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Background The level of evidence for HIV transmission risk through condomless sex in serodifferent gay couples with the HIV-positive partner taking virally suppressive antiretroviral therapy (ART) is limited compared with the evidence available for transmission risk in heterosexual couples. The aim of the second phase of the PARTNER study (PARTNER2) was to provide precise estimates of transmission risk in gay serodifferent partnerships. Methods The PARTNER study was a prospective observational study done at 75 sites in 14 European countries. The first phase of the study (PARTNER1; Sept 15, 2010, to May 31, 2014) recruited and followed up both heterosexual and gay serodifferent couples (HIV-positive partner taking suppressive ART) who reported condomless sex, whereas the PARTNER2 extension (to April 30, 2018) recruited and followed up gay couples only. At study visits, data collection included sexual behaviour questionnaires, HIV testing (HIV-negative partner), and HIV-1 viral load testing (HIV-positive partner). If a seroconversion occurred in the HIV-negative partner, anonymised phylogenetic analysis was done to compare HIV-1 pol and env sequences in both partners to identify linked transmissions. Couple-years of follow-up were eligible for inclusion if condomless sex was reported, use of pre-exposure prophylaxis or post-exposure prophylaxis was not reported by the HIV-negative partner, and the HIV-positive partner was virally suppressed (plasma HIV-1 RNA < 200 copies per mL) at the most recent visit (within the past year). Incidence rate of HIV transmission was calculated as the number of phylogenetically linked HIV infections that occurred during eligible couple-years of follow-up divided by eligible couple-years of follow-up. Two-sided 95% CIs for the incidence rate of transmission were calculated using exact Poisson methods. Findings Between Sept 15, 2010, and July 31, 2017, 972 gay couples were enrolled, of which 782 provided 1593 eligible couple-years of follow-up with a median follow-up of 2.0 years (IQR 1.1-3.5). At baseline, median age for HIV-positive partners was 40 years (IQR 33-46) and couples reported condomless sex for a median of 1.0 years (IQR 0.4-2.9). During eligible couple-years of follow-up, couples reported condomless anal sex a total of 76 088 times. 288 (37%) of 777 HIV-negative men reported condomless sex with other partners. 15 new HIV infections occurred during eligible couple-years of follow-up, but none were phylogenetically linked within-couple transmissions, resulting in an HIV transmission rate of zero (upper 95% CI 0.23 per 100 couple-years of follow-up). Interpretation Our results provide a similar level of evidence on viral suppression and HIV transmission risk for gay men to that previously generated for heterosexual couples and suggest that the risk of HIV transmission in gay couples through condomless sex when HIV viral load is suppressed is effectively zero. Our findings support the message of the U=U (undetectable equals untransmittable) campaign, and the benefits of early testing and treatment for HIV. Copyright (C) 2019 The Author(s). Published by Elsevier Ltd.

National supercomputing was for the first time introduced in Denmark in 2014. Three national supercomputers were jointly funded by the Danish Government, Ministry of Higher Education & Science, the larger universities in Denmark and the Royal Danish Library. National compute facilities were to fill the gap of computing resources between local university resources, Nordic, European and Internationally. However, more importantly the goal was to give all researchers in Denmark equal access to computing resources in order to meet and qualify within the foreseeable future of Big Data. Three years have passed and the amount of national HPC users is steadily increasing every day. Workflows across university borders have been established, national payment models are in place and eScience expert hubs and centers are forming and adjusting to local needs and resources available. All in all, eScience is forming its landscape in Denmark. This paper illustrates the journey Denmark has been through in establishing and integrating national supercomputing into its research culture. Previously, such significant compute resources were strong competitive research parameters. They are now national collaborative facilities opening up for newcomers to HPC, increasing interdisciplinary research, transferring of HPC expertise between scientific disciplines etc. Furthermore, this paper addresses the challenges and successes in reaching this cornerstone for Denmark and in addition identifies the impact of national supercomputing on science in Denmark.

AF : Atrial fibrillation ATP : Antitachycardia pacing CRT : Cardiac resynchronization therapy EHRA : European Heart Rhythm Association ES : Electrical storm HRS : Heart Rhythm Society ICD : Implantable cardiac defibrillator SCD : Sudden cardiac death SSRI : Selective serotonin receptor inhibitor VF : Ventricular fibrillation VT : Ventricular tachycardia This expert consensus aims to provide guidance for the management of patients receiving one or multiple shocks from an ICD. The document expresses the view of a multidisciplinary group of experts in the fields of general adult cardiology, ICD treatment, invasive electrophysiology, and psychosomatic medicine. A variety of clinical settings, including emergency medicine, general cardiology, and interventional electrophysiology, are addressed as well as the different groups of clinicians involved in the care of these patients. To cover different levels of expertise in ICD treatment, it is intended to provide comprehensive information ranging from a basic explanation of how an ICD works to specialist advice for device programming. Almost 30 years after the first human implants, ICD therapy has become the treatment of choice in patients at risk of developing malignant ventricular arrhythmias.1,2 Accordingly, the number of patients implanted with an ICD has increased substantially over the past decade,3 mainly as a consequence of the expansion of ICD indications into the field of primary prevention of SCD in patients with decreased left ventricular function. In 2008, ∼120 000 patients received an ICD worldwide.3 As a result of the growing number of ICD patients, ICD-related problems are increasingly encountered and patients with one or multiple shocks are to day frequently seen at emergency departments, hospital wards, or ICD clinics. Therefore, personnel working in these environments should have specific knowledge concerning the management of ICD-related problems. Table 1 summarizes the most common causes of ICD shocks. Trials reported appropriate therapies in 17–64% of patients, whereas inappropriate shocks, most often caused by supraventricular tachycardia, occurred in 10–24%.4 Among patients enrolled in primary prevention ICD trials, women experienced less appropriate ICD interventions than men.5 Modern device algorithms facilitate effective termination of VT without shock delivery by ATP, discrimination …