Diagnosing diabetes mellitus - Do we need new criteria?

The current classification and diagnostic criteria for diabetes mellitus were introduced by the United States National Data Group in 1979 and endorsed by the World Health Organization in 1980, with modifications in 1985 and 1994. The criteria, chosen to reflect the risk of complications, were the synthesis of considerable thought and expertise and represented a consensus which, it was hoped, would prove helpful to all those involved with diabetes practising clinician, research scientist and epidemiologist alike. The inconvenience, variability and nonphysiological nature of the oral glucose tolerance test (OGTT) are well-recognised. In spite of these limitations the 2-h post-load plasma glucose has remained the standard against which all other tests have been evaluated. This article reviews the original justification for the OGTT, and in the light of more recent epidemiological research seeks to place the current diagnostic criteria for diabetes into a pathophysiological, diagnostic and prognostic perspective.

Nonclassicality Criteria from Phase-Space Representations and Information-Theoretical Constraints Are Maximally Inequivalent

We consider two celebrated criteria for defining the nonclassicality of bipartite bosonic quantum systems, the first stemming from information theoretic concepts and the second from physical constraints on the quantum phase space. Consequently, two sets of allegedly classical states are singled out: (i) the set C composed of the so-called classical-classical (CC) states—separable states that are locally distinguishable and do not possess quantum discord; (ii) the set P of states endowed with a positive P representation (P-classical states)—mixtures of Glauber coherent states that, e.g., fail to show negativity of their Wigner function. By showing that C and P are almost disjoint, we prove that the two defining criteria are maximally inequivalent. Thus, the notions of classicality that they put forward are radically different. In particular, generic CC states show quantumness in their P representation, and vice versa, almost all P-classical states have positive quantum discord and, hence, are not CC. This inequivalence is further elucidated considering different applications of P-classical and CC states. Our results suggest that there are other quantum correlations in nature than those revealed by entanglement and quantum discord.

Scaling of the entanglement spectrum near quantum phase transitions

The entanglement spectrum describing quantum correlations in many-body systems has been recently recognized as a key tool to characterize different quantum phases, including topological ones. Here we derive its analytically scaling properties in the vicinity of some integrable quantum phase transitions and extend our studies also to nonintegrable quantum phase transitions in one-dimensional spin models numerically. Our analysis shows that, in all studied cases, the scaling of the difference between the two largest nondegenerate Schmidt eigenvalues yields with good accuracy critical points and mass scaling exponents.

Laser-ion accelerators: State-of-the-art and scaling laws

A significant amount of experimental work has been devoted over the last decade to the development and optimization of proton acceleration based on the so-called Target Normal Sheath acceleration mechanism. Several studies have been dedicated to the determination of scaling laws for the maximum energy of the protons as a function of the parameters of the irradiating pulses, studies based on experimental results and on models of the acceleration process. We briefly summarize the state of the art in this area, and review some of the scaling studies presented in the literature. We also discuss some recent results, and projected scalings, related to a different acceleration mechanism for ions, based on the Radiation Pressure of an ultraintense laser pulse.

Economies of scaling: More evidence that allometry of metabolism is linked to activity, metabolic rate and habitat

Organismal metabolic rates influence many ecological processes, and the mass-specific metabolic rate of organisms decreases with increasing body mass according to a power law. The exponent in this equation is commonly thought to be the three-quarter-power of body mass, determined by fundamental physical laws that extend across taxa. However, recent work has cast doubt as to the universality of this relationship, the value of 0.75 being an interspecies 'average' of scaling exponents that vary naturally between certain boundaries. There is growing evidence that metabolic scaling varies significantly between even closely related species, and that different values can be associated with lifestyle, activity and metabolic rates. Here we show that the value of the metabolic scaling exponent varies within a group of marine ectotherms, chitons (Mollusca: Polyplacophora: Mopaliidae), and that differences in the scaling relationship may be linked to species-specific adaptations to different but overlapping microhabitats. Oxygen consumption rates of six closely related, co-occurring chiton species from the eastern Pacific (Vancouver Island, British Columbia) were examined under controlled experimental conditions. Results show that the scaling exponent varies between species (between 0.64 and 0.91). Different activity levels, metabolic rates and lifestyle may explain this variation. The interspecific scaling exponent in these data is not significantly different from the archetypal 0.75 value, even though five out of six species-specific values are significantly different from that value. Our data suggest that studies using commonly accepted values such as 0.75 derived from theoretical models to extrapolate metabolic data of species to population or community levels should consider the likely variation in exponents that exists in the real world, or seek to encompass such error in their models. This study, as in numerous previous ones, demonstrates that scaling exponents show large, naturally occurring variation, and provides more evidence against the existence of a universal scaling law. © 2012 Elsevier B.V.

Selection and Treatment of Data for Radiocarbon Calibration: An Update to the International Calibration (IntCal) Criteria

High-quality data from appropriate archives are needed for the continuing improvement of radiocarbon calibration curves. We discuss here the basic assumptions behind 14C dating that necessitate calibration and the relative strengths and weaknesses of archives from which calibration data are obtained. We also highlight the procedures, problems and uncertainties involved in determining atmospheric and surface ocean 14C/12C in these archives, including a discussion of the various methods used to derive an independent absolute timescale and uncertainty. The types of data required for the current IntCal database and calibration curve model are tabulated with examples.

Revised response criteria for polycythemia vera and essential thrombocythemia:an ELN and IWG-MRT consensus project

Standardized response criteria to interpret and compare clinical trials are needed for approval of new therapeutic agents by regulatory agencies. The European LeukemiaNet (ELN) response criteria for essential thrombocythemia (ET) and polycythemia vera (PV) issued in 2009 have been widely adopted as end points in a number of recent clinical trials. However, evidence exists that they do not predict response or provide clinically relevant measures of benefit for the patients. This article presents revised recommendations for assessing response in ET and PV provided by a working group established by ELN and International Working Group-Myeloproliferative Neoplasms Research and Treatment. New definitions of complete and partial remission incorporate clinical, hematological, and histological response assessments that include a standardized symptom assessment form and consider absence of disease progression and vascular events. We anticipate that these criteria will be adopted widely to facilitate the development of new and more effective therapies for ET and PV.

A scaling method for modelling the crashworthiness of novel roadside barrier designs

In this paper, a novel method for modelling a scaled vehicle–barrier crash test similar to the 20◦ angled barrier test specified in EN 1317 is reported. The intended application is for proof-of-concept evaluation of novel roadside barrier designs, and as a cost-effective precursor to full-scale testing or detailed computational modelling. The method is based on the combination of the conservation of energy law and the equation of motion of a spring mass system representing the impact, and shows, for the first time, the feasibility of applying classical scaling theories to evaluation of roadside barrier design. The scaling method is used to set the initial velocity of the vehicle in the scaled test and to provide scaling factors to convert the measured vehicle accelerations in the scaled test to predicted full-scale accelerations. These values can then be used to calculate the Acceleration Severity Index score of the barrier for a full-scale test. The theoretical validity of the method is demonstrated by comparison to numerical simulations of scaled and full-scale angled barrier impacts using multibody analysis implemented in the crash simulation software MADYMO. Results show a maximum error of 0.3% ascribable to the scaling method.

Risk assessment of patient handling with ambulance stretcher systems (ramp/(winch), easi-loader, tail-lift) using biomechanical failure criteria

The research aims to carry out a detailed analysis of the loads applied by the ambulance workers when loading/unloading ambulance stretchers. The forces required of the ambulance workers for each system are measured using a load cell in a force handle arrangement. The process of loading and unloading is video recorded for all the systems to register the posture of the ambulance workers in different stages of the process. The postures and forces exerted by the ambulance workers are analyzed using biomechanical assessment software to examine if the work loads at any stage of the process are harmful. Kinetic analysis of each stretcher loading system is performed. Comparison of the kinetic analysis and measurements shows very close agreement for most of the cases. The force analysis results are evaluated against derived failure criteria. The evaluation is extended to a biomechanical failure analysis of the ambulance worker's lower back using 3DSSPP software developed at the Centre for Ergonomics at the University of Michigan. The critical tasks of each ambulance worker during the loading and unloading operations for each system are identified. Design recommendations are made to reduce the forces exerted based on loading requirements from the kinetic analysis. © 2006 IPEM.

Power Scaling of Uplink Massive MIMO Systems with Arbitrary-Rank Channel Means

This paper investigates the uplink achievable rates of massive multiple-input multiple-output (MIMO) antenna systems in Ricean fading channels, using maximal-ratio combining (MRC) and zero-forcing (ZF) receivers, assuming perfect and imperfect channel state information (CSI). In contrast to previous relevant works, the fast fading MIMO channel matrix is assumed to have an arbitrary-rank deterministic component as well as a Rayleigh-distributed random component. We derive tractable expressions for the achievable uplink rate in the large-antenna limit, along with approximating results that hold for any finite number of antennas. Based on these analytical results, we obtain the scaling law that the users' transmit power should satisfy, while maintaining a desirable quality of service. In particular, it is found that regardless of the Ricean K-factor, in the case of perfect CSI, the approximations converge to the same constant value as the exact results, as the number of base station antennas, M, grows large, while the transmit power of each user can be scaled down proportionally to 1/M. If CSI is estimated with uncertainty, the same result holds true but only when the Ricean K-factor is non-zero. Otherwise, if the channel experiences Rayleigh fading, we can only cut the transmit power of each user proportionally to 1/√M. In addition, we show that with an increasing Ricean K-factor, the uplink rates will converge to fixed values for both MRC and ZF receivers.

Massive MIMO with Non-Ideal Arbitrary Arrays: Hardware Scaling Laws and Circuit-Aware Design

Massive multiple-input multiple-output (MIMO) systems are cellular networks where the base stations (BSs) are equipped with unconventionally many antennas, deployed on colocated or distributed arrays. Huge spatial degrees-of-freedom are achieved by coherent processing over these massive arrays, which provide strong signal gains, resilience to imperfect channel knowledge, and low interference. This comes at the price of more infrastructure; the hardware cost and circuit power consumption scale linearly/affinely with the number of BS antennas N. Hence, the key to cost-efficient deployment of large arrays is low-cost antenna branches with low circuit power, in contrast to today’s conventional expensive and power-hungry BS antenna branches. Such low-cost transceivers are prone to hardware imperfections, but it has been conjectured that the huge degrees-of-freedom would bring robustness to such imperfections. We prove this claim for a generalized uplink system with multiplicative phasedrifts, additive distortion noise, and noise amplification. Specifically, we derive closed-form expressions for the user rates and a scaling law that shows how fast the hardware imperfections can increase with N while maintaining high rates. The connection between this scaling law and the power consumption of different transceiver circuits is rigorously exemplified. This reveals that one can make the circuit power increase as p N, instead of linearly, by careful circuit-aware system design.

Voltage over-scaling:A cross-layer design perspective for energy efficient systems

Today's multi-media electronic era is driven by the increasing demand for small multifunctional devices able to support diverse services. Unfortunately, the high levels of transistor integration and performance required by such devices lead to an unprecedented increase of on-chip power that significantly limits the battery lifetime and even poses reliability concerns. Several techniques have been developed to address the power increase, but voltage over-scaling (VOS) is considered to be one of the most effective ones due to the quadratic dependence of voltage on dynamic power consumption. However, VOS may not always be applicable since it increases the delay in all paths of a system and may limit high performance required by today's complex applications. In addition, application of VOS is further complicated since it increases the variations in transistor characteristics imposed by their tiny size which can lead to large delay and leakage variations, making it difficult to meet delay and power budgets. This paper presents a review of various cross-layer design options that can provide solutions for dynamic voltage over-scaling and can potentially assist in meeting the strict power budgets and yield/quality requirements of future systems. © 2011 IEEE.