Are glucose profiles well-controlled within the targets recommended by the International Diabetes Federation in type 2 diabetes? A meta-analysis of results from continuous glucose monitoring based studies

AIMS: To assess continuous glucose monitoring (CGM) derived intra-day glucose profiles using global guideline for type 2 diabetes recommended by the International Diabetes Federation (IDF). METHODS: The Cochrane Library, MEDLINE, PubMed, CINAHL and Science Direct were searched to identify observational studies reporting intra-day glucose profiles using CGM in people with type 2 diabetes on any anti-diabetes agents. Overall and subgroup analyses were conducted to summarise mean differences between reported glucose profiles (fasting glucose, pre-meal glucose, postprandial glucose and post-meal glucose spike/excursion) and the IDF targets. RESULTS: Twelve observational studies totalling 731 people were included. Pooled fasting glucose (0.81 mmol/L, 95% CI, 0.53-1.09 mmol/L), postprandial glucose after breakfast (1.63 mmol/L, 95% CI, 0.79-2.48 mmol/L) and post-breakfast glucose spike (1.05 mmol/L, 95% CI, 0.13-1.96 mmol/L) were significantly higher than the IDF targets. Pre-lunch glucose, pre-dinner glucose and postprandial glucose after lunch and dinner were above the IDF targets but not significantly. Subgroup analysis showed significantly higher fasting glucose and postprandial glucose after breakfast in all groups: HbA1c <7% and ≥7% (53 mmol/mol) and duration of diabetes <10 years and ≥10 years. CONCLUSIONS: Independent of HbA1c, fasting glucose and postprandial glucose after breakfast are not well-controlled in type 2 diabetes

Reduced-Complexity Maximum-Likelihood Detection in Downlink SDMA Systems

The literature of up-link SDMA systems is rich, but at the time of writing there is a paucity of information on the employment of SDMA techniques in the down-link. Hence, in this paper a Space Division Multiple Access (SDMA) down-link (DL) multi-user communication system invoking a novel low-complexity Maximum Likelihood (ML) space-time detection technique is proposed, which can be regarded as an advanced extension of the Complex Sphere Decoder (CSD). We demonstrate that as opposed to the previously published variants of the CSD, the proposed technique may be employed for obtaining a high effective throughput in the so-called “over-loaded” scenario, where the number of transmit antennas exceeds that of the receive antennas. The proposed method achieves the optimum performance of the ML detector even in heavily over-loaded scenarios, while the associated computational complexity is only moderately increased. As an illustrative example, the required Eb/N0 increased from 2 dB to 9 dB, when increasing the normalized system load from unity, representing the fully loaded system, to a normalized load of 1.556

Dose-response between frequency of breaks in sedentary time and glucose control in type 2 diabetes: a proof of concept study

Objectives This study aimed to investigate dose-response between frequency of breaks in sedentary time and glucose control.DesignRandomised three-treatment, two-period balanced incomplete block trial.MethodsTwelve adults with type 2 diabetes (age, 60 ± 11 years; body mass index, 30.2 ± 4.7 kg/m2) participated in two of the following treatment conditions: sitting for 7 h interrupted by 3 min light-intensity walking breaks every (1) 60 min (Condition 1), (2) 30 min (Condition 2), and (3) 15 min (Condition 3). Postprandial glucose incremental area under the curves (iAUCs) and 21-h glucose total area under the curve (AUC) were measured using continuous glucose monitoring. Standardised meals were provided. Results Compared with Condition 1 (6.7 ± 0.8 mmol L−1 × 3.5 h−1), post-breakfast glucose iAUC was reduced for Condition 3 (3.5 ± 0.9 mmol L−1 × 3.5 h−1, p ˂ 0.04). Post-lunch glucose iAUC was lower in Condition 3 (1.3 ± 0.9 mmol L−1 × 3.5 h−1, p ˂ 0.03) and Condition 2 (2.1 ± 0.7 mmol L−1 × 3.5 h−1, p ˂ 0.05) relative to Condition 1 (4.6 ± 0.8 mmol L−1 × 3.5 h−1). Condition 3 (1.0 ± 0.7 mmol L−1 × 3.5 h−1, p = 0.02) and Condition 2 (1.6 ± 0.6 mmol L−1 × 3.5 h−1, p ˂ 0.04) attenuated post-dinner glucose iAUC compared with Condition 1 (4.0 ± 0.7 mmol L−1 × 3.5 h−1). Cumulative 10.5-h postprandial glucose iAUC was lower in Condition 3 than Condition 1 (p = 0.02). Condition 3 reduced 21-h glucose AUC compared with Condition 1 (p < 0.001) and Condition 2 (p = 0.002). However, post-breakfast glucose iAUC, cumulative 10.5-h postprandial glucose iAUC and 21-h glucose AUC were not different between Condition 2 and Condition 1 (p ˃ 0.05).Conclusions There could be dose-response between frequency of breaks in sedentary time and glucose. Interrupting sedentary time every 15 min could produce better glucose control

Representing moisture fluxes and phase changes in glacier debris cover using a reservoir approach

Due to the complexity of treating moisture in supraglacial debris, surface energy balance models to date have neglected moisture infiltration and phase changes in the debris layer. The latent heat flux (QL) is also often excluded due to the uncertainty in determining the surface vapour pressure. To quantify the importance of moisture on the surface energy and climatic mass balance (CMB) of debris-covered glaciers, we developed a simple reservoir parameterization for the debris ice and water content, as well as an estimation of the latent heat flux. The parameterization was incorporated into a CMB model adapted for debris-covered glaciers. We present the results of two point simulations, using both our new “moist” and the conventional “dry” approaches, on the Miage Glacier, Italy, during summer 2008 and fall 2011. The former year coincides with available in situ glaciological and meteorological measurements, including the first eddy-covariance measurements of the turbulent fluxes over supraglacial debris, while the latter contains two refreeze events that permit evaluation of the influence of phase changes. The simulations demonstrate a clear influence of moisture on the glacier energy and mass-balance dynamics. When water and ice are considered, heat transmission to the underlying glacier ice is lower, as the effective thermal diffusivity of the saturated debris layers is reduced by increases in both the density and the specific heat capacity of the layers. In combination with surface heat extraction by QL, subdebris ice melt is reduced by 3.1% in 2008 and by 7.0% in 2011 when moisture effects are included. However, the influence of the parameterization on the total accumulated mass balance varies seasonally. In summer 2008, mass loss due to surface vapour fluxes more than compensates for the reduction in ice melt, such that the total ablation increases by 4.0 %. Conversely, in fall 2011, the modulation of basal debris temperature by debris ice results in a decrease in total ablation of 2.1 %. Although the parameterization is a simplified representation of the moist physics of glacier debris, it is a novel attempt at including moisture in a numerical model of debris-covered glaciers and one that opens up additional avenues for future research

Phenology of the Diamondback moth (Plutella xylostella) in the UK and provision of decision support for brassica growers

In the UK, severe infestations by Plutella xylostella occur sporadically and are due mainly to the immigration of moths. The aim of this study was to develop a more detailed understanding of the phenology of P. xylostella in the UK and investigate methods of monitoring moth activity, with the aim of providing warnings to growers. Plutella xylostella was monitored using pheromone traps, by counting immature stages on plants, and by accessing citizen science data (records of sightings of moths) from websites and Twitter. The likely origin of migrant moths was investigated by analysing historical weather data. The study confirmed that P. xylostella is a sporadic but important pest, and that very large numbers of moths can arrive suddenly, most often in early summer. Their immediate sources are countries in the western part of continental Europe. A network of pheromone traps, each containing a small camera sending images to a website, to monitor P. xylostella remotely provided accessible and timely information, but the particular system tested did not appear to catch many moths. In another approach, sightings by citizen scientists were summarised on a web page. These were accessed regularly by growers and, at present, this approach appears to be the most effective way of providing timely warnings

Measurement of the Nodal Precession of WASP-33 b via Doppler Tomography

We have analyzed new and archival time series spectra taken six years apart during transits of the hot Jupiter WASP-33 b, and spectroscopically resolved the line profile perturbation caused by the Rossiter-McLaughlin effect. The motion of this line profile perturbation is determined by the path of the planet across the stellar disk, which we show to have changed between the two epochs due to nodal precession of the planetary orbit. We measured rates of change of the impact parameter and the sky-projected spin-orbit misalignment of $db/dt=-0.0228_{-0.0018}^{+0.0050}$ yr$^{-1}$ and $d\lambda/dt=-0.487_{-0.076}^{+0.089}$~$^{\circ}$ yr$^{-1}$, respectively, corresponding to a rate of nodal precession of $d\Omega/dt=0.373_{-0.083}^{+0.031}$~$^{\circ}$ yr$^{-1}$. This is only the second measurement of nodal precession for a confirmed exoplanet transiting a single star. Finally, we used the rate of precession to set limits on the stellar gravitational quadrupole moment of $9.4\times10^{-5}<J_2<6.1\times10^{-4}$.Comment: Published in ApJL. 5 pages, 3 figures. Corrected error in the calculation of J_

miR-34a-/- mice are susceptible to diet-induced obesity

Objective: MicroRNA (miR)−34a regulates inflammatory pathways, and increased transcripts have been observed in serum and subcutaneous adipose of subjects who have obesity and type 2 diabetes. Therefore, the role of miR-34a in adipose tissue inflammation and lipid metabolism in murine diet-induced obesity was investigated. Methods: Wild-type (WT) and miR-34a−/− mice were fed chow or high-fat diet (HFD) for 24 weeks. WT and miR-34a−/− bone marrow-derived macrophages were cultured in vitro with macrophage colony-stimulating factor (M-CSF). Brown and white preadipocytes were cultured from the stromal vascular fraction (SVF) of intrascapular brown and epididymal white adipose tissue (eWAT), with rosiglitazone. Results: HFD-fed miR-34a−/− mice were significantly heavier with a greater increase in eWAT weight than WT. miR-34a−/− eWAT had a smaller adipocyte area, which significantly increased with HFD. miR-34a−/− eWAT showed basal increases in Cd36, Hmgcr, Lxrα, Pgc1α, and Fasn. miR-34a−/− intrascapular brown adipose tissue had basal reductions in c/ebpα and c/ebpβ, with in vitro miR-34a−/− white adipocytes showing increased lipid content. An F4/80high macrophage population was present in HFD miR-34a−/− eWAT, with increased IL-10 transcripts and serum IL-5 protein. Finally, miR-34a−/− bone marrow-derived macrophages showed an ablated CXCL1 response to tumor necrosis factor-α. Conclusions: These findings suggest a multifactorial role of miR-34a in controlling susceptibility to obesity, by regulating inflammatory and metabolic pathways