Publications by authors named "Rayner C"

Individuals with type 2 diabetes are at high risk of postprandial falls in blood pressure (BP) (i.e., a reduction in systolic BP of ≥20mmHg, termed postprandial hypotension (PPH)), which increases the risk of falls and mortality.

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Background: Limited literature exists on nutrition practices for long-stay patients in the intensive care unit (ICU). We aimed to compare nutrition practices in the first and second weeks of an ICU admission.

Method: A post hoc exploratory analysis of The Augmented vs Routine Approach to Giving Energy Trial (TARGET) randomized controlled trial (RCT) was undertaken.

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Trained pharmacometricians remain scarce in Africa due to limited training opportunities, lack of a pharmaceutical product development ecosystem, and emigration to high-income countries. The Applied Pharmacometrics Training (APT) fellowship program was established to address these gaps and specifically foster job creation for talent retention. We review the APT program's progress over 3 years and encourage collaboration to enhance local clinical data analysis in Africa.

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Glucagon-like peptide-1 (GLP-1) receptor agonists and the dual GLP-1- and glucose-dependent insulinotropic polypeptide receptor co-agonist tirzepatide (referred to here collectively as "GLP-1-based therapy") are incretin-based therapies being used increasingly in the management of both type 2 diabetes and obesity. They are now recognized to have beneficial effects beyond improved glycemic control and weight loss, including cardiovascular and renal protection. GLP-1-based therapy also slows gastric emptying, which has benefits (lowering postprandial glucose), but also potential risks (eg, hypoglycemia in individuals on insulin or sulphonylurea therapy).

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  • - The study investigates the effects of non-nutritive sweeteners (NNS) on glucose absorption and gut microbiota in mice, revealing that NNS increases glucose absorption without relying on gut microbiota.
  • - Mice given antibiotics to reduce gut microbiota showed improved glucose tolerance, suggesting that gut bacteria play an important role in glycemic responses.
  • - Results indicate that while NNS enhances glucose absorption, it does not negatively affect glycemic responses, and gut microbiota depletion positively impacts glucose tolerance through the activity of GLP-1.
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  • Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are commonly used to manage type 2 diabetes and obesity, helping to slow gastric emptying which can help control blood sugar levels but may lead to issues like retained gastric contents during medical procedures.
  • A review of studies indicates that while retained gastric contents during endoscopy is more common with GLP-1 RA usage, serious complications like pulmonary aspiration are rare, but guidelines for managing these medications during procedures are limited and not well-defined.
  • To enhance patient safety, further research is needed on strategies such as extended fasting before procedures, ultrasound checks for gastric contents, and the potential use of prokinetic drugs like erythromycin.
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  • - The study explored the effects of injecting phosphorus-32 (P) microparticles into pancreatic tumors during chemotherapy (FOLFIRINOX) to improve poor blood flow—which hinders treatment responses—in patients with locally advanced pancreatic cancer (LAPC).
  • - Out of 20 patients, the results showed a significant decrease in tumor size and increased vascularity after P implantation, with 25% achieving tumor downstaging and four patients opting for surgery.
  • - Most patients (75%) remained alive after an average follow-up of 11.2 months, but the study found no significant difference in overall survival between patients who showed increased tumor blood flow and those who did not.
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  • Study focused on how long COVID symptoms fluctuate in response to various activities, measuring severity, timing, and recovery through Ecological Momentary Assessments.
  • 376 participants recorded data on 8 core symptoms and results showed increased symptom severity shortly after physical, social, and cognitive exertions, with notable rises in fatigue levels.
  • Findings suggest clear patterns of symptom variations can aid in self-management and highlight potential therapeutic targets for treatment.
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Aim: To examine the associations of tea consumption (both frequency and type) with (1) prediabetes and diabetes and (2) urinary glucose and sodium excretion in Chinese community-dwelling adults.

Materials And Methods: In 1923 participants (457 with diabetes, 720 with prediabetes, and 746 with normoglycaemia), the frequency (occasional, frequent, daily, or nil) and type (green, black, dark, or other) of tea consumption were assessed using a standardized questionnaire. Morning spot urinary glucose and urine glucose-to-creatinine ratios (UGCRs) were assessed as markers of urinary glucose excretion.

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  • Moxidectin is FDA-approved for treating river-blindness in individuals aged 12 and older, and it's being considered for use in mass drug administration (MDA) programs to help control and potentially eliminate the disease.
  • Infants in onchocerciasis-endemic areas are often breastfed until age 2, raising concerns about the effects of moxidectin on nursing infants during MDA programs.
  • Studies show that moxidectin concentrations in breast milk peak around 4 hours post-dosing, but drop below safe exposure levels within two days, providing reassurance for prescribers regarding its use in lactating women.
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Gestational diabetes mellitus (GDM) represents one of the most common medical complications of pregnancy and is important to the well-being of both mothers and offspring in the short and long term. Lifestyle intervention remains the mainstay for the management of GDM. The efficacy of nutritional approaches ( calorie restriction and small frequent meals) to improving the maternal-neonatal outcomes of GDM was attested to by Chinese population data, discussed in two articles in recent issues of this journal.

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The availability of glucagon-like peptide-1 (GLP-1) receptor agonists (RAs) such as liraglutide and semaglutide, and a GLP-1 and glucose dependent insulinotropic polypeptide coagonist (tirzepatide) represents a paradigm shift in the management of both type 2 diabetes and obesity. There is now considerable attention, including in the public media, on the effect of both long-acting and short-acting GLP-1RAs to delay gastric emptying. Although slowed gastric emptying is integral to reducing post-prandial blood glucose responses in type 2 diabetes, marked slowing of gastric emptying might also increase the propensity for longer intragastric retention of food, with a consequent increased risk of aspiration at the time of surgery or upper gastrointestinal endoscopy.

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  • Multidisciplinary teams (MDTs) in these clinics built knowledge through shared practices and focused on either patient rehabilitation or understanding the condition's underlying biological damage.
  • Conflicts sometimes arose between MDTs when patients shared online narratives about microscopic damage, highlighting differences in treatment approaches and understandings of long covid.
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Under US Food and Drug Administration (FDA) grant (2U18FD005320-06), the Critical Path Institute (C-Path) and experienced private sector partners collaborated with global health organizations to create didactic video materials in an e-learning format on model-informed drug development (MIDD) topics relevant to a non-modeling audience. Several multinational pharmaceutical companies contributed case studies illustrating the application of the MIDD approach in practice. Training videos were created and divided into several modules: introducing the MIDD landscape for drug development and regulatory science, a review of various model types used for MIDD, discussions of how models inform drug development and regulatory decisions, future goals of MIDD, and discussions on the interconnectedness of models used for MIDD.

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Elevated fasting glucagon concentrations and/or attenuated postprandial glucagon suppression are characteristics of type 2 diabetes (T2D) and contribute to hyperglycaemia. This study shows that hyperglucagonaemia is more prominent in males than females after a nutrient load in T2D, adding insights into sex differences in relation to the pathophysiology of T2D.

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Aim: To evaluate insulin and glucagon sensitivity in Han Chinese women with and without gestational diabetes mellitus (GDM).

Methods: In total, 81 women with GDM and 81 age-matched healthy controls were evaluated with a 75 g oral glucose tolerance test (OGTT) at gestational weeks 24-28. Plasma glucose concentrations were measured at fasting and 1 h and 2 h post-OGTT.

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Aim: To perform a direct, double-blind, randomised, crossover comparison of subcutaneous and intravenous glucagon-like peptide-1 (GLP-1) in hyperglycaemic subjects with type 2 diabetes naïve to GLP-1-based therapy.

Materials And Methods: Ten fasted, hyperglycaemic subjects (1 female, age 63 ± 10 years [mean ± SD], glycated haemoglobin 73.5 ± 22.

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  • Gastrointestinal (GI) symptoms are common in type 2 diabetes (T2D) and negatively affect quality of life, potentially contributing to diabetes distress (DD) and depressive symptoms.
  • A study involving 1,406 T2D patients in Bangladesh found that 31.1% reported GI symptoms, while over half experienced elevated DD and nearly 38% showed depressive symptoms.
  • The results indicate that GI symptoms are significantly linked to both DD and depressive symptoms, with a higher likelihood of experiencing these issues in individuals with GI symptoms.
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  • A study measured how fast a glucose drink empties from the stomach in people with type 2 diabetes who took either lixisenatide or a placebo for 8 weeks.
  • Those taking lixisenatide showed significantly less gastric emptying after 240 minutes compared to those on the placebo (2% vs 48%).
  • This suggests that lixisenatide can greatly delay the process of liquid gastric emptying.
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Araki H, Tazawa H, Kanaya N, et al. Oncolytic virus-mediated p53 overexpression promotes immunogenic cell death and efficacy of PD-1 blockade in pancreatic cancer. Mol Ther Oncolytics.

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Background And Aim: Rates of antimicrobial-resistant Helicobacter pylori infection are rising globally, but little is known about contemporary resistance patterns, virulence factors, and phylogenetic patterns of isolates within Australia. We aimed to characterize antimicrobial resistance and genetic mutations associated with adverse clinical outcomes.

Methods: Whole genome sequencing, culturing, and antibiotic sensitivity data for refractory H.

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