Identifying the unmet needs of individuals with Type 2 diabetes: an international web-based survey

Aim: To identify and understand the main unmet needs of individuals with Type 2 diabetes (T2D). Materials & methods: An online survey was conducted in Brazil, China and Russia of individuals with recently diagnosed T2D. Results: The survey, involving 300 individuals with T2D, identified a need for more information regarding food/diet and for increased awareness of T2D symptoms. While most participants (94%) had experienced symptoms prior to their diagnosis, only 55% of symptomatic individuals sought medical attention. Conclusion: Novel strategies to increase awareness of diabetes should be developed and tested, and may enable earlier diagnosis and improve patients' quality of life.publishersversionpublishe

Erratum to: Methods for evaluating medical tests and biomarkers

[This corrects the article DOI: 10.1186/s41512-016-0001-y.]

Evidence synthesis to inform model-based cost-effectiveness evaluations of diagnostic tests: a methodological systematic review of health technology assessments

Background: Evaluations of diagnostic tests are challenging because of the indirect nature of their impact on patient outcomes. Model-based health economic evaluations of tests allow different types of evidence from various sources to be incorporated and enable cost-effectiveness estimates to be made beyond the duration of available study data. To parameterize a health-economic model fully, all the ways a test impacts on patient health must be quantified, including but not limited to diagnostic test accuracy. Methods: We assessed all UK NIHR HTA reports published May 2009-July 2015. Reports were included if they evaluated a diagnostic test, included a model-based health economic evaluation and included a systematic review and meta-analysis of test accuracy. From each eligible report we extracted information on the following topics: 1) what evidence aside from test accuracy was searched for and synthesised, 2) which methods were used to synthesise test accuracy evidence and how did the results inform the economic model, 3) how/whether threshold effects were explored, 4) how the potential dependency between multiple tests in a pathway was accounted for, and 5) for evaluations of tests targeted at the primary care setting, how evidence from differing healthcare settings was incorporated. Results: The bivariate or HSROC model was implemented in 20/22 reports that met all inclusion criteria. Test accuracy data for health economic modelling was obtained from meta-analyses completely in four reports, partially in fourteen reports and not at all in four reports. Only 2/7 reports that used a quantitative test gave clear threshold recommendations. All 22 reports explored the effect of uncertainty in accuracy parameters but most of those that used multiple tests did not allow for dependence between test results. 7/22 tests were potentially suitable for primary care but the majority found limited evidence on test accuracy in primary care settings. Conclusions: The uptake of appropriate meta-analysis methods for synthesising evidence on diagnostic test accuracy in UK NIHR HTAs has improved in recent years. Future research should focus on other evidence requirements for cost-effectiveness assessment, threshold effects for quantitative tests and the impact of multiple diagnostic tests

Erratum to: Methods for evaluating medical tests and biomarkers

[This corrects the article DOI: 10.1186/s41512-016-0001-y.]

Development of a mechanical frame adapted to Arcan tests to identify the creep behaviour of adhesive joints

International audienceThe use of structural adhesive bonding is increasing in the structural assembly field. It has indeed several advantages compared to other assembly techniques such as welding and riveting: uniform stress distribution, assembly of materials with different natures, no heat production. Creep is an important long-term phenomenon that needs to be considered for adhesive joints. To investigate this aspect, a study at the scale of the adhesive joint is required. At this scale, Arcan test presents several advantages compared to other existing tests (analysis of different loads, limited edge effects). Consequently, Arcan test was chosen for an ongoing creep study aimed at studying bonded fasteners. A mechanically operated creep testing machine for adhesive joints and adapted to this test was developed. To study the local strain of the adhesive, two LVDT sensors measure the displacements according to two directions: normal and tangential to the bonded surface. These sensors are placed in a support, which is fixed at the beaks of the sample. This mechanically welded frame enables investigating the creep behaviour of adhesive joints according to a lot of parameters (load levels, type of load, temperature, adhesive thickness). The analysis of the behaviour allowed suggesting some design tools adapted for the use of the bonded fasteners under creep loads.Le collage structural est une méthode d’assemblage de plus en plus utilisée. En effet, cette solution présente plusieurs avantages par rapport à d’autres techniques comme le rivetage et le soudage : distribution uniforme de contraintes, assemblage de matériaux de nature différente, pas de production de chaleur. Le fluage est un phénomène important à prendre en compte en termes de durabilité lors de la conception d’un assemblage collé. Pour étudier ce phénomène, une analyse à l’échelle du joint mince est nécessaire. L’essai Arcan dispose de plusieurs avantages par rapport à d’autres méthodes expérimentales à l’échelle du joint de colle (plusieurs types de chargement possibles, effets de bord limités). Par conséquent, cet essai a été choisi dans le cadre d’un projet s’intéressant au fluage de connecteurs collés. Pour utiliser cette géométrie, un bâti de fluage spécifique a été conçu. Pour analyser la déformation locale au niveau de la couche d’adhésif, deux capteurs LVDT mesurent le déplacement selon deux directions (normale et tangente à la surface collée). L’ensemble de ce dispositif expérimental permet d’étudier le comportement en fluage selon plusieurs paramètres : niveau de chargement, type de chargement, température, réversibilité du fluage. L’analyse des résultats de ces investigations expérimentales permet d’appréhender au mieux le comportement l’utilisation de l’assemblage collé vis-à-vis de son utilisation

Development of a Creep Mechanical Frame Setting Based on Arcan Test

International audienceStructural adhesive bonding has several advantages compared to other assembly techniques such as welding and riveting. Yet, creep is an important long-term phenomenon that needs to be considered for the design of such joints. To investigate this aspect, experimental investigations are needed at the scale of the adhesive layer. At such a scale, Arcan setting presents several advantages compared to other existing tests (analysis of different loads, limited edge effects) and was thus chosen for the development of an experimental approach aiming at providing creep characterization of adhesive layers. A mechanically operated testing machine was thus developed and is presented herein. To measure local strains of the adhesive layer, two linear variable differential transformer sensors are fixed on a support placed on the beaks of the Arcan sample according to two directions: normal and tangential to the bonded surface. The developed system (mechanical system and strain measurement) proved to be successful in investigating the creep behavior of adhesive layers while varying several parameters (load levels, type of load, temperature, adhesive thickness)

Palynological evidence of the agro-pastoral systems evolution on the French medium mountains

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Impact of the load level on the creep behaviour of adhesively bonded fastener in tension: experimental investigations, analytical and numerical modelling

International audienceThe use of structural adhesive bonding is increasing in structural assembly. It has indeed several advantages compared to other assembly techniques such as welding and riveting: uniform stress distribution, assembly of materials with different natures, no heat production. This last aspect is particularly interesting for the offshore activities. The firm Cold Pad has developed adhesively bonded fastener solutions, whose aim is to replace welding by structural bonding for the reinforcement of steel structures. Yet, some issues remain about the appraisal of the durability for such assembly and particularly creep. To address this issue, experimental creep investigations were carried out at real scale for one geometry of a fastener bonded with a methacrylate adhesive, and at different tension load levels. An inverse identification method has been developed in a previous study to identify the material creep properties from these investigations, independently of the fastener geometry. Considering the industrial applications of this fastener, the aim of this modelling approach is to describe correctly the primary and secondary creep stages. In this article, this identification method was applied to all the experimental results, using the Burger creep model. The dependency of the parameters with the load level is highlighted, which led to a nonlinear model. These results were then compared to finite element investigations to verify the consistency of the method and its ability to correctly identify the adhesive creep behaviour. This offers good perspectives in the transposition of the study to alternative fastener geometries using simple analytical design approaches.Highlights Bonded fastener’s creep behaviour experimentally investigated under different load levels. Creep modelling using a nonlinear and analytical approach with Burger model Identification of the material creep properties from experimental investigations at real scale on the bonded assembly. Numerical model developed to assess the consistency of the analytical approach

An Rpb4/Rpb7-Like Complex in Yeast RNA Polymerase III Contains the Orthologue of Mammalian CGRP-RCP

The essential C17 subunit of yeast RNA polymerase (Pol) III interacts with Brf1, a component of TFIIIB, suggesting a role for C17 in the initiation step of transcription. The protein sequence of C17 (encoded by RPC17) is conserved from yeasts to humans. However, mammalian homologues of C17 (named CGRP-RCP) are known to be involved in a signal transduction pathway related to G protein-coupled receptors, not in transcription. In the present work, we first establish that human CGRP-RCP is the genuine orthologue of C17. CGRP-RCP was found to functionally replace C17 in Δrpc17 yeast cells; the purified mutant Pol III contained CGRP-RCP and had a decreased specific activity but initiated faithfully. Furthermore, CGRP-RCP was identified by mass spectrometry in a highly purified human Pol III preparation. These results suggest that CGRP-RCP has a dual function in mammals. Next, we demonstrate by genetic and biochemical approaches that C17 forms with C25 (encoded by RPC25) a heterodimer akin to Rpb4/Rpb7 in Pol II. C17 and C25 were found to interact genetically in suppression screens and physically in coimmunopurification and two-hybrid experiments. Sequence analysis and molecular modeling indicated that the C17/C25 heterodimer likely adopts a structure similar to that of the archaeal RpoE/RpoF counterpart of the Rpb4/Rpb7 complex. These RNA polymerase subunits appear to have evolved to meet the distinct requirements of the multiple forms of RNA polymerases