Observational study of the association of first insulin type in uncontrolled type 2 diabetes with macrovascular and microvascular disease

<p>Aims: To compare the risk of vascular disease, HbA1c and weight change, between first prescribed insulins in people with type 2 diabetes.</p> <p>Methods: People included in THIN United Kingdom primary care record database who began insulin (2000–2007) after poor control on oral glucose-lowering agents (OGLD) were grouped by the number of OGLDs in their treatment regimen immediately before starting insulin (n = 3,485). Within OGLD group, Cox regression compared macrovascular (all-cause mortality, myocardial infarction, acute coronary syndrome and stroke) and microvascular disease (peripheral neuropathy, nephropathy, and retinopathy) between insulin type (basal, pre-mix or Neutral Protamine Hagedorn, NPH) while ANCOVAs compared haemoglobin A1c (HbA1c) and weight change.</p> <p>Results: Mean follow-up was 3.6 years. Rates of incident macrovascular events were similar when basal insulin was compared to pre-mix or NPH, adjusted hazard ratio versus basal: pre-mix 1.08 (95% CI 0.73, 1.59); NPH 1.00 (0.63, 1.58) after two OGLDs, and pre-mix 0.97 (0.46, 2.02); NPH 0.77 (0.32, 1.86) after three OGLDs. An increased risk of microvascular disease in NPH versus basal after 3 OGLDs, adjusted hazard ratio1.87 (1.04, 3.36), was not seen after two agents or in comparisons of basal and pre-mix. At one year, after two OGLDs, weight increase was less with basal compared with pre-mix. After three OGLDs, mean HbA1c had reduced less in basal versus pre-mix or NPH at 6–8 and at 9–11 months, and versus pre-mix at 12–14 months.</p> <p>Conclusion: We found no difference in the risk of macrovascular events between first insulins in the medium term when started during poor glycaemia control. The increased risk of microvascular events with NPH warrants further study. In certain groups, first use of basal insulin was associated with less gain in weight and decrease in HbA1c compared to other insulins.</p&gt

‘Getting Back Into the Swing of Things’: A Qualitative Study Into Barriers and Facilitators to Golf Participation for Stroke Survivors

This paper draws on interviews with four stroke survivors (age range = 52–68 years), who participated in a six week ‘Get-into-Golf’ program and four coaches with experiences of delivering disability golf sessions, to examine the barriers and facilitators to golf participation. Findings indicate a positive response from participants, who referred to the social and physical benefits of the program that was perceived to promote independence. The results also highlight that considerations in regards to format, equipment, cost, access and overall awareness should be borne in mind for golf programs among people with disabilities. Golf clubs could employ this framework to help facilitate the participation of people with physical limitations. It is argued that opportunities to promote golf as a lifelong physical activity among people with disabilities may be missed in clubs where personnel are unsure of the barriers and facilitators to participation outlined here

SDSS J094604.90+183541.8: A Gravitationally Lensed Quasar at z=4.8

We report the discovery of a gravitationally lensed quasar identified serendipitously in the Sloan Digital Sky Survey (SDSS). The object, SDSS J094604.90+183541.8, was initially targeted for spectroscopy as a luminous red galaxy, but the SDSS spectrum has the features of both a z=0.388 galaxy and a z=4.8 quasar. We have obtained additional imaging that resolves the system into two quasar images separated by 3.06 arcsec and a bright galaxy that is strongly blended with one of the quasar images. We confirm spectroscopically that the two quasar images represent a single lensed source at z=4.8 with a total magnification of 3.2, and we derive a model for the lensing galaxy. This is the highest redshift lensed quasar currently known. We examine the issues surrounding the selection of such an unusual object from existing data and briefly discuss implications for lensed quasar surveys.Comment: AJ accepted, 9 pages, 6 figures, referee suggestions include

An Overdensity of Extremely Red Objects Around Faint Mid-IR galaxies

We have searched for Extremely Red Objects (EROs) around faint mid-IR selected galaxies in ELAIS fields. We find a significant overdensity, by factors of 2 to 5, of these EROs compared to field EROs in the same region and literature random field ERO counts. The excess is similar to that found previously in the fields of known high redshift quasars and AGN. While with the present data it cannot be definitely shown whether the overdensity is physically connected to the mid-IR source, a derived radial distribution does suggest this. The fraction of EROs among K-selected galaxies is high in the mid-IR fields in agreement with the picture that the EROs responsible for the overdensity are members of high redshift clusters of galaxies. We find R-K>5 selected EROs to be more clustered around the mid-IR galaxies than I-K>4 EROs, though statistics are weak because of small numbers. However, this would be consistent with a cluster/galaxy group scenario if, as we argue, the former colour selection finds preferentially more strongly clustered early type galaxies, whereas the latter selection includes a larger fraction of dusty EROs. Finally, using the mid-IR data, we are able to limit the fraction of ULIRG type very dusty EROs at K<18 magnitude to less than 10% of the total ERO population.Comment: A&A, accepted, 13 pages and 5 ps-fig

Identifying Best Practices for Management of Electric Scooters

Course Code: AEDE 4567The purpose of this project was to conduct an analysis of the usage of rentable electric scooters (eScooters) and to identify any potential areas of safety concern regarding the usage of the eScooters within the City of Columbus. From there, we benchmarked Columbus to other cities based on policy regulations concerning the status of eScooters. We could then offer the City policy recommendations in order to properly manage the eScooters. This project was conducted in partnership with SMART Columbus and The Ohio State University.SMART ColumbusAcademic Major: Environment, Economy, Development, and Sustainabilit

Number Counts of Bright Extremely Red Objects: Evolved Massive Galaxies at z~1

We present results on number counts of Extremely Red Objects (EROs) in a 2850 arcmin^2 near-infrared survey performed in European Large Area ISO Survey (ELAIS) fields at K<17.5. Counts of EROs are extended to brighter levels than available previously, giving 0.002 +/- 0.001 arcmin^-2 at K<16.5 and consistent numbers with literature values at fainter magnitudes. Photometric redshifts from HYPERZ as well as GRASIL model SEDs of galaxies imply that our EROs are located in the range z=0.7-1.5, with the bulk of the population at z~1. Taking advantage of the ISO data in the fields, we use mid-IR detections to constrain the number of dusty EROs, and also discuss the superior capabilities of Spitzer Space Telescope to detect dusty EROs. Both the mid-IR data and the use of colour-colour diagrammes indicate that at most 10-20% of the EROs in this bright regime are dusty starbursting systems. The space density of our EROs, interpreted to be counterparts of local >2-3L^star massive galaxies at around z~1, is estimated to be approx. 2x10^-5 Mpc^-3, which is consistent with local values. Furthermore, the cumulative number counts at our bright magnitudes are remarkably well fitted by pure luminosity evolution models.Comment: A&A, accepted, 14 pages and 8 ps-fig

Shaping electron wave functions in a carbon nanotube with a parallel magnetic field

A magnetic field, through its vector potential, usually causes measurable changes in the electron wave function only in the direction transverse to the field. Here we demonstrate experimentally and theoretically that in carbon nanotube quantum dots, combining cylindrical topology and bipartite hexagonal lattice, a magnetic field along the nanotube axis impacts also the longitudinal profile of the electronic states. With the high (up to 17T) magnetic fields in our experiment the wave functions can be tuned all the way from "half-wave resonator" shape, with nodes at both ends, to "quarter-wave resonator" shape, with an antinode at one end. This in turn causes a distinct dependence of the conductance on the magnetic field. Our results demonstrate a new strategy for the control of wave functions using magnetic fields in quantum systems with nontrivial lattice and topology.Comment: 5 figure