Upper quantum Lyapunov Exponent and Anosov relations for quantum systems driven by a classical flow

We generalize the definition of quantum Anosov properties and the related Lyapunov exponents to the case of quantum systems driven by a classical flow, i.e. skew-product systems. We show that the skew Anosov properties can be interpreted as regular Anosov properties in an enlarged Hilbert space, in the framework of a generalized Floquet theory. This extension allows us to describe the hyperbolicity properties of almost-periodic quantum parametric oscillators and we show that their upper Lyapunov exponents are positive and equal to the Lyapunov exponent of the corresponding classical parametric oscillators. As second example, we show that the configurational quantum cat system satisfies quantum Anosov properties.Comment: 17 pages, no figur

Once-Weekly Exenatide Versus Once- or Twice-Daily Insulin Detemir: Randomized, open-label, clinical trial of efficacy and safety in patients with type 2 diabetes treated with metformin alone or in combination with sulfonylureas

OBJECTIVEdThis multicenter, open-label, parallel-arm study compared the efficacy and safety of exenatide once weekly (EQW) with titrated insulin detemir in patients with type 2 diabetes inadequately controlled with metformin (with or without sulfonylureas). RESEARCH DESIGN AND METHODSdPatients were randomized to EQW (2 mg) or detemir (once or twice daily, titrated to achieve fasting plasma glucose #5.5 mmol/L) for 26 weeks. The primary outcome was proportion of patients achieving A1C #7.0% and weight loss $1.0 kg at end point, analyzed by means of logistic regression. Secondary outcomes included measures of glycemic control, cardiovascular risk factors, and safety and tolerability. RESULTSdOf 216 patients (intent-to-treat population), 111 received EQW and 105 received detemir. Overall, 44.1% (95% CI, 34.7–53.9) of EQW-treated patients compared with 11.4% (6.0–19.1) of detemir-treated patients achieved the primary outcome (P , 0.0001). Treatment with EQW resulted in significantly greater reductions than detemir in A1C (least-square mean 6 SE, 21.30 6 0.08% vs. 20.88 6 0.08%; P , 0.0001) and weight (22.7 6 0.3 kg vs. +0.8 6 0.4 kg; P , 0.0001). Gastrointestinal-related and injection site–related adverse events occurred more frequently with EQW than with detemir. There was no major hypoglycemia in either group. Five (6%) patients in the EQW group and six (7%) patients in the detemir group experienced minor hypoglycemia; only one event occurred without concomitant sulfonylureas (detemir group). CONCLUSIONSdTreatment with EQW resulted in a significantly greater proportion of patients achieving target A1C and weight loss than treatment with detemir, with a low risk of hypoglycemia. These results suggest that EQW is a viable alternative to insulin detemir treatment in patients with type 2 diabetes with inadequate glycemic control using oral antidiabetes drugs

Bioaccumulation of perfluoroalkyl compounds in midge (Chironomus riparius) larvae exposed to sediment

Midge larvae (Chironomus riparius) were exposed to sediments from a deposition sampled at a site along the Rhône River (France) downstream of an industrial site releasing various perfluorinated chemicals. This sediment is characterized by high concentrations of perfluoroundecanoic acid (PFUnA) and perfluorotridecanoic acid (PFTrDA) and a low perfluorooctane sulfonate (PFOS) concentration. Concentrations of 23 perfluoroalkyl compounds, including C4eC14 carboxylate acids, C4eC10 sulfonates, and seven precursors, were analyzed in overlying and pore water, sediment, and larvae. Midge larvae accumulated carboxylate acids (C11eC14), PFOS, and two precursors (perfluorooctane sulfonamide: FOSA and 6:2 fluorotelomer sulfonic acid, 6:2 FTSA). These substances accumulated mainly during the fourth instar larvae exponential growth phase. Accumulation of 6:2 FTSA, PFUnA, and PFOS occured via trophic and tegumentary routes. Other compounds mainly accumulated from food. Kinetics followed a partition model, from which uptake and elimination constants were derived

The Real-World Observational Prospective Study of Health Outcomes with Dulaglutide and Liraglutide in Type 2 Diabetes Patients (TROPHIES): Baseline Patient-Reported Outcomes

Introduction: Although patient-reported outcome (PRO) measures provide important information beyond clinical data, studies that assess the PROs of type 2 diabetes mellitus (T2DM) patients initiating injectable glucose-lowering medications in routine clinical practice are limited. We describe the perspectives of patients based on a diversified panel of generic and disease-specific PRO measures at the time of enrollment (baseline) in the TROPHIES study. Methods: TROPHIES is a 24-month prospective observational study performed in France, Germany, and Italy in patients with T2DM who initiated their first injectable glucose-lowering medication with once-weekly dulaglutide or once-daily liraglutide. To better understand the perspectives of these patients regarding their overall health, treatment satisfaction, and quality of life and work, the patients’ responses to the following questionnaires were collected at baseline before they initiated treatment with dulaglutide or liraglutide: EQ-5D-5L (scale: 0–1), EQ-VAS (visual analog scale: 0–100), Impact of Weight on Self-Perceptions Questionnaire (IW-SP; scale: 0–100), Diabetes Treatment Satisfaction Questionnaire Status (DTSQs; scale: 0–36), and Diabetes Productivity Measure (DPM; scale: 0–100). Analyses were descriptive in nature, with higher scores reflecting better outcomes. Results: Data from patients at the time of enrollment were analyzed. At baseline, patients initiating dulaglutide (N = 1130) or liraglutide (N = 1051) rated their quality of life in terms of mean EQ-5D-5L index as 0.84 and 0.83, and in terms of mean EQ-VAS as 67.5 and 67.5, respectively. The mean baseline scores in patients initiating dulaglutide or liraglutide were 59.8 and 61.3 for IW-SP, 24.6 and 25.8 for DTSQs, 78.6 and 79.5 for DPM Life Productivity, and 87.5 and 86.8 for DPM Work Productivity, respectively. Conclusion: The information from this varied panel of PRO instruments collected at baseline complements clinical outcomes data

The Real-World Observational Prospective Study of Health Outcomes with Dulaglutide and Liraglutide in Type 2 Diabetes Patients (TROPHIES): Design and Baseline Characteristics

Introduction: The TROPHIES observational study enrolled patients with type 2 diabetes mellitus (T2DM) initiating their first injectable treatment with the glucagon-like peptide 1 receptor agonists (GLP-1 RAs) dulaglutide or liraglutide. This manuscript focuses on the study design, baseline characteristics of the enrolled population, and factors associated with GLP-1 RA choice. Methods: TROPHIES is a prospective, observational, 24-month study conducted in France, Germany, and Italy. Inclusion criteria include adult patients with T2DM, naïve to injectable antihyperglycemic treatments, initiating dulaglutide or liraglutide per routine clinical practice. The primary outcome is the duration of treatment on dulaglutide or liraglutide without a significant treatment change. Results: The analysis included 2181 patients (dulaglutide, 1130; liraglutide, 1051) (cutoff date May 15, 2019). The population was 56% male with mean [standard deviation (SD)] patient characteristics at baseline as follows: age, 59.2 (11.0) years; body mass index (BMI), 33.9 (6.6) kg/m2; T2DM duration, 8.5 (6.9) years; and glycated hemoglobin (HbA1c), 8.2 (1.3)%. Between-cohort demographic and clinical characteristics were balanced. The mean (SD) HbA1c and BMI values for French, German, and Italian patients were, respectively, 8.6 (1.4)%, 8.2 (1.4)%, 8.0 (0.8)%; 33.3 (6.1) kg/m2, 36.0 (7.2) kg/m2, and 32.6 (5.9) kg/m2. Conclusion: This study analysis at baseline provides an opportunity to evaluate between-country differences in baseline HbA1c, weight, macrovascular complications, and factors driving GLP-1 RA selection for patients with T2DM in daily practice

Comorbidity of Symptoms of Alcohol and Cannabis Use Disorders among a Population-Based Sample of Simultaneous Users. Insight from a Network Perspective.

Research into comorbidity of alcohol and cannabis use disorders has resulted in inconsistent findings, especially among simultaneous users, who used alcohol and cannabis together on a single occasion. This study investigated the association of alcohol and cannabis use disorders among simultaneous users using a network perspective, which considers direct relationships between symptoms. We used a subset of simultaneous alcohol and cannabis users driven from the representative population-based sample of young Swiss men cohort study on substance use risk factors (C-SURF) (n = 1559 at baseline and n = 991 at follow-up). Self-reported symptoms of alcohol and cannabis use disorders were collected. Network analyses included network estimation, visualization, and community detection tests. Alcohol and cannabis use symptoms were separated in two distinct clusters, with few paths between them (eleven positive edges at baseline, three at follow-up). Withdrawal symptoms were likely to connect the two disorders at baseline, but not at follow-up. Alcohol and cannabis use disorders appeared as separate disorders among simultaneous users. Our findings mitigated previous findings on the detrimental association between alcohol and cannabis use. Future studies should incorporate network analyses as a means to study comorbidity in other community and clinical samples to confirm our preliminary findings

Cellular automaton supercolliders

Gliders in one-dimensional cellular automata are compact groups of non-quiescent and non-ether patterns (ether represents a periodic background) translating along automaton lattice. They are cellular-automaton analogous of localizations or quasi-local collective excitations travelling in a spatially extended non-linear medium. They can be considered as binary strings or symbols travelling along a one-dimensional ring, interacting with each other and changing their states, or symbolic values, as a result of interactions. We analyse what types of interaction occur between gliders travelling on a cellular automaton `cyclotron' and build a catalog of the most common reactions. We demonstrate that collisions between gliders emulate the basic types of interaction that occur between localizations in non-linear media: fusion, elastic collision, and soliton-like collision. Computational outcomes of a swarm of gliders circling on a one-dimensional torus are analysed via implementation of cyclic tag systems

Operational optimisation of a non-recuperative 1-kWe organic Rankine cycle engine prototype

Several heat-to-power conversion technologies are being proposed as suitable for waste-heat recovery (WHR) applications, including thermoelectric generators, hot-air (e.g., Ericsson or Stirling) engines and vapour-cycle engines such as steam or organic Rankine cycle (ORC) power systems. The latter technology has demonstrated the highest efficiencies at small and intermediate scales and low to medium heat-source temperatures and is considered a suitable option for WHR in relevant applications. However, ORC systems experience variations in performance at part-load or off-design conditions, which need to be predicted accurately by empirical or physics-based models if one is to assess accurately the techno-economic potential of such ORC-WHR solutions. This paper presents results from an experimental investigation of the part-load performance of a 1-kWe ORC engine, operated with R245fa as a working fluid, with the aim of producing high-fidelity steady-state and transient data relating to the operational performance of this system. The experimental apparatus is composed of a rotary-vane pump, brazed-plate evaporator and condenser units and a scroll expander magnetically coupled to a generator with an adjustable resistive load. An electric heater is used to provide a hot oil-stream to the evaporator, supplied at three different temperatures in the current study: 100, 120 and 140 ∘ C. The optimal operating conditions, that is, pump speed and expander load, are determined at various heat-source conditions, thus resulting in a total of 124 steady-state data points used to analyse the part-load performance of the engine. A maximum thermal efficiency of 4.2 ± 0.1% is reported for a heat-source temperature of 120 ∘ C, while a maximum net power output of 508 ± 2 W is obtained for a heat-source temperature at 140 ∘ C. For a 100- ∘ C heat source, a maximum exergy efficiency of 18.7 ± 0.3% is achieved. A detailed exergy analysis allows us to quantify the contribution of each component to the overall exergy destruction. The share of the evaporator, condenser and expander components are all significant for the three heat-source conditions, while the exergy destroyed in the pump is negligible by comparison (below 4%). The data can be used for the development and validation of advanced models capable of steady-state part-load and off-design performance predictions, as well as predictions of the transient/dynamic operation of ORC systems.</jats:p

Outcome of alimentary tract duplications operated on by minimally invasive surgery: a retrospective multicenter study by the GECI (Groupe d&#039;Etude en Coeliochirurgie Infantile).

BACKGROUND: Alimentary tract duplications (ATD) are a rare cause of intestinal obstruction in childhood. There are many case reports but few series about laparoscopy or thoracoscopy for ATD. The aim of our study was to report the outcome of minimally invasive surgery (MIS) for ATD. METHODS: This was a retrospective multicenter study from the GECI (Groupe d\u27Etude en Coeliochirurgie Infantile). We reviewed the charts of 114 patients operated on by MIS for ATD from 1994 to 2009. RESULTS: Sixty-two patients (54 %) had a prenatal diagnosis. Forty-nine patients (43 %) were symptomatic before surgery: 33 of those patients (63 %) with postnatal diagnosis compared to 16 (25 %) with prenatal diagnosis (P &lt; 0.01). In this last group, the median age at onset of symptoms was 16 days (range = 0-972). One hundred and two patients had laparoscopy (esophageal to rectal duplications) and 12 patients had thoracoscopy for esophageal duplications. The mean operative time was 90 min (range = 82-98). There were 32 (28 %) resection anastomoses, 55 (48 %) enucleations, and 27 (24 %) unroofings. The conversion rate was 32 %, and in a multivariate analysis, it was significantly higher, up to 41 % for patients weighing &lt;10 kg (P &lt; 0.01). Ten patients (8 %) had unintentional perioperative opening of the digestive tract during the dissection. Eight patients had nine postoperative complications, including six small bowel obstructions. The median length of hospital stay was 4 days (range = 1-21) without conversion and 6 days (range = 1-27) with conversion (P = 0.01). The median follow-up was 3 months (range = 1-120). Eighteen of the 27 patients who underwent partial surgery had an ultrasound examination during follow-up. Five (18 %) of them had macroscopic residue. CONCLUSION: This study showed that MIS for ATD is feasible with a low rate of complications. Patients with prenatal diagnosis should have prompt surgery to prevent symptoms, despite a high rate of conversion in small infants