Understanding diabetic neuropathy: From subclinical nerve lesions to severe nerve fiber deficits. A cross-sectional study in patients with type 2 diabetes and healthy controls.

Studies on magnetic resonance neurography (MRN) in diabetic polyneuropathy (DPN) have found proximal sciatic nerve lesions. The aim of this study was to evaluate the functional relevance of sciatic nerve lesions in DPN, expecting correlations with the impairment of large fiber function. 61 patients with diabetes mellitus type 2 (48 with, 13 without DPN) and 12 controls were enrolled, undergoing MRN, quantitative sensory testing, and electrophysiological examinations. There were differences in mechanical detection (Aβ fibers) and mechanical pain (Aδ fibers), but not in thermal pain and thermal detection clusters (C fibers) between the groups. Lesion load correlated with lower Aα, Aβ, and Aδ fiber, but not C fiber function in all participants. Patients with lower function showed a higher load of nerve lesions than patients with elevated function or no measurable deficit despite apparent DPN. Longer diabetes duration was associated with higher lesion load in patients with DPN, suggesting that nerve lesions in DPN may accumulate over time and become clinically relevant once a critical amount of nerve fascicles is affected. Moreover, MRN is an objective method for determining lower function mainly in medium and large fibers in DPN

Diabetic neuropathy is a generalized phenomenon with impact on hand functional performance and quality of life.

BACKGROUND: Diabetic sensorimotor peripheral neuropathy (DSPN) is usually considered to affect predominantly the lower limbs (LL-N), while the impact of upper limb neuropathy (UL-N) on hand functional performance and quality of life (QoL) has not been evaluated systematically. This study aims to investigate the prevalence and characteristics of UL-N and its functional and psychosocial consequences in type 2 diabetes. METHODS: Individuals with type 2 diabetes (n=141) and an age- and sex-matched control group (n=73) underwent comprehensive assessment of neuropathy, hand functional performance and psychosocial status. RESULTS: The prevalence of UL-N was 30.5% in patients with diabetes and that of LL-N 49.6%, with 25.5% exhibiting both. Patients with diabetes showed similar sensory phenotype regarding both large and small fiber functions in hands and feet. Patients with UL-N showed reduced manual dexterity, but normal hand grip force. Additionally, there was a correlation between reduced dexterity and sensory deficits. Patients with UL-N had reduced estimates of psychosocial health including health-related QoL compared to control subjects and patients without UL-N. UL-N correlated with the severity of LL-N, but not with duration of diabetes, glycaemia, age, or sex. CONCLUSIONS: This study points to a substantial prevalence of UL-N in type 2 diabetes. The sensory phenotype of patients with UL-N was similar to LL-N and was characterized by loss of sensory function. Our study demonstrated an association of UL-N with impaired manual dexterity and reduced health-related QoL. Thus, upper limb sensorimotor functions should be assessed early in patients with diabetes

Direct, mold-less production systems

Additive Manufacturing (AM) technologies in general-and in particular, Selective Laser Melting (SLM)-are characterized by a fundamentally different relationship with respect to costs, lot size, and product complexity compared to conventional manufacturing processes. There is no increase of costs for small lot sizes (in contrast to mold-based technologies) and none for shape complexity either (in contrast to subtractive technologies). Thus, only the holistic development of a direct, mold-less production system that takes all relevant interdependencies along the product creation chain into account provides the full economic, ecologic and social benefits of AM technologies in future production. The following six subjects of the product creation chain were examined: (i) New business models and customer willingness to pay for AM parts are revealed. (ii) The Product Production System (PPS) was totally revised regarding the adoption of SLM technology into conventional manufacturing environment. (iii) The SLM manufacturing costs were examined regarding different machine configurations. (iv) A high-power SLM process was developed for enhancing the process productivity. (v) High manganese steel was qualified for the SLM process. (vi) Finally, two lattice structure types and a design methodology for customer parts were developed

Measurement of single-diffractive dijet production in proton–proton collisions at √s=8Te with the CMS and TOTEM experiments

Measurements are presented of the single-diffractive dijet cross section and the diffractive cross section as a function of the proton fractional momentum loss ξ and the four-momentum transfer squared t. Both processes pp→pX and pp→Xp, i.e. with the proton scattering to either side of the interaction point, are measured, where X includes at least two jets; the results of the two processes are averaged. The analyses are based on data collected simultaneously with the CMS and TOTEM detectors at the LHC in proton–proton collisions at s=8Te during a dedicated run with β∗=90m at low instantaneous luminosity and correspond to an integrated luminosity of 37.5nb-1. The single-diffractive dijet cross section σjjpX, in the kinematic region ξ< 0.1 , 0.03<|t|<1Ge2, with at least two jets with transverse momentum pT>40Ge, and pseudorapidity | η| < 4.4 , is 21.7±0.9(stat)-3.3+3.0(syst)±0.9(lumi)nb. The ratio of the single-diffractive to inclusive dijet yields, normalised per unit of ξ, is presented as a function of x, the longitudinal momentum fraction of the proton carried by the struck parton. The ratio in the kinematic region defined above, for x values in the range - 2.9 ≤ log 10x≤ - 1.6 , is R=(σjjpX/Δξ)/σjj=0.025±0.001(stat)±0.003(syst), where σjjpX and σjj are the single-diffractive and inclusive dijet cross sections, respectively. The results are compared with predictions from models of diffractive and nondiffractive interactions. Monte Carlo predictions based on the HERA diffractive parton distribution functions agree well with the data when corrected for the effect of soft rescattering between the spectator partons. © 2020, CERN for the benefit of the CMS and TOTEM collaborations

A Deep Neural Network for Simultaneous Estimation of b Jet Energy and Resolution

We describe a method to obtain point and dispersion estimates for the energies of jets arising from b quarks produced in proton–proton collisions at an energy of s=13TeV at the CERN LHC. The algorithm is trained on a large sample of simulated b jets and validated on data recorded by the CMS detector in 2017 corresponding to an integrated luminosity of 41 fb-1. A multivariate regression algorithm based on a deep feed-forward neural network employs jet composition and shape information, and the properties of reconstructed secondary vertices associated with the jet. The results of the algorithm are used to improve the sensitivity of analyses that make use of b jets in the final state, such as the observation of Higgs boson decay to b b ¯. © 2020, The Author(s)

Search for low mass vector resonances decaying into quark-antiquark pairs in proton-proton collisions at root s=13 Tev

A search for low mass narrow vector resonances decaying into quark-antiquark pairs is presented. The analysis is based on data collected in 2017 with the CMS detector at the LHC in proton-proton collisions at a center-of-mass energy of 13 TeV, corresponding to an integrated luminosity of 41.1 fb-1. The results of this analysis are combined with those of an earlier analysis based on data collected at the same collision energy in 2016, corresponding to 35.9 fb-1. Signal candidates will be recoiling against initial state radiation and are identified as energetic, large-radius jets with two pronged substructure. The invariant jet mass spectrum is probed for a potential narrow peaking signal over a smoothly falling background. No evidence for such resonances is observed within the mass range of 50-450 GeV. Upper limits at the 95% confidence level are set on the coupling of narrow resonances to quarks, as a function of the resonance mass. For masses between 50 and 300 GeV these are the most sensitive limits to date. This analysis extends the earlier search to a mass range of 300-450 GeV, which is probed for the first time with jet substructure techniques