XI. STRATEGIES FOR IMPROVING DIABETES CARE D iabetes is a chronic illness that requires continuing medical care and patient self-management education to prevent acute complications and to reduce the risk of long-term complications. Diabetes care is complex and requires that many issues, beyond glycemic control, be addressed. A large body of evidence exists that supports a range of interventions to improve diabetes outcomes. These standards of care are intended to provide clinicians, patients, researchers, payors, and other interested individuals with the components of diabetes care, treatment goals, and tools to evaluate the quality of care. While individual preferences, comorbidities, and other patient factors may require modification of goals, targets that are desirable for most patients with diabetes are provided. These standards are not intended to preclude more extensive evaluation and management of the patient by other specialists as needed. For more detailed information, refer to Bode (Ed.): Medical Management of Type 1 Diabetes (1), Burant (Ed): Medical Management of Type 2 Diabetes (2), and Klingensmith (Ed): Intensive Diabetes Management (3). The recommendations included are diagnostic and therapeutic actions that are known or believed to favorably affect health outcomes of patients with diabetes. A grading system (Table 1), developed by the American Diabetes Association (ADA) and modeled after existing methods, was utilized to clarify and codify the evidence that forms the basis for the recommendations. The level of evidence that supports each recommendation is listed after each recommendation using the letters A, B, C, or E.

Standards of Medical Care in Diabetes

Additive manufacturing of metallic components – Process, structure and properties

Additive manufacturing of metals

Selective Laser Melting (SLM) is a particular rapid prototyping, 3D printing, or Additive Manufacturing (AM) technique designed to use high power-density laser to melt and fuse metallic powders. A component is built by selectively melting and fusing powders within and between layers. The SLM technique is also commonly known as direct selective laser sintering, LaserCusing, and direct metal laser sintering, and this technique has been proven to produce near net-shape parts up to 99.9% relative density. This enables the process to build near full density functional parts and has viable economic benefits. Recent developments of fibre optics and high-power laser have also enabled SLM to process different metallic materials, such as copper, aluminium, and tungsten. Similarly, this has also opened up research opportunities in SLM of ceramic and composite materials. The review presents the SLM process and some of the common physical phenomena associated with this AM technology. It then focuses on the following a...

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Review of selective laser melting : materials and applications

Heat treatment of Ti6Al4V produced by Selective Laser Melting: Microstructure and mechanical properties

The microstructure and mechanical behavior of simple product geometries produced by layered manufacturing using the electron beam melting (EBM) process and the selective laser melting (SLM) process are compared with those characteristic of conventional wrought and cast products of Ti-6Al-4V. Microstructures are characterized utilizing optical metallography (OM), scanning electron microscopy (SEM) and transmission electron microscopy (TEM), and included alpha (hcp), beta (bcc) and alpha(') (hcp) martensite phase regimes which give rise to hardness variations ranging from HRC 37 to 57 and tensile strengths ranging from 0.9 to 1.45 GPa. The advantages and disadvantages of layered manufacturing utilizing initial powders in custom building of biomedical components by EBM and SLM in contrast to conventional manufacturing from Ti-6Al-4V wrought bar stock are discussed.

Microstructure and mechanical behavior of Ti-6Al-4V produced by rapid-layer manufacturing, for biomedical applications.

Microstructures and mechanical properties of electron beam-rapid manufactured Ti–6Al–4V biomedical prototypes compared to wrought Ti–6Al–4V

Annual deaths in the U.S. attributed to diabetes are expected to increase from 280,210 in 2015 to 385,840 in 2030. The increase in the number of people affected by diabetes has made it one of the major public health challenges around the world. Better management of diabetes has the potential to decrease yearly medical costs and deaths associated with the disease. Non-invasive methods are in high demand to take the place of the traditional finger prick method as they can facilitate continuous glucose monitoring. Research groups have been trying for decades to develop functional commercial non-invasive glucose measurement devices. The challenges associated with non-invasive glucose monitoring are the many factors that contribute to inaccurate readings. We identify and address the experimental and physiological challenges and provide recommendations to pave the way for a systematic pathway to a solution. We have reviewed and categorized non-invasive glucose measurement methods based on: (1) the intrinsic properties of glucose, (2) blood/tissue properties and (3) breath acetone analysis. This approach highlights potential critical commonalities among the challenges that act as barriers to future progress. The focus here is on the pertinent physiological aspects, remaining challenges, recent advancements and the sensors that have reached acceptable clinical accuracy.

https://www.mdpi.com/1424-8220/20/5/1251/pdf

Review of Non-invasive Glucose Sensing Techniques: Optical, Electrical and Breath Acetone.

Projectile/target behavior for 1100 Al/Cu, soda-lime glass/Cu, soda-lime glass/1100 Al, ferritic stainless steel/Cu, and ferritic stainless steel/1100 Al for spherical (3.18 mm diameter) projectiles at impact velocities ranging from 0.8 to ∼6 km s −1 has been examined by light metallography, SEM, and TEM. At a reference velocity of 1 km s −1 , the crater depth/crater diameter ratio ( p / D c ) is observed to be linearly related to bulk density ratios ( ρ p / ρ t ) 1/2 and elastic modulus ratios ( E p / E t )( ρ p / ρ t ) 1/2 , and to vary from about 0.2 to 2.95. The hypervelocity ( u o >5 km s −1 ) threshold value for p / D c is also shown to be linearly related to these functionalities and ranges from p / D c =0.4 for the 1100 Al/Cu system and 0.85 for the ferritic stainless steel/1100 Al system. The residual crater microstructures are all characterized by a zone of dynamic recrystallization at the crater wall (which thickens with impact velocity), and decreasing dislocation density beyond this zone; consistent with residual hardness profiles whose amplitudes decrease with distance from the crater wall. Computer simulations and validation of these simulations utilizing the ranges of experimentally measured crater geometries with impact velocity were developed which fairly accurately represented residual crater shapes and related features. These results also demonstrate the importance of appropriate projectile/target strength ratios in computer simulations; and illustrate the potential for extrapolations to new systems, and for impact velocities well beyond those achievable in the laboratory.

Stella Quinones

Papers

Microstructure and mechanical behavior of Ti-6Al-4V produced by rapid-layer manufacturing, for biomedical applications.

Microstructures and mechanical properties of electron beam-rapid manufactured Ti–6Al–4V biomedical prototypes compared to wrought Ti–6Al–4V

Review of Non-invasive Glucose Sensing Techniques: Optical, Electrical and Breath Acetone.

The low-velocity-to-hypervelocity penetration transition for impact craters in metal targets

End cap nucleation of carbon nanotubes