A Minority of Patients with Type 1 Diabetes Routinely Downloads and Retrospectively Reviews Device Data.

BackgroundIn type 1 diabetes (T1D), periodic review of blood glucose and insulin dosing should be performed, but it is not known how often patients review these data on their own. We describe the proportion of patients with T1D who routinely downloaded and reviewed their data at home.Materials and methodsA cross-sectional survey of 155 adults and 185 caregivers of children with T1D at a single academic institution was performed. "Routine Downloaders" (downloaded four or more times in the past year) were also considered "Routine Reviewers" if they reviewed their data most of the time they downloaded from devices. Logistic regression was used to identify factors associated with being a Routine Reviewer.ResultsOnly 31% of adults and 56% of caregivers reported ever downloading data from one or more devices, whereas 20% and 40%, respectively, were considered Routine Downloaders. Only 12% of adults and 27% of caregivers were Routine Reviewers. Mean hemoglobin A1c was lower in Routine Reviewers compared with non-Routine Reviewers (7.2±1.0% vs. 8.1±1.6% [P=0.03] in adults and 7.8±1.4% vs. 8.6±1.7% [P=0.001] in children). In adjusted analysis of adults, the odds ratio of being a Routine Reviewer of one or more devices for every 10-year increase in age was 1.5 (95% confidence interval, 1.1, 2.1 [P=0.02]). For every 10 years since diabetes diagnosis, the odds ratio of being a Routine Reviewer was 1.7 (95% confidence interval, 1.2, 2.4 [P=0.01]). For caregivers, there were no statistically significant factors associated with being a Routine Reviewer.ConclusionsA minority of T1D patients routinely downloads and reviews data from their devices on their own. Further research is needed to understand obstacles, provide better education and tools for self-review, and determine if patient self-review is associated with improved glycemic control

Geometric Approach to Pontryagin's Maximum Principle

Since the second half of the 20th century, Pontryagin's Maximum Principle has been widely discussed and used as a method to solve optimal control problems in medicine, robotics, finance, engineering, astronomy. Here, we focus on the proof and on the understanding of this Principle, using as much geometric ideas and geometric tools as possible. This approach provides a better and clearer understanding of the Principle and, in particular, of the role of the abnormal extremals. These extremals are interesting because they do not depend on the cost function, but only on the control system. Moreover, they were discarded as solutions until the nineties, when examples of strict abnormal optimal curves were found. In order to give a detailed exposition of the proof, the paper is mostly self\textendash{}contained, which forces us to consider different areas in mathematics such as algebra, analysis, geometry.Comment: Final version. Minors changes have been made. 56 page

Indikatoren einer tiergerechten Mastputenhaltung unter den Bedingungen der ökologischen Geflügelmast

Ziel der Studie war eine Analyse der Häufigkeit und des Ausprägungsgrades tierschutzrelevanter Veränderungen bei Puten, die gemäß den Bedingungen der EU-Verordnung 889/2008 für den ökologischen Landbau gehalten wurden. In zwei Durchgängen wurden in neun Aufzucht- und 14 Mastbetrieben 32 Herden mit insgesamt 105.483 Tieren erfasst. Der Tiergesundheitsstatus der einzelnen Herden wurde stichprobenartig an fünf Zeitpunkten durch Beurteilung von 60 Einzeltieren dokumentiert. Bei jedem Bestandsbesuch wurden außerdem Einstreuproben entnommen und ihr Feuchtigkeitsgehalt thermogravimetrisch bestimmt. Die mittlere kumulierte Verlustrate in der Aufzuchtphase lag bei 3,3 % und in der 16. Lebenswoche bei 4,5%. Am Ende der Aufzuchtphase wiesen bis zu 44 % der untersuchten Tiere Epithelnekrosen an den Fußballen auf. Häufigkeit und Schweregrad von Ballenveränderungen nahmen im Verlauf der Mastphase weiter zu. So wurden in der 16. Lebenswoche bei über 80 % der untersuchten Puten Ballennekrosen festgestellt. Am Schlachthof erfolgte eine Aufnahme allgemeiner Daten zur Schlachtung und folgend die visuelle Beschau von 60 Puten je Herde. Der überwiegende Teil der Tiere (97,7%) wies zum Zeitpunkt der Schlachtung Veränderungen der Fußballen auf, während Brusthautveränderungen nur selten dokumentiert wurden. Vermehrt traten weiterhin Leberveränderungen, insbesondere Grünfärbungen auf, wobei deutliche Unterschiede zwischen verschiedenen Betrieben sowie zwischen den einzelnen Durchgängen festgestellt wurden. Auch Gelenksveränderungen waren häufige Befunde. Als ein maßgeblicher Faktor für die Gesunderhaltung eines Putenbestandes ist die Befähigung des bestandsbetreuenden Personenkreises anzusehen, gesundheitliche Probleme frühzeitig zu erkennen und zeitnah darauf zu reagieren. Neben der Qualität des Einstreusubstrates inklusive Beurteilung der Kotkonsistenz können Häufigkeit und Ausprägung von Ballenveränderungen wertvolle Hinweise für eine Einschätzung des Tierhaltungsstandards in einem Bestand liefern und sind als wichtige, einfach erfassbare Tierschutzindikatoren einzustufen . Auch Gelenks- und Leberveränderungen sind aufgrund hoher Prävalenzen als relevante Tiergesundheitsparameter zu betrachten, die im Rahmen eines Monitorings routinemäßig erfasst werden sollten

New-particle formation events in a continental boundary layer: first results from the SATURN experiment

International audienceDuring the SATURN experiment, which took place from 27 May to 14 June 2002, new particle formation in the continental boundary layer was investigated. Simultaneous ground-based and tethered-balloon-borne measurements were performed, including meteorological parameters, particle number concentrations and size distributions, gaseous precursor concentrations and SODAR and LIDAR observations. Newly formed particles were observed inside the residual layer, before the break-up process of the nocturnal inversion, and inside the mixing layer throughout the break-up of the nocturnal inversion and during the evolution of the planetary boundary layer.</p

An case of extreme particulate matter concentrations over Central Europe caused by dust emitted over the southern Ukraine

On 24 March 2007, an extraordinary dust plume was observed in the Central European troposphere. Satellite observations revealed its origins in a dust storm in Southern Ukraine, where large amounts of soil were resuspended from dried-out farmlands at wind gusts up to 30 m s?1. Along the pathway of the plume, maximum particulate matter (PM10) mass concentrations between 200 and 1400 ?g m?3 occurred in Slovakia, the Czech Republic, Poland, and Germany. Over Germany, the dust plume was characterised by a volume extinction coefficient up to 400 Mm?1 and a particle optical depth of 0.71 at wavelength 0.532 ?m. In-situ size distribution measurements as well as the wavelength dependence of light extinction from lidar and Sun photometer measurements confirmed the presence of a coarse particle mode with diameters around 2?3 ?m. Chemical particle analyses suggested a fraction of 75% crustal material in daily average PM10 and up to 85% in the coarser fraction PM10?2.5. Based on the particle characteristics as well as a lack of increased CO and CO2 levels, a significant impact of biomass burning was ruled out. The reasons for the high particle concentrations in the dust plume were twofold: First, dust was transported very rapidly into Central Europe in a boundary layer jet under dry conditions. Second, the dust plume was confined to a relatively stable boundary layer of 1.4?1.8 km height, and could therefore neither expand nor dilute efficiently. Our findings illustrate the capacity of combined in situ and remote sensing measurements to characterise large-scale dust plumes with a variety of aerosol parameters. Although such plumes from Southern Eurasia seem to occur rather infrequently in Central Europe, its unexpected features highlights the need to improve the description of dust emission, transport and transformation processes needs, particularly when facing the possible effects of further anthropogenic desertification and climate change

An episode of extremely high PM concentrations over Central Europe caused by dust emitted over the southern Ukraine

International audienceOn 24 March 2007, the atmosphere over Central Europe was affected by an episode of exceptionally high mass concentrations of aerosol particles, most likely caused by a dust storm in the Southern Ukraine on the preceding day. At ground-based measurement stations in Slovakia, the Czech Republic, Poland and Germany PM10 mass concentrations rose to values between 200 and 1400 ?g m?3. An evaluation of PM10 measurements from 360 monitoring stations showed that the dust cloud advanced along a narrow corridor at speeds of up to 70 km h?1. According to lidar observations over Leipzig, Germany, the high aerosol concentrations were confined to a homogeneous boundary layer of 1800 m height. The wavelength dependence of light extinction using both lidar and sun photometer measurements suggested the dominance of coarse particles during the main event. At a wavelength of 532 nm, relatively high volume extinction coefficients (300?400 Mm?1) and a particle optical depth of 0.65 was observed. In-situ measurements with an aerodynamic particle sizer at Melpitz, Germany, confirmed the presence of a coarse particle mode with a mode diameter >2 ?m, whose maximum concentration coincided with that of PM10. A chemical particle analysis confirmed the dominance of non-volatile and insoluble matter in the coarse mode as well as high enrichments of Ti and Fe, which are characteristic of soil dust. A combination of back trajectory calculations and satellite images allowed to identify the dust source with confidence: On 23 March 2007, large amounts of dust were emitted from dried-out farmlands in the southern Ukraine, facilitated by wind gusts up to 100 km h?1. The unusual vertical stability and confined height of this dust layer as well as the rapid transport under dry conditions led to the conservation of high aerosol mass concentrations along the transect and thus to the extraordinary high aerosol concentrations over Central Europe. Our observations demonstrate the capacity of a combined apparatus of in situ and remote sensing measurements to characterise such a dust with a variety of aerosol parameters. As a conclusion, the description of dust emission, transport and transformation processes needs to be improved, especially when facing the possible effects of further anthropogenic desertification and climate change

Relativistic quantum dynamics in strong fields: Photon emission from heavy, few-electron ions

Recent progress in the study of the photon emission from highly-charged heavy ions is reviewed. These investigations show that high-$Z$ ions provide a unique tool for improving the understanding of the electron-electron and electron-photon interaction in the presence of strong fields. Apart from the bound-state transitions, which are accurately described in the framework of Quantum Electrodynamics, much information has been obtained also from the radiative capture of (quasi-) free electrons by high-$Z$ ions. Many features in the observed spectra hereby confirm the inherently relativistic behavior of even the simplest compound quantum systems in Nature.Comment: Version 18/11/0