Improving blood pressure control in patients with diabetes mellitus and high cardiovascular risk

Patients with diabetes mellitus and symptomatic coronary artery disease are also likely to be hypertensive and, overall, are at very high cardiovascular (CV) risk. This paper reports the findings of a posthoc analysis of the 1113 patients with diabetes mellitus in the ACTION trial: ACTION itself showed that outcomes in patients with stable angina and hypertension were significantly improved when a long-acting calcium channel blocking drug (nifedipine GITS) was added to their treatment regimens. This further analysis of the ACTION database in those patients with diabetes has identified a number of practical therapeutic issues which are still relevant because of potential outcome benefits, particularly in relation to BP control. For example, despite background CV treatment and, specifically, despite the widespread use of ACE Inhibitor drugs, the addition of nifedipine GITS was associated with significant benefits: improvement in BP control by an average of 6/3 mmHg and significant improvements in outcome. In summary, this retrospective analysis has identified that the addition of nifedipine GITS resulted in improved BP control and significant outcome benefits in patients with diabetes who were at high CV risk. There is evidence to suggest that these findings are of direct relevance to current therapeutic practice

Effect of socioeconomic deprivation on waiting time for cardiac surgery: retrospective cohort study

OBJECTIVE: To determine whether the priority given to patients referred for cardiac surgery is associated with socioeconomic status. DESIGN: Retrospective study with multivariate logistic regression analysis of the association between deprivation and classification of urgency with allowance for age, sex, and type of operation. Multivariate linear regression analysis was used to determine association between deprivation and waiting time within each category of urgency, with allowance for age, sex, and type of operation. SETTING: NHS waiting lists in Scotland. PARTICIPANTS: 26 642 patients waiting for cardiac surgery, 1 January 1986 to 31 December 1997. MAIN OUTCOME MEASURES: Deprivation as measured by Carstairs deprivation category. Time spent on NHS waiting list. RESULTS: Patients who were most deprived tended to be younger and were more likely to be female. Patients in deprivation categories 6 and 7 (most deprived) waited about three weeks longer for surgery than those in category 1 (mean difference 24 days, 95% confidence interval 15 to 32). Deprived patients had an odds ratio of 0.5 (0.46 to 0.61) for having their operations classified as urgent compared with the least deprived, after allowance for age, sex, and type of operation. When urgent and routine cases were considered separately, there was no significant difference in waiting times between the most and least deprived categories. CONCLUSIONS: Socioeconomically deprived patients are thought to be more likely to develop coronary heart disease but are less likely to be investigated and offered surgery once it has developed. Such patients may be further disadvantaged by having to wait longer for surgery because of being given lower priority

Experimental Study of Boundary Layer Flow Control Using an Array of Ramp-Shaped Vortex Generators

The objective of this study was to obtain a database on the flowfield past an array of vortex generators (VGs) in a turbulent boundary layer. All testing was carried out in a low speed wind tunnel with a flow velocity of 29 ft/sec, giving a Reynolds number of 17,500 based on the width of the VG. The flowfield generated by an array of five ramp-shaped vortex generators was examined with hot wire anemometry and smoke flow visualization. The magnitude and extent of the velocity increase near the wall, the penetration of the velocity deficit into the core flow, and the peak streamwise vorticity are examined. Influence of various parameters on the effectiveness of the array is considered on the basis of the ability to pull high momentum fluid into the near wall region

Low-profile independently- and concurrently-tunable quad-band antenna for single chain sub-6GHz 5G new radio applications

This paper presents a quad-band frequency agile antenna, with independent and concurrent frequency tunability in each band, for a tunable, concurrent, quad-band single chain radio receiver for 5G New Radio (NR). More specifically, the antenna comprises of four planar slots etched in a ground plane and fed through a single microstrip feedline, without any impedance matching network. The structure is optimized to maximize isolation between the individual slots and their respective resonant frequencies. Furthermore, a novel high order harmonic suppression method is demonstrated, which controls the current distribution via creating a fictitious short circuit in the slot antenna-enabling the antenna to achieve a much wider tuning range. Numerical simulations are verified using experimental implementation and measurements, with good agreement observed. The four slots resonate around the 830 MHz, 1.8 GHz, 2.4 GHz and 3.4 GHz frequency bands, which are independently tuned (using a varactor diode in each slot) to achieve tuning ranges of approximately 64%, 66%, 27% and 33%, respectively. More importantly, the contiguous four bands covers a total frequency tuning from 0.6 to 3.6 GHz i.e. a tuning range of approximately 143%. Finally, far-field measurements are performed and the antenna is evaluated in over-the-air testbed (quad-band radio receiver), which measures the Error Vector Magnitude performance for the individual channels. Good performance is observed, confirming acceptable isolation performance between the four bands. The data reported in this paper is available, from ORDA-The University of Sheffield Research Data Catalogue and Repository, at https://doi.org/10.15131/shef.data.11219000.v1

Density matrix operatorial solution of the non--Markovian Master Equation for Quantum Brownian Motion

An original method to exactly solve the non-Markovian Master Equation describing the interaction of a single harmonic oscillator with a quantum environment in the weak coupling limit is reported. By using a superoperatorial approach we succeed in deriving the operatorial solution for the density matrix of the system. Our method is independent of the physical properties of the environment. We show the usefulness of our solution deriving explicit expressions for the dissipative time evolution of some observables of physical interest for the system, such as, for example, its mean energy.Comment: 16 pages, 1 figur

The Effect of Negative-Energy Shells on the Schwarzschild Black Hole

We construct Penrose diagrams for Schwarzschild spacetimes joined by massless shells of matter, in the process correcting minor flaws in the similar diagrams drawn by Dray and 't Hooft, and confirming their result that such shells generate a horizon shift. We then consider shells with negative energy density, showing that the horizon shift in this case allows for travel between the heretofore causally separated exterior regions of the Schwarzschild geometry. These drawing techniques are then used to investigate the properties of successive shells, joining multiple Schwarzschild regions. Again, the presence of negative-energy shells leads to a causal connection between the exterior regions, even in (some) cases with two successive shells of equal but opposite total energy.Comment: 12 pages, 10 figure

Exact Diagonalization of Two Quantum Models for the Damped Harmonic Oscillator

The damped harmonic oscillator is a workhorse for the study of dissipation in quantum mechanics. However, despite its simplicity, this system has given rise to some approximations whose validity and relation to more refined descriptions deserve a thorough investigation. In this work, we apply a method that allows us to diagonalize exactly the dissipative Hamiltonians that are frequently adopted in the literature. Using this method we derive the conditions of validity of the rotating-wave approximation (RWA) and show how this approximate description relates to more general ones. We also show that the existence of dissipative coherent states is intimately related to the RWA. Finally, through the evaluation of the dynamics of the damped oscillator, we notice an important property of the dissipative model that has not been properly accounted for in previous works; namely, the necessity of new constraints to the application of the factorizable initial conditions.Comment: 19 pages, 2 figures, ReVTe

Finite-temperature scalar fields and the cosmological constant in an Einstein universe

We study the back reaction effect of massless minimally coupled scalar field at finite temperatures in the background of Einstein universe. Substituting for the vacuum expectation value of the components of the energy-momentum tensor on the RHS of the Einstein equation, we deduce a relationship between the radius of the universe and its temperature. This relationship exhibit a maximum temperature, below the Planck scale, at which the system changes its behaviour drastically. The results are compared with the case of a conformally coupled field. An investigation into the values of the cosmological constant exhibit a remarkable difference between the conformally coupled case and the minimally coupled one.Comment: 7 pages, 2 figure

Tri-band single chain radio receiver for concurrent radio

The bandwidth available for improving throughputs to future mobile devices at sub-6 GHz frequencies can be increased through aggregating multiple non-contiguous bands, which may be using the same or different radio access technologies to transmit information. However, with conventional radio technology, a complete radio frequency (RF) chain is required for each band, limiting the possible increase due to space and energy consumption restraints in the mobile station (MS). This paper presents and measures a single RF chain radio for concurrent reception of three non-contiguous bands transmitting 16-QAM LTE signals, using a tunable analogue front-end and software defined radio (SDR) techniques. The receiver sensitivity is degraded by only 6dB under worst-case concurrent reception, compared with reception of a single band. This demonstrates that complex signaling techniques can be received concurrently with a single radio chain while meeting the 3GPP standards, opening the way to compact, efficient, multiband receivers for future standards

Gravitational Coupling and Dynamical Reduction of The Cosmological Constant

We introduce a dynamical model to reduce a large cosmological constant to a sufficiently small value. The basic ingredient in this model is a distinction which has been made between the two unit systems used in cosmology and particle physics. We have used a conformal invariant gravitational model to define a particular conformal frame in terms of large scale properties of the universe. It is then argued that the contributions of mass scales in particle physics to the vacuum energy density should be considered in a different conformal frame. In this manner, a decaying mechanism is presented in which the conformal factor appears as a dynamical field and plays a key role to relax a large effective cosmological constant. Moreover, we argue that this model also provides a possible explanation for the coincidence problem.Comment: To appear in GR