The OmniPod Insulin Management System: the latest innovation in insulin pump therapy

This review of insulin pump therapy focuses on the OmniPod® Insulin Management System (Insulet Corp., Bedford, MA, USA). The OmniPod System is the first commercially available “patch pump.” It is a fully integrated wearable pump, controlled wirelessly through a handheld device containing a built-in blood glucose meter. This is an evaluation of the OmniPod System, with the aim of providing an educational tool for physicians who are considering recommending this product to their patients. The review includes a discussion of the traditional insulin pump configuration and its limitations, a detailed overview of the OmniPod System, references to clinical study data, planned product enhancements, its use as an insulin delivery system in the Juvenile Diabetes Research Foundation’s Artificial Pancreas Project, and its use to deliver additional compounds

Transformer-based Time-to-Event Prediction for Chronic Kidney Disease Deterioration

Deep-learning techniques, particularly the transformer model, have shown great potential in enhancing the prediction performance of longitudinal health records. While previous methods have mainly focused on fixed-time risk prediction, time-to-event prediction (also known as survival analysis) is often more appropriate for clinical scenarios. Here, we present a novel deep-learning architecture we named STRAFE, a generalizable survival analysis transformer-based architecture for electronic health records. The performance of STRAFE was evaluated using a real-world claim dataset of over 130,000 individuals with stage 3 chronic kidney disease (CKD) and was found to outperform other time-to-event prediction algorithms in predicting the exact time of deterioration to stage 5. Additionally, STRAFE was found to outperform binary outcome algorithms in predicting fixed-time risk, possibly due to its ability to train on censored data. We show that STRAFE predictions can improve the positive predictive value of high-risk patients by 3-fold, demonstrating possible usage to improve targeting for intervention programs. Finally, we suggest a novel visualization approach to predictions on a per-patient basis. In conclusion, STRAFE is a cutting-edge time-to-event prediction algorithm that has the potential to enhance risk predictions in large claims datasets

How will London change in the 2020s? Five possible scenarios

The convergence of COVID-19 and the endgame of Brexit will change London permanently. They mean that the full extent of economic, social and cultural change likely to take place in the next five to ten years is difficult to predict with accuracy. In order to set out some of the effects of these changes on the London boroughs of Lambeth and Southwark, Tony Travers, Ricky Burdett and Alexandra Zisser (LSE Cities) set out four scenarios in which the capital would change

Auswirkung des Musizierens auf das subjektive Wohlbefinden und das kardiovaskuläre System

Musik führt zu positiven Gefühlen, erhöhter Stimmung und beeinflusst das kardiovaskuläre System. Verschiedene Studie zeigen, dass das Musikmachen stärkere Effekte erzielt, als das Musikhören. Deshalb soll untersucht werden, inwieweit das Musizieren das subjektive Wohlbefinden und das kardiovaskuläre System beeinflusst. Ein 1x4 Design mit Messwiederholung liegt vor. Die Stichprobe umfasst 22 Personen, die in vier Instrumentengruppen geteilt wird. Zu vier Messzeitpunkten wurde der BASTI und der Trimmel-State vorgegeben. Bezüglich der Physiologie sollen vier Vergleichstunden aus der 24 Stundenaufzeichnung herausgenommen werden. Das Musizieren führt in dieser Untersuchung zu einer Erhöhung der positiven Stimmung und zu einem Absinken der negativen Stimmung. Die HRV ist während des Musizierens höher, als zu den anderen Vergleichsstunden. Es zeigen sich bei den Instrumentengruppen Unterschiede in der Physiologie. Die Schlagzeuger zeigen eine eingeschränkte HRV während des Musizierens. Die positive Stimmung korreliert, wider Erwarten, negativ mit der Gesamtvariabilität (SDNN), aber positiv mit der Variation der RR-Intervalle (pNN50%, rMSSD), die der parasympathischen Aktivität zugeordnet wird. Der negative Affekt korreliert mit beiden negativ

MAMZER/BASTARD: Incorporating Jewish Cantorial Music into Contemporary Opera

This practice-based research supports the creation of my opera MAMZER/BASTARD, a new operatic work for performance by an Orthodox Jewish Cantor and opera singers, staged by the Royal Opera House, Covent Garden. The context for this research project is the doctoral composer-in-residence scheme in association with the Royal Opera House (ROH) and the Guildhall School of Music and Drama (GSMD). The research sets out to explore the juxtaposition of opera and Eastern European Ashkenazi Jewish Orthodox Cantorial Music. It builds upon my personal history and background with Cantorial music traditions and expands on my previous experience in bringing together different genres and musical practices in my stage works. As this musical tradition is little known in the West, the focus of this practice-based research project was to contextualise this musical world in a theatrical and dramatic environment, specifically: 1) examining the tradition of Cantorial Music, in particular its relation with opera and drama; 2) finding an appropriate dramaturgical framework in which to place this music. The methodology used to examine and establish a relationship between the Cantorial Music tradition and my own compositional operatic practice focuses on four key aspects: Found Material, Jewish Prayer Modes, Heritage and Hauntology and Cantorial Improvisation. As will be discussed, a historical connection between opera and Cantorial Music exists; however, to the best of my knowledge, this has never been explored in an impactful way that has resulted in significant new work, contributing to new knowledge and offering an insight into a type of musical tradition largely unknown to western audiences

Dominant ethnicity: from minority to majority

This article argues that the world is in the midst of a long-term transition from dominant minority to dominant majority ethnicity. Whereas minority domination was common in premodern societies, modernity (with its accent on democracy and popular sovereignty) has engendered a shift to dominant majority ethnicity. The article begins with conceptual clarifications. The second section provides a broad overview of the general patterns of ethnic dominance that derive from the logic of modern nationalism and democratisation. The third section discusses remnants of dominant minorities in the modern era and suggests that their survival hinges on peculiar historical and social circumstances coupled with resistance to democratisation. The fourth section shifts the focus to dominant majorities in the modern era and their relationship to national identities. The article ends with a discussion of the fortunes of dominant ethnicity in the West

MICROSTRUCTURAL IMPACT ON ELECTROMIGRATION: A TCAD STUDY

Current electromigration models used for simulation and analysis of interconnect reliability lack the appropriate description of metal microstructure and consequently have a very limited predictive capability. Therefore, the main objective of our work was obtaining more sop histicated electromigration models. The problem is addressed through a combination of different levels of atomistic modeling and already available continuum level macroscopic models. A novel method for an ab initio calculation  of the effective valence for electromigration is presented and its application on the analysis of EM behavior is demonstrated. Additionally, a simple analytical model for the early electromigration lifetime is obtained. We have shown that itsapplication gives a reasonable estimate for the early electromigration failuresincluding the effect of microstructure

Mechanism of completion of peptidyltransferase centre assembly in eukaryotes.

During their final maturation in the cytoplasm, pre-60S ribosomal particles are converted to translation-competent large ribosomal subunits. Here, we present the mechanism of peptidyltransferase centre (PTC) completion that explains how integration of the last ribosomal proteins is coupled to release of the nuclear export adaptor Nmd3. Single-particle cryo-EM reveals that eL40 recruitment stabilises helix 89 to form the uL16 binding site. The loading of uL16 unhooks helix 38 from Nmd3 to adopt its mature conformation. In turn, partial retraction of the L1 stalk is coupled to a conformational switch in Nmd3 that allows the uL16 P-site loop to fully accommodate into the PTC where it competes with Nmd3 for an overlapping binding site (base A2971). Our data reveal how the central functional site of the ribosome is sculpted and suggest how the formation of translation-competent 60S subunits is disrupted in leukaemia-associated ribosomopathies.Bloodwise, MRC, Wellcome Trus