Non-alcoholic fatty liver disease in type-2 diabetes mellitus: population analysis, metabolic profile and referral management pathway

Introduction: Non-alcoholic fatty liver disease is strongly associated with type-2 diabetes mellitus, with diabetic patients being at higher risk for adverse outcomes. The aim of this thesis was to explore in detail the clinical and metabolic phenotype of diabetics screened for NAFLD in primary care and to develop a referral management pathway for this population. Moreover, this thesis investigated the impact of alterations of the gut-liver axis on the severity of liver disease in such cohort. Methods: In this cross-sectional study, consecutive diabetic patients from primary care were screened for liver disease and NAFLD. Nuclear magnetic resonance and liquid chromatography-mass spectrometry were used to explore the metabolic profile of the patients against severity of liver disease. Stool meta-taxagenomics allowed for the analysis of the composition of the microbiome, while gut permeability was investigated using an in-vitro model and an ex-vivo measurement of faecal protease activity. Inflammatory cytokines profile was also analysed in serum as well as in faecal samples. Results: Clinically significant NAFLD was highly prevalent in the diabetic population in primary care. According to the results of this study, applying FIB-4 with a cut-off of 1.3 in this population would miss up to 38% of the patients with significant liver disease. The BIMAST score, which was derived based on simple clinical parameters, was validated both internally and externally, outperformed conventional screening methods and optimised risk-stratification in primary care. Among the metabolites, only lysine deficiency was associated with increased hepatic collagen content. Moreover, specific changes in gut microbiome were associated with more severe liver disease, while intestinal permeability tended to increase with liver disease severity. A combination of host and microbiota-related factors were associated with a leakier gut in this population. Conclusions: Current risk-stratification for NAFLD among diabetics in primary care can be improved. Exploring the gut-liver axis may offer diagnostic as well as therapeutical insights in this population.Open Acces

Making Custodians: A design anthropology approach to designing emotionally enduring built environment artefacts

My doctoral research through creative production takes a Design Anthropology approach to examine the person-object relationship typical of artefacts with long-term attachment and significance. I then speculate on the implications of these findings with the goal of designing enduring new built environment artefacts, surfaces, and furniture. The exegesis explores the context of this enquiry within design theory and practice and its significance, given the environmental impact of high levels of premature disposal and ‘fast’ consumption

A remark on norm inflation for nonlinear wave equations

In this note, we study the ill-posedness of nonlinear wave equations (NLW). Namely, we show that NLW experiences norm inflation at every initial data in negative Sobolev spaces. This result covers a gap left open in a paper of Christ, Colliander, and Tao (2003) and extends the result by Oh, Tzvetkov, and the second author (2019) to non-cubic integer nonlinearities. In particular, for some low dimensional cases, we obtain norm inflation above the scaling critical regularity. We also prove ill-posedness for NLW, via norm inflation at general initial data, in negative regularity Fourier-Lebesgue and Fourier-amalgam spaces.Comment: 20 pages. Published in Dyn. Partial Differ. Eq

On the transport of Gaussian measures under the one-dimensional fractional nonlinear Schrödinger equations

Under certain regularity conditions, we establish quasi-invariance of Gaussian measures on periodic functions under the flow of cubic fractional nonlinear Schr\"{o}dinger equations on the one-dimensional torus.Comment: 42 pages; typos corrected, added Remark 1.8. To appear in Ann. Inst. H. Poincar\'e Anal. Non Lin\'eair

Search and the City: Comparing the Use of WiFi in New York, Budapest and Montreal

Over the past five years, the use of mobile and wireless technology in public spaces of cities around the country has grown exponentially. Recently, cities including Philadelphia, San Francisco, Boston, Minneapolis, and Austin have announced plans to build municipal wireless networks. These projects make a number of assumptions about the payoffs of municipal wireless networks without the benefit of research on the communication practices of users. To date, there is little such research. In addition, wireless technology – specifically, wireless fidelity or WiFi -- is often discussed as one of many ways to access the high-speed (broadband) Internet i.e. cable, digital subscriber line (DSL), fiber etc. Thus, there has been little analysis of the ways in which the use of the wireless Internet via WiFi may differ from that of the wireline Internet. In order to understand the potential user patterns that will be observed with respect to emerging technologies, it is necessary to disaggregate research about the various ways of connecting to the Internet.This paper compares the results from a six-month survey of the use of WiFi hotspots in New York, Budapest and Montreal. It is hoped that further analysis of these survey results will contribute to a more acute understanding of the ways in which the user patterns of particular modes of Internet access may differ internationally. The major research questions addressed in this paper are: 1) How is WiFi being used in public spaces, by whom, where, for what purposes?; 2) How does the use of WiFi differ from other communication technology?; and, 3) How is the use of WiFi similar or different across cities internationally? This paper makes the following arguments based on the survey data: first, WiFi is an important factor in attracting people to specific locations; second, the use of WiFi highly localized in that it is often used to search for information relevant to one's geographic location; third, there are significant differences in the way that WiFi is used across a variety of locations including cafes, parks and other public spaces; fourth, at present, WiFi users are, for the most part, young, male and highly educated displaying the characteristics of early adopters of technology; and, fifth, there is a convergence in the ways in which WiFi is used internationally in some respects, however there are also important differences in the reasons for these uses as well divergence in other respects.These findings may have an important impact in shaping current discussions municipal wireless networks by helping to identify content, applications and services that can be delivered overmobile and wireless networks. In addition, the answers to these questions are vital to inform a wide variety of legal and public policy issues related to information and communication technologies in addition to being important to the development of content and applications for mobile and wireless technologies. These include policies surrounding municipal wireless networks, spectrum, universal service, community media and network neutrality