How to effectively design and create a concept mobile application to aid in the management of type 1 diabetes in adolescents

Diabetes is one of the eight most prevalent chronic health conditions in the World; therefore there is a wide range of diabetes-related mobile applications available to the public to aid in glycaemic control and self-management. Statistically, adherence to medication is extremely low in adolescents with Type 1 Diabetes Mellitus (T1DM), therefore it is crucial that adolescents adhere to their medication from a young age and adopt good medication regimes. This paper focuses on the research and design of an interactive and educational concept mobile application aimed at adolescents, aged 11 to 16 years old, to aid in their understanding of T1DM. As visual elements are an essential part to the design of a mobile application, this research outlines how the visual components of the application were designed specifically for the target audience of adolescents with T1DM

Implications of the Patient Protection and Affordable Care Act for Health Inequities

To assess implications , opportunities, and challenges of health care reform for improving the health and health care of racially and ethnically diverse populations

Rapid sediment re-deposition may limit carbon release during catastrophic thermokarst lake drainage

ACKNOWLEDGMENTS We thank Georgina Heldreich for valuable discussions on delta formation, and the two constructive anonymous reviews, which greatly improved the manuscript.Peer reviewedPublisher PD

The potential for utilising in-hospital glucose measurements to detect individuals at high risk of previously undiagnosed diabetes: retrospective cohort study

Background Many people with undiagnosed diabetes have hyperglycaemia when admitted to hospital. Inpatient hyperglycaemia can be an indication of diabetes mellitus but can also indicate a stress response. This study reports the extent to which an in-hospital maximum observed random glucose measurement is an indicator of the need for in-hospital (or subsequent) HbA1c measurement to look for undiagnosed diabetes. Methods Blood glucose, HbA1c, age and sex were collected for all adults following admission to a UK NHS trust hospital from 1 January 2019 to 31 December 2020. We restricted the analysis to those participants who were registered with a GP practice that uses the trust laboratory and who had at least some tests requested by those practices since 2008. We stratified individuals according to their maximum in-hospital glucose measurement and report the number of these with HbA1c measurement ≥48 mmol/mol (6.5%) prior to the index admission, and during and after admission. We calculated an estimated proportion of individuals in each blood glucose stratum without a follow-up HbA1c who could have undiagnosed diabetes. Results In toal, 764,241 glucose measurements were recorded for 81,763 individuals who were admitted to the Oxford University Hospitals Trust. The median (Q1, Q3) age was 70 (56, 81) years, and 53% were males. Of the population, 70.7% of individuals declared themselves to be of White ethnicity, 3.1% of Asian background, and 1.1% of Black background, with 23.1% unstated. Of those individuals, 22,375 (27.4%) had no previous HbA1c measurement recorded. A total of 1689 individuals had a diabetes-range HbA1c during or after their hospital admission (2.5%) while we estimate an additional 1496 (2.2%) may have undiagnosed diabetes, with the greatest proportion of these having an in-hospital glucose of ≥15 mmol/L. We estimate that the number needed to detect a possible new case of diabetes falls from 16 (in-hospital glucose 8 mmol/L to <9 mmol/L) to 4 (14 mmol/L to <15 mmol/L). Conclusion The number of people who need to be tested to identify an individual who may have diabetes decreases as a testing threshold based on maximum in-hospital glucose concentration increases. Among those with hyperglycaemia and no previous HbA1c measurement in the diabetes range, there appears to be a lack of subsequent HbA1c measurement. This work identifies the potential for integrating the testing and follow-up of people, with apparently unrecognised hospital hyperglycaemia across primary and secondary care

Superhumps in Cataclysmic Binaries. XXII. 1RXS J232953.9+062814

We report photometry of 1RXS J232953.9+062814, a recently discovered dwarf nova with a remarkably short 64.2-minute orbital period. In quiescence, the star's light curve is that of a double sinusoid, arising from the "ellipsoidal" distortion of the Roche-lobe-filling secondary. During superoutburst, common superhumps develop with a period 3-4% longer than P_orb. This indicates a mass ratio M_2/M_1=0.19+-0.02, a surprisingly large value in so compact a binary. This implies that the secondary star has a density 2-3 times higher than that of other short-period dwarf novae, suggesting a secondary enriched by H-burning prior to the common-envelope phase of evolution. We estimate i=50+-5 deg, M_1=0.63 (+0.12, -0.09) M_sol, M_2=0.12 (+0.03, -0.02) M_sol, R_2=0.121 (+0.010, -0.007) R_sol, and a distance to the binary of 180+-40 pc.Comment: PDF, 17 pages, 3 tables, 5 figures; accepted, in press, to appear June 2002, PASP; more info at http://cba.phys.columbia.edu

Differential Expression of Immune Response Genes in Steller Sea Lions (\u3ci\u3eEumetopias jubatus\u3c/i\u3e): An Indicator of Ecosystem Health?

Characterization of the polygenic and polymorphic features of the Steller sea lion major histocompatibility complex (MHC) provides an ideal window for evaluating immunologic vigor of the population and identifying emergence of new genotypes that reflect ecosystem pressures. MHC genotyping can be used to measure the potential immunologic vigor of a population. However, since ecosystem-induced changes to MHC genotype can be slow to emerge, measurement of differential expression of these genes can potentially provide real-time evidence of immunologic perturbations. MHC DRB genes were cloned and sequenced using peripheral blood mononuclear leukocytes derived from 10 Steller sea lions from southeast Alaska, Prince William Sound, and the Aleutian Islands. Nine unique DRB gene sequences were represented in each of ten animals. MHC DRB gene expression was measured in a subset of six sea lions. Although DRB in genomic DNA was identical in all individuals, relative levels of expressed DRB mRNA was highly variable. Selective suppression of MHC DRB genes could be indicative of geographically disparate environmental pressures, thereby serving as an immediate and sensitive indicator of population and ecosystem health

Pneumomediastinum from nasal insufflation of cocaine

Chest pain is a common presenting symptom of cocaine users to the emergency department that requires a thorough work up. Pneumomediastinum is an uncommon complication of cocaine abuse that occurs more commonly when cocaine is smoked, but can also occur when cocaine is nasally insufflated. Our case report presents a patient with pneumomediastinum secondary to cocaine insufflation and reviews the necessary diagnostic tests that must be performed to rule out secondary pneumomediastinum, a severe life-threatening condition. Our case is unique, as it is one of a few reported cases of pneumomediastinum occurring after the use of intranasal cocaine

Superhumps in Cataclysmic Binaries. XXIII. V442 Ophiuchi and RX J1643.7+3402

We report the results of long observing campaigns on two novalike variables: V442 Ophiuchi and RX J1643.7+3402. These stars have high-excitation spectra, complex line profiles signifying mass loss at particular orbital phases, and similar orbital periods (respectively 0.12433 and 0.12056 d). They are well-credentialed members of the SW Sex class of cataclysmic variables. Their light curves are also quite complex. V442 Oph shows periodic signals with periods of 0.12090(8) and 4.37(15) days, and RX J1643.7+3402 shows similar signals at 0.11696(8) d and 4.05(12) d. We interpret these short and long periods respectively as a "negative superhump" and the wobble period of the accretion disk. The superhump could then possibly arise from the heating of the secondary (and structures fixed in the orbital frame) by inner-disk radiation, which reaches the secondary relatively unimpeded since the disk is not coplanar. At higher frequencies, both stars show another type of variability: quasi-periodic oscillations (QPOs) with a period near 1000 seconds. Underlying these strong signals of low stability may be weak signals of higher stability. Similar QPOs, and negative superhumps, are quite common features in SW Sex stars. Both can in principle be explained by ascribing strong magnetism to the white dwarf member of the binary; and we suggest that SW Sex stars are borderline AM Herculis binaries, usually drowned by a high accretion rate. This would provide an ancestor channel for AM Hers, whose origin is still mysterious.Comment: PDF, 41 pages, 4 tables, 16 figures; accepted, in press, to appear December 2002, PASP; more info at http://cba.phys.columbia.edu