Recovery of hypoglycemia awareness in long-standing type 1 diabetes: a multicenter 2 × 2 factorial randomized controlled trial comparing insulin pump with multiple daily injections and continuous with conventional glucose self-monitoring (HypoCOMPaSS)

To determine whether impaired awareness of hypoglycemia (IAH) can be improved and severe hypoglycemia (SH) prevented in type 1 diabetes, we compared an insulin pump (continuous subcutaneous insulin infusion [CSII]) with multiple daily injections (MDIs) and adjuvant real-time continuous glucose monitoring (RT) with conventional self-monitoring of blood glucose (SMBG).

Conductive wool yarns by continuous vapour phase polymerization of pyrrole

Conducting polypyrrole (PPy) coated wool yarns were prepared by a continuous vapour polymerization technique, using a speed of 1 m/min with different iron(III) chloride (FeCl₃) as the oxidant at different concentrations. The resistivities, tensile properties, longitudinal and cross-sectional views of PPy-coated wool yarns were investigated. Optimum specific electrical resistances of 2.96 Ω g/cm² at 80 g/L FeCl₃ and 1.69 Ω g/cm² at 70 g/L FeCl₃ were obtained for 500 and 400 twist per meter (TPM) yarns, respectively. PPy-coated wool yarns exhibited higher elongation than uncoated yarns. Longitudinal and cross-sectional views of the yarns indicate that PPy coating penetrated deep into the yarn cross-section and a uniform coating was obtained on the surface of the yarn surface.

Predicting the grade of disability 1 year after stroke following rehabilitation

The purpose of this study was to identify predictors of grades of disability at least 1 year after stroke rehabilitation therapy. We recruited stroke patients from the inpatient rehabilitation department of a university hospital. The degree of disability was graded using the disability evaluation at least 1 year after stroke onset. Functional ability was evaluated using the Functional Independence Measure instrument on admission, on discharge from the inpatient rehabilitation program, and at the 6-month follow-up visit after discharge. Major sociodemographic, medical, and rehabilitative factors were also collected during the hospitalization period. Of the 109 patients surveyed, 64 (58.7%) had severe or very severe grades of disability. The correlates of severe or very severe disability in logistic regression analyses were bilaterally affected (odds ratio, OR, 10.8), impaired orientation (OR, 3.6), and poorer functional ability at discharge (OR, 7.6). Based on the significant predictors identified, the logistic regression model correctly classified severe or very severe disability in 68.0% of subjects. The higher frequency of severe or very severe disability in this study may have been due to the relatively more severely affected stroke patient population in the inpatient rehabilitation service and the use of unique disability evaluation criteria. These results may provide information useful in planning continuous rehabilitation care and setting relevant socio-welfare policies for stroke victims.

Supply chain security: the need for continuous assessment

Ease of Internet accessibility has offered business the opportunity to incorporate this electronic infrastructure technology into establishing electronic-based supply chains. With the improved efficiency that this brings to the management and functionality of the supply chain, there are also security considerations that should be taken into account for protecting the integrity of the electronic supply chain, not only within each business node, but also across the entire supply chain. Such security vulnerabilities can be negated with the implementation of security measures and policies, however these need to be consistent throughout the supply chain and regularly assessed against security benchmarks in order to ensure they meet dequate security standards.

Conducting nylon, cotton and wool yarns by continuous vapor polymerization of pyrrole

Conductive textile yarns were prepared by a continuous vapor polymerization method; the application of polypyrrole by the continuous vapor polymerization method used is designed for the easy adaptation into industrial procedures. The resultant conductive yarns were examined by longitudinal and cross-sectional views, clearly showing the varying levels of penetration of the polymer into the yarn structure. It was found that for wool the optimum specific resistance was achieved by using the 400 TPM yarn with a FeCl3 solution concentration of 80 g/L FeCl3 to produce 1.69 Ω g/cm2. For cotton yarn, the optimum specific resistance of 1.53 Ω g/cm2 was obtained with 80 g/L of a FeCl3 solution.

Television time and continuous metabolic risk in physically active adults

Purpose: Among Australian adults who met the public health guideline for the minimum health-enhancing levels of physical activity, we examined the dose-response associations of television-viewing time with continuous metabolic risk variables.

Methods: Data were analyzed on 2031 men and 2033 women aged >= 25 yr from the 1999-2000 Australian Diabetes, Obesity and Lifestyle study without clinically diagnosed diabetes or heart disease, who reported at least 2.5 h·wk-1 of moderate- to vigorous-intensity physical activity. Waist circumference, resting blood pressure, and fasting and 2-h plasma glucose, triglycerides, and high-density-lipoprotein cholesterol (HDL-C) were measured. The cross-sectional associations of these metabolic variables with quartiles and hours per day of self-reported television-viewing time were examined separately for men and for women. Analyses were adjusted for age, education, income, smoking, diet quality, alcohol intake, parental history of diabetes, and total physical activity time, as well as menopausal status and current use of postmenopausal hormones for women.

Results: Significant, detrimental dose-response associations of television-viewing time were observed with waist circumference, systolic blood pressure, and 2-h plasma glucose in men and women, and with fasting plasma glucose, triglycerides, and HDL-C in women. The associations were stronger in women than in men, with significant gender interactions observed for triglycerides and HDL-C. Though waist circumference attenuated the associations, they remained statistically significant for 2-h plasma glucose in men and women, and for triglycerides and HDL-C in women.

Conclusions: In a population of healthy Australian adults who met the public health guideline for physical activity, television-viewing time was positively associated with a number of metabolic risk variables. These findings support the case for a concurrent sedentary behavior and health guideline for adults, which is in addition to the public health guideline on physical activity.

Development of a stable continuous flow immobilized enzyme reactor for the hydrolysis of inulin

A 23.5-fold purified exoinulinase with a specific activity of 413 IU/mg and covalently immobilized on Duolite A568 has been used for the development of a continuous flow immobilized enzyme reactor for the hydrolysis of inulin. In a packed bed reactor containing 72 IU of exoinulinase from Kluyveromyces marxianus YS-1, inulin solution (5%, pH 5.5) with a flow rate of 4 mL/h was completely hydrolyzed at 55 °C. The reactor was run continuously for 75 days and its experimental half-life was 72 days under the optimized operational conditions. The volumetric productivity and fructose yield of the reactor were 44.5 g reducing sugars/L/h and 53.3 g/L, respectively. The hydrolyzed product was a mixture of fructose (95.8%) and glucose (4.2%) having an average fructose/glucose ratio of 24. An attempt has also been made to substitute pure inulin with raw Asparagus racemosus inulin to determine the operational stability of the developed reactor. The system remained operational only for 11 days, where 85.9% hydrolysis of raw inulin was achieved.

Stability theory and numerical analysis of non-autonomous dynamical systems

The development and use of cocycles for analysis of non-autonomous behaviour is a technique that has been known for several years. Initially developed as an extension to semi-group theory for studying rion-autonornous behaviour, it was extensively used in analysing random dynamical systems [2, 9, 10, 12]. Many of the results regarding asymptotic behaviour developed for random dynamical systems, including the concept of cocycle attractors were successfully transferred and reinterpreted for deterministic non-autonomous systems primarily by P. Kloeden and B. Schmalfuss [20, 21, 28, 29]. The theory concerning cocycle attractors was later developed in various contexts specific to particular classes of dynamical systems [6, 7, 13], although a comprehensive understanding of cocycle attractors (redefined as pullback attractors within this thesis) and their role in the stability of non-autonomous dynamical systems was still at this stage incomplete. It was this purpose that motivated Chapters 1-3 to define and formalise the concept of stability within non-autonomous dynamical systems. The approach taken incorporates the elements of classical asymptotic theory, and refines the notion of pullback attraction with further development towards a study of pull-back stability arid pullback asymptotic stability. In a comprehensive manner, it clearly establishes both pullback and forward (classical) stability theory as fundamentally unique and essential components of non-autonomous stability. Many of the introductory theorems and examples highlight the key properties arid differences between pullback and forward stability. The theory also cohesively retains all the properties of classical asymptotic stability theory in an autonomous environment. These chapters are intended as a fundamental framework from which further research in the various fields of non-autonomous dynamical systems may be extended. A preliminary version of a Lyapunov-like theory that characterises pullback attraction is created as a tool for examining non-autonomous behaviour in Chapter 5. The nature of its usefulness however is at this stage restricted to the converse theorem of asymptotic stability. Chapter 7 introduces the theory of Loci Dynamics. A transformation is made to an alternative dynamical system where forward asymptotic (classical asymptotic) behaviour characterises pullback attraction to a particular point in the original dynamical system. This has the advantage in that certain conventional techniques for a forward analysis may be applied. The remainder of the thesis, Chapters 4, 6 and Section 7.3, investigates the effects of perturbations and discretisations on non-autonomous dynamical systems known to possess structures that exhibit some form of stability or attraction. Chapter 4 investigates autonomous systems with semi-group attractors, that have been non-autonomously perturbed, whilst Chapter 6 observes the effects of discretisation on non-autonomous dynamical systems that exhibit properties of forward asymptotic stability. Chapter 7 explores the same problem of discretisation, but for pullback asymptotically stable systems. The theory of Loci Dynamics is used to analyse the nature of the discretisation, but establishment of results directly analogous to those discovered in Chapter 6 is shown to be unachievable. Instead a case by case analysis is provided for specific classes of dynamical systems, for which the results generate a numerical approximation of the pullback attraction in the original continuous dynamical system. The nature of the results regarding discretisation provide a non-autonomous extension to the work initiated by A. Stuart and J. Humphries [34, 35] for the numerical approximation of semi-group attractors within autonomous systems. . Of particular importance is the effect on the system's asymptotic behaviour over non-finite intervals of discretisation.

Computational thermal analysis of a continuous flow micro Polymerase Chain Reaction (PCR) chip

The first continuous flow micro PCR introduced in 1998 has attracted considerable attention for the past several years because of its ability to amplify DNA at much faster rate than the conventional PCR and micro chamber PCR method. The amplification is obtained by moving the sample through 3 different fixed temperature zones. In this paper, the thermal behavior of a continuous flow PCR chip is studied using commercially available finite element software. We study the temperature uniformity and temperature gradient on the chip’s top surface, the cover plate and the interface of the two layers. The material for the chip body and cover plate is glass. The duration for the PCR chip to achieve equilibrium temperature is also studied.

Influence of stocking rate and mixed grazing of Angora goats and Merino sheep on animal and pasture production in southern Australia : 1 : botanical composition, sward characteristics and availability of components of annual temperate pastures

The effects of animal species (AS; Angora goats, Merino sheep or goats and sheep mixed grazed together at ratio 1:1) and stocking rate (SR; 7.5, 10 and 12.5 animals/ha) on the availability, botanical composition and sward characteristics of annual temperate pastures under continuous grazing were determined in a replicated experiment from 1981 to 1984. AS and SR had significant effects on pasture availability and composition and many AS SR interactions were detected. The pastures grazed by sheep had significantly reduced content and proportion of subterranean clover and more undesirable grasses compared with those grazed by goats. There were no differences in dry matter availabilities between goat- and sheep-grazed pastures at 7.5/ha, but at 10 and 12.5/ha goat pastures had significantly increased availabilities of green grass, dead and green clover and less weeds compared with sheep pastures. There was a significant AS SR interaction for the density of seedlings in May following pasture germination. Between July and January, the height of pastures was greater under goats than sheep but from January to March pasture height declined more on goat-grazed than on sheep-grazed pastures. There was an AS SR interaction for incidence of bare ground. Increasing the SR increased bare ground in pastures grazed by sheep but no change occurred on pastures grazed by goats. Changes in pasture characteristics due to increased SR were minimised on pastures grazed by goats but the grazing of sheep caused larger and faster changes and the pastures were damaged at the highest SR. Goats did not always select the same herbage material as sheep, changed their selection between seasons and were not less selective than sheep. Angora goats were flexible grazers and continually adapted their grazing behaviour to changing herbage conditions. Goat grazing led to an increase in subterranean clover, an accumulation of dead herbage at the base of the sward, reduced bare ground, taller pastures in spring and a more stable botanical composition. Mixed-grazed pasture characteristics were altered with SR. With careful management Angora goats on sheep farms may be used to manipulate pasture composition, to speed up establishment of subterranean clover, to decrease soil erosion and to reduce weed invasion.

Milk lactate determination with a rotating bioreactor based on an electron transfer mediated by osmium complexes incorporating a continuous-flow/stopped-flow system

The high sensitivity that can be attained using a bienzymatic system and mediated by the redox polymer [Os(bpy)₂ClPyCH₂NHpoly(allylamine)] (Os-PAA), has been verified by on-line interfacing of a rotating bioreactor and continuous-flow/stopped-flow/continuous-flow processing. When the hydrogen peroxide formed by LO_x layer reaches the inner layer, the electronic flow between the immobilized peroxidase and the electrode surface produces a current, proportional to lactate concentration. The determination of lactate was possible with a limit of detection of 5 nmol l⁻¹ in the processing of as many as 30 samples per hour. This arrangement allows working in undiluted milk samples with a good stability and reproducibility. Horseradish peroxidase [EC 1.11.1.7] and Os-PAA were covalently immobilized on the glassy carbon electrode surface (upper cell body), lactate oxidase [EC 1.1.3.x] was immobilized on a disk that can be rotated.

Investigation of the performance of the menifocal Z gas-permeable bifocal contact lens during continuous wear

Purpose. The Menifocal Z is an alternating vision, concentric, bifocal gas-permeable (GP) contact lens; center distance is connected to near periphery by a smooth transition zone. The lens is produced using tisilfocon A (Menicon Z material), which is approved for up to 30 days of continuous wear (CW). The aim of this study was to evaluate the clinical performance of the Menifocal Z when worn for up to 30 days of CW for 6 months.

Methods. Thirty-five existing GP lens wearers were enrolled in the study. Subjects were fitted with Menifocal Z lenses and follow-up visits were conducted after 2 weeks of daily wear and 1 day, 1 week, 6 weeks, 3 and 6 months of CW. A range of objective and subjective clinical performance measures were assessed, including distance and near visual acuity, the physiological response to CW, and subjective evaluation of vision and comfort.

Results. Twenty-seven subjects (77%) completed the study and eight (23%) discontinued: five (14%) as a result of lens-related problems (four vision, one comfort) and three (9%) as a result of non-lens related reasons. Average CW time achieved by the subjects was 22 ± 2 days. Mean binocular logarithm of the minimum angle of resolution (logMAR) acuities at 6 months were: high contrast distance 0.03 (20/20-), low contrast distance 0.63 (20/80-), and high contrast near 0.26 (20/25, N4). Adverse responses and lens binding were minimal, and there were no significant increases in corneal staining, corneal vascularization, or superior palpebral conjunctival papillae over time (p > 0.05). Problems with night vision (distance and near) with the lenses were the most common difficulties reported by the subjects.

Conclusions. The Menifocal Z appears to be a promising option for presbyopic vision correction, providing successful correction of distance and near vision in a group of experienced GP lens wearers. The hyper Dk tisilfocon A (Menicon Z) material allowed for safe wear of the lenses on a CW basis.

Continuous cooling transformation of deformed austenite in highly hole-expandable steels

The effects of Si and Mn contents on transformation temperature _r3, transformed microstructure and mechanical properties of three kinds of low-carbon steels during continuous cooling were investigated. A _r3 rises by 15-25°C when increasing Si content from 0.50% to 1.35%, and it drops by 30-50°C when increasing Mn content from 0.97% to 1.43%. The effect of Mn on A _r3 is more significant than Si. Si stimulates the precipitation of the high-temperature equiaxed ferrite to suppress the bainite transformation, but Mn not only provides the grain refining of transformed microstructure but also stimulates the forming of bainite. The homogeneous and grain refining diphase ferrite/bainite steel (w(Si)=0.56, w(Mn)=1.43) can be obtained after deformed at 850°C and cooled at the rate 30°C/s, of which the tensile strength is up to 654 MPa.

Phase II trial of continuous low-dose temozolomide for patients with recurrent malignant glioma

Background In this phase II trial, we investigated the efficacy of a metronomic temozolomide schedule in the treatment of recurrent malignant gliomas (MGs).

Methods Eligible patients received daily temozolomide (50 mg/m2) continuously until progression. The primary endpoint was progression-free survival rate at 6 months in the glioblastoma cohort (N = 37). In an exploratory analysis, 10 additional recurrent grade III MG patients were enrolled. Correlative studies included evaluation of 76 frequent mutations in glioblastoma (iPLEX assay, Sequenom) aiming at establishing the frequency of potentially “drugable” mutations in patients entering recurrent MG clinical trials.

Results Among glioblastoma patients, median age was 56 y; median Karnofsky Performance Score (KPS) was 80; 62% of patients had been treated for ≥2 recurrences, including 49% of patients having failed bevacizumab. Treatment was well tolerated; clinical benefit (complete response + partial response + stable disease) was seen in 10 (36%) patients. Progression-free survival rate at 6 months was 19% and median overall survival was 7 months. Patients with previous bevacizumab exposure survived significantly less than bevacizumab-naive patients (median overall survival: 4.3 mo vs 13 mo; hazard ratio = 3.2; P = .001), but those patients had lower KPS (P = .04) and higher number of recurrences (P < .0001). Mutations were found in 13 of the 38 MGs tested, including mutations of EGFR (N = 10), IDH1 (N = 5), and ERBB2 (N = 1).

Conclusions In spite of a heavily pretreated population, including nearly half of patients having failed bevacizumab, the primary endpoint was met, suggesting that this regimen deserves further investigation. Results in bevacizumab-naive patients seemed particularly favorable, while results in bevacizumab-failing patients highlight the need to develop further treatment strategies for advanced MG.