Burden of liver disease progression in hospitalized patients with type 2 diabetes mellitus

BACKGROUND AND AIMS: There are uncertainties on the burden of liver disease in patients with type-2 diabetes (T2D). METHODS: We measured adjusted hazard ratios of liver disease progression to hepatocellular cancer and/or decompensated cirrhosis in a 2010-2020 retrospective, bicentric, longitudinal, cohort of 52,066 hospitalized patients with T2D. RESULTS: Mean age was 64±14 years and 58% were men. Alcohol use disorders accounted for 57% of liver-related complications and were associated with all liver-related risk factors. Non-metabolic liver-related risk factors accounted for 37% of the liver burden. T2D control was not associated with liver disease progression. The incidence (95% confidence interval) of liver-related complications and of competing mortality were 3.9 (3.5-4.3) and 27.8 (26.7-28.9) per 1000 person-years at risk, respectively. The cumulative incidence of liver disease progression exceeded the cumulative incidence of competing mortality only in the presence of a well-identified risk factors of liver disease progression, including alcohol use. The incidence of hepatocellular cancer was 0.3 (95% CI, 0.1-0.5) per 1000 person-year in patients with obesity and it increased with age. The adjusted hazard ratios of liver disease progression were 55.7 (40.5-76.6), 3.5 (2.3-5.2), 8.9 (6.9-11.5), and 1.5 (1.1-2.1), for alcoholic liver disease, alcohol use disorders without alcoholic liver disease, non-metabolic liver-related risk factors, and obesity, respectively. The attributable fractions of alcohol use disorders, non-metabolic liver risk-related risk factors, and obesity to the liver burden were 55%, 14%, and 7%, respectively. CONCLUSIONS: In this analysis of data from two hospital-based cohorts of patients with T2D, alcohol use disorders, rather than obesity, contributed to most of the liver burden. These results suggest that patients with T2D should be advised to drink minimal amounts of alcohol. LAY SUMMARY: • There is uncertainty on the burden of liver-related complications in patients with type-2 diabetes • We studied the risks of liver cancer and complications of liver disease in over 50,000 patients with type-2 diabetes • We found that alcohol was the main factor associated with complications of liver disease • This finding has major implications on the alcohol advice given to patients with type-2 diabetes

Rapid expansion and international spread of M1 UK in the post-pandemic UK upsurge of Streptococcus pyogenes

The UK observed a marked increase in scarlet fever and invasive group A streptococcal infection in 2022 with severe outcomes in children and similar trends worldwide. Here we report lineage M1UK to be the dominant source of invasive infections in this upsurge. Compared with ancestral M1global strains, invasive M1UK strains exhibit reduced genomic diversity and fewer mutations in two-component regulator genes covRS. The emergence of M1UK is dated to 2008. Following a bottleneck coinciding with the COVID-19 pandemic, three emergent M1UK clades underwent rapid nationwide expansion, despite lack of detection in previous years. All M1UK isolates thus-far sequenced globally have a phylogenetic origin in the UK, with dispersal of the new clades in Europe. While waning immunity may promote streptococcal epidemics, the genetic features of M1UK point to a fitness advantage in pathogenicity, and a striking ability to persist through population bottlenecks

q-deformed and c-Deformed Harmonic Oscillators

Hamilton functions of classical deformed oscillators (c-deformed oscillators) are derived from Hamiltonians of g-deformed oscillators of the Macfarlane and Dubna types. A new scale parameter, lq, with the dimension of length, is introduced to relate a dimensionless parameter characterizing the deformation with the natural length of the harmonic oscillator. Contraction from q-deformed oscillators to c-deformed oscillators is accomplished by keeping lq finite while taking the limit ℏ → 0. The c-deformed Hamilton functions for both types of oscillators are found to be invariant under discrete translations: the step of the translation for the Dubna oscillator is half of that for the Macfarlane oscillator. The c-deformed oscillator of the Macfarlane type has propagating solutions in addition to localized ones. Reinvestigation of the g-deformed oscillator carried out in the light of these findings for the c-deformed systems proves that the g-deformed systems are invariant under the same translation symmetries as the c-deformed systems and have propagating waves of the Bloch typ

Motion Planning for an Articulated Body in a Perfect Planar Fluid ∗

Abstract. Understanding fish-like locomotion as a result of internal shape changes may result in improved underwater propulsion mechanisms. We use a geometric framework to consider the simplified problem of an articulated two-dimensional body in a potential flow. This paper builds upon the current geometric theory by showing that although the group of Euclidean transformations is non-Abelian, certain tools available for Abelian groups may still be exploited, making use of the semidirect-product structure of this group. In particular, the holonomy in the rotation component may be explicitly computed as a function of the area enclosed by a path in shape space. We use this tool to develop open-loop gaits for an articulated body with two shape variables, using plots of the curvature of the mechanical connection, which relates motion in the shape space to motion of the overall body. Results from numerical computations of the mechanical connection are compared to theoretical results assuming the joints are hydrodynamically decoupled. Finally, we consider a simple method for trajectory tracking in the plane, using a one-parameter family of gaits

MOTION PLANNING FOR AN ARTICULATED BODY IN A PERFECT FLUID

Abstract. Understanding fish-like locomotion as a result of internal shape changes may result in improved underwater propulsion mechanisms. We use a geometric framework to consider the simplified problem of an articulated two-dimensional body in a potential flow. This paper builds upon the current geometric theory by showing that although the group of Euclidean transformations is non-Abelian, certain tools available for Abelian groups may still be exploited, making use of the semidirect-product structure of this group. In particular, the holonomy in the rotation component may be explicitly computed as a function of the area enclosed by a path in shape space. We use this tool to develop open-loop gaits for an articulated body with two shape variables, using plots of the curvature of the mechanical connection, which relates motion in the shape space to motion of the overall body. Results from numerical computations of the mechanical connection are compared to theoretical results assuming the joints are hydrodynamically decoupled. Finally, we consider a simple method for trajectory tracking in the plane, using a one-parameter family of gaits

Micromixing and Co-Precipitation in Continuous Microreactors with Swirled Flows and Microreactors with Impinging Swirled Flows

One of the promising methods for process intensification for micromixing, co-precipitation, and crystallization in continuous reactors is the use of vigorous vortices. A combination of the high intensity of the kinetic energy input with the small volume of the micromixing volume allows to concentrate the energy dissipation rate up to 104 W/kg and more. As the embodiment of such an idea, four new types of microreactors with intensively swirled flows were created and studied as a tool for continuous co-precipitation and crystallization. A correlation between residence time and segregation index was found: the smaller residence time, the higher energy dissipation rate and better quality of micromixing. A method for the synthesis of oxides of a number of transition metals in microreactors with intensively swirled flows with subsequent thermal treatment of co-precipitation products has been developed. This method was used to obtain ensembles of nanosized particles of zirconium oxides, as well as calcium and strontium fluorides. In comparison with the currently widely used hydro- and solvothermal methods, the proposed method has high productivity (around 10 m3/day for lab scale device), can significantly reduce the duration of the process, provides low energy consumption, does not require a large number of labor-intensive operations, is technologically advanced and easily scalable

11 septembre 2012 : Story Telling d'une renaissance

Le Huffington Pos