Gestational diabetes in a rural setting.

Women who are already diabetic and become pregnant, as well as women who develop gestational diabetes, have increased risks of complications to both fetus and mother. These risks in gestational diabetes mellitus (GDM) can be reduced to near that of a non-diabetic mother by normalizing the blood sugar. The current recommended standards are reviewed. Utilizing a team approach, care was provided to patients with GDM in a rural primary care setting in order to attempt to normalize the blood sugar to the recommended level. Review of the outcomes of these pregnancies supports the conclusion that acceptable care for patients with GDM can be provided away from the tertiary care centers and in the primary care setting

Exploration of Non-Resonant Divertor Features on the Compact Toroidal Hybrid

Non-resonant divertors (NRDs) separate the confined plasma from the surrounding plasma facing components (PFCs). The resulting striking field line intersection pattern on these PFCs is insensitive to plasma equilibrium effects. However, a complex scrape-off layer (SOL), created by chaotic magnetic topology in the plasma edge, connects the core plasma to the PFCs through varying magnetic flux tubes. The Compact Toroidal Hybrid (CTH) serves as a test-bed to study this by scanning across its inductive current. Simulations observe a significant change of the chaotic edge structure and an effective distance between the confined plasma and the instrumented wall targets. The intersection pattern is observed to be a narrow helical band, which we claim is a resilient strike line pattern. However, signatures of finger-like structures, defined as heteroclinic tangles in chaotic domains, within the plasma edge connect the island chains to this resilient pattern. The dominant connection length field lines intersecting the targets are observed via heat flux modelling with EMC3-EIRENE. At low inductive current levels, the excursion of the field lines resembles a limited plasma wall scenario. At high currents, a private flux region is created in the area where the helical strike line pattern splits into two bands. These bands are divertor legs with distinct SOL parallel particle flow channels. The results demonstrate the NRD strike line pattern resiliency within CTH, but also show the underlying chaotic edge structure determining if the configuration is diverted or limited. This work supports future design efforts for a mechanical structure for the NRD.Comment: 26 pages, 16 figure

Hospital food service: a comparative analysis of systems and introducing the ‘Steamplicity’ concept

Background Patient meals are an integral part of treatment hence the provision and consumption of a balanced diet, essential to aid recovery. A number of food service systems are used to provide meals and the Steamplicity concept has recently been introduced. This seeks, through the application of a static, extended choice menu, revised patient ordering procedures, new cooking processes and individual patient food heated/cooked at ward level, to address some of the current hospital food service concerns. The aim of this small-scale study, therefore, was to compare a cook-chill food service operation against Steamplicity. Specifically, the goals were to measure food intake and wastage at ward level; ‘stakeholders’ (i.e. patients, staff, etc.) satisfaction with both systems; and patients’ acceptability of the food provided. Method The study used both quantitative (self-completed patient questionnaires, n = 52) and qualitative methods (semi-structured interviews, n = 16) with appropriate stakeholders including medical and food service staff, patients and their visitors. Results Patients preferred the Steamplicity system overall and in particular in terms of food choice, ordering, delivery and food quality. Wastage was considerably less with the Steamplicity system, although care must be taken to ensure that poor operating procedures do not negate this advantage. When the total weight of food consumed in the ward at each meal is divided by the number of main courses served, at lunch, the mean intake with the cook-chill system was 202 g whilst that for the Steamplicity system was 282 g and for the evening meal, 226 g compared with 310 g. Conclusions The results of this small study suggest that Steamplicity is more acceptable to patients and encourages the consumption of larger portions. Further evaluation of the Steamplicity system is warranted. The purpose of this study was to directly compare selected aspects (food wastage at ward level; satisfaction with systems and food provided) of a traditional cook-chill food service operation against ‘Steamplicity’. Results indicate that patients preferred the ‘Steamplicty’ system in all areas: food choice, ordering, delivery, food quality and overall. Wastage was considerably less with the ‘Steamplicity’ system; although care must be taken to ensure that poor operating procedures do not negate this advantage. When the total weight of food consumed in the ward at each meal is divided by the number of main courses served, results show that at lunch, mean intake with the cook-chill system was 202g whilst that for the ‘Steamplicity’ system was 282g and for the evening meal, 226g compared with 310g

Effects of elevated [CO2 ] on maize defence against mycotoxigenic Fusarium verticillioides.

Maize is by quantity the most important C4 cereal crop; however, future climate changes are expected to increase maize susceptibility to mycotoxigenic fungal pathogens and reduce productivity. While rising atmospheric [CO2 ] is a driving force behind the warmer temperatures and drought, which aggravate fungal disease and mycotoxin accumulation, our understanding of how elevated [CO2 ] will effect maize defences against such pathogens is limited. Here we report that elevated [CO2 ] increases maize susceptibility to Fusarium verticillioides proliferation, while mycotoxin levels are unaltered. Fumonisin production is not proportional to the increase in F. verticillioides biomass, and the amount of fumonisin produced per unit pathogen is reduced at elevated [CO2 ]. Following F. verticillioides stalk inoculation, the accumulation of sugars, free fatty acids, lipoxygenase (LOX) transcripts, phytohormones and downstream phytoalexins is dampened in maize grown at elevated [CO2 ]. The attenuation of maize 13-LOXs and jasmonic acid production correlates with reduced terpenoid phytoalexins and increased susceptibility. Furthermore, the attenuated induction of 9-LOXs, which have been suggested to stimulate mycotoxin biosynthesis, is consistent with reduced fumonisin per unit fungal biomass at elevated [CO2 ]. Our findings suggest that elevated [CO2 ] will compromise maize LOX-dependent signalling, which will influence the interactions between maize and mycotoxigenic fungi

Improved algebraic cryptanalysis of QUAD, Bivium and Trivium via graph partitioning on equation systems

We present a novel approach for preprocessing systems of polynomial equations via graph partitioning. The variable-sharing graph of a system of polynomial equations is defined. If such graph is disconnected, then the corresponding system of equations can be split into smaller ones that can be solved individually. This can provide a tremendous speed-up in computing the solution to the system, but is unlikely to occur either randomly or in applications. However, by deleting certain vertices on the graph, the variable-sharing graph could be disconnected in a balanced fashion, and in turn the system of polynomial equations would be separated into smaller systems of near-equal sizes. In graph theory terms, this process is equivalent to finding balanced vertex partitions with minimum-weight vertex separators. The techniques of finding these vertex partitions are discussed, and experiments are performed to evaluate its practicality for general graphs and systems of polynomial equations. Applications of this approach in algebraic cryptanalysis on symmetric ciphers are presented: For the QUAD family of stream ciphers, we show how a malicious party can manufacture conforming systems that can be easily broken. For the stream ciphers Bivium and Trivium, we nachieve significant speedups in algebraic attacks against them, mainly in a partial key guess scenario. In each of these cases, the systems of polynomial equations involved are well-suited to our graph partitioning method. These results may open a new avenue for evaluating the security of symmetric ciphers against algebraic attacks

Design and testing of a unique active Compton-suppressed LaBr3(Ce) detector system for improved sensitivity assays of TRU in remote-handled TRU wastes

The US Department of Energy’s transuranic (TRU) waste inventory includes about 4,500 m3 of remote-handled TRU (RH-TRU) wastes composed of a variety of containerized waste forms having a contact surface dose rate that exceeds 2 mSv/hr (200 mrem/hr) containing waste materials with a total TRU concentration greater than 3700 Bq/g (100 nCi/g). As part of a research project to investigate the use of active Compton-suppressed room-temperature gamma-ray detectors for direct non-destructive quantification of the TRU content of these RH-TRU wastes, we have designed and purchased a unique detector system using a LaBr3(Ce) primary detector and a NaI(Tl) suppression mantle. The LaBr3(Ce) primary detector is a cylindrical unit ~25 mm in diameter by 76 mm long viewed by a 38 mm diameter photomultiplier. The NaI(Tl) suppression mantle (secondary detector) is 175 mm by 175 mm with a center well that accommodates the primary detector. An important feature of this arrangement is the lack of any “can” between the primary and secondary detectors. These primary and secondary detectors are optically isolated by a thin layer (.003") of aluminized kapton, but the hermetic seal and thus the aluminum can surrounds the outer boundary of the detector system envelope. The hermetic seal at the primary detector PMT is at the PMT wall. This arrangement virtually eliminates the “dead” material between the primary and secondary detectors, a feature that preliminary modeling indicated would substantially improve the Compton suppression capability of this device. This paper presents both the expected performance of this unit determined from modeling with MCNPX, and the performance measured in our laboratory with radioactive sources

Measurement of Endogenous versus Exogenous Formaldehyde-Induced DNA-Protein Crosslinks in Animal Tissues by Stable Isotope Labeling and Ultrasensitive Mass Spectrometry

DNA-protein crosslinks (DPCs) arise from a wide range of endogenous and exogenous chemicals, such as chemotherapeutic drugs and formaldehyde. Importantly, recent identification of aldehydes as endogenous genotoxins in Fanconi anemia has provided new insight into disease causation. Due to their bulky nature, DPCs pose severe threats to genome stability, but previous methods to measure formaldehyde-induced DPCs were incapable of discriminating between endogenous and exogenous sources of chemical. In this study, we developed methods that provide accurate and distinct measurements of both exogenous and endogenous DPCs in a structurally-specific manner. We exposed experimental animals to stable isotope-labeled formaldehyde ([13CD2]-formaldehyde) by inhalation and performed ultrasensitive mass spectrometry to measure endogenous (unlabeled) and exogenous (13CD2-labeled) DPCs. We found that exogenous DPCs readily accumulated in nasal respiratory tissues, but were absent in tissues distant to the site of contact. This observation together with the finding that endogenous formaldehyde-induced DPCs were present in all tissues examined suggests that endogenous DPCs may be responsible for increased risks of bone marrow toxicity and leukemia. Furthermore, the slow rate of DPC repair provided evidence for persistence of DPCs. In conclusion, our method for measuring endogenous and exogenous DPCs presents a new perspective for the potential health risks inflicted by endogenous formaldehyde, and may inform improved disease prevention and treatment strategies

Development of an IEC neutron source for NDE

This paper concerns the development of a neutron so based on the inertial electrostatic confinement (IEC) of a low density fusion plasma in a gridded, spherically-focusing device. With the motivation of using such sources for nondestructive evaluation (NDE) applications, the focus of the development is on : Small size devices, sealed operation with D{sub 2} or D{sub 2}/T{sub 2} mixtures, Power-utilization and neutron-output optimization, and integration into an assay system. In this paper, we describe an experimental system that has been established for the development and testing of IEC neutron sources, and we present preliminary results of tests conducted for 25-cm and 15-cm diameter IEC devices