Angiotensin AT-1 receptor antagonism: complementary or alternative to ACE inhibition in cardiovascular and renal disease

Both angiotensin-converting enzyme (ACE) inhibitors and AT-1 receptor antagonists reduce the effects of angiotensin II, however they may have different clinical effects. This is because the ACE inhibitors, but not the AT-1 receptor antagonists, increase the levels of substance P, bradykinin and tissue plasminogen activator. The AT-1 receptor antagonists, but not the ACE inhibitors, are capable of inhibiting the effects of angiotensin II produced by enzymes other than ACE. On the basis of the present clinical trial evidence, AT-1 receptor antagonists, rather than the ACE inhibitors, should be used to treat hypertension associated with left ventricular (LV) hypertrophy. Both groups of drugs are useful when hypertension is not complicated by LV hypertrophy, and in diabetes. In the treatment of diabetes with or without hypertension, there is good clinical support for the use of either an ACE inhibitor or an AT-1 receptor antagonist. ACE inhibitors are recommended in the treatment of renal disease that is not associated with diabetes, after myocardial infarction when left ventricular dysfunction is present, and in heart failure. As the incidence of cough is much lower with the AT-1 receptor antagonists, these can be substituted for ACE inhibitors in patients with hypertension or heart failure who have persistent cough. Preliminary studies suggest that combining an AT-1 receptor antagonist with an ACE inhibitor may be more effective than an ACE inhibitor alone in the treatment of hypertension, diabetes with hypertension, renal disease without diabetes and heart failure. However, further trials are required before combination therapy can be recommended in these conditions.

Complementary and layered expression of Ephs and Ephrins in developing mouse inner ear

The distributions of the Eph-class receptors EphA4 and EphB 1, and their ligands ephrin-A2, ephrin-B1, and ephrin-B2, were analysed by immunostaining in the mouse inner ear. Complementary patterns of EphA4 and its potential ligand ephrin-A2 were found, with ephrin-A2 in many of the structures lining the cochlear duct and within the cochlear nerve cells, and EphA4 in the deeper structures underlying the cochlear duct and in the cells lining the nerve pathway. EphB1 and its potential ligands ephrin-B1 and ephrin-B2 showed a segregated layered expression in the lateral wall of the cochlear duct (the external sulcus), which together with EphA4 expressed in the area, form a four-layered structure with an alternating pattern of receptors and ligands in the different layers. This arrangement gives the potential for different bidirectional Eph-mediated interactions between each of the layers. The results suggest that the Eph system in the cochlea may have a role in maintaining cell segregation during phases of cochlear development. (C) 2002 Wiley-Liss, Inc.

The regulation of complementary health: sacrificing integrity?

In response to the increasing use of complementary and alternative medicine (CAM), governments are exploring ways to ensure patients' safety and respond to complaints. One solution is to establish registration boards and procedures based on the model of existing health practitioner Acts. Registration will require defined minimum standards for competence, which will have to be based on scientific evidence. As scientific evidence accumulates, these modalities are likely to lose their identities as alternative and become assimilated into Western medicine.

Use of complementary and alternative medicine and quality of life: changes at the end of life

The purpose of this study was to compare the physical, psychological and social dimensions associated with quality-of-life outcomes over the last year of life, between advanced cancer users and nonusers of complementary and alternative medicine. One hundred and eleven patients were identified through Queensland Cancer Registry records, and followed up every four to six weeks until close to death using standardized protocols. Outcome measures were symptom burden, psychological distress, subjective wellbeing, satisfaction with conventional medicine and need for control over treatment decisions. At the initial interview, 36 (32%) participants had used complementary/ alternative medicine the previous week; mainly vitamins, minerals and tonics and herbal remedies. Among all participants, 53 (48%) used at least one form of complementary/ alternative medicine over the study period. Only six (11%) visited alternative practitioners on a regular basis. Overall, complementary/ alternative medicine users reported higher levels of anxiety and pain, less satisfaction with conventional medicine and lower need for control over treatment decisions compared with nonusers. These differences tend to change as death approaches. A more rigorous assessment of complementary/ alternative medicine use, psychological distress, pain and subjective wellbeing among patients with advanced cancer is needed in the clinical setting.

Mate choice in the brown thornbill (Acanthiza pusilla): are settlement decisions, divorce and extrapair mating complementary strategies?

In socially monogamous birds, females may express mate preferences when they first select a breeding partner, through divorce and subsequent breeding dispersal to a new partner and through extrapair mating. We examined settlement patterns, divorce and breeding dispersal in a sedentary Australian passerine, the brown thornbill (Acanthiza pusilla), in relation to two traits known to influence extrapair paternity (male age and male size). Settlement decisions, divorce and territory switching behaviour were all female strategies that reduced their likelihood of breeding with 1-year-old males. Females preferred to settle in territories with 2+ -year-old males, were more likely to divorce 1-year-old males, and only switched territories if they had an opportunity to form a new pair bond with an old male. In contrast, female settlement and divorce decisions were not influenced by male size. Female thornbills obtain a direct benefit from preferring older males as social mates because breeding success improves with male age in brown thornbills. Nevertheless, divorce rates in this species were low (14% of pair bonds were terminated by divorce), and individuals rarely switched territories following the death of a mate. Both of these mating strategies appeared to be primarily constrained by the distance adults moved to initiate a new pair bond (1-2 territories) and by the limited availability of unpaired older males in the immediate neighbourhood.

Vertical handover supporting pervasive computing in future wireless networks

A variety of current and future wired and wireless networking technologies can be transformed into a seamless communication environments through application of context-based vertical handovers. Such seamless communication environments are needed for future pervasive/ubiquitous systems. Pervasive systems are context aware and need to adapt to context changes, including network disconnections and changes in network Quality of Service (QoS). Vertical handover is one of many possible adaptation methods. It allows users to roam freely between heterogeneous networks while maintaining the continuity of their applications. This paper proposes a vertical handover mechanism suitable for multimedia applications in pervasive systems. The paper focuses on the handover decision making process which uses context information regarding user devices, user location, network environment and requested QoS. (C) 2004 Elsevier B.V. All rights reserved.

Nonlinear quantum optical computing via measurement

We show how the measurement induced model of quantum computation proposed by Raussendorf and Briegel ( 2001, Phys. Rev. Letts., 86, 5188) can be adapted to a nonlinear optical interaction. This optical implementation requires a Kerr nonlinearity, a single photon source, a single photon detector and fast feed forward. Although nondeterministic optical quantum information proposals such as that suggested by KLM ( 2001, Nature, 409, 46) do not require a Kerr nonlinearity they do require complex reconfigurable optical networks. The proposal in this paper has the benefit of a single static optical layout with fixed device parameters, where the algorithm is defined by the final measurement procedure.

Charge-based quantum computing using single donors in semiconductors

Solid-state quantum computer architectures with qubits encoded using single atoms are now feasible given recent advances in the atomic doping of semiconductors. Here we present a charge qubit consisting of two dopant atoms in a semiconductor crystal, one of which is singly ionized. Surface electrodes control the qubit and a radio-frequency single-electron transistor provides fast readout. The calculated single gate times, of order 50 ps or less, are much shorter than the expected decoherence time. We propose universal one- and two-qubit gate operations for this system and discuss prospects for fabrication and scale up.

Design and implementation of a windows-based parallel computing environment for large scale optimization

A parallel computing environment to support optimization of large-scale engineering systems is designed and implemented on Windows-based personal computer networks, using the master-worker model and the Parallel Virtual Machine (PVM). It is involved in decomposition of a large engineering system into a number of smaller subsystems optimized in parallel on worker nodes and coordination of subsystem optimization results on the master node. The environment consists of six functional modules, i.e. the master control, the optimization model generator, the optimizer, the data manager, the monitor, and the post processor. Object-oriented design of these modules is presented. The environment supports steps from the generation of optimization models to the solution and the visualization on networks of computers. User-friendly graphical interfaces make it easy to define the problem, and monitor and steer the optimization process. It has been verified by an example of a large space truss optimization. (C) 2004 Elsevier Ltd. All rights reserved.