Non-adherence to eye care in people with diabetes

Objective Evaluate individual factors that impact adherence to eye care follow-up in patients with diabetes. Design and methods A 4-year retrospective chart review was conducted for 1968 patients with diabetes over age 40 from an urban academic center. Data collected included demographics, insurance, visual acuity, smoking status, medications, dates of dilated fundus examinations (DFE), and reported hemoglobin A1C and blood glucose levels. The primary outcome was timely DFE follow-up adherence following the initial eye exam visit. Results Overall, 41.6% of patients adhered to initial follow-up eye care recommendations. Multivariable analysis demonstrated that patients with severe diabetic retinopathy (DR) were more adherent than patients with mild DR (OR 1.86). Other variables associated with increased adherence were visual impairment and reported A1C or blood glucose. Smoking was associated with decreased adherence. Ethnicity and insurance were also significantly associated with adherence. Longitudinal follow-up rates were influenced by additional factors, including ethnicity and neighborhood deprivation index. Conclusions Patients with moderate to severe DR and/ or visual impairment were more likely to adhere to timely DFE follow-up. This could relate to the presence of visual symptoms and/or other systemic manifestations of diabetes. Smokers were less likely to adhere to timely DFE follow-up. One hypothesis is patients who smoke have other symptomatic health problems which patients prioritize over asymptomatic ocular disorders. In order to reduce vision loss from DR, practitioners should be aware that patients with mild and moderate DR, patients with normal vision, and smokers are at greater risk for poor follow-up eye care adherence. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved

Vitiligo-like manifestations of graft-versus-host disease in a pediatric population

Vitiligo-like changes are an uncommon cutaneous manifestation of graft-versus-host disease (GVHD). We report three cases and review the literature of pediatric patients with vitiligo-like changes associated with GVHD. Improved characterization of this phenomenon may lend insight into the biologic pathways that underlie both vitiligo and GVHD

String Theory Dynamics In Various Dimensions

The strong coupling dynamics of string theories in dimension $d\geq 4$ are studied. It is argued, among other things, that eleven-dimensional supergravity arises as a low energy limit of the ten-dimensional Type IIA superstring, and that a recently conjectured duality between the heterotic string and Type IIA superstrings controls the strong coupling dynamics of the heterotic string in five, six, and seven dimensions and implies $S$ duality for both heterotic and Type II strings.Comment: 54 pages, harvmac. Some references have been added and discussion of five-dimensional heterotic string expanded

IIA and IIB spinors from K(E10)

We analyze the decomposition of recently constructed unfaithful spinor representations of K(E10) under its SO(9) x SO(9), and SO(9) x SO(2) subgroups, respectively, where K(E10) is the `maximal compact' subgroup of the hyperbolic Kac--Moody group E(10). We show that under these decompositions, respectively, one and the same K(E10) spinor gives rise to both the fermionic fields of IIA supergravity, and to the (chiral) fermionic fields of IIB supergravity. This result is thus the fermionic analogue of the decomposition of E(10) under its SO(9,9) and SL(9) x SL(2) subgroups, respectively, which yield the correct bosonic multiplets of (massive) IIA and IIB supergravity. The essentially unique Lagrangian for the supersymmetric E(10)/K(E10) sigma-model therefore can also capture the dynamics of IIA and IIB including bosons and fermions in the known truncations.Comment: 16 pages, v2: added paragraph on spinors for K(E9) and K(E11

Monitoring activity at the Daguangbao mega-landslide (China) using Sentinel-1 TOPS time series interferometry

The Daguangbao mega-landslide (China), induced by the 2008 Wenchuan earthquake (Mw = 7.9), with an area of approximately 8 km2, is one of the largest landslides in the world. Experts predicted that the potential risk and instability of the landslide might remain for many decades, or even longer. Monitoring the activity of such a large landslide is hence critical. Terrain Observation by Progressive Scans (TOPS) mode from the Sentinel-1 satellite provides us with up-to-date high-quality Synthetic Aperture Radar (SAR) images over a wide ground coverage (250 × 250 km), enabling full exploitation of various InSAR applications. However, the TOPS mode introduces azimuth-dependent Doppler variations to radar signals, which requires an additional processing step especially for SAR interferometry. Sentinel-1 TOPS data have been widely applied to earthquakes, but the performance of TOPS data-based time series analysis requires further exploitation. In this study, Sentinel-1 TOPS data were employed to investigate landslide post-seismic activities for the first time. To deal with the azimuth-dependent Doppler variations, a processing chain of TOPS time series interferometry approach was developed. Since the Daguangbao landslide is as a result of the collapse of a whole mountain caused by the 2008 Mw 7.9 Wenchuan earthquake, the existing Digital Elevation Models (DEMs, e.g. SRTM and ASTER) exhibit height differences of up to approximately 500 m. Tandem-X images acquired after the earthquake were used to generate a high resolution post-seismic DEM. The high gradient topographic errors of the SRTM DEM (i.e. the differences between the pre-seismic SRTM and the actual post-seismic elevation), together with low coherence in mountainous areas make it difficult to derive a precise DEM using the traditional InSAR processing procedure. A re-flattening iterative method was hence developed to generate a precise TanDEM-X DEM in this study. The volume of the coseismic Daguangbao landslide was estimated to be of 1.189 ± 0.110 × 109 m3 by comparing the postseismic Tandem-X DEM with the preseismic SRTM DEM, which is consistent with the engineering geological survey result. The time-series results from Sentinel-1 show that some sectors of the Daguangbao landslide are still active (and displaying four sliding zones) and exhibiting a maximum displacement rate of 8 cm/year, even eight years after the Wenchuan earthquake. The good performance of TOPS in this time series analysis indicates that up-to-date high-quality TOPS data with spatiotemporal baselines offer significant potential in terms of future InSAR applications.This work was supported by the National Natural Science Foundation of China under Grant No. 41474003. The research stay of Dr. Tomás at Newcastle University was funded by the Ministry of Education, Culture and Sport within the framework of Project PRX14/00100. Additional funding was obtained from the Spanish Government under projects TIN2014-55413-C2-2-P and ESP2013-47780-C2-2-R. Part of this work is also supported by the UK Natural Environmental Research Council (NERC) through the Centre for the Observation and Modelling of Earthquakes, Volcanoes and Tectonics (COMET, ref.: come30001) and the LICS and CEDRRiC projects (ref. NE/K010794/1 and NE/N012151/1, respectively), the ESA-MOST DRAGON-3 projects (ref. 10607 and 10665), the ESA-MOST DRAGON-4 project (ref. 32244) and the Open Fund from the Key Laboratory of Earth Fissures Geological Disaster, Ministry of Land and Resources (ref.: gla2013001)

U-Duality and Integral Structures

We analyze the U-duality group for the case of a type II superstring compactified to four dimensions on a K3 surface times a torus. The various limits of this theory are considered which have interpretations as type IIA and IIB superstrings, the heterotic string, and eleven-dimensional supergravity, allowing all these theories to be directly related to each other. The integral structure which appears in the Ramond-Ramond sector of the type II superstring is related to the quantum cohomology of general Calabi-Yau threefolds which allows the moduli space of type II superstring compactifications on Calabi-Yau manifolds to be analyzed.Comment: 14 pages, latex once only (Revision has minor changes and an added reference

The Dilemma of Diagnosing Type-2 Diabetes Mellitus [T2DM] in Overweight Children and Adolescents

American Diabetes Association [ADA] has recommended that diabetes should be diagnosed when HbA1c is ?6.5%. Subjects with HbA1c of 6.0 to < 6.5% were at the highest-risk for developing diabetes. Objectives: To determine the sensitivity and specificity of HbA1c ? 6.5% to diagnose Type 2 Diabetes Mellitus [T2DM] in overweight children and the adolescents as compared to an oral glucose tolerance test. Retrospective chart review was done from January 2004-December 2008, and search criteria included overweight children who had OGTT and HbA1c done. Based on OGGT we divided the data into normal, impaired and diabetic groups. The results shows that HbA1c cut-off of ? 6.5% had a specificity of 96% and a sensitivity of 40% in accurately diagnosing patients with T2DM. Sixty percent of T2DM and 44.60% of impaired OGTT subjects would show a normal glycemic status if only HbA1c is used to diagnose them. Homeostasis Model of Assessment - Insulin Resistance [HOMA-IR], Quantitative Insulin Sensitivity Check Index [QUICKI] and HbA1c levels were statistically significant between normal versus diabetic and normal versus impaired groups [p<0.05]. Due to the low sensitivity of the HbA1c test in diagnosing diabetes, it may result in missed or delayed diagnosis of T2DM if used exclusively to diagnose diabetes