An overview of insulin pump therapy: Appropriate use of an expensive resource

Insulin pump therapy is an option for intensive insulin therapy in patients with type 1 diabetes who meet the criteria described in this article. Pump therapy may assist in the reduction of haemoglobin A1c (HbA1c) and the frequency of severe hypoglycaemia. It can also lead to improvements in awareness of hypoglycaemia and quality of life. Careful assessment of patients is vital, as pump therapy is an expensive treatment option and can be dangerousif used incorrectly. Intensive education of patients who meet the criteria is essential. This will reduce possible risks associated with pump therapy. A team approach is needed, consisting of a minimum of a doctor and a diabetes educator who are experienced in pump therapy, as well as a registered dietitian who has expertise in carbohydrate counting. A psychologist is also a useful member of the team and can help with patient assessment and selection

Food or friends? What motivates zebrafish (Danio rerio) performing a visual discrimination

This work was supported in part by the University of St Andrews’ QR block grant and the following grants awarded to CHB: NC3Rs G1000053; BBSRC BB/M007863; Leverhulme RPG-2016-143. CHB and VJB are Members of the Royal Society Industry Fellows’ College.As a model organism, zebrafish have much to offer neuroscientific research and they are increasingly being used in behavioral neuroscience, for example to study the genetics of learning and memory. As fish are often considered “less clever” than mammals, it is important to understand how they learn and to establish optimal testing conditions. In this study, we compared the efficacy of food reinforcement and social stimuli in supporting Pavlovian conditioning, Pavlovian-to-instrumental transfer, and acquisition of a two-alternative forced choice visual discrimination. Although equally effective in conditioning and in motivating discrimination learning, fish responded with shorter latencies when they were anticipating food but responded for a greater number of trials when anticipating the social stimulus. After learning, the reward was changed: food-reinforcement was replaced with the social stimulus and vice versa. Performance accuracy did not change, but response latency did: the group previously rewarded with food, but now rewarded with the social stimulus, showed a decrease in response vigor. This is a negative contrast effect, which is well established in rats, but was thought to be absent in fish because they lacked goal representation. Our results show that zebrafish, like rats, do have goal representations. Furthermore, we have shown that whereas food has greater incentive salience than social stimuli, fish become satiated rapidly, but motivation to seek social stimuli is sustained. We conclude that zebrafish are well motivated by a mixed economy of social stimuli and food.PostprintPeer reviewe

Bedaquiline as Treatment for Disseminated Nontuberculous Mycobacteria Infection in 2 Patients Co-Infected with HIV.

Nontuberculous mycobacteria can cause disseminated infections in immunocompromised patients and are challenging to treat because of antimicrobial resistance and adverse effects of prolonged multidrug treatment. We report successful treatment with bedaquiline, a novel antimycobacterial drug, as part of combination therapy for 2 patients with disseminated nontuberculous mycobacteria co-infected with HIV

Measurement of water uptake in thin-film Nafion and anion alkaline exchange membranes using the quartz crystal microbalance

Water uptake, sorption mechanics and swelling characteristics of thin-film Nafion and a commercially available Tokuyama alkaline anion exchange membrane ionomer from the vapour phase is explored using a quartz crystal microbalance (QCM). The water uptake measures the number of water molecules adsorbed by the ionomer per functional group and is determined in-situ using the QCM frequency responses allowing for comparison with nanogram precision. Crystal admittance spectroscopy, along with equivalent circuit fitting, is applied to both thin films for the first time and is used to investigate the ionomer's viscoelastic changes during hydration; to elucidate the mechanisms at play during low, medium and high relative humidities

Following the electroreduction of uranium dioxide to uranium in LiCl-KCl eutectic in situ using synchrotron radiation

The electrochemical reduction of uranium dioxide to metallic uranium has been investigated in lithium chloride–potassium chloride eutectic molten salt. Laboratory based electrochemical studies have been coupled with in situ energy dispersive X-ray diffraction, for the first time, to deduce the reduction pathway. No intermediate phases were identified using the X-ray diffraction before, during or after electroreduction to form α-uranium. This suggests that the electrochemical reduction occurs via a single, 4-electron-step, process. The rate of formation of α-uranium is seen to decrease during electrolysis and could be a result of a build-up of oxygen anions in the molten salt. Slow transport of O2− ions away from the UO2 working electrode could impede the electrochemical reduction

Pulmonary vasoconstrictor action of KCNQ potassium channel blockers

KCNQ channels have been widely studied in the nervous system, heart and inner ear, where they have important physiological functions. Recent reports indicate that KCNQ channels may also be expressed in portal vein where they are suggested to influence spontaneous contractile activity. The biophysical properties of K+ currents mediated by KCNQ channels resemble a current underlying the resting K+ conductance and resting potential of pulmonary artery smooth muscle cells. We therefore investigated a possible role of KCNQ channels in regulating the function of pulmonary arteries by determining the ability of the selective KCNQ channel blockers, linopirdine and XE991, to promote pulmonary vasoconstriction. Linopirdine and XE991 both contracted rat and mouse pulmonary arteries but had little effect on mesenteric arteries. In each case the maximum contraction was almost as large as the response to 50 mM K+. Linopirdine had an EC50 of around 1 μM and XE991 was almost 10-fold more potent. Neither removal of the endothelium nor exposure to phentolamine or α,β-methylene ATP, to block α1-adrenoceptors or P2X receptors, respectively, affected the contraction. Contraction was abolished in Ca2+-free solution and in the presence of 1 μM nifedipine or 10 μM levcromakalim

Acceptability and feasibility of peer assisted supervision and support for intervention practitioners: a Q-methodology evaluation

Evidence-based interventions often include quality improvement methods to support fidelity and improve client outcomes. Clinical supervision is promoted as an effective way of developing practitioner confidence and competence in delivery; however, supervision is often inconsistent and embedded in hierarchical line management structures that may limit the opportunity for reflective learning. The Peer Assisted Supervision and Support (PASS) supervision model uses peer relationships to promote the self-regulatory capacity of practitioners to improve intervention delivery. The aim of the present study was to assess the acceptability and feasibility of PASS amongst parenting intervention practitioners. A Q-methodology approach was used to generate data and 30 practitioners volunteered to participate in the study. Data were analyzed and interpreted using standard Q-methodology procedures and by-person factor analysis yielded three factors. There was consensus that PASS was acceptable. Participants shared the view that PASS facilitated an environment of support where negative aspects of interpersonal relationships that might develop in supervision were not evident. Two factors represented the viewpoint that PASS was also a feasible model of supervision. However, the third factor was comprised of practitioners who reported that PASS could be time consuming and difficult to fit into existing work demands. There were differences across the three factors in the extent to which practitioners considered PASS impacted on their intervention delivery. The findings highlight the importance of organizational mechanisms that support practitioner engagement in supervision