Motor Vehicle Crashes in Diabetic Patients with Tight Glycemic Control: A Population-based Case Control Analysis

Using a population-based case control analysis, Donald Redelmeier and colleagues found that tighter glycemic control, as measured by the HbA1c, is associated with an increased risk of a motor vehicle crash

Patient characteristics.

<p>Data are count (percentage) except where noted as mean (standard deviation).</p>a<p>Includes myocardial infarction.</p>b<p>Includes sweating or any other signal symptom.</p>c<p>Defined as requiring outside assistance.</p

Australian Geography and Strategic and Military Geography

Military geography in Australia is being revived. Under the Institute of Australian Geographers a Strategic and Military Geography Study Group has been formed to contribute some new thinking on military geography. Current themes are: strategic security geography, strategic military geography and military landscape ecology. The initial work of the group is framed by four key tenets: thinking “big picture” and taking a holistic view; using systems thinking; taking a participatory approach and engaging broadly; and using a multi-level learning process that maps across tactical, operational and strategic military domains. These concepts are applied through methodologies such as Systemic Action Research (Burns 2009) and are described in Holloway et al (2015) as an analytical framework that includes physical geography, human geography and cyber-geography. These explorations are firmly based on existing theories and practices in military geography and integrative geography, and seek to consider inter-linked fields such as post-conflict activities and humanitarian aid. The outcomes of the group’s inaugural meeting included consideration of climate change impacts on the military and on security, Defence land management and military ecology, Defence-civilian information sharing and joint operations, teaching and using geography within Defence. Problem based and mission based research, integrated researchThe paper outlines this new thinking, some results and discusses potential opportunities for collaborations with other researchers interested in strategic and military geography

Crash risk in different subgroups.

<p>Each analysis examines correlation of lower HbA1c levels with higher risk of a crash. Results expressed as odds ratio (solid circle) and 95% confidence interval (horizontal line) per 1% point decrease in HbA1c. Analyses of chronic complication subgroups exclude patients reporting corresponding symptom. Results for full cohort appear at bottom and show an odds ratio of 1.26 with 95% confidence interval 1.03–1.54.</p

Copper indium diselenide: crystallography and radiation-induced dislocation loops

Copper indium diselenide (CIS) is a prime candidate as the absorber layer in solar cells for use in extraterrestrial environments due to its good photovoltaic efficiency and ability to resist radiation damage. While CIS-based devices have been tested extensively in the laboratory using electron and proton irradiation, there is still little understanding of the underlying mechanisms which give rise to its radiation hardness. To gain better insight into the response of CIS to displacing radiation, transmission electron microscope samples have been irradiated in situ with 400 keV Xe ions at the Intermediate Voltage Electron Microscope facility at Argonne National Laboratory, USA. At room temperature, dislocation loops were observed to form and grow with increasing fluence. These loops have been investigated using g  ·  b techniques and inside/outside contrast analysis. They have been found to reside on {112} planes and to be interstitial in nature. The Burgers vector were calculated as b  = 1/6 221. The compositional content of these interstitial loops was found to be indistinguishable from the surrounding matrix within the sensitivity of the techniques used. To facilitate this work, experimental electron-diffraction zone-axis pattern maps were produced and these are also presented, along with analysis of the [100] zone-axis pattern

Effect of hydrolyzed infant formula vs conventional formula on risk of type 1 diabetes the TRIGR randomized clinical trial

IMPORTANCE Early exposure to complex dietary proteins may increase the risk of type 117 diabetes in children with genetic disease susceptibility. There are no intact proteins in extensively hydrolyzed formulas. OBJECTIVE To test the hypothesis that weaning to an extensively hydrolyzed formula decreases the cumulative incidence of type 117 diabetes in young children. DESIGN, SETTING, AND PARTICIPANTS An international double-blind randomized clinical trial of 211759 infants with human leukocyte antigen-conferred disease susceptibility and a first-degree relative with type 117 diabetes recruited from May 2002 to January 2007 in 78 study centers in 1175 countries; 11708117 were randomized to be weaned to the extensively hydrolyzed casein formula and 117078 to a conventional formula. The follow-up of the participants ended on February 28, 201177. INTERVENTIONS The participants received either a casein hydrolysate or a conventional adapted cow's milk formula supplemented with 20%of the casein hydrolysate. The minimum duration ofstudy formula exposure was 60 days by6 to 8 months ofage. MAINOUTCOMES ANDMEASURES Primary outcome was type 117 diabetes diagnosed according to World Health Organization criteria. Secondary outcomes included age at diabetes diagnosis and safety (adverse events). RESULTS Among 211759 newborn infants (11702117 female [47.3%]) who were randomized, 117744 (80.8%) completed the trial. The participants were observed for a median of 117117.5 years (quartile [Q] 117-Q3, 1170.2-1172.8). The absolute risk of type 117 diabetes was 8.4% among those randomized tothe casein hydrolysate (n = 9117) vs 7.6% among those randomized to the conventional formula (n = 82) (difference, 0.8% [95% CI, -117.6% to 3.2%]). The hazard ratio for type 117 diabetes adjusted for human leukocyte antigen risk group, duration of breastfeeding, duration of study formula consumption, sex, and region while treating study center as a random effect was 117.117 (95% CI, 0.8 to 117.5; P =.46). The median age at diagnosis of type 117 diabetes was similar in the 2 groups (6.0 years [Q117-Q3, 3.117-8.9] vs 5.8 years [Q117-Q3, 2.6-9.117]; difference, 0.2 years [95% CI, -0.9 to 117.2]). Upper respiratory infections were the most common adverse event reported (frequency, 0.48 events/year in the hydrolysate group and 0.50 events/year in the control group). CONCLUSIONS AND RELEVANCE Among infants at risk for type 117 diabetes, weaning to a hydrolyzed formula compared with a conventional formula did not reduce the cumulative incidence of type 117 diabetes after median follow-up for 117117.5 years. These findings do not support a need to revise the dietary recommendations for infants at risk for type 117 diabetes