Background Among asymptomatic patients with severe carotid artery stenosis but no recent stroke or transient cerebral ischaemia, either carotid artery stenting (CAS) or carotid endarterectomy (CEA) can restore patency and reduce long-term stroke risks. However, from recent national registry data, each option causes about 1% procedural risk of disabling stroke or death. Comparison of their long-term protective effects requires large-scale randomised evidence.Methods ACST-2 is an international multicentre randomised trial of CAS versus CEA among asymptomatic patients with severe stenosis thought to require intervention, interpreted with all other relevant trials. Patients were eligible if they had severe unilateral or bilateral carotid artery stenosis and both doctor and patient agreed that a carotid procedure should be undertaken, but they were substantially uncertain which one to choose. Patients were randomly allocated to CAS or CEA and followed up at 1 month and then annually, for a mean 5 years. Procedural events were those within 30 days of the intervention. Intention-to-treat analyses are provided. Analyses including procedural hazards use tabular methods. Analyses and meta-analyses of non-procedural strokes use Kaplan-Meier and log-rank methods. The trial is registered with the ISRCTN registry, ISRCTN21144362.

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Abstract. With the arrival of electric vehicles, battery storage and smart appliances, households now have the opportunity to actively participate in balancing supply and demand in electricity networks. We propose to coordinate this multi-agent system using distributed optimisation, in order to scale to large systems whilst preserving agent privacy. However, the practical applicability of distributed optimisation remains an open question in this context, as AC power flows are inherently nonconvex and households often make discrete decisions about how to schedule their loads. In this paper we show that one such method, the alternating direction method of multipliers (ADMM), can be adapted to remain practical in this challenging microgrid setting. We formulate and solve a multi-period optimal power flow (OPF) problem featuring household agents with shiftable loads, and study the results obtained with a range of power flow models and approaches to managing discrete decisions. Our experiments on a suburb-sized microgrid show that the AC power flows and a simple two-stage approach to handling discrete decisions do not appear to cause convergence issues, and provide near optimal results in a time that is practical for receding horizon control. This brings distributed control of microgrids several steps closer to reality.

The U.S. Nuclear Regulatory Commission (NRC) and the Electric Power Research Institute (EPRI) are working cooperatively under a memorandum of understanding to validate welding residual stress (WRS) predictions in pressurized water reactor (PWR) primary cooling loop components containing dissimilar metal (DM) welds. These stresses are of interest as DM welds in PWRs are susceptible to primary water stress corrosion cracking (PWSCC) and tensile weld residual stresses are the primary driver of this degradation mechanism. The NRC/EPRI weld residual stress (WRS) analysis validation program consists of four phases, with each phase increasing in complexity from laboratory size specimens to component mock-ups and cancelled-plant material. This paper discusses Phase 2 of the WRS characterization program involving an international round robin analysis project in which participants analyzed a prototypic reactor coolant pressure boundary component. Mock-up fabrication, WRS measurements and comparison with predicted stresses through the DM weld region are described. The results of this study show that, on average, analysts can develop WRS predictions that are a reasonable estimate for actual configurations as quantified by measurements. However, the scatter in predicted results from analyst to analyst can be quite large. For example, in this study, the scatter in WRSs through the centerline of the main DM weld (prior to stainless steel weld application) predicted by analysts is approximately +/− 200 to 300 MPa at 3 standard deviations for axial stresses and +/− 300 to 400 MPa at 3 standard deviations for hoop stresses. Sensitivity studies that vary important parameters, such as material hardening behavior, can be used to bound such large variations.