Pulmonary hypertension is a complex and progressive condition that is either idiopathic or heritable, or associated with one or multiple health conditions, with or without congenital or acquired cardiovascular disease. Recent developments have tremendously increased the armamentarium of diagnostic and therapeutic approaches in children and young adults with pulmonary hypertension that is still associated with a high morbidity and mortality. These modalities include non-invasive imaging, pharmacotherapy, interventional and surgical procedures, and supportive measures. The optimal, tailored diagnostic and therapeutic strategies for pulmonary hypertension in the young are rapidly evolving but still face enormous challenges: Healthcare providers need to take the patient’s age, development, disease state, and family concerns into account when initiating advanced diagnostics and treatment. Therefore, there is a need for guidance on core and advanced medical training in paediatric pulmonary hypertension. The Association for European Paediatric and Congenital Cardiology working group “pulmonary hypertension, heart failure and transplantation” has produced this document as an expert consensus statement; however, all recommendations must be considered and applied in the context of the local and national infrastructure and legal regulations.

The polyphenol quercetin may prevent CVD due to its antihypertensive and vasorelaxant properties. We investigated the effects of quercetin after regular intake on blood pressure (BP) in overweight-to-obese patients with pre-hypertension and stage I hypertension. In addition, the potential mechanisms responsible for the hypothesised effect of quercetin on BP were explored. Subjects (n 70) were randomised to receive 162 mg/d quercetin from onion skin extract powder or placebo in a double-blinded, placebo-controlled cross-over trial with 6-week treatment periods separated by a 6-week washout period. Before and after the intervention, ambulatory blood pressure (ABP) and office BP were measured; urine and blood samples were collected; and endothelial function was measured by EndoPAT technology. In the total group, quercetin did not significantly affect 24 h ABP parameters and office BP. In the subgroup of hypertensives, quercetin decreased 24 h systolic BP by −3·6 mmHg (P=0·022) when compared with placebo (mean treatment difference, −3·9 mmHg; P=0·049). In addition, quercetin significantly decreased day-time and night-time systolic BP in hypertensives, but without a significant effect in inter-group comparison. In the total group and also in the subgroup of hypertensives, vasoactive biomarkers including endothelin-1, soluble endothelial-derived adhesion molecules, asymmetric dimethylarginine, angiotensin-converting enzyme activity, endothelial function, parameters of oxidation, inflammation, lipid and glucose metabolism were not affected by quercetin. In conclusion, supplementation with 162 mg/d quercetin from onion skin extract lowers ABP in patients with hypertension, suggesting a cardioprotective effect of quercetin. The mechanisms responsible for the BP-lowering effect remain unclear.

In this paper, the concept of load-modulated power amplifiers (PAs) is studied. Two GaN-HEMT power amplifiers (PAs), targeted for high efficiency at maximum and output back-off (OBO) power levels, are designed, implemented, and tested across 1.8–2.2 GHz. The load modulation in the first design is realized by tuning the shunt capacitors in the output matching network. A novel method is employed in the second design, where barium–stronrium–titante is used for the realization of load modulation. The large-signal measurement results across the desired band show 59–70% drain efficiency at 44–44.5 dBm output power for both designs. Using the available tunable technique, the drain efficiency of the PAs is enhanced by 4–20% at 6 dB OBO across the bandwidth.

Charles Taylor begins his essay “Kant's Theory of Freedom” by stating that in the last three centuries people have sought recognition, equality and justice as corollaries of “liberation”. The process, he says, “has been punctuated, and partly shaped, by paradigm statements by major thinkers …. Among these statements, Kant's has been very important. It marked a crucial step on the way.” Similar sentiments are expressed by Hayek, Rawls and others.

In the last several years, ethicists have discussed problems of medical, professional, business and environmental ethics with much animation, and political philosophers have shown more interest than before in details of public policy. Yet this “applied turn,” as it has been called, has not swept much philosophical attention in the direction of taxation and public finance, though they offer numerous conceptual challenges. Nor have these subjects engaged the attention of those in the critical thinking business, though distortions in representing them are common enough.