Alpha blockaders--first or second line antihypertensive agents?

Alpha-receptor blockers reduce blood pressure by blocking of the alpha 1-receptors in the smooth muscle cells in the arteriolar walls. The heart pump function is not disturbed. Most studies have shown that the alpha-receptor blockers induce a reduction in plasma-triglycerides and an increase in the ratio between HDL- and LDL-cholesterol. They do not interfere with the metabolism of electrolytes, glucose or uric acid and have no negative effect on pulmonary function. Although long-term use does not induce a permanent increase in heart rate, some patients respond to initial therapy with faster heart rate and palpitations. The alpha-receptor blockers should not be used in patients with coronary heart disease if the patient is not on chronic beta-blockade. When these precautions are followed, the alpha-blockers can be used as first-line treatment--just like ACE-inhibitors and calcium-antagonists.     

A comparison among 1-, 3-, and 7-horn feeds for a 37-beam MBA

A very common multiple beam antenna (MBA) configuration consists of a collimating device illuminated by an array of feeds. The collimating device is usually a reflector or a lens. The feeds are usually horn antennas with a circular aperture. The reflector is usually offset-fed to eliminate aperture blockage; the lens is center fed. The antenna's feeds are excited to produce a finite number of beams, so as to provide contiguous coverage of the field of view. The designer is forced to minimize the angular spacing between adjacent beams in order to maximize the minimum gain over the antenna's field of view. On the other hand, the feed horn's aperture gain is maximized when the feed horn spacing and its aperture diameter are equal. This results in antenna efficiency of the order of 30% when a single feed horn is excited to produce a beam. When a cluster of 3 or 7 adjacent feed horns are excited to produce a single beam, antenna efficiency can be increased to 50%. When it is tolerable, several identical antenna apertures can be used to replace a single aperture configuration. In this case, each of M apertures produces approximately N/M beams of an MBA that produces N beams. Horns producing adjacent beams do not illuminate the same aperture. This permits the use of a much larger horn aperture for a given beam spacing. This results in reduced spillover, higher gain of each beam, and increased antenna efficiency of each aperture. This paper investigates the maximization of gain for several lens antennas. It shows that antenna gain is increased as its focal length is decreased. That is, a focal length-to-diameter ratio (F/D) less than 1 is preferred     

Activation of auditory cortex during silent lipreading

Watching a speaker's lips during face-to-face conversation (lipreading) markedly improves speech perception, particularly in noisy conditions. With functional magnetic resonance imaging it was found that these linguistic visual cues are sufficient to activate auditory cortex in normal hearing individuals in the absence of auditory speech sounds. Two further experiments suggest that these auditory cortical areas are not engaged when an individual is viewing nonlinguistic facial movements but appear to be activated by silent meaningless speechlike movements (pseudospeech). This supports psycholinguistic evidence that seen speech influences the perception of heard speech at a prelexical stage.     

Non-smoking policies and practices in Norwegian delivery units in 1994

OBJECTIVE: To determine the number of delivery units in Norway that have become smoke free for employees and patients. DESIGN: A pre- categorised questionnaire was sent in September 1994 to the physician or midwife responsible for each of the 68 delivery units in the country. MAIN OUTCOME MEASURES: Hospital smoking policies, reported difficulties in implementation, use of nicotine replacement therapy in patients, and provision of information on tobacco-related health hazards to patients. RESULTS: Fifty-six units (82.3%), accounting for 93% of all deliveries in Norway in 1993, responded. Of these, 42 (75%) were smoke-free for employees, and 33 (59%) for patients. Nearly all had become smoke-free after 1990. No significant difference was seen according to type or size of delivery unit. No difficulties in the implementation of policies restricting smoking were reported. Thirty- one (55%) routinely informed patients of the health implications of smoking during pregnancy. Two units offered nicotine replacement therapy to patients. CONCLUSION: Most Norwegian delivery units were smoke-free for both employees and patients. Provided that the recent trend toward adoption of smoke-free policies continues, all delivery units in Norway should be smoke-free by 1997-1998.




     

Suspension system performance optimization with discrete design variables

Suspension systems on commercial vehicles have become an important feature meeting the requirements from costumers and legislation. The performance of the suspension system is often limited by available catalogue components. Additionally the suspension performance is restricted by the travel speed which highly influences the ride comfort. In this article a suspension system for an articulated dump truck is optimized in sense of reducing elapsed time for two specified duty cycles without violating a certain comfort threshold level. The comfort threshold level is here defined as a whole-body vibration level calculated by ISO 2631-1. A three-dimensional multibody dynamics simulation model is applied to evaluate the suspension performance. A non-gradient optimization routine is used to find the best possible combination of continuous and discrete design variables including the optimum operational speed without violating a set of side constraints. The result shows that the comfort level converges to the comfort threshold level. Thus it is shown that the operational speed and hence the operator input influences the ride comfort level. Three catalogue components are identified by the optimization routine together with a set of continuous design variables and two operational speeds one for each load case. Thus the work demonstrates handling of human factors in optimization of a mechanical system with discrete and continuous design variables.     

Cultivation and engineering of a software metrics program

Abstract. This paper reports from a case study of an organization that implements a software metrics program to measure the effects of its improvement efforts. The program measures key indicators of all completed projects and summarizes progress information in a quarterly management report. The implementation turns out to be long and complex, as the organization is confronted with dilemmas based on contradictory demands and value conflicts. The process is interpreted as a combination of a rational engineering process in which a metrics program is constructed and put into use, and an evolutionary cultivation process in which basic values of the software organization are confronted and transformed. The analysis exemplifies the difficulties and challenges that software organizations face when bringing known principles for software metrics programs into practical use. The article discusses the insights gained from the case in six lessons that may be used by Software Process Improvement managers in implementing a successful metrics program.     

Chronic obstructive pulmonary disease in patients with end‐stage kidney disease on hemodialysis

The objectives of this study were to assess the prevalence of chronic obstructive pulmonary disease (COPD) in hemodialysis patients with spirometry and to examine the effects of fluid removal by hemodialysis on lung volumes. Patients ≥18 years at two Danish hemodialysis centers were included. Forced expiratory volume in one second (FEV₁), forced vital capacity (FVC), and FEV₁/FVC ratio were measured with spirometry before and after hemodialysis. The diagnosis of COPD was based on both the GOLD criteria and the lower limit of normal criteria. There were 372 patients in treatment at the two centers, 255 patients (69%) completed spirometry before dialysis and 242 of these (65%) repeated the test after. In the initial test, 117 subjects (46%) had airflow limitation indicative of COPD with GOLD criteria and 103 subjects (40.4%) with lower limit of normal criteria; COPD was previously diagnosed in 24 patients (9%). Mean FVC and FEV₁ decreased mildly after dialysis (FVC: 2.84 to 2.79 L, P < 0.01. FEV₁: 1.97 to 1.93 L, P < 0.01) Hemodialysis did not affect the FEV₁/FVC ratio or number of subjects with airflow limitation indicative of COPD (113 vs. 120, P = 0.324; n = 242). COPD is a frequent and underdiagnosed comorbidity in patients on chronic hemodialysis. Spirometry should be considered in all patients on dialysis in order to address dyspnea adequately. Hemodialysis induced a small fall in mean FEV₁ and FVC, which was more pronounced in patients with little or no fluid removal, but the FEV₁/FVC ratio and the number of subjects with airflow limitation indicative of COPD were not affected by dialysis.     

Estimation of the Characteristics of Multiflow Models with Fixed Number of Retrials

For the cases of overload and limited number of retrials of the blocked message, an algorithm for approximate evaluation of the service indices of the multiflow model of a digital line was presented. The calculation procedure is based on the assumption that the arrival of repeated calls is Poissonian, which enabled one to reduce the evaluation procedure to a loss model for which there exists an efficient algorithm to calculate the characteristics by the convolution algorithm.