Effect of risedronate on joint structure and symptoms of knee osteoarthritis: results of the BRISK randomized, controlled trial [ISRCTN01928173]

To determine the efficacy and safety of risedronate in patients with knee osteoarthritis (OA), the British study of risedronate in structure and symptoms of knee OA (BRISK), a 1-year prospective, double-blind, placebo-controlled study, enrolled patients (40–80 years of age) with mild to moderate OA of the medial compartment of the knee. The primary aims were to detect differences in symptoms and function. Patients were randomized to once-daily risedronate (5 mg or 15 mg) or placebo. Radiographs were taken at baseline and 1 year for assessment of joint-space width using a standardized radiographic method with fluoroscopic positioning of the joint. Pain, function, and stiffness were assessed using the Western Ontario and McMaster Universities (WOMAC) OA index. The patient global assessment and use of walking aids were measured and bone and cartilage markers were assessed. The intention-to-treat population consisted of 284 patients. Those receiving risedronate at 15 mg showed improvement of the WOMAC index, particularly of physical function, significant improvement of the patient global assessment (P < 0.001), and decreased use of walking aids relative to patients receiving the placebo (P = 0.009). A trend towards attenuation of joint-space narrowing was observed in the group receiving 15 mg risedronate. Eight percent (n = 7) of patients receiving placebo and 4% (n = 4) of patients receiving 5 mg risedronate exhibited detectable progression of disease (joint-space width ≥ 25% or ≥ 0.75 mm) versus 1% (n = 1) of patients receiving 15 mg risedronate (P = 0.067). Risedronate (15 mg) significantly reduced markers of cartilage degradation and bone resorption. Both doses of risedronate were well tolerated. In this study, clear trends towards improvement were observed in both joint structure and symptoms in patients with primary knee OA treated with risedronate

Maternal obesity is associated with the formation of small dense LDL and hypoadiponectinemia in the third trimester

Context: Maternal obesity is associated with high plasma triglyceride, poor vascular function, and an increased risk for pregnancy complications. In normal-weight pregnant women, higher triglyceride is associated with increased small, dense low-density lipoprotein (LDL). Hypothesis: In obese pregnancy, increased plasma triglyceride concentrations result in triglyceride enrichment of very low-density lipoprotein-1 particles and formation of small dense LDL via lipoprotein lipase. Design: Women (n = 55) of body mass index of 18–46 kg/m2 were sampled longitudinally at 12, 26, and 35 weeks' gestation and 4 months postnatally. Setting: Women were recruited at hospital antenatal appointments, and study visits were in a clinical research suite. Outcome Measures: Plasma concentrations of lipids, triglyceride-rich lipoproteins, lipoprotein lipase mass, estradiol, steroid hormone binding globulin, insulin, glucose, leptin, and adiponectin were determined. Results: Obese women commenced pregnancy with higher plasma triglyceride, reached the same maximum, and then returned to higher postnatal levels than normal-weight women. Estradiol response to pregnancy (trimester 1–3 incremental area under the curve) was positively associated with plasma triglyceride response (r2 adjusted 25%, P &#60; .001). In the third trimester, the proportion of small, dense LDL was 2-fold higher in obese women than normal-weight women [mean (SD) 40.7 (18.8) vs 21.9 (10.9)%, P = .014], and 35% of obese, 14% of overweight, and none of the normal-weight women displayed an atherogenic LDL subfraction phenotype. The small, dense LDL mass response to pregnancy was inversely associated with adiponectin response (17%, P = .013). Conclusions: Maternal obesity is associated with an atherogenic LDL subfraction phenotype and may provide a mechanistic link to poor vascular function and adverse pregnancy outcome

Preeclampsia is associated with compromized maternal synthesis of long chain polyunsaturated fatty acids leading to offspring deficiency

Obesity and excessive lipolysis are implicated in preeclampsia (PE). Intrauterine growth restriction is associated with low maternal body mass index and decreased lipolysis. Our aim was to assess how maternal and offspring fatty acid metabolism is altered in mothers in the third trimester of pregnancy with PE (n=62) or intrauterine growth restriction (n=23) compared with healthy pregnancies (n=164). Markers of lipid metabolism and erythrocyte fatty acid concentrations were measured. Maternal adipose tissue fatty acid composition and mRNA expression of adipose tissue fatty acid–metabolizing enzymes and placental fatty acid transporters were compared. Mothers with PE had higher plasma triglyceride (21%, P&#60;0.001) and nonesterified fatty acid (50%, P&#60;0.001) concentrations than controls. Concentrations of major n−6 and n−3 long-chain polyunsaturated fatty acids in erythrocytes were 23% to 60% lower (all P&#60;0.005) in PE and intrauterine growth restriction mothers and offspring compared with controls. Subcutaneous adipose tissue Δ−5 and Δ−6 desaturase and very long-chain fatty acid elongase mRNA expression was lower in PE than controls (respectively, mean [SD] control 3.38 [2.96] versus PE 1.83 [1.91], P=0.030; 3.33 [2.25] versus 1.03 [0.96], P&#60;0.001; 0.40 [0.81] versus 0.00 [0.00], P=0.038 expression relative to control gene [square root]). Low maternal and fetal long-chain polyunsaturated fatty acid concentrations in PE may be the result of decreased maternal synthesis

Computer simulation of bistable switching in a nematic device containing pear-shaped particles

We study the microscopic basis of bistable switching of a confined liquid crystal via Monte Carlo simulations of hard pear-shaped particles. Using both dielectric and dipolar field couplings to this intrinsically flexoelectric fluid, it is shown that pulsed fields of opposing polarity can be used to switch between the vertical and hybrid aligned states. Further, it is shown that the field-susceptibility of the surface polarisation, rather than the bulk flexoelectricity, is the main driver of this switching behaviour.</p

Statistical analysis and the equivalent of a Thouless energy in lattice QCD Dirac spectra

Random Matrix Theory (RMT) is a powerful statistical tool to model spectral fluctuations. This approach has also found fruitful application in Quantum Chromodynamics (QCD). Importantly, RMT provides very efficient means to separate different scales in the spectral fluctuations. We try to identify the equivalent of a Thouless energy in complete spectra of the QCD Dirac operator for staggered fermions from SU(2) lattice gauge theory for different lattice size and gauge couplings. In disordered systems, the Thouless energy sets the universal scale for which RMT applies. This relates to recent theoretical studies which suggest a strong analogy between QCD and disordered systems. The wealth of data allows us to analyze several statistical measures in the bulk of the spectrum with high quality. We find deviations which allows us to give an estimate for this universal scale. Other deviations than these are seen whose possible origin is discussed. Moreover, we work out higher order correlators as well, in particular three--point correlation functions.Comment: 24 pages, 24 figures, all included except one figure, missing eps file available at http://pluto.mpi-hd.mpg.de/~wilke/diff3.eps.gz, revised version, to appear in PRD, minor modifications and corrected typos, Fig.4 revise

New, Highly Accurate Propagator for the Linear and Nonlinear Schr\"odinger Equation

A propagation method for the time dependent Schr\"odinger equation was studied leading to a general scheme of solving ode type equations. Standard space discretization of time-dependent pde's usually results in system of ode's of the form u_t -Gu = s where G is a operator (matrix) and u is a time-dependent solution vector. Highly accurate methods, based on polynomial approximation of a modified exponential evolution operator, had been developed already for this type of problems where G is a linear, time independent matrix and s is a constant vector. In this paper we will describe a new algorithm for the more general case where s is a time-dependent r.h.s vector. An iterative version of the new algorithm can be applied to the general case where G depends on t or u. Numerical results for Schr\"odinger equation with time-dependent potential and to non-linear Schr\"odinger equation will be presented.Comment: 14 page

Classical BI: Its Semantics and Proof Theory

We present Classical BI (CBI), a new addition to the family of bunched logics which originates in O'Hearn and Pym's logic of bunched implications BI. CBI differs from existing bunched logics in that its multiplicative connectives behave classically rather than intuitionistically (including in particular a multiplicative version of classical negation). At the semantic level, CBI-formulas have the normal bunched logic reading as declarative statements about resources, but its resource models necessarily feature more structure than those for other bunched logics; principally, they satisfy the requirement that every resource has a unique dual. At the proof-theoretic level, a very natural formalism for CBI is provided by a display calculus \`a la Belnap, which can be seen as a generalisation of the bunched sequent calculus for BI. In this paper we formulate the aforementioned model theory and proof theory for CBI, and prove some fundamental results about the logic, most notably completeness of the proof theory with respect to the semantics.Comment: 42 pages, 8 figure