Barriers and facilitators to diabetes self‐management: Perspectives of older community dwellers and health professionals in China

Little is known about self‐management among people with Type 2 diabetes living in mainland China. Understanding the experiences of this target population is needed to provide socioculturally relevant education to effectively promote self‐management. The aim of this study was to explore perceived barriers and facilitators to diabetes self‐management for both older community dwellers and health professionals in China. Four focus groups, two for older people with diabetes and two for health professionals, were conducted. All participants were purposively sampled from two communities in Shanghai, China. Six barriers were identified: overdependence on but dislike of western medicine, family role expectations, cuisine culture, lack of trustworthy information sources, deficits in communication between clients and health professionals, and restriction of reimbursement regulations. Facilitators included family and peer support, good relationships with health professionals, simple and practical instruction and a favourable community environment. The findings provide valuable information for diabetes self‐management intervention development in China, and have implications for programmes tailored to populations in similar sociocultural circumstances.     

Assignment test method using hypervariable markers for blue marlin (Makaira nigricans) stock identification

Blue marlin (Makaira nigricans) stock status varies among ocean basins, and the Atlantic-wide stock is overfished. United States regulations prohibit commercial landing, importation and sale of Atlantic blue marlin, but not of Pacific or Indian Ocean conspecifics. We genotyped 344 blue marlin of known origin and 16 samples used as unknowns at 13 microsatellite loci and the mitochondrial control region. Assignment tests were conducted using GENECLASS2 to investigate the efficacy of available genotypic data to identify individual origin. We successfully discriminated Atlantic and Pacific blue marlin using genetic characters, providing more power to assign marketed blue marlin products to ocean of origin.     

Isolation and characterization of ten nuclear microsatellite loci for the Portuguese dogfish Centroscymnus coelolepis

The Portuguese dogfish Centroscymnus coelolepis is a deepwater squaloid shark with a wide distribution and is also an important fishing resource in parts of its range. Despite concerns about the species’ sustainability, current fisheries management measures have been implemented without a good understanding of the stock structure. The assessment of the population structure of C. coelolepis using molecular markers will provide important information for future management efforts. Here we describe the first attempt at isolating nuclear microsatellite markers for C. coelolepis. Ten polymorphic microsatellite loci were developed and screened in 43–45 individuals collected off western Portugal, showing 3–29 alleles per loci (average: 12.5 alleles/locus) and observed heterozygosities ranging from 0.60 to 0.98. None of the markers exhibited genotypic distributions that deviated from HWE expectations, or showed evidence of linkage disequilibrium or the presence of null alleles.     

Species of Propionibacterium and Propionibacterium acnes phylotypes associated with orthopedic implants

Propionibacterium sp. is commonly isolated in association with orthopedic implants, either as a pathogen or a colonizer. Microbial characteristics that indicate whether the isolated species is a likely cause of orthopedic implant infection versus a colonizing agent would be clinically useful. We performed a prospective trial to determine the species of Propionibacterium and the phylotype (IA, IB, II, III) of Propionibacterium acnes isolated from the surface of removed orthopedic implants, and we correlated these findings with the presence or absence of infection. P. acnes represented 61 of 62 isolates. P. acnes type I was more commonly isolated than was type II (62% versus 38%, respectively), whether associated with infection or not. P. acnes type III was not detected. There was no clear association between types I and II P. acnes and infection or colonization of failed orthopedic implants (P = 0.75), however type IB strains were more frequently isolated than type IA from infected prosthese.     

Team training for surgical trainees

Healthcare professionals work in teams but are rarely trained together. Realizing the adverse impact of poor teamwork on patient care, the Accreditation Council for Graduate Medical Education requires surgical trainees to demonstrate a mastery of teamwork-related competencies. A number of team training curricula are available in the USA, the best known of which is TeamSTEPPS – developed by the U.S. Department of Defense Patient Safety Program in collaboration with the Agency for Healthcare Research and Quality.     

Update on Specifically Targeted Antiviral Therapy for Hepatitis C Infection: Progress and Pitfalls on the Road to Viral Eradication

The global prevalence of hepatitis C virus (HCV) infection exceeds that of HIV but only has a 40% response rate to the currently available standard of care. In contrast to HIV infection, eradication of HCV is possible, with cure rather than viral suppression the goal of treatment. Specifically targeted antiviral therapy against hepatitis C (STAT-C) hopes to improve this low rate of response using small molecules designed to inhibit key viral processes. Protease and polymerase inhibitors are the most studied of the STAT-C small molecules with protease inhibitors being the closest to commercial availability. The most promising of these new approaches to therapy rely on a persistent need for pegylated interferon and ribavirin and may be limited by the development of viral resistance.     

The inhibition of apoptosis by melatonin in VSC4.1 motoneurons exposed to oxidative stress,glutamate excitotoxicity,or TNF‐α toxicity involves membrane melatonin receptors

Abstract: Loss of motoneurons may underlie some of the deficits in motor function associated with the central nervous system (CNS) injuries and diseases. We tested whether melatonin, a potent antioxidant and free radical scavenger, would prevent motoneuron apoptosis following exposure to toxins and whether this neuroprotection is mediated by melatonin receptors. Exposure of VSC4.1 motoneurons to either 50 μm H₂O₂, 25 μm glutamate (LGA), or 50 ng/mL tumor necrosis factor‐alpha (TNF‐α) for 24 h caused significant increases in apoptosis, as determined by Wright staining and ApopTag assay. Analyses of mRNA and proteins showed increased expression and activities of stress kinases and cysteine proteases and loss of mitochondrial membrane potential during apoptosis. These insults also caused increases in intracellular free [Ca²⁺] and activities of calpain and caspases. Cells exposed to stress stimuli for 15 min were then treated with 200 nm melatonin. Post‐treatment of cells with melatonin attenuated production of reactive oxygen species (ROS) and phosphorylation of p38, MAPK, and JNK1, prevented cell death, and maintained whole‐cell membrane potential, indicating functional neuroprotection. Melatonin receptors (MT1 and MT2) were upregulated following treatment with melatonin. To confirm the involvement of MT1 and MT2 in providing neuroprotection, cells were post‐treated (20 min) with 10 μm luzindole (melatonin receptor antagonist). Luzindole significantly attenuated melatonin‐induced neuroprotection, suggesting that melatonin worked, at least in part, via its receptors to prevent VSC4.1 motoneuron apoptosis. Results suggest that neuroprotection rendered by melatonin to motoneurons is receptor mediated and melatonin may be an effective neuroprotective agent to attenuate motoneuron death in CNS injuries and diseases.