Optimal glycaemic control, pre-eclampsia and gestational hypertension in women with type 1 diabetes in the Diabetes and Pre-Eclampsia Intervention Trial

OBJECTIVE
To assess the relationship between glycemic control, pre-eclampsia, and gestational hypertension in women with type 1 diabetes.

RESEARCH DESIGN AND METHODS
Pregnancy outcome (pre-eclampsia or gestational hypertension) was assessed prospectively in 749 women from the randomized controlled Diabetes and Pre-eclampsia Intervention Trial (DAPIT). HbA1c (A1C) values were available up to 6 months before pregnancy (n = 542), at the first antenatal visit (median 9 weeks) (n = 721), at 26 weeks’ gestation (n = 592), and at 34 weeks’ gestation (n = 519) and were categorized as optimal (<6.1%: referent), good (6.1–6.9%), moderate (7.0–7.9%), and poor (=8.0%) glycemic control, respectively.

RESULTS
Pre-eclampsia and gestational hypertension developed in 17 and 11% of pregnancies, respectively. Women who developed pre-eclampsia had significantly higher A1C values before and during pregnancy compared with women who did not develop pre-eclampsia (P < 0.05, respectively). In early pregnancy, A1C =8.0% was associated with a significantly increased risk of pre-eclampsia (odds ratio 3.68 [95% CI 1.17–11.6]) compared with optimal control. At 26 weeks’ gestation, A1C values =6.1% (good: 2.09 [1.03–4.21]; moderate: 3.20 [1.47–7.00]; and poor: 3.81 [1.30–11.1]) and at 34 weeks’ gestation A1C values =7.0% (moderate: 3.27 [1.31–8.20] and poor: 8.01 [2.04–31.5]) significantly increased the risk of pre-eclampsia compared with optimal control. The adjusted odds ratios for pre-eclampsia for each 1% decrement in A1C before pregnancy, at the first antenatal visit, at 26 weeks’ gestation, and at 34 weeks’ gestation were 0.88 (0.75–1.03), 0.75 (0.64–0.88), 0.57 (0.42–0.78), and 0.47 (0.31–0.70), respectively. Glycemic control was not significantly associated with gestational hypertension.

CONCLUSIONS
Women who developed pre-eclampsia had significantly higher A1C values before and during pregnancy. These data suggest that optimal glycemic control both early and throughout pregnancy may reduce the risk of pre-eclampsia in women with type 1 diabetes.

Impact of operator experience on information feedback and reusability

Keeping a record of operator experience remains a challenge to operation management and a major source of inefficiency in information management. The objective is to develop a framework that enables an explicit presentation of experience based on information use. A purposive sampling method is used to select four small and medium-sized enterprises as case studies. The unit of analysis is the production process in the machine shop. Data collection is by structured interview, observation and documentation. A comparative case analysis is applied. The findings suggest experience is an accumulation of tacit information feedback, which can be made explicit in information use interoperatability matrix. The matrix is conditioned upon information use typology, which is strategic in waste reduction. The limitations include difficulty of participant anonymity where the organisation nominates a participant. Areas for further research include application of the concepts to knowledge management and shop floor resource management.

Beyond the Sign. Henri Meschonnic's Poetics of Rhythm and Continuum. Towards an Anthropological Theory of Language

Basing the conception of language on the sign represents also an obstacle to the awareness of certain elements of human life, especially to a full understanding of what language or art do, Henri Meschonnic’s poetics of the continuum and of rhythm criticizes the sign based on Benveniste’s terms of rhythm and discourse, developing an anthropology of language. Rhythm, for Meschonnic, is no formal metrical but a semantic principle, each time unique and unforeseeable. As for Humboldt, his starting point is not the word but the ensemble of speech; language is not ergon but energeia. The poem then is not a literary form but a process of transformation that Meschonnic defines as the invention of a form of life by a form of language and vice versa. Thus a poem is a way of thinking and rhythm is form in movement. The particular subject of art and literature is consequently not the author but a process of subjectivation – this is the contrary of the conception of the sign. By demonstrating the limits of the sign, Meschonnic’s poetics attempts to thematize the intelligibility of presence. Art and literature raise our awareness of this element of human life we cannot grasp conceptually. This poetical thinking is a necessary counterforce against all institutionalization.

A STUDY OF CARBON-MONOXIDE AND NEUTRAL CARBON IN THE S106 MOLECULAR CORE

Maps are presented of J=2-1 and J=3-2 (CO)-O-18 emission from the molecular environment of the bipolar nebula S106, together with complementary observations of the P-3(1)-P-3(0), C I emission. Line splitting observed extensively over the E molecular cloud suggests that it is best explained as the expanding remnant of a thick toroid surrounding the optical lobes. The poor correlation between the observed molecular line emission and dust continuum emission in the E cloud is probably due to a large temperature gradient. Strong C I emission from the protostellar candidate S106 FIR suggests the nearby presence of a powerful source of far-UV radiation, whose energy supply is unlikely to arise from gravitational contraction of a protostar. It is probable that this source is the star S106 LR, which also heats S106 FIR. There is evidence, in both C I and (CO)-O-18, for a predominantly blueshifted outflow from S106 IR, best interpreted as a stellar wind-driven shock into the toroidal remnant. (CO)-O-18 and (CO)-C-13 appear to be depleted, relative to canonical values for their abundances, in S106 FIR, despite its high optical extinction, which should discourage selective photodissociation. Elsewhere in the cloud the C I line profiles show a resemblance to those of (CO)-O-18, with intensity equivalent to a few photodissociation regions (PDRs) along the line of sight.