Diet management, lifestyle factors and education needs by target attainment in Italian youth with type 1 diabetes from the Global TEENs study

Background and aims: TEENs is an international, cross-sectional observational study, conducted in 20 countries in order to assess T1D management and psychosocial parameters in 8-25-year-olds (y/o). Data on diet management, lifestyle factors and education needs by target HbA1c attainment from the Italian cohort are reported. Materials and methods: Data were collected at 23 centres by participant interview, medical record review and participant/parent survey from 1,009 Italian youth (46% female) in three age groups: 8-12 y/o (n=330), 13-18 y/o (n=490), and 19-25 y/o (n=189). HbA1c was measured uniformly using A1cNow™ with target HbA1c defined as <7.5% (58 mmol/mol) for ≤18 y/o (ISPAD) and <7% (53 mmol/mol) for >18 y/o (ADA). Results: Overall, 40% of participants met HbA1c targets. Measuring food intake based on experience was the most common method used by all age groups, followed by carbohydrate counting (Table). Of the participants who used carbohydrate counting, a higher percentage met target HbA1c than did not in all age groups, with a significant effect on target attainment due to carbohydrate counting compared with other methods observed in 13-18 y/o (p=0.035). Avoiding sugars was the least common method used in all age groups. Across all age groups, participants who did not undertake any exercise were numerically less likely to reach HbA1c target; on the contrary, participants who exercised 1-2 days/week were numerically more likely to reach HbA1c target. Performing exercise had a significant effect on target HbA1c attainment in 8-12 y/o (p=0.012). The majority of participants were in the underweight/normal body mass index (BMI) category in all age groups, with no clear pattern between BMI class and the proportion of patients reaching HbA1c target. Participants of all ages commonly requested education on diet, carbohydrate counting, how to manage T1D during illness, and how to manage blood glucose levels with exercise. Conclusion: Carbohydrate counting and exercising at least twice per week help to attain HbA1c target across all age groups. Assessment of lifestyle factors suggests that efforts targeting carbohydrate counting and exercise could promote successful health outcomes and help more patients with T1D to reach the recommended HbA1c target. Supported by: Sanof

Alirocumab therapy in individuals with type 2 diabetes mellitus and atherosclerotic cardiovascular disease:analysis of the ODYSSEY DM-DYSLIPIDEMIA and DM-INSULIN studies

Background Individuals with diabetes often have high levels of atherogenic lipoproteins and cholesterol reflected by elevated low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (non-HDL-C), apolipoprotein B (ApoB), and LDL particle number (LDL-PN). The presence of atherosclerotic cardiovascular disease (ASCVD) increases the risk of future cardiovascular events. We evaluated the efficacy and safety of the proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor, alirocumab, among individuals with type 2 diabetes (T2DM), high LDL-C or non-HDL-C, and established ASCVD receiving maximally tolerated statin in ODYSSEY DM-DYSLIPIDEMIA (NCT02642159) and DM-INSULIN (NCT02585778). Methods In DM-DYSLIPIDEMIA, individuals with T2DM and mixed dyslipidemia (non-HDL-C ≥ 100 mg/dL; n = 413) were randomized to open-label alirocumab 75 mg every 2 weeks (Q2W) or usual care (UC) for 24 weeks, with UC options selected before stratified randomization. In DM-INSULIN, insulin-treated individuals with T2DM (LDL-C ≥ 70 mg/dL; n = 441) were randomized in a double-blind fashion to alirocumab 75 mg Q2W or placebo for 24 weeks. Study participants also had a glycated hemoglobin < 9% (DM-DYSLIPIDEMIA) or < 10% (DM-INSULIN). Alirocumab dose was increased to 150 mg Q2W at week 12 if week 8 LDL-C was ≥ 70 mg/dL (DM-INSULIN) or non-HDL-C was ≥ 100 mg/dL (DM-DYSLIPIDEMIA). Lipid reductions and safety were assessed in patients with ASCVD from these studies. Results This analysis included 142 DM-DYSLIPIDEMIA and 177 DM-INSULIN participants with ASCVD, including 95.1% and 86.4% with coronary heart disease, and 32.4% and 49.7% with microvascular diabetes complications, respectively. At week 24, alirocumab significantly reduced LDL-C, non-HDL-C, ApoB, and LDL-PN from baseline versus control. This translated into a greater proportion of individuals achieving non-HDL-C < 100 mg/dL (64.6% alirocumab/23.8% UC [DM-DYSLIPIDEMIA]; 65.4% alirocumab/14.9% placebo [DM-INSULIN]) and ApoB < 80 mg/dL (75.1% alirocumab/35.4% UC and 76.8% alirocumab/24.8% placebo, respectively) versus control at week 24 (all P < 0.0001). In pooling these studies, 66.4% (alirocumab) and 67.0% (control) of individuals reported treatment-emergent adverse events. The adverse event pattern was similar with alirocumab versus controls. Conclusions Among individuals with T2DM and ASCVD who had high non-HDL-C/LDL-C levels despite maximally tolerated statin, alirocumab significantly reduced atherogenic cholesterol and LDL-PN versus control. Alirocumab was generally well tolerated

New Strahler numbers for rooted plane trees

In this paper, we present an extension of Strahler numbers to rooted plane trees. Several asymptotic properties are proved, others are conjectured. We als

molybdenum behaviour during u-al research reactor spent fuel dissolution

International audienceIn the frame of Research Reactors Spent Fuel (RRSF) treatment by hydrometallurgy, the dissolution in nitric acid of irradiated U-Al, is a key issue because of the low solubility of molybdenum fission product in presence of high concentration of aluminium. In this study, the values of molybdenum solubility have been accurately measured in different operating conditions. Studies have carried out with non-active materials. To be more representative of metallic fuel, uranium-molybdenum alloy powder and molybdenum metal have been dissolved in aluminium nitrate solutions at high temperature. In order to be sure that molybdenum solubility has been reached, experiments have been carried out with an excess of molybdenum metal. In spite of this excess addition, metallic elements have been dissolved completely after stirring time of thirty minutes with a magnetic stirrer. Shortly after this total dissolution, a slow molybdenum precipitation has been observed for almost 15 hours. An experimental protocol has been developed to properly wash precipitates in order to determine their elemental composition. No uranium has been detected in the washed precipitate by ICP-AES measurements performed after redissolution of solids in aluminium free nitric acid solutions. Further analyses by Scanning Electron Microscope have shown a needle-like morphology. Energy-dispersive X-ray spectroscopy analyses on several selected areas have confirmed the absence of uranium in precipitates. EDX semi-quantification has been carried out on ionically polished particles. They are composed of 75% oxygen and 25% molybdenum, suggesting MoO3 compounds. X-ray diffraction spectra of powders have confirmed this result all samples matched the crystallographic form of MoO3

Anatomically Constrained Weak Classifier Fusion for Early Detection of Alzheimer's Disease

International audienceThe early detection of Alzheimer's disease (AD) is a key step to accelerate the development of new therapies and to diminish the associated socio-economic burden. To address this challenging problem, several biomarkers based on MRI have been proposed. Although numer- ous efforts have been devoted to improve MRI-based feature quality or to increase machine learning methods accuracy, the current AD prog- nosis accuracy remains limited. In this paper, we propose to combine both high quality biomarkers and advanced learning method. Our ap- proach is based on a robust ensemble learning strategy using gray matter grading. The estimated weak classifiers are then fused into high infor- mative anatomical sub-ensembles. Through a sparse logistic regression, the most relevant anatomical sub-ensembles are selected, weighted and used as input to a global classifier. Validation on the full ADNI1 dataset demonstrates that the proposed method obtains competitive results of prediction of conversion to AD in the Mild Cognitive Impairment group with an accuracy of 75.6%

Experimental study and thermodynamic modelling of corium mixtures Application to severe accidents in Pressurized Water Reactors

International audienceDuring a severe accident in a nuclear reactor, extreme temperatures may be reached (T > 2500 K). In these conditions, the nuclear fuel may react with the Zircaloy cladding and then with the steel vessel, forming a mixture of solid-liquid phases called in-vessel corium. In the worst scenario, this mixture may pierce the vessel and reach the concrete underneath the reactor. In the framework of the development of the TAF-ID thermodynamic database (www.oecd-nea.org/science/taf-id) on nuclear fuel and to predict the high temperature behaviour of the corium+concrete system, new high temperature thermodynamic data are needed. The LM2T at CEA Saclay centre started an experimental campaign of measure of phase equilibria at high temperature (up to 2400 K) on interesting corium sub-systems. Furthermore a new laser heating setup has been conceived. This technique allows very high temperature measures (T>3000 K) limiting the interactions between the sample and the surroundings. New phase equilibria data on the U-Zr-O system and on the U-Zr-Al-Ca-Si-O system will be presented. Moreover original melting temperature data on the PuO2-UO2-ZrO2 system obtained in collaboration with the JRC-ITU, will be also shown