K022: Effect of combination therapy (ANG II antagonist, valsartan and a calcium channel blocker) in a hypertensive model of diabetic nephropathy

Recently, it has been suggested that in the context of diabetes and hypertension, more aggressive blood pressure targets should be considered. To achieve these levels of blood pressure control, it is likely that combination therapy will need to be used. The present study has explored the role of the addition of either a dihydropyridine or a non-dihydropyridine calcium channel blocker (CCB) to Ang II antagonist based treatment in an experimental model of hypertension and diabetes. The doses chosen for the combination therapy groups were lower than those used with monotherapy in order to achieve similar antihypertensive efficacy. Diabetic (streptozotocin induced) SHR were randomised to no treatment, valsartan (30 mg/kg/day), the non-dihydropyridine CCB verapamil (20 mg/kg/day), the dihydropyridine CCB amlodipine (6 mg/kg/day), a combination of valsartan and amlodipine (20 mg + 4 mg/kg/day respectively) or valsartan and verapamil (20 mg + 15 mg/kg/day respectively). Serial measurements of systolic blood pressure (BP) and albumin excretion rate (AER) were performed monthly (data are shown at week 16 for AER and mean of wk 20-28 for BP). This model was associated with hypertension (control, 217 ± 8, diabetic, 200 ± 5 mmHg) which was reduced by most treatments to a similar degree (valsartan 165 ± 3, amlodipine 164 ± 2, verapamil 182 ± 4, valsartan + amlodipine 151 ± 3 and valsartan + verapamil 169 ± 5 mmHg). Diabetes was associated with a progressive increase in AER (control 1.5 vs diabetic 17 mg/24 hr). Valsartan retarded the increase in AER (11 mg/24 hr). Similar efficacy was observed in the valsartan + amlodipine combination (9 mg/24 hr) but not with amlodipine alone (16 mg/24 hr) despite similar effects on blood pressure. No advantage of verapamil versus amlodipine either as monotherapy or in combination with valsartan was observed. The present study indicates that the combination of an Ang II antagonist and a dihydropyridine CCB is an effective regimen at reducing blood pressure and albuminuria in the context of diabetes and hypertensio

Isotope Effect in the Superfluid Density of HTS Cuprates: Stripes, Pseudogap and Impurities

Underdoped cuprates exhibit a normal-state pseudogap, and their spins and doped carriers tend to spatially separate into 1- or 2-D stripes. Some view these as central to superconductivity, others as peripheral and merely competing. Using La$_{2-x}$Sr$_x$Cu$_{1-y}$Zn$_y$O$_4$ we show that an oxygen isotope effect in $T_c$ and in the superfluid density can be used to distinguish between the roles of stripes and pseudogap and also to detect the presence of impurity scattering. We conclude that stripes and pseudogap are distinct, and both compete and coexist with superconductivity.Comment: Revised submission to PRL with added appendix on a possible isotope effect in the effective mass, 4 pages, 3 figure

Learning to prescribe - pharmacists' experiences of supplementary prescribing training in England

Background: The introduction of non-medical prescribing for professions such as pharmacy and nursing in recent years offers additional responsibilities and opportunities but attendant training issues. In the UK and in contrast to some international models, becoming a non-medical prescriber involves the completion of an accredited training course offered by many higher education institutions, where the skills and knowledge necessary for prescribing are learnt. Aims: to explore pharmacists' perceptions and experiences of learning to prescribe on supplementary prescribing (SP) courses, particularly in relation to inter-professional learning, course content and subsequent use of prescribing in practice. Methods: A postal questionnaire survey was sent to all 808 SP registered pharmacists in England in April 2007, exploring demographic, training, prescribing, safety culture and general perceptions of SP. Results: After one follow-up, 411 (51%) of pharmacists responded. 82% agreed SP training was useful, 58% agreed courses provided appropriate knowledge and 62% agreed that the necessary prescribing skills were gained. Clinical examination, consultation skills training and practical experience with doctors were valued highly; pharmacology training and some aspects of course delivery were criticised. Mixed views on inter-professional learning were reported – insights into other professions being valued but knowledge and skills differences considered problematic. 67% believed SP and recent independent prescribing (IP) should be taught together, with more diagnostic training wanted; few pharmacists trained in IP, but many were training or intending to train. There was no association between pharmacists' attitudes towards prescribing training and when they undertook training between 2004 and 2007 but earlier cohorts were more likely to be using supplementary prescribing in practice. Conclusion: Pharmacists appeared to value their SP training and suggested improvements that could inform future courses. The benefits of inter-professional learning, however, may conflict with providing professionspecific training. SP training may be perceived to be an instrumental 'stepping stone' in pharmacists' professional project of gaining full IP status

Attractor states and infrared scaling in de Sitter space

The renormalized expectation value of the energy-momentum tensor for a scalar field with any mass m and curvature coupling xi is studied for an arbitrary homogeneous and isotropic physical initial state in de Sitter spacetime. We prove quite generally that has a fixed point attractor behavior at late times, which depends only on m and xi, for any fourth order adiabatic state that is infrared finite. Specifically, when m^2 + xi R > 0, approaches the Bunch-Davies de Sitter invariant value at late times, independently of the initial state. When m = xi = 0, it approaches instead the de Sitter invariant Allen-Folacci value. When m = 0 and xi \ge 0 we show that this state independent asymptotic value of the energy-momentum tensor is proportional to the conserved geometrical tensor (3)H_{ab}, which is related to the behavior of the quantum effective action of the scalar field under global Weyl rescaling. This relationship serves to generalize the definition of the trace anomaly in the infrared for massless, non-conformal fields. In the case m^2 + xi R = 0, but m and xi separately different from zero, grows linearly with cosmic time at late times. For most values of m and xi in the tachyonic cases, m^2 + xi R grows exponentially at late cosmic times for all physically admissable initial states.Comment: 30 pages, 6 figures, 46 kB tar.gz fil

Strong electron-phonon coupling in delta-phase stabilized Pu

Heat capacity measurements of the delta-phase stabilized alloy Pu-Al suggest that strong electron-phonon coupling is required to explain the moderate renormalization of the electronic density of states near the Fermi energy. We calculate the heat capacity contributions from the lattice and electronic degrees of freedom as well as from the electron-lattice coupling term and find good overall agreement between experiment and theory assuming a dimensionless electron-phonon coupling parameter of order unity, lambda ~ 0.8. This large electron-phonon coupling parameter is comparable to reported values in other superconducting metals with face-centered cubic crystal structure, for example, Pd (lambda ~ 0.7) and Pb (lambda ~ 1.5). Further, our analysis shows evidence of a sizable residual low-temperature entropy contribution, S_{res} ~ 0.4 k_B (per atom). We can fit the residual specific heat to a two-level system. Therefore, we speculate that the observed residual entropy originates from crystal-electric field effects of the Pu atoms or from self-irradiation induced defects frozen in at low temperatures.Comment: 9 pages, 11 figures, to appear in Phys. Rev.

Proximity effect in ultrathin Pb/Ag multilayers within the Cooper limit

We report on transport and tunneling measurements performed on ultra-thin Pb/Ag (strong coupled superconductor/normal metal) multilayers evaporated by quench condensation. The critical temperature and energy gap of the heterostructures oscillate with addition of each layer, demonstrating the validity of the Cooper limit model in the case of multilayers. We observe excellent agreement with a simple theory for samples with layer thickness larger than 30\AA . Samples with single layers thinner than 30\AA deviate from the Cooper limit theory. We suggest that this is due to the "inverse proximity effect" where the normal metal electrons improve screening in the superconducting ultrathin layer and thus enhance the critical temperature.Comment: 4 pages, 4 figure

Burying the 'refuse revolution': the rise of controlled tipping in Britain 1920-1960

The definitive, peer-reviewed and edited version of this article is published in Environment and Planning A, 42, 5, 1033-1048, 2010, 10.1068/a42120.This paper investigates the emergence of ‘controlled tipping’ as the dominant method of municipal waste disposal in Britain between 1920 and 1960. The triumph of controlled tipping, despite the availability of alternative disposal technologies, needs to be understood in the context of the contested meanings of ‘waste’ and ‘wasteland’, which helped to determine attitudes and approaches to disposal. Following the conclusion of the First World War there was an urgent requirement for a cheap means of disposing of increasing amounts of urban municipal waste. The obvious choice was tipping. Before the war, however, refuse tipping had been rejected as insanitary by the emerging waste disposal profession. Public cleansing professionals therefore had to recuperate tipping as a medically and environmentally benign mode of disposal that was reconcilable with the needs of sanitary science and landscape preservation. Controlled tipping, with its combined claims to scientific progress and the revalorization of refuse, enabled dumping to be successfully re-produced as the dominant mode of municipal refuse disposal in Britain. However, tipping faced further challenges after 1945 from changing popular understandings of the value of ‘derelict’ landscapes and from the politics of amenity. The ‘refuse revolution’ was a work in progress

The prevalence and incidence of mental ill-health in adults with autism and intellectual disabilities

The prevalence, and incidence, of mental ill-health in adults with intellectual disabilities and autism were compared with the whole population with intellectual disabilities, and with controls, matched individually for age, gender, ability-level, and Down syndrome. Although the adults with autism had a higher point prevalence of problem behaviours compared with the whole adult population with intellectual disabilities, compared with individually matched controls there was no difference in prevalence, or incidence of either problem behaviours or other mental ill-health. Adults with autism who had problem behaviours were less likely to recover over a two-year period than were their matched controls. Apparent differences in rates of mental ill-health are accounted for by factors other than autism, including Down syndrome and ability level

No sex scandals please, we're French: French attitudes towards politicians' public and private conduct

The notion of distinct ‘public’ and ‘private’ spheres underpins much normative and practical engagement with political misconduct. What is less clear is whether citizens draw distinctions between misdemeanours in the ‘public’ and ‘private’ spheres, and whether they judge these in systematically different ways. This paper explores attitudes to political misconduct in France. French citizens are often said to be particularly relaxed about politicians’ private affairs, but there has been little empirical evidence for this proposition. Drawing on original survey data, this paper demonstrates clearly that French citizens draw a sharp distinction between politicians’ public and private transgressions, and are more tolerant of the latter

Vortex-antivortex wavefunction of a degenerate quantum gas

A mechanism of a pinning of the quantized matter wave vortices by optical vortices in a specially arranged optical dipole traps is discussed. The vortex-antivortex optical arrays of rectangular symmetry are shown to transfer angular orbital momentum and form the "antiferromagnet"-like matter waves. The separable Hamiltonian for matter waves in pancake trapping geometry is proposed and 3D-wavefunction is factorized in a product of wavefunctions of the 1D harmonic oscillator and 2D vortex-antivortex quantum state. The 2D wavefunction's phase gradient field associated via Madelung transform with the field of classical velocities forms labyrinth-like structure. The macroscopic quantum state composed of periodically spaced counter-rotating BEC superfluid vortices has zero angular momentum and nonzero rotational energy.Comment: 11 pages, 5 figure