Community Needs Assessment of Mayasandra Village, Karnataka, India

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Electron interferometry with nano-gratings

We present an electron interferometer based on near-field diffraction from two nanostructure gratings. Lau fringes are observed with an imaging detector, and revivals in the fringe visibility occur as the separation between gratings is increased from 0 to 3 mm. This verifies that electron beams diffracted by nanostructures remain coherent after propagating farther than the Talbot length $z_T = 2d^2/\lambda$ = 1.2 mm, and hence is a proof of principle for the function of a Talbot-Lau interferometer for electrons. Distorted fringes due to a phase object demonstrates an application for this new type of electron interferometer.Comment: 4 pgs, 6 figure

Improving the clinical value and utility of CGM systems: issues and recommendations : a joint statement of the European Association for the Study of Diabetes and the American Diabetes Association Diabetes Technology Working Group

The first systems for continuous glucose monitoring (CGM) became available over 15 years ago. Many then believed CGM would revolutionise the use of intensive insulin therapy in diabetes; however, progress towards that vision has been gradual. Although increasing, the proportion of individuals using CGM rather than conventional systems for self-monitoring of blood glucose on a daily basis is still low in most parts of the world. Barriers to uptake include cost, measurement reliability (particularly with earlier-generation systems), human factors issues, lack of a standardised format for displaying results and uncertainty on how best to use CGM data to make therapeutic decisions. This scientific statement makes recommendations for systemic improvements in clinical use and regulatory (pre- and postmarketing) handling of CGM devices. The aim is to improve safety and efficacy in order to support the advancement of the technology in achieving its potential to improve quality of life and health outcomes for more people with diabetes

Improving the clinical value and utility of CGM systems: issues and recommendations: a joint statement of the European Association for the Study of Diabetes and the American Diabetes Association Diabetes Technology Working Group

The first systems for continuous glucose monitoring (CGM) became available over 15 years ago. Many then believed CGM would revolutionize the use of intensive insulin therapy in diabetes; however, progress toward that vision has been gradual. Although increasing, the proportion of individuals using CGM rather than conventional systems for self-monitoring of blood glucose on a daily basis is still low in most parts of the world. Barriers to uptake include cost, measurement reliability (particularly with earlier-generation systems), human factors issues, lack of a standardized format for displaying results, and uncertainty on how best to use CGM data to make therapeutic decisions. This Scientific Statement makes recommendations for systemic improvements in clinical use and regulatory (pre- and postmarketing) handling of CGM devices. The aim is to improve safety and efficacy in order to support the advancement of the technology in achieving its potential to improve quality of life and health outcomes for more people with diabetes

Characterisation of geomechanical properties of bentonite clay used for plug and abandonment operations of coal seam gas wells

Compressed bentonite in the form of pellets or plugs is used for the abandonment of production wells for the oil and gas industry. The design of the abandonment systems is based on the hydro-mechanical behaviour of the compressed bentonite defined by mechanical parameters that are used from published data rather than quantified for the used material by laboratory investigations. This paper presents an experimental study on characterising the swelling and shear strength behaviour of raw and polymer (polyvinylpyrrolidone, PVP) treated bentonite. Dislodgement tests consist of three hydrated bentonite plugs inserted in steel casings with the failure mechanism characterised. The bentonite used comes from a local mine (in Queensland, Australia) and is comparable to other bentonites usually used for the abandonment of wells or for other problems where mineral sealing is required (e.g. basal clay barriers of landfills). The experiments have shown that polymer treated bentonite shows significantly larger shear strengths than raw bentonite with simultaneously less swelling. More compressed samples also showed higher shear strengths and less swelling. The dislodgement tests have characterised for the first time the cascaded failure mechanism of a series of plugs forming an abandonment system. This investigation is the first step towards the development of an improved design for abandonment systems for wells using bentonite plugs

On the way to gender equality? Reports from Austria, Denmark, France, Germany, Hungary, Sweden, Switzerland, the United Kingdom and the United States

Questions of gender and family occupy a central place in public and political debate today. Discussions about gender roles and family benefits are often conducted in a highly emotional and polarising tone. One consequence of this is an instrumentalisation of family and gender questions by populist political parties, seeking to whip up support with anti-emancipatory slogans. This development is not only observed in Germany, but affects many other societies too. The growing centrality of family and gender issues also needs to be understood in the context of changing gender roles and growing female economic participation. In many cases the successes have been driven by progressive political forces. This study summarises the latest developments and centre-left discourses in concise contributions from nine countries and supplies a basis for comparison (including France, Germany, Sweden and the United States)

Skilled Care Requirements for Elderly Patients After Coronary Artery Bypass Grafting

To examine the extent to which elderly individuals use various skilled care facilities after coronary artery bypass grafting (CABG). Design : Retrospective cohort study. Setting : State of Michigan from 1997 to 1998. Participants : Residents aged 65 and older enrolled in Medicare who underwent CABG. Measurements : Cumulative incidence of admission within 100 days of hospital discharge, relative risk (RR) of admission, readmission or extended stay at a skilled care facility, and length of stay in a skilled care facility. Results : Fifty percent of patients aged 80 and older used a skilled care facility after CABG, with most requiring admission to a skilled nursing facility (SNF) or readmission to an acute-care hospital within 100 days after discharge. Patients aged 80 and older had a significantly higher risk of admission to a SNF (adjusted RR=3.3, 95% confidence interval (CI)=2.8–4.0) than did those aged 65 to 69, as did patients aged 75 to 79 (adjusted RR=2.2, 95% CI=1.8–2.6) and those aged 70 to 74 (adjusted RR=1.5, 95% CI=1.3–1.8). The length of time spent in skilled care facilities significantly increased with age (mean days=13.3 for aged 65–69, 16.9 for 70–74, 19.6 for 75–79, and 22.9 for 80 and older; P< .001). Conclusion : Older patients are more likely to be admitted to a SNF, be readmitted to an acute-care hospital, and have longer institutional stays after CABG. When balancing the risks and benefits of CABG, physicians, patients, families, and policy-makers need to carefully consider the likelihood of follow-up institutional care in elderly patients.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/66314/1/j.1532-5415.2005.53356.x.pd

Diabetes Digital App Technology: Benefits, Challenges, and Recommendations. A Consensus Report by the European Association for the Study of Diabetes (EASD) and the American Diabetes Association (ADA) Diabetes Technology Working Group

Digital health technology, especially digital and health applications ("apps"), have been developing rapidly to help people manage their diabetes. Numerous health-related apps provided on smartphones and other wireless devices are available to support people with diabetes who need to adopt either lifestyle interventions or medication adjustments in response to glucose-monitoring data. However, regulations and guidelines have not caught up with the burgeoning field to standardize how mobile health apps are reviewed and monitored for patient safety and clinical validity. The available evidence on the safety and effectiveness of mobile health apps, especially for diabetes, remains limited. The European Association for the Study of Diabetes (EASD) and the American Diabetes Association (ADA) have therefore conducted a joint review of the current landscape of available diabetes digital health technology (only stand-alone diabetes apps, as opposed to those that are integral to a regulated medical device, such as insulin pumps, continuous glucose monitoring systems, and automated insulin delivery systems) and practices of regulatory authorities and organizations. We found that, across the U.S. and Europe, mobile apps intended to manage health and wellness are largely unregulated unless they meet the definition of medical devices for therapeutic and/or diagnostic purposes. International organizations, including the International Medical Device Regulators Forum and the World Health Organization, have made strides in classifying different types of digital health technology and integrating digital health technology into the field of medical devices. As the diabetes digital health field continues to develop and become more fully integrated into everyday life, we wish to ensure that it is based on the best evidence for safety and efficacy. As a result, we bring to light several issues that the diabetes community, including regulatory authorities, policy makers, professional organizations, researchers, people with diabetes, and health care professionals, needs to address to ensure that diabetes health technology can meet its full potential. These issues range from inadequate evidence on app accuracy and clinical validity to lack of training provision, poor interoperability and standardization, and insufficient data security. We conclude with a series of recommended actions to resolve some of these shortcomings

Incidence, prevalence and care of type 1 diabetes in children and adolescents in Germany: Time trends and regional socioeconomic situation

Background: Trends over time and possible socio-spatial inequalities in the incidence and care of type 1 diabetes mellitus (T1D) in children and adolescents are important parameters for the planning of target-specific treatment structures. Methodology: The incidence and prevalence of type 1 diabetes, diabetic ketoacidosis and severe hypoglycaemia as well as the HbA1c value are presented for under 18-year-olds based on data from the nationwide Diabetes Prospective Follow-up Registry (DPV) and the diabetes registry of North Rhine-Westphalia. Indicators were mapped by sex over time between 2014 and 2020, and stratified by sex, age and regional socioeconomic deprivation for 2020. Results: In 2020, the incidence was 29.2 per 100,000 person-years and the prevalence was 235.5 per 100,000 persons, with the figures being higher in boys than in girls in either case. The median HbA1c value was 7.5%. Ketoacidosis manifested in 3.4% of treated children and adolescents, significantly more often in regions with very high (4.5%) deprivation than in regions with very low deprivation (2.4%). The proportion of severe hypoglycaemia cases was 3.0%. Between 2014 and 2020, the incidence, prevalence and HbA1c levels changed little, while the proportions of ketoacidosis and severe hypoglycaemia decreased. Conclusions: The decrease in acute complications indicates that type 1 diabetes care has improved. Similar to previous studies, the results suggest an inequality in care by regional socioeconomic situation