Comparison of Accu Chek Inform II point-of-care test blood glucose meter with Hexokinase Plasma method for a diabetes mellitus population during surgery under general anesthesia

Purpose Blood glucose (BG) concentrations of patients with diabetes mellitus (DM) are monitored during surgery to prevent hypo- and hyperglycemia. Access to point-of-care test (POCT) glucose meters at an operating room will usually provide monitoring at shorter intervals and may improve glycemic control. However, these meters are not validated for patients under general anesthesia. Methods This cross-sectional study included 75 arterial BG measurements from 75 patients (71 with DM, mostly insulin dependent) who underwent elective non-cardiac surgery under general anesthesia. Arterial blood samples were taken at least 60 minutes after induction. One drop of blood was used for Accu Chek Inform II (ACI II) POCT BG meter and the residual blood was sent to the clinical laboratory for a Hexokinase Plasma reference method. A Bland-Altman plot was used to visualize the differences between both methods, and correlation was assessed using the intra-class correlation coefficient (ICC). Results The results showed an estimated mean difference of 0.8 mmol/L between ACI II and the reference method, with limits of agreement equal to -0.6 and 2.2 mmol/L. In general, the reference method produced higher values than ACI II. ICC was 0.955 (95% CI 0.634-0.986), P &lt; 0.001, and concordance correlation coefficient (CCC) was 0.955 (95% CI 0.933-0.970). Conclusion Arterial BG measurements during surgery in patients with DM under general anesthesia using POCT BG meter are in general lower than laboratory measurements, but the ICC and CCC show a clinically acceptable correlation. We conclude that POCT measurements conducted on arterial specimens using the ACI II provide sufficiently accurate results for glucose measurement during surgery under general anesthesia.</p

Fourier transform and the Verlinde formula for the quantum double of a finite group

A Fourier transform S is defined for the quantum double D(G) of a finite group G. Acting on characters of D(G), S and the central ribbon element of D(G) generate a unitary matrix representation of the group SL(2,Z). The characters form a ring over the integers under both the algebra multiplication and its dual, with the latter encoding the fusion rules of D(G). The Fourier transform relates the two ring structures. We use this to give a particularly short proof of the Verlinde formula for the fusion coefficients.Comment: 15 pages, small errors corrected and references added, version to appear in Journal of Physics

Morphodynamics of a width-variable gravel bed stream: new insights on pool-riffle formation from physical experiments

Field observations, experiments, and numerical simulations suggest that pool-riffles along gravel bed mountain streams develop due to downstream variations of channel width. Where channels narrow, pools are observed, and at locations of widening, riffles occur. Based on previous work, we hypothesize that the bed profile is coupled to downstream width variations through momentum fluxes imparted to the channel surface, which scale with downstream changes of flow velocity. We address this hypothesis with flume experiments understood through scaling theory. Our experiments produce pool-riffle like structures across average Shields stresses t* that are a factor 1.5–2 above the threshold mobility condition of the experimental grain size distribution. Local topographic responses are coupled to channel width changes, which drive flows to accelerate or decelerate on average, for narrowing and widening, respectively. We develop theory which explains the topography-width-velocity coupling as a ratio of two reinforcing timescales. The first timescale captures the time necessary to do work to the channel bed. The second timescale characterizes the relative time magnitude of momentum transfer from the flowing fluid to the channel bed surface. Riffle-like structures develop where the work and momentum timescales are relatively large, and pools form where the two timescales are relatively small. We show that this result helps to explain local channel bed slopes along pool-riffles for five data sets representing experimental, numerical, and natural cases, which span 2 orders of magnitude of reach-averaged slope. Additional model testing is warranted.Peer ReviewedPostprint (published version

One-Sided Position-Dependent Smoothness-Increasing Accuracy-Conserving (SIAC) Filtering Over Uniform and Non-Uniform Meshes

In this paper, we introduce a new position-dependent Smoothness-Increasing Accuracy-Conserving (SIAC) filter that retains the benefits of position dependence while ameliorating some of its shortcomings. As in the previous position-dependent filter, our new filter can be applied near domain boundaries, near a discontinuity in the solution, or at the interface of different mesh sizes; and as before, in general, it numerically enhances the accuracy and increases the smoothness of approximations obtained using the discontinuous Galerkin (dG) method. However, the previously proposed position-dependent one-sided filter had two significant disadvantages: (1) increased computational cost (in terms of function evaluations), brought about by the use of $4k+1$ central B-splines near a boundary (leading to increased kernel support) and (2) increased numerical conditioning issues that necessitated the use of quadruple precision for polynomial degrees of $k\ge 3$ for the reported accuracy benefits to be realizable numerically. Our new filter addresses both of these issues --- maintaining the same support size and with similar function evaluation characteristicsas the symmetric filter in a way that has better numerical conditioning --- making it, unlike its predecessor, amenable for GPU computing. Our new filter was conceived by revisiting the original error analysis for superconvergence of SIAC filters and by examining the role of the B-splines and their weights in the SIAC filtering kernel. We demonstrate, in the uniform mesh case, that our new filter is globally superconvergent for $k=1$ and superconvergent in the interior (e.g., region excluding the boundary) for $k\ge2$. Furthermore, we present the first theoretical proof of superconvergence for postprocessing over smoothly varying meshes, and explain the accuracy-order conserving nature of this new filter when applied to certain non-uniform meshes cases. We provide numerical examples supporting our theoretical results and demonstrating that our new filter, in general, enhances the smoothness and accuracy of the solution. Numerical results are presented for solutions of both linear and nonlinear equation solved on both uniform and non-uniform one- and two-dimensional meshes

Hemodynamic response to primary prophylactic therapy with nonselective beta-blockers is related to a reduction of first variceal bleeding risk in liver cirrhosis: a meta-analysis

Development and application of statistical models for medical scientific researc

Smoothness-Increasing Accuracy-Conserving (SIAC) filtering and quasi interpolation: A unified view

Filtering plays a crucial role in postprocessing and analyzing data in scientific and engineering applications. Various application-specific filtering schemes have been proposed based on particular design criteria. In this paper, we focus on establishing the theoretical connection between quasi-interpolation and a class of kernels (based on B-splines) that are specifically designed for the postprocessing of the discontinuous Galerkin (DG) method called Smoothness-Increasing Accuracy-Conserving (SIAC) filtering. SIAC filtering, as the name suggests, aims to increase the smoothness of the DG approximation while conserving the inherent accuracy of the DG solution (superconvergence). Superconvergence properties of SIAC filtering has been studied in the literature. In this paper, we present the theoretical results that establish the connection between SIAC filtering to long-standing concepts in approximation theory such as quasi-interpolation and polynomial reproduction. This connection bridges the gap between the two related disciplines and provides a decisive advancement in designing new filters and mathematical analysis of their properties. In particular, we derive a closed formulation for convolution of SIAC kernels with polynomials. We also compare and contrast cardinal spline functions as an example of filters designed for image processing applications with SIAC filters of the same order, and study their properties

A Double-Blind, Randomized, Placebo-Controlled Clinical Trial on Benfotiamine Treatment in Patients With Diabetic Nephropathy

OBJECTIVE - To investigate the effect of benfotiamine on urinary albumin excretion (UAE) and the tubular damage marker kidney injury molecule-1 (KIM-1) in patients with type 2 diabetes and nephropathy. RESEARCH DESIGN AND METHODS - Patients with type 2 diabetes and UAE equivalent to 15-300 mg/24 h, despite ACE inhibitors (ACE-Is) or angiotensin receptor blockers (ARBs), were randomly assigned to 12 weeks of benfotiamine (900 mg/day) (n = 39) or placebo (n = 43). RESULTS - Compared with placebo, benfotiamine treatment resulted in significant improvement of thiamine status (P <0.001). Benfotiamine treatment did not significantly decrease 24-h UAE or 24-h KIM-1 excretion. CONCLUSIONS - In patients with type 2 diabetes and nephropathy, high-dose benfotiamine treatment for 12 weeks in addition to ACE-Is or ARBs did not reduce UAE or KIM-1 excretion, despite improvement of thiamine status

Degeneracy of non-abelian quantum Hall states on the torus: domain walls and conformal field theory

We analyze the non-abelian Read-Rezayi quantum Hall states on the torus, where it is natural to employ a mapping of the many-body problem onto a one-dimensional lattice model. On the thin torus--the Tao-Thouless (TT) limit--the interacting many-body problem is exactly solvable. The Read-Rezayi states at filling $\nu=\frac k {kM+2}$ are known to be exact ground states of a local repulsive $k+1$-body interaction, and in the TT limit this is manifested in that all states in the ground state manifold have exactly $k$ particles on any $kM+2$ consecutive sites. For $M\neq 0$ the two-body correlations of these states also imply that there is no more than one particle on $M$ adjacent sites. The fractionally charged quasiparticles and quasiholes appear as domain walls between the ground states, and we show that the number of distinct domain wall patterns gives rise to the nontrivial degeneracies, required by the non-abelian statistics of these states. In the second part of the paper we consider the quasihole degeneracies from a conformal field theory (CFT) perspective, and show that the counting of the domain wall patterns maps one to one on the CFT counting via the fusion rules. Moreover we extend the CFT analysis to topologies of higher genus.Comment: 15 page

A model of quiescent tumour microregions for evaluating multicellular resistance to chemotherapeutic drugs

The quiescent cell population of tumours poses a barrier to the success of many cancer therapies. Most chemotherapeutic drugs target proliferating cells, but the growth fraction of many tumours is low. Based on the multicellular tumour spheroid model, a system was developed using human colon adenocarcinoma (DLD-1) cells to mimic the microenvironment of quiescent microregions of solid tumours. The quiescent tumour spheroids (TSQ) showed decreased expression of the proliferation marker Ki-67 and increased expression of the quiescence marker p27kip1 compared to proliferating spheroids (TSP). The quiescent status of the TSQ was confirmed by long-term growth assessment. The quiescence was completely reversible demonstrating that the TSQ retained the ability to proliferate and morphological assessment by light microscopy confirmed the absence of significant apoptosis. When the efficacy of widely used chemotherapeutic drugs was determined, vinblastine, doxorubicin, cisplatin and 5-fluorouracil (5-FU) all produced significant cell death in the TSP. However, while still effective, the potencies of doxorubicin and cisplatin were significantly reduced in TSQ. In contrast, 5-FU and vinblastine did not produce cell death in the TSQ. In summary, TSQ show considerable resistance to a panel of established chemotherapeutic agents and represent a useful model for evaluating the efficacy of drugs and other cancer therapies in quiescent tumours