Impact of a structured multicomponent educational intervention program on metabolic control of patients with type 2 diabetes

Background

Diabetes is one of the most common metabolic disorders, with a high prevalence of patients with poor metabolic control. Worldwide, evidence highlights the importance of developing and implementing educational interventions that can reduce this burden. The main objective of this study was to analyse the impact of a lifestyle centred intervention on glycaemic control of poorly controlled type 2 diabetic patients, followed in a Community Care Centre.

Methods

A type 2 experimental design was conducted over 6 months, including 122 adults with HbA1c?≥?7.5%, randomly allocated into Experimental group (EG) or Control Group (CG). EG patients attended a specific Educational Program while CG patients frequented usual care. Personal and health characterization variables, clinical metrics and self-care activities were measured before and after the implementation of the intervention. Analysis was done by comparing gains between groups (CG vs EG) through differential calculations (post minus pre-test results) and Longitudinal analysis.

Results

Statistical differences were obtained between groups for HbA1c and BMI: EG had a decrease in 11% more (effect-size r2?=?.11) than CG for HbA1c (p?<?.001) and 4% more (effect-size r2?=?.04) in BMI (p?<?.05). When controlling for socioeconomic characteristics and comorbidities that showed to be associated to each parameter in pre-test, from pre to post-test only EG participants significantly decreased HbA1c [Wilks’ ??=?.702; F(1,57)?=?24.16; p?<?.001; ηp2?=?.298; observed power?=?.998]; BMI values [Wilks’ ??=?.900; F(1,59)?=?6.57; p?=?.013; ηp2?=?.100; observed power?=?.713]; systolic Blood pressure [Wilks’ ??=?.735; F(1,61)?=?21.94; p?<?.001; ηp2?=?.265; observed power?=?.996] and diastolic Blood pressure [Wilks’ ??=?.795; F(1,59)?=?15.20; p?<?.001; ηp2?=?.205; observed power?=?.970].

Conclusions

The impact of a structured multicomponent educational intervention program by itself, beyond standard educational approach alone, supported in a Longitudinal analysis that controlled variables statistically associated with clinical metrics in pre-test measures, has demonstrated its effectiveness in improving HbA1c, BMI and Blood pressure values.

Trial registration

RBR-8ns8pb. (Retrospectively registered: October 30,2017).

     

Dbf4‐dependent kinase and the Rtt107 scaffold promote Mus81‐Mms4 resolvase activation during mitosis

DNA repair by homologous recombination is under stringent cell cycle control. This includes the last step of the reaction, disentanglement of DNA joint molecules (JMs). Previous work has established that JM resolving nucleases are activated specifically at the onset of mitosis. In case of budding yeast Mus81‐Mms4, this cell cycle stage‐specific activation is known to depend on phosphorylation by CDK and Cdc5 kinases. Here, we show that a third cell cycle kinase, Cdc7‐Dbf4 (DDK), targets Mus81‐Mms4 in conjunction with Cdc5—both kinases bind to as well as phosphorylate Mus81‐Mms4 in an interdependent manner. Moreover, DDK‐mediated phosphorylation of Mms4 is strictly required for Mus81 activation in mitosis, establishing DDK as a novel regulator of homologous recombination. The scaffold protein Rtt107, which binds the Mus81‐Mms4 complex, interacts with Cdc7 and thereby targets DDK and Cdc5 to the complex enabling full Mus81 activation. Therefore, Mus81 activation in mitosis involves at least three cell cycle kinases, CDK, Cdc5 and DDK. Furthermore, tethering of the kinases in a stable complex with Mus81 is critical for efficient JM resolution.     

On the Attractiveness of Product Recovery: The Forces that Shape Reverse Markets

Product recovery is a major contributor for implementing sustainable business practices. Within such operations, which are either driven by legislation or economic rationales, practitioners face strategic issues concerning reverse market entry and positioning. Although the complexity of acting on reverse markets is widely acknowledged, a comprehensive framework to facilitate decision making in this area is lacking. In an attempt to fill that gap, we develop a model that supports original equipment manufacturers’ (OEMs’) assessment of the attractiveness of reverse markets. We identify, from a comprehensive literature analysis, in‐depth interviews, and engagement with a dozen companies from different countries, factors that influence key characteristics of reverse markets, and consolidate this lengthy list into a comprehensive model intuitively applicable to business practice. The model combines five forces that drive reverse markets: access to recoverable products; threat of independent recovery companies’ (IRCs’) market entry; rivalry for recoverable products; adverse effects on core business; and remarketing opportunities. We propose for each a set of attributes that influences its power and direction. To demonstrate the efficacy of the model, we apply it in two industry settings: recovery of white goods in the United Kingdom and paper recycling in Germany. The present research enables OEMs to understand the structure and forces that drive reverse markets, identify levers to influence those markets, anticipate market developments, and formulate resilient strategies for product recovery.     

NSP-interacting GTPase: A cytosolic protein as cofactor for nuclear shuttle proteins

Despite the significant progress in the identification of essential components of the nuclear transport machinery, some events of this process are still unclear. Particularly, functional information about the release of nuclear-exported macromolecules at the cytoplasmic side of the nuclear pore complex and their subsequent trans-cytoplasmic movement is lacking. Recently, we identified a cytoplasmic GTPase, designated NIG (NSP-interacting GTPase), which may play a relevant role in these processes. NIG interacts in vivo with the geminivirus NSP and promotes the translocation of the viral protein from the nucleus to the cytoplasm where it is redirected to the cell surface to interact with the viral movement protein, MP. Here we position the NIG function into the mechanistic model for the intracellular trafficking of viral DNA and discuss the putative role of NIG in general cellular nucleocytoplasmic transport of nucleic acid-protein complexes.Key words: geminivirus, NIG, NSP, nucleocytoplasmic trafficking, transport activity     

Desulfovibrio vulgaris Hildenborough HydE and HydG interact with the HydA subunit of the [FeFe] hydrogenase

HydE, HydF, and HydG participate in the synthesis of the complex di-iron center of [FeFe] hydrogenases. The hydE, hydF, hydG, hydA, and hydB genes of Desulfovibrio vulgaris Hildenborough were cloned and His-tag pull-down assays were used to study the potential interaction between HydE, HydF, and HydG with the HydA and HydB protein subunits of the D. vulgaris [FeFe] hydrogenase. Interaction of HydE and HydG with HydA was demonstrated. HydF did not interact with HydA, and none of the accessory proteins appeared to interact with HydB. This suggests that specific protein-protein interactions may be required during [FeFe] cluster synthesis and/or insertion.     

Metabolism of tryptophan,methionine and arginine in <Emphasis Type="Italic">Diplodus sargus</Emphasis> larvae fed rotifers: effect of amino acid supplementation

Dietary amino acids imbalances have been described when fish larvae are fed rotifers, what may lead to a reduction in growth rate. The tube-feeding technique can be used to assess the effect of free amino acid short term supplementation. In this study supplementation of tryptophan, methionine and arginine were tested in Diplodus sargus. Single crystalline ¹⁴C amino acids as well as a mix of ¹⁴C amino acids were used as tracers to compare results of individual amino acids metabolism with the average of all amino acids. The results show low absorption efficiencies for tryptophan (70%) and arginine (80%) and similar absorption for methionine (90%) when compared with the average of all amino acids. Supplementation of these amino acids seems to be viable but it did not result in higher retention compared to the amino acid mix. This means that tryptophan, methionine and arginine are probably not the limiting amino acid when Diplodus sargus larvae are fed rotifers. However, supplementation in these IAA may be required for their roles as precursors of important molecules other than proteins, in order to improve larval quality and/or performance.     

The effects of water availability on root growth and morphology in an Amazon rainforest

This study examined how root growth and morphology were affected by variation in soil moisture at four Amazon rainforest sites with contrasting vegetation and soil types. Mean annual site root mass, length and surface area growth ranged between 3–7 t ha^?1, 2–4 km m^?2 and 8–12 m² m^?2 respectively. Mean site specific root length and surface area varied between 8–10 km kg^?1 and 24–34 m² kg^?1. Growth of root mass, length and surface area was lower when soil water was depleted (P?<?0.001) while specific root length and surface area showed the opposite pattern (P?<?0.001). These results indicate that changes in root length and surface area per unit mass, and pulses in root growth to exploit transient periods of high soil water availability may be important means for trees in this ecosystem to increase nutrient and water uptake under seasonal and longer-term drought conditions.     

Self-incompatibility, Inbreeding Depression and Crossing Potential in Five BrazilianPleurothallis (Orchidaceae) Species

Intra- and interspecific experimental pollinations were madeto determine the mating systems and the interspecific crossingpotential in individuals from 24 populations of five Pleurothallisspecies. Pleurothallis johannensis, P. ochreata and P. teresshow weak or partial self-incompatibility while P. adamantinensisand P.fabiobarrosii are more strictly self-incompatible. Wefound no differences in fruit set between intra- and interpopulationintraspecific crosses, and there was no correlation betweenfruit set and genetic variability or inbreeding in these species.All species are interfertile and showed no correlation betweengenetic similarity and crossing potential. We scored fruitsfor seed viability and observed a strong inbreeding depressionin all populations; however, there was no difference in seedviability among intrapopulation, interpopulation intraspecificand interspecific cross-pollinations. These species are pollinatedby flies with a behavioural pattern that facilitates self-pollination.Self-incompatibility and inbreeding depression are apparentlyimportant in the maintenance of the unusually high levels ofgenetic variability found in these species. As generally observedin other orchid species, barriers to hybridization between thesePleurothallis species are at the level of pollination. Copyright2001 Annals of Botany Company Pleurothallis, Orchidaceae, mating system, self-incompatibility, inbreeding depression, fruit set, seed set, polyembryony, interspecific compatibility