Meta-analysis of insulin aspart versus regular human insulin used in a basal-bolus regimen for the treatment of diabetes mellitus

Background: The objective of the current study was to compare the efficacy of two different insulin formulations, insulin aspart (IAsp) and regular human insulin (RHI), for prandial insulin coverage with neutral protamine Hagedorn (NPH) insulin as basal insulin using a meta-analysis approach. The primary endpoint was change in A1c over time. Secondary endpoints included incidence of hypoglycemia and postprandial glycemic control. Methods: Clinical trials (Type 1 and Type 2 diabetes) complying with Good Clinical Practice, and with individual patient data, were included in the meta-analysis. Trials were randomized, consisting of (at least) two treatment arms and had a minimum duration of 12 weeks. Estimates were calculated using fixed-effects and random-effects models. Heterogeneity was assessed for each analysis. The effect of baseline parameters on A1c was analyzed in extended simultaneous models. Results: The mean difference in A1c was 0.1% (95% confidence interval [CI] [−0.15; −0.04], P < 0.001) in favor of IAsp. Higher accumulated dose of IAsp, higher age and increased rates of hypoglycemia were associated with improved A1c outcome. Fasting plasma glucose was not significantly different between regimens. Postprandial glucose was significantly lower after treatment with IAsp compared with RHI, but the analysis did present a significant level of heterogeneity (P < 0.001). The overall rate of hypoglycemia was the same with both regimens, but nocturnal hypoglycemia was significantly lower with IAsp. Conclusions: A basal–bolus regimen with IAsp as bolus insulin provided minimal, but statistically significant, improvement in overall glycemic control with a lower rate of nocturnal hypoglycemic episodes, compared with a corresponding regimen with bolus RHI

Computational modeling of gradient hardening in polycrystals

A gradient hardening crystal plasticity model for polycrystals is introduced in Ekh et al. (2007). It is formulated in a thermodynamically consistent fashion and is capable of modeling a grain-size-dependent stress-strain response. In this contribution we extend that model to also include cross-hardening. A free energy is stated which includes contributions from the gradient of hardening along each slip direction. This leads to hardening stresses depending on the second derivative of the plastic slip. The governing equations for a nonlinear coupled system of equations is solved numerically with the help of a dual-mixed finite element method. The numerical results show that the macroscopic strength increases with decreasing grain size as a result of gradient hardening: Moreover, cross-hardening further enhances the strengthening gradient effect

Numerical modeling of phase-separation in binary media based on the cahn-hilliard equation

In the article numerical procedure for solution of the Cahn-Hilliard equation which is based on the forward Euler method in time and mixed (due to 4th order nature of differential operator) linear finite element formulation in space is described. Numerical examples consist of idealized model with double well potential (in 2 and 3 spatial dimensions) and more physically relevant model with logarithmic potential (in 2D only).У статті описано процедуру наближеного рішення рівняння Кана-Хіллярда в частинних похідних 4-го порядку, котра базується на явному методі Ейлера в часі та змішаній постановці з білінійними скінченими елементами в просторі. Наведено чисельні рішення для ідеалізованої моделі з двуямним потенціалом (в 2-х та 3-х просторових вимірах) та більш фізично релевантної моделі з логарифмічним потенціалом (тільки в 2-х просторових вимірах)

Influence of mountain waves and NAT nucleation mechanisms on Polar Stratospheric Cloud formation at local and synoptic scales during the 1999?2000 Arctic winter

International audienceA scheme for introducing mountain wave-induced temperature pertubations in a microphysical PSC model has been developed. A data set of temperature fluctuations attributable to mountain waves as computed by the Mountain Wave Forecast Model (MWFM-2) has been used for the study. The PSC model has variable microphysics, enabling different nucleation mechanisms for nitric acid trihydrate, NAT, to be employed. In particular, the difference between the formation of NAT and ice particles in a scenario where NAT formation is not dependent on preexisting ice particles, allowing NAT to form at temperatures above the ice frost point, Tice, and a scenario, where NAT nucleation is dependent on preexisting ice particles, is examined. The performance of the microphysical model in the different microphysical scenarios and a number of temperature scenarios with and without the influence of mountain waves is tested through comparisons with lidar measurements of PSCs made from the NASA DC-8 on 23 and 25 January during the SOLVE/THESEO 2000 campaign in the 1999?2000 winter and the effect of mountain waves on local PSC production is evaluated in the different microphysical scenarios. Mountain wave-induced temperature fluctuations are introduced in vortex-covering model runs, extending the full 1999?2000 winter season, and the effect of mountain waves on large-scale PSC production is estimated in the different microphysical scenarios

Modeling and Simulation of 3D EMF Processes

A recent interest in potential industrial applications of electromagnetic forming processes has inspired a demand for adequate simulation tools. Aiming at the virtual design of industrial applications, the purpose of this work is to develop algorithmic formulations particularly suitable to reduce the enormous computational cost inherent to 3D simulations. These formulations comprise a carefully chosen discretization, highly accurate methods for data transfer between electromagnetic and mechanical subsystems, an efficient solid shell formulation, and a termination criterion for the electromagnetic field computation. As a result the simulation time is reduced by about one order of magnitude

Modellierung der Eigenspannungen an der Rißspitze mit einem Schädigungsmodell

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The TNF Receptors p55 and p75 Mediate Chemotaxis of PMN Induced by TNFα and a TNFα 36–62 Peptide

The present study was performed to examine whether residues 36–62 of TNFα contain the chemotactic domain of TNFα, and whether the p55 and p75 TNF receptors are involved in TNFα induced chemotaxis. The chemotactic effect of TNFα on PMN was inhibited by the mAbs Hrt-7b and Utr-1, against the p55 and p75 TNF receptors, respectively. Both receptors may therefore be required for mediating the chemotactic effect of TNFcz. The synthetic TNFα 36–62, similar to TNFα, had chemotactic effects on both PMN and monocytes. The chemotactic activity of the TNFα 36–62 peptide on PMN, was inhibited by Htr-7b, Utr-1 and soluble p55 receptor, which shows that the peptide possessed the ability to induce chemotaxis through the TNF receptors. In contrast to TNFα, the peptide did not show a cytotoxic activity against WEHI 164 flbrosarcoma cells. It is suggested that different domains of the TNFα molecule induce distinct biological effects

Diagnostic validity of fatal cerebral strokes and coronary deaths

Mortality statistics represent important endpoints in epidemiological studies. The diagnostic validity of cerebral stroke and ischemic heart disease recorded as the underlying cause of death in Norwegian mortality statistics was assessed by using mortality data of participants in the Bergen Clinical Blood Pressure Study in Norway and autopsy records from the Gade Institute in Bergen. In the 41 years of the study (1965–2005) 4,387 subjects had died and 1,140 (26%) had undergone a post mortem examination; 548 (12%) died from cerebral stroke and 1,120 (24%) from ischemic heart disease according to the mortality statistics, compared to 113 (10%) strokes and 323 (28%) coronary events registered in the autopsy records. The sensitivity and positive predictive value of fatal cerebral strokes in the mortality statistics were 0.75, 95% confidence interval (CI) [0.66, 0.83] and 0.86 [0.77, 0.92], respectively, whereas those of coronary deaths were 0.87 [0.84, 0.91] and 0.85 [0.81, 0.89] respectively. Cohen’s Kappa coefficients were 0.78 [0.72, 0.84] for stroke and 0.80 [0.76, 0.84] for coronary deaths. In addition to female gender and increasing age at death, cerebral stroke was a negative predictor of an autopsy being carried out (odds ratio (OR) 0.69, 95% CI [0.54, 0.87]), whereas death from coronary heart disease was not (OR 1.14, 95% CI [0.97, 1,33]), both adjusted for gender and age at death. There was substantial agreement between mortality statistics and autopsy findings for both fatal strokes and coronary deaths. Selection for post mortem examinations was associated with age, gender and cause of death.publishedVersio