Assessment of risk for severe hypoglycemia among adults with IDDM: validation of the low blood glucose index

OBJECTIVE: To evaluate the clinical/research utility of the low blood glucose index (LBGI), a measure of the risk of severe hypoglycemia (SH), based on self-monitoring of blood glucose (SMBG). RESEARCH DESIGN AND METHODS: There were 96 adults with IDDM (mean age 35+/-8 years, duration of diabetes 16+/-10 years, HbA1 8.6+/-1.8%), 43 of whom had a recent history of SH (53 did not), who used memory meters for 135+/-53 SMBG readings over a month, and then for the next 6 months recorded occurrence of SH. The SMBG data were mathematically transformed, and an LBGI was computed for each patient. RESULTS: The two patient groups did not differ with respect to HbA1, insulin units per day, average blood glucose (BG) and BG variability. Patients with history of SH demonstrated a higher LBGI (P < 0.0005) and a trend to be older with longer diabetes duration. Analysis of odds for future SH classified patients into low- (LBGI <2.5), moderate- (LBGI 2.5-5), and high- (LBGI >5) risk groups. Over the following 6 months low-, moderate-, and high-risk patients reported 0.4, 2.3, and 5.2 SH episodes, respectively (P = 0.001). The frequency of future SH was predicted by the LBGI and history of SH (R2 = 40%), while HbA1, age, duration of diabetes, and BG variability were not significant predictors. CONCLUSIONS: LBGI provides an accurate assessment of risk of SH. In the traditional relationship history of SH-to-future SH, LBGI may be the missing link that reflects present risk. Because it is based on SMBG records automatically stored by many reflectance meters, the LBGI is an effective and clinically useful on-line indicator for SH risk.     

Rupture recurrence after surgical repair of postinfarction ventricular septal rupture. Influence of early thrombolysis

OBJECTIVES: The aim of this study was to identify factors causing rupture recurrence after surgical repair of postinfarction ventricular septal rupture and to evaluate the indication for reoperation. PATIENTS: Recurrence of rupture was analysed in 25 out of a series of 109 patients who underwent surgical repair for postinfarction ventricular septal rupture between 1980 and 1992 in our institution. RESULTS: The mean interval between initial operation and recurrence was 3.6 days with a median of 2 days. Multivariate logistic regression analysis identified early thrombolysis after infarction (P = 0.0085) as a risk factor for recurrence of the rupture. Rupture recurrence occurred more in the anterior then in the posterior infarction site, although non-significant. Reoperation was indicated in 15 patients, in 13 for postrecurrent cardiac failure. The main determinant of cardiac failure was a large postrecurrent shunt (P = 0.05). The mean interval between initial operation and reoperation was 136 days with a median of 101 days. In 6 patients a combined apical ventricular septal rupture recurrence and anterior ventricular aneurysm was found, in 9 patients the recurrent rupture was proximally located, without concomitant aneurysm formation. Of 15 patients who were reoperated, one died in hospital and three after the in-hospital period. Of 10 patients treated conservatively, one died in hospital and two after the in-hospital period. One residual ventricular septal rupture closed spontaneously. CONCLUSIONS: Rupture recurrence is mainly determined by early thrombolysis. Postrecurrent cardiac failure, as the main indication for reoperation, is dependent on postrecurrent shunt size.     

Preparation and Electrocatalytic Application of Composites Containing Gold Nanoparticles Protected with Rhodium-Substituted Polyoxometalates

Substitution of a metal center of phosphomolybdate, PMo₁₂O₄₀³⁻ (PMo₁₂), or its tungsten analogue with dirhodium(II) and subsequent stabilization of gold nanoparticles, AuNPs, with Rh₂PMo₁₁ are demonstrated. The AuNP-Rh₂PMo₁₁ mediates oxidations but adsorbs too weakly for direct modification of electrode materials. Stability in quiescent solution was achieved by modifying glassy carbon (GC) with 3-aminopropyltriethoxysilane (APTES) and then electrostatically assembling AuNP-Rh₂PMo₁₁. At GC|APTES|AuNP-Rh₂PMo₁₁, cyclic voltammetry showed the expected set of three reversible peak-pairs for PMo₁₁ in the range −0.2 to 0.6 vs. (Ag/AgCl)/V and the reversible Rh^II,III couple at 1.0 vs. (Ag/AgCl)/V. The presence of AuNPs increased the current for the reduction of bromate by a factor of 2.5 relative to that at GC|Rh₂PMo₁₁, and the electrocatalytic oxidation of methionine displayed characteristics of synergism between the AuNP and Rh^II. To stabilize AuNP-Rh₂PMo₁₁ on a surface in a flow system, GC was modified by electrochemically assisted deposition of a sol–gel with templated 10-nm pores prior to immobilizing the catalyst in the pores. The resulting electrode permitted determination of bromate by flow-injection amperometry with a detection limit of 4.0 × 10⁻⁸ mol dm⁻³.     

Modelling the surface adsorption of methane on carbon nanostructures

Methane (CH₄) adsorption is investigated on both graphite and in the region between two aligned single-walled carbon nanotubes, which we refer to as the groove site. We exploit the Lennard–Jones potential function and the continuous approximation to determine surface binding energies between a single CH₄ molecule and graphite and between a single CH₄ and two aligned single-walled carbon nanotubes. Our modelling indicates that for a CH₄ molecule interacting with graphite, the binding energy of the system is minimized when the CH₄ carbon is 3.83 Å above the surface of the graphitic carbon, while the binding energy of the CH₄–groove site system is minimized when the CH₄ carbon is 5.17 Å away from the common axis shared by the two aligned single-walled carbon nanotubes. Our results confirm the current view that for larger groove sites, CH₄ molecules in grooves are likely to move towards the outer surfaces of one of the single-walled carbon nanotubes. Our results are computationally efficient and are in good agreement with experiments and molecular dynamics simulations, and show that CH₄ adsorption on graphite and groove surfaces is more favourable at lower temperatures and higher pressures.     

Characterizing In‐Plane Geometrical Variability in Textile Ceramic Composites

We present a methodology for characterizing and reconstructing in‐plane weave variability in textile composites. Surface topography of a partially processed C‐fiber/SiC matrix composite panel was measured using digital image correlation. The centroids of tow segments that appear periodically on the fabric surface were located by image analysis and used as fiducial markers. Stochastic deviations of the fiducial markers from the ideal periodic weave structure indicate geometrical variance. Fourier analysis shows that spatial wavelengths of the deviations range from the size of one unit cell to the dimensions of the entire panel. Long‐range deviations are attributed principally to fabric deformation after manufacture, during handling. Short‐range fluctuations, extracted by computing spatial derivatives of the positions of the fiducial markers, are attributed to variations in tow packing density that arises during weaving. A simple set of statistics for these deviations is presented and its use in generating stochastic virtual specimens is demonstrated.     

Isolation and Characterisation of a Ferrirhodin Synthetase Gene from the Sugarcane Pathogen Fusarium sacchari

FSN1, a gene isolated from the sugar‐cane pathogen Fusarium sacchari, encodes a 4707‐residue nonribosomal peptide synthetase consisting of three complete adenylation, thiolation and condensation modules followed by two additional thiolation and condensation domain repeats. This structure is similar to that of ferricrocin synthetase, which makes a siderophore that is involved in intracellular iron storage in other filamentous fungi. Heterologous expression of FSN1 in Aspergillus oryzae resulted in the accumulation of a secreted metabolite that was identified as ferrirhodin. This siderophore was found to be present in both mycelium and culture filtrates of F. sacchari, whereas ferricrocin is found only in the mycelium, thus suggesting that ferricrocin is an intracellular storage siderophore in F. sacchari, whereas ferrirhodin is used for iron acquisition. To our knowledge, this is the first report to characterise a ferrirhodin synthetase gene functionally.     

DNA Antenna Tile‐Associated Deoxyribozyme Sensor with Improved Sensitivity

Some natural enzymes increase the rate of diffusion‐limited reactions by facilitating substrate flow to their active sites. Inspired by this natural phenomenon, we developed a strategy for efficient substrate delivery to a deoxyribozyme (DZ) catalytic sensor. This resulted in a three‐ to fourfold increase in sensitivity and up to a ninefold improvement in the detection limit. The reported strategy can be used to enhance catalytic efficiency of diffusion‐limited enzymes and to improve sensitivity of enzyme‐based biosensors.     

Determination of peroxide value by fourier transform near-infrared spectroscopy

A Fourier transform-near infrared (FT-NIR) method originally designed to determine the peroxide value (PV) of triacylglycerols at levels of 10–100 PV was improved upon to allow for the analysis of PV between 0 and 10 PV, a range of interest to the edible oil industry. The FT-NIR method uses convenient disposable glass vials for sample handling, and PV is determined by spectroscopically measuring the conversion of triphenylphosphine (TPP) to triphenylphosphine oxide (TPPO) when reacted with hydroperoxides. A partial-leastsquares calibration was developed for 8 mm o.d. vials by preparing randomized mixtures of TPP and TPPO in a zero-PV oil. The method was validated with samples prepared by gravimetric dilution of oxidized oil with a zero-PV oil. It was shown that the American Oil Chemists’ Society primary reference method was quite reproducible (±0.5 PV), but relatively insensitive to PV differences at lower (0–2) PV. The FT-NIR method on the other hand was shown to be more accurate overall in tracking PV, but slightly less reproducible (0.9 PV) due to working close to the limit of detection. The sensitivity and reproducibility of the FT-NIR method could be improved upon through the use of larger-diameter vials combined with a detector having a wider dynamic range. The proposed FT-NIR PV method is simple to calibrate and implement and can be automated to allow for routine quality control analysis of edible fats and oils.