Estimation of individual beneficial and adverse effects of intensive glucose control for patients with type 2 diabetes

AIMS/HYPOTHESIS: Intensive glucose control reduces the risk of vascular complications while increasing the risk of severe hypoglycaemia at a group level. We sought to estimate individual beneficial and adverse effects of intensive glucose control in patients with type 2 diabetes. METHODS: We performed a post hoc analysis of the Action in Diabetes and Vascular Disease: Preterax and Diamicron MR Controlled Evaluation (ADVANCE) trial, a randomised controlled trial evaluating standard vs intensive glucose control (HbA1c target ≤6.5% [48 mmol/mol]). In 11,140 participants, we estimated the individual 5 year absolute risk reduction (ARR) for the composite outcome of major micro- and macrovascular events and absolute risk increase (ARI) for severe hypoglycaemia for intensive vs standard glucose control. Predictions were based on competing risks models including clinical characteristics and randomised treatment. RESULTS: Based on these models, 76% of patients had a substantial estimated 5 year ARR for major vascular events (>1%, 5 year number-needed-to-benefit [NNTB5] 200). Similarly, 36% of patients had a substantial estimated ARI for severe hypoglycaemia (5 year number-needed-to-harm [NNTH5] 200). When assigning similar or half the weight to severe hypoglycaemia compared with a major vascular event, net benefit was positive in 85% or 99% of patients, respectively. Limiting intensive treatment to the 85% patient subgroup had no significant effect on the overall incidence of major vascular events and severe hypoglycaemia compared with treating all patients. CONCLUSIONS/INTERPRETATION: Taking account of the effects of intensive glucose control on major micro- and macrovascular events and severe hypoglycaemia for individual patients, the estimated net benefit was positive in the majority of the participants in the ADVANCE trial. The estimated individual effects can inform treatment decisions once individual weights assigned to positive and adverse effects have been specified. TRIAL REGISTRATION: ClinicalTrials.gov NCT00145925

Influence of diffraction on the spectrum and wavefunctions of an open system

In this paper, we demonstrate the existence and significance of diffractive orbits in an open microwave billiard, both experimentally and theoretically. Orbits that diffract off of a sharp edge of the system are found to have a strong influence on the transmission spectrum of the system, especially in the regime where there are no stable classical orbits. On resonance, the wavefunctions are influenced by both classical and diffractive orbits. Off resonance, the wavefunctions are determined by the constructive interference of multiple transient, nonperiodic orbits. Experimental, numerical, and semiclassical results are presented.Comment: 27 pages, 29 figures, and 3 tables. Submitted to Physical Review E. A copy with higher resolution figures is available at http://monsoon.harvard.edu/~hersch/papers.htm

Instantons revisited: dynamical tunnelling and resonant tunnelling

Starting from trace formulae for the tunnelling splittings (or decay rates) analytically continued in the complex time domain, we obtain explicit semiclassical expansions in terms of complex trajectories that are selected with appropriate complex-time paths. We show how this instanton-like approach, which takes advantage of an incomplete Wick rotation, accurately reproduces tunnelling effects not only in the usual double-well potential but also in situations where a pure Wick rotation is insufficient, for instance dynamical tunnelling or resonant tunnelling. Even though only one-dimensional autonomous Hamiltonian systems are quantitatively studied, we discuss the relevance of our method for multidimensional and/or chaotic tunnelling

Heavy Quark Free Energies and Screening in SU(2) Gauge Theory

We investigate the singlet, triplet and colour average heavy quark free energies in SU(2) pure gauge theory at various temperatures T. We focus on the long distance behaviour of the free energies, studying in particular the temperature dependence of the string tension and the screening masses. The results are qualitatively similar to the SU(3) scenario, except near the critical temperature Tc of the deconfining transition. Finally we test a recently proposed method to renormalize the Polyakov loop.Comment: 5 pages, 4 figures, contribution to the Proceedings of SEWM 2002 (Heidelberg

Husimi Maps in Lattices

We build upon previous work that used coherent states as a measurement of the local phase space and extended the flux operator by adapting the Husimi projection to produce a vector field called the Husimi map. In this article, we extend its definition from continuous systems to lattices. This requires making several adjustments to incorporate effects such as group velocity and multiple bands. Several phenomena which uniquely occur in lattice systems, like group-velocity warping and internal Bragg diffraction, are explained and demonstrated using Husimi maps. We also show that scattering points between bands and valleys can be identified in the divergence of the Husimi map

Biosensing platform combining label-free and labelled analysis using Bloch surface waves

Bloch surface waves (BSW) propagating at the boundary of truncated photonic crystals (1D-PC) have emerged as an attractive approach for label-free sensing in plasmon-like sensor configurations. Due to the very low losses in such dielectric thin film stacks, BSW feature very low angular resonance widths compared to the surface plasmon resonance (SPR) case. Besides label-free operation, the large field enhancement and the absence of quenching allow utilizing BSW coupled fluorescence detection to additionally sense the presence of fluorescent labels. This approach can be adapted to the case of angularly resolved resonance detection, thus giving rise to a combined label-free / labelled biosensor platform. It features a parallel analysis of multiple spots arranged as a one-dimensional array inside a microfluidic channel of a disposable chip. Application of such a combined biosensing approach to the detection of the Angiopoietin-2 cancer biomarker in buffer solutions is reported

The 1/N-expansion, quantum-classical correspondence and nonclassical states generation in dissipative higher-order anharmonic oscillators

We develop a method for the determination of thecdynamics of dissipative quantum systems in the limit of large number of quanta N, based on the 1/N-expansion of Heidmann et al. [ Opt. Commun. 54, 189 (1985) ] and the quantum-classical correspondence. Using this method, we find analytically the dynamics of nonclassical states generation in the higher-order anharmonic dissipative oscillators for an arbitrary temperature of a reservoir. We show that the quantum correction to the classical motion increases with time quadratically up to some maximal value, which is dependent on the degree of nonlinearity and a damping constant, and then it decreases. Similarities and differences with the corresponding behavior of the quantum corrections to the classical motion in the Hamiltonian chaotic systems are discussed. We also compare our results obtained for some limiting cases with the results obtained by using other semiclassical tools and discuss the conditions for validity of our approach.Comment: 15 pages, RevTEX (EPSF-style), 3 figs. Replaced with final version (stylistic corrections

Classical and quantum chaos in a circular billiard with a straight cut

We study classical and quantum dynamics of a particle in a circular billiard with a straight cut. This system can be integrable, nonintegrable with soft chaos, or nonintegrable with hard chaos, as we vary the size of the cut. We use a quantum web to show differences in the quantum manifestations of classical chaos for these three different regimes.Comment: LaTeX2e, 8 pages including 3 Postscript figures and 4 GIF figures, submitted to Phys. Rev.

Relaxation and Localization in Interacting Quantum Maps

We quantise and study several versions of finite multibaker maps. Classically these are exactly solvable K-systems with known exponential decay to global equilibrium. This is an attempt to construct simple models of relaxation in quantum systems. The effect of symmetries and localization on quantum transport is discussed.Comment: 32 pages. LaTex file. 9 figures, not included. For figures send mail to first author at '[email protected]

Quarkonium Suppression

I discuss quarkonium suppression in equilibriated strongly interacting matter. After a brief review of basic features of quarkonium production I discuss the application of recent lattice data on the heavy quark potential to the problem of quarkonium dissociation as well as the problem of direct lattice determination of quarkonium properties in finite temperature lattice QCD.Comment: Invited plenary talk presented on 4th International Conference on Physics and Astrophysics of Quark Gluon Plasma (ICPAQGP-2001), November 26-30, 2001, Jaipur; 12 pp, LaTeX, uses pramana.st