61 research outputs found
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A Comparative Effectiveness Analysis of Three Continuous Glucose Monitors
OBJECTIVE To compare three continuous glucose monitoring (CGM) devices in subjects with type 1 diabetes under closed-loop blood glucose (BG) control. RESEARCH DESIGN AND METHODS Six subjects with type 1 diabetes (age 52 ± 14 years, diabetes duration 32 ± 14 years) each participated in two 51-h closed-loop BG control experiments in the hospital. Venous plasma glucose (PG) measurements (GlucoScout, International Biomedical) obtained every 15 min (2,360 values) were paired in time with corresponding CGM glucose (CGMG) measurements obtained from three CGM devices, the Navigator (Abbott Diabetes Care), the Seven Plus (DexCom), and the Guardian (Medtronic), worn simultaneously by each subject. Errors in paired PG–CGMG measurements and data reporting percentages were obtained for each CGM device. RESULTS The Navigator had the best overall accuracy, with an aggregate mean absolute relative difference (MARD) of all paired points of 11.8 ± 11.1% and an average MARD across all 12 experiments of 11.8 ± 3.8%. The Seven Plus and Guardian produced aggregate MARDs of all paired points of 16.5 ± 17.8% and 20.3 ± 18.0%, respectively, and average MARDs across all 12 experiments of 16.5 ± 6.7% and 20.2 ± 6.8%, respectively. Data reporting percentages, a measure of reliability, were 76% for the Seven Plus and nearly 100% for the Navigator and Guardian. CONCLUSIONS A comprehensive head-to-head-to-head comparison of three CGM devices for BG values from 36 to 563 mg/dL revealed marked differences in performance characteristics that include accuracy, precision, and reliability. The Navigator outperformed the other two in these areas
Physical Conditions in Shocked Interstellar Gas Interacting with the Supernova Remnant IC 443
We present the results of a detailed investigation into the physical
conditions in interstellar material interacting with the supernova remnant IC
443. Our analysis is based on a comprehensive examination of high-resolution
far-ultraviolet spectra obtained with the Space Telescope Imaging Spectrograph
onboard the Hubble Space Telescope of two stars behind IC 443. One of our
targets (HD 43582) probes gas along the entire line of sight through the
supernova remnant, while the other (HD 254755) samples material located ahead
of the primary supernova shock front. We identify low velocity quiescent gas in
both directions and find that the densities and temperatures in these
components are typical of diffuse atomic and molecular clouds. Numerous high
velocity components are observed in the absorption profiles of neutral and
singly-ionized atomic species toward HD 43582. These components exhibit a
combination of greatly enhanced thermal pressures and significantly reduced
dust-grain depletions. We interpret this material as cooling gas in a
recombination zone far downstream from shocks driven into neutral gas clumps.
The pressures derived for a group of ionized gas components at high positive
velocity toward HD 43582 are lower than those of the other shocked components,
pointing to pressure inhomogeneities across the remnant. A strong very high
velocity component near -620 km/s is seen in the absorption profiles of
highly-ionized species toward HD 43582. The velocity of this material is
consistent with the range of shock velocities implied by observations of soft
thermal X-ray emission from IC 443. Moderately high-velocity gas toward HD
254755 may represent shocked material from a separate foreground supernova
remnant.Comment: 88 pages, 27 figures, accepted for publication in Ap
Home use of a bihormonal bionic pancreas versus insulin pump therapy in adults with type 1 diabetes: a multicentre randomised crossover trial
The safety and effectiveness of a continuous, day-and-night automated glycaemic control system using insulin and glucagon has not been shown in a free-living, home-use setting. We aimed to assess whether bihormonal bionic pancreas initialised only with body mass can safely reduce mean glycaemia and hypoglycaemia in adults with type 1 diabetes who were living at home and participating in their normal daily routines without restrictions on diet or physical activity
Registered Replication Report on Fischer, Castel, Dodd, and Pratt (2003)
The attentional spatial-numerical association of response codes (Att-SNARC) effect (Fischer, Castel, Dodd, & Pratt, 2003)—the finding that participants are quicker to detect left-side targets when the targets are preceded by small numbers and quicker to detect right-side targets when they are preceded by large numbers—has been used as evidence for embodied number representations and to support strong claims about the link between number and space (e.g., a mental number line). We attempted to replicate Experiment 2 of Fischer et al. by collecting data from 1,105 participants at 17 labs. Across all 1,105 participants and four interstimulus-interval conditions, the proportion of times the effect we observed was positive (i.e., directionally consistent with the original effect) was .50. Further, the effects we observed both within and across labs were minuscule and incompatible with those observed by Fischer et al. Given this, we conclude that we failed to replicate the effect reported by Fischer et al. In addition, our analysis of several participant-level moderators (finger-counting habits, reading and writing direction, handedness, and mathematics fluency and mathematics anxiety) revealed no substantial moderating effects. Our results indicate that the Att-SNARC effect cannot be used as evidence to support strong claims about the link between number and space
Early Release Science of the exoplanet WASP-39b with JWST NIRCam
Measuring the metallicity and carbon-to-oxygen (C/O) ratio in exoplanet
atmospheres is a fundamental step towards constraining the dominant chemical
processes at work and, if in equilibrium, revealing planet formation histories.
Transmission spectroscopy provides the necessary means by constraining the
abundances of oxygen- and carbon-bearing species; however, this requires broad
wavelength coverage, moderate spectral resolution, and high precision that,
together, are not achievable with previous observatories. Now that JWST has
commenced science operations, we are able to observe exoplanets at previously
uncharted wavelengths and spectral resolutions. Here we report time-series
observations of the transiting exoplanet WASP-39b using JWST's Near InfraRed
Camera (NIRCam). The long-wavelength spectroscopic and short-wavelength
photometric light curves span 2.0 - 4.0 m, exhibit minimal systematics,
and reveal well-defined molecular absorption features in the planet's spectrum.
Specifically, we detect gaseous HO in the atmosphere and place an upper
limit on the abundance of CH. The otherwise prominent CO feature at 2.8
m is largely masked by HO. The best-fit chemical equilibrium models
favour an atmospheric metallicity of 1-100 solar (i.e., an enrichment
of elements heavier than helium relative to the Sun) and a sub-stellar
carbon-to-oxygen (C/O) ratio. The inferred high metallicity and low C/O ratio
may indicate significant accretion of solid materials during planet formation
or disequilibrium processes in the upper atmosphere.Comment: 35 pages, 13 figures, 3 tables, Nature, accepte
The genetics of blood pressure regulation and its target organs from association studies in 342,415 individuals
To dissect the genetic architecture of blood pressure and assess effects on target-organ damage, we analyzed 128,272 SNPs from targeted and genome-wide arrays in 201,529 individuals of European ancestry and genotypes from an additional 140,886 individuals were used for validation. We identified 66 blood pressure loci, of which 17 were novel and 15 harbored multiple distinct association signals. The 66 index SNPs were enriched for cis-regulatory elements, particularly in vascular endothelial cells, consistent with a primary role in blood pressure control through modulation of vascular tone across multiple tissues. The 66 index SNPs combined in a risk score showed comparable effects in 64,421 individuals of non-European descent. The 66-SNP blood pressure risk score was significantly associated with target-organ damage in multiple tissues, with minor effects in the kidney. Our findings expand current knowledge of blood pressure pathways and highlight tissues beyond the classic renal system in blood pressure regulation
Correction to: Two years later: Is the SARS-CoV-2 pandemic still having an impact on emergency surgery? An international cross-sectional survey among WSES members
Background: The SARS-CoV-2 pandemic is still ongoing and a major challenge for health care services worldwide. In the first WSES COVID-19 emergency surgery survey, a strong negative impact on emergency surgery (ES) had been described already early in the pandemic situation. However, the knowledge is limited about current effects of the pandemic on patient flow through emergency rooms, daily routine and decision making in ES as well as their changes over time during the last two pandemic years. This second WSES COVID-19 emergency surgery survey investigates the impact of the SARS-CoV-2 pandemic on ES during the course of the pandemic.
Methods: A web survey had been distributed to medical specialists in ES during a four-week period from January 2022, investigating the impact of the pandemic on patients and septic diseases both requiring ES, structural problems due to the pandemic and time-to-intervention in ES routine.
Results: 367 collaborators from 59 countries responded to the survey. The majority indicated that the pandemic still significantly impacts on treatment and outcome of surgical emergency patients (83.1% and 78.5%, respectively). As reasons, the collaborators reported decreased case load in ES (44.7%), but patients presenting with more prolonged and severe diseases, especially concerning perforated appendicitis (62.1%) and diverticulitis (57.5%). Otherwise, approximately 50% of the participants still observe a delay in time-to-intervention in ES compared with the situation before the pandemic. Relevant causes leading to enlarged time-to-intervention in ES during the pandemic are persistent problems with in-hospital logistics, lacks in medical staff as well as operating room and intensive care capacities during the pandemic. This leads not only to the need for triage or transferring of ES patients to other hospitals, reported by 64.0% and 48.8% of the collaborators, respectively, but also to paradigm shifts in treatment modalities to non-operative approaches reported by 67.3% of the participants, especially in uncomplicated appendicitis, cholecystitis and multiple-recurrent diverticulitis.
Conclusions: The SARS-CoV-2 pandemic still significantly impacts on care and outcome of patients in ES. Well-known problems with in-hospital logistics are not sufficiently resolved by now; however, medical staff shortages and reduced capacities have been dramatically aggravated over last two pandemic years
Modelling human choices: MADeM and decision‑making
Research supported by FAPESP 2015/50122-0 and DFG-GRTK 1740/2. RP and AR are also part of the Research, Innovation and Dissemination Center for Neuromathematics FAPESP grant (2013/07699-0). RP is supported by a FAPESP scholarship (2013/25667-8). ACR is partially supported by a CNPq fellowship (grant 306251/2014-0)
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