307 research outputs found

    Dawn to dusk counts of common or garden birds, Wellington, New Zealand

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    Abstract Common Iand-birds in a rural suburban garden, Wellington, New Zealand, were counted for 10 minutes twice an hour, twice a month for 2 years, from dawn to dusk. The birds' behaviour sometimes changed or they entered or left the study area during the day; so there is no ided time of day for counting buds

    HbA1c response and hospital admissions following commencement of flash glucose monitoring in adults with type 1 diabetes

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    Introduction Our aim was to assess the effect of introducing flash monitoring in adults with type 1 diabetes with respect to change in hemoglobin A1c (HbA1c) and frequency of hospital admissions.Research design and methods Prospective observational study of adults with type 1 diabetes in our center, in whom a prescription for a flash monitoring sensor was collected. Primary outcome was change in HbA1c between 2016 and after flash monitoring. Rates of hospital admission were compared between the first year after flash monitoring and the corresponding 12-month period 2 years earlier.Results Approximately half of all adults with type 1 diabetes, attending our center, collected prescriptions for flash monitoring sensors (n=2216). Median fall in HbA1c was −1 (−0.1) mmol/mol (%) (p<0.001) and was greatest in those with baseline HbA1c >75 (9.0) mmol/mol (%): −10 (−0.9) mmol/mol (%), p<0.001. 43% of those with a baseline HbA1c >53 mmol/mol (7%) experienced a ≥5 mmol/mol (0.5%) fall in HbA1c. In addition to higher HbA1c, early commencement within 1 month of NHS-funded flash monitoring (p<0.001), and male gender (p=0.013) were associated with a fall in HbA1c of ≥5 (0.5) mmol/mol (%). Socioeconomic deprivation (p=0.009) and collecting fewer than 2 sensors per month (p=0.002) were associated with lack of response. Overall, hospital admissions did not change but an increase in admissions for hypoglycemia was observed (1.1% vs 0.3%, p=0.026).Conclusions Flash monitoring is associated with reduction in HbA1c in individuals with HbA1c >58 mmol/mol. Numerous clinical features are independently associated with HbA1c response. An increase in hypoglycemia admissions occurred following flash monitoring

    Practical Guide for Ground-water Sampling

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    Marked improvements in glycaemic outcomes following insulin pump therapy initiation in people with type 1 diabetes:a nationwide observational study in Scotland

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    This study was supported by funding from Diabetes UK (17/0005627) and the Chief Scientist Office (ref. ETM/47).Aims/hypothesis Our aim was to assess the use of continuous subcutaneous insulin infusion (CSII) in people with type 1 diabetes in Scotland and its association with glycaemic control, as measured by HbA1c levels, frequency of diabetic ketoacidosis (DKA) and severe hospitalised hypoglycaemia (SHH), overall and stratified by baseline HbA1c. Methods We included 4684 individuals with type 1 diabetes from the national Scottish register, who commenced CSII between 2004 and 2019. We presented crude within-person differences from baseline HbA1c over time since initiation, crude DKA and SHH event-rates pre-/post-CSII exposure. We then used mixed models to assess the significance of CSII exposure, taking into account: (1) the diffuse nature of the intervention (i.e. structured education often precedes initiation); (2) repeated within-person measurements; and (3) background time-trends occurring pre-intervention. Results HbA1c decreased after CSII initiation, with a median within-person change of −5.5 mmol/mol (IQR −12.0, 0.0) (−0.5% [IQR −1.1, 0.0]). Within-person changes were most substantial in those with the highest baseline HbA1c, with median −21.0 mmol/mol (−30.0, −11.0) (−1.9% [−2.7, −1.0]) change in those with a baseline >84 mmol/mol (9.8%) within a year of exposure, that was sustained: −19.0 mmol/mol (−27.6, −6.5) (−1.7% [−2.5, −0.6]) at ≥5 years. Statistical significance and magnitude of change were supported by the mixed models results. The crude DKA event-rate was significantly lower in post-CSII person-time compared with pre-CSII person-time: 49.6 events (95% CI 46.3, 53.1) per 1000 person-years vs 67.9 (64.1, 71.9); rate ratio from Bayesian mixed models adjusting for pre-exposure trend: 0.61 (95% credible interval [CrI] 0.47, 0.77; posterior probability of reduction pp = 1.00). The crude overall SHH event-rate in post-CSII vs pre-CSII person-time was also lower: 17.8 events (95% CI 15.8, 19.9) per 1000 person-years post-exposure vs 25.8 (23.5, 28.3) pre-exposure; rate ratio from Bayesian mixed models adjusting for pre-exposure trend: 0.67 (95% CrI 0.45, 1.01; pp = 0.97). Conclusions/interpretation CSII therapy was associated with marked falls in HbA1c especially in those with high baseline HbA1c. CSII was independently associated with reduced DKA and SHH rates. CSII appears to be an effective option for intensive insulin therapy in people with diabetes for improving suboptimal glycaemic control.Publisher PDFPeer reviewe

    Rising Rates And Widening Socio-economic Disparities In Diabetic Ketoacidosis In Type 1 Diabetes In Scotland:A Nationwide Retrospective Cohort Observational Study

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    OBJECTIVE: Whether advances in the management of type 1 diabetes are reducing rates of diabetic ketoacidosis (DKA) is unclear. We investigated time trends in DKA rates in a national cohort of individuals with type 1 diabetes monitored for 14 years, overall and by socioeconomic characteristics. RESEARCH DESIGN AND METHODS: All individuals in Scotland with type 1 diabetes who were alive and at least 1 year old between 1 January 2004 and 31 December 2018 were identified using the national register (N 5 37,939). DKA deaths and hospital admissions were obtained through linkage to Scottish national death and morbidity records. Bayesian regression was used to test for DKA time trends and association with risk markers, including socioeconomic deprivation. RESULTS: There were 30,427 DKA admissions and 472 DKA deaths observed over 393,223 person-years at risk. DKA event rates increased over the study period (incidence rate ratio [IRR] per year 1.058 [95% credibility interval 1.054–1.061]). Males had lower rates than females (IRR male-to-female 0.814 [0.776–0.855]). DKA incidence rose in all age-groups other than 10- to 19-year-olds, in whom rates were the highest, but fell over the study. There was a large socioeconomic differential (IRR least-to-most deprived quintile 0.446 [0.406–0.490]), which increased during follow-up. Insulin pump use or completion of structured education were associated with lower DKA rates, and antidepressant and methadone prescription were associated with higher DKA rates. CONCLUSIONS: DKA incidence has risen since 2004, except in 10- to 19-year-olds. Of particular concern are the strong and widening socioeconomic disparities in DKA outcomes. Efforts to prevent DKA, especially in vulnerable groups, require strengthening

    Mitochondrial calcium exchange links metabolism with the epigenome to control cellular differentiation.

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    Fibroblast to myofibroblast differentiation is crucial for the initial healing response but excessive myofibroblast activation leads to pathological fibrosis. Therefore, it is imperative to understand the mechanisms underlying myofibroblast formation. Here we report that mitochondrial calcium (mCa2+) signaling is a regulatory mechanism in myofibroblast differentiation and fibrosis. We demonstrate that fibrotic signaling alters gating of the mitochondrial calcium uniporter (mtCU) in a MICU1-dependent fashion to reduce mCa2+ uptake and induce coordinated changes in metabolism, i.e., increased glycolysis feeding anabolic pathways and glutaminolysis yielding increased α-ketoglutarate (αKG) bioavailability. mCa2+-dependent metabolic reprogramming leads to the activation of αKG-dependent histone demethylases, enhancing chromatin accessibility in loci specific to the myofibroblast gene program, resulting in differentiation. Our results uncover an important role for the mtCU beyond metabolic regulation and cell death and demonstrate that mCa2+ signaling regulates the epigenome to influence cellular differentiation

    PTF10nvg: An Outbursting Class I Protostar in the Pelican/North American Nebula

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    During a synoptic survey of the North American Nebula region, the Palomar Transient Factory (PTF) detected an optical outburst (dubbed PTF10nvg) associated with the previously unstudied flat or rising spectrum infrared source IRAS 20496+4354. The PTF R-band light curve reveals that PTF10nvg brightened by more than 5 mag during the current outburst, rising to a peak magnitude of R~13.5 in 2010 Sep. Follow-up observations indicate PTF10nvg has undergone a similar ~5 mag brightening in the K band, and possesses a rich emission-line spectrum, including numerous lines commonly assumed to trace mass accretion and outflows. Many of these lines are blueshifted by ~175 km/s from the North American Nebula's rest velocity, suggesting that PTF10nvg is driving an outflow. Optical spectra of PTF10nvg show several TiO/VO bandheads fully in emission, indicating the presence of an unusual amount of dense (> 10^10 cm^-3), warm (1500-4000 K) circumstellar material. Near-infrared spectra of PTF10nvg appear quite similar to a spectrum of McNeil's Nebula/V1647 Ori, a young star which has undergone several brightenings in recent decades, and 06297+1021W, a Class I protostar with a similarly rich near--infrared emission line spectrum. While further monitoring is required to fully understand this event, we conclude that the brightening of PTF10nvg is indicative of enhanced accretion and outflow in this Class-I-type protostellar object, similar to the behavior of V1647 Ori in 2004-2005.Comment: Accepted to the Astronomical Journal; 21 pages, 11 figures, 6 tables in emulateapj format; v2 fixes typo in abstract; v3 updates status to accepted, adjusts affiliations, adds acknowledgmen
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