Effect of Carelink, an internet-based insulin pump monitoring system, on glycemic control in rural and urban children with type 1 diabetes mellitus

Objective: To determine whether use of the internet-based insulin pump monitoring system, Carelink, improved glycemic control in rural and urban children treated with insulin pump therapy. Research Design: We reviewed records of 94 children treated with insulin pump therapy between the years 2004 and 2007 and compared glycemic control, diabetes self-care measures, frequency of clinic visits, and geographic location associated with Carelink use. Results: Carelink users showed improvement in hemoglobin Alc (HBAlc)levels [8.0 ± 0.1 (SE) vs. 7.7 ± 0.1 (SE), p=0.002]. Carelink users uploaded pump and glucometer data 2.2 ± 1.8 (SD) times per month over 0.8 ± 0.4 (SD) yr. Patients who had no access to Carelink software and were followed in a conventional manner showed no change in HbA1c levels [8.0 ± 0.2 (SE) vs. 8.1 ± 0.2 (SE), p=0.17] during the study period. Carelink non-users, defined as patients who had Carelink access but did not use it, had a higher HbA1c level at the start of the study and did not change over the study period [8.9 ± 0.2 (SE) vs. 9.0 ± 0.3 (SE), p=0.82. Rural Carelink users showed improvement in IIbA1c levels following Carelink use [7.9 ± 0.2 (SE) vs. 7.4 ± 0.2 (SE), p=0.001], yet had significantly fewer clinic visits per year compared with urban patients [2.8 ± 0.2 (SE) vs. 3.5 ± 0.1 (SE), p=0.001]. Conclusion: Use of the Carelink system was associated with improved glycemic control in children with type 1 diabetes on insulin pump therapy

Water level fluctuations and the ecosystem functioning of lakes

Hydrological regimes are key drivers of productivity and structure in freshwater ecosystems but are increasingly impacted by human activity. Using 17 published food web models of 13 African lakes as a case study, we explored relationships between seasonal and interannual water level fluctuations and 15 attributes related to ecosystem function. We interpreted our results in the context of Odum's ecosystem maturity hypothesis, as systems with higher magnitude fluctuations may be kept at an earlier maturity stage than those that are relatively stable. The data we compiled indicate that long-term changes in the hydrological regimes of African lakes have already taken place. We used Least Absolute Shrinkage and Selection Operator (LASSO) regression to examine relationships between ecosystem attributes and seven physical characteristics. Of these characteristics, interannual water level fluctuation magnitude was the most frequently retained predictor in the regression models. Our results indicate that interannual water level fluctuations are positively correlated with primary and overall production, but negatively correlated with fish diversity, transfer efficiency, and food chain length. These trends are opposite those expected with increasing ecosystem maturity. Interestingly, we found seasonal water level fluctuations to be positively correlated with biomass. An increase in standing biomass is generally associated with more mature ecosystems. However, we found that less production and biomass occurred at high trophic levels in highly fluctuating compared to relatively stable systems. This synthesis provides evidence that water level fluctuations are a key process influencing ecosystem structure and function in lakes.publishedVersio

Effect of Carelink, an Internet-Based Insulin Pump Monitoring System, on Glycemic Control in Children with Type 1 Diabetes Mellitus

Objective : To determine whether use of the internet-based Carelink system improved glycemic control in children on insulin pump therapy. Research Design and Methods - We reviewed records of 146 children treated with insulin pump therapy between the years 2004-2007, and compared glycemic control and diabetes self-care measures associated with Carelink use. Forty percent of the patients resided one hour or more from our clinic. Results: Patients who used the Carelink software and website showed significant improvement in HbA1c levels following use (8.0 ± 0.1 (SE) vs 7.7 ± 0.1 (SE), p=0.002). They uploaded data from their pump and glucometer 2.2 ± 1.8 times per month over 0.8 ± 0.4 (SD) years. Patients who had no access to Carelink software and were followed in a conventional manner showed no change in HbA1c ( 8.0 ± 0.1 (SE) vs 8.1 ± 0.1 (SE), p=0.27) during the study period. These patients did not differ significantly from Carelink users in diabetes self care behaviors. Patients who had Carelink access but did not use it had a higher HbA1c level at the onset and did not change over the study period (HbA1c 8.9 ± 0.2 (SE) vs 8.9 ± 0.3 (SE), p=0.76). These patients differed significantly from Carelink users in self-care behaviors, but not in the frequency of blood glucose monitoring. Patients in a rural location benefited equally as compared to patients who lived within one hour of our clinic. Conclusions: The Carelink software program is a powerful tool that can be used by diabetes care providers and parents to manage insulin pump therapy in children and to improve glycemic control, especially in states with a large rural population

Aunt Sallie\u27s Lament

Diamond shape bound book, 24 pages, mounted color illustrations. Limited edition of 120 copies signed by Claire Van Vliet, Mary Richardson, Audrey Holden and E.D. Levitt. This edition was made using the Permalin text block of the 1993 edition by Chronicle Books.. The design was made with Ellen Dorn Levitt and Audrey Holden who did most of the assembly and made the boxes with Mary Richardson. --Colophon. Book bound in a diamond-shape with the left point blunted for the spine. Each page is a different combination of colors and geometric shapes resembling quilt blocks. Additional Japanese and handmade papers added to this edition. Issued in a drop-spine box (31 cm.) covered with quilt-type fabric.https://digitalcommons.risd.edu/specialcollections_artistsbooks/1139/thumbnail.jp

The Iowa Homemaker vol.22, no.1

Keeping Up With Today, page 2 Meat – to the Front, Dorothy Ann Roost, page 3 When Defense Workers Eat, Marjorie Beneke, page 4 “Martha Duncan Says to You”, Julie Wendel, page 5 Design for Spring, Trymby Calhoun, page 6 Homemaking on the Test, Katherine Kaufman, page 8 A Textiles Journalist Talks Shop, Ida Halpin, page 9 What’s New in Home Economics, Ruth Vogel, page 10 Dress for Action, Betty Roth, page 12 Army Health Marches On, Marabeth Porter, page 13 Departmental Highlights, Lila Williamson, page 14 Across Alumnae Desks, Mary Ellen Sullivan, page 15 A Book for Home Managers, Helen Pundt, page 16 Alums in the News, Harriet Zook, page 18 Bookmarks, Eileen Dudgeon, page 19 Victory Shipments Advance, Bernadine Nelson, page 2

Polymorphisms in the Hsp70 gene locus are genetically associated with systemic lupus erythematosus

Background Heat shock proteins (Hsps) play a role in the delivery and presentation of antigenic peptides and are thought to be involved in the pathogenesis of multifactorial diseases. Objective To investigate genes encoding cytosolic Hsp70 proteins for associations of allelic variants with systemic lupus erythematosus (SLE). Methods Case-control studies of two independent Caucasian SLE cohorts were performed. In a haplotype-tagging single-nucleotide polymorphism approach, common variants of HspA1L, HspA1A and HspA1B were genotyped and principal component analyses were performed for the cohort from the Oklahoma Medical Research Foundation (OMRF). Relative quantification of mRNA was carried out for each Hsp70 gene in healthy controls. Conditional regression analysis was performed to determine if allelic variants in Hsp70 act independently of HLA-DR3. Results On analysis of common genetic variants of HspA1L, HspA1A and HspA1B, a haplotype significantly associated with SLE in the Erlangen-SLE cohort was identified, which was confirmed in the OMRF cohort. Depending on the cohorts, OR ranging from 1.43 to 1.88 and 2.64 to 3.16 was observed for individuals heterozygous and homozygous for the associated haplotype, respectively. Patients carrying the risk haplotype or the risk allele more often displayed autoantibodies to Ro and La in both cohorts. In healthy controls bearing this haplotype, the amount of HspA1A mRNA was significantly increased, whereas total Hsp70 protein concentration was not altered. Conclusions Allelic variants of the Hsp70 genes are significantly associated with SLE in Caucasians, independently of HLA-DR3, and correlate with the presence of autoantibodies to Ro and La. Hence, the Hsp70 gene locus appears to be involved in SLE pathogenesis

Caribbean Corals in Crisis: Record Thermal Stress, Bleaching, and Mortality in 2005

BACKGROUND The rising temperature of the world's oceans has become a major threat to coral reefs globally as the severity and frequency of mass coral bleaching and mortality events increase. In 2005, high ocean temperatures in the tropical Atlantic and Caribbean resulted in the most severe bleaching event ever recorded in the basin. METHODOLOGY/PRINCIPAL FINDINGS Satellite-based tools provided warnings for coral reef managers and scientists, guiding both the timing and location of researchers' field observations as anomalously warm conditions developed and spread across the greater Caribbean region from June to October 2005. Field surveys of bleaching and mortality exceeded prior efforts in detail and extent, and provided a new standard for documenting the effects of bleaching and for testing nowcast and forecast products. Collaborators from 22 countries undertook the most comprehensive documentation of basin-scale bleaching to date and found that over 80% of corals bleached and over 40% died at many sites. The most severe bleaching coincided with waters nearest a western Atlantic warm pool that was centered off the northern end of the Lesser Antilles. CONCLUSIONS/SIGNIFICANCE Thermal stress during the 2005 event exceeded any observed from the Caribbean in the prior 20 years, and regionally-averaged temperatures were the warmest in over 150 years. Comparison of satellite data against field surveys demonstrated a significant predictive relationship between accumulated heat stress (measured using NOAA Coral Reef Watch's Degree Heating Weeks) and bleaching intensity. This severe, widespread bleaching and mortality will undoubtedly have long-term consequences for reef ecosystems and suggests a troubled future for tropical marine ecosystems under a warming climate.This work was partially supported by salaries from the NOAA Coral Reef Conservation Program to the NOAA Coral Reef Conservation Program authors. NOAA provided funding to Caribbean ReefCheck investigators to undertake surveys of bleaching and mortality. Otherwise, no funding from outside authors' institutions was necessary for the undertaking of this study. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript