Clinical Experience with Insulin Detemir: Results from the Bangladesh Cohort of Global A 1 chieve Study

Abstract Objective: To present results from the Bangladesh cohort of the A 1 chieve study receiving insulin detemir (Levemir) ± oral anti diabetic drugs. Methods: Out of 1093 patients recruited from 49 sites in Bangladesh, 370 were initiated on insulin detemir (Levemir).Study visits were defined as baseline, interim (around 12 weeks from baseline) and final (around 24 weeks from baseline) visit. Results: Glycaemic control was poor in all the groups at baseline. In the entire cohort at 24 weeks, significant reductions from baseline were observed in mean HbA 1c (from 10.0 % to 7.2%, p<0.001), FPG (from 10.5 to 6.7 mmol/L, p<0.001) and PPPG (from 15.3 to 8.9 mmol/L, p<0.001) levels. Overall 45.5% of th

Factors associated with the usage of pharmacy value-added services at public health clinics in the state of Perlis, Malaysia

Pharmacy value-added services were developed to make it easier for patients to refill their chronic prescriptions in public health facilities in Malaysia. However, little is known about patients’ awareness, attitudes and practice towards pharmacy value-added services provided by health clinics. This study was conducted to investigate factors associated with the usage of pharmacy value-added services at public health clinics in Perlis, Malaysia. A cross-sectional study was conducted from January to March 2021 at the pharmacy waiting area of all public health clinics in Perlis. All patients (≥18 years old) taking chronic medications and with the need to follow-up at the health clinic in Perlis were recruited in this study using quota sampling. Data was collected using a validated self-administered questionnaire. Descriptive analyses on the usage, awareness and attitudes of respondents were performed, followed by multiple logistic regression. A total of 582 patients responded to this study (response rate, 97.0%). Only 12.9% of respondents used pharmacy value-added services offered by health clinics. Age, gender, ethnicity, education level, occupation, monthly household income, length of stay in Perlis, distance from home to the clinic, total awareness and attitudes scores were factors significantly associated with the practice of pharmacy value-added services after adjusting for other variables (p<0.05). In conclusion, the proportion of patients using pharmacy value-added services at health clinics in Perlis is still low. The study’s findings suggest that a more extensive promotion of pharmacy value-added services is needed to ensure more patients could benefit from these services

Interpopulation crosses, inheritance study, and genetic variability in the brown planthopper complex, Nilaparvata lugens (Homoptera: Delphacidae)

Studies on hybridization, inheritance, and population genetics of brown planthoppers that infest rice and weeds were undertaken using starch gel electrophoresis to determine whether the weed-infesting population represents a biological race or a species. F(1) and F(2) generations were produced by crosses between parental insects from the two populations with little indication of hybrid sterility. Gpi, Mdh, and Idh loci were inherited in a simple Mendelian fashion in families of two sympatric populations. Sixteen populations of Nilaparvata spp. from eight locations were collected. The Mdh, Idh, Pgm, Gpi, 6Pgd, and Acp loci were polymorphic. The N. lugens of rice with high esterase activity were clustered into a group and characterized by the presence of alleles Gpi (110) and Gpi (120), whereas N. lugens from weeds with low esterase activity were clustered into another group and characterized by Gpi (100) and Gpi (90) . There was a lack of heterozygotes between the common alleles of the two populations. This means that the two groups of individuals belong to different gene pools

Bromocarbons in the tropical coastal and open ocean atmosphere during the 2009 Prime Expedition Scientific Cruise (PESC-09)

Abstract. Atmospheric concentrations of very short-lived species (VSLS) bromocarbons, including CHBr3, CH2Br2, CHCl2Br, CHClBr2, and CH2BrCl, were measured in the Strait of Malacca and the South China and Sulu–Sulawesi seas during a two-month research cruise in June–July 2009. The highest bromocarbon concentrations were found in the Strait of Malacca, with smaller enhancements in coastal regions of northern Borneo. CHBr3 was the most abundant bromocarbon, ranging from 5.2 pmol mol−1 in the Strait of Malacca to 0.94 pmol mol−1 over the open ocean. Other bromocarbons showed lower concentrations, in the range of 0.8–1.3 pmol mol−1 for CH2Br2, 0.1–0.5 pmol mol−1 for CHCl2Br, and 0.1–0.4 pmol mol−1 for CHClBr2. There was no significant correlation between bromocarbons and in situ chlorophyll a, but positive correlations with both MODIS and SeaWiFS satellite chlorophyll a. Together, the short-lived bromocarbons contribute an average of 8.9 pmol mol−1 (range 5.2–21.4 pmol mol−1) to tropospheric bromine loading, which is similar to that found in previous studies from global sampling networks (Montzka et al., 2011). Statistical tests showed strong Spearman correlations between brominated compounds, suggesting a common source. Log–log plots of CHBr3/CH2Br2 versus CHBr2Cl/CH2Br2 show that both chemical reactions and dilution into the background atmosphere contribute to the composition of these halocarbons at each sampling point. We have used the correlation to make a crude estimate of the regional emissions of CHBr3 and to derive a value of 32 Gg yr−1 for the Southeast (SE) Asian region (10° N–20° S, 90–150° E). Finally, we note that satellite-derived chlorophyll a (chl a) products do not always agree well with in situ measurements, particularly in coastal regions of high turbidity, meaning that satellite chl a may not always be a good proxy for marine productivity. We would like to thank MOSTI (Malaysian Ministry of Science, Technology and Innovation). for giving opportunities and financial support for the University of Malaya (UM) and Universiti Kebangsaan Malaysia to participate in this scientific cruise, and other Malaysian public universities and agencies who helped during sampling. The Malaysian Royal Navy is thanked for their help and assistance in all aspects of the cruise. We also thank the SHIVA European FP7 project (grant 226224), NERC, NERC-NCAS and the British Council, through a PMI2 grant, for their support. Neil Harris would like to thank NERC for his Research Fellowship; Emma Leedham and Matt Ashfold thank NERC for studentships, and Doreena Dominick, Lin Chin Yik, Fatimah Ahamad and Nur Ily Hamizah for their assistance and the Ministry of Higher Education Malaysia (KPT’s) ERGS grant ER025-2013A. Finally, we also would like to thank Universiti Kebangsaan Malaysia (UKM) for the ICONIC-2013-004 grant, MOSTI e-science grant 04-01-02-SF-0752 for Universiti Kebangsaan Malaysia (UKM), UKM GGPM-2013-080 and UKM DPP-2014-162 and GUP-2013-057 for financial support.This paper was originally published in Atmospheric Chemistry and Physics, 14, 8137-8148, doi:10.5194/acp-14-8137-2014, 201

Air quality and health impacts of vegetation and peat fires in Equatorial Asia during 2004–2015

Particulate matter (PM) emissions from vegetation and peat fires in Equatorial Asia cause poor regional air quality. Burning is greatest during drought years, resulting in strong inter-annual variability in emissions. We make the first consistent estimate of the emissions, air quality and public health impacts of Equatorial Asian fires during 2004–2015. The largest dry season (August—October) emissions occurred in 2015, with PM emissions estimated as 9.4 Tg, more than triple the average dry season emission (2.7 Tg). Fires in Sumatra and Kalimantan caused 94% of PM emissions from fires in Equatorial Asia. Peat combustion in Indonesian peatlands contributed 45% of PM emissions, with a greater contribution of 68% in 2015. We used the WRF-chem model to simulate dry season PM for the 6 biggest fire years during this period (2004, 2006, 2009, 2012, 2014, 2015). The model reproduces PM concentrations from a measurement network across Malaysia and Indonesia, suggesting our PM emissions are realistic. We estimate long-term exposure to PM resulted in 44 040 excess deaths in 2015, with more than 15 000 excess deaths annually in 2004, 2006, and 2009. Exposure to PM from dry season fires resulted in an estimated 131 700 excess deaths during 2004–2015. Our work highlights that Indonesian vegetation and peat fires frequently cause adverse impacts to public health across the region

New estimate of particulate emissions from Indonesian peat fires in 2015

Indonesia contains large areas of peatland that have been drained and cleared of natural vegetation, making them susceptible to burning. Peat fires emit considerable amounts of carbon dioxide, particulate matter (PM) and other trace gases, contributing to climate change and causing regional air pollution. However, emissions from peat fires are uncertain, due to uncertainties in emission factors and fuel consumption. We used the Weather Research and Forecasting model with chemistry and measurements of PM concentrations to constrain PM emissions from Indonesian fires during 2015, one of the largest fire seasons in recent decades.Published versio

Circulating Very Small Embryonic-Like Stem Cells in Cardiovascular Disease

Very small embryonic-like cells (VSELs) are a population of stem cells residing in the bone marrow (BM) and several organs, which undergo mobilization into peripheral blood (PB) following acute myocardial infarction and stroke. These cells express markers of pluripotent stem cells (PSCs), such as Oct-4, Nanog, and SSEA-1, as well as early cardiac, endothelial, and neural tissue developmental markers. VSELs can be effectively isolated from the BM, umbilical cord blood, and PB. Peripheral blood and BM-derived VSELs can be expanded in co-culture with C2C12 myoblast feeder layer and undergo differentiation into cells from all three germ layers, including cardiomyocytes and vascular endothelial cells. Isolation of VSLEs using fluorescence-activated cell sorting multiparameter live cell sorting system is dependent on gating strategy based on their small size and expression of PSC and absence of hematopoietic lineage markers. VSELs express early cardiac and endothelial lineages markers (GATA-4, Nkx2.5/Csx, VE-cadherin, and von Willebrand factor), SDF-1 chemokine receptor CXCR4, and undergo rapid mobilization in acute MI and ischemic stroke. Experiments in mice showed differentiation of BM-derived VSELs into cardiac myocytes and effectiveness of expanded and pre-differentiated VSLEs in improvement of left ventricular ejection fraction after myocardial infarction