Severe hypoglycaemia in type 1 diabetes mellitus: underlying drivers and potential strategies for successful prevention

Hypoglycaemia remains an over-riding factor limiting optimal glycaemic control in type 1 diabetes. Severe hypoglycaemia is prevalent in almost half of those with long-duration diabetes and is one of the most feared diabetes-related complications. In this review, we present an overview of the increasing body of literature seeking to elucidate the underlying pathophysiology of severe hypoglycaemia and the limited evidence behind the strategies employed to prevent episodes. Drivers of severe hypoglycaemia including impaired counter-regulation, hypoglycaemia-associated autonomic failure, psychosocial and behavioural factors and neuroimaging correlates are discussed. Treatment strategies encompassing structured education, insulin analogue regimens, continuous subcutaneous insulin infusion pumps, continuous glucose sensing and beta-cell replacement therapies have been employed, yet there is little randomized controlled trial evidence demonstrating effectiveness of new technologies in reducing severe hypoglycaemia. Optimally designed interventional trials evaluating these existing technologies and using modern methods of teaching patients flexible insulin use within structured education programmes with the specific goal of preventing severe hypoglycaemia are required. Individuals at high risk need to be monitored with meticulous collection of data on awareness, as well as frequency and severity of all hypoglycaemic episodes.

Diorganotin dications stabilized by neutral ligands in the solid state: [R2Sn(H2O)2(OPPh3)2](O3SCF3)2 (R = Me, Bu)

The synthesis of [R₂Sn(H₂O)₂(OPPh₃)₂](O₃SCF₃)₂ (R = Me (1), Bu (2)) by the consecutive reaction of R₂SnO (R = Me, Bu) with triflic acid and Ph₃PO is described. Compounds 1 and 2 feature dialkyltin(IV) dications [R₂Sn(H₂O)₂(OPPh₃)₂]^₂+ apparently stabilized by the neutral ligands in the solid state. Compounds 1 and 2 readily dehydrate upon heating at 105 and 86 °C, respectively. The preparative dehydration of 1 afforded [Me₂Sn(OPPh₃)₂(O₃SCF₃)](O₃SCF₃) (1a), which features both bidentate and non-coordinating triflate anions. In compounds 1 and 2 the ligands Ph₃PO and H₂O are kinetically labile in solution and undergo reversible ligand exchange reactions. Compounds 1, 1a and 2 were characterized by multinuclear solution and solid-state NMR spectroscopy, IR spectroscopy, electrospray mass spectrometry, conductivity measurements, thermogravimetry and X-ray crystallography.

Handling of neutral information by aggregation operators

We generalize the notion of a neutral element of aggregation operators. Our construction involves tuples of values that are neutral with respect to the result of aggregation. Neutral tuples are useful to model situations in which information from different sources, or preferences of several decision makers, cancel each other. We examine many popular classes of aggregation operators in respect to their neutral sets, and also construct new aggregation operators with predefined neutral sets

Handling of neutral information by aggregation operators

We generalize the notion of a neutral element of aggregation operators. Our construction involves tuples of values that are neutral with respect to the result of aggregation. Neutral tuples are useful to model situations in which information from different sources, or preferences of several decision makers, cancel each other. We examine many popular classes of aggregation operators in respect to their neutral sets, and also construct new aggregation operators with predefined neutral sets.

Steric and electronic factors influencing recognition by a simple, charge neutral norbornene based anion receptor

Based on 1H NMR studies, subtle electronic factors rather than pre-organisation dictate the binding stoichiometry of the new, norbornene based, anion hosts 1 and 2 with acetate, however, the binding of dihydrogenphosphate appears to be based solely on steric constraints.

Handling neutral and absorbent information in aggregation processes

We generalize the concepts of neutral and absorbent elements of aggregation operators. We introduce two types of tuples of values: the neutral tuples and the absorbent tuples. the neutral tuples are useful in situations in which information from different sources, or preferences of several decision makers, cancel each other. Absorbent tuples are useful in situations in which certain decision makers may decide the outcome irrespective of the opinion of the others. We examine the most important classes of aggregation operators in respect to their neutral and absorbent tuples.

Design of linear functional observers for time-delay systems of the neutral-type

This paper presents the design of reduced-order linear functional observers for a class of linear time-delay systems of the neutral-type. The type of the observer proposed in this paper is without internal delay and its order is the same as the number of linear functions to be estimated. First, conditions for the existence of the reduced-order functional observers that are capable of asymptotically estimating any given function of the state vector are derived. Then, based on the newly derived existence conditions, a procedure is given for the determination of the observer parameters. The results derived in this paper include a range of linear systems and extend some existing results of linear functional observers to linear neutral delay systems. A numerical example is given to illustrate the design procedure.

Design of reduced-order observers for neutral time-delay systems

This paper presents a method for the design of reduced-order observers for a class of linear time-delay systems of the neutral-type. Conditions for the existence of reduced-order observers that are capable of asymptotically estimating any given function of the state vector are derived. A step-by-step design procedure is given for the determination of the observer parameters. A numerical example is given to illustrate the design procedure.

Synthesis and comparative physical-chemical characterisation of neutral and cationic amphiphiles using RP-HPLC

A series of norbornane containing amphiphiles was synthesized, their lipophilicity corresponding to neutral and cationic forms was then investigated using reverse phase HPLC (High Performance Liquid Chromatography). This series of amphiphiles incorporated varied lipophilic chain length and also varied distances between the polar/cationic head group from the norbornane scaffold. Our investigation included studying the impact of the stationary phase as a replication of a membrane for both cationic and neutral amphiphiles. The choice of stationary phase was shown to be a very important consideration for this type of measurement. In this connection, C18, Cyano and Polar columns were all investigated, the cyano column was observed to be the optimal stationary phase for the comparison of both charged and neutral amphiphiles.

Expected shannon entropy and shannon differentiation between subpopulations for neutral genes under the finite island model

Shannon entropy H and related measures are increasingly used in molecular ecology and population genetics because (1) unlike measures based on heterozygosity or allele number, these measures weigh alleles in proportion to their population fraction, thus capturing a previously-ignored aspect of allele frequency distributions that may be important in many applications; (2) these measures connect directly to the rich predictive mathematics of information theory; (3) Shannon entropy is completely additive and has an explicitly hierarchical nature; and (4) Shannon entropy-based differentiation measures obey strong monotonicity properties that heterozygosity-based measures lack. We derive simple new expressions for the expected values of the Shannon entropy of the equilibrium allele distribution at a neutral locus in a single isolated population under two models of mutation: the infinite allele model and the stepwise mutation model. Surprisingly, this complex stochastic system for each model has an entropy expressable as a simple combination of well-known mathematical functions. Moreover, entropy- and heterozygosity-based measures for each model are linked by simple relationships that are shown by simulations to be approximately valid even far from equilibrium. We also identify a bridge between the two models of mutation. We apply our approach to subdivided populations which follow the finite island model, obtaining the Shannon entropy of the equilibrium allele distributions of the subpopulations and of the total population. We also derive the expected mutual information and normalized mutual information ("Shannon differentiation") between subpopulations at equilibrium, and identify the model parameters that determine them. We apply our measures to data from the common starling (Sturnus vulgaris) in Australia. Our measures provide a test for neutrality that is robust to violations of equilibrium assumptions, as verified on real world data from starlings.

Novel criteria for exponential stability of linear neutral time-varying differential systems

Using a novel approach, we get explicit criteria for exponential stability of linear neutral time-varying differential systems. A brief discussion to the obtained results is given. To the best of our knowledge, the results of this paper are new.

Living and deceased organ donation should be financially neutral acts

The supply of organs—particularly kidneys—donated by living and deceased donors falls short of the number of patients added annually to transplant waiting lists in the United States. To remedy this problem, a number of prominent physicians, ethicists, economists and others have mounted a campaign to suspend the prohibitions in the National Organ Transplant Act of 1984 (NOTA) on the buying and selling of organs. The argument that providing financial benefits would incentivize enough people to part with a kidney (or a portion of a liver) to clear the waiting lists is flawed. This commentary marshals arguments against the claim that the shortage of donor organs would best be overcome by providing financial incentives for donation. We can increase the number of organs available for transplantation by removing all financial disincentives that deter unpaid living or deceased kidney donation. These disincentives include a range of burdens, such as the costs of travel and lodging for medical evaluation and surgery, lost wages, and the expense of dependent care during the period of organ removal and recuperation. Organ donation should remain an act that is financially neutral for donors, neither imposing financial burdens nor enriching them monetarily.