Abnormal Myocardial Blood Flow Reserve Observed in Cardiac Amyloidosis

We performed real-time myocardial contrast echocardiography on a patient with cardiac amyloidosis and previous normal coronary angiography presenting with atypical chest pain to assess myocardial blood flow reserve (MBFR). Myocardial contrast echocardiography was performed and flash microbubble destruction and replenishment analysis was used to calculate myocardial blood flow. Dipyridamole was used to achieve hyperemia. MBFR was derived from the ratio of peak myocardial blood flow at hyperemia and rest. The results show a marked reduction in MBFR in our patient. Previous reports of luminal obstruction of intramyocardial rather than epicardial vessels by amyloid deposition may be causing microvascular dysfunction

Adaptive Subcarrier PSK Intensity Modulation in Free Space Optical Systems

We propose an adaptive transmission technique for free space optical (FSO) systems, operating in atmospheric turbulence and employing subcarrier phase shift keying (S-PSK) intensity modulation. Exploiting the constant envelope characteristics of S-PSK, the proposed technique offers efficient utilization of the FSO channel capacity by adapting the modulation order of S-PSK, according to the instantaneous state of turbulence induced fading and a pre-defined bit error rate (BER) requirement. Novel expressions for the spectral efficiency and average BER of the proposed adaptive FSO system are presented and performance investigations under various turbulence conditions and target BER requirements are carried out. Numerical results indicate that significant spectral efficiency gains are offered without increasing the transmitted average optical power or sacrificing BER requirements, in moderate-to-strong turbulence conditions. Furthermore, the proposed variable rate transmission technique is applied to multiple input multiple output (MIMO) FSO systems, providing additional improvement in the achieved spectral efficiency as the number of the transmit and/or receive apertures increases.Comment: Submitted To IEEE Transactions On Communication

Interference in Poisson Networks with Isotropically Distributed Nodes

Practical wireless networks are finite, and hence non-stationary with nodes typically non-homo-geneously deployed over the area. This leads to a location-dependent performance and to boundary effects which are both often neglected in network modeling. In this work, interference in networks with nodes distributed according to an isotropic but not necessarily stationary Poisson point process (PPP) are studied. The resulting link performance is precisely characterized as a function of (i) an arbitrary receiver location and of (ii) an arbitrary isotropic shape of the spatial distribution. Closed-form expressions for the first moment and the Laplace transform of the interference are derived for the path loss exponents $\alpha=2$ and $\alpha=4$, and simple bounds are derived for other cases. The developed model is applied to practical problems in network analysis: for instance, the accuracy loss due to neglecting border effects is shown to be undesirably high within transition regions of certain deployment scenarios. Using a throughput metric not relying on the stationarity of the spatial node distribution, the spatial throughput locally around a given node is characterized.Comment: This work was presented in part at ISIT 201

A Numerical study of resistance in a rough walled channel flow where the ratio of roughness length scale to the depth of flow varies over a wide range

Numerical calculations were performed over a variety of two-dimensional rib roughness configurations in which the ratio of flow depth to roughness height was varied from 1.1 to 40. Periodically fully developed flow was achieved by employing periodic boundary conditions and the effect of turbulence was accounted for by a two-layer model. These calculations were used to test the hypothesis that any rough wall resistance may be reduced to an equivalent wall shear stress located on a plane wall. The position of the plane wall is determined by a novel method of prediction obtained by consideration of strearnwise force moments. The resistance is then determined by three dynamically significant length scales: the first (yo) specifies the position of the equivalent plane wall, the second is the depth of flow h and the third is similar to Nikuradse's sand grain roughness k,,. The latter length scale is however depth dependent and a universal relationship is postulated: ks y,, -,= F(Tkwhere ksw is the asymptotic value of ks at very large flow depths. For the calculation of friction factor, a resistance equation is proposed of the form typical of fully rough flows. These postulates are supported by the numerical model results though further work including physical experiments is required to confirm them. Before applying the two-layer model to this problem it was tested on smooth rectangular duct flows and Schlichting's (1936) long angle roughness experiments. The opportunity was taken to further explore these flows, and in addition calculations were carried out for Grass et al's ( 199 1) open channel rib roughness experiments. The periodic boundary conditions were also applied to a larninar counter-flow plate-fin heat exchanger.A novel source-sinka rrangemenfto r heat flux was developedi n order to implement these boundary conditions

Electrodynamics of an omega-band as deduced from optical and magnetometer data

We investigate an omega-band event that took place above northern Scandinavia around 02:00–02:30 UT on 9 March 1999. In our analysis we use ground based magnetometer, optical and riometer measurements together with satellite based optical images. The optical and riometer data are used to estimate the ionospheric Hall and Pedersen conductances, while ionospheric equivalent currents are obtained from the magnetometer measurements. These data sets are used as input in a local KRM calculation, which gives the ionospheric potential electric field as output, thus giving us a complete picture of the ionospheric electrodynamic state during the omega-band event. <br><br> The overall structure of the electric field and field-aligned current (FAC) provided by the local KRM method are in good agreement with previous studies. Also the <I><B>E</B></I>&times;<I><B>B</B></I> drift velocity calculated from the local KRM solution is in good qualitative agreement with the plasma velocity measured by the Finnish CUTLASS radar, giving further support for the new local KRM method. The high-resolution conductance estimates allow us to discern the detailed structure of the omega-band current system. The highest Hall and Pedersen conductances, ~50 and ~25 S, respectively, are found at the edges of the bright auroral tongue. Inside the tongue, conductances are somewhat smaller, but still significantly higher than typical background values. The electric field shows a converging pattern around the tongues, and the field strength drops from ~40 mV/m found at optically dark regions to ~10 mV/m inside the areas of enhanced conductivity. Downward FAC flow in the dark regions, while upward currents flow inside the auroral tongue. Additionally, sharp conductance gradients at the edge of an auroral tongue are associated with narrow strips of intense FACs, so that a strip of downward current flows at the eastern (leading) edge and a similar strip of upward current is present at the western (trailing) edge. The Joule heating follows the electric field pattern, so that it is diminished inside the bright auroral tongue

Effect of curvature on the backscattering from leaves

Using a model previously developed for the backscattering cross section of a planar leaf at X-band frequencies and above, the effect of leaf curvature is examined. For normal incidence on a rectangular section of a leaf curved in one and two dimensions, an integral expression for the backscattered field is evaluated numerically and by a stationary phase approximation, leading to a simple analytical expression for the cross section reduction produced by the curvature. Numerical results based on the two methods are virtually identical, and in excellent agreement with measured data for rectangular sections of coleus leaves applied to the surfaces of styrofoam cylinders and spheres of different radii

Dual-Branch MRC Receivers under Spatial Interference Correlation and Nakagami Fading

Despite being ubiquitous in practice, the performance of maximal-ratio combining (MRC) in the presence of interference is not well understood. Because the interference received at each antenna originates from the same set of interferers, but partially de-correlates over the fading channel, it possesses a complex correlation structure. This work develops a realistic analytic model that accurately accounts for the interference correlation using stochastic geometry. Modeling interference by a Poisson shot noise process with independent Nakagami fading, we derive the link success probability for dual-branch interference-aware MRC. Using this result, we show that the common assumption that all receive antennas experience equal interference power underestimates the true performance, although this gap rapidly decays with increasing the Nakagami parameter $m_{\text{I}}$ of the interfering links. In contrast, ignoring interference correlation leads to a highly optimistic performance estimate for MRC, especially for large $m_{\text{I}}$. In the low outage probability regime, our success probability expression can be considerably simplified. Observations following from the analysis include: (i) for small path loss exponents, MRC and minimum mean square error combining exhibit similar performance, and (ii) the gains of MRC over selection combining are smaller in the interference-limited case than in the well-studied noise-limited case.Comment: to appear in IEEE Transactions on Communication

Prevalence and risk factors of sarcopenia among adults living in nursing homes

Objectives: Sarcopenia is a progressive loss of skeletal muscle and muscle function, with significant healthand disability consequences for older adults. We aimed to evaluate the prevalence and risk factors ofsarcopenia among older residential aged care adults using the European Working Group on Sarcopeniain Older People (EWGSOP) criteria.Study design: A cross-sectional study design that assessed older people (n = 102, mean age 84.5 ± 8.2 years)residing in 11 long-term nursing homes in Australia.Main outcome measurements: Sarcopenia was diagnosed from assessments of skeletal mass index bybioelectrical impedance analysis, muscle strength by handheld dynamometer, and physical performanceby the 2.4 m habitual walking speed test. Secondary variables where collected to inform a risk factoranalysis.Results: Forty one (40.2%) participants were diagnosed as sarcopenic, 38 (95%) of whom were categorizedas having severe sarcopenia. Univariate logistic regression found that body mass index (BMI) (Oddsratio (OR) = 0.86; 95% confidence interval (CI) 0.78–0.94), low physical performance (OR = 0.83; 95% CI0.69–1.00), nutritional status (OR = 0.19; 95% CI 0.05–0.68) and sitting time (OR = 1.18; 95% CI 1.00–1.39)were predictive of sarcopenia. With multivariate logistic regression, only low BMI (OR = 0.80; 95% CI0.65–0.97) remained predictive.Conclusions: The prevalence of sarcopenia among older residential aged care adults is very high. Inaddition, low BMI is a predictive of sarcopenia

An update on informed consent and the effect on the clinical practice of those working with people with a learning disability

In people with learning disability who have capacity under the Mental Capacity Act 2005 health professionals need to ensure that, when they are giving consent to treatment with medication, the consent is truly ‘informed’. The judgment of Montgomery v Lanarkshire Health Board [2015] and the Accessible Information Standard (NHS England 2016) seek to clarify this position which affects learning disability nurses as well as other healthcare professionals. This article examines how the law affects the way information is provided to service users. For people without capacity ‘Best Interests’ will continue to be applied

DENFIS: Dynamic Evolving Neural-Fuzzy Inference System and its Application for Time Series Prediction

This paper introduces a new type of fuzzy inference systems, denoted as DENFIS (dynamic evolving neural-fuzzy inference system), for adaptive on-line and off-line learning, and their application for dynamic time series prediction. DENFIS evolve through incremental, hybrid (supervised/unsupervised), learning and accommodate new input data, including new features, new classes, etc. through local element tuning. New fuzzy rules are created and updated during the operation of the system. At each time moment the output of DENFIS is calculated through a fuzzy inference system based on m-most activated fuzzy rules which are dynamically chosen from a fuzzy rule set. Two approaches are proposed: (1) dynamic creation of a first-order TakagiSugeno type fuzzy rule set for a DENFIS on-line model; (2) creation of a first-order TakagiSugeno type fuzzy rule set, or an expanded high-order one, for a DENFIS off-line model. A set of fuzzy rules can be inserted into DENFIS before, or during its learning process. Fuzzy rules can also be extracted during the learning process or after it. An evolving clustering method (ECM), which is employed in both on-line and off-line DENFIS models, is also introduced. It is demonstrated that DENFIS can effectively learn complex temporal sequences in an adaptive way and outperform some well known, existing models