Overall, 662/6414 (10.3%) in all cases with CPR attempted survived for at least 30 days or to hospital discharge.ConclusionThe results of EuReCa ONE highlight that OHCA is still a major public health problem accounting for a substantial number of deaths in Europe.EuReCa ONE very clearly demonstrates marked differences in the processes for data collection and reported outcomes following OHCA all over Europe. Using these data and analyses, different countries, regions, systems, and concepts can benchmark themselves and may learn from each other to further improve survival following one of our major health care events

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Inline ECE measurements for NTM control on ASDEX upgrade

\u3cp\u3eThe successful use of a tokamak for generating fusion power requires an active control of magnetic instabilities, such as neoclassical tearing modes (NTMs). Commonly, the NTM location is determined using electron cyclotron emission (ECE) and this is used to apply electron cyclotron heating (ECH) on the NTM location. In this paper, an inline ECE set-up at ASDEX Upgrade is presented in which ECE is measured and ECH is applied via the same path. First results are presented and a means to interpret the measurement data is given. Amplitude and phase with respect to a reference magnetic signal are calculated. Based on the amplitude and phase, the time of mode crossing is determined and shown to compare well with real-time estimates of the mode crossing time. The ECH launcher and flux surface geometries at ASDEX Upgrade, which are optimized for current drive by a beam path that is tangential to the flux surface near deposition, make it difficult to identify the mode crossing without inline ECE launcher movement. Therefore, NTM control based on inline ECE requires launcher movement to determine and maintain a reliable estimate of the NTM location.\u3c/p\u3

Linearity and PCF:a Semantic Insight!

Linearity is a multi-faceted and ubiquitous notion in the analysis and the development of programming language concepts. We study linearity in a denotational perspective by picking out programs that correspond to linear functions between coherence spaces. We introduce a language, named SPCF, that increases the higher-order expressivity of a linear core of PCF by means of new operators related to exception handling and parallel evaluation. SPCF allows us to program all the finite elements of the model and, consequently, it entails a full abstraction result that makes the reasoning on the equivalence between programs simpler. Denotational linearity provides also crucial information for the operational evaluation of programs. We formalize two evaluation machineries for the language. The first one is an abstract and concise operational semantics designed with the aim of explaining the new operators, and is based on an infinite-branching search of the evaluation space. The second one is more concrete and it prunes such a space, by exploiting the linear assumptions. This can also be regarded as a base for an implementation

Combined electron cyclotron emission and heating for the suppression of magnetic islands in fusion plasmas

\u3cp\u3eIn a tokamak, magnetic islands need to be suppressed. Suppression is possible with electron cyclotron heating (ECH), which can be positioned using electron cyclotron emission (ECE) temperature measurements. A set-up to detect ECE in the line of sight of ECH has been built for the TEXTOR tokamak and the ASDEX Upgrade tokamak. In TEXTOR, a dielectric filter was used to separate low power ECE from high power ECH and successful aiming of ECH and suppression of a magnetic island could be demonstrated. At ASDEX Upgrade, a fast directional switch (FADIS) was used to separate ECE from ECH. Measurements of magnetic islands at ASDEX Upgrade are presented. The applicability of these measurements for magnetic island detection is discussed.\u3c/p\u3