772 resultados para glycaemic control


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The beta-blockers carvedilol and metoprolol provide important therapeutic strategies for heart failure treatment. Therapy with metoprolol facilitates the control by phosphodiesterase PDE3, but not PDE4, of inotropic effects of catecholamines in human failing ventricle. However, it is not known whether carvedilol has the same effect. We investigated whether the PDE3-selective inhibitor cilostamide (0.3 mu M) or PDE4-selective inhibitor rolipram (1 mu M) modified the positive inotropic and lusitropic effects of catecholamines in ventricular myocardium of heart failure patients treated with carvedilol. Right ventricular trabeculae from explanted hearts of nine carvedilol-treated patients with terminal heart failure were paced to contract at 1 Hz. The effects of (-)-noradrenaline, mediated through beta(1)-adrenoceptors (beta(2)-adrenoceptors blocked with ICI118551), and (-)-adrenaline, mediated through beta(2)-adrenoceptors (beta(1)-adrenoceptors blocked with CGP20712A), were assessed in the absence and presence of the PDE inhibitors. The inotropic potency, estimated from -logEC(50)s, was unchanged for (-)-noradrenaline but decreased 16-fold for (-)-adrenaline in carvedilol-treated compared to non-beta-blocker-treated patients, consistent with the previously reported beta(2)-adrenoceptor-selectivity of carvedilol. Cilostamide caused 2- to 3-fold and 10- to 35-fold potentiations of the inotropic and lusitropic effects of (-)-noradrenaline and (-)-adrenaline, respectively, in trabeculae from carvedilol-treated patients. Rolipram did not affect the inotropic and lusitropic potencies of (-)-noradrenaline or (-)-adrenaline. Treatment of heart failure patients with carvedilol induces PDE3 to selectively control the positive inotropic and lusitropic effects mediated through ventricular beta(2)-adrenoceptors compared to beta(1)-adrenoceptors. The beta(2)-adrenoceptor-selectivity of carvedilol may provide protection against beta(2)-adrenoceptor-mediated ventricular overstimulation in PDE3 inhibitor-treated patients. PDE4 does not control beta(1)- and beta(2)-adrenoceptor-mediated inotropic and lusitropic effects in carvedilol-treated patients.

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AIMS: To examine changes in illicit drug consumption between peak holiday season (23 December-3 January) in Australia and a control period two months later in a coastal urban area, an inland semi-rural area and an island populated predominantly by vacationers during holidays. DESIGN: Analysis of representative daily composite wastewater samples collected from the inlet of the major wastewater treatment plant in each area. SETTING: Three wastewater treatment plants. PARTICIPANTS: Wastewater treatment plants serviced approximately 350, 000 persons in the urban area, 120,000 in the semi-rural area and 1100-2400 on the island. MEASUREMENTS: Drug residues were analysed using liquid chromatography coupled to a tandem mass spectrometer. Per capita drug consumption was estimated. Changes in drug use were quantified using Hedges' g. FINDINGS: During the holidays, cannabis consumption in the semi-rural area declined (g = -2.8) as did methamphetamine (-0.8), whereas cocaine (+1.5) and ecstasy (+1.6) use increased. In the urban area, consumption of all drugs increased during holidays (cannabis +1.6, cocaine +1.2, ecstasy +0.8 and methamphetamine +0.3). In the vacation area, methamphetamine (+0.7), ecstasy (+0.7) and cocaine (+1.1) use increased, but cannabis (-0.5) use decreased during holiday periods. CONCLUSIONS: While the peak holiday season in Australia is perceived as a period of increased drug use, this is not uniform across all drugs and areas. Substantial declines in drug use in the semi-rural area contrasted with substantial increases in urban and vacation areas. Per capita drug consumption in the vacation area was equivalent to that in the urban area, implying that these locations merit particular attention for drug use monitoring and harm minimisation measures.

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Introduction and Aims: Holiday periods are potentially a time for increased substance use as social events and private parties are more common. Data on community illicit drug consumption during holiday periods are limited. Besides existing methods for determining drug use, such as population surveys, one emerging method is to measure illicit drugs and/or their metabolites in wastewater samples. This study examined the change in consumption of cannabis, methamphetamine, cocaine and 3,4- methylenedioxymethamphetamine in three different types of areas (an inland semi-rural area, a coastal urban area and a vacation island) with respect to holiday times. Design and Methods: Samples were collected at the inlet of the major wastewater treatment plant in each area during a key annual holiday (i.e. the summer holiday including Christmas and New Year) and control period. Illicit drug residues in the daily composited samples were measured by liquid chromatography coupled with tandem mass spectrometry. Results: Drug use varied substantially among the three areas within each monitoring period as well as between the holiday and control period within each area. Use consistently increased and peaked over New Year particularly for cocaine and 3,4-methylenedioxymethamphetamine whereas cannabis and methamphetamine were relatively less subjected to holiday times in all the areas. Discussion and Conclusions: Wastewater sampling and analysis provides higher spatio-temporal resolution than national surveys and supplements drug epidemiology studies originating primary in metropolitan locations. Such data is essential for policy makers to plan potential intervention strategies associated with these illicit substances in regional areas and other settings besides urban areas in the future.

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Experiments were carried out to verify the effectiveness of the excess water storage depth (EWSD) in reducing runoff losses of simetryn and thiobencarb from paddy fields upon appreciable rainfall events. A paddy plot having an EWSD of 2 cm was effective in controlling runoff with the herbicide losses of less than 1% of the applied herbicides. Meanwhile, a plot with 0-cm EWSD lost 18.1 and 3.7% of the applied mass of simetryn and thiobencarb, respectively. Therefore, an appropriate EWSD is essential during the recommended 7-day water holding period in order to completely hold the water inside the field in case of rainfall.

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The applicability of ELISA kits was evaluated as an alternative to monitor bensulfuron-methyl and simetryn behavior in paddy water under intermittent (Plot 1) and continuous (Plot 2) irrigation schemes. Simetryn concentrations in both plots decreased exponentially from the peak of the first day. However, the simetryn kit systematically underestimated by a factor of 0.79 as compared to the GC method. Bensulfuron-methyl concentrations exhibited similar dissipation kinetics in paddy water and the drainage water. The bensulfuron-methyl kit was capable of distinguishing spatial variations of concentrations in the paddy field. The ELISA kits clearly indicated differences in the loss of both herbicides between the two plots and therefore may be useful for evaluating the water management practice of pesticide runoff control in paddy fields.

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Copy number variations (CNVs) as described in the healthy population are purported to contribute significantly to genetic heterogeneity. Recent studies have described CNVs using lymphoblastoid cell lines or by application of specifically developed algorithms to interrogate previously described data. However, the full extent of CNVs remains unclear. Using high-density SNP array, we have undertaken a comprehensive investigation of chromosome 18 for CNV discovery and characterisation of distribution and association with chromosome architecture. We identified 399 CNVs, of which loss represents 98%, 58% are less than 2.5 kb in size and 71% are intergenic. Intronic deletions account for the majority of copy number changes with gene involvement. Furthermore, one-third of CNVs do not have putative breakpoints within repetitive sequences. We conclude that replicative processes, mediated either by repetitive elements or microhomology, account for the majority of CNVs in the healthy population. Genomic instability involving the formation of a non-B structure is demonstrated in one region.

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Objectives. It has been shown previously that IL-23R variants are associated with AS. We conducted an extended analysis in the UK population and a meta-analysis with the previously published studies, in order to refine these IL-23R associations with AS. Methods. The UK case-control study included 730 new cases and 1331 healthy controls. In the extended study, the 730 cases were combined with 1088 published cases. Allelic associations were analysed using contingency tables. In the meta-analysis, 3482 cases and 3150 controls from four different published studies and the new UK cases were combined. DerSimonian-Laird test was used to calculate random effects pooled odds ratios (ORs). Results. In the UK case-control study with new cases, four of the eight SNPs showed significant associations, whereas in the extended UK study, seven of the eight IL-23R SNPs showed significant associations (P < 0.05) with AS, maximal with rs11209032 (P < 10-5, OR 1.3), when cases with IBD and/or psoriasis were excluded. The meta-analysis showed significant associations with all eight SNPs; the strongest associations were again seen not only with rs11209032 (P = 4.06 × 10-9, OR ∼1.2) but also with rs11209026 (P < 10-10, OR ∼0.6). Conclusions. IL-23R polymorphisms are clearly associated with AS, but the primary causal association(s) is(are) still not established. These polymorphisms could contribute either increased or decreased susceptibility to AS; functional studies will be required for their full evaluation. Additionally, observed stronger associations with SNPs rs11209026 and rs11465804 upon exclusion of IBD and/or psoriasis cases may represent an independent association with AS. © The Author 2009. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved.

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Genetic factors are known to influence both the peak bone mass and probably the rate of change in bone density. A range of regulatory and structural genes has been proposed to be involved including collagen 1α1 (COL1A1), the estrogen receptor (ER), and the vitamin D receptor (VDR), but the actual genes involved are uncertain. We therefore studied the role of the COL1A1 and VDR loci in control of bone density by linkage in 45 dizygotic twin pairs and 29 nuclear families comprising 120 individuals. The influences on bone density of polymorphisms of COL1A1, VDR, and ER were studied by association both cross-sectionally and longitudinally in 193 elderly postmenopausal women (average age, 69 years) over a mean follow-up time of 6.3 years. Weak linkage of the COL1A1 locus with bone density was observed in both twins and families (p = 0.02 in both data sets), confirming previous observations of linkage of this locus with bone density. Association between the MscI polymorphism of COL1A1 and rate of lumbar spine bone loss was observed with significant gene-environment interaction related to dietary calcium intake (p = 0.0006). In the lowest tertile of dietary calcium intake, carriers of "s" alleles lost more bone than "SS" homozygotes (p = 0.01), whereas the opposite was observed in the highest dietary calcium intake (p = 0.003). Association also was observed between rate of bone loss at both the femoral neck and the lumbar spine and the TaqI VDR polymorphism (p = 0.03). This association was strongest in those in the lowest tertile of calcium intake, also suggesting the presence of gene-environment interaction involving dietary calcium and VDR, influencing bone turnover. No significant association was observed between the PvuII ER polymorphism alone or in combination with VDR or COL1A1 genotypes, with either bone density or its rate of change. These data support the involvement of COL1A1 in determination of bone density and the interaction of both COL1A1 and VDR with calcium intake in regulation of change of bone density over time.

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Purpose: It is relatively common for many mine workers in Australia to drive an average of 250 kilometers to and from work following long shifts and shift blocks. Despite the long distances travelled following long shifts of 12- to 14-hours, there is evidence to suggest that these workers are not engaging in a break following their shift prior to driving home. This naturally raises issues of fatigue and sleepiness when driving. There is limited research in respect to commuting behaviours of mine workers and little is known about the factors that influence these workers to leave site immediately following their shift. Using the theory of planned behaviour, this paper examines individual control beliefs that encourage or prevent workers from leaving the site immediately following their shift block. Method: Data was collected using a cross-sectional survey. The survey instrument was developed following a series of in-depth interviews with workers from a Queensland coal mine (n=37). The quantitative written survey sample (n=461) was drawn from the same coal mine and consisted of workers from all levels of the organisation. Results: The results examine workers intentions to leave the work site and drive home immediately following a shift block. The results show differences in control beliefs between workers finishing night shifts compared with those finishing day shifts. Implications: An understanding of these control beliefs may potentially inform more targeted intervention strategies in the attempt to encourage a safer approach to driving home following shift blocks.

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A number of hurdles must be overcome in order to integrate unmanned aircraft into civilian airspace for routine operations. The ability of the aircraft to land safely in an emergency is essential to reduce the risk to people, infrastructure and aircraft. To date, few field-demonstrated systems have been presented that show online re-planning and repeatability from failure to touchdown. This paper presents the development of the Guidance, Navigation and Control (GNC) component of an Automated Emergency Landing System (AELS) intended to address this gap, suited to a variety of fixed-wing aircraft. Field-tested on both a fixed-wing UAV and Cessna 172R during repeated emergency landing experiments, a trochoid-based path planner computes feasible trajectories and a simplified control system executes the required manoeuvres to guide the aircraft towards touchdown on a predefined landing site. This is achieved in zero-thrust conditions with engine forced to idle to simulate failure. During an autonomous landing, the controller uses airspeed, inertial and GPS data to track motion and maintains essential flight parameters to guarantee flyability, while the planner monitors glide ratio and re-plans to ensure approach at correct altitude. Simulations show reliability of the system in a variety of wind conditions and its repeated ability to land within the boundary of a predefined landing site. Results from field-tests for the two aircraft demonstrate the effectiveness of the proposed GNC system in live operation. Results show that the system is capable of guiding the aircraft to close proximity of a predefined keyhole in nearly 100% of cases.

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This study examines and quantifies the effect of adding polyelectrolytes to cellulose nanofibre suspensions on the gel point of cellulose nanofibre suspensions, which is the lowest solids concentration at which the suspension forms a continuous network. The lower the gel point, the faster the drainage time to produce a sheet and the higher the porosity of the final sheet formed. Two new techniques were designed to measure the dynamic compressibility and the drainability of nanocellulose–polyelectrolyte suspensions. We developed a master curve which showed that the independent variable controlling the behaviour of nanocellulose suspensions and its composite is the structure of the flocculated suspension which is best quantified as the gel point. This was independent of the type of polyelectrolyte used. At an addition level of 2 mg/g of nanofibre, a reduction in gel point over 50 % was achieved using either a high molecular weight (13 MDa) linear cationic polyacrylamide (CPAM, 40 % charge), a dendrimer polyethylenimine of high molecular weight of 750,000 Da (HPEI) or even a low molecular weight of 2000 Da (LPEI). There was no significant difference in the minimum gel point achieved, despite the difference in polyelectrolyte morphology and molecular weight. In this paper, we show that the gel point controls the flow through the fibre suspension, even when comparing fibre suspensions with solids content above the gel point. A lower gel point makes it easier for water to drain through the fibre network,reducing the pressure required to achieve a given dewatering rate and reducing the filtering time required to form a wet laid sheet. We further show that the lower gel point partially controls the structure of the wet laid sheet after it is dried. Halving the gel point increased the air permeability of the dry sheet by 37, 46 and 25 %, when using CPAM, HPEI and LPEI, respectively. The resistance to liquid flow was reduced by 74 and 90 %, when using CPAM and LPEI. Analysing the paper formed shows that sheet forming process and final sheet properties can be engineered and controlled by adding polyelectrolytes to the nanofibre suspension.

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The undesirable effects of roll motion of ships (rocking about the longitudinal axis) became noticeable in the mid-nineteenth century when significant changes were introduced to the design of ships as a result of sails being replaced by steam engines and the arrangement being changed from broad to narrow hulls. The combination of these changes led to lower transverse stability (lower restoring moment for a given angle of roll) with the consequence of larger roll motion. The increase in roll motion and its effect on cargo and human performance lead to the development several control devices that aimed at reducing and controlling roll motion. The control devices most commonly used today are fin stabilizers, rudder, anti-roll tanks, and gyrostabilizers. The use of different types of actuators for control of ship roll motion has been amply demonstrated for over 100 years. Performance, however, can still fall short of expectations because of difficulties associated with control system design, which have proven to be far from trivial due to fundamental performance limitations and large variations of the spectral characteristics of wave-induced roll motion. This short article provides an overview of the fundamentals of control design for ship roll motion reduction. The overview is limited to the most common control devices.

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This paper presents a motion control system for tracking of attitude and speed of an underactuated slender-hull unmanned underwater vehicle. The feedback control strategy is developed using the Port-Hamiltonian theory. By shaping of the target dynamics (desired dynamic response in closed loop) with particular attention to the target mass matrix, the influence of the unactuated dynamics on the controlled system is suppressed. This results in achievable dynamics independent of stable uncontrolled states. Throughout the design, the insight of the physical phenomena involved is used to propose the desired target dynamics. Integral action is added to the system for robustness and to reject steady disturbances. This is achieved via a change of coordinates that result in input-to-state stable (ISS) target dynamics. As a final step in the design, an anti-windup scheme is implemented to account for limited actuator capacity, namely saturation. The performance of the design is demonstrated through simulation with a high-fidelity model.

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A gyrostabiliser control system and method for stabilising marine vessel motion based on precession information only. The control system employs an Automatic Gain Control (AGC) precession controller (60). This system operates with a gain factor that is always being gradually minimized so as to let the gyro flywheel (12) develop as much precession as possible - the higher the precession, the higher the roll stabilising moment. This continuous gain change provides adaptation to changes in sea state and sailing conditions. The system effectively predicts the likelihood of maximum precession being reached. Should this event be detected, then the gain is rapidly increased so as to provide a breaking precession torque. Once the event has passed, the system again attempts to gradually decrease the gain.