Home Telemonitoring of Patients With Type 2 Diabetes: A Meta-Analysis and Systematic Review

Telehealth has emerged as an evolving care management strategy that is playing an increasingly vital role, particularly with the onset of the coronavirus disease 2019 pandemic. A meta-analysis of 20 randomized controlled trials was conducted to test the effectiveness of home telemonitoring (HTM) in patients with type 2 diabetes in reducing A1C, blood pressure, and BMI over a median 180-day study duration. HTM was associated with a significant reduction in A1C by 0.42% (P = 0.0084). Although we found statistically significant changes in both systolic and diastolic blood pressure (−0.10 mmHg [P = 0.0041], and −0.07 mmHg [P = 0.044], respectively), we regard this as clinically nonsignificant in the context of HTM. Comparisons across different methods of transmitting vital signs suggest that patients logging into systems with moderate interaction with the technology platform had significantly higher reductions in A1C than those using fully automatic transmission methods or fully manual uploading methods. A1C did not vary significantly by study duration (from 84 days to 5 years). HTM has the potential to provide patients and their providers with timely, up-to-date information while simultaneously improving A1C.

Analysis of Potential Interaction between Antiretrovirals and Comorbid Medications of HIV Patients at a Top Referral Hospital in Indonesia

Background: HIV/AIDS usually present with comorbid diseases such as tuberculosis, pneumonia, toxoplasmosis, fungal infections, etc., that need multiple medications. Potential interaction between ARV and comorbid drugs is unavoidable. Objective: This study aimed to investigate the potential interaction between ARV drugs and medications used to treat comorbid diseases among HIV patients at the Dr. Cipto Mangunkusumo Hospital, Jakarta. Methods: This was an observational study using medical record data of 121 HIV/AIDS patients treated at the CM Hospital between January 2016 and July 2017. Potential interaction was classified as “major” if it could lead to increase or decrease of plasma drug levels which potentially result in either drug toxicity or treatment failure, or clinically significant harm to the patient; “moderate” if the interaction is not major, but with the recommendation of close monitoring. National, European, Australian, and Liverpool iChart guidelines were used for the classification of drug interactions. Results: Major interactions were noted in 17 (14.05%)patients. Fourteen of them received rifampicin, which potentially decreases plasma level of nevirapine (9 patients), rilpivirine (1 patient), and lopinavir/ritonavir (4 patients). Potential increase of ARV level was found in 3 patients involving interaction between voriconazole-efavirenz (2) and omeprazole-rilpivirine (1). Moderate interaction with the potential decrease of ARV level occurred in 46 patients (38.01%); consisting of a combination of rifampicin with efavirenz (38 pts), rifampicin with zidovudine (6 pts), and phenytoin with efavirenz or nevirapine (2 patients). Conclusion: Potential major interaction occurred in 17 (14.05%), which mostly attributed to rifampicin use; while moderate interaction occurred in 46 (38.01%) of patients. Although no serious adverse event was observed in this study, special care should be taken when the drugs with potential major interaction are to be administered

Kajian Interaksi Obat pada Pasien Gagal Jantung Di RSUD Abdul Wahab Sjahranie Kota Samarinda

Cardiovascular diseases is first cause of death and heart failure is the end of all heart diseases and heart failure is causative factor enhancement of mortalities and morbidities heart failure patient. The purpose of the research is to know drug interaction in heart failure patient who undergoing hospitalization in RSUD Abdul Wahab Sjahranie in Samarinda. This research is non experimental and use retrospective to take a material during periods January – December in 2018. The result analyzed use descriptive evaluative and show heart failure case more suffer to the men (59.25%) at age 55-65 (35.80%) with the most of level education is senior high school (39.50%). The studies showed 163 drug interaction case with 18 (11.04%) minor interaction, 140(85.88%) moderate interaction and 5 (3.06%) major interaction.

Long-lived Triplet Excitons Formed by Exergonic Intramolecular Singlet Fission of an Adamantane-linked Tetracene Dyad

<div>An adamantane-linked tetracene dyad (Tc–Ad–Tc) undergoes exergonic intramolecular singlet fission (SF), producing longlived (τ = 175 μs) and high-energy (2 x 1.03 eV) multiexcitons. Timeresolved absorption, fluorescence decay, and electron paramagnetic resonance (EPR) spectroscopic analysis revealed that the long-lived triplet species is generated in this system via correlated triplet pair having singlet and quintet characteristics. Time-resolved EPR analysis revealed that conversion of ¹(³Tc–Ad–³Tc)* -> ⁵(³Tc–Ad–³Tc)* requires small conformational dynamics accompanied by molecular motion. Analysis of the geometries of the quintet states shows that formation of the long-lived multiexciton is enabled by precise and close alignment of the tetracene moieties, which leads to their moderate interaction in the singlet excited state, while triplet–triplet annihilation is prevented by quintet generation. The presence of aliphatic linkages, like the rigid adamantane group, might enable effective conservation of intrinsic S₁ and T₁ levels of the original monomers, and moderate bridge-mediated σ–π interaction leading to exergonic intramolecular SF involving ¹Tc*–Ad–Tc -> ¹(³Tc–Ad–³Tc)*.</div><div><br></div>

Long-lived Triplet Excitons Formed by Exergonic Intramolecular Singlet Fission of an Adamantane-linked Tetracene Dyad

<div>An adamantane-linked tetracene dyad (Tc–Ad–Tc) undergoes exergonic intramolecular singlet fission (SF), producing longlived (τ = 175 μs) and high-energy (2 x 1.03 eV) multiexcitons. Timeresolved absorption, fluorescence decay, and electron paramagnetic resonance (EPR) spectroscopic analysis revealed that the long-lived triplet species is generated in this system via correlated triplet pair having singlet and quintet characteristics. Time-resolved EPR analysis revealed that conversion of ¹(³Tc–Ad–³Tc)* -> ⁵(³Tc–Ad–³Tc)* requires small conformational dynamics accompanied by molecular motion. Analysis of the geometries of the quintet states shows that formation of the long-lived multiexciton is enabled by precise and close alignment of the tetracene moieties, which leads to their moderate interaction in the singlet excited state, while triplet–triplet annihilation is prevented by quintet generation. The presence of aliphatic linkages, like the rigid adamantane group, might enable effective conservation of intrinsic S₁ and T₁ levels of the original monomers, and moderate bridge-mediated σ–π interaction leading to exergonic intramolecular SF involving ¹Tc*–Ad–Tc -> ¹(³Tc–Ad–³Tc)*.</div><div><br></div>

Systematic exploration of N, C configurational effects on the ORR performance of Fe–N doped graphene catalysts based on DFT calculations

An optimum Fe–N–C ORR catalyst should exhibit a moderate surface stress property and an ideal N, C ligand configurations that results in a moderate interaction between the ORR intermediates and its surface sites.

Drug-Drug Interaction Associated with Mold-Active Triazoles among Hospitalized Patients

The majority of hospitalized patients receiving mold-active triazoles are at risk of drug-drug interactions (DDIs). Efforts are needed to increase awareness of DDIs that pose a serious risk of adverse events. Triazoles remain the most commonly utilized antifungals. Recent developments have included the mold-active triazoles (MATs) itraconazole, voriconazole, and posaconazole, which are first-line agents for the treatment of filamentous fungal infections but have the potential for DDIs. This objective of this study was to evaluate the prevalence of triazole DDIs. Hospitalized U.S. adults with MAT use were identified in the Cerner HealthFacts database, which contained data from over 150 hospitals (2005 to 2013). The severities of DDIs with MATs were categorized, using drug labels and the drug information from the Drugdex system (Thompson Micromedex), into four groups (contraindicated, major, moderate, and minor severity). DDIs of minor severity were not counted. A DDI event was considered to have occurred if the following two conditions were met: (i) the patient used at least one drug with a classification of at least a moderate interaction with the MAT during the hospitalization and (ii) there was a period of overlap between the administration of the MAT and that of the interacting drug of at least 1 day. A total of 6,962 hospitalizations with MAT use were identified. Among them, 88% of hospitalizations with voriconazole use, 86% of hospitalizations with itraconazole use, and 93% of hospitalizations with posaconazole use included the use of a concomitant interacting drug. A total of 68% of hospitalizations with posaconazole use, 34% of hospitalizations with itraconazole use, and 20% of hospitalizations with voriconazole use included the use of at least one drug with a DDI of contraindicated severity. A total of 83% of hospitalizations with posaconazole use, 61% of hospitalizations with itraconazole use, and 82% of hospitalizations with voriconazole use included the use of at least one drug that resulted in a severe DDI. The findings of this study demonstrate that a majority of hospitalized patients receiving MAT are at risk for severe drug-drug interactions and highlight the need for antifungal stewardship.

Attitudes towards Work among Prison Inmates and the Long-Term Unemployed

The article includes an analysis of differences in attitudes towards work in conditions of imprisonment and among employed and long-term unemployed men not detained in prison.The results of the analysis showed a moderate interaction effect of the factors: imprisonment and unemployment (F (1.407) = 6.16, p <0.05, Eta 2 = 0.36). It turned out that the environment of prison isolation and unemployment are mutually related, and the least favorable attitudes towards were shown by the men serving imprisonment sentence, having at the same time no employment opportunities.

Phase Separation in Silica Sol-gel System Containing Anionic Surfactant

ABSTRACTBy inducing phase separation parallel to the sol-gel transition of alkoxy-derived silica systems, silica monoliths with well-defined co-continuous macropores were obtained from the systems containing anionic surfactants. We adopted three kinds of anionic surfactants which differ from each other in the length of alkyl chain (CH3(CH2)17SO3Na, CH3(CH2)15SO3Na, CH3(CH2)13SO3Na). Mesopores were also found in the silica skeletons presumably by the supramolecular templating. Characterization of the dried or heat-treated samples was carried out by a scanning electron microscope (SEM) and nitrogen adsorption measurements. Experimental results showed that due to the moderate interaction between silica oligomers and surfactants, most of the surfactants are distributed to the solvent phase which determines the macropore volume. The median size and volume of the macropores could be controlled independently by the starting composition. In the absence of any additive to enhance templating by the surfactant, the samples exhibited only amorphous mesopores.