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

Supersymmetric Triplet Higgs Model of Neutrino Masses and Leptogenesis

We construct a supersymmetric version of the triplet Higgs model for neutrino masses, which can generate a baryon asymmetry of the Universe through lepton-number violation and is consistent with the gravitino constraints.Comment: 24 pages, 4 figure

Gravitino constraints on models of neutrino masses and leptogenesis

In the supersymmetric extensions of the standard model, neutrino masses and leptogenesis requires existence of new particles. We point out that if these particles with lepton number violating interactions have standard model gauge interactions, then they may not be created after reheating because of the gravitino problem. This will rule out all existing models of neutrino masses and leptogenesis, except the one with right-handed singlet neutrinos.Comment: 12 pages latex file with one postscript figur

Spatially resolved observations of a split-band coronal type-II radio burst

Context. The origin of coronal type-II radio bursts and of their band-splitting are still not fully understood. Aims. To make progress in solving this problem on the basis of one extremely well observed solar eruptive event. Methods. The relative dynamics of multi-thermal eruptive plasmas, observed in detail by the SDO/AIA and of the harmonic type-II burst sources, observed by the NRH at ten frequencies from 445 to 151 MHz, is studied for the partially behind the limb event on 3 November 2010. Special attention is given to the band-splitting of the burst. Analysis is supplemented by investigation of coronal hard X-ray (HXR) sources observed by the RHESSI. Results. It is found that the flare impulsive phase was accompanied by the formation of a double coronal HXR source, whose upper part coincided with the hot (T~10 MK) eruptive plasma blob. The leading edge (LE) of the eruptive plasmas (T~1-2 MK) moved upward from the flare region with the speed of v=900-1400 km/s. The type II burst source initially appeared just above the LE apex and moved with the same speed and in the same direction. After about 20 s it started to move about twice faster, but still in the same direction. At any given moment the low frequency component (LFC) source of the splitted type-II burst was situated above the high frequency component (HFC) source, which in turn was situated above the LE. It is also found that at a given frequency the HFC source was located slightly closer to the photosphere than the LFC source. Conclusions. The shock wave, which could be responsible for the observed type-II radio burst, was initially driven by the multi-temperature eruptive plasmas, but later transformed to a freely propagating blast shock wave. The most preferable interpretation of the type-II burst splitting is that its LFC was emitted from the upstream region of the shock, whereas the HFC - from the downstream region.Comment: 14 pages, 10 figure

Loop Quantum Gravity and the The Planck Regime of Cosmology

The very early universe provides the best arena we currently have to test quantum gravity theories. The success of the inflationary paradigm in accounting for the observed inhomogeneities in the cosmic microwave background already illustrates this point to a certain extent because the paradigm is based on quantum field theory on the curved cosmological space-times. However, this analysis excludes the Planck era because the background space-time satisfies Einstein's equations all the way back to the big bang singularity. Using techniques from loop quantum gravity, the paradigm has now been extended to a self-consistent theory from the Planck regime to the onset of inflation, covering some 11 orders of magnitude in curvature. In addition, for a narrow window of initial conditions, there are departures from the standard paradigm, with novel effects, such as a modification of the consistency relation involving the scalar and tensor power spectra and a new source for non-Gaussianities. Thus, the genesis of the large scale structure of the universe can be traced back to quantum gravity fluctuations \emph{in the Planck regime}. This report provides a bird's eye view of these developments for the general relativity community.Comment: 23 pages, 4 figures. Plenary talk at the Conference: Relativity and Gravitation: 100 Years after Einstein in Prague. To appear in the Proceedings to be published by Edition Open Access. Summarizes results that appeared in journal articles [2-13

Models of Neutrino Masses and Baryogenesis

Majorana masses of the neutrino implies lepton number violation and is intimately related to the lepton asymmetry of the universe, which gets related to the baryon asymmetry of the universe in the presence of the sphalerons during the electroweak phase transition. Assuming that the baryon asymmetry of the universe is generated before the electroweak phase transition, it is possible to dicriminate different classes of models of neutrino masses. While see-saw mechanism and the triplet higgs mechanism are preferred, the Zee-type radiative models and the R-parity breaking models requires additional inputs to generate baryon asymmetry of the universe during the electroweak phase transition.Comment: 27 pages including 5 figures; Review article for Pramana: the Indian Journal of Physic

Phase-Coherent Synthesis of Optical Frequencies and Waveforms

Precision phase control of an ultrawide-bandwidth optical-frequency comb has produced remarkable and unexpected progress in both areas of optical-frequency metrology and ultrafast optics. A frequency comb (with 100 MHz spacing) spanning an entire optical octave (\u3e300 THz) has been produced, corresponding to millions of marks on a frequency “ruler” that are stable at the Hz level. The precision comb has been used to establish a simple optical clock based on an optical transition of iodine molecules, providing an rf clock signal with a frequency stability comparable to that of an optical standard, and which is superior to almost all conventional rf sources. To realize a high-power cw optical frequency synthesizer, a separate, widely tunable single-frequency cw laser has been employed to randomly access the stabilized optical comb and lock to any desired comb component. Carrier-envelope phase stabilization of few-cycle optical pulses has recently been realized. This advance in femtosecond technology is important for both extreme non-linear optics and optical-frequency metrology. With two independent femtosecond lasers, we have not only synchronized their relative pulse timing at the femtosecond level, but have also phase-locked their carrier frequencies, thus establishing phase coherence between the two lasers. By coherently stitching the optical bandwidth together, a “synthesized” pulse has been generated with its 2nd-order autocorrelation signal displaying a shorter width than those of the two “parent” lasers

Epidemiologic Survey of Kawasaki Disease in Jilin from 1999 Through 2008

The epidemiologic pictures of Kawasaki disease (KD) in Jilin Province of China is still not clear. We sent a questionnaire form and diagnostic guidelines for KD to the province's 32 hospitals above the county and city level with pediatric in-patients. All patients with KD diagnosed during January 1999 through December 2008 were recruited in this survey. The incidence of KD was 1.39 to 11.07 (5.26 ± 3.97) per 100,000 children under the age of 5 years between 1999 and 2008. The ratio of male to female was 1.96 to 1. Ages at onset ranged from 58 days to 14 years. Patients under 5 years of age accounted of 88.73%. The disease occurred throughout the year, but it occurred more frequently in May to July and November. The most common cardiac abnormality was coronary artery dilatation (49.5%). Age at onset and hypoalbuminemia (<30 g/l) were selected for multivariate logistic regression equation. In conclusion, incidences of KD increased in Jilin Province. Age and gender distribution shared similarities with previous reports, and the seasonal distribution was different. Age and lower serum albumin were the most important risk factors of coronary arterial lesions (CAL) in KD. In addition, patients treated with steroids also had a possible heightened risk of contracting CAL

Desensitizing Inflation from the Planck Scale

A new mechanism to control Planck-scale corrections to the inflationary eta parameter is proposed. A common approach to the eta problem is to impose a shift symmetry on the inflaton field. However, this symmetry has to remain unbroken by Planck-scale effects, which is a rather strong requirement on possible ultraviolet completions of the theory. In this paper, we show that the breaking of the shift symmetry by Planck-scale corrections can be systematically suppressed if the inflaton field interacts with a conformal sector. The inflaton then receives an anomalous dimension in the conformal field theory, which leads to sequestering of all dangerous high-energy corrections. We analyze a number of models where the mechanism can be seen in action. In our most detailed example we compute the exact anomalous dimensions via a-maximization and show that the eta problem can be solved using only weakly-coupled physics.Comment: 34 pages, 3 figures