Infections related to implantable cardiac electronic devices (ICEDs), including pacemakers, implantable cardiac defibrillators and cardiac resynchronization therapy devices, are increasing in ...incidence in the USA and are likely to increase in the UK, because more devices are being implanted. These devices have both intravascular and extravascular components and infection can involve the generator, device leads and native cardiac structures or various combinations. ICED infections can be life-threatening, particularly when associated with endocardial infection, and all-cause mortality of up to 35% has been reported. Like infective endocarditis, ICED infections can be difficult to diagnose and manage. This guideline aims to (i) improve the quality of care provided to patients with ICEDs, (ii) provide an educational resource for all relevant healthcare professionals, (iii) encourage a multidisciplinary approach to ICED infection management, (iv) promote a standardized approach to the diagnosis, management, surveillance and prevention of ICED infection through pragmatic evidence-rated recommendations, and (v) advise on future research projects/audit. The guideline is intended to assist in the clinical care of patients with suspected or confirmed ICED infection in the UK, to inform local infection prevention and treatment policies and guidelines and to be used in the development of educational and training material by the relevant professional societies. The questions covered by the guideline are presented at the beginning of each section.
The BSAC guidelines on treatment of infectious endocarditis (IE) were last published in 2004. The guidelines presented here have been updated and extended to reflect developments in diagnostics, new ...trial data and the availability of new antibiotics. The aim of these guidelines, which cover both native valve and prosthetic valve endocarditis, is to standardize the initial investigation and treatment of IE. An extensive review of the literature using a number of different search criteria has been carried out and cited publications used to support any changes we have made to the existing guidelines. Publications referring to in vitro or animal models have only been cited if appropriate clinical data are not available. Randomized, controlled trials suitable for the development of evidenced-based guidelines in this area are still lacking and therefore a consensus approach has again been adopted for most recommendations; however, we have attempted to grade the evidence, where possible. The guidelines have also been extended by the inclusion of sections on clinical diagnosis, echocardiography and surgery.
Short-term demonstrations of packaged 4H-SiC junction field-effect transistor (JFET) logic integrated circuits (ICs) at temperatures exceeding 800 °C in air are reported, including a 26-transistor ...11-stage ring oscillator that functioned at 961 °C ambient temperature believed unprecedented for electrical operation of a semiconductor IC. The expanded temperature range should assist temperature acceleration testing/qualification of such ICs intended for long-term use in applications near 500 °C ambient, and perhaps spawn new applications. Ceramic package assembly leakage currents inhibited the determination of some intrinsic SiC device/circuit performance properties at these extreme temperatures, so it is conceivable that even higher operating temperatures might be obtained from SiC JFET ICs by employing packaging and circuit design intended/optimized for T ≥ 800 °C.
These evidence-based guidelines are an updated version of those published in 2006. They have been produced after a literature review of the treatment and prophylaxis of methicillin-resistant ...Staphylococcus aureus (MRSA). The guidelines aim to complement those recently published for the antibiotic treatment of common and emerging community-onset MRSA infections in the UK. The guidelines have reviewed and updated, where appropriate, previous recommendations, taking into account any changes in the UK epidemiology of MRSA, ongoing national surveillance data and the value of new antistaphylococcal agents licensed for use in UK practice. Emerging therapies that have not been licensed for UK use are not reviewed, but their future potential role has been mentioned where deemed appropriate. Recommendations are given for the treatment of common infections caused by MRSA, elimination of MRSA from carriage sites and prophylaxis of surgical site infection.
Operational testing of prototopye 4H-SiC JFET ICs across an unrivaled ambient temperature span in excess of 1000 °C, from-190 °C to +812 °C, has been demonstrated without any change/adjustment of ...input signal levels or power supply voltages. This unique ability is expected to simplify infusion of this IC technology into a broader range of beneficial applications.
Substantial expansion of the practical environmental envelope for integrated circuit (IC) operation offers important benefits to a variety of automotive, aerospace, deep-well drilling, and ...manufacturing applications 1. ICs that can reliably operate for long time periods (years) in a harsh environment without degradation or need of diagnostic/maintenance intervention enable the largest benefits compared to IC technologies requiring added shielding, cooling, remote-location, maintenance, or other overhead to perform beneficial system functions. The ability to "cold-start" at low temperature (T ≤ −55°C) and continuously function through "warm-up" to extreme temperature is also important to most applications. Fig. 1 illustrates the massive difference between a Venus lander mission that relies on sheltering electronics from the caustic 91-atmosphere pressure 460°C surface environment (600 kg lander that returns data for less than a day) compared to the mission possible with electronics that can function for long duration without need of environmental sheltering (20 kg lander that operates for 60 days) 2, 3.
This report describes more than 5000 hours of successful 500 °C operation of semiconductor integrated circuits (ICs) with more than 100 transistors. Multiple packaged chips with two different 4H-SiC ...junction field effect transistor (JFET) technology demonstrator circuits have surpassed thousands of hours of oven-testing at 500 °C. After 100 hours of 500 °C burn-in, the circuits (except for 2 failures) exhibit less than 10% change in output characteristics for the remainder of 500 °C testing. We also describe the observation of important differences in IC materials durability when subjected to the first nine constituents of Venus-surface atmosphere at 9.4 MPa and 460 °C in comparison to what is observed for Earth-atmosphere oven testing at 500 °C.
About 40 000 ICEDs were implanted in the UK in 2010, and the number of implantations of implantable cardiac defibrillators and cardiac resynchronisation therapy devices is increasing by 12-15% every ...year. 3 Although robust data for rates of ICED infection within the UK National Health Service (NHS) are not available, anecdotal evidence suggests that such infections are increasingly common.