What Next After Metformin in Type 2 Diabetes? Selecting the Right Drug for the Right Patient

This is the final version. Available on open access from Springer via the DOI in this recordIntroduction: Metformin is the recommended initial treatment in type 2 diabetes mellitus (T2DM), but when this does not give adequate glucose control the choice of which second-line drug to use is uncertain as none have been found to have a better overall glycaemic response. In this real-world study dipeptidyl peptidase 4 inhibitors (DPP4i), sulphonylureas (SU), thiazolidinediones (TZD) and sodium glucose co-transporter 2 inhibitors (SGLT2i) were compared for their effectiveness in lowering glycated haemoglobin (HbA1c) levels for a particular individual based on their clinical characteristics. Methods: A retrospective analysis was undertaken of electronic health records of people with T2DM prescribed metformin alongside a DPP4i, SU, TZD or SGLT2i at second-line. Regression modelling was used to model the changes in HbA1c from baseline at month 6 and month 12 for the individual therapies, adjusting for demographic and clinical characteristics. Results: There were 7170 people included in the study. Treatment at second-line with SUs, DPP4i, TZDs and SGLT2i resulted in similar percentages of people achieving the recommended HbA1c target of < 7.5% (58 mmol/mol) at both 6 and 12 months. For those receiving SGLT2i and SUs, the greatest improvement in HbA1c was observed in relatively younger and older people, respectively. Trends were detected between other baseline characteristics and HbA1c improvement by drug class, but they were not statistically significant. Non-adherence rates were low for all drug classes. People with a higher medication possession ratio (≥ 80%) also had greater improvements in HbA1c at 12 months. Conclusion: This study identified patients’ phenotypic characteristics that may have the potential to influence individual treatment response. Accounting for these characteristics in clinical treatment decisions may facilitate individualised prescribing by being able to select the right drug for the right patient.Takeda UK Ltd

Developing effective practice learning for tomorrow's social workers

This paper considers some of the changes in social work education in the UK, particularly focusing on practice learning in England. The changes and developments are briefly identified and examined in the context of what we know about practice learning. The paper presents some findings from a small scale qualitative study of key stakeholders involved in practice learning and education in social work and their perceptions of these anticipated changes, which are revisited at implementation. The implications for practice learning are discussed

Mind the gap!: Students' Understanding and Application of Social Work Values

This paper discusses a research project that explored the development of student social workers' values during the first year of professional education at one Scottish university. Questionnaires, based on a vignette, and focus groups established baseline information at the outset of the study. These methods were reapplied a year later to identify the extent to which students' values framework had developed, and the factors that had supported this. The study revealed that, by the end of that year, students could both identify and apply values to support them in their work with individuals to a greater extent than they could those to help them challenge structural discrimination. The study also highlighted the need for university-based teaching, and practice learning experiences, to provide more opportunities for reflection and discussion to support the development of values in student social workers

Mind the gap!: Students' Understanding and Application of Social Work Values

This paper discusses a research project that explored the development of student social workers' values during the first year of professional education at one Scottish university. Questionnaires, based on a vignette, and focus groups established baseline information at the outset of the study. These methods were reapplied a year later to identify the extent to which students' values framework had developed, and the factors that had supported this. The study revealed that, by the end of that year, students could both identify and apply values to support them in their work with individuals to a greater extent than they could those to help them challenge structural discrimination. The study also highlighted the need for university-based teaching, and practice learning experiences, to provide more opportunities for reflection and discussion to support the development of values in student social workers

Lattice Boltzmann simulations of soft matter systems

This article concerns numerical simulations of the dynamics of particles immersed in a continuum solvent. As prototypical systems, we consider colloidal dispersions of spherical particles and solutions of uncharged polymers. After a brief explanation of the concept of hydrodynamic interactions, we give a general overview over the various simulation methods that have been developed to cope with the resulting computational problems. We then focus on the approach we have developed, which couples a system of particles to a lattice Boltzmann model representing the solvent degrees of freedom. The standard D3Q19 lattice Boltzmann model is derived and explained in depth, followed by a detailed discussion of complementary methods for the coupling of solvent and solute. Colloidal dispersions are best described in terms of extended particles with appropriate boundary conditions at the surfaces, while particles with internal degrees of freedom are easier to simulate as an arrangement of mass points with frictional coupling to the solvent. In both cases, particular care has been taken to simulate thermal fluctuations in a consistent way. The usefulness of this methodology is illustrated by studies from our own research, where the dynamics of colloidal and polymeric systems has been investigated in both equilibrium and nonequilibrium situations.Comment: Review article, submitted to Advances in Polymer Science. 16 figures, 76 page

Neural field models with threshold noise

The original neural field model of Wilson and Cowan is often interpreted as the averaged behaviour of a network of switch like neural elements with a distribution of switch thresholds, giving rise to the classic sigmoidal population firing-rate function so prevalent in large scale neuronal modelling. In this paper we explore the effects of such threshold noise without recourse to averaging and show that spatial correlations can have a strong effect on the behaviour of waves and patterns in continuum models. Moreover, for a prescribed spatial covariance function we explore the differences in behaviour that can emerge when the underlying stationary distribution is changed from Gaussian to non-Gaussian. For travelling front solutions, in a system with exponentially decaying spatial interactions, we make use of an interface approach to calculate the instantaneous wave speed analytically as a series expansion in the noise strength. From this we find that, for weak noise, the spatially averaged speed depends only on the choice of covariance function and not on the shape of the stationary distribution. For a system with a Mexican-hat spatial connectivity we further find that noise can induce localised bump solutions, and using an interface stability argument show that there can be multiple stable solution branches

Deep context of citations using machine‑learning models in scholarly full‑text articles

Information retrieval systems for scholarly literature rely heavily not only on text matching but on semantic- and context-based features. Readers nowadays are deeply interested in how important an article is, its purpose and how influential it is in follow-up research work. Numerous techniques to tap the power of machine learning and artificial intelligence have been developed to enhance retrieval of the most influential scientific literature. In this paper, we compare and improve on four existing state-of-the-art techniques designed to identify influential citations. We consider 450 citations from the Association for Computational Linguistics corpus, classified by experts as either important or unimportant, and further extract 64 features based on the methodology of four state-of-the-art techniques. We apply the Extra-Trees classifier to select 29 best features and apply the Random Forest and Support Vector Machine classifiers to all selected techniques. Using the Random Forest classifier, our supervised model improves on the state-of-the-art method by 11.25%, with 89% Precision-Recall area under the curve. Finally, we present our deep-learning model, the Long Short-Term Memory network, that uses all 64 features to distinguish important and unimportant citations with 92.57% accuracy

Unequivocal identification of intracellular aluminium adjuvant in a monocytic THP-1 cell line.

Aluminium-based adjuvants (ABA) are the predominant adjuvants used in human vaccinations. While a consensus is yet to be reached on the aetiology of the biological activities of ABA several studies have identified shape, crystallinity and size as critical factors affecting their adjuvanticity. In spite of recent advances, the fate of ABA following their administration remains unclear. Few if any studies have demonstrated the unequivocal presence of intracellular ABA. Herein we demonstrate for the first time the unequivocal identification of ABA within a monocytic T helper 1 (THP-1) cell line, using lumogallion as a fluorescent molecular probe for aluminium. Use of these new methods revealed that particulate ABA was only found in the cell cytoplasm. Transmission electron microscopy revealed that ABA were contained within vesicle-like structures of approximately 0.5-1 μm in diameter

State of nature

For the first time ever, the UK’s wildlife organisations have joined forces to undertake a health check of nature in the UK and its Overseas Territories. 60% of the 3,148 UK species we assessed have declined over the last 50 years and 31% have declined strongly. Half of the species assessed have shown strong changes in their numbers or range, indicating that recent environmental changes are having a dramatic impact on nature in the UK. Species with specific habitat requirements seem to be faring worse than generalist species. A new Watchlist Indicator, developed to measure how conservation priority species are faring, shows that their overall numbers have declined by 77% in the last 40 years, with little sign of recovery. Of more than 6,000 species that have been assessed using modern Red List criteria, more than one in 10 are thought to be under threat of extinction in the UK. Our assessment looks back over 50 years at most, yet there were large declines in the UK’s wildlife prior to this, linked to habitat loss. The UK’s Overseas Territories hold a wealth of wildlife of huge international importance and over 90 of these species are at high risk of global extinction. There is a lack of knowledge on the trends of most of the UK’s species. As a result, we can report quantitative trends for only 5% of the 59,000 or so terrestrial and freshwater species in the UK, and for very few of the 8,500 marine species. Much needs to be done to improve our knowledge. What we do know about the state of the UK’s nature is often based upon the efforts of thousands of dedicated volunteer enthusiasts who contribute their time and expertise to monitoring schemes and species recording. The threats to the UK’s wildlife are many and varied, the most severe acting either to destroy valuable habitat or degrade the quality and value of what remains. Climate change is having an increasing impact on nature in the UK. Rising average temperatures are known to be driving range expansion in some species, but evidence for harmful impacts is also mounting. The full report is online: www.rspb.org.uk/stateofnature We should act to save nature both for its intrinsic value and for the benefits it brings to us that are essential to our wellbeing and prosperity. Targeted conservation has produced inspiring success stories and, with sufficient determination, resources and public support, we can turn the fortunes of our wildlife around. The State of Nature report serves to illustrate that with shared resolve and commitment we can save nature

Laser-induced photo-polymerisation for creation of paper-based fluidic devices

Paper-based microfluidics is a rapidly progressing inter-disciplinary technology driven by the need for low-cost alternatives to conventional point-of-care diagnostic tools. For transport of reagents/analytes, such devices often consist of interconnected hydrophilic fluid-flow channels that are demarcated by hydrophobic barrier walls that extend through the thickness of the paper. Here, we present a laser-based fabrication procedure that uses polymerisation of a photopolymer to produce the required fluidic channels in paper. Experimental results showed that the structures successfully guide the flow of fluids and allow containment of fluids in wells, and hence the technique is suitable for fabrication of paper-based microfluidic devices. The minimum width for the hydrophobic barriers that successfully prevented fluid leakage was ~120 μm and the minimum width for the fluidic channels that can be formed was ~80 μm, the smallest reported so far for paper-based fluidic patterns