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Peculiarities of the Acoustic Wave Propagation in Diamond-Based Multilayer Piezoelectric Structures as “Me1/(Al,Sc)N/Me2/(100) Diamond/Me3” and “Me1/AlN/Me2/(100) Diamond/Me3” under Metal Thin-Film Deposition
New theoretical and experimental results of microwave acoustic wave propagation in diamond-based multilayer piezoelectric structures (MPS) as “Me1/(Al,Sc)N/Me2/(100) diamond/Me3” and “Me1/AlN/Me2/(100) diamond/Me3” under three metal film depositions, including the change in the quality factor Q as a result of Me3 impact, were obtained. Further development of our earlier studies was motivated by the necessity of creating a sensor model based on the above fifth layered MPS and its in-depth study using the finite element method (FEM). Experimental results on the change in operational checkpoint frequencies and quality factors under the effect of film deposition are in satisfactory accordance with FEM data. The relatively small decrease in the quality factor of diamond-based high overtone bulk acoustic resonator (HBAR) under the metal layer effect observed in a wide microwave band could be qualified as an important result. Changes in operational resonant frequencies vs. film thickness were found to have sufficient distinctions. This fact can be quite explained in terms of the difference between acoustic impedances of diamond and deposited metal films
Cardiac myosin activation with omecamtiv mecarbil in systolic heart failure
BACKGROUND The selective cardiac myosin activator omecamtiv mecarbil has been shown to improve cardiac function in patients with heart failure with a reduced ejection fraction. Its effect on cardiovascular outcomes is unknown. METHODS We randomly assigned 8256 patients (inpatients and outpatients) with symptomatic chronic heart failure and an ejection fraction of 35% or less to receive omecamtiv mecarbil (using pharmacokinetic-guided doses of 25 mg, 37.5 mg, or 50 mg twice daily) or placebo, in addition to standard heart-failure therapy. The primary outcome was a composite of a first heart-failure event (hospitalization or urgent visit for heart failure) or death from cardiovascular causes. RESULTS During a median of 21.8 months, a primary-outcome event occurred in 1523 of 4120 patients (37.0%) in the omecamtiv mecarbil group and in 1607 of 4112 patients (39.1%) in the placebo group (hazard ratio, 0.92; 95% confidence interval [CI], 0.86 to 0.99; P = 0.03). A total of 808 patients (19.6%) and 798 patients (19.4%), respectively, died from cardiovascular causes (hazard ratio, 1.01; 95% CI, 0.92 to 1.11). There was no significant difference between groups in the change from baseline on the Kansas City Cardiomyopathy Questionnaire total symptom score. At week 24, the change from baseline for the median N-terminal pro-B-type natriuretic peptide level was 10% lower in the omecamtiv mecarbil group than in the placebo group; the median cardiac troponin I level was 4 ng per liter higher. The frequency of cardiac ischemic and ventricular arrhythmia events was similar in the two groups. CONCLUSIONS Among patients with heart failure and a reduced ejection, those who received omecamtiv mecarbil had a lower incidence of a composite of a heart-failure event or death from cardiovascular causes than those who received placebo. (Funded by Amgen and others; GALACTIC-HF ClinicalTrials.gov number, NCT02929329; EudraCT number, 2016 -002299-28.)