Advances in Automated Insulin Delivery with the Medtronic 780G: The Australian Experience

Aim: To assess the real-world performance of MiniMed™ 780G for Australians with type 1 diabetes (T1D) following advanced hybrid closed loop (AHCL) activation and to evaluate the effect of changing from MiniMed 670/770G to 780G. Methods: We analyzed deidentified Carelink™ continuous glucose monitoring (CGM) data from Australian users from January 2020 to December 2022, including the proportion attaining three major consensus targets: Glucose management indicator (GMI <7.0%), time in range (TIR 70-180 mg/dL >70%), and time below range (TBR 70 mg/dL <4%). Results: Comparing 670/770G users (n = 5676) for mean ± standard deviation 364 ± 244 days with 780G users (n = 3566) for 146 ± 145 days, the latter achieved a higher TIR (72.6% ± 10.6% vs. 67.3% ± 11.4%; P < 0.001), lower time above range (TAR) (25.5% ± 10.9% vs. 30.6% ± 11.7%; P < 0.001), and lower GMI (6.9% ± 0.4% vs. 7.2% ± 0.4%; P < 0.001) without compromising TBR (1.9% ± 1.8% vs. 2.0% ± 1.8%; P = 0.0015). Of 1051 670/770G users transitioning to 780G, TIR increased (70.0% ± 10.7% to 74.0% ± 10.2%; P < 0.001), TAR decreased (28.1% ± 10.9% to 24.0% ± 10.7%; P < 0.001), and TBR was unchanged. The percentage of users attaining all three CGM targets was higher in 780G users (50.1% vs. 29.5%; P < 0.001). CGM metrics were stable at 12 months post-transition. Conclusion: Real-world data from Australia shows that a higher proportion of MiniMed 780G users meet clinical targets for CGM consensus metrics compared to MiniMed 670/770G users and glucose control was sustained over 12 months.

A review on thermal and catalytic pyrolysis of plastic solid waste (PSW)

Plastic plays an important role in our daily lives due to its versatility, light weight and low production cost. Plastics became essential in many sectors such as construction, medical, engineering applications, automotive, aerospace, etc. In addition, economic growth and development also increased our demand and dependency on plastics which leads to its accumulation in landfills imposing risk on human health, animals and cause environmental pollution problems such as ground water contamination, sanitary related issues, etc. Hence, a sustainable and an efficient plastic waste treatment is essential to avoid such issues. Pyrolysis is a thermo-chemical plastic waste treatment technique which can solve such pollution problems, as well as, recover valuable energy and products such as oil and gas. Pyrolysis of plastic solid waste (PSW) has gained importance due to having better advantages towards environmental pollution and reduction of carbon footprint of plastic products by minimizing the emissions of carbon monoxide and carbon dioxide compared to combustion and gasification. This paper presents the existing techniques of pyrolysis, the parameters which affect the products yield and selectivity and identify major research gaps in this technology. The influence of different catalysts on the process as well as review and comparative assessment of pyrolysis with other thermal and catalytic plastic treatment methods, is also presented.

Safety and tolerability of aripiprazole in the treatment of irritability associated with autistic disorder in pediatric patients: Results from a 52-week open-label study

Objective

Evaluate the time-course, severity and resolution patterns of adverse events (AEs) occurring with long-term aripiprazole treatment for irritability associated with autistic disorder.

Methods

Participants were treated with aripiprazole in a 52-week, open-label, flexibly dosed (2–15 mg/day) study. Subjects had either completed one of two 8-week randomised trials or were de novo. AEs with an incidence of ≥10% were evaluated by incidence, peak first onset, severity, percent resolved and time to resolution.

Results

A total of 330 subjects entered open-label treatment; 199 completed 52 weeks. Mean dose for the population stabilised at around 10 mg/day after approximately 4 months. Thirteen AEs had an incidence of ≥10%; most were mild or moderate in severity. Vomiting, diarrhoea and headache had an early first onset and tended to resolve fairly quickly.

Sedation, fatigue and insomnia also appeared early and resolved in a majority of cases, but not as quickly. Increased appetite appeared early (followed by increased weight) and fewer weight-related AEs resolved. More than half of the subjects increased their weight by at least one percentile category rank; nevertheless, only a small proportion of subjects with normal baseline metabolic or glucose measures had a treatment-emergent, clinically relevant laboratory abnormality. Nasopharyngitis, upper respiratory infection, cough, nasal congestion and pyrexia all had peak onset at variable times during the study, resolving in nearly all cases, with short time to resolution.

Conclusion

AEs were mostly mild or moderate and of variable duration. Increased weight was observed.

Intramuscular aripiprazole or haloperidol and transition to oral therapy in patients with agitation associated with schizophrenia: sub-analysis of a double-blind study

OBJECTIVE

A sub-population analysis of 325 patients with agitation (Positive and Negative Syndrome Scale Excited Component [PEC] score > or = 15 and < or = 32; score of > or = 4 on > or = 2 items) associated with schizophrenia in a randomized, double-blind study investigating the efficacy and tolerability of intramuscular (IM) aripiprazole 9.75 mg, IM haloperidol 6.5 mg, or IM placebo and the transition to oral therapy.

RESEARCH DESIGN AND METHODS

Over 24 h, patients could receive up to three IM injections; the second and third administered > or = 2 and > or = 4 h, respectively, after the first, if deemed clinically necessary. Following IM treatment, oral aripiprazole or haloperidol was administered for 4 days. The primary efficacy measure was the mean change in PEC score from baseline at 2 h.

RESULTS

At 2 h, mean improvements in PEC scores with IM aripiprazole (-8.0) were significantly greater versus IM placebo (-5.7; p < or = 0.01), and similar versus IM haloperidol (-8.3). Secondary efficacy measures also significantly improved with active IM treatment versus IM placebo. Continuation with oral treatment provided continued efficacy with both active treatments. The safety profiles of IM and oral aripiprazole were similar. The incidence of extrapyramidal symptom-related adverse events was 0% with IM aripiprazole, 1.6% with IM placebo and 16.5% with IM haloperidol.

CONCLUSION

Intramuscular aripiprazole is effective in patients with acute agitation associated with schizophrenia, comparable to IM haloperidol, and enables convenient transfer to oral aripiprazole therapy.

Bacteriological and epidemiological findings during examination of the uterine content of ewes with retention of fetal membranes

We included 92 pairs of ewes with or without retention of fetal membranes in a cohort study of 25 flocks in Southern Greece. We obtained two uterine content samples under aseptic conditions, by introducing a swab into the uterus of these ewes, on the 2nd-4th and the 5th-9th day after lambing. We used conventional bacteriological techniques to isolate and identify bacteria and to carry out antimicrobial agents susceptibility testing. The prevalence of bacterial intrauterine contamination among ewes with retention was 24% on the first and 46% on the second sampling (P < 0.0001) and that among ewes without retention was 8 and 2% (P > 0.05), respectively. Clinical signs accompanying the retention of fetal membranes were more frequently observed among ewes with intrauterine contamination than among those without (P = 0.0007). The odds of an ewe having an intrauterine contamination increased multiplicatively by 1.06 when the median duration of retention in the flock increased by 6 h. The principal bacteria isolated from the ewes with retention were Arcanobacterium pyogenes and Escherichia coli; 21% of 73 isolates tested were found resistant to at least one antimicrobial agent.

Characterisation of zeolitic materials with a HEU-type structure modified by transition metal elements: definition of acid sites in nickel-loaded crystals in the light of experimental and quantum-chemical results

Nickel-loaded HEU-type zeolite crystals have been obtained by well-known synthetic procedures and characterised by X-ray fluorescence (XRF), scanning-electron microscopy/ energy-dispersive spectroscopy (SEM-EDS), FT-IR, diffuse reflectance UV/ Vis spectroscopy (DR(UV/Vis)S) and X-ray photoelectron spectroscopy (XPS) measurements as non-homoionic and non-stoichiometric substances containing exchangeable hydrated Ni2+ ions in the micropores and nickel hydroxide phases supported on the surface. Thermogravimetric analysis/differential gravimetry (TGA/DTG) and differential thermal analysis (DTA) demonstrated that full dehydration below approximately 400 degrees C follows a clearly endothermic process, whereas at higher temperatures the zeolite is amorphised and finally partially recrystallised to Ni(Al,Si) oxides, detected by powder X-ray powder diffraction (XRD). The solid acidity of NiHEU, initially determined by temperature-programmed desorption (TPD) of ammonia to be 8.93 mgg(-1) NH3, is attributed to the weak acid sites (fundamentally Lewis sites) resolved at approximately 183 degrees C, and to the strong acid sites (essentially Brønsted sites) resolved at approximately 461 degrees C in the TPD pattern. A more sophisticated study based on in situ/ex situ FT-IR with in situ/ex situ 27Al MAS NMR and pyridine (Py) as a probe molecule, revealed that the Lewis acid sites can be attributed primarily to Ni2+ ions, whereas the Brønsted ones can probably be associated with the surface-supported nickel hydroxide phases. The spectroscopic measurements in conjunction with powder XRD and 29Si MAS NMR data strongly suggest that distorted Al tetrahedra are formed during the dehydration process and Py chemisorption/complexation (NiHEU-Py), whereas the crystal structure is remarkably well preserved in the rehydrated material (NiHEU-Py/R). The structural, electronic, energetic and spectroscopic properties of all possible nickel(II) aqua and dihydroxy complexes absorbed in the zeolite micropores or supported on the zeolite surface were studied theoretically by density functional theory (DFT). The computed proton affinity, found to be in the range 182.0-210.0 kcalmol(-1), increases with increasing coordination number of the aqua and dihydroxy nickel(II) complexes.

The utility of the Brief MAST' and the CAGE' in identifying alcohol problems: results from national high-risk and community samples

BACKGROUND

The CAGE and the Brief MAST questionnaires are widely used to screen for alcohol problems. We tested the performance of these instruments in 2 population-based groups: a high-risk sample composed of relatives of alcoholic subjects and a community sample consisting of families not selected for alcoholism (ie, alcohol dependence disorder).

METHODS

A total of 3435 relatives of alcoholics and 795 control subjects were interviewed with the Semi-Structured Assessment for the Genetics of Alcoholism (SSAGA) semistructured interview in a multicenter collaborative study on the genetics of alcoholism. The performance of "CAGE" and "Brief MAST" equivalent items in the SSAGA was characterized by their positive predictive value, sensitivity, specificity, and percentage of the sample who screened positive.

RESULTS

Both questionnaires performed well in the highrisk sample, where the base rate of alcoholism was 35%. However, in the community sample, where the 16% rate of alcoholism was comparable to that of the US population (14%), an acceptable positive predictive value could be achieved only through a substantial reduction in sensitivity. Results were similar when men were compared with women and when lifetime alcoholics were compared with current alcoholics.

CONCLUSION

The "Brief MAST" and "CAGE" can be effective instruments to screen for significant alcohol problems in both community and high-risk patients; as expected, their positive predictive value increases with the base rate of alcoholism in the population being screened.