Results from the first culturally tailored, multidisciplinary diabetes education in Lebanese adults with type 2 diabetes: effects on self-care and metabolic outcomes

Objective: Diabetes self-management education (DSME) is an essential component of lifestyle management needed for diabetes care. This pilot-study tested the effect of culturally-tailored education targeting diabetes selfcare on glycemia and cardiovascular risk factors of Lebanese with type 2 diabetes mellitus (T2DM) (n = 27; Age: 61 ± 10 yrs, 59% males, HbA1c: 8.98 ± 1.38%). Results: Diabetes self-care (Diet, Self-Monitoring Blood Glucose and foot care) improved after 6 months, which was reflected in a significant drop in glycemic levels (HbA1c:-0.5%; FPG: − 38 mg/dl), and cholesterol/HDL ratio (4.45 ± 1.39 vs. 4.06 ± 1.29). Waist circumference decreased at 6 months compared to 3 months (p < 0.05). This is the first effective culturally-tailored intervention that improved self-care, glycemic control, body adiposity and lipid profile of Lebanese with T2DM. Larger scale implementation with representative sample is warranted.This work was supported by the Lebanese American University-intramural fund granted to the first author. Roche Diagnostics Middle East provided screening tools for HbA1c levels and LifeScan MEA donated the glucometers and test strips. The companies did not have any role in the design of the study, data analyses, or decision to publish

PABPN1 gene therapy for oculopharyngeal muscular dystrophy

International audienceOculopharyngeal muscular dystrophy (OPMD) is an autosomal dominant, late-onset muscle disorder characterized by ptosis, swallowing difficulties, proximal limb weakness and nuclear aggregates in skeletal muscles. OPMD is caused by a trinucleotide repeat expansion in the PABPN1 gene that results in an N-terminal expanded polyalanine tract in polyA-binding protein nuclear 1 (PABPN1). Here we show that the treatment of a mouse model of OPMD with an adeno-associated virus-based gene therapy combining complete knockdown of endogenous PABPN1 and its replacement by a wild-type PABPN1 substantially reduces the amount of insoluble aggregates, decreases muscle fibrosis, reverts muscle strength to the level of healthy muscles and normalizes the muscle transcriptome. The efficacy of the combined treatment is further confirmed in cells derived from OPMD patients. These results pave the way towards a gene replacement approach for OPMD treatment

Project CellNet: Evolving an Autonomous Pattern Recogniser

We describe the desire for a black box approach to pattern classification: a generic Autonomous Pattern Recognizer, which is capable of self-adapting to specific alphabets without human intervention. The CellNet software system is introduced, an evolutionary system that optimizes a set of pattern-recognizing agents relative to a provided set of features and a given pattern database. CellNet utilizes a new genetic operator designed to facilitate a canalization of development: Merger. CellNet utilizes our own set of arbitrarily chosen features, and is applied to the CEDAR Database of handwritten Latin characters, as well as to a database of handwritten Indian digits provided by CENPARMI. CellNet&apos;s cooperative co-evolutionary approach shows significant improvement over a more standard Genetic Algorithm, both in terms of efficiency and in nearly eliminating over-fitting (to the training set). Additionally, the binary classifiers autonomously evolved by CellNet return validation accuracies approaching 98% for both Latin and Indian digits, with no global changes to the system between the two trials

Psychometric properties of the Arabic version of the 12-item diabetes fatalism scale

<div><p>Background</p><p>There are widespread fatalistic beliefs in Arab countries, especially among individuals with diabetes. However, there is no tool to assess diabetes fatalism in this population. This study describes the processes used to create an Arabic version of the Diabetes Fatalism Scale (DFS) and examine its psychometric properties.</p><p>Methods</p><p>A descriptive correlational design was used with a convenience sample of Lebanese adults (N = 274) with type 2 diabetes recruited from a major hospital in Beirut, Lebanon and by snowball sampling. The 12- item Diabetes Fatalism Scale- Arabic (12-item DFS-Ar) was back-translated from the original version, pilot tested on 22 adults with type 2 diabetes and then administered to 274 patients to assess the validity and reliability of the scale. Confirmatory factor analysis (CFA) was used to test the hypothesized factor structure. Cronbach’s alpha was used to test for reliability.</p><p>Results</p><p>CFA supported the existence of the three factor hypothesis of the original DFS scale. The five items measuring “emotional distress” loaded under Factor 1, the four items measuring “spiritual coping” loaded under factor 2 and the last three items measuring “perceived self-efficacy” of the original scale loaded under Factor 3 (p <0.001 for all three subscales). Goodness of fit indices confirmed adequateness of the CFA model (CFI = 0.97, TLI = 0.96, RMSEA = 0.067 and pclose = 0.05). The 12-item DFS-Ar showed good reliability (Cronbach’s alpha of 0.86) and significantly predicted HbA1c (β = 0.20, p < 0.01). After adjusting for the demographic characteristics and the number of diabetes comorbid conditions, the 12-item DFS-Ar score was independently associated with HbA1c in a multivariable model (β = 0.16, p < 0.05).</p><p>Conclusions</p><p>The 12-item DFS-Ar demonstrated good psychometric properties that are comparable to the original scale. It is a valid and reliable measure of diabetes fatalism. Further testing with larger and non-Lebanese Arabic population is needed.</p></div

Demographic characteristics of study participants^*.

<p>Demographic characteristics of study participants^{<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0190719#t001fn001" target="_blank">*</a>}.</p

Structural equation model with standardized path coefficients of Diabetes Fatalism Scale dimensions.

<p>The fit of the final model was as follows: R2 = 99, root mean square error of approximation = 0.067, pclose = 0.05, comparative fit index = 0.97. *p < 0.05. **p < 0.01.</p

Independent relationship between 12-item DFS and demographic characteristics and hemoglobin A1c.

<p>Independent relationship between 12-item DFS and demographic characteristics and hemoglobin A1c.</p