Automated symptom and treatment side effect monitoring for improved quality of life among adults with diabetic peripheral neuropathy in primary care: a pragmatic, cluster, randomized, controlled trial.

AIMS: To evaluate the effectiveness of automated symptom and side effect monitoring on quality of life among individuals with symptomatic diabetic peripheral neuropathy. METHODS: We conducted a pragmatic, cluster randomized controlled trial (July 2014 to July 2016) within a large healthcare system. We randomized 1834 primary care physicians and prospectively recruited from their lists 1270 individuals with neuropathy who were newly prescribed medications for their symptoms. Intervention participants received automated telephone-based symptom and side effect monitoring with physician feedback over 6 months. The control group received usual care plus three non-interactive diabetes educational calls. Our primary outcomes were quality of life (EQ-5D) and select symptoms (e.g. pain) measured 4-8 weeks after starting medication and again 8 months after baseline. Process outcomes included receiving a clinically effective dose and communication between individuals with neuropathy and their primary care provider over 12 months. Interviewers collecting outcome data were blinded to intervention assignment. RESULTS: Some 1252 participants completed the baseline measures [mean age (sd): 67 (11.7), 53% female, 57% white, 8% Asian, 13% black, 20% Hispanic]. In total, 1179 participants (93%) completed follow-up (619 control, 560 intervention). Quality of life scores (intervention: 0.658 ± 0.094; control: 0.653 ± 0.092) and symptom severity were similar at baseline. The intervention had no effect on primary [EQ-5D: -0.002 (95% CI -0.01, 0.01), P = 0.623; pain: 0.295 (-0.75, 1.34), P = 0.579; sleep disruption: 0.342 (-0.18, 0.86), P = 0.196; lower extremity functioning: -0.079 (-1.27, 1.11), P = 0.896; depression: -0.462 (-1.24, 0.32); P = 0.247] or process outcomes. CONCLUSIONS: Automated telephone monitoring and feedback alone were not effective at improving quality of life or symptoms for people with symptomatic diabetic peripheral neuropathy. TRIAL REGISTRATION: ClinicalTrials.gov (NCT02056431).

Development of fast heating electron beam annealing setup for ultra high vacuum chamber.

We report the design and development of a simple, electrically low powered and fast heating versatile electron beam annealing setup (up to 1000 °C) working with ultra high vacuum (UHV) chamber for annealing thin films and multilayer structures. The important features of the system are constant temperature control in UHV conditions for the temperature range from room temperature to 1000 ºC with sufficient power of 330 W, at constant vacuum during annealing treatment. It takes approximately 6 min to reach 1000 °C from room temperature (∼10(-6) mbar) and 45 min to cool down without any extra cooling. The annealing setup consists of a UHV chamber, sample holder, heating arrangement mounted on suitable UHV electrical feed-through and electronic control and feedback systems to control the temperature within ±1 ºC of set value. The outside of the vacuum chamber is cooled by cold air of 20 °C of air conditioning machine used for the laboratory, so that chamber temperature does not go beyond 50 °C when target temperature is maximum. The probability of surface oxidation or surface contamination during annealing is examined by means of x-ray photoelectron spectroscopy of virgin Cu sample annealed at 1000 °C.

Note: development of fast heating inert gas annealing apparatus operated at atmospheric pressure.

Here, we report the development of a simple, small, fast heating, and portable, homemade, inert gas (Ar) atmospheric annealing setup. Instead of using a conventional heating element, a commercial soldering rod having an encapsulated fast heating heater is used here. The sample holder is made of a block of stainless steel. It takes 200 s to reach 700 °C, and 10 min to cool down. The probability of oxidation or surface contamination has been examined by means of x ray photoelectron spectroscopy of virgin Cu sample after annealing at 600 °C. In addition, we compare the annealing of a hydrogenated carbon nitride film (HCN(x)) in both a conventional vacuum and our newly developed ambient Ar atmosphere setup.

Evaluation of antimicrobial effects of novel implant materials by testing the prevention of biofilm formation using a simple small scale medium-throughput growth inhibition assay.

Staphylococcal colonization of implants is a serious complication of orthopaedic surgery. Anti-infectious modification of implant surfaces may serve to prevent bacterial colonization. The authors set out to develop an in vitro test system for the analysis of prevention of biofilm formation by Staphylococcus epidermidis and Staphylococcus aureus on implant materials. Biofilm growth was monitored over 10 days on titanium disks in order to develop appropriate test parameters. Bacterial cell counts following ultrasonic treatment of the colonized samples were compared with scanning electron microscope images of the specimens. Copper ion containing surfaces (ie copper [Cu] and inter-metallic Ti-Cu films) were used for growth inhibition assays: copper ion releasing specimens led to reduced bacterial numbers in biofilms and decreased bacterial persistence in the model used. The assay used represents an inexpensive and quick in vitro screen for the antibacterial effects of novel implant surface materials.

Kinetic aspects of the formation of aluminium oxide by use of a microwave-induced plasma.

The oxidation of thin aluminium layers in a microwave plasma has been investigated to determine the kinetics of oxide growth. Thin Al-coatings were oxidized by means of a variety of gas mixtures, characterized by different partial pressures of oxygen, in microwave-induced plasmas of different power. To study the whole kinetic process the Al-metal and the oxide formed were investigated by means of a combination of grazing incidence X-ray reflectometry (GIXR) and grazing incidence X-ray diffractometry (GIXRD). XPS and FTIR spectroscopy confirmed the formation of stoichiometric Al(2)O(3). The alumina formed is X-ray amorphous. Quantitative description of oxide formation was achieved indirectly by determination of the decrease in the integrated intensity of the Al(111)-peak and the total thickness of the whole coating. These values enabled calculation of kinetic data. It was found that oxide growth was a combination of two simultaneous processes - diffusion and sputter processes. The diffusion coefficient D (cm(2) s(-1)) and the sputter rate S (nm s(-1)) were determined. The effect of the composition of the gas mixture, microwave power, and concentration of activated oxygen species on the oxidation process will be discussed. For calculation of the activation energy, E(A), of this plasma-enhanced diffusion process the temperature-dependence of D was investigated.

Reduçäo fechada e fixaçäo esquelética externa tipo I para tratamento de fraturas de tibiotarso em pombos domésticos (Columba livia) / Closed reduction and type-I external skeletal fixation for treatment of tibiotarsus fractures in domestic pigeons (Columba livia)

Estudaram-se a reduçäo fechada e a fixaçäo esquelética externa tipo I para o tratamento de fraturas de tibiotarso em 10 pombos domésticos (Columba livia) adultos. As aves foram anestesiadas com a associaçäo de xilazina e cetamina e em seguida foi realizada fratura do tibiotarso direito por pressäo digital sobre a diáfise do membro. Quatro pinos de Kirschner, dois proximais e dois distais à linha da fratura, foram inseridos percutaneamente através de ambas as corticais ósseas e, após reduçäo fechada da fratura, conectados externamente por uma barra de acrílico autopolimerizável na face lateral do membro. Em três aves foi observado radiograficamente desvio ósseo angular, porém, a funçäo do membro näo foi afetada. O tempo médio e o desvio-padräo para a cicatrizaçäo óssea foram 23,4± 3,0 dias. Os resultados demonstram que a reduçäo fechada e a aplicaçäo de fixador esquelético externo tipo I é um método efetivo para o tratamento de fraturas de tibiotarso em pombos domésticos (Columba livia)