Diabetes Medication Assistance Service: The pharmacist's role in supporting patient self-management of type 2 diabetes (T2DM) in Australia

Objective. To evaluate the capacity and effectiveness of trained community pharmacists in delivering the Diabetes Medication Assistance Service (DMAS) via (1) number and types of self-management support interventions (SMSIs); (2) number of goals set and attained by patients and (3) patient outcomes (glycaemic control, medication adherence and satisfaction). Methods. Pharmacists (n = 109) from 90 community pharmacies in Australia were trained and credentialed to deliver the DMAS. The training focused on developing pharmacists’ knowledge and skills in supporting patients’ diabetes self-management. Results. A total of 387 patients completed the trial. The mean number of SMSIs per patient was 35 (SD ±31) and the majority (87%) had at least one documented goal that was fully or partially attained. There were significant health benefits for patients including improved glycaemic control and a reduced risk of non-adherence to medications. Over 90% of DMAS patients reported improvements in their knowledge about diabetes self-management.Conclusion. The DMAS provides self management support in the community pharmacy for people with T2DM which may result in improved clinical outcomes. Practice implication. Given appropriate training in diabetes care and behavior change strategies, community pharmacists can offer programs which provide self-management support to their patients with T2DM and improve their health outcomes

The role of tank-treading motions in the transverse migration of a spheroidal vesicle in a shear flow

The behavior of a spheroidal vesicle, in a plane shear flow bounded from one side by a wall, is analysed when the distance from the wall is much larger than the spheroid radius. It is found that tank treading motions produce a transverse drift away from the wall, proportional to the spheroid eccentricity and the inverse square of the distance from the wall. This drift is independent of inertia, and is completely determined by the characteristics of the vesicle membrane. The relative strength of the contribution to drift from tank-treading motions and from the presence of inertial corrections, is discussed.Comment: 16 pages, 1 figure, Latex. To appear on J. Phys. A (Math. Gen.

A Methodology for Flash Drought Identification: Application of Flash Drought Frequency across the United States

With the increasing use of the term ‘‘flash drought’’ within the scientific community, Otkin et al. provide a general definition that identifies flash droughts based on their unusually rapid rate of intensification. This study presents an objective percentile-based methodology that builds upon that work by identifying flash droughts using standardized evaporative stress ratio (SESR) values and changes in SESR over some period of time. Four criteria are specified to identify flash droughts: two that emphasize the vegetative impacts of flash drought and two that focus on the rapid rate of intensification. The methodology was applied to the North American Regional Reanalysis (NARR) to develop a 38-yr flash drought climatology (1979–2016) across the United States. It was found that SESR derived from NARR data compared well with the satellite-based evaporative stress index for four previously identified flash drought events. Furthermore, four additional flash drought cases were compared with the U.S. Drought Monitor (USDM), and SESR rapidly declined 1–2 weeks before a response was evident with the USDM. From the climatological analysis, a hot spot of flash drought occurrence was revealed over the Great Plains, the Corn Belt, and the western Great Lakes region. Relatively few flash drought events occurred over mountainous and arid regions. Flash droughts were categorized based on their rate of intensification, and it was found that the most intense flash droughts occurred over the central Great Plains, Corn Belt, and western Great Lakes region

Time Dependent Monte Carlo Radiative Transfer Calculations For 3-Dimensional Supernova Spectra, Lightcurves, and Polarization

We discuss Monte-Carlo techniques for addressing the 3-dimensional time-dependent radiative transfer problem in rapidly expanding supernova atmospheres. The transfer code SEDONA has been developed to calculate the lightcurves, spectra, and polarization of aspherical supernova models. From the onset of free-expansion in the supernova ejecta, SEDONA solves the radiative transfer problem self-consistently, including a detailed treatment of gamma-ray transfer from radioactive decay and with a radiative equilibrium solution of the temperature structure. Line fluorescence processes can also be treated directly. No free parameters need be adjusted in the radiative transfer calculation, providing a direct link between multi-dimensional hydrodynamical explosion models and observations. We describe the computational techniques applied in SEDONA, and verify the code by comparison to existing calculations. We find that convergence of the Monte Carlo method is rapid and stable even for complicated multi-dimensional configurations. We also investigate the accuracy of a few commonly applied approximations in supernova transfer, namely the stationarity approximation and the two-level atom expansion opacity formalism.Comment: 16 pages, ApJ accepte

Primary leptomeningeal oligodendrogliomatosis

Primary leptomeningeal oligodendrogliomas (PLOs) are rare intracranial malignancies where tumors grow in the subarachnoid space without an obvious connection to the brain or spinal cord parenchyma. Adding to the three previously reported cases of PLO with no parenchymal involvement we report a fourth case of the same in this paper in a 50-year-old woman presenting with unrelenting headaches. CT scan of her head revealed hydrocephalus and MRI revealed diffuse enhancement of her leptomeninges throughout her brain and spine, prominent over the basilar region. Biopsy obtained using a frameless stereotactic biopsy showed sharply defined cell borders, clear cytoplasm, and rounded nuclei consistent with an oligodendroglioma. Our case suggests that PLO can mimic diffuse forms of granulomatous meningitis and should be suspected in patients that clinically and radiographically present like granulomatous meningitis but without blood or CSF markers for the same

Algebraic Comparison of Partial Lists in Bioinformatics

The outcome of a functional genomics pipeline is usually a partial list of genomic features, ranked by their relevance in modelling biological phenotype in terms of a classification or regression model. Due to resampling protocols or just within a meta-analysis comparison, instead of one list it is often the case that sets of alternative feature lists (possibly of different lengths) are obtained. Here we introduce a method, based on the algebraic theory of symmetric groups, for studying the variability between lists ("list stability") in the case of lists of unequal length. We provide algorithms evaluating stability for lists embedded in the full feature set or just limited to the features occurring in the partial lists. The method is demonstrated first on synthetic data in a gene filtering task and then for finding gene profiles on a recent prostate cancer dataset

Basement membrane and vascular remodelling in smokers and chronic obstructive pulmonary disease: a cross-sectional study

<p>Abstract</p> <p>Background</p> <p>Little is known about airway remodelling in bronchial biopsies (BB) in smokers and chronic obstructive pulmonary disease (COPD). We conducted an initial pilot study comparing BB from COPD patients with nonsmoking controls. This pilot study suggested the presence of reticular basement membrane (Rbm) fragmentation and altered vessel distribution in COPD.</p> <p>Methods</p> <p>To determine whether Rbm fragmentation and altered vessel distribution in BB were specific for COPD we designed a cross-sectional study and stained BB from 19 current smokers and 14 ex-smokers with mild to moderate COPD and compared these to 15 current smokers with normal lung function and 17 healthy and nonsmoking subjects.</p> <p>Results</p> <p>Thickness of the Rbm was not significantly different between groups; although in COPD this parameter was quite variable. The Rbm showed fragmentation and splitting in both current smoking groups and ex-smoker COPD compared with healthy nonsmokers (p < 0.02); smoking and COPD seemed to have additive effects. Rbm fragmentation correlated with smoking history in COPD but not with age. There were more vessels in the Rbm and fewer vessels in the lamina propria in current smokers compared to healthy nonsmokers (p < 0.05). The number of vessels staining for vascular endothelial growth factor (VEGF) in the Rbm was higher in both current smoker groups and ex-smoker COPD compared to healthy nonsmokers (p < 0.004). In current smoker COPD VEGF vessel staining correlated with FEV1% predicted (r = 0.61, p < 0.02).</p> <p>Conclusions</p> <p>Airway remodelling in smokers and mild to moderate COPD is associated with fragmentation of the Rbm and altered distribution of vessels in the airway wall. Rbm fragmentation was also present to as great an extent in ex-smokers with COPD. These characteristics may have potential physiological consequences.</p

Carbon dioxide capture and separation techniques for advanced power generation point sources

The capture/separation step for carbon dioxide (CO2) from large-point sources is a critical one with respect to the technical feasibility and cost of the overall carbon sequestration scenario. For large-point sources, such as those found in power generation, the carbon dioxide capture techniques being investigated by the in-house research area of the National Energy Technology Laboratory possess the potential for improved efficiency and costs as compared to more conventional technologies. The investigated techniques can have wide applications, but the research has focused on capture/separation of carbon dioxide from flue gas (postcombustion from fossil fuel-fired combustors) and from fuel gas (precombustion, such as integrated gasification combined cycle – IGCC). With respect to fuel gas applications, novel concepts are being developed in wet scrubbing with physical absorption; chemical absorption with solid sorbents; and separation by membranes. In one concept, a wet scrubbing technique is being investigated that uses a physical solvent process to remove CO2 from fuel gas of an IGCC system at elevated temperature and pressure. The need to define an ideal solvent has led to the study of the solubility and mass transfer properties of various solvents. Fabrication techniques and mechanistic studies for hybrid membranes separating CO2 from the fuel gas produced by coal gasification are also being performed. Membranes that consist of CO2-philic silanes incorporated into an alumina support or ionic liquids encapsulated into a polymeric substrate have been investigated for permeability and selectivity. An overview of two novel techniques is presented along with a research progress status of each technology

Peculiarities and variations in the optical spectrum of the post-AGB star V448Lac=IRAS22223+4327

Repeated observations with high spectral resolution acquired in 1998-2008 are used to study the temporal behavior of the spectral line profiles and velocity field in the atmosphere and circumstellar envelope of the post-AGB star V448Lac. Asymmetry of the profiles of the strongest absorption lines with low-level excitation potentials less 1eV and time variations of these profiles have been detected, most prominently the profiles of the resonance lines of BaII, YII, LaII, SiII. The peculiarity of these profiles can be explained using a superposition of stellar absorption line and shell emission lines. Emission in the (0;1) 5635A Swan band of the C2 molecule has been detected in the spectrum of V448Lac for the first time. The core of the Halpha line displays radial velocity variations with an amplitude ~8 km/s. Radial velocity variations displayed by weakest metallic lines with lower amplitudes, 1-2 km/s, may be due to atmospheric pulsations. Differential line shifts, 0 -- 8 km/s, have been detected on various dates. The position of the molecular spectrum is stationary in time, indicating a constant expansion velocity of the circumstellar shell, Vexp=15.2 km/s, as derived from the C2 and NaI lines.Comment: 19 pages, 8 figures, 1 tabl