Minimizing hypoglycemia while maintaining glycemic control in diabetes

In the accompanying Perspective, Cryer identifies a number of different areas where therapeutic interventions have the potential to reduce hypoglycemia without compromising glycemic control. Some approaches provide well defined clinical benefits, a few offer dramatic reductions in hypoglycemia but remain out of reach for most people while others, although promising have yet to be properly evaluated. (Table 1) In this Perspective, I examine the evidence which underpins these interventions. It is beyond the scope of this article to review the data for each potential intervention in detail but the reader is directed to the appropriate source where appropriate. The Perspective focuses on treatment of Type 1 diabetes as most of the potential specific therapies have been evaluated in this group although I have commented in relation to recent trials of intensive therapy in Type 2 diabetes

Targeting acute hyperglycaemia in clinical practice

The UKPDS established the benefit of tight glycaemic control in preventing microvascular disease but was unable to demonstrate an effect on cardiovascular disease. This may have been due to the limitation of traditional agents which were unable to maintain particularly tight glycaemic control in the participants. A number of new oral agents and insulins are now available and show promise in achieving better glycaemic control which is maintained for longer. Side effects of weight gain and hypoglycaemia may also be less frequent and some of the new therapies have direct effects on post-prandial glucose. However the precise clinical benefit of new treatments has yet to be established, particularly in terms of relevant clinical outcomes such as death or cardiovascular disease. Many of the existing data are derived from regulatory studies which establish safety and equivalence and do not often define clinical benefit or value for money. However, some trials which do measure relevant endpoints are in progress and are due to report in the next few years. It seems likely that many of the new treatments will supplant existing therapy and the hope is that this will result in better glycaemic control and less micro and macrovascular disease

Noncommutative Dynamics of Random Operators

We continue our program of unifying general relativity and quantum mechanics in terms of a noncommutative algebra ${\cal A}$ on a transformation groupoid $\Gamma = E \times G$ where $E$ is the total space of a principal fibre bundle over spacetime, and $G$ a suitable group acting on $\Gamma$. We show that every $a \in {\cal A}$ defines a random operator, and we study the dynamics of such operators. In the noncommutative regime, there is no usual time but, on the strength of the Tomita-Takesaki theorem, there exists a one-parameter group of automorphisms of the algebra ${\cal A}$ which can be used to define a state dependent dynamics; i.e., the pair $({\cal A}, \phi)$, where $\phi$ is a state on ${\cal A}$, is a ``dynamic object''. Only if certain additional conditions are satisfied, the Connes-Nikodym-Radon theorem can be applied and the dependence on $\phi$ disappears. In these cases, the usual unitary quantum mechanical evolution is recovered. We also notice that the same pair $({\cal A}, \phi)$ defines the so-called free probability calculus, as developed by Voiculescu and others, with the state $\phi$ playing the role of the noncommutative probability measure. This shows that in the noncommutative regime dynamics and probability are unified. This also explains probabilistic properties of the usual quantum mechanics.Comment: 13 pages, LaTe

The Work Ethic

[Excerpt] In everyday usage of the term \u27Work Ethic\u27 is almost indistinguishable from work satisfaction or simply attitudes to work. Do people value work or not, or are they in various degrees indifferent to it? Since most adults are expected to work and most do in order to make a living, the work ethic in this popular use of the term is, on average, positive for most people. Nevertheless there are bound to be variations in this average and in the distribution around the average for different groups of people

A feasibility assessment of installation, operation and disposal options for nuclear reactor power system concepts for a NASA growth space station

A preliminary feasibility assessment of the integration of reactor power system concepts with a projected growth space station architecture was conducted to address a variety of installation, operational disposition, and safety issues. A previous NASA sponsored study, which showed the advantages of space station - attached concepts, served as the basis for this study. A study methodology was defined and implemented to assess compatible combinations of reactor power installation concepts, disposal destinations, and propulsion methods. Three installation concepts that met a set of integration criteria were characterized from a configuration and operational viewpoint, with end-of-life disposal mass identified. Disposal destinations that met current aerospace nuclear safety criteria were identified and characterized from an operational and energy requirements viewpoint, with delta-V energy requirement as a key parameter. Chemical propulsion methods that met current and near-term application criteria were identified and payload mass and delta-V capabilities were characterized. These capabilities were matched against concept disposal mass and destination delta-V requirements to provide the feasibility of each combination

Anatomy of Malicious Singularities

As well known, the b-boundaries of the closed Friedman world model and of Schwarzschild solution consist of a single point. We study this phenomenon in a broader context of differential and structured spaces. We show that it is an equivalence relation $\rho$, defined on the Cauchy completed total space $\bar{E}$ of the frame bundle over a given space-time, that is responsible for this pathology. A singularity is called malicious if the equivalence class $[p_0]$ related to the singularity remains in close contact with all other equivalence classes, i.e., if $p_0 \in \mathrm{cl}[p]$ for every $p \in E$. We formulate conditions for which such a situation occurs. The differential structure of any space-time with malicious singularities consists only of constant functions which means that, from the topological point of view, everything collapses to a single point. It was noncommutative geometry that was especially devised to deal with such situations. A noncommutative algebra on $\bar{E}$, which turns out to be a von Neumann algebra of random operators, allows us to study probabilistic properties (in a generalized sense) of malicious singularities. Our main result is that, in the noncommutative regime, even the strongest singularities are probabilistically irrelevant.Comment: 16 pages in LaTe

Red yeasts from leaf surfaces and other habitats : three new species and a new combination of Symmetrospora (Pucciniomycotina, Cystobasidiomycetes)

A

Eigenvalue distribution of the Dirac operator at finite temperature with (2+1)-flavor dynamical quarks using the HISQ action

We report on the behavior of the eigenvalue distribution of the Dirac operator in (2+1)-flavor QCD at finite temperature, using the HISQ action. We calculate the eigenvalue density at several values of the temperature close to the pseudocritical temperature. For this study we use gauge field configurations generated on lattices of size $32^3 \times 8$ with two light quark masses corresponding to pion masses of about 160 and 115 MeV. We find that the eigenvalue density below $T_c$ receives large contributions from near-zero modes which become smaller as the temperature increases or the light quark mass decreases. Moreover we find no clear evidence for a gap in the eigenvalue density up to 1.1$T_c$. We also analyze the eigenvalue density near $T_c$ where it appears to show a power-law behavior consistent with what is expected in the critical region near the second order chiral symmetry restoring phase transition in the massless limit.Comment: 7 pages, 7 figures, talk presented at the XXIX International Symposium on Lattice Field Theory, July 10-16 2011, Squaw Valley, Lake Tahoe, California, US

Technology transfer - A selected bibliography

Selected bibliography on technology transfe