Home and Online Management and Evaluation of Blood Pressure (HOME BP) using a digital intervention in poorly controlled hypertension: randomised controlled trial

Objective: The HOME BP (Home and Online Management and Evaluation of Blood Pressure) trial aimed to test a digital intervention for hypertension management in primary care by combining self-monitoring of blood pressure with guided self-management. Design: Unmasked randomised controlled trial with automated ascertainment of primary endpoint. Setting: 76 general practices in the United Kingdom. Participants: 622 people with treated but poorly controlled hypertension (>140/90 mm Hg) and access to the internet. Interventions: Participants were randomised by using a minimisation algorithm to self-monitoring of blood pressure with a digital intervention (305 participants) or usual care (routine hypertension care, with appointments and drug changes made at the discretion of the general practitioner; 317 participants). The digital intervention provided feedback of blood pressure results to patients and professionals with optional lifestyle advice and motivational support. Target blood pressure for hypertension, diabetes, and people aged 80 or older followed UK national guidelines. Main outcome measures: The primary outcome was the difference in systolic blood pressure (mean of second and third readings) after one year, adjusted for baseline blood pressure, blood pressure target, age, and practice, with multiple imputation for missing values. Results: After one year, data were available from 552 participants (88.6%) with imputation for the remaining 70 participants (11.4%). Mean blood pressure dropped from 151.7/86.4 to 138.4/80.2 mm Hg in the intervention group and from 151.6/85.3 to 141.8/79.8 mm Hg in the usual care group, giving a mean difference in systolic blood pressure of −3.4 mm Hg (95% confidence interval −6.1 to −0.8 mm Hg) and a mean difference in diastolic blood pressure of −0.5 mm Hg (−1.9 to 0.9 mm Hg). Results were comparable in the complete case analysis and adverse effects were similar between groups. Within trial costs showed an incremental cost effectiveness ratio of £11 ($15, €12; 95% confidence interval £6 to £29) per mm Hg reduction. Conclusions: The HOME BP digital intervention for the management of hypertension by using self-monitored blood pressure led to better control of systolic blood pressure after one year than usual care, with low incremental costs. Implementation in primary care will require integration into clinical workflows and consideration of people who are digitally excluded. Trial registration: ISRCTN13790648

Atmospheric Corrosion of Silver and Silver Nanoparticles

Even though it is a noble metal, silver will corrode in ambient atmospheres, predominantly by reacting with sulfur-containing gases such as hydrogen sulfide (H2S) and carbonyl sulfide (OCS) to form the silver sulfide (Ag2S) acanthite. Other aspects of the environment, such as relative humidity and the presence of oxidizing species, also play a critical role. With the emergence of silver nanoparticles for a range of technological and medical applications, there has been a revival of interest in the corrosion behavior of this important metal. This article reviews the current understanding of the atmospheric corrosion of silver in both the bulk and nanoparticle forms. Gaps in our current understanding and areas for future investigation are identified

Optimizing EELS acquisition

A method for spectral acquisition, called binned gain averaging, will be described and tested. Systematic or correlated noise is efficiently suppressed with this method by averaging the gain over a series of CCD pixels. As a result, improved signal-to-noise ratios are obtained that allow the detection of very weak signals. At the same time, the spectral energy resolution is not degraded-even for long acquisition periods. It will be demonstrated that with this method, it is possible to significantly enhance the acquisition speed and quality of electron energy-loss (EEL) spectra and EELS maps. Examples will be given of double ionic scattering (i.e. the detection of the second boron K-edge) and the mapping of gold surface plasmons in the near-infrared and visible energy range

TDDFT study of the optical absorption spectra of bare gold clusters

Time-dependent density functional theory (TDDFT) was used to calculate the optical absorption spectra of gold clusters of 20-171 atoms. The spectra for the smallest clusters agree with previous results, and the spectra for the largest clusters show features consistent with classical Mie theory. The systematic exploration of particles of sizes within these two extremes has allowed the trends linking optical absorption spectra and particle size and symmetry to be identified. A transition from molecular-like spectra to a more classical response is observed

Measuring and mapping surface plasmons with nanometre scale resolution in the electron microscope

Electron energy-loss spectroscopy (EELS) has been used to observe the energy and distribution of surface plasmons at the nanometre scale. In addition, an entirely new method for imaging surface plasmons, based on phase retrieval methods, and which can be used on a conventional transmission electron microscope, will also be presented

Quantitative TEM-based phase retrieval of MgO nano-cubes using the transport of intensity equation

Through focus series of images are collected from MgO nano-cube crystals in the transmission electron microscope (TEM). The experimental data is used to solve the transport of intensity equation (TIE) to retrieve phase maps, which portray the morphology of the cubes and are quantified by the mean inner potential V 0₋. Particular attention is given to the practical difficulties associated with TIE phase retrieval of non-conducting polyhedron particles

Higher order plasmonic modes excited in Ag triangular nanoplates by an electron beam

Ag triangular nanoplates are known to generate strong plasmonic resonances when excited by both light and electron beams. Experimental electron energy-loss spectra (EELS) and maps were acquired using an aberration-corrected JEOL-ARM microscope. The corner, edge and centre modes that are often observed in such structures were also observed in these measurements. In addition, novel higher order internal modes were observed and were found to be well reproduced by theoretical cal- culations using boundary element method (BEM). These modes are dark modes so are not observed in the optical extinction spectra. They are confined surface propagating modes and are analogous to laser cavity mode