Interaction between Mean Arterial Pressure and HbA1c in Prediction of Cardiovascular Disease Hospitalisation: A Population-Based Case-Control Study

Objective. To explore the relationship between mean arterial pressure (MAP), HbA1c, and cardiovascular (CV) hospitalisation risk in type 2 diabetes. Design. Population-based case-control study. Settings. Primary and secondary care level in Cambridgeshire, United Kingdom. Participants. 588 patients with type 2 diabetes from 18 English general practices recording a CV hospitalisation in 2009–2011 were included. Risk-set sampling was used to select 2920 gender, age, and practice matched control type 2 diabetes patients. Main Outcome Measure. Conditional logistic regression was used to explore further dose-response relationships between MAP, HbA1c, and CV hospitalisation risk. Results. The relationship between MAP and CV hospitalisation was nonlinear ( for linearity test). The MAP associated with the lowest CV hospitalisation risk was 97 (95% CI: 93–101) mmHg. An interaction between MAP and HbA1c for increased risk of cardiovascular hospitalisation was observed among those with HbA1c < 7% (53 mmol/mol) and MAP < 97 mmHg. Conclusions. In type 2 diabetes, MAP is a good predictor of CV hospitalisation risk. CV hospitalisation is lowest with a MAP between 93 and 101 mmHg. CV hospitalisation was particularly high among those with both a low MAP and a lower HbA1c

Quantifying and Controlling Prethermal Nonergodicity in Interacting Floquet Matter

The use of periodic driving for synthesizing many-body quantum states depends crucially on the existence of a prethermal regime, which exhibits drive-tunable properties while forestalling the effects of heating. This dependence motivates the search for direct experimental probes of the underlying localized nonergodic nature of the wave function in this metastable regime. We report experiments on a many-body Floquet system consisting of atoms in an optical lattice subjected to ultrastrong sign-changing amplitude modulation. Using a double-quench protocol, we measure an inverse participation ratio quantifying the degree of prethermal localization as a function of tunable drive parameters and interactions. We obtain a complete prethermal map of the drive-dependent properties of Floquet matter spanning four square decades of parameter space. Following the full time evolution, we observe sequential formation of two prethermal plateaux, interaction-driven ergodicity, and strongly frequency-dependent dynamics of long-time thermalization. The quantitative characterization of the prethermal Floquet matter realized in these experiments, along with the demonstration of control of its properties by variation of drive parameters and interactions, opens a new frontier for probing far-from-equilibrium quantum statistical mechanics and new possibilities for dynamical quantum engineering

Quantum authentication with key recycling

We show that a family of quantum authentication protocols introduced in [Barnum et al., FOCS 2002] can be used to construct a secure quantum channel and additionally recycle all of the secret key if the message is successfully authenticated, and recycle part of the key if tampering is detected. We give a full security proof that constructs the secure channel given only insecure noisy channels and a shared secret key. We also prove that the number of recycled key bits is optimal for this family of protocols, i.e., there exists an adversarial strategy to obtain all non-recycled bits. Previous works recycled less key and only gave partial security proofs, since they did not consider all possible distinguishers (environments) that may be used to distinguish the real setting from the ideal secure quantum channel and secret key resource.Comment: 38+17 pages, 13 figures. v2: constructed ideal secure channel and secret key resource have been slightly redefined; also added a proof in the appendix for quantum authentication without key recycling that has better parameters and only requires weak purity testing code

Association between systolic blood pressure and cardiovascular inpatient cost moderated by peer-support intervention among adult patients with type 2 diabetes : a 2-cohort study

Objectives People with type 2 diabetes and increased systolic blood pressure (SBP) are at high risk of cardiovascular disease (CVD). In this study, we aimed to investigate the association between CVD-related hospital payments and SBP and tested whether this association is influenced by diabetes peer support. Methods Two cohorts comprising people with type 2 diabetes were included in the study. The first cohort comprised 4,704 patients with type 2 diabetes assessed between 2008 and 2009 from 18 general practices in Cambridgeshire and followed up to 2009–2011. The second cohort comprised 1,121 patients with type 2 diabetes from post-trial follow-up data, recruited between 2011 and 2012 and followed up to 2015. SBP was measured at baseline. Inpatient payments for CVD hospitalization within 2 years since baseline was the main outcome. The impact of 1:1, group or combined diabetes peer support and usual care were investigated in the second cohort. Adjusted mean CVD inpatient payments per person were estimated using a 2-part model after adjusting for baseline characteristics. Results A “hockey-stick” relationship between baseline SBP and estimated CVD inpatient payment was identified in both cohorts, with a threshold at 133 to 141 mmHg, suggesting increased payments for patients with SBP below and above the threshold. The combined peer-support intervention altered the aforementioned association, with no increased payment with SBP above the threshold, and payment slightly decreased with SBP beyond the threshold. Conclusions SBP maintained between 133 and 141 mmHg is associated with the lowest CVD disease management costs for patients with type 2 diabetes. Combined peer-support intervention could significantly decrease CVD-related hospital payments

Persistent currents in two dimensions: New regimes induced by the interplay between electronic correlations and disorder

Using the persistent current I induced by an Aharonov-Bohm flux in square lattices with random potentials, we study the interplay between electronic correlations and disorder upon the ground state (GS) of a few polarized electrons (spinless fermions) with Coulomb repulsion. K being the total momentum, we show that I is proportional to K in the continuum limit. We use this relation to distinguish between the continuum regimes, where the lattice GS behaves as in the continuum limit and I is independent of the interaction strength U when K is conserved, and the lattice regimes where I decays as U increases. Changing the disorder strength W and U, we obtain many regimes which we study using the map of local currents carried by three spinless fermions

Family-Centered Care: Current Applications and Future Directions in Pediatric Health Care

Family-centered care (FCC) is a partnership approach to health care decision-making between the family and health care provider. FCC is considered the standard of pediatric health care by many clinical practices, hospitals, and health care groups. Despite widespread endorsement, FCC continues to be insufficiently implemented into clinical practice. In this paper we enumerate the core principles of FCC in pediatric health care, describe recent advances applying FCC principles to clinical practice, and propose an agenda for practitioners, hospitals, and health care groups to translate FCC into improved health outcomes, health care delivery, and health care system transformation

Derivation and Validation of Risk Scores to Predict Cerebrovascular Mortality Among Incident Peritoneal Dialysis Patients

Background/Aims: Cerebrovascular disease (CeVD) is one of the leading causes of death in patients initialising peritoneal dialysis (PD). Currently there is no risk score to predict the future risk of CeVD on entry into PD. This study aimed to derive and validate a risk prediction model for CeVD mortality in 2 years after the initialisation of PD. Methods: All patients registered with the Henan Peritoneal Dialysis Registry (HPDR) between 2007 and 2014 were included. Multivariable logistic regression modelling was applied to derive the risk score. All accessible clinical measurements were screened as potential predictors. Internal validation through bootstrapping was applied to test the model performance. Results: The absolute risk of CeVD mortality was 2.9%. Systolic and diastolic blood pressure, total cholesterol, phosphate, and sodium concentrations were the strongest predictors of CeVD mortality in the final risk score. Good model discrimination with C statistics above 0.70 and calibration of agreed observed and predicted risks were identified in the model. Conclusion: The new risk score, developed and validated using clinical measurements that are accessible on entry into PD, could be used clinically to screen for patients at high risk of CeVD mortality. Such patients might benefit from therapies reducing the incidence of CeVD related events

The Fourth Element: Characteristics, Modelling, and Electromagnetic Theory of the Memristor

In 2008, researchers at HP Labs published a paper in {\it Nature} reporting the realisation of a new basic circuit element that completes the missing link between charge and flux-linkage, which was postulated by Leon Chua in 1971. The HP memristor is based on a nanometer scale TiO$_2$ thin-film, containing a doped region and an undoped region. Further to proposed applications of memristors in artificial biological systems and nonvolatile RAM (NVRAM), they also enable reconfigurable nanoelectronics. Moreover, memristors provide new paradigms in application specific integrated circuits (ASICs) and field programmable gate arrays (FPGAs). A significant reduction in area with an unprecedented memory capacity and device density are the potential advantages of memristors for Integrated Circuits (ICs). This work reviews the memristor and provides mathematical and SPICE models for memristors. Insight into the memristor device is given via recalling the quasi-static expansion of Maxwell's equations. We also review Chua's arguments based on electromagnetic theory.Comment: 28 pages, 14 figures, Accepted as a regular paper - the Proceedings of Royal Society