A web-based and mobile health social support intervention to promote adherence to inhaled asthma medications: randomized controlled trial

Background: Online communities hold great potential as interventions for health, particularly for the management of chronic illness. The social support that online communities can provide has been associated with positive treatment outcomes, including medication adherence. There are few studies that have attempted to assess whether membership of an online community improves health outcomes using rigorous designs. Objective: Our objective was to conduct a rigorous proof-of-concept randomized controlled trial of an online community intervention for improving adherence to asthma medicine. Methods: This 9-week intervention included a sample of asthmatic adults from the United Kingdom who were prescribed an inhaled corticosteroid preventer. Participants were recruited via email and randomized to either an “online community” or “no online community” (diary) condition. After each instance of preventer use, participants (N=216) were required to report the number of doses of medication taken in a short post. Those randomized to the online community condition (n=99) could read the posts of other community members, reply, and create their own posts. Participants randomized to the no online community condition (n=117) also posted their medication use, but could not read others’ posts. The main outcome measures were self-reported medication adherence at baseline and follow-up (9 weeks postbaseline) and an objective measure of adherence to the intervention (visits to site). Results: In all, 103 participants completed the study (intervention: 37.8%, 39/99; control: 62.2%, 64/117). MANCOVA of self-reported adherence to asthma preventer medicine at follow-up was not significantly different between conditions in either intention-to-treat (P=.92) or per-protocol (P=.68) analysis. Site use was generally higher in the control compared to intervention conditions. Conclusions: Joining an online community did not improve adherence to preventer medication for asthma patients. Without the encouragement of greater community support or more components to sustain engagement over time, the current findings do not support the use of an online community to improve adherence

With a little help from my goals : integrating intergoal facilitation with the theory of planned behaviour to predict physical activity

Reproduced with permission from British Journal of Health Psychology © The British Psychological Society 2010.Peer reviewedPostprin

Statistical Mechanics of Stochastic Quantum Control: dd-adic R\'enyi Circuits

The dynamics of quantum information in many-body systems with large onsite Hilbert space dimension admits an enlightening description in terms of effective statistical mechanics models. Motivated by this fact, we reveal a connection between three separate models: the classically chaotic $d$-adic R\'{e}nyi map with stochastic control, a quantum analog of this map for qudits, and a Potts model on a random graph. The classical model and its quantum analog share a transition between chaotic and controlled phases, driven by a randomly applied control map that attempts to order the system. In the quantum model, the control map necessitates measurements that concurrently drive a phase transition in the entanglement content of the late-time steady state. To explore the interplay of the control and entanglement transitions, we derive an effective Potts model from the quantum model and use it to probe information-theoretic quantities that witness both transitions. The entanglement transition is found to be in the bond-percolation universality class, consistent with other measurement-induced phase transitions, while the control transition is governed by a classical random walk. These two phase transitions merge as a function of model parameters, consistent with behavior observed in previous small-size numerical studies of the quantum model.Comment: 14+3 pages, 13+1 figures, 3+4 table

Separate measurement- and feedback-driven entanglement transitions in the stochastic control of chaos

We study measurement-induced entanglement and control phase transitions in a quantum analog of the Bernoulli map subjected to a classically-inspired control protocol. When entangling gates are restricted to the Clifford group, separate entanglement ($p_\mathrm{ent}$) and control ($p_\mathrm{ctrl}$) transitions emerge, revealing two distinct universality classes. The control transition has critical exponents $\nu$ and $z$ consistent with the classical map (a random walk) while the entanglement transition is revealed to have similar exponents as the measurement-induced phase transition in Clifford hybrid dynamics. This is distinct from the case of generic entangling gates in the same model, where $p_\mathrm{ent} = p_\mathrm{ctrl}$ and universality is controlled by the random walk.Comment: 6 + 1 pages, 4 + 1 figure

A Novel ascaroside controls the parasitic life cycle of the entomopathogenic nematode heterorhabditis bacteriophora

Entomopathogenic nematodes survive in the soil as stress-resistant infective juveniles that seek out and infect insect hosts. Upon sensing internal host cues, the infective juveniles regurgitate bacterial pathogens from their gut that ultimately kill the host. Inside the host, the nematode develops into a reproductive adult and multiplies until unknown cues trigger the accumulation of infective juveniles. Here, we show that the entomopathogenic nematode Heterorhabditis bacteriophora uses a small-molecule pheromone to control infective juvenile development. The pheromone is structurally related to the dauer pheromone ascarosides that the free-living nematode Caenorhabditis elegans uses to control its development. However, none of the C. elegans ascarosides are effective in H. bacteriophora, suggesting that there is a high degree of species specificity. Our report is the first to show that ascarosides are important regulators of development in a parasitic nematode species. An understanding of chemical signaling in parasitic nematodes may enable the development of chemical tools to control these species. © 2012 American Chemical Society

Recurrence risk of occult micrometastases and isolated tumor cells in early stage endometrial cancer: A case control study

Objectives: To determine whether previously undetected occult micrometastasis (MM) or isolated tumor cells (ITC) is associated with increased recurrence odds in stage I-II endometrioid adenocarcinoma. Methods: Women with recurrent stage I/II EC who had complete pelvic and para-aortic were identified as the outcome of interest. A case-control study was designed with the exposure defined as occult MM/ITC not seen on original nodal pathology. Controls were found by frequency-matching in a 1:2 case control ratio. Original nodal slides were re-reviewed, stained and tested with immunohistochemical to detect occult MM/ITC and the odds of associated recurrence was calculated. Results: Of 153 included, 50 with and 103 without recurrence, there was no difference in age (p = 0.46), race (p = 0.24), stage (p = 0.75), FIGO grade (p = 0.64), lymphovascular space invasion (LVSI); p = 1.00, or GOG 99 high-intermediate risk (HIR) criteria (p = 0.35). A total of 18 ITC (11.8%) and 3 MM (2.0%) not previously identified were found in 19 patients. Finding occult MM/ITC was not associated with more lymph nodes (LN) removed (p = 0.67) or tumor grade (p = 0.48) but was significantly associated with stage (p \u3c 0.01). LVSI (p = 0.09) and meeting high-intermediate risk criteria (p = 0.09), were closely associated but not statistically significant. Isolated ITC were not associated with increased odds for recurrence (OR 0.71, CL: 0.20 - 2.22, p = 0.57), recurrence free survival (RFS) (p = 0.85) or overall survival (OS) (p = 0.92). Conclusions: In early-stage EC, identification of occult MM or ITC is uncommon and associated with stage. The presence of ITC was not associated with increased odds of recurrence. Adjusting stage or treatment may avoided based on ITC alone. Isolated MM were rare in our population, and further investigation is warranted

Targeting Aquaporin-4 Subcellular Localization to Treat Central Nervous System Edema

Swelling of the brain or spinal cord (CNS edema) affects millions of people every year. All potential pharmacological interventions have failed in clinical trials, meaning that symptom management is the only treatment option. The water channel protein aquaporin-4 (AQP4) is expressed in astrocytes and mediates water flux across the blood-brain and blood-spinal cord barriers. Here we show that AQP4 cell-surface abundance increases in response to hypoxia-induced cell swelling in a calmodulin-dependent manner. Calmodulin directly binds the AQP4 carboxyl terminus, causing a specific conformational change and driving AQP4 cell-surface localization. Inhibition of calmodulin in a rat spinal cord injury model with the licensed drug trifluoperazine inhibited AQP4 localization to the blood-spinal cord barrier, ablated CNS edema, and led to accelerated functional recovery compared with untreated animals. We propose that targeting the mechanism of calmodulin-mediated cell-surface localization of AQP4 is a viable strategy for development of CNS edema therapies

Does Removing Coyotes for Livestock Protection Benefit Free-Ranging Ungulates?

We studied the effects of coyote (Canis latrans) control for livestock protection on native ungulates during 2003 and 2004 on 7 sites in Utah and Colorado, USA, totaling over 1,900 km2. We found no relationships between coyote control variables and offspring/female deer ratios. However, control effort (no. of hr spent aerial gunning for coyotes) and success (no. of coyotes taken) were positively correlated with numbers of mule deer (Odocoileus hemionus) and pronghorn (Antilocapra americana) observed per kilometer of transect. Our results suggest that coyote control for livestock protection may increase densities of mule deer and pronghorn in areas where it is conducted

Sentinel-based Surveillance of Coyotes to Detect Bovine Tuberculosis, Michigan

Coyotes could be used as sentinels to detect Mycobacterium bovis in the wild

Testing a TheoRY-inspired MEssage ('TRY-ME'): a sub-trial within the Ontario Printed Educational Message (OPEM) trial

<p>Abstract</p> <p>Background</p> <p>A challenge for implementation researchers is to develop principles that could generate testable hypotheses that apply across a range of clinical contexts, thus leading to generalisability of findings. Such principles may be provided by systematically developed theories. The opportunity has arisen to test some of these theoretical principles in the Ontario Printed Educational Materials (OPEM) trial by conducting a sub-trial within the existing trial structure. OPEM is a large factorial cluster-randomised trial evaluating the effects of short directive and long discursive educational messages embedded into <b><it>informed</it></b>, an evidence-based newsletter produced in Canada by the Institute for Clinical Evaluative Sciences (ICES) and mailed to all primary care physicians in Ontario. The content of educational messages in the sub-trial will be constructed using both standard methods and methods inspired by psychological theory. The aim of this study is to test the effectiveness of the TheoRY-inspired MEssage ('TRY-ME') compared with the 'standard' message in changing prescribing behaviour.</p> <p>Methods</p> <p>The OPEM trial participants randomised to receive the short directive message attached to the outside of <b><it>informed </it></b>(an 'outsert') will be sub-randomised to receive either a standard message or a message informed by the theory of planned behaviour (TPB) using a two (long insert or no insert) by three (theory-based outsert or standard outsert or no outsert) design. The messages will relate to prescription of thiazide diuretics as first line drug treatment for hypertension (described in the accompanying protocol, "The Ontario Printed Educational Materials trial"). The short messages will be developed independently by two research teams.</p> <p>The primary outcome is prescription of thiazide diuretics, measured by routinely collected data available within ICES. The study is designed to answer the question, is there any difference in guideline adherence (i.e., thiazide prescription rates) between physicians in the six groups? A process evaluation survey instrument based on the TPB will be administered pre- and post-intervention (described in the accompanying protocol, "Looking inside the black box"). The second research question concerns processes that may underlie observed differences in prescribing behaviour. We expect that effects of the messages on prescribing behaviour will be mediated through changes in physicians' cognitions.</p> <p>Trial registration number</p> <p>Current controlled trial ISRCTN72772651</p