A missed diagnosis. A missed opportunity for community integration

The quality of life of people with learning disability and epilepsy, in the community, can be improved by regular review and appropriate use of anti-convulsants. This paper reports two successful outcomes using a newer anti-convulsant, lamotrigine

Process modelling for Space Station experiments

Examined here is the sensitivity of a variety of space experiments to residual accelerations. In all the cases discussed the sensitivity is related to the dynamic response of a fluid. In some cases the sensitivity can be defined by the magnitude of the response of the velocity field. This response may involve motion of the fluid associated with internal density gradients, or the motion of a free liquid surface. For fluids with internal density gradients, the type of acceleration to which the experiment is sensitive will depend on whether buoyancy driven convection must be small in comparison to other types of fluid motion, or fluid motion must be suppressed or eliminated. In the latter case, the experiments are sensitive to steady and low frequency accelerations. For experiments such as the directional solidification of melts with two or more components, determination of the velocity response alone is insufficient to assess the sensitivity. The effect of the velocity on the composition and temperature field must be considered, particularly in the vicinity of the melt-crystal interface. As far as the response to transient disturbances is concerned, the sensitivity is determined by both the magnitude and frequency of the acceleration and the characteristic momentum and solute diffusion times. The microgravity environment, a numerical analysis of low gravity tolerance of the Bridgman-Stockbarger technique, and modeling crystal growth by physical vapor transport in closed ampoules are discussed

A probabilistic approach to some results by Nieto and Truax

In this paper, we reconsider some results by Nieto and Truax about generating functions for arbitrary order coherent and squeezed states. These results were obtained using the exponential of the Laplacian operator; more elaborated operational identities were used by Dattoli et al. \cite{Dattoli} to extend these results. In this note, we show that the operational approach can be replaced by a purely probabilistic approach, in the sense that the exponential of derivatives operators can be identified with equivalent expectation operators. This approach brings new insight about the kinks between operational and probabilistic calculus.Comment: 2nd versio

The need to implement nonindustry COVID-19 clinical trials in non-high-income countries

The online version of this article contains supplementary materia

On some entropy functionals derived from R\'enyi information divergence

We consider the maximum entropy problems associated with R\'enyi $Q$-entropy, subject to two kinds of constraints on expected values. The constraints considered are a constraint on the standard expectation, and a constraint on the generalized expectation as encountered in nonextensive statistics. The optimum maximum entropy probability distributions, which can exhibit a power-law behaviour, are derived and characterized. The R\'enyi entropy of the optimum distributions can be viewed as a function of the constraint. This defines two families of entropy functionals in the space of possible expected values. General properties of these functionals, including nonnegativity, minimum, convexity, are documented. Their relationships as well as numerical aspects are also discussed. Finally, we work out some specific cases for the reference measure $Q(x)$ and recover in a limit case some well-known entropies

Glucose-stimulated insulin response in pregnant sheep following acute suppression of plasma non-esterified fatty acid concentrations

BACKGROUND: Elevated non-esterified fatty acids (NEFA) concentrations in non-pregnant animals have been reported to decrease pancreatic responsiveness. As ovine gestation advances, maternal insulin concentrations fall and NEFA concentrations increase. Experiments were designed to examine if the pregnancy-associated rise in NEFA concentration is associated with a reduced pancreatic sensitivity to glucose in vivo. We investigated the possible relationship of NEFA concentrations in regulating maternal insulin concentrations during ovine pregnancy at three physiological states, non-pregnant, non-lactating (NPNL), 105 and 135 days gestational age (dGA, term 147+/- 3 days). METHODS: The plasma concentrations of insulin, growth hormone (GH) and ovine placental lactogen (oPL) were determined by double antibody radioimmunoassay. Insulin responsiveness to glucose was measured using bolus injection and hyperglycaemic clamp techniques in 15 non-pregnant, non-lactating ewes and in nine pregnant ewes at 105 dGA and near term at 135 dGA. Plasma samples were also collected for hormone determination. In addition to bolus injection glucose and insulin Area Under Curve calculations, the Mean Plasma Glucose Increment, Glucose Infusion Rate and Mean Plasma Insulin Increment and Area Under Curve were determined for the hyperglycaemic clamp procedures. Statistical analysis of data was conducted with Students t-tests, repeated measures ANOVA and 2-way ANOVA. RESULTS: Maternal growth hormone, placental lactogen and NEFA concentrations increased, while basal glucose and insulin concentrations declined with advancing gestation. At 135 dGA following bolus glucose injections, peak insulin concentrations and insulin area under curve (AUC) profiles were significantly reduced in pregnant ewes compared with NPNL control ewes (p < 0.001 and P < 0.001, respectively). In hyperglycaemic clamp studies, while maintaining glucose levels not different from NPNL ewes, pregnant ewes displayed significantly reduced insulin responses and a maintained depressed insulin secretion. In NPNL ewes, 105 and 135 dGA ewes, the Glucose Infusion Rate (GIR) was constant at approximately 5.8 mg glucose/kg/min during the last 40 minutes of the hyperglycaemic clamp and the Mean Plasma Insulin Increment (MPII) was only significantly (p < 0.001) greater in NPNL ewes. Following the clamp, NEFA concentrations were reduced by approximately 60% of pre-clamp levels in all groups, though a blunted and suppressed insulin response was maintained in 105 and 135 dGA ewes. CONCLUSIONS: Results suggest that despite an acute suppression of circulating NEFA concentrations during pregnancy, the associated steroids and hormones of pregnancy and possibly NEFA metabolism, may act to maintain a reduced insulin output, thereby sparing glucose for non-insulin dependent placental uptake and ultimately, fetal requirements