Baseline characteristics and enrichment results from the SONAR trial

Aim: The SONAR trial uses an enrichment design based on the individual response to the selective endothelin receptor antagonist atrasentan on efficacy (the degree of the individual response in the urinary albumin‐to‐creatinine ratio [UACR]) and safety/tolerability (signs of sodium retention and acute increases in serum creatinine) to assess the effects of this agent on major renal outcomes. The patient population and enrichment results are described here. Methods: Patients with type 2 diabetes with an estimated glomerular filtration rate (eGFR) within 25 to 75 mL/min/1.73 m2 and UACR between 300 and 5000 mg/g were enrolled. After a run‐in period, eligible patients received 0.75 mg/d of atrasentan for 6 weeks. A total of 2648 responder patients in whom UACR decreased by ≥30% compared to baseline were enrolled, as were 1020 non‐responders with a UACR decrease of <30%. Patients who experienced a weight gain of >3 kg and in whom brain natriuretic peptide exceeded ≥300 pg/mL, or who experienced an increase in serum creatinine >20% (0.5 mg/dL), were not randomized. Results: Baseline characteristics were similar for atrasentan responders and non‐responders. Upon entry to the study, median UACR was 802 mg/g in responders and 920 mg/g in non‐responders. After 6 weeks of treatment with atrasentan, the UACR change in responders was −48.8% (95% CI, −49.8% to −47.9%) and in non‐responders was −1.2% (95% CI, −6.4% to 3.9%). Changes in other renal risk markers were similar between responders and non‐responders except for a marginally greater reduction in systolic blood pressure and eGFR in responders. Conclusions: The enrichment period has successfully identified a population with a profound UACR reduction without clinical signs of sodium retention in whom a large atrasentan effect on clinically important renal outcomes is possible. The SONAR trial aims to establish whether atrasentan confers renal protection

Self-organized criticality in the hysteresis of the Sherrington - Kirkpatrick model

We study hysteretic phenomena in random ferromagnets. We argue that the angle dependent magnetostatic (dipolar) terms introduce frustration and long range interactions in these systems. This makes it plausible that the Sherrington - Kirkpatrick model may be able to capture some of the relevant physics of these systems. We use scaling arguments, replica calculations and large scale numerical simulations to characterize the hysteresis of the zero temperature SK model. By constructing the distribution functions of the avalanche sizes, magnetization jumps and local fields, we conclude that the system exhibits self-organized criticality everywhere on the hysteresis loop.Comment: 4 pages, 4 eps figure

Local mean-field study of capillary condensation in silica aerogels

We apply local mean-field (i.e. density functional) theory to a lattice model of a fluid in contact with a dilute, disordered gel network. The gel structure is described by a diffusion-limited cluster aggregation model. We focus on the influence of porosity on both the hysteretic and the equilibrium behavior of the fluid as one varies the chemical potential at low temperature. We show that the shape of the hysteresis loop changes from smooth to rectangular as the porosity increases and that this change is associated to disorder-induced out-of-equilibrium phase transitions that differ on adsorption and on desorption. Our results provide insight in the behavior of $^4$He in silica aerogels.Comment: 19 figure

Low field hysteresis in disordered ferromagnets

We analyze low field hysteresis close to the demagnetized state in disordered ferromagnets using the zero temperature random-field Ising model. We solve the demagnetization process exactly in one dimension and derive the Rayleigh law of hysteresis. The initial susceptibility a and the hysteretic coefficient b display a peak as a function of the disorder width. This behavior is confirmed by numerical simulations d=2,3 showing that in limit of weak disorder demagnetization is not possible and the Rayleigh law is not defined. These results are in agreement with experimental observations on nanocrystalline magnetic materials.Comment: Extended version, 18 pages, 5 figures, to appear in Phys. Rev.

Dynamics of a ferromagnetic domain wall: avalanches, depinning transition and the Barkhausen effect

We study the dynamics of a ferromagnetic domain wall driven by an external magnetic field through a disordered medium. The avalanche-like motion of the domain walls between pinned configurations produces a noise known as the Barkhausen effect. We discuss experimental results on soft ferromagnetic materials, with reference to the domain structure and the sample geometry, and report Barkhausen noise measurements on Fe$_{21}$Co$_{64}$B$_{15}$ amorphous alloy. We construct an equation of motion for a flexible domain wall, which displays a depinning transition as the field is increased. The long-range dipolar interactions are shown to set the upper critical dimension to $d_c=3$, which implies that mean-field exponents (with possible logarithmic correction) are expected to describe the Barkhausen effect. We introduce a mean-field infinite-range model and show that it is equivalent to a previously introduced single-degree-of-freedom model, known to reproduce several experimental results. We numerically simulate the equation in $d=3$, confirming the theoretical predictions. We compute the avalanche distributions as a function of the field driving rate and the intensity of the demagnetizing field. The scaling exponents change linearly with the driving rate, while the cutoff of the distribution is determined by the demagnetizing field, in remarkable agreement with experiments.Comment: 17 RevTeX pages, 19 embedded ps figures + 1 extra figure, submitted to Phys. Rev.

Rayleigh loops in the random-field Ising model on the Bethe lattice

We analyze the demagnetization properties of the random-field Ising model on the Bethe lattice focusing on the beahvior near the disorder induced phase transition. We derive an exact recursion relation for the magnetization and integrate it numerically. Our analysis shows that demagnetization is possible only in the continous high disorder phase, where at low field the loops are described by the Rayleigh law. In the low disorder phase, the saturation loop displays a discontinuity which is reflected by a non vanishing magnetization m_\infty after a series of nested loops. In this case, at low fields the loops are not symmetric and the Rayleigh law does not hold.Comment: 8pages, 6 figure

Follow-up of blood-pressure lowering and glucose control in type 2 diabetes.

BACKGROUND In the Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation (ADVANCE) factorial trial, the combination of perindopril and indapamide reduced mortality among patients with type 2 diabetes, but intensive glucose control, targeting a glycated hemoglobin level of less than 6.5%, did not. We now report results of the 6-year post-trial follow-up. METHODS We invited surviving participants, who had previously been assigned to perindopril–indapamide or placebo and to intensive or standard glucose control (with the glucose-control comparison extending for an additional 6 months), to participate in a post-trial follow-up evaluation. The primary end points were death from any cause and major macrovascular events. RESULTS The baseline characteristics were similar among the 11,140 patients who originally underwent randomization and the 8494 patients who participated in the post-trial follow-up for a median of 5.9 years (blood-pressure–lowering comparison) or 5.4 years (glucose-control comparison). Between-group differences in blood pressure and glycated hemoglobin levels during the trial were no longer evident by the first post-trial visit. The reductions in the risk of death from any cause and of death from cardiovascular causes that had been observed in the group receiving active blood-pressure–lowering treatment during the trial were attenuated but significant at the end of the post-trial follow-up; the hazard ratios were 0.91 (95% confidence interval [CI], 0.84 to 0.99; P=0.03) and 0.88 (95% CI, 0.77 to 0.99; P=0.04), respectively. No differences were observed during follow-up in the risk of death from any cause or major macrovascular events between the intensive-glucose-control group and the standard-glucose-control group; the hazard ratios were 1.00 (95% CI, 0.92 to 1.08) and 1.00 (95% CI, 0.92 to 1.08), respectively. CONCLUSIONS The benefits with respect to mortality that had been observed among patients originally assigned to blood-pressure–lowering therapy were attenuated but still evident at the end of follow-up. There was no evidence that intensive glucose control during the trial led to long-term benefits with respect to mortality or macrovascular events

Long-term Benefits of Intensive Glucose Control for Preventing End-Stage Kidney Disease: ADVANCE-ON

OBJECTIVE The Action in Diabetes and Vascular Disease: Preterax and Diamicron MR Controlled Evaluation (ADVANCE) trial reported that intensive glucose control prevents end-stage kidney disease (ESKD) in patients with type 2 diabetes, but uncertainty about the balance between risks and benefits exists. Here, we examine the long-term effects of intensive glucose control on risk of ESKD and other outcomes. RESEARCH DESIGN AND METHODS Survivors, previously randomized to intensive or standard glucose control, were invited to participate in post-trial follow-up. ESKD, defined as the need for dialysis or kidney transplantation, or death due to kidney disease, was documented overall and by baseline CKD stage, along with hypoglycemic episodes, major cardiovascular events, and death from other causes. RESULTS A total of 8,494 ADVANCE participants were followed for a median of 5.4 additional years. In-trial HbA1c differences disappeared by the first post-trial visit. The in-trial reductions in the risk of ESKD (7 vs. 20 events, hazard ratio [HR] 0.35, P = 0.02) persisted after 9.9 years of overall follow-up (29 vs. 53 events, HR 0.54, P 0.26). CONCLUSIONS Intensive glucose control was associated with a long-term reduction in ESKD, without evidence of any increased risk of cardiovascular events or death. These benefits were greater with preserved kidney function and with well-controlled blood pressure

Critical Hysteresis from Random Anisotropy

Critical hysteresis in ferromagnets is investigated through a $N$-component spin model with random anisotropies, more prevalent experimentally than the random fields used in most theoretical studies. Metastability, and the tensorial nature of anisotropy, dictate its physics. Generically, random field Ising criticality occurs, but other universality classes exist. In particular, proximity to $\mathcal{O}(N)$ criticality may explain the discrepancy between experiment and earlier theories. The uniaxial anisotropy constant, which can be controlled in magnetostrictive materials by an applied stress, emerges as a natural tuning parameter.Comment: four pages, revtex4; minor corrections in the text and typos corrected (published version