747 resultados para Diabetes and challenges


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This paper focuses on the advantages of Open Access, (OA) particularly from the point of view of individual researchers, research centres and disciplines, and institutions. The advantage described by the phrase “OA advantage”, is multifaceted. The experience of Queensland University of Technology in Australia in pioneering OA as preferred practice in an institution with a growing research profile and energy, has seen evidence of the OA advantage develop in the experience of our researchers. The University has witnessed the development of practical evidence about improved recognition and impact, and this has occurred in the context of sector wide activity and policy where fresh approaches and leadership will result in even greater rewards for researchers whose outputs are “in the open”.

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Background: Increased hospital readmission and longer stays in the hospital for patients with type 2 diabetes and cardiac disease can result in higher healthcare costs and heavier individual burden. Thus, knowledge of the characteristics and predictive factors for Vietnamese patients with type 2 diabetes and cardiac disease, at high risk of hospital readmission and longer stays in the hospital, could provide a better understanding on how to develop an effective care plan aimed at improving patient outcomes. However, information about factors influencing hospital readmission and length of stay of patients with type 2 diabetes and cardiac disease in Vietnam is limited. Aim: This study examined factors influencing hospital readmission and length of stay of Vietnamese patients with both type 2 diabetes and cardiac disease. Methods: An exploratory prospective study design was conducted on 209 patients with type 2 diabetes and cardiac disease in Vietnam. Data were collected from patient charts and patients' responses to self-administered questionnaires. Descriptive statistics, bivariate correlation, logistic and multiple regression were used to analyse the data. Results: The hospital readmission rate was 12.0% among patients with both type 2 diabetes and cardiac disease. The average length of stay in the hospital was 9.37 days. Older age (OR= 1.11, p< .05), increased duration of type 2 diabetes (OR= 1.22, p< .05), less engagement in stretching/strengthening exercise behaviours (OR= .93, p< .001) and in communication with physician (OR= .21, p< .001) were significant predictors of 30-dayhospital readmission. Increased number of additional co-morbidities (β= .33, p< .001) was a significant predictor of longer stays in the hospital. High levels of cognitive symptom management (β= .40, p< .001) significantly predicted longer stays in the hospital, indicating that the more patients practiced cognitive symptom management, the longer the stay in hospital. Conclusions: This study provides some evidence of factors influencing hospital readmission and length of stay and argues that this information may have significant implications for clinical practice in order to improve patients' health outcomes. However, the findings of this study related to the targeted hospital only. Additionally, the investigation of environmental factors is recommended for future research as these factors are important components contributing to the research model.

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In April 2014, the World Health Organization announced the beginning of a post-antibiotic era and declared antimicrobial resistance (AMR) a public health priority demanding global action. If no action is taken, by 2050 AMR will kill more people each year than cancer, with 10 million estimated annual deaths at a cost of $100 trillion to the global economy. New therapies to tackle multidrug resistant bacterial pathogens are urgently needed. Unlike traditional antibiotics, antivirulence drugs inhibit bacterial virulence instead of growth promising to offer a new class of superior therapeutics that will be ‘evolution-proof’ and ‘tailored-spectrum’. This mini-review discusses the latest emerging evidence on the promised benefits of antivirulence drugs over conventional antibiotics, also highlighting the challenges in evaluating these properties for each of the diverse virulence targets that are currently under investigation. The author argues that overcoming such challenges early in the development process constitutes an important step towards successfully progressing each of the expanding number of antivirulence strategies into next-generation therapies for common human and animal infections that are becoming increasingly refractory to all available antibiotics.

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Background Several prospective studies have suggested that gait and plantar pressure abnormalities secondary to diabetic peripheral neuropathy contributes to foot ulceration. There are many different methods by which gait and plantar pressures are assessed and currently there is no agreed standardised approach. This study aimed to describe the methods and reproducibility of three-dimensional gait and plantar pressure assessments in a small subset of participants using pre-existing protocols. Methods Fourteen participants were conveniently sampled prior to a planned longitudinal study; four patients with diabetes and plantar foot ulcers, five patients with diabetes but no foot ulcers and five healthy controls. The repeatability of measuring key biomechanical data was assessed including the identification of 16 key anatomical landmarks, the measurement of seven leg dimensions, the processing of 22 three-dimensional gait parameters and the analysis of four different plantar pressures measures at 20 foot regions. Results The mean inter-observer differences were within the pre-defined acceptable level (<7 mm) for 100 % (16 of 16) of key anatomical landmarks measured for gait analysis. The intra-observer assessment concordance correlation coefficients were > 0.9 for 100 % (7 of 7) of leg dimensions. The coefficients of variations (CVs) were within the pre-defined acceptable level (<10 %) for 100 % (22 of 22) of gait parameters. The CVs were within the pre-defined acceptable level (<30 %) for 95 % (19 of 20) of the contact area measures, 85 % (17 of 20) of mean plantar pressures, 70 % (14 of 20) of pressure time integrals and 55 % (11 of 20) of maximum sensor plantar pressure measures. Conclusion Overall, the findings of this study suggest that important gait and plantar pressure measurements can be reliably acquired. Nearly all measures contributing to three-dimensional gait parameter assessments were within predefined acceptable limits. Most plantar pressure measurements were also within predefined acceptable limits; however, reproducibility was not as good for assessment of the maximum sensor pressure. To our knowledge, this is the first study to investigate the reproducibility of several biomechanical methods in a heterogeneous cohort.

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The Intergovernmental Panel on Climate Change (IPCC) has successfully produced four assessment reports since 1990 along with a number of special reports and greenhouse gas inventory guidelines. It has very rigorous and robust procedures and guidelines for preparing the assessment reports largely based on synthesis of peer-reviewed and published scientific literature. IPCC has attracted controversy since the Second Assessment Report of 1995. The recent controversies surrounding the IPCC reports surfaced nearly two years after the release of the report in 2007, especially in the wake of the crucial Copenhagen Climate Convention. Many of the controversies can be traced to the use of information sourced from reports published outside the scientific journals such as reports of the World Wildlife Fund. It is true that there are a few errors in the IPCC reports, which may have escaped the multilayered rigorous review process. Many of the errors found in the main reports, which are over a thousand page each, have not been quoted in the crucial and most referred Summary for Policy Makers. IPCC may have to develop a more robust policy for sourcing literature published outside the scientific journals. The United Nations Secretary General has requested the prestigious Inter-Academy Council to review the IPCC principles, procedures and guidelines. The controversies raised in the recent past do not in any way change the main conclusions of the IPCC Assessment Report.

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Climate change is projected to lead to shift of forest types leading to irreversible damage to forests by rendering several species extinct and potentially affecting the livelihoods of local communities and the economy. Approximately 47% and 42% of tropical dry deciduous grids are projected to undergo shifts under A2 and B2 SRES scenarios respectively, as opposed to less than 16% grids comprising of tropical wet evergreen forests. Similarly, the tropical thorny scrub forest is projected to undergo shifts in majority of forested grids under A2 (more than 80%) as well as B2 scenarios (50% of grids). Thus the forest managers and policymakers need to adapt to the ecological as well as the socio-economic impacts of climate change. This requires formulation of effective forest management policies and practices, incorporating climate concerns into long-term forest policy and management plans. India has formulated a large number of innovative and progressive forest policies but a mechanism to ensure effective implementation of these policies is needed. Additional policies and practices may be needed to address the impacts of climate change. This paper discusses an approach and steps involved in the development of an adaptation framework as well as policies, strategies and practices needed for mainstreaming adaptation to cope with projected climate change. Further, the existing barriers which may affect proactive adaptation planning given the scale, accuracy and uncertainty associated with assessing climate change impacts are presented.

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This article explores issues and challenges in the field of education in nanoscience and technology with special emphasis with respect to India, where an expanding programme of research in nano science and technology is in place. The article does not concentrate on actual curricula that are needed in nano science and technology education course. Rather it focuses on the desirability of nanoscience and technology education at different levels of education and future prospect of students venturing into this within the economic and cultural milieu of India. We argue that care is needed in developing the education programme in India. However, the risk is worth taking as the education on nanoscience and technology can bridge the man power gap not only in this area of technology but also related technologies of hardware and micro electronics for which the country is a promising destination at global level. This will also unlock the demographical advantage that India will enjoy in the next five decades.

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In the last decade, there has been a tremendous interest in Graphene transistors. The greatest advantage for CMOS nanoelectronics applications is the fact that Graphene is compatible with planar CMOS technology and potentially offers excellent short channel properties. Because of the zero bandgap, it will not be possible to turn off the MOSFET efficiently and hence the typical on current to off current ratio (Ion/Ioff) has been less than 10. Several techniques have been proposed to open the bandgap in Graphene. It has been demonstrated, both theoretically and experimentally, that Graphene Nanoribbons (GNR) show a bandgap which is inversely proportional to their width. GNRs with about 20 nm width have bandgaps in the range of 100meV. But it is very difficult to obtain GNRs with well defined edges. An alternate technique to open the band gap is to use bilayer Graphene (BLG), with an asymmetric bias applied in the direction perpendicular to their plane. Another important CMOS metric, the subthreshold slope is also limited by the inability to turn off the transistor. However, these devices could be attractive for RF CMOS applications. But even for analog and RF applications the non-saturating behavior of the drain current can be an issue. Although some studies have reported current saturation, the mechanisms are still not very clear. In this talk we present some of our recent findings, based on simulations and experiments, and propose possible solutions to obtain high on current to off current ratio. A detailed study on high field transport in grapheme transistors, relevant for analog and RF applications will also be presented.

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Rapidly depleting stocks of fossil fuels and increasing greenhouse gas (GHG) emissions have necessitated the exploration of cost effective sustainable energy sources focussing on biofuels through algae. Abundant wastewaters generated in urban localities every day provide the nourishment to nurture algae for biofuel generation. The present communication focuses on the lipid prospects of algae grown in wastewater systems. Euglena sp., Spirogyra sp. and Phormidium sp. were collected from selected locations of sewage fed urban lakes and sewage treatment plants of Bangalore and Mysore. The total lipid content of Euglena sp. was higher (24.6%) compared to Spirogyra sp. (18.4%) followed by Phormidium sp. (8.8%) and their annual lipid yield potential was 6.52, 1.94 and 2.856 t/ha/year, respectively. These species showed higher content of fatty acids (palmitate, stearate followed by oleic and linoleic acids) with the desirable biofuel properties. (C) 2013 Elsevier Ltd. All rights reserved.