Isosorbide dinitrate, with or without hydralazine, does not reduce wave reflections, left ventricular hypertrophy, or myocardial fibrosis in patients with heart failure with preserved ejection fraction

Background-Wave reflections, which are increased in patients with heart failure with preserved ejection fraction, impair diastolic function and promote pathologic myocardial remodeling. Organic nitrates reduce wave reflections acutely, but whether this is sustained chronically or affected by hydralazine coadministration is unknown. Methods and Results-We randomized 44 patients with heart failure with preserved ejection fraction in a double-blinded fashion to isosorbide dinitrate (ISDN; n=13), ISDN+hydralazine (ISDN+hydral; n=15), or placebo (n=16) for 6months. The primary end point was the change in reflection magnitude (RM; assessed with arterial tonometry and Doppler echocardiography). Secondary end points included change in left ventricular mass and fibrosis, measured with cardiac magnetic resonance imaging, and the 6-minute walk distance. ISDN reduced aortic characteristic impedance (mean baseline=0.15 [95% CI, 0.14-0.17], 3 months=0.11 [95% CI, 0.10-0.13], 6 months=0.10 [95% CI, 0.08-0.12] mmHg/mL per second; P=0.003) and forward wave amplitude (P-f, mean baseline=54.8 [95% CI, 47.6-62.0], 3 months=42.2 [95% CI, 33.2-51.3]; 6 months=37.0 [95% CI, 27.2-46.8] mmHg, P=0.04), but had no effect on RM (P=0.64), left ventricular mass (P=0.33), or fibrosis (P=0.63). ISDN+hydral increased RM (mean baseline=0.39 [95% CI, 0.35-0.43]; 3 months=0.31 [95% CI, 0.25-0.36]; 6 months=0.44 [95% CI, 0.37-0.51], P=0.03), reduced 6-minute walk distance (mean baseline=343.3 [95% CI, 319.2-367.4]; 6 months=277.0 [95% CI, 242.7-311.4] meters, P=0.022), and increased native myocardial T1 (mean baseline=1016.2 [95% CI, 1002.7-1029.7]; 6 months=1054.5 [95% CI, 1036.5-1072.3], P=0.021). A high proportion of patients experienced adverse events with active therapy (ISDN=61.5%, ISDN+hydral=60.0%; placebo=12.5%; P=0.007). Conclusions-ISDN, with or without hydralazine, does not exert beneficial effects on RM, left ventricular remodeling, or submaximal exercise and is poorly tolerated. ISDN+hydral appears to have deleterious effects on RM, myocardial remodeling, and submaximal exercise. Our findings do not support the routine use of these vasodilators in patients with heart failure with preserved ejection fraction

Black hole entropy functions and attractor equations

The entropy and the attractor equations for static extremal black hole solutions follow from a variational principle based on an entropy function. In the general case such an entropy function can be derived from the reduced action evaluated in a near-horizon geometry. BPS black holes constitute special solutions of this variational principle, but they can also be derived directly from a different entropy function based on supersymmetry enhancement at the horizon. Both functions are consistent with electric/magnetic duality and for BPS black holes their corresponding OSV-type integrals give identical results at the semi-classical level. We clarify the relation between the two entropy functions and the corresponding attractor equations for N=2 supergravity theories with higher-derivative couplings in four space-time dimensions. We discuss how non-holomorphic corrections will modify these entropy functions.Comment: 21 pages,LaTeX,minor change

On the Rotating Charged Black String Solution

A rotating charged black string solution in the low energy effective field theory describing five dimensional heterotic string theory is constructed. The solution is labelled by mass, electric charge, axion charge and angular momentum per unit length. The extremal limit of this solution is also studied.Comment: 12 pages, IMSC-93/6,(Phyzzx macro), January 199

A tachyonic extension of the stringy no-go theorem

We investigate the tachyon-dilaton-metric system to study the "graceful exit" problem in string theoretic inflation, where tachyon plays the role of the scalar field. From the phase space analysis, we find that the inflationary phase does not smoothly connect to a Friedmann-Robertson-Walker (FRW) expanding universe, thereby providing a simple tachyonic extension of the recently proved stringy no-go theorem.Comment: TeX file (PHYZZX), 10 pages, change in the title, many changes in the text (the version to appear in Phys. Rev. D

Intersecting 6-branes from new 7-manifolds with G_2 holonomy

We discuss a new family of metrics of 7-manifolds with G_2 holonomy, which are R^3 bundles over a quaternionic space. The metrics depend on five parameters and have two Abelian isometries. Certain singularities of the G_2 manifolds are related to fixed points of these isometries; there are two combinations of Killing vectors that possess co-dimension four fixed points which yield upon compactification only intersecting D6-branes if one also identifies two parameters. Two of the remaining parameters are quantized and we argue that they are related to the number of D6-branes, which appear in three stacks. We perform explicitly the reduction to the type IIA model.Comment: 25 pages, 1 figure, Latex, small changes and add refs, version appeared in JHE

De Sitter vacua from N=2 gauged supergravity

Typical de Sitter (dS) vacua of gauged supergravity correspond to saddle points of the potential and often the unstable mode runs into a singularity. We explore the possibility to obtain dS points where the unstable mode goes on both sides into a supersymmetric smooth vacuum. Within N=2 gauged supergravity coupled to the universal hypermultiplet, we have found a potential which has two supersymmetric minima (one of them can be flat) and these are connected by a de Sitter saddle point. In order to obtain this potential by an Abelian gauging, it was important to include the recently proposed quantum corrections to the universal hypermultiplet sector. Our results apply to four as well as five dimensional gauged supergravity theories.Comment: 25 pages, 1 figure, add refs and corrected typo

Moduli and (un)attractor black hole thermodynamics

We investigate four-dimensional spherically symmetric black hole solutions in gravity theories with massless, neutral scalars non-minimally coupled to gauge fields. In the non-extremal case, we explicitly show that, under the variation of the moduli, the scalar charges appear in the first law of black hole thermodynamics. In the extremal limit, the near horizon geometry is $AdS_2\times S^2$ and the entropy does not depend on the values of moduli at infinity. We discuss the attractor behaviour by using Sen's entropy function formalism as well as the effective potential approach and their relation with the results previously obtained through special geometry method. We also argue that the attractor mechanism is at the basis of the matching between the microscopic and macroscopic entropies for the extremal non-BPS Kaluza-Klein black hole.Comment: 36 pages, no figures, V2: minor changes, misprints corrected, expanded references; V3: sections 4.3 and 4.5 added; V4: minor changes, matches the published versio

Mental health status and perceived burden in caregiving spouses of persons with psychotic illness (a study from India)

Mental illness poses a great deal of burden on other family members, particularly the primary caregiver. In the Indian context for a married person with mental illness, the caregiving burden is usually experienced by the spouse, who is considered to be the ‘natural’ option. This quantitative study used survey methodology to assess caregiving burden in fifty spouses of persons diagnosed with a psychotic illness. Data was collected at a neuro-psychiatric facility in Tiruchirappalli, India. The Depression, Anxiety and Stress Scale and the Burden Assessment Schedule were the instruments administered to assess the mental health status of the spouse and their perceived burden. Findings revealed that the majority of spouses were classified as experiencing ‘severe’ and ‘extremely severe’ in terms of their depression, anxiety and stress levels and ‘high’ in terms of perceived burden. The specific ‘type’ of clinical diagnosis, however, did not differentiate the spouses on the key variables studied. The correlation of these key variables with other background variables has also been examined. The implications of the results of this study for psychosocial intervention have also been discussed in this article

Physics Potential of the ICAL detector at the India-based Neutrino Observatory (INO)

The upcoming 50 kt magnetized iron calorimeter (ICAL) detector at the India-based Neutrino Observatory (INO) is designed to study the atmospheric neutrinos and antineutrinos separately over a wide range of energies and path lengths. The primary focus of this experiment is to explore the Earth matter effects by observing the energy and zenith angle dependence of the atmospheric neutrinos in the multi-GeV range. This study will be crucial to address some of the outstanding issues in neutrino oscillation physics, including the fundamental issue of neutrino mass hierarchy. In this document, we present the physics potential of the detector as obtained from realistic detector simulations. We describe the simulation framework, the neutrino interactions in the detector, and the expected response of the detector to particles traversing it. The ICAL detector can determine the energy and direction of the muons to a high precision, and in addition, its sensitivity to multi-GeV hadrons increases its physics reach substantially. Its charge identification capability, and hence its ability to distinguish neutrinos from antineutrinos, makes it an efficient detector for determining the neutrino mass hierarchy. In this report, we outline the analyses carried out for the determination of neutrino mass hierarchy and precision measurements of atmospheric neutrino mixing parameters at ICAL, and give the expected physics reach of the detector with 10 years of runtime. We also explore the potential of ICAL for probing new physics scenarios like CPT violation and the presence of magnetic monopoles.Comment: 139 pages, Physics White Paper of the ICAL (INO) Collaboration, Contents identical with the version published in Pramana - J. Physic

Black Holes and Flop Transitions in M-Theory on Calabi-Yau Threefolds

We present fivedimensional extreme black hole solutions of M-theory compactified on Calabi-Yau threefolds and study these solutions in the context of flop transitions in the extended Kahler cone. In particular we consider a specific model and present black hole solutions, breaking half of N=2 supersymmetry, in two regions of the extended Kahler cone, which are connected by a flop transition. The conditions necessary to match both solutions at the flop transition are analysed. Finally we also discuss the conditions to obtain massless black holes at the flop transition.Comment: 19 pp, LaTe