Interventions To Improve Patients' Compliance With Therapies Aimed At Lowering Glycated Hemoglobin (hba1c) In Type 1 Diabetes: Systematic Review And Meta-analyses Of Randomized Controlled Clinical Trials Of Psychological, Telecare, And Educational Interventions

Brazilian records on glycemic control in patients with type 1 diabetes show treatment efficacy. Poor patient adherence to therapeutic proposals influences these results and can be associated with social, psychological, and economic aspects, besides others factors. The aim of this study was to evaluate the efficacy of psychological, telecare, and educational interventions to improve treatment compliance among patients with type 1 diabetes. Compliance was assessed indirectly using reduction of glycated hemoglobin (HbA1c) as the principal outcome measure. Methods: Systematic review and meta-analyses of randomized controlled clinical trials (RCTs) were performed using Medline, Embase, Cochrane and Scopus databases up to April 2015. The following medical subject headings were used: Diabetes Mellitus, Type 1, Patient Compliance or Adherence, Hemoglobin A, glycated, and Randomized Controlled Trial. The principal outcome was change in HbA1c between baseline and follow-up. Where appropriate, trials were combined in meta-analysis using fixed effects models. Results: From 191 articles initially identified, 57 were full text reviewed, and 19 articles met the inclusion criteria providing data from 1782 patients (49.4 % males, age 18 years). The RCTs (2 to 24 months in duration) were divided into four groups according to type of intervention: psychology (seven studies; 818 patients), telecare (six studies; 494 patients); education (five studies; 349 patients), and psychoeducation (one study; 153 patients). All studies reported some type of adherence measurement of the interventions. Decrease in HbA1c was observed after psychology (MD -0.310; 95 % CI, -0.599 to -0.0210, P = 0.035) but not after telecare (MD -0.124 %; 95 % CI, -0.268, 0.020; P = 0.090) or educational (MD -0.001; 95 % CI, -0.202, 0.200; P = 0.990) interventions. Conclusion: Psychological approaches to improve adherence to diabetes care treatment modestly reduced HbA1c in patients with type 1 diabetes; telecare and education interventions did not change glycemic control. However, the limited number of studies included as well as their methodological quality should be taken into account. © 2016 Viana et al.17

Multidimensional Rovella-like attractors

We present a multidimensional flow exhibiting a Rovella-like attractor: a transitive invariant set with a non-Lorenz-like singularity accumulated by regular orbits and a multidimensional non-uniformly expanding invariant direction. Moreover, this attractor has a physical measure with full support but persists along certain0909.1033 submanifolds of the space of vector fields. As in the 3-dimensional Rovella-like attractor, this example is not robust. The construction introduces a class of multidimensional dynamics, whose suspension provides the Rovella-like attractor, which are partially hyperbolic, and whose quotient over stable leaves is a multidimensional endomorphism to which Benedicks-Carleson type arguments are applied to prove non-uniform expansion.Comment: 45 pages, 14 figures; improved introduction with more citations to other relevant related works. To appear in Journal of Differential Equation

Statistical mechanics of the random K-SAT model

The Random K-Satisfiability Problem, consisting in verifying the existence of an assignment of N Boolean variables that satisfy a set of M=alpha N random logical clauses containing K variables each, is studied using the replica symmetric framework of diluted disordered systems. We present an exact iterative scheme for the replica symmetric functional order parameter together for the different cases of interest K=2, K>= 3 and K>>1. The calculation of the number of solutions, which allowed us [Phys. Rev. Lett. 76, 3881 (1996)] to predict a first order jump at the threshold where the Boolean expressions become unsatisfiable with probability one, is thoroughly displayed. In the case K=2, the (rigorously known) critical value (alpha=1) of the number of clauses per Boolean variable is recovered while for K>=3 we show that the system exhibits a replica symmetry breaking transition. The annealed approximation is proven to be exact for large K.Comment: 34 pages + 1 table + 8 fig., submitted to Phys. Rev. E, new section added and references update

CMB-Cluster Lensing

Clusters of galaxies are powerful cosmological probes, particularly if their masses can be determined. One possibility for mass determination is to study the cosmic microwave background (CMB) on small angular scales and observe deviations from a pure gradient due to lensing of massive clusters. I show that, neglecting contamination, this technique has the power to determine cluster masses very accurately, in agreement with estimates by Seljak and Zaldarriaga (1999). However, the intrinsic small scale structure of the CMB significantly degrades this power. The resulting mass constraints are useless unless one imposes a prior on the concentration parameter c. With even a modest prior on c, an ambitious CMB experiment (0.5' resolution and 1 microK per pixel) could determine masses of high redshift (z>0.5) clusters with ~ 30% accuracy.Comment: 17 pages, 10 figure

Colossal dielectric constants in transition-metal oxides

Many transition-metal oxides show very large ("colossal") magnitudes of the dielectric constant and thus have immense potential for applications in modern microelectronics and for the development of new capacitance-based energy-storage devices. In the present work, we thoroughly discuss the mechanisms that can lead to colossal values of the dielectric constant, especially emphasising effects generated by external and internal interfaces, including electronic phase separation. In addition, we provide a detailed overview and discussion of the dielectric properties of CaCu3Ti4O12 and related systems, which is today's most investigated material with colossal dielectric constant. Also a variety of further transition-metal oxides with large dielectric constants are treated in detail, among them the system La2-xSrxNiO4 where electronic phase separation may play a role in the generation of a colossal dielectric constant.Comment: 31 pages, 18 figures, submitted to Eur. Phys. J. for publication in the Special Topics volume "Cooperative Phenomena in Solids: Metal-Insulator Transitions and Ordering of Microscopic Degrees of Freedom