Community pharmacy type 2 diabetes risk assessment: demographics and risk results

Objectives: To determine the demographics and risk results of patients accessing a community pharmacy diabetes risk assessment service. Method: Participating patients underwent an assessment using a validated questionnaire to determine their 10-year risk of developing type 2 diabetes. Patients were given appropriate lifestyle advice or referred to their general practitioner if necessary. Key findings: In total, 21 302 risk assessments were performed. Nearly one-third (29%) of 3427 risk assessments analysed yielded a result of moderate or high chance of developing the condition. Conclusions: Community pharmacies can identify a significant number of patients at risk of developing type 2 diabetes in the next 10 years. Further follow-up work needs to be done to determine the cost-effectiveness of such a service and the consequences of receiving a risk assessment

Latency reversal and viral clearance to cure HIV-1

Research toward a cure for human immunodeficiency virus type 1 (HIV-1) infection has joined prevention and treatment efforts in the global public health agenda. A major approach to HIV eradication envisions antiretroviral suppression, paired with targeted therapies to enforce the expression of viral antigen from quiescent HIV-1 genomes, and immunotherapies to clear latent infection. These strategies are targeted to lead to viral eradication—a cure for AIDS. Paired testing of latency reversal and clearance strategies has begun, but additional obstacles to HIV eradication may emerge. Nevertheless, there is reason for optimism that advances in long-acting antiretroviral therapy and HIV prevention strategies will contribute to efforts in HIV cure research and that the implementation of these efforts will synergize to markedly blunt the effect of the HIV pandemic on society

Profiling invasive Plasmodium falciparum merozoites using an integrated omics approach

The symptoms of malaria are brought about by blood-stage parasites, which are established when merozoites invade human erythrocytes. Our understanding of the molecular events that underpin erythrocyte invasion remains hampered by the short-period of time that merozoites are invasive. To address this challenge, a Plasmodium falciparum gamma-irradiated long-lived merozoite (LLM) line was developed and investigated. Purified LLMs invaded erythrocytes by an increase of 10–300 fold compared to wild-type (WT) merozoites. Using an integrated omics approach, we investigated the basis for the phenotypic difference. Only a few single nucleotide polymorphisms within the P. falciparum genome were identified and only marginal differences were observed in the merozoite transcriptomes. By contrast, using label-free quantitative mass-spectrometry, a significant change in protein abundance was noted, of which 200 were proteins of unknown function. We determined the relative molar abundance of over 1100 proteins in LLMs and further characterized the major merozoite surface protein complex. A unique processed MSP1 intermediate was identified in LLM but not observed in WT suggesting that delayed processing may be important for the observed phenotype. This integrated approach has demonstrated the significant role of the merozoite proteome during erythrocyte invasion, while identifying numerous unknown proteins likely to be involved in invasion

A Photometric Method for Quantifying Asymmetries in Disk Galaxies

A photometric method for quantifying deviations from axisymmetry in optical images of disk galaxies is applied to a sample of 32 face-on and nearly face-on spirals. The method involves comparing the relative fluxes contained within trapezoidal sectors arranged symmetrically about the galaxy center of light, excluding the bulge and/or barred regions. Such a method has several advantages over others, especially when quantifying asymmetry in flocculent galaxies. Specifically, the averaging of large regions improves the signal-to-noise in the measurements; the method is not strongly affected by the presence of spiral arms; and it identifies the kinds of asymmetry that are likely to be dynamically important. Application of this "method of sectors" to R-band images of 32 disk galaxies indicates that about 30% of spirals show deviations from axisymmetry at the 5-sigma level.Comment: 17 pages, 2 tables and 6 figures, uses psfig and AAS LaTex; to appear in A

PREDICTING THE OUTCOME OF RODENTICIDE TRIALS AGAINST NORWAY RATS LIVING ON FARMS

Difenacoum and bromadiolone treatments against Norway rats may fail because: 1) the animals eat little or no bait, 2) reinvasion rapidly offsets any success, or 3) the population contains resistant individuals. By monitoring bait takes and employing independent measures of rat activity such as tracking plates, it is possible to identify, often in the early stages of a treatment, patterns that indicate the contribution of each of these causes to the eventual outcome. If there is no bait take from the majority of bait points visited by rats in the first week then the treatment is unlikely to be successful, no matter how long it continues. Furthermore, treatments carried out on arable farms, where cereals are stored and the environment is relatively undisturbed, are likely to be less successful than those carried out on livestock farms, where alternative food may also be abundant but where the environment is less predictable. Bait takes that persist at the same bait points for longer than 16 days strongly suggest the presence of resistant rats, while immigration may be significantly affecting the treatment if takes recur at more than 30% of points after a period of seven days. Once a given problem has been identified remedial measures can be taken

Transient scaling and resurgence of chimera states in networks of Boolean phase oscillators

We study networks of non-locally coupled electronic oscillators that can be described approximately by a Kuramoto-like model. The experimental networks show long complex transients from random initial conditions on the route to network synchronization. The transients display complex behaviors, including resurgence of chimera states, which are network dynamics where order and disorder coexists. The spatial domain of the chimera state moves around the network and alternates with desynchronized dynamics. The fast timescale of our oscillators (on the order of $100\;\mathrm{ns}$) allows us to study the scaling of the transient time of large networks of more than a hundred nodes, which has not yet been confirmed previously in an experiment and could potentially be important in many natural networks. We find that the average transient time increases exponentially with the network size and can be modeled as a Poisson process in experiment and simulation. This exponential scaling is a result of a synchronization rate that follows a power law of the phase-space volume.Comment: http://journals.aps.org/pre/abstract/10.1103/PhysRevE.90.03090

Reservoir computing with a single time-delay autonomous Boolean node

We demonstrate reservoir computing with a physical system using a single autonomous Boolean logic element with time-delay feedback. The system generates a chaotic transient with a window of consistency lasting between 30 and 300 ns, which we show is sufficient for reservoir computing. We then characterize the dependence of computational performance on system parameters to find the best operating point of the reservoir. When the best parameters are chosen, the reservoir is able to classify short input patterns with performance that decreases over time. In particular, we show that four distinct input patterns can be classified for 70 ns, even though the inputs are only provided to the reservoir for 7.5 ns.Comment: 5 pages, 5 figure

Long period grating in multicore optical fiber:an ultra-sensitive vector bending sensor for low curvatures

Long period grating was UV inscribed into a multicore fiber consisting of 120 single mode cores. The multicore fiber that hosts the grating was fusion spliced into a single mode fiber at both ends. The splice creates a taper transition between the two types of fiber that produces a nonadiabatic mode evolution; this results in the illumination of all the modes in the multicore fiber. The spectral characteristics of this fiber device as a function of curvature were investigated. The device yielded a significant spectral sensitivity as high as 1.23 nm/m-1 and 3.57 dB/m-1 to the ultra-low curvature values from 0 to 1 m-1. This fiber device can also distinguish the orientation of curvature experienced by the fiber as the long period grating attenuation bands producing either a blue or red wavelength shift. The finite element method (FEM) model was used to investigate the modal behavior in multicore fiber and to predict the phase-matching curves of the long period grating inscribed into multicore fiber

Issues for palliative medicine doctors surrounding the withdrawal of non-invasive ventilation at the request of a patient with motor neurone disease: a scoping study

Background Non-invasive ventilation (NIV) is beneficial for respiratory failure in motor neurone disease (MND) but some patients may wish to stop the intervention. Guidance from the National Institute for Health and Care Excellence recommends that research is needed on NIV withdrawal. There is little in the literature focusing on the issues doctors face when withdrawing NIV in this group. Aim To identify issues and challenges that palliative medicine doctors encounter in relation to the withdrawal of NIV in MND patients. Method An electronic questionnaire was sent to members of the Association of Palliative Medicine of Great Britain and Ireland. Participants rated how practically, emotionally and ethically challenging they found the process of NIV withdrawal. Results 76 doctors responding had been directly involved in withdrawal of NIV at the request of a patient with MND. A high percentage rated the practical, ethical and emotional challenges as 7 or more on a 0–10 scale. Thematic analysis of the free text revealed some common difficulties. Lack of guidance on practical aspects of withdrawal, poor advance care planning and the need to support all involved to prevent conflict were recurrent themes. Statements relating to the emotional burden were diverse but suggest many palliative care doctors feel significant personal impact. Conclusions The withdrawal of NIV in patients with MND appears to pose considerable challenges to palliative medicine doctors; emotionally, practically and to a lesser extent ethically. Development of guidelines and a clear ethical statement of conduct may help but emotional issues appear more complex

Diffuse HI Disks in Isolated Galaxies

In order to investigate the contribution of diffuse components to their total HI emission, we have obtained high precision HI line flux densities with the 100m Green Bank Telescope for a sample of 100 isolated spiral and irregular galaxies which we have previously observed with the 43m telescope. A comparison of the observed HI line fluxes obtained with the two different telescopes, characterized by half-power beam widths of 9 arcmin and 21 arcmin respectively, exploits a ``beam matching'' technique to yield a statistical determination of the occurrence of diffuse HI components in their disks. A simple model of the HI distribution within a galaxy well describes ~75 % of the sample and accounts for all of the HI line flux density. The remaining galaxies are approximately evenly divided into two categories: ones which appear to possess a significantly more extensive HI distribution than the model predicts, and ones for which the HI distribution is more centrally concentrated than predicted. Examples of both extremes can be found in the literature but little attention has been paid to the centrally concentrated HI systems. Our sample has demonstrated that galaxies do not commonly possess extended regions of low surface brightness HI gas which is not accounted for by our current understanding of the structure of HI disks. Eight HI-rich companions to the target objects are identified, and a set of extragalactic HI line flux density calibrators is presented.Comment: 26 page