A dietary intervention for chronic diabetic neuropathy pain: a randomized controlled pilot study

Background: Diabetic neuropathy is a common and often debilitating condition for which available treatments are limited. Because a low-fat plant-based diet has been shown to improve glycemic control in individuals with type 2 diabetes, we hypothesized that such a diet would reduce painful symptoms of diabetic neuropathy. Methods: In this 20-week pilot study, individuals with type 2 diabetes and painful diabetic neuropathy were randomly assigned to two groups. The intervention group was asked to follow a low-fat, plant-based diet, with weekly classes for support in following the prescribed diet, and to take a vitamin B12 supplement. The control group was asked to take the same vitamin B12 supplement, but received no other intervention. At baseline, midpoint and 20 weeks, clinical, laboratory and questionnaire data were collected. Questionnaires included an analog ‘worst pain’ scale, Michigan Neuropathy Screening Instrument, global impression scale, Short Form McGill Pain Questionnaire, Neuropathy Total Symptom Score, a weekly pain diary and Norfolk Quality of Life Questionnaire. Results: After 20 weeks, body weight change with the intervention was −6.4 kg (95% confidence interval (CI) −9.4 to −3.4, PP=0.03) with the intervention in an effect size analysis. The between-group difference in change in pain, as measured by the McGill pain questionnaire, was −8.2 points (95% CI −16.1 to −0.3, P=0.04). Michigan Neuropathy Screening Instrument questionnaire score change was −1.6 points (95% CI −3.0 to −0.2, P=0.03). Conclusions: Improvements were seen in some clinical and pain measures. This pilot study suggests the potential value of a plant-based diet intervention, including weekly support classes, for treating painful diabetic neuropathy

Finite element simulation of three-dimensional free-surface flow problems

An adaptive finite element algorithm is described for the stable solution of three-dimensional free-surface-flow problems based primarily on the use of node movement. The algorithm also includes a discrete remeshing procedure which enhances its accuracy and robustness. The spatial discretisation allows an isoparametric piecewise-quadratic approximation of the domain geometry for accurate resolution of the curved free surface. The technique is illustrated through an implementation for surface-tension-dominated viscous flows modelled in terms of the Stokes equations with suitable boundary conditions on the deforming free surface. Two three-dimensional test problems are used to demonstrate the performance of the method: a liquid bridge problem and the formation of a fluid droplet

Revising the Local Bubble Model due to Solar Wind Charge Exchange X-ray Emission

The hot Local Bubble surrounding the solar neighborhood has been primarily studied through observations of its soft X-ray emission. The measurements were obtained by attributing all of the observed local soft X-rays to the bubble. However, mounting evidence shows that the heliosphere also produces diffuse X-rays. The source is solar wind ions that have received an electron from another atom. The presence of this alternate explanation for locally produced diffuse X-rays calls into question the existence and character of the Local Bubble. This article addresses these questions. It reviews the literature on solar wind charge exchange (SWCX) X-ray production, finding that SWCX accounts for roughly half of the observed local 1/4 keV X-rays found at low latitudes. This article also makes predictions for the heliospheric O VI column density and intensity, finding them to be smaller than the observational error bars. Evidence for the continued belief that the Local Bubble contains hot gas includes the remaining local 1/4 keV intensity, the observed local O VI column density, and the need to fill the local region with some sort of plasma. If the true Local Bubble is half as bright as previously thought, then its electron density and thermal pressure are 1/square-root(2) as great as previously thought, and its energy requirements and emission measure are 1/2 as great as previously thought. These adjustments can be accommodated easily, and, in fact, bring the Local Bubble's pressure more in line with that of the adjacent material. Suggestions for future work are made.Comment: 9 pages, refereed, accepted for publication in the proceedings of the "From the Outer Heliosphere to the Local Bubble: Comparisons of New Observations with Theory" conference and in Space Science Review

No One is Immune: A Community Education Partnership Addressing HIV/AIDS and Older Adults

There has been a dramatic increase in the number of new HIV diagnoses among people aged 50 to 64 in the United States, and according to the Centers for Disease Control and Prevention (CDC), in just 7 years (by 2015) 50% of those living with AIDS will be aged 50 or older. To address this public health concern, viable HIV/AIDS prevention and treatment options for individuals over the age of 50 are necessary. This article discusses the No One Is Immune initiative that planned, implemented, and coordinated evidence- based HIV/AIDS prevention and education programs specifically tailored for middle-aged and older adults. Guided by the health belief model, an educational conference entitled “Sexuality, Medication, and HIV/AIDS in Middle and Later Adulthood” was conducted along with research activities that assessed HIV/AIDS knowledge gained using both qualitative and quantitative measures. This project can be replicated by other providers within the aging network