The high-luminosity large-hadron collider (HL-LHC) is planned to offer a very ambitious physics program, with high-precision measurement and evaluation of the standard model (SM), and motivate the ...searches for new physics. The efficient data collection and precise events reconstruction in the harsh environment of 200 proton-proton interactions are vital for achieving the success of the HL-LHC program. To realize these requirements, the compact muon solenoid (CMS) detector has planned to completely replace the data acquisition (DAQ) and trigger system. The CMS Level-1 trigger system will handle the enormous detector input bandwidth of 63 Tb/s with a maximum output rate of 750 kHz and is desired to complete the processing within <inline-formula> <tex-math notation="LaTeX">12.5 \mu \text{s} </tex-math></inline-formula>. For this purpose, CMS has planned to replace the Phase-<inline-formula> <tex-math notation="LaTeX">1 \mu </tex-math></inline-formula> telecommunications computing architecture (TCA)-based processor boards and crates an advanced TCA (ATCA) form factor. Each ATCA board will host Xilinx large UltraScale/UltraScale+ family field programmable gate arrays (FPGAs) and support more than a hundred high-speed optical links (<inline-formula> <tex-math notation="LaTeX">\sim </tex-math></inline-formula>28 Gb/s), capable of meeting the high bandwidth and processing requirements of HL-LHC. Along with the advancement in hardware, the Level-1 trigger system will employ highly modular, flexible, and adequately sophisticated algorithms that were only possible in offline reconstruction, such as the particle-flow (PF) algorithm. The modular and flexible architecture will help address the HL-LHC dynamic physics requirements. We will discuss the details of system design, prototyping, and the algorithms employed for the Level-1 trigger system.
The LUX-ZEPLIN (LZ) experiment will search for dark matter particle interactions with a detector containing a total of 10 tonnes of liquid xenon within a double-vessel cryostat. The large mass and ...proximity of the cryostat to the active detector volume demand the use of material with extremely low intrinsic radioactivity. We report on the radioassay campaign conducted to identify suitable metals, the determination of factors limiting radiopure production, and the selection of titanium for construction of the LZ cryostat and other detector components. This titanium has been measured with activities of 238Ue < 1.6 mBq/kg, 238Ul < 0.09 mBq/kg, 232The=0.28±0.03 mBq/kg, 232Thl=0.25±0.02 mBq/kg, 40K < 0.54 mBq/kg, and 60Co < 0.02 mBq/kg (68% CL). Such low intrinsic activities, which are some of the lowest ever reported for titanium, enable its use for future dark matter and other rare event searches. Monte Carlo simulations have been performed to assess the expected background contribution from the LZ cryostat with this radioactivity. In 1,000 days of WIMP search exposure of a 5.6-tonne fiducial mass, the cryostat will contribute only a mean background of 0.160 ± 0.001(stat) ± 0.030(sys) counts.
ObjectivesTo assess the feasibility and change in clinical outcomes associated with continuous glucose monitoring (CGM) use among a rural population in Malawi living with type 1 diabetes.DesignA 2:1 ...open randomised controlled feasibility trial.SettingTwo Partners In Health-supported Ministry of Health-run first-level district hospitals in Neno, Malawi.Participants45 people living with type 1 diabetes (PLWT1D).InterventionsParticipants were randomly assigned to Dexcom G6 CGM (n=30) use or usual care (UC) (n=15) consisting of Safe-Accu glucose monitors and strips. Both arms received diabetes education.OutcomesPrimary outcomes included fidelity, appropriateness and severe adverse events. Secondary outcomes included change in haemoglobin A1c (HbA1c), acceptability, time in range (CGM arm only) SD of HbA1c and quality of life.ResultsParticipants tolerated CGM well but were unable to change their own sensors which resulted in increased clinic visits in the CGM arm. Despite the hot climate, skin rashes were uncommon but cut-out tape overpatches were needed to secure the sensors in place. Participants in the CGM arm had greater numbers of dose adjustments and lifestyle change suggestions than those in the UC arm. Participants in the CGM arm wore their CGM on average 63.8% of the time. Participants in the UC arm brought logbooks to clinic 75% of the time. There were three hospitalisations all in the CGM arm, but none were related to the intervention.ConclusionsThis is the first randomised controlled trial conducted on CGM in a rural region of a low-income country. CGM was feasible and appropriate among PLWT1D and providers, but inability of participants to change their own sensors is a challenge.Trial registration numberPACTR202102832069874.
IntroductionThe Package of Essential Noncommunicable Disease Interventions—Plus (PEN-Plus) is a strategy decentralising care for severe non-communicable diseases (NCDs) including type 1 diabetes, ...rheumatic heart disease and sickle cell disease, to increase access to care. In the PEN-Plus model, mid-level clinicians in intermediary facilities in low and lower middle income countries are trained to provide integrated care for conditions where services traditionally were only available at tertiary referral facilities. For the upcoming phase of activities, 18 first-level hospitals in 9 countries and 1 state in India were selected for PEN-Plus expansion and will treat a variety of severe NCDs. Over 3 years, the countries and state are expected to: (1) establish PEN-Plus clinics in one or two district hospitals, (2) support these clinics to mature into training sites in preparation for national or state-level scale-up, and (3) work with the national or state-level stakeholders to describe, measure and advocate for PEN-Plus to support development of a national operational plan for scale-up.Methods and analysisGuided by Proctor outcomes for implementation research, we are conducting a mixed-method evaluation consisting of 10 components to understand outcomes in clinical implementation, training and policy development. Data will be collected through a mix of quantitative surveys, routine reporting, routine clinical data and qualitative interviews.Ethics and disseminationThis protocol has been considered exempt or covered by central and local institutional review boards. Findings will be disseminated throughout the project’s course, including through quarterly M&E discussions, semiannual formative assessments, dashboard mapping of progress, quarterly newsletters, regular feedback loops with national stakeholders and publication in peer-reviewed journals.
The antipyretic effect of nimesulide has not been adequately compared with paracetamol and ibuprofen-paracetamol combination in children. Hence, a randomized, double blind, and parallel groups' ...design and multicenter study was conducted on children with respiratory tract infections. Eighty-nine patients with temperatures above 38.5 degrees C were randomly administered nimesulide (1.5 mg/kg/dose), paracetamol (10.0 mg/kg/dose), or ibuprofen-patients combination (10.0 mg/kg/dose), thrice daily for five days. The axillary temperature was recorded at the baseline and at different time intervals post administration of drugs. The hematological and biochemical investigations were performed at the basal level and at the end of the treatment period. The adverse drug reactions were monitored during the trial. All the drugs produced a significant fall in temperature as compared to their respective basal values (p < 0.001). However, on looking at the change in temperatures at different time intervals from the respective basal levels, no significant difference was found among all the drugs. Surprisingly, nimesulide had a tendency to raise serum glutamate pyruvate transaminase and serum glutamate oxaloacetate transaminase levels as compared to its baseline values. There was no marked adverse effect of the drugs on other hematological and biochemical parameters investigated. No other serious adverse reaction occurred in the study. Ibuprofen-paracetamol combination, nimesulide, and paracetamol had almost similar antipyretic effects in children.
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