Optimizing Heart Failure Outcomes Through Diet: A Review

Heart failure is a growing epidemic that will add significant monetary and human costs to an already overtaxed health-care system. Though promising new medications have recently been approved, this complex condition is largely preventable through aggressive risk factor modification, with diet being shown to have a greater effect than exercise. An underrated component of a healthy diet is the simple addition of nuts – the anti-inflammatory fatty acids, healthy proteins, and general availability have been shown to improve survival and reduce the primary risk factors contributing to heart failure, making the addition of nuts and legumes to the diet an attractive, cost-effective tool to promote cardiovascular well-being

Ab initio Wannier-function-based correlated calculations of Born effective charges of crystalline Li2_{2}O and LiCl

In this paper we have used our recently developed ab initio Wannier-function-based methodology to perform extensive Hartree-Fock and correlated calculations on Li$_{2}$O and LiCl to compute their Born effective charges. Results thus obtained are in very good agreement with the experiments. In particular, for the case of Li$_{2}$O, we resolve a controversy originating in the experiment of Osaka and Shindo {[}Solid State Commun. 51 (1984) 421] who had predicted the effective charge of Li ions to be in the range 0.58--0.61, a value much smaller compared to its nominal value of unity, thereby, suggesting that the bonding in the material could be partially covalent. We demonstrate that effective charge computed by Osaka and Shindo is the Szigeti charge, and once the Born charge is computed, it is in excellent agreement with our computed value. Mulliken population analysis of Li$_{2}$O also confirms ionic nature of the bonding in the substance.Comment: 11 pages, 1 figure. To appear in Phys. Rev. B (Feb 2008

Delayed antibiotic prescriptions for respiratory infections

Background: Concerns exist regarding antibiotic prescribing for respiratory tract infections (RTIs) owing to adverse reactions, cost, and antibacterial resistance. One proposed strategy to reduce antibiotic prescribing is to provide prescriptions, but to advise delay in antibiotic use with the expectation that symptoms will resolve first. This is an update of a Cochrane Review originally published in 2007, and updated in 2010 and 2013. Objectives: To evaluate the effects on clinical outcomes, antibiotic use, antibiotic resistance, and patient satisfaction of advising a delayed prescription of antibiotics in respiratory tract infections. Search methods: For this 2017 update we searched the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, Issue 4, 2017), which includes the Cochrane Acute Respiratory Infection Group's Specialised Register; Ovid MEDLINE (2013 to 25 May 2017); Ovid Embase (2013 to 2017 Week 21); EBSCO CINAHL Plus (1984 to 25 May 2017); Web of Science (2013 to 25 May 2017); WHO International Clinical Trials Registry Platform (1 September 2017); and ClinicalTrials.gov (1 September 2017). Selection criteria: Randomised controlled trials involving participants of all ages defined as having an RTI, where delayed antibiotics were compared to immediate antibiotics or no antibiotics. We defined a delayed antibiotic as advice to delay the filling of an antibiotic prescription by at least 48 hours. We considered all RTIs regardless of whether antibiotics were recommended or not. Data collection and analysis: We used standard Cochrane methodological procedures. Three review authors independently extracted and collated data. We assessed the risk of bias of all included trials. We contacted trial authors to obtain missing information. Main results: For this 2017 update we added one new trial involving 405 participants with uncomplicated acute respiratory infection. Overall, this review included 11 studies with a total of 3555 participants. These 11 studies involved acute respiratory infections including acute otitis media (three studies), streptococcal pharyngitis (three studies), cough (two studies), sore throat (one study), common cold (one study), and a variety of RTIs (one study). Five studies involved only children, two only adults, and four included both adults and children. Six studies were conducted in a primary care setting, three in paediatric clinics, and two in emergency departments. Studies were well reported, and appeared to be of moderate quality. Randomisation was not adequately described in two trials. Four trials blinded the outcomes assessor, and three included blinding of participants and doctors. We conducted meta-analysis for antibiotic use and patient satisfaction. We found no differences among delayed, immediate, and no prescribed antibiotics for clinical outcomes in the three studies that recruited participants with cough. For the outcome of fever with sore throat, three of the five studies favoured immediate antibiotics, and two found no difference. For the outcome of pain related to sore throat, two studies favoured immediate antibiotics, and three found no difference. One study compared delayed antibiotics with no antibiotic for sore throat, and found no difference in clinical outcomes. Three studies included participants with acute otitis media. Of the two studies with an immediate antibiotic arm, one study found no difference for fever, and the other study favoured immediate antibiotics for pain and malaise severity on Day 3. One study including participants with acute otitis media compared delayed antibiotics with no antibiotics and found no difference for pain and fever on Day 3. Two studies recruited participants with common cold. Neither study found differences for clinical outcomes between delayed and immediate antibiotic groups. One study favoured delayed antibiotics over no antibiotics for pain, fever, and cough duration (moderate quality evidence for all clinical outcomes - GRADE assessment). There were either no differences for adverse effects or results favoured delayed antibiotics over immediate antibiotics (low quality evidence - to GRADE assessment) with no significant differences in complication rates. Delayed antibiotics resulted in a significant reduction in antibiotic use compared to immediate antibiotics prescription (odds ratio (OR) 0.04, 95% confidence interval (CI) 0.03 to 0.05). However, a delayed antibiotic was more likely to result in reported antibiotic use than no antibiotics (OR 2.55, 95% CI 1.59 to 4.08) (moderate quality evidence - GRADE assessment). Patient satisfaction favoured delayed over no antibiotics (OR 1.49, 95% CI 1.08 to 2.06). There was no significant difference in patient satisfaction between delayed antibiotics and immediate antibiotics (OR 0.65, 95% CI 0.39 to 1.10) (moderate quality evidence - GRADE assessment). None of the included studies evaluated antibiotic resistance. Authors' conclusions: For many clinical outcomes, there were no differences between prescribing strategies. Symptoms for acute otitis media and sore throat were modestly improved by immediate antibiotics compared with delayed antibiotics. There were no differences in complication rates. Delaying prescribing did not result in significantly different levels of patient satisfaction compared with immediate provision of antibiotics (86% versus 91%) (moderate quality evidence). However, delay was favoured over no antibiotics (87% versus 82%). Delayed antibiotics achieved lower rates of antibiotic use compared to immediate antibiotics (31% versus 93%) (moderate quality evidence). The strategy of no antibiotics further reduced antibiotic use compared to delaying prescription for antibiotics (14% versus 28%). Delayed antibiotics for people with acute respiratory infection reduced antibiotic use compared to immediate antibiotics, but was not shown to be different to no antibiotics in terms of symptom control and disease complications. Where clinicians feel it is safe not to prescribe antibiotics immediately for people with respiratory infections, no antibiotics with advice to return if symptoms do not resolve is likely to result in the least antibiotic use while maintaining similar patient satisfaction and clinical outcomes to delaying prescription of antibiotics. Where clinicians are not confident in using a no antibiotic strategy, a delayed antibiotics strategy may be an acceptable compromise in place of immediate prescribing to significantly reduce unnecessary antibiotic use for RTIs, and thereby reduce antibiotic resistance, while maintaining patient safety and satisfaction levels. Editorial note: As a living systematic review, this review is continually updated, incorporating relevant new evidence as it becomes available. Please refer to the Cochrane Database of Systematic Reviews for the current status of this review

Development and field validation of a burst localisation methodology

Reducing water loss through bursts is a major challenge throughout the developed and developing world. Currently burst lifetimes are often long because awareness and location of them is time- and labor-intensive. Advances that can reduce these periods will lead to improved leakage performance, customer service, and reduce resource wastage. In water-distribution systems the sensitivity of a pressure instrument to change, including burst events, is greatly influenced by its own location and that of the event within the network. A method is described here that utilizes hydraulic-model simulations to determine the sensitivity of potential pressure-instrument locations by sequentially applying leaks to all potential burst locations. The simulation results are used to populate a Jacobian matrix, quantifying the different sensitivities. This matrix may then be searched to identify different instrument locations to achieve required goals: maximising overall sensitivity to all potential events or selective sensitivity to events in different network areas. It is shown here that by searching this matrix to optimize such selective sensitivity, while minimising instrument numbers, it is possible to provide useful burst-localization information. Results are presented from field studies that demonstrate the practical application of the method, showing that current standard network models can provide sufficiently accurate quantification of differential sensitivities and that, once combined with event-detection techniques for data analysis, events can effectively be localized using a small number of instruments

Black hole evaporation in a spherically symmetric non-commutative space-time

Recent work in the literature has studied the quantum-mechanical decay of a Schwarzschild-like black hole, formed by gravitational collapse, into almost-flat space-time and weak radiation at a very late time. The relevant quantum amplitudes have been evaluated for bosonic and fermionic fields, showing that no information is lost in collapse to a black hole. On the other hand, recent developments in noncommutative geometry have shown that, in general relativity, the effects of non-commutativity can be taken into account by keeping the standard form of the Einstein tensor on the left-hand side of the field equations and introducing a modified energy-momentum tensor as a source on the right-hand side. Relying on the recently obtained non-commutativity effect on a static, spherically symmetric metric, we have considered from a new perspective the quantum amplitudes in black hole evaporation. The general relativity analysis of spin-2 amplitudes has been shown to be modified by a multiplicative factor F depending on a constant non-commutativity parameter and on the upper limit R of the radial coordinate. Limiting forms of F have been derived which are compatible with the adiabatic approximation.Comment: 8 pages, Latex file with IOP macros, prepared for the QFEXT07 Conference, Leipzig, September 200

The effect of wave conditions and surfer ability on performance and the physiological response of recreational surfers.

This study investigated the effects of wave conditions on performance and the physiological responses of surfers. After institutional ethical approval 39 recreational surfers participated in 60 surfing sessions where performance and physiological response were measured using global positioning system (GPS) heart rate monitors. Using GPS, the percentage time spent in surfing activity categories was on average 41.6, 47.0, 8.1, and 3.1% for waiting, paddling, riding, and miscellaneous activities, respectively. Ability level of the surfers, wave size, and wave period are significantly associated with the physiological, ride, and performance parameters during surfing. As the ability level of the surfers increases there is a reduction in the relative exercise intensity (e.g., average heart rate as a percentage of laboratory maximum, rpartial = -0.412, p < 0.01) which is in contrast to increases in performance parameters (e.g., maximum ride speed (0.454, p < 0.01). As the wave size increased there were reductions in physiological demand (e.g., total energy expenditure rpartial = -0.351, p ≤ 0.05) but increases in ride speed and distance measures (e.g., the maximum ride speed, 0.454, p < 0.01). As the wave period increased there were increases in intensity (e.g., average heart rate as a percentage of laboratory maximum, rp = 0.490, p < 0.01) and increases in ride speed and distance measures (e.g., the maximum ride speed, rpartial = 0.371, p < 0.01). This original study is the first to show that wave parameters and surfer ability are significantly associated with the physiological response and performance characteristics of surfing

Gravitational amplitudes in black-hole evaporation: the effect of non-commutative geometry

Recent work in the literature has studied the quantum-mechanical decay of a Schwarzschild-like black hole, formed by gravitational collapse, into almost-flat space-time and weak radiation at a very late time. The relevant quantum amplitudes have been evaluated for bosonic and fermionic fields, showing that no information is lost in collapse to a black hole. On the other hand, recent developments in noncommutative geometry have shown that, in general relativity, the effects of noncommutativity can be taken into account by keeping the standard form of the Einstein tensor on the left-hand side of the field equations and introducing a modified energy-momentum tensor as a source on the right-hand side. The present paper, relying on the recently obtained noncommutativity effect on a static, spherically symmetric metric, considers from a new perspective the quantum amplitudes in black hole evaporation. The general relativity analysis of spin-2 amplitudes is shown to be modified by a multiplicative factor F depending on a constant non-commutativity parameter and on the upper limit R of the radial coordinate. Limiting forms of F are derived which are compatible with the adiabatic approximation here exploited. Approximate formulae for the particle emission rate are also obtained within this framework.Comment: 14 pages, 2 figures, Latex macros. In the final version, section 5 has been amended, the presentation has been improved, and References 21-24 have been added. Last misprints amended in Section 5 and Ref. 2

Fluctuation characteristics of the TCV snowflake divertor measured with high speed visible imaging

Tangentially viewing fast camera footage of the low-field side snowflake minus divertor in TCV is analysed across a four point scan in which the proximity of the two X-points is varied systematically. The motion of structures observed in the post- processed movie shows two distinct regions of the camera frame exhibiting differing patterns. One type of motion in the outer scrape-off layer remains present throughout the scan whilst the other, apparent in the inner scrape-off layer between the two nulls, becomes increasingly significant as the X-points contract towards one another. The spatial structure of the fluctuations in both regions is shown to conform to the equilibrium magnetic field. When the X-point gap is wide the fluctuations measured in the region between the X-points show a similar structure to the fluctuations observed above the null region, remaining coherent for multiple toroidal turns of the magnetic field and indicating a physical connectivity of the fluctuations between the upstream and downstream regions. When the X-point gap is small the fluctuations in the inner scrape-off layer between the nulls are decorrelated from fluctuations upstream, indicating local production of filamentary structures. The motion of filaments in the inter-null region differs, with filaments showing a dominantly poloidal motion along magnetic flux surfaces when the X-point gap is large, compared to a dominantly radial motion across flux-surfaces when the gap is small. This demonstrates an enhancement to cross-field tranport between the nulls of the TCV low-field-side snowflake minus when the gap between the nulls is small.Comment: Accepted for publication in Plasma Physics and Controlled Fusio

Strain dependence of the Mn anisotropy in ferromagnetic semiconductors observed by x-ray magnetic circular dichroism

We demonstrate sensitivity of the Mn 3d valence states to strain in the ferromagnetic semiconductors (Ga,Mn)As and (Al,Ga,Mn)As, using x-ray magnetic circular dichroism (XMCD). The spectral shape of the Mn $L_{2,3}$ XMCD is dependent on the orientation of the magnetization, and features with cubic and uniaxial dependence are distinguished. Reversing the strain reverses the sign of the uniaxial anisotropy of the Mn $L_3$ pre-peak which is ascribed to transitions from the Mn 2p core level to p-d hybridized valence band hole states. With increasing carrier localization, the $L_3$ pre-peak intensity increases, indicating an increasing 3d character of the hybridized holes.Comment: 4 pages plus 2 figures, accepted for publication in Physical Review