Showing papers by "University of Bedfordshire published in 2016"

Alternatives to antibiotics—a pipeline portfolio review

Abstract: Antibiotics have saved countless lives and enabled the development of modern medicine over the past 70 years. However, it is clear that the success of antibiotics might only have been temporary and we now expect a long-term and perhaps never-ending challenge to find new therapies to combat antibiotic-resistant bacteria. A broader approach to address bacterial infection is needed. In this Review, we discuss alternatives to antibiotics, which we defined as non-compound approaches (products other than classic antibacterial agents) that target bacteria or any approaches that target the host. The most advanced approaches are antibodies, probiotics, and vaccines in phase 2 and phase 3 trials. This first wave of alternatives to antibiotics will probably best serve as adjunctive or preventive therapies, which suggests that conventional antibiotics are still needed. Funding of more than £1·5 billion is needed over 10 years to test and develop these alternatives to antibiotics. Investment needs to be partnered with translational expertise and targeted to support the validation of these approaches in phase 2 trials, which would be a catalyst for active engagement and investment by the pharmaceutical and biotechnology industry. Only a sustained, concerted, and coordinated international effort will provide the solutions needed for the future.

A BEME systematic review of the effects of interprofessional education: BEME Guide No. 39

Abstract: Background: Interprofessional education (IPE) aims to bring together different professionals to learn with, from, and about one another in order to collaborate more effectively in the delivery of safe, high-quality care for patients/clients. Given its potential for improving collaboration and care delivery, there have been repeated calls for the wider-scale implementation of IPE across education and clinical settings. Increasingly, a range of IPE initiatives are being implemented and evaluated which are adding to the growth of evidence for this form of education.Aim: The overall aim of this review is to update a previous BEME review published in 2007. In doing so, this update sought to synthesize the evolving nature of the IPE evidence.Methods: Medline, CINAHL, BEI, and ASSIA were searched from May 2005 to June 2014. Also, journal hand searches were undertaken. All potential abstracts and papers were screened by pairs of reviewers to determine inclusion. All included papers were assessed for metho...

The impact of different environmental conditions on cognitive function: a focused review

Abstract: Cognitive function defines performance in objective tasks that require conscious mental effort. Extreme environments, namely heat, hypoxia, and cold can all alter human cognitive function due to a variety of psychological and/or biological processes. The aims of this Focused Review were to discuss; 1) the current state of knowledge on the effects of heat, hypoxic and cold stress on cognitive function, 2) the potential mechanisms underpinning these alterations, and 3) plausible interventions that may maintain cognitive function upon exposure to each of these environmental stressors. The available evidence suggests that the effects of heat, hypoxia and cold stress on cognitive function are both task and severity dependent. Complex tasks are particularly vulnerable to extreme heat stress, whereas both simple and complex task performance appear to be vulnerable at even at moderate altitudes. Cold stress also appears to negatively impact both simple and complex task performance, however, the research in this area is sparse in comparison to heat and hypoxia. In summary, this focused review provides updated knowledge regarding the effects of extreme environmental stressors on cognitive function and their biological underpinnings. Tyrosine supplementation may help individuals maintain cognitive function in very hot, hypoxic, and/or cold conditions. However, more research is needed to clarify these and other postulated interventions.

Advances in vehicular ad-hoc networks (VANETs): Challenges and road-map for future development

Abstract: Recent advances in wireless communication technologies and auto-mobile industry have triggered a significant research interest in the field of vehicular ad-hoc networks (VANETs) over the past few years. A vehicular network consists of vehicle-to-vehicle (V2V) and vehicle-to-infrastructure (V2I) communications supported by wireless access technologies such as IEEE 802.11p. This innovation in wireless communication has been envisaged to improve road safety and motor traffic efficiency in near future through the development of intelligent transportation system (ITS). Hence, governments, auto-mobile industries and academia are heavily partnering through several ongoing research projects to establish standards for VANETs. The typical set of VANET application areas, such as vehicle collision warning and traffic information dissemination have made VANET an interesting field of mobile wireless communication. This paper provides an overview on current research state, challenges, potentials of VANETs as well as the ways forward to achieving the long awaited ITS.

Effective ways to use Internet of Things in the field of medical and smart health care

Abstract: The recent advancements in technology and the availability of the Internet make it possible to connect various devices that can communicate with each other and share data. The Internet of Things (IoT) is a new concept that allows users to connect various sensors and smart devices to collect real-time data from the environment. However, it has been observed that a comprehensive platform is still missing in the e-Health and m-Health architectures to use smartphone sensors to sense and transmit important data related to a patient's health. In this paper, our contribution is twofold. Firstly, we critically evaluate the existing literature, which discusses the effective ways to deploy IoT in the field of medical and smart health care. Secondly, we propose a new semantic model for patients' e-Health. The proposed model named as ‘k-Healthcare’ makes use of 4 layers; the sensor layer, the network layer, the Internet layer and the services layer. All layers cooperate with each other effectively and efficiently to provide a platform for accessing patients' health data using smart phones.

Gene family expansions and contractions are associated with host range in plant pathogens of the genus Colletotrichum

Abstract: Many species belonging to the genus Colletotrichum cause anthracnose disease on a wide range of plant species. In addition to their economic impact, the genus Colletotrichum is a useful model for the study of the evolution of host specificity, speciation and reproductive behaviors. Genome projects of Colletotrichum species have already opened a new era for studying the evolution of pathogenesis in fungi. We sequenced and annotated the genomes of four strains in the Colletotrichum acutatum species complex (CAsc), a clade of broad host range pathogens within the genus. The four CAsc proteomes and secretomes along with those representing an additional 13 species (six Colletotrichum spp. and seven other Sordariomycetes) were classified into protein families using a variety of tools. Hierarchical clustering of gene family and functional domain assignments, and phylogenetic analyses revealed lineage specific losses of carbohydrate-active enzymes (CAZymes) and proteases encoding genes in Colletotrichum species that have narrow host range as well as duplications of these families in the CAsc. We also found a lineage specific expansion of necrosis and ethylene-inducing peptide 1 (Nep1)-like protein (NLPs) families within the CAsc. This study illustrates the plasticity of Colletotrichum genomes, and shows that major changes in host range are associated with relatively recent changes in gene content.

Misuse of "Power" and Other Mechanical Terms in Sport and Exercise Science Research

Abstract: Despite the Systeme International d'Unites (SI) that was published in 1960, there continues to be widespread misuse of the terms and nomenclature of mechanics in descriptions of exercise performance. Misuse applies principally to failure to distinguish between mass and weight, velocity and speed, and especially the terms "work" and "power." These terms are incorrectly applied across the spectrum from high-intensity short-duration to long-duration endurance exercise. This review identifies these misapplications and proposes solutions. Solutions include adoption of the term "intensity" in descriptions and categorizations of challenge imposed on an individual as they perform exercise, followed by correct use of SI terms and units appropriate to the specific kind of exercise performed. Such adoption must occur by authors and reviewers of sport and exercise research reports to satisfy the principles and practices of science and for the field to advance.

Optical Based Noninvasive Glucose Monitoring Sensor Prototype

Abstract: Diabetes mellitus claims millions of lives every year. It affects the body in various ways by leading to many serious illnesses and premature mortality. Heart and kidney diseases, which are caused by diabetes, are increasing at an alarming rate. In this paper, we report a study of a noninvasive measurement technique to determine the glucose levels in the human body. Current existing methods to quantify the glucose level in the blood are predominantly invasive that involve taking the blood samples using finger pricking. In this paper, we report a spectroscopy-based noninvasive glucose monitoring system to measure glucose concentration. Near-infrared transmission spectroscopy is used and in vitro experiments are conducted, as well as in vivo . Our experimental study confirms a correlation between the sensor output voltage and glucose concentration levels. We report a low-cost prototype of spectroscopy-based noninvasive glucose monitoring system that demonstrates promising results in vitro and establishes a relationship between the optical signals and the changing levels of blood–glucose concentration.

Automated telephone communication systems for preventive healthcare and management of long-term conditions

Abstract: BACKGROUND: Automated telephone communication systems (ATCS) can deliver voice messages and collect health-related information from patients using either their telephone's touch-tone keypad or voice recognition software. ATCS can supplement or replace telephone contact between health professionals and patients. There are four different types of ATCS: unidirectional (one-way, non-interactive voice communication), interactive voice response (IVR) systems, ATCS with additional functions such as access to an expert to request advice (ATCS Plus) and multimodal ATCS, where the calls are delivered as part of a multicomponent intervention. OBJECTIVES: To assess the effects of ATCS for preventing disease and managing long-term conditions on behavioural change, clinical, process, cognitive, patient-centred and adverse outcomes. SEARCH METHODS: We searched 10 electronic databases (the Cochrane Central Register of Controlled Trials; MEDLINE; Embase; PsycINFO; CINAHL; Global Health; WHOLIS; LILACS; Web of Science; and ASSIA); three grey literature sources (Dissertation Abstracts, Index to Theses, Australasian Digital Theses); and two trial registries (www.controlled-trials.com; www.clinicaltrials.gov) for papers published between 1980 and June 2015. SELECTION CRITERIA: Randomised, cluster- and quasi-randomised trials, interrupted time series and controlled before-and-after studies comparing ATCS interventions, with any control or another ATCS type were eligible for inclusion. Studies in all settings, for all consumers/carers, in any preventive healthcare or long term condition management role were eligible. DATA COLLECTION AND ANALYSIS: We used standard Cochrane methods to select and extract data and to appraise eligible studies. MAIN RESULTS: We included 132 trials (N = 4,669,689). Studies spanned across several clinical areas, assessing many comparisons based on evaluation of different ATCS types and variable comparison groups. Forty-one studies evaluated ATCS for delivering preventive healthcare, 84 for managing long-term conditions, and seven studies for appointment reminders. We downgraded our certainty in the evidence primarily because of the risk of bias for many outcomes. We judged the risk of bias arising from allocation processes to be low for just over half the studies and unclear for the remainder. We considered most studies to be at unclear risk of performance or detection bias due to blinding, while only 16% of studies were at low risk. We generally judged the risk of bias due to missing data and selective outcome reporting to be unclear.For preventive healthcare, ATCS (ATCS Plus, IVR, unidirectional) probably increase immunisation uptake in children (risk ratio (RR) 1.25, 95% confidence interval (CI) 1.18 to 1.32; 5 studies, N = 10,454; moderate certainty) and to a lesser extent in adolescents (RR 1.06, 95% CI 1.02 to 1.11; 2 studies, N = 5725; moderate certainty). The effects of ATCS in adults are unclear (RR 2.18, 95% CI 0.53 to 9.02; 2 studies, N = 1743; very low certainty).For screening, multimodal ATCS increase uptake of screening for breast cancer (RR 2.17, 95% CI 1.55 to 3.04; 2 studies, N = 462; high certainty) and colorectal cancer (CRC) (RR 2.19, 95% CI 1.88 to 2.55; 3 studies, N = 1013; high certainty) versus usual care. It may also increase osteoporosis screening. ATCS Plus interventions probably slightly increase cervical cancer screening (moderate certainty), but effects on osteoporosis screening are uncertain. IVR systems probably increase CRC screening at 6 months (RR 1.36, 95% CI 1.25 to 1.48; 2 studies, N = 16,915; moderate certainty) but not at 9 to 12 months, with probably little or no effect of IVR (RR 1.05, 95% CI 0.99, 1.11; 2 studies, 2599 participants; moderate certainty) or unidirectional ATCS on breast cancer screening.Appointment reminders delivered through IVR or unidirectional ATCS may improve attendance rates compared with no calls (low certainty). For long-term management, medication or laboratory test adherence provided the most general evidence across conditions (25 studies, data not combined). Multimodal ATCS versus usual care showed conflicting effects (positive and uncertain) on medication adherence. ATCS Plus probably slightly (versus control; moderate certainty) or probably (versus usual care; moderate certainty) improves medication adherence but may have little effect on adherence to tests (versus control). IVR probably slightly improves medication adherence versus control (moderate certainty). Compared with usual care, IVR probably improves test adherence and slightly increases medication adherence up to six months but has little or no effect at longer time points (moderate certainty). Unidirectional ATCS, compared with control, may have little effect or slightly improve medication adherence (low certainty). The evidence suggested little or no consistent effect of any ATCS type on clinical outcomes (blood pressure control, blood lipids, asthma control, therapeutic coverage) related to adherence, but only a small number of studies contributed clinical outcome data.The above results focus on areas with the most general findings across conditions. In condition-specific areas, the effects of ATCS varied, including by the type of ATCS intervention in use.Multimodal ATCS probably decrease both cancer pain and chronic pain as well as depression (moderate certainty), but other ATCS types were less effective. Depending on the type of intervention, ATCS may have small effects on outcomes for physical activity, weight management, alcohol consumption, and diabetes mellitus. ATCS have little or no effect on outcomes related to heart failure, hypertension, mental health or smoking cessation, and there is insufficient evidence to determine their effects for preventing alcohol/substance misuse or managing illicit drug addiction, asthma, chronic obstructive pulmonary disease, HIV/AIDS, hypercholesterolaemia, obstructive sleep apnoea, spinal cord dysfunction or psychological stress in carers.Only four trials (3%) reported adverse events, and it was unclear whether these were related to the interventions. AUTHORS' CONCLUSIONS: ATCS interventions can change patients' health behaviours, improve clinical outcomes and increase healthcare uptake with positive effects in several important areas including immunisation, screening, appointment attendance, and adherence to medications or tests. The decision to integrate ATCS interventions in routine healthcare delivery should reflect variations in the certainty of the evidence available and the size of effects across different conditions, together with the varied nature of ATCS interventions assessed. Future research should investigate both the content of ATCS interventions and the mode of delivery; users' experiences, particularly with regard to acceptability; and clarify which ATCS types are most effective and cost-effective.

Overview of the interactive task in BioCreative V

Abstract: Fully automated text mining (TM) systems promote efficient literature searching, retrieval, and review but are not sufficient to produce ready-to-consume curated documents. These systems are not meant to replace biocurators, but instead to assist them in one or more literature curation steps. To do so, the user interface is an important aspect that needs to be considered for tool adoption. The BioCreative Interactive task (IAT) is a track designed for exploring user-system interactions, promoting development of useful TM tools, and providing a communication channel between the biocuration and the TM communities. In BioCreative V, the IAT track followed a format similar to previous interactive tracks, where the utility and usability of TM tools, as well as the generation of use cases, have been the focal points. The proposed curation tasks are user-centric and formally evaluated by biocurators. In BioCreative V IAT, seven TM systems and 43 biocurators participated. Two levels of user participation were offered to broaden curator involvement and obtain more feedback on usability aspects. The full level participation involved training on the system, curation of a set of documents with and without TM assistance, tracking of time-on-task, and completion of a user survey. The partial level participation was designed to focus on usability aspects of the interface and not the performance per se. In this case, biocurators navigated the system by performing pre-designed tasks and then were asked whether they were able to achieve the task and the level of difficulty in completing the task. In this manuscript, we describe the development of the interactive task, from planning to execution and discuss major findings for the systems tested.

Do stiffness and asymmetries predict change of direction performance

Abstract: Change of direction speed (CODS) underpins performance in a wide range of sports but little is known about how stiffness and asymmetries affect CODS. Eighteen healthy males performed unilateral drop jumps to determine vertical, ankle, knee and hip stiffness, and a CODS test to evaluate left and right leg cutting performance during which ground reaction force data were sampled. A step-wise regression analysis was performed to ascertain the determinants of CODS time. A two-variable regression model explained 63% (R2 = 0.63; P = 0.001) of CODS performance. The model included the mean vertical stiffness and jump height asymmetry determined during the drop jump. Faster athletes (n = 9) exhibited greater vertical stiffness (F = 12.40; P = 0.001) and less asymmetry in drop jump height (F = 6.02; P = 0.026) than slower athletes (n = 9); effect sizes were both “large” in magnitude. Results suggest that overall vertical stiffness and drop jump height asymmetry are the strongest predictors of CODS in a heal...

Advances in Body-Centric Wireless Communication: Applications and State-of-the-art

Abstract: Body-centric wireless networking (BCWN) and communications is an emerging 4G technology for short (1-5m) and very short (below 1m) range communications systems, with great potential for applications in healthcare delivery, entertainment, surveillance, and emergency services. This book brings together contributions from a multidisciplinary team of researchers in the field of wireless and mobile communications, signal processing and medical measurements, to present the underlying theory, implementation challenges and applications of this exciting new technology. Topics covered include antennas and radio systems design challenges for BCWNs; on/off body propagation and modelling at narrow band frequencies; ultra wideband radio channel characterization and system modelling for BANs; millimeter-wave radio propagation for BCWN; implantable devices and in-vivo communication challenges for medical technologies; diversity and MIMO front-ends for efficient body-centric wireless communications; on-body antennas and radio channels for GPS applications; materials characterization and flexible structure design for textile-based wearable applications in military and consumer applications; ultra wideband body-centric networks for localization and motion capture; down-scaling to the nano-scale in body-centric nano-networks; and the road ahead for body-centric wireless communication and networks. Advances in Body-Centric Wireless Communication will be of interest to researchers in academia and industry working in telecommunications engineering, antenna design, mobile and wireless networks, and healthcare technologies.

Running performance and thermal sensation in the heat are improved with menthol mouth rinse but not ice slurry ingestion.

Abstract: The purpose of this study was to compare the effects of a cooling strategy designed to predominately lower thermal state with a strategy designed to lower thermal sensation on endurance running performance and physiology in the heat. Eleven moderately trained male runners completed familiarization and three randomized, crossover 5-km running time trials on a non-motorized treadmill in hot conditions (33 °C). The trials included ice slurry ingestion before exercise (ICE), menthol mouth rinse during exercise (MEN), and no intervention (CON). Running performance was significantly improved with MEN (25.3 ± 3.5 min; P = 0.01), but not ICE (26.3 ± 3.2 min; P = 0.45) when compared with CON (26.0 ± 3.4 min). Rectal temperature was significantly decreased with ICE (by 0.3 ± 0.2 °C; P < 0.01), which persisted for 2 km of the run and MEN significantly decreased perceived thermal sensation (between 4 and 5 km) and ventilation (between 1 and 2 km) during the time trial. End-exercise blood prolactin concentration was elevated with MEN compared with CON (by 25.1 ± 24.4 ng/mL; P = 0.02). The data demonstrate that a change in the perception of thermal sensation during exercise from menthol mouth rinse was associated with improved endurance running performance in the heat. Ice slurry ingestion reduced core temperature but did not decrease thermal sensation during exercise or improve running performance.

Exploring the factors that influence the decision to adopt and engage with an integrated assistive telehealth and telecare service in Cambridgeshire, UK: a nested qualitative study of patient ‘users’ and ‘non-users’

Abstract: Background There is a political drive in the UK to use assistive technologies such as telehealth and telecare as an innovative and efficient approach to healthcare delivery. However, the success of implementation of such services remains dependent on the ability to engage the wider population to adopt these services. It has been widely acknowledged that low acceptance of technology, forms a key barrier to adoption although findings been mixed. Further, it remains unclear what, if any barriers exist between patients and how these compare to those who have declined or withdrawn from using these technologies. This research aims to address this gap focusing on the UK based Cambridgeshire Community Services Assistive Telehealth and Telecare service, an integrated model of telehealth and telecare. Methods Qualitative semi-structured interviews were conducted between 1 st February 2014 and 1 st December 2014, to explore the views and experiences of ‘users’ and ‘non-users’ using this service. ‘Users’ were defined as patients who used the service ( N = 28) with ‘non-users’ defined as either referred patients who had declined the service before allocation ( N = 3) or had withdrawn after using the ATT service ( N = 9). Data were analysed using the Framework Method. Results This study revealed that there are a range of barriers and facilitators that impact on the decision to adopt and continue to engage with this type of service. Having a positive attitude and a perceived need that could be met by the ATT equipment were influential factors in the decision to adopt and engage in using the service. Engagement of the service centred on ‘usability’, ‘usefulness of equipment’, and ‘threat to identity and independence’. Conclusions The paper described the influential role of referrers in decision-making and the need to engage with such agencies on a strategic level. The findings also revealed that reassurance from the onset was paramount to continued engagement, particularly in older patients who appeared to have more negative feelings towards technology. In addition, there is a clear need for continued product development and innovation to not only increase usability and functionality of equipment but also to motivate other sections of the population who could benefit from such services. Uncovering these factors has important policy implications in how services can improve access and patient support through the application of assistive technology which could in turn reduce unnecessary cost and burden on overstretched health services.

Serum testosterone, testosterone replacement therapy and all‐cause mortality in men with type 2 diabetes: retrospective consideration of the impact of PDE5 inhibitors and statins

Abstract: SummaryBackground Low testosterone levels occur in over 40% of men with type 2 diabetes mellitus (T2DM) and have been associated with increased mortality. Testosterone replacement together with statins and phosphodiesterase 5 inhibitors (PDE5I) are widely used in men with T2DM. Purpose To determine the impact of testosterone and testosterone replacement therapy (TRT) on mortality and assess the independence of this effect by adjusting statistical models for statin and PDE5I use. Methods We studied 857 men with T2DM screened from five primary care practices during April 2007–April 2009. Of the 857 men, 175/637 men with serum total testosterone ≤ 12 nmol/l or free testosterone (FT) ≤ 0.25 nmol/l received TU for a mean of 3.8 ± 1.2 (SD) years. PDE5I and statins were prescribed to 175/857 and 662/857 men respectively. All-cause mortality was the primary end-point. Cox regression models were used to compare survival in the three testosterone level/treatment groups, the analysis adjusted for age, statin and PDE5I use, BMI, blood pressure and lipids. Results Compared with the Low T/untreated group, mortality in the Normal T/untreated (HR: 0.62, CI: 0.41–0.94) or Low T/treated (HR: 0.38, CI: 0.16–0.90) groups was significantly reduced. PDE5I use was significantly associated with reduced mortality (HR: 0.21, CI: 0.066–0.68). After repeating the Cox regression in the 682 men not given a PDE5I, mortality in the Normal T/untreated and Low T/treated groups was significantly lower than that in the reference Low T/untreated group. Mortality in the PDE5I/treated was significantly reduced compared with the PDE5I/untreated group (OR: 0.06, CI: 0.009–0.47). Conclusions Testosterone replacement therapy is independently associated with reduced mortality in men with T2DM. PDE5I use, included as a confounding factor, was associated with decreased mortality in all patients and, those not on TRT, suggesting independence of effect. The impact of PDE5I treatment on mortality (both HR and OR < 0.25) needs confirmation by independent studies.

Impact of Community Pharmacy Diabetes Monitoring and Education Programme on Diabetes Management: A Randomized Controlled Study

Abstract: Objectives: To evaluate the impact of a pharmacist-led patient education and diabetes monitoring program on HbA1c and other cardiovascular risk factors in the community setting. Materials and methods: Patients with Type 2 diabetes (n=46) attending two community pharmacies in Hertfordshire, UK were randomized to one of two groups. The 'intervention' group (n=23) received a program of education about diabetes, its treatment and associated cardiovascular risk factors. They were seen for monitoring/counselling by community pharmacist on 6 occasions over a 12-month period. Measures included HbA1c, BMI, BP, blood glucose and lipid profile. The 'control' group (n=23) underwent these measurements at baseline and at 12 months only, without specific counselling or education over and above usual care. Results: HbA1c fell from 8.2% (65.55 mmol/mol) to 6.6% (48.73 mmol/mol) (p<0.001) in the intervention group, compared with a fall from 8.1% (64.54 mmol/mol) to 7.5% (58.76 mmol/mol) in the control group (p=0.03). BP fell from 146/87 mmHg to 126/81 mmHg in the intervention group (p=0.01) compared with no significant change in the control group (136/86 mmHg to 139/82 mmHg). Significant reductions in BMI (30.8 kg/m2 to 27 kg/m2, p<0.001) and blood glucose (8.8 mmol/l to 6.9 mmol/l, p<0.001) were also observed in the intervention group as compared to no significant changes in the control group. Lipid profile changes were mixed. In the intervention group, improvements were seen in diabetes-related quality of life (p=0.001), diabetes knowledge (p=0.018), belief about the need for medication (p=0.004) and a reduced concern regarding their medication (p<0.001). Conclusion: Education and counselling by community pharmacists can result in favourable improvements to cardiovascular risk profile of patients with Type 2 diabetes.

The influence of cognition on self-management of type 2 diabetes in older people

Abstract: Diabetes is a growing public health issue, increasing in prevalence, eroding quality of life, and burdening health care systems. The complications of diabetes can be avoided or delayed by maintaining good glycemic control, which is achievable through self-management and, where necessary, medication. Older people with diabetes are at increased risk for cognitive impairment. This review aims to bring together current research that has investigated both cognition and diabetes self-management together. The Cumulative Index to Nursing and Allied Health (Cinahl), Excerpta Medica Database (Embase), Medical Literature Analysis and Retrieval System (Medline), and Psychological Information (PsychInfo) databases were searched. Studies were included if they featured older people with type 2 diabetes and had looked for associations between at least one distinct measure of cognition and at least one distinct measure of diabetes self-management. English language publications from the year 2000 were included. Cognitive measures of executive function, memory, and low scores on tests of global cognitive functioning showed significant correlations with multiple areas of diabetes self-management, including diabetes-specific numeracy ability, diabetes knowledge, insulin adjustment skills, ability to learn to perform insulin injections, worse adherence to medications, decreased frequency of self-care activities, missed appointments, decreased frequency of diabetes monitoring, and increased inaccuracies in reporting blood glucose monitoring. The nature of the subjects studied was quite variable in terms of their disease duration, previous medical histories, associated medical comorbidities, and educational level attained prior to being diagnosed with diabetes. The majority of studies were of an associational nature and not findings confirmed by repeat testing or by the effects of an intervention, neither were the majority of studies designed to give a view or conclusion on the clinical value or implications of the research. This only allows speculation of their importance. Most studies do not separate out the influence of aging itself in altering diabetes self-care behavior. We conclude that older people with type 2 diabetes are at increased risk for cognitive dysfunction. Changes in cognition may negatively affect diabetes self-management behaviors, influencing self-care outcomes. Age and depression may exacerbate any cognitive impairment.

Refocusing distance of a standard plenoptic camera.

Abstract: Recent developments in computational photography enabled variation of the optical focus of a plenoptic camera after image exposure, also known as refocusing. Existing ray models in the field simplify the camera’s complexity for the purpose of image and depth map enhancement, but fail to satisfyingly predict the distance to which a photograph is refocused. By treating a pair of light rays as a system of linear functions, it will be shown in this paper that its solution yields an intersection indicating the distance to a refocused object plane. Experimental work is conducted with different lenses and focus settings while comparing distance estimates with a stack of refocused photographs for which a blur metric has been devised. Quantitative assessments over a 24 m distance range suggest that predictions deviate by less than 0.35 % in comparison to an optical design software. The proposed refocusing estimator assists in predicting object distances just as in the prototyping stage of plenoptic cameras and will be an essential feature in applications demanding high precision in synthetic focus or where depth map recovery is done by analyzing a stack of refocused photographs.

Interference Mitigation in D2D Communication Underlaying LTE-A Network

Abstract: The mobile data traffic has risen exponentially in recent days due to the emergence of data intensive applications, such as online gaming and video sharing It is driving the telecommunication industry as well as the research community to come up with new paradigms that will support such high data rate requirements within the existing wireless access network, in an efficient and effective manner To respond to this challenge, device-to-device (D2D) communication in cellular networks is viewed as a promising solution, which is expected to operate, either within the coverage area of the existing eNB and under the same cellular spectrum (in-band) or separate spectrum (out-band) D2D provides the opportunity for users located in close proximity of each other to communicate directly, without traversing data traffic through the eNB It results in several transmission gains, such as improved throughput, energy gain, hop gain, and reuse gain However, integration of D2D communication in cellular systems at the same time introduces new technical challenges that need to be addressed Containment of the interference among D2D nodes and cellular users is one of the major problems D2D transmission radiates in all directions, generating undesirable interference to primary cellular users and other D2D users sharing the same radio resources resulting in severe performance degradation Efficient interference mitigation schemes are a principal requirement in order to optimize the system performance This paper presents a comprehensive review of the existing interference mitigation schemes present in the open literature Based on the subjective and objective analysis of the work available to date, it is also envisaged that adopting a multi-antenna beamforming mechanism with power control, such that the transmit power is maximized toward the direction of the intended D2D receiver node and limited in all other directions will minimize the interference in the network This could maximize the sum throughput and hence, guarantees the reliability of both the D2D and cellular connections

Breaking up prolonged sitting time with walking does not affect appetite or gut hormone concentrations but does induce an energy deficit and suppresses postprandial glycaemia in sedentary adults

Abstract: Breaking up periods of prolonged sitting can negate harmful metabolic effects but the influence on appetite and gut hormones is not understood and is investigated in this study. Thirteen sedentary (7 female) participants undertook three 5-h trials in random order: (i) uninterrupted sitting (SIT), (ii) seated with 2-min bouts of light-intensity walking every 20 min (SIT + LA), and (iii) seated with 2-min bouts of moderate-intensity walking every 20 min (SIT + MA). A standardised test drink was provided at the start of each trial and an ad libitum pasta test meal provided at the end of each trial. Subjective appetite ratings and plasma acylated ghrelin, peptide YY, insulin, and glucose were measured at regular intervals. Area under the curve (AUC) was calculated for each variable. AUC values for appetite and gut hormone concentrations were unaffected in the activity breaks conditions compared with uninterrupted sitting (linear mixed modelling: p > 0.05). Glucose AUC was lower in SIT + MA than in SIT + LA (p = 0.004) and SIT (p = 0.055). There was no difference in absolute ad libitum energy intake between conditions (p > 0.05); however, relative energy intake was lower in SIT + LA (39%; p = 0.011) and SIT + MA (120%; p < 0.001) than in SIT. In conclusion, breaking up prolonged sitting does not alter appetite and gut hormone responses to a meal over a 5-h period. Increased energy expenditure from activity breaks could promote an energy deficit that is not compensated for in a subsequent meal.

Lead Exposure during Early Human Development and DNA Methylation of Imprinted Gene Regulatory Elements in Adulthood.

Abstract: Background:Lead exposure during early development causes neurodevelopmental disorders by unknown mechanisms. Epidemiologic studies have focused recently on determining associations between lead exp...