First Cold Powering Test of REBCO Roebel Wound Coil for the EuCARD2 Future Magnet Development Project

EuCARD-2 is a project partly supported by FP7-European Commission aiming at exploring accelerator magnet technology for 20 T dipole operating field. The EuCARD-2 collaboration is liaising with similar programs for high field magnets in the USA and Japan. EuCARD-2 focuses, through the work-package 10 'Future magnets,' on the development of a 10 kA-class superconducting, high current density cable suitable for accelerator magnets, for a 5 T stand-alone dipole of 40 mm bore and about 1 m length. After standalone testing, the magnet will possibly be inserted in a large bore background dipole, to be tested at a peak field up to 18 T. This paper starts by reporting on a few of the highlight simulations that demonstrate the progress made in predicting: dynamic current distribution and influence on field quality, complex quench propagation between tapes, and minimum quench energy in the multitape cable. The multiphysics output importantly helps predicting quench signals and guides the development of the novel early detection systems. Knowing current position within individual tapes of each cable we present stress distribution throughout the coils. We report on the development of the mechanical component and assembly processes selected for Feather-M2 the 5 T EuCARD2 magnet. We describe the CERN variable temperature flowing helium cold gas test system. We describe the parallel integration of the FPGA early quench detection system, using pickup coils and temperature sensors, alongside the standard CERN magnet quench detection system using voltage taps. Finally we report on the first cold tests of the REBCO 10 kA class Roebel subscale coil named Feather-M0

Clinical implications of clopidogrel non-response in cardiovascular patients: a systematic review and meta-analysis

BSUMMARY BACKGROUND: Previous studies have shown an important risk of cardiovascular events in patients with clopidogrel biological non-response, and data have shown considerable, unexplored heterogeneity. OBJECTIVES: To evaluate the magnitude of cardiovascular risk associated with clopidogrel non-response and to explore heterogeneity. METHODS: This was a systematic review and meta-analysis of prospective studies of patients treated with clopidogrel for symptomatic atherothrombosis, evaluated by light transmission aggregometry with ADP and monitored prospectively for clinical ischemic events. RESULTS: Fifteen studies were included, totaling 3960 patients, of whom 25% were considered to be clopidogrel non-responders. The global relative risk (RR) for recurrent ischemic events in clopidogrel non-responders was 3.5 [95% confidence interval (CI) 2.4-5.2, P 65%) for clopidogrel non-response than in studies using lower cut-offs [RR = 5.8 (95% CI 3.2-10.3) and RR = 2.9 (95% CI 2.2-3.7), respectively, P = 0.03]. CONCLUSIONS: The risk of ischemic events associated with clopidogrel non-response is now more precisely defined. The risk is heterogeneous across studies, possibly because of an interaction with GPIIb-IIIa inhibitors and the use of different cut-offs to identify non-responders

Mechanism-Based Modeling of Perioperative Variations in Hemoglobin Concentration in Patients Undergoing Laparoscopic Surgery

Hemoglobin concentration ([Hb]) in the perioperative setting should be interpreted in the context of the variables and processes that may affect it to differentiate the dilution effects caused by changes in intravascular volume. However, it is unclear what variables and processes affect [Hb]. Here, we modeled the perioperative variations in [Hb] to identify the variables and processes that govern [Hb] and to describe their effects.We first constructed a mechanistic framework based on the main variables and processes related to the perioperative [Hb] variations. We then prospectively studied patients undergoing laparoscopic surgery, divided into 2 consecutive cohorts for the development and validation of the model. The study protocol consisted of serial measurements of [Hb] along with recordings of hemoglobin mass loss, blood volume loss, fluid infusion, urine volume, and inflammatory biomarkers measurements, up to 96 hours postoperatively. Mathematical fitting was performed using nonlinear mixed-effects. Additionally, we performed simulations to explore the effects of blood loss and fluid therapy protocols on [Hb].We studied 154 patients: 118 enrolled in the development group and 36 in the validation group. We characterized the perioperative course of [Hb] using a mass balance model that accounted for hemoglobin losses during surgery, and a 2-compartment model that estimated fluid kinetics and intravascular volume changes. During model development, we found that urinary fluid elimination represented only 24% of the total fluid elimination, and that total fluid elimination was inhibited after surgery in a time-dependent manner and influenced by age. Also, covariate evaluation showed a significant association between the type of surgery and proportion of fluid eliminated via urine. In contrast, neither the type of infused solution, blood volume loss nor inflammatory biomarkers were found to correlate with model parameters. In the validation analysis, the model demonstrated a considerable predictive capacity, with 95% of the predicted [Hb] within -4.4 and +5.5 g/L. Simulations demonstrated that hemoglobin mass loss determined most of the postoperative changes in [Hb], while intravascular volume changes due to fluid infusion, distribution, and elimination induced smaller but clinically relevant variations. Simulated patients receiving standard fluid therapy protocols exhibited a hemodilution effect that resulted in a [Hb] decrease between 7 and 15 g/L at the end of surgery, and which was responsible for the lowest [Hb] value during the perioperative period.Our model provides a mechanistic and quantitative understanding of the causes underlying the perioperative [Hb] variations.Copyright © 2023 International Anesthesia Research Society

First Cold Powering Test of REBCO Roebel Wound Coil for the EuCARD2 Future Magnet Development Project

International audienceEuCARD-2 is a project partly supported by FP7-European Commission aiming at exploring accelerator magnet technology for 20 T dipole operating field. The EuCARD-2 collaboration is liaising with similar programs for high field magnets in the USA and Japan. EuCARD-2 focuses, through the work-package 10 “Future magnets,” on the development of a 10 kA-class superconducting, high current density cable suitable for accelerator magnets, for a 5 T stand-alone dipole of 40 mm bore and about 1 m length. After standalone testing, the magnet will possibly be inserted in a large bore background dipole, to be tested at a peak field up to 18 T. This paper starts by reporting on a few of the highlight simulations that demonstrate the progress made in predicting: dynamic current distribution and influence on field quality, complex quench propagation between tapes, and minimum quench energy in the multitape cable. The multiphysics output importantly helps predicting quench signals and guides the development of the novel early detection systems. Knowing current position within individual tapes of each cable we present stress distribution throughout the coils. We report on the development of the mechanical component and assembly processes selected for Feather-M2 the 5 T EuCARD2 magnet. We describe the CERN variable temperature flowing helium cold gas test system. We describe the parallel integration of the FPGA early quench detection system, using pickup coils and temperature sensors, alongside the standard CERN magnet quench detection system using voltage taps. Finally we report on the first cold tests of the REBCO 10 kA class Roebel subscale coil named Feather-M0