The Role of Haemoglobin A1c in Screening Obese Children and Adolescents for Glucose Intolerance and Type 2 Diabetes

Introdução: Em 2012, um comité internacional de peritos em diabetes aconselhou a hemoglobina glicada como teste de rastreio de intolerância à glicose e diabetes mellitus tipo 2 no adulto e em idade pediátrica. O objetivo deste estudo foi avaliar a utilidade deste exame numa população de crianças e adolescentes obesos, maioritariamente de etnia caucasiana. Material e Métodos: Foram recrutados 226 doentes [índice de massa corporal z-score 3,35 ± 0,59, 90% caucasianos, 55% do sexo feminino, idade mediana de 12,3 (âmbito: 8,9 – 17,6) anos] referenciados à consulta de obesidade pediátrica de um hospital terciário, com critérios para rastreio de diabetes mellitus tipo 2. Situações de hemoglobinopatia ou de alteração da sobrevida eritrocitária foram excluídas. Todos os indivíduos foram submetidos a uma prova de tolerância à glicose oral e à medição da hemoglobina glicada. Resultados: Segundo a prova de tolerância à glicose oral, 13 (4,9%) eram pré-diabéticos e nenhum diabético. De acordo com a hemoglobina glicada, 32 seriam pré-diabéticos (29 falsos-positivos) e um diabético (falso positivo, sendo este, na realidade, apenas intolerante à glicose). Por outro lado, 10 pré-diabéticos não seriam identificados (falsos-negativos). A área sob a curva receiver operator characteristic analysis da hemoglobina glicada foi 0,59 (IC 95% 0,40 - 0,78), confirmando a sua reduzida capacidade de discriminação para pré-diabetes. Mais promissoras foram as áreas sob as curvas receiver operator characteristic analysis da glicemia em jejum (0,76; IC 95% 0,66 - 0,87), homeostasis model assessment for insulin resistance (0,77; IC 95% 0,64 - 0,90) e razão triglicerídeos: colesterol HDL (0,81; IC 95% 0,66 - 0,96). Discussão: Em Pediatria, particularmente em populações maioritariamente caucasianas, a hemoglobina glicada parece ser uma má ferramenta para diagnóstico de pré-diabetes. Conclusão: Pelo exposto, parece-nos prematura a utilização da hemoglobina glicada com fins diagnósticos até um maior número de estudos estar disponível. O homeostasis model assessment for insulin resistance e a razão triglicerídeos :colesterol HDL demonstraram uma maior exatidão diagnóstica, podendo ser calculados com base numa amostra única em jejum

Structural and magnetic properties of Pr-alloyed MnBi nanostructures

The structural and magnetic properties of Pr-alloyed MnBi (short MnBi-Pr) nanostructures with a range of Pr concentrations have been investigated. The nanostructures include thin films having Pr concentrations 0, 2, 3, 5 and 9 atomic percent and melt-spun ribbons having Pr concentrations 0, 2, 4 and 6 percent respectively. Addition of Pr into the MnBi lattice has produced a significant change in the magnetic properties of these nanostructures including an increase in coercivity and structural phase transition temperature, and a decrease in saturation magnetization and anisotropy energy. The highest value of coercivity measured in the films is 23 kOe and in the ribbons is 5.6 kOe. The observed magnetic properties are explained as the consequences of competing ferromagnetic and antiferromagnetic interactions

Rocks and Hard Places: Exploring Educational Psychologists’ Perspectives on “Off-Rolling” or Illegal Exclusionary Practices in Mainstream Secondary Schools in England

Research being undertaken by the Universities of Exeter and Plymouth is exploring educational psychologists’ knowledge of, and perspectives on, exclusionary practices in schools in England, particularly illegal practices referred to as “off-rolling”. Preliminary findings from the survey element of a mixed methods research project are reported here. The role of business models in the provision of educational psychology services to schools is considered through the conceptual lens of Giroux, Agamben and Ball to highlight ambiguities around the client relationship and to recast individualised ethical dilemmas as systemic features that inhibit direct challenges to school practices relating to inclusion. It is suggested that traded and privatised services risk implicating educational psychologists in schools’ management of the (in)visibility of “off-rolling” and the manufactured legitimacy of varied exclusionary practices

Magnetic behavior of Sm-Co-based permanent magnets during order/disorder phase transformations

The structural transformation from the metastable disordered TbCu7-type SmCo7 structure to the equilibrium ordered Th2Zn17-type Sm2Co17 structure was revealed by x-ray diffraction analysis using Reitveld refinement. The magnetic properties depended strongly on the stage of the transformation, as the coercivity strongly depended on the annealing temperature. The as-solidified alloy in the TbCu7-type structure had a coercivity of 4 kOe, which increased to greater than 9 kOe. The coercivity decreased to around 5 kOe as the transformation neared completion upon annealing at higher temperatures. The magnetization processes were also strongly influenced by the structural state. Initially it was totally controlled by nucleation followed by the domain wall pinning-controlled magnetization process

Magnetic behavior of Sm-Co-based permanent magnets during order/disorder phase transformations

The structural transformation from the metastable disordered TbCu7-type SmCo7 structure to the equilibrium ordered Th2Zn17-type Sm2Co17 structure was revealed by x-ray diffraction analysis using Reitveld refinement. The magnetic properties depended strongly on the stage of the transformation, as the coercivity strongly depended on the annealing temperature. The as-solidified alloy in the TbCu7-type structure had a coercivity of 4 kOe, which increased to greater than 9 kOe. The coercivity decreased to around 5 kOe as the transformation neared completion upon annealing at higher temperatures. The magnetization processes were also strongly influenced by the structural state. Initially it was totally controlled by nucleation followed by the domain wall pinning-controlled magnetization process

Order-disorder transformations in Sm–Co and Sm–Co–ZrC systems with 2-17 stoichiometry

This work investigates the order-disorder transformations utilizing time-resolved x-ray diffraction at the Advanced Photon Source. The metastable phases that can form during the order-disorder transformations in the Sm–Co intermetallics have the potential to produce materials with enhanced permanent magnetic properties. The high-temperature experiments transformed the disordered alloys with the TbCu7-type structure obtained by rapid solidification into the mixture of the hexagonal and rhombohedral ordered structures at 1375 K. The ordering process and the role of the ZrC alloying on the phase formation and ordering transformations were examined. The results showed the formation of shoulders of the fundamental peaks and superlattice peak broadening prior to complete ordering. The lattice parameters expanded linearly up to the onset of ordering, after which an abrupt change of slope was observed. The change in slope suggests a nucleation and growth mechanism for the ordering transformation. The effect of ZrC alloying promoted the formation of the disordered structure in the as-solidified state and lowered the onset of the ordering temperature

Spontaneous Chelation-Driven Reduction of the Neptunyl Cation in Aqueous Solution.

Octadentate hydroxypyridinone (HOPO) and catecholamide (CAM) siderophore analogues are known to be efficacious chelators of the actinide cations, and these ligands are also capable of facilitating both activation and reduction of actinyl species. Utilizing X-ray absorption near edge structure (XANES) and extended X-ray absorption fine structure (EXAFS) spectroscopies, as well as cyclic voltammetry measurements, herein, we elucidate chelation-based mechanisms for driving reactivity and initiating redox processes in a family of neptunyl-HOPO and CAM complexes. Based on the selected chelator, the ability to control the oxidation state of neptunium and the speed of reduction and concurrent oxo group activation was demonstrated. Most notably, reduction kinetics for the NpV O2 +/ /NpIV redox couple upon chelation by the ligands 3,4,3-LI(1,2-HOPO) and 3,4,3-LI(CAM)2 (1,2-HOPO)2 was observed to be faster than ever reported, and in fact quicker than we could measure using either X-ray absorption spectroscopy or electrochemical techniques