Successful Implementation of an All-or-None Diabetes Measure in 10 US Health Systems.
Population health management
Type 2 diabetes mellitus (T2DM) affects 31.5 million adults in the United States and is commonly treated in primary care settings. One promising approach to comprehensive care is to focus on an all-or-none diabetes bundle measure, which ensures each patient meets a set of guideline-recommended measures. This requires a practice-level coordinated strategy. The purpose of this initiative was to help health care organizations (HCOs) improve the care and outcomes of patients with T2DM using an all-or-none bundle measure. This observational study was carried out in the context of a national best practices learning Collaborative that implemented targeted interventions in primary care settings and measured success using an all-or-none bundle measure. Ten AMGA member-HCOs, across 8 states, treating nearly 300,000 adult patients with T2DM in primary care participated. The primary measure, the Together 2 Goal Core Bundle, included hemoglobin A1c (A1c) control (<8%), blood pressure (BP) control (<140/90 mmHg), lipid management (prescribed a statin), and medical attention for nephropathy. All 10 HCOs improved the Core Bundle measure during the 12-month Collaborative. The rate for the Core Bundle improved from 40.2% to 42.8%, an absolute increase of 2.6% ( < 0.001). In addition, 9 HCOs improved BP control, 8 improved lipid management, 6 improved attention to nephropathy, and 4 improved A1c control. Implementing interventions in primary care settings was successful in achieving comprehensive care for an estimated additional 7700 people living with T2DM who met all 4 components of the bundle measure during the 12-month intervention period.
10.1089/pop.2021.0266
Interrelations between the physiology of sodium, potassium and water, and nutrition.
Patrick J
Journal of human nutrition
The relationships between altered nutrition and body composition of sodium, potassium and water are reviewed. The physiological mechanisms involved in cellular homeostasis of sodium and potassium are also discussed with particular reference to energy costs. Alterations in mineral metabolism in protein energy malnutrition, oedema, potassium adaptation, fasting and hypertension are described.
First Report of the Colistin Resistance Gene Carried by Inc Plasmid pSL12517-mcr10.1 in Enterobacter cloacae in Sierra Leone.
Microbiology spectrum
Mobile colistin resistance () gene has been distributed widely since it was initially identified in 2020. The aim of this study was to report the first in Africa and the first in Sierra Leone; furthermore, we presented diverse modular structures of loci. Here, the complete sequence of one -carrying plasmid in one clinical Enterobacter cloacae isolate from Sierra Leone was determined. Detailed genetic dissection and comparison were applied to this plasmid, together with a homologous plasmid carrying from GenBank. Moreover, a genetic comparison of 19 loci was performed. In this study, was carried by an Inc plasmid from one Enterobacter cloacae isolate. A total of 19 loci displayed diversification in modular structures through complex transposition and homologous recombination. A site-specific tyrosine recombinase XerC was located upstream of , and at least one insertion sequence element was inserted adjacent to a conserved --- region. Integration of into a different gene context and carried by various Inc plasmids contributed to the wide distribution of and enhanced the ability of bacteria to survive under colistin selection pressure. Colistin is used as one of the last available choices of antibiotics for patients infected by carbapenem-resistant bacterial strains, but the unrestricted use of colistin aggravated the acquisition and dissemination of mobile colistin resistance () genes. So far, 10 genes have been reported in four continents around the world. This study presented one -carrying Enterobacter cloacae isolate from Sierra Leone. The gene was identified on an Inc plasmid. According to the results of genetic comparison of 19 loci, the gene was found to be located in a conserved --- region, and at least one insertion sequence element was inserted adjacent to this region. To our knowledge, this is the first report of identifying the gene in Africa and the gene in Sierra Leone.
10.1128/spectrum.01127-22
In silico, screening of plant extracts for anti-SARS-CoV-2 activity and evaluation of their acute and sub-acute toxicity.
Phytomedicine Plus : International journal of phytotherapy and phytopharmacology
Background:In the absence of a specific drug for COVID 19, treatment with plant extracts could be an option worthy of further investigation and has motivated to evaluate the safety and anti-SARS-CoV-2 activity of plant extracts. Purpose:To screen the phytochemicals for anti-SARS-CoV-2 and evaluate their safety and efficacy and Method:The phytochemicals for anti-SARS-CoV-2 were screened using molecular docking. The hits generated from screening were subjected for extraction, isolation and purification. The anti-SARS-CoV-2 activity of (E1), (E2), (E3), (E4), (E5) ethanol extracts. The aerial parts were used for E1, E3, E4, E5 and root was used for E2. The safety and anti-SARS-CoV-2 activity of plant methanol extracts were performed in VeroE6 cells using Remdesivir as positive control. The acute and sub-acute toxicity study was performed in Wistar male and female rats. Results:The percentage of cell viability for E4, E5 and E2 treated VeroE6 cells were remarkably good on the 24th and 48th hour of treatment. The anti-SARS-CoV-2 activity of E4, E5 and E2 were significant for both E gene and N gene. The percentage of SARS-CoV-2 inhibition for E4 was better than Remdesivir. For E gene and N gene, Remdesivir showed IC of 0.15 µM and 0.11 µM respectively, For E gene and N gene, E4 showed IC of 1.18 µg and 1.16 µg respectively. Taking the clue from findings, the E4 E5 and E2 were combined (E 4.5.2) and evaluated for acute and sub-acute toxicity in Wistar male and female rats. No statistically significant difference in haematological, biochemical and histopathological parameters were noticed. Conclusion:The study demonstrated the anti-SARS-CoV-2 activity and safety of plant extracts in both and experimental conditions.
10.1016/j.phyplu.2022.100233