DreamTel; Diabetes risk evaluation and management tele-monitoring study protocol

<p>Abstract</p> <p>Background</p> <p>The rising prevalence of type 2 diabetes underlines the importance of secondary strategies for the prevention of target organ damage. While access to diabetes education centers and diabetes intensification management has been shown to improve blood glucose control, these services are not available to all that require them, particularly in rural and northern areas. The provision of these services through the Home Care team is an advance that can overcome these barriers. Transfer of blood glucose data electronically from the home to the health care provider may improve diabetes management.</p> <p>Methods and design</p> <p>The study population will consist of patients with type 2 diabetes with uncontrolled A1c levels living on reserve in the Battlefords region of Saskatchewan, Canada. This pilot study will take place over three phases. In the first phase over three months the impact of the introduction of the Bluetooth enabled glucose monitor will be assessed. In the second phase over three months, the development of guidelines based treatment algorithms for diabetes intensification will be completed. In the third phase lasting 18 months, study subjects will have diabetes intensification according to the algorithms developed.</p> <p>Discussion</p> <p>The first phase will determine if the use of the Bluetooth enabled blood glucose devices which can transmit results electronically will lead to changes in A1c levels. It will also determine the feasibility of recruiting subjects to use this technology. The rest of the Diabetes Risk Evaluation and Management Tele-monitoring (DreamTel) study will determine if the delivery of a diabetes intensification management program by the Home Care team supported by the Bluetooth enabled glucose meters leads to improvements in diabetes management.</p> <p>Trial Registration</p> <p>Protocol NCT00325624</p

Microfluidic device for robust generation of two-component liquid-in-air slugs with individually controlled composition

Using liquid slugs as microreactors and microvessels enable precise control over the conditions of their contents on short-time scales for a wide variety of applications. Particularly for screening applications, there is a need for control of slug parameters such as size and composition. We describe a new microfluidic approach for creating slugs in air, each comprising a size and composition that can be selected individually for each slug. Two-component slugs are formed by first metering the desired volume of each reagent, merging the two volumes into an end-to-end slug, and propelling the slug to induce mixing. Volume control is achieved by a novel mechanism: two closed chambers on the chip are initially filled with air, and a valve in each is briefly opened to admit one of the reagents. The pressure of each reagent can be individually selected and determines the amount of air compression, and thus the amount of liquid that is admitted into each chamber. We describe the theory of operation, characterize the slug generation chip, and demonstrate the creation of slugs of different compositions. The use of microvalves in this approach enables robust operation with different liquids, and also enables one to work with extremely small samples, even down to a few slug volumes. The latter is important for applications involving precious reagents such as optimizing the reaction conditions for radiolabeling biological molecules as tracers for positron emission tomography

Quel avenir pour les forêts de la République démocratique du Congo?

Phytochemical Study of Two Medicinal Plants of Cameroon: Garcinia smeathmannii and Garcinia polyantha (Guttiferae)/Evaluation of their Biological Activity and some Chemical Transformations. Les rapports entre le poids de l'oeuf de la pintade locale (Numida meleagris) et les paramètres de la production de pintadeaux ont été étudiés dans la région centrale du Burkina Faso. Les oeufs (n= 2.500) de la pintade locale sont classés par intervalle de 5 g en cinq catégories de poids allant de 25 g à 50 g. Le taux moyen de fertilité est de 84,4% et varie avec le poids de l'oeuf. Le taux de mortalité embryonnaire moyen est de 17,3% et les taux de 11,2% et de 6,1% ont été relevés respectivement entre le 1er et le 24ème jour puis entre le 25ème et le 31ème jour après la mise en incubation. Le taux réel d'éclosion est significativement (p&amp;amp;amp;amp;amp;amp;lt; 0,05) corrélé (r= 0,85) au poids de l'oeuf. Le poids moyen du pintadeau d'un jour est de 25,2 ± 1,9 g et est significativement (p&amp;amp;amp;amp;amp;amp;lt; 0,05) corrélé (r= 0,96) au poids de l'oeuf. Cette relation positive est aussi observée entre le poids de l'oeuf et la cinétique de croissance du pintadeau (r= 0,97). Le poids du pintadeau à un jour d'âge (y) est estimé par celui de l'oeuf (x) avec l'équation de régression y(g)= 0,4461 x g + 5,3867 (r2= 0,72). Le taux moyen de mortalité des pintadeaux est de 16,5% et baisse quand le poids de l'oeuf augmente. Cette moyenne est fortement influencée par le taux de mortalité de 46,4% relevé dans la catégorie de poids des oeufs de 25 à 30 g

Design of a defocused transducer for targeted cancer drug delivery by ultrasound-mediated hyperthermia

A major challenge in chemotherapy is that the systemic delivery of drugs to both healthy tissue as well as the tumour results in unwanted side effects. Thermosensitive liposomal carriers are designed to release their payload when they are exposed to mild hyperthermia (a few degrees above body temperature). If a tumour can be locally heated, thermosensitive liposomes can provide triggered and localised delivery of the drug which should reduce systemic toxicity. Ultrasound is a noninvasive modality which can be used to produce localised heating at depth. However, most clinically approved high-intensity focused ultrasound (HIFU) systems are designed for tumour ablation and exhibit a focal volume which typically spans 1-3mm in width and 10-15mm in length, generating temperatures in excess of 50◦C for a few seconds to directly kill tissue within the focal volume. Hyperthermia-triggered drug release usually requires maintaining a tumour volume which often spans several centimetres in size at a consistent therapeutic temperature of 39.5-42◦C for durations up to an hour. This is difficult to achieve for most current HIFU transducers due to their small focal volume. The approach employed here is to design an acoustic lens that retrofits onto a clinical HIFU system to produce a focal volume better suited for mild hyperthermia. 3D printing is employed in this work to produce the lenses, and sectored lenses which enable a single-element transducer to produce acoustic fields with multiple foci in an annular pattern are investigated. Experimental measurements of the pressure and temperature using a small therapeutic transducer are consistent with simulations, and the simulated -3dB free-field focal volume of the transducer was increased from 9.6mm3 to 90.9mm3. Finite element software is used to perform 3D linear full-wave simulations of an acoustic lens in a human liver target derived from a segmented CT dataset. The computational challenges with performing large 3D finite element simulations are addressed by dividing the simulation domain into several subregions. A phase-conjugate lens combined with masking transducer locations associated with ribs is explored as a solution to address aberrations in the acoustic field caused by tissue inhomogeneity. Experiments with a sectored acoustic lens on a clinical HIFU system showed the radial location of the free-field focus was shifted from 0mm to ±2.8mm in an annular pattern. This work shows that retrofitting a HIFU system with an acoustic lens is a practical approach to broadening the focal spot.</p