Female sex is a risk factor for painful diabetic peripheral neuropathy: the EURODIAB prospective diabetes complications study

Aims/hypothesis While the risk factors for diabetic peripheral neuropathy (DPN) are now well recognised, the risk factors for painful DPN remain unknown. We performed analysis of the EURODIAB Prospective Complications Study data to elucidate the incidence and risk factors of painful DPN. Methods The EURODIAB Prospective Complications Study recruited 3250 participants with type 1 diabetes who were followed up for 7.3±0.6 (mean ± SD) years. To evaluate DPN, a standardised protocol was used, including clinical assessment, quantitative sensory testing and autonomic function tests. Painful DPN (defined as painful neuropathic symptoms in the legs in participants with confirmed DPN) was assessed at baseline and follow-up. Results At baseline, 234 (25.2%) out of 927 participants with DPN had painful DPN. At follow-up, incident DPN developed in 276 (23.5%) of 1172 participants. Of these, 41 (14.9%) had incident painful DPN. Most of the participants who developed incident painful DPN were female (73% vs 48% painless DPN p=0.003) and this remained significant after adjustment for duration of diabetes and HbA1c (OR 2.69 [95% CI 1.41, 6.23], p=0.004). The proportion of participants with macro- or microalbuminuria was lower in those with painful DPN compared with painless DPN (15% vs 34%, p=0.02), and this association remained after adjusting for HbA1c, diabetes duration and sex (p=0.03). Conclusions/interpretation In this first prospective study to investigate the risk factors for painful DPN, we definitively demonstrate that female sex is a risk factor for painful DPN. Additionally, there is less evidence of diabetic nephropathy in incident painful, compared with painless, DPN. Thus, painful DPN is not driven by cardiometabolic factors traditionally associated with microvascular disease. Sex differences may therefore play an important role in the pathophysiology of neuropathic pain in diabetes. Future studies need to look at psychosocial, genetic and other factors in the development of painful DPN

Application of heavy-quark effective theory to lattice QCD: III. Radiative corrections to heavy-heavy currents

We apply heavy-quark effective theory (HQET) to separate long- and short-distance effects of heavy quarks in lattice gauge theory. In this paper we focus on flavor-changing currents that mediate transitions from one heavy flavor to another. We stress differences in the formalism for heavy-light currents, which are discussed in a companion paper, showing how HQET provides a systematic matching procedure. We obtain one-loop results for the matching factors of lattice currents, needed for heavy-quark phenomenology, such as the calculation of zero-recoil form factors for the semileptonic decays $B\to D^{(*)}l\nu$. Results for the Brodsky-Lepage-Mackenzie scale $q^*$ are also given.Comment: 35 pages, 17 figures. Program LatHQ2QCD to compute matching one-loop coefficients available at http://theory.fnal.gov/people/kronfeld/LatHQ2QCD

Relations between Financing and Output in the Not-for-Profit Hospital

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68639/2/10.1177_107755878804500204.pd

Influence of wall friction on flow regimes and scale-up of counter-current swirl spray dryers

The structure of the vortex flow in swirl spray dryers is investigated after having fouled the walls with deposits typical of detergent manufacture. The range of Re and swirl intensity Ω characteristic of industry are studied using three counter-current units of varying scale and design. The friction with the deposits increases the flow turbulence kinetic energy and causes a drastic attenuation of the swirl and as a result, the vortex breaks down in the chamber forming recirculation regions (i.e. areas of reverse flow). Three flow regimes (1) no recirculation, (2) central and (3) annular recirculation have been identified depending on the swirl intensity. New control and scale up strategies are proposed for swirl dryers based in predicting the decay and the flow regime using the unit geometry (i.e. initial swirl intensity Ωi) and experimental decay rates function of the coverage and thickness of deposits. The impact in design and numerical modelling must be stressed. Adequate prediction of the swirl is vital to study fouling and recirculation, which surely play an important part in the dispersion and aggregation of the solid phase. Current models have no means to replicate these phenomena, and yet, in this case neglecting the deposits and assuming smooth walls would result in (a) over-prediction of swirl velocity up to 40-186% (b) under-prediction of turbulent kinetic energy up to 67-85% and (c) failure to recognise recirculation areas

An experimental investigation of the swirling flow in a tall-form counter current spray dryer

This work studies the air flow in a large swirl counter-current dryer using sonic anemometry. Air velocity and turbulence fields are reported at isothermal conditions and in the absence of particles. In a tall-form unit the structure of the flow is largely influenced by the design of the exit. A contraction originates a central jet and suppresses the formation of recirculation zones despite the vortex acquires a high swirl intensity Ω (i.e. 1<Ω<2). Access to a full scale tower has permitted to: (a) identify asymmetries owed to the design of inlet and exhaust ducts, (b) present the first detailed turbulence data in production units, characterized by a highly anisotropic field and the axial decay of the turbulence kinetic energy, (c) study the flow stability, identifying the precession of the vortex core and oscillations at a constant Strouhal number and (d) study the impact that a rough wall has in the strength of the swirl. This work presents the first clear evidence of significant friction in spray dryers. The swirl intensity Ω decays exponentially in the dryer at a rate between 0.08 and 0.09, much higher than expected in pipe flow and independent of Re in the range 105-2.2{dot operator}105. Production dryers have a large characteristic wall roughness due the presence of deposits, which explains the stronger friction and the discrepancies found in the past between data at full scale or clean laboratory or pilot scale units. It is essential to address this phenomenon in current numerical models, which are validated on laboratory or pilot scale facilities and ignore the role of deposits, thus causing an overprediction of the tangential velocity above 30-40%

Point sets on the sphere S2\mathbb{S}^2 with small spherical cap discrepancy

In this paper we study the geometric discrepancy of explicit constructions of uniformly distributed points on the two-dimensional unit sphere. We show that the spherical cap discrepancy of random point sets, of spherical digital nets and of spherical Fibonacci lattices converges with order $N^{-1/2}$. Such point sets are therefore useful for numerical integration and other computational simulations. The proof uses an area-preserving Lambert map. A detailed analysis of the level curves and sets of the pre-images of spherical caps under this map is given

Low Q^2 Jet Production at HERA and Virtual Photon Structure

The transition between photoproduction and deep-inelastic scattering is investigated in jet production at the HERA ep collider, using data collected by the H1 experiment. Measurements of the differential inclusive jet cross-sections dsigep/dEt* and dsigmep/deta*, where Et* and eta* are the transverse energy and the pseudorapidity of the jets in the virtual photon-proton centre of mass frame, are presented for 0 < Q2 < 49 GeV2 and 0.3 < y < 0.6. The interpretation of the results in terms of the structure of the virtual photon is discussed. The data are best described by QCD calculations which include a partonic structure of the virtual photon that evolves with Q2.Comment: 20 pages, 5 Figure

Hadron Production in Diffractive Deep-Inelastic Scattering

Characteristics of hadron production in diffractive deep-inelastic positron-proton scattering are studied using data collected in 1994 by the H1 experiment at HERA. The following distributions are measured in the centre-of-mass frame of the photon dissociation system: the hadronic energy flow, the Feynman-x (x_F) variable for charged particles, the squared transverse momentum of charged particles (p_T^{*2}), and the mean p_T^{*2} as a function of x_F. These distributions are compared with results in the gamma^* p centre-of-mass frame from inclusive deep-inelastic scattering in the fixed-target experiment EMC, and also with the predictions of several Monte Carlo calculations. The data are consistent with a picture in which the partonic structure of the diffractive exchange is dominated at low Q^2 by hard gluons.Comment: 16 pages, 6 figures, submitted to Phys. Lett.

Measurement of D* Meson Cross Sections at HERA and Determination of the Gluon Density in the Proton using NLO QCD

With the H1 detector at the ep collider HERA, D* meson production cross sections have been measured in deep inelastic scattering with four-momentum transfers Q^2>2 GeV2 and in photoproduction at energies around W(gamma p)~ 88 GeV and 194 GeV. Next-to-Leading Order QCD calculations are found to describe the differential cross sections within theoretical and experimental uncertainties. Using these calculations, the NLO gluon momentum distribution in the proton, x_g g(x_g), has been extracted in the momentum fraction range 7.5x10^{-4}< x_g <4x10^{-2} at average scales mu^2 =25 to 50 GeV2. The gluon momentum fraction x_g has been obtained from the measured kinematics of the scattered electron and the D* meson in the final state. The results compare well with the gluon distribution obtained from the analysis of scaling violations of the proton structure function F_2.Comment: 27 pages, 9 figures, 2 tables, submitted to Nucl. Phys.

An Integrated TCGA Pan-Cancer Clinical Data Resource to Drive High-Quality Survival Outcome Analytics

For a decade, The Cancer Genome Atlas (TCGA) program collected clinicopathologic annotation data along with multi-platform molecular profiles of more than 11,000 human tumors across 33 different cancer types. TCGA clinical data contain key features representing the democratized nature of the data collection process. To ensure proper use of this large clinical dataset associated with genomic features, we developed a standardized dataset named the TCGA Pan-Cancer Clinical Data Resource (TCGA-CDR), which includes four major clinical outcome endpoints. In addition to detailing major challenges and statistical limitations encountered during the effort of integrating the acquired clinical data, we present a summary that includes endpoint usage recommendations for each cancer type. These TCGA-CDR findings appear to be consistent with cancer genomics studies independent of the TCGA effort and provide opportunities for investigating cancer biology using clinical correlates at an unprecedented scale. Analysis of clinicopathologic annotations for over 11,000 cancer patients in the TCGA program leads to the generation of TCGA Clinical Data Resource, which provides recommendations of clinical outcome endpoint usage for 33 cancer types