The Control System for the Cryogenics in the LHC Tunnel [First Experience and Improvements]

The Large Hadron Collider (LHC) was commissioned at CERN and started operation with beams in 2008. Several months of operation in nominal cryogenic conditions have triggered an optimisation of the process functional analysis. This lead to a few revisions of the control logic, which were realised on-the-fly. During the 2008-09 shut-down, and in order to enhance the safety, availability and operability of the LHC cryogenics, a major rebuild of the logic and several hardware modifications were implemented. The databases, containing instruments and controls in-formation, are being rationalized; the automatic tool, that extracts data for the control software, is being simplified. This paper describes the main improvements and sug-gests perspectives of further developments

Quantum Eavesdropping without Interception: An Attack Exploiting the Dead Time of Single Photon Detectors

The security of quantum key distribution (QKD) can easily be obscured if the eavesdropper can utilize technical imperfections of the actual implementation. Here we describe and experimentally demonstrate a very simple but highly effective attack which even does not need to intercept the quantum channel at all. Only by exploiting the dead time effect of single photon detectors the eavesdropper is able to gain (asymptotically) full information about the generated keys without being detected by state-of-the-art QKD protocols. In our experiment, the eavesdropper inferred up to 98.8% of the key correctly, without increasing the bit error rate between Alice and Bob significantly. Yet, we find an evenly simple and effective countermeasure to inhibit this and similar attacks

The phrase 'The Great War' in british discourse during world war one

The association of the term ‘The Great War’ with World War One, if it began 100 years ago, could be seen as telling, not only about attitudes at the time (and whether it meant ‘jolly big’ or ‘jolly good’), but about our retrospective attitudes to those who were involved. Through an examination of propaganda, periodicals, political statements and specific pre-war literature, an assumption that as a phrase it is indicative of jingoistic and bellicose hysteria generated by influential politicians for the gullible citizens of whichever participant nation, can be shown as a misleading simplification. Instead, with a concentration on Britain, a study of its use by statesmen such as Asquith and Lloyd George, the very particular circumstances under which it appeared in Punch magazine, and the overt zeal some advocates of war with Germany displayed from several years before 1914, is revealing of very different public standpoints among supporters of the war.info:eu-repo/semantics/publishedVersio

Errores de medicación en pediatría

Concerns regarding patient safety affect healthcare, and medication errors are the most frequent category of medical errors and linked with severe consequences. This study discusses epidemiologic characteristics of medication errors in pediatric patients and points out prevention strategies. Approximately 8% of the studies on the subject of medication errors identified in different national and international databases are distinctively related to the pediatric population. Children are vulnerable to medication errors due to intrinsic factors, such as proper anatomic and physiological characteristics; and due to extrinsic factors, with emphasis on the lack of public health politics and changes in the pharmaceutical industry to attend children's needs. The available evidences indicate, as imperative, the implementation of strategies to prevent medication errors, contributing to promote patient safety.La seguridad del paciente es un problema de salud pública y los errores con medicamentos son los más frecuentes y más graves. Este artículo describe características epidemiológicas de errores de medicación en áreas de atención pediátrica y algunas estrategias de prevención. Aproximadamente 8% de las investigaciones sobre errores de medicación identificadas en las bases de datos nacionales e internacionales se refieren específicamente a niños. Los niños tienen mayor vulnerabilidad a la ocurrencia de errores debidos a factores intrínsecos, con destaque para características anatómicas y fisiológicas, e extrínsecos, en particular con respecto a falta de políticas sanitarias y de la industria farmacéutica orientada a la atención de tales características. Evidencias muestran la necesidad de aplicar estrategias para prevenir errores de medicación, promoviendo la seguridad del paciente.A segurança do paciente constitui problema de saúde pública, e erros com medicamentos são os mais freqüentes e graves. O artigo apresenta características epidemiológicas dos erros de medicação em diferentes áreas de atendimento pediátrico, e aponta estratégias de prevenção. Aproximadamente 8% das pesquisas sobre erros de medicação identificadas em bases de dados nacionais e internacionais referem-se à população pediátrica. Crianças apresentam maior vulnerabilidade à ocorrência de erros devido a fatores intrínsecos, destacando-se características anatômicas e fisiológicas; e extrínsecos, relativos à falta de políticas de saúde e da indústria farmacêutica voltadas ao atendimento de tais especificidades. As evidências apontam para a necessidade de implementação de estratégias de prevenção de erros de medicação, contribuindo para promover a segurança do paciente.Universidade Federal de São Paulo (UNIFESP) Departamento de EnfermagemUNIFESP, Depto. de EnfermagemSciEL

Congenital and childhood atrioventricular blocks: pathophysiology and contemporary management

Atrioventricular block is classified as congeni- tal if diagnosed in utero, at birth, or within the first month of life. The pathophysiological process is believed to be due to immune-mediated injury of the conduction system, which occurs as a result of transplacental pas- sage of maternal anti-SSA/Ro-SSB/La antibodies. Childhood atrioventricular block is therefore diagnosed between the first month and the 18th year of life. Genetic variants in multiple genes have been described to date in the pathogenesis of inherited progressive car- diac conduction disorders. Indications and techniques of cardiac pacing have also evolved to allow safe perma- nent cardiac pacing in almost all patients, including those with structural heart abnormalities

Comparison of mortality in people with type 2 diabetes between different ethnic groups: Systematic review and meta-analysis of longitudinal studies.

AIMS: Type 2 diabetes (T2D) is more common in certain ethnic groups. This systematic review compares mortality risk between people with T2D from different ethnic groups and includes recent larger studies. METHODS: We searched nine databases using PRISMA guidelines (PROSPERO CRD42022372542). We included community-based prospective studies among adults with T2D from at least two different ethnicities. Two independent reviewers undertook screening, data extraction and quality assessment using the Newcastle-Ottawa Scale. The primary outcome compared all-cause mortality rates between ethnic groups (hazard ratio (HR) with 95% confidence intervals). RESULTS: From 30,825 searched records, we included 13 studies (7 meta-analysed), incorporating 573,173 T2D participants; 12 were good quality. Mortality risk was lower amongst people with T2D from South Asian [HR 0.68 (0.65-0.72)], Black [HR 0.82 (0.77-0.87)] and Chinese [HR 0.57 (0.46-0.70)] ethnicity compared to people of White ethnicity. Narrative synthesis corroborated these findings but demonstrated that people of indigenous Māori ethnicity had greater mortality risk compared to European ethnicity. CONCLUSIONS: People with T2D of South Asian, Black and Chinese ethnicity have lower all-cause mortality risk than White ethnicity, with Māori ethnicity having higher mortality risk. Factors explaining mortality differences require further study, including understanding complication risk by ethnicity, to improve diabetes outcomes

A comparative analysis of predictive models of morbidity in intensive care unit after cardiac surgery – Part II: an illustrative example

<p>Abstract</p> <p>Background</p> <p>Popular predictive models for estimating morbidity probability after heart surgery are compared critically in a unitary framework. The study is divided into two parts. In the first part modelling techniques and intrinsic strengths and weaknesses of different approaches were discussed from a theoretical point of view. In this second part the performances of the same models are evaluated in an illustrative example.</p> <p>Methods</p> <p>Eight models were developed: Bayes linear and quadratic models, <it>k</it>-nearest neighbour model, logistic regression model, Higgins and direct scoring systems and two feed-forward artificial neural networks with one and two layers. Cardiovascular, respiratory, neurological, renal, infectious and hemorrhagic complications were defined as morbidity. Training and testing sets each of 545 cases were used. The optimal set of predictors was chosen among a collection of 78 preoperative, intraoperative and postoperative variables by a stepwise procedure. Discrimination and calibration were evaluated by the area under the receiver operating characteristic curve and Hosmer-Lemeshow goodness-of-fit test, respectively.</p> <p>Results</p> <p>Scoring systems and the logistic regression model required the largest set of predictors, while Bayesian and <it>k</it>-nearest neighbour models were much more parsimonious. In testing data, all models showed acceptable discrimination capacities, however the Bayes quadratic model, using only three predictors, provided the best performance. All models showed satisfactory generalization ability: again the Bayes quadratic model exhibited the best generalization, while artificial neural networks and scoring systems gave the worst results. Finally, poor calibration was obtained when using scoring systems, <it>k</it>-nearest neighbour model and artificial neural networks, while Bayes (after recalibration) and logistic regression models gave adequate results.</p> <p>Conclusion</p> <p>Although all the predictive models showed acceptable discrimination performance in the example considered, the Bayes and logistic regression models seemed better than the others, because they also had good generalization and calibration. The Bayes quadratic model seemed to be a convincing alternative to the much more usual Bayes linear and logistic regression models. It showed its capacity to identify a minimum core of predictors generally recognized as essential to pragmatically evaluate the risk of developing morbidity after heart surgery.</p

Predictors of treatment REsponse to inhaled corticosteroids (ICS) in Chronic Obstructive pulmonary disease: randomised controlled trials individual participant Data re-Evaluation-protocol of the ICS-RECODE individual participant data meta-analysis

Introduction Inhaled corticosteroids (ICS) can improve clinical outcomes in patients with chronic obstructive pulmonary disease (COPD) and eosinophilic airway inflammation, but they also increase the risk of side effects like pneumonia. Blood eosinophils guide ICS use, though evidence is limited. The predictors of treatment REsponse to ICS in COPD: a randomised controlled trials (RCTs) individual participant Data re-Evaluation (ICS-RECODE) research programme will leverage data from large RCTs to identify patients who benefit most from ICS with minimal risk. This protocol details an individual participant data (IPD) meta-analysis, assessing ICS safety, efficacy and treatment×covariate interactions to identify predictors of treatment response. Methods and analysis This meta-analysis will adhere to Cochrane, IPD handbook and Grading of Recommendations Assessment, Development and Evaluation (GRADE) guidance. We will conduct a two-stage IPD meta-analysis of RCTs evaluating the addition of ICS to maintenance COPD treatments. Only RCTs with at least 500 participants across all eligible arms will be included, to allow for treatment×covariate interaction evaluation. Primary outcomes are severe and moderate or severe exacerbation rates; secondary outcomes assess both safety and efficacy. Data from each RCT will be reanalysed using rigorous, consistent statistical methods. Treatment×covariate interactions will be assessed at the RCT level. Trial treatment effects and the coefficients of treatment×covariate interaction analyses will be pooled using random effects model meta-analysis. Risk of bias will be appraised using RoB-2 informed by IPD, and certainty of evidence will be assessed with GRADE and the Instrument to assess the Credibility of Effect Modification Analyses. The ICS-RECODE IPD meta-analysis will make use of the best available data to define evidence-based, precision medicine approaches for ICS use in COPD. Ethics and dissemination The Health Research Authority approved the ICS-RECODE study, exempting it from ethics review (HRA UK, Reference: 24/HRA/0460). Our findings will be published in peer-reviewed journals and shared with the scientific and broader stakeholder communities. PROSPERO registration number CRD42024508286

Clinical and research priorities for children and young people with bronchiectasis: an international roadmap.

The global burden of children and young people (CYP) with bronchiectasis is being recognised increasingly. They experience a poor quality of life and recurrent respiratory exacerbations requiring additional treatment, including hospitalisation. However, there are no published data on patient-driven clinical needs and/or research priorities for paediatric bronchiectasis. Parent/patient-driven views are required to understand the clinical needs and research priorities to inform changes that benefit CYP with bronchiectasis and reduce their disease burden. The European Lung Foundation and the European Respiratory Society Task Force for paediatric bronchiectasis created an international roadmap of clinical and research priorities to guide, and as an extension of, the clinical practice guideline. This roadmap was based on two global web-based surveys. The first survey (10 languages) was completed by 225 respondents (parents of CYP with bronchiectasis and adults with bronchiectasis diagnosed in childhood) from 21 countries. The parent/patient survey encompassed both clinical and research priorities. The second survey, completed by 258 health practitioners from 54 countries, was limited to research priorities. The two highest clinical needs expressed by parents/patients were: having an action management plan for flare-ups/exacerbations and access to physiotherapists. The two highest health practitioners' research priorities related to eradication of airway pathogens and optimal airway clearance techniques. Based on both surveys, the top 10 research priorities were derived, and unanimous consensus statements were formulated from these priorities. This document addresses parents'/patients' clinical and research priorities from both the parents'/patients' and clinicians' perspectives and will help guide research and clinical efforts to improve the lives of people with bronchiectasis