Stakeholder perspectives on the development of a virtual clinic for diabetes care : qualitative study

Background: The development of the Internet has created new opportunities for health care provision, including its use as a tool to aid the self-management of chronic conditions. We studied stakeholder reactions to an Internet-based “virtual clinic,” which would allow people with diabetes to communicate with their health care providers, find information about their condition, and share information and support with other users. Objective: The aim of the study was to present the results of a detailed consultation with a variety of stakeholder groups in order to identify what they regard as the desirable, important, and feasible characteristics of an Internet-based intervention to aid diabetes self-management. Methods: Three focus groups were conducted with 12 people with type 1 diabetes who used insulin pumps. Participants were recruited through a local diabetes clinic. One-on-one interviews were conducted with 5 health care professionals from the same clinic (2 doctors, 2 nurses, 1 dietitian) and with 1 representative of an insulin pump company. We gathered patient consensus via email on the important and useful features of Internet-based systems used for other chronic conditions (asthma, epilepsy, myalgic encephalopathy, mental health problems). A workshop to gather expert consensus on the use of information technology to improve the care of young people with diabetes was organized. Results: Stakeholder groups identified the following important characteristics of an Internet-based virtual clinic: being grounded on personal needs rather than only providing general information; having the facility to communicate with, and learn from, peers; providing information on the latest developments and news in diabetes; being quick and easy to use. This paper discusses these characteristics in light of a review of the relevant literature. The development of a virtual clinic for diabetes that embodies these principles, and that is based on self-efficacy theory, is described. Conclusions: Involvement of stakeholders is vital early in the development of a complex intervention. Stakeholders have clear and relevant views on what a virtual clinic system should provide, and these views can be captured and synthesized with relative ease. This work has led to the design of a system that is able to meet user needs and is currently being evaluated in a pilot study

KnetMiner:A comprehensive approach for supporting evidence-based gene discovery and complex trait analysis across species

Generating new ideas and scientific hypotheses is often the result of extensive literature and database reviews, overlaid with scientists’ own novel data and a creative process of making connections that were not made before. We have developed a comprehensive approach to guide this technically challenging data integration task and to make knowledge discovery and hypotheses generation easier for plant and crop researchers. KnetMiner can digest large volumes of scientific literature and biological research to find and visualise links between the genetic and biological properties of complex traits and diseases. Here we report the main design principles behind KnetMiner and provide use cases for mining public datasets to identify unknown links between traits such grain colour and pre-harvest sprouting in Triticum aestivum, as well as, an evidence-based approach to identify candidate genes under an Arabidopsis thaliana petal size QTL. We have developed KnetMiner knowledge graphs and applications for a range of species including plants, crops and pathogens. KnetMiner is the first open-source gene discovery platform that can leverage genome-scale knowledge graphs, generate evidence-based biological networks and be deployed for any species with a sequenced genome. KnetMiner is available at http://knetminer.org

Study of variable stars in the MOA data base: long-period red variables in the Large Magellanic Cloud

One hundred and forty six long-period red variable stars in the Large Magellanic Cloud (LMC) from the three year MOA project database were analysed. A careful periodic analysis was performed on these stars and a catalogue of their magnitudes, colours, periods and amplitudes is presented. We convert our blue and red magnitudes to $K$ band values using 19 oxygen-rich stars. A group of red short-period stars separated from the Mira sequence has been found on a (log P, K) diagram. They are located at the short period side of the Mira sequence consistent with the work of Wood and Sebo (1996). There are two interpretations for such stars; a difference in pulsation mode or a difference in chemical composition. We investigated the properties of these stars together with their colour, amplitude and periodicity. We conclude that they have small amplitudes and less regular variability. They are likely to be higher mode pulsators. A large scatter has been also found on the long period side of the (log P, K) diagram. This is possibly a systematic spread given that the blue band of our photometric system covers both standard B and V bands and affects carbon-rich stars.Comment: 19 pages, 19 figures, accepted for publication in MNRA

Microlensing optical depth towards the Galactic bulge from MOA observations during 2000 with Difference Image Analysis

We analyze the data of the gravitational microlensing survey carried out by by the MOA group during 2000 towards the Galactic Bulge (GB). Our observations are designed to detect efficiently high magnification events with faint source stars and short timescale events, by increasing the the sampling rate up to 6 times per night and using Difference Image Analysis (DIA). We detect 28 microlensing candidates in 12 GB fields corresponding to 16 deg^2. We use Monte Carlo simulations to estimate our microlensing event detection efficiency, where we construct the I-band extinction map of our GB fields in order to find dereddened magnitudes. We find a systematic bias and large uncertainty in the measured value of the timescale $t_{\rm Eout}$ in our simulations. They are associated with blending and unresolved sources, and are allowed for in our measurements. We compute an optical depth tau = 2.59_{-0.64}^{+0.84} \times 10^{-6} towards the GB for events with timescales 0.3<t_E<200 days. We consider disk-disk lensing, and obtain an optical depth tau_{bulge} = 3.36_{-0.81}^{+1.11} \times 10^{-6}[0.77/(1-f_{disk})] for the bulge component assuming a 23% stellar contribution from disk stars. These observed optical depths are consistent with previous measurements by the MACHO and OGLE groups, and still higher than those predicted by existing Galactic models. We present the timescale distribution of the observed events, and find there are no significant short events of a few days, in spite of our high detection efficiency for short timescale events down to t_E = 0.3 days. We find that half of all our detected events have high magnification (>10). These events are useful for studies of extra-solar planets.Comment: 65 pages and 30 figures, accepted for publication in ApJ. A systematic bias and uncertainty in the optical depth measurement has been quantified by simulation

Probing the atmosphere of a solar-like star by galactic microlensing at high magnification

We report a measurement of limb darkening of a solar-like star in the very high magnification microlensing event MOA 2002-BLG-33. A 15 hour deviation from the light curve profile expected for a single lens was monitored intensively in V and I passbands by five telescopes spanning the globe. Our modelling of the light curve showed the lens to be a close binary system whose centre-of-mass passed almost directly in front of the source star. The source star was identified as an F8-G2 main sequence turn-off star. The measured stellar profiles agree with current stellar atmosphere theory to within ~4% in two passbands. The effective angular resolution of the measurements is <1 micro-arcsec. These are the first limb darkening measurements obtained by microlensing for a Solar-like star.Comment: Accepted for publication in A&A Letters. 5 pages, 2 embedded colour ps figures plus 1 jpg figure. Version with all figures embedded available from: http://www.roe.ac.uk/~iab/moa33paper

Structure and Evolution of Nearby Stars with Planets. I. Short-Period Systems

Using the Yale stellar evolution code, we have calculated theoretical models for nearby stars with planetary-mass companions in short-period nearly circular orbits: 51 Pegasi, Tau Bootis, Upsilon Andromedae, Rho Cancri, and Rho Coronae Borealis. We present tables listing key stellar parameters such as mass, radius, age, and size of the convective envelope as a function of the observable parameters (luminosity, effective temperature, and metallicity), as well as the unknown helium fraction. For each star we construct best models based on recently published spectroscopic data and the present understanding of galactic chemical evolution. We discuss our results in the context of planet formation theory, and, in particular, tidal dissipation effects and stellar metallicity enhancements.Comment: 48 pages including 13 tables and 5 figures, to appear in Ap

On Planetary Companions to the MACHO-98-BLG-35 Microlens Star

We present observations of microlensing event MACHO-98-BLG-35 which reached a peak magnification factor of almost 80. These observations by the Microlensing Planet Search (MPS) and the MOA Collaborations place strong constraints on the possible planetary system of the lens star and show intriguing evidence for a low mass planet with a mass fraction $4\times 10^{-5} \leq \epsilon \leq 2\times 10^{-4}$. A giant planet with $\epsilon = 10^{-3}$ is excluded from 95% of the region between 0.4 and 2.5 $R_E$ from the lens star, where $R_E$ is the Einstein ring radius of the lens. This exclusion region is more extensive than the generic "lensing zone" which is $0.6 - 1.6 R_E$. For smaller mass planets, we can exclude 57% of the "lensing zone" for $\epsilon = 10^{-4}$ and 14% of the lensing zone for $\epsilon = 10^{-5}$. The mass fraction $\epsilon = 10^{-5}$ corresponds to an Earth mass planet for a lensing star of mass \sim 0.3 \msun. A number of similar events will provide statistically significant constraints on the prevalence of Earth mass planets. In order to put our limits in more familiar terms, we have compared our results to those expected for a Solar System clone averaging over possible lens system distances and orientations. We find that such a system is ruled out at the 90% confidence level. A copy of the Solar System with Jupiter replaced by a second Saturn mass planet can be ruled out at 70% confidence. Our low mass planetary signal (few Earth masses to Neptune mass) is significant at the $4.5\sigma$ confidence level. If this planetary interpretation is correct, the MACHO-98-BLG-35 lens system constitutes the first detection of a low mass planet orbiting an ordinary star without gas giant planets.Comment: ApJ, April 1, 2000; 27 pages including 8 color postscript figure

The Diabetes Manual trial protocol – a cluster randomized controlled trial of a self-management intervention for type 2 diabetes [ISRCTN06315411]

Background The Diabetes Manual is a type 2 diabetes self-management programme based upon the clinically effective 'Heart Manual'. The 12 week programme is a complex intervention theoretically underpinned by self-efficacy theory. It is a one to one intervention meeting United Kingdom requirements for structured diabetes-education and is delivered within routine primary care. Methods/design In a two-group cluster randomized controlled trial, GP practices are allocated by computer minimisation to an intervention group or a six-month deferred intervention group. We aim to recruit 250 participants from 50 practices across central England. Eligibility criteria are adults able to undertake the programme with type 2 diabetes, not taking insulin, with HbA1c over 8% (first 12 months) and following an agreed protocol change over 7% (months 13 to 18). Following randomisation, intervention nurses receive two-day training and delivered the Diabetes Manual programme to participants. Deferred intervention nurses receive the training following six-month follow-up. Primary outcome is HbA1c with total and HDL cholesterol; blood pressure, body mass index; self-efficacy and quality of life as additional outcomes. Primary analysis is between-group HbA1c differences at 6 months powered to give 80% power to detect a difference in HbA1c of 0.6%. A 12 month cohort analysis will assess maintenance of effect and assess relationship between self-efficacy and outcomes, and a qualitative study is running alongside. Discussion This trial incorporates educational and psychological diabetes interventions into a single programme and assesses both clinical and psychosocial outcomes. The trial will increase our understanding of intervention transferability between conditions, those diabetes related health behaviours that are more or less susceptible to change through efficacy enhancing mechanisms and how this impacts on clinical outcomes