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

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

A COLLABORATIVE WEB-GIS BASED DECISION SUPPORT PLATFORM FOR RISK MANAGEMENT OF NATURAL HAZARDS

L'un des principaux problèmes dans la gestion des risques est le manque de bonne communication et de collaboration efficace entre les services, agences et organisations chargés de la prévention, l'atténuation et la gestion des risques. La participation des différents groupes d'acteurs est une importante composante de la prévention et l'atténuation des risques. Cela demande une approche intégrée et coordonnée, qui aide les parties prenantes responsables de gérer le risque, depuis l'identification des risques jusqu'au processus de prise de décision, à obtenir la meilleure combinaison des stratégies de réduction des risques. Comme les dangers naturels et les risques liés à ces dangers sont de nature spatiale, les outils d'aide à la décision basés sur le web et intégrés aux systèmes d'informations géographiques (SIG, GIS en anglais] ont été considérés de plus en plus comme des instruments utiles. En prenant les avantages du web moderne, les technologies géospatiales et open-source pour obtenir une structure intégrée et centralisée, une plateforme collaborative web-SIG est proposée pour la gestion des risques avec la participation des différentes parties prenantes. Les principaux objectifs de cette recherche sont 1) de proposer une approche systématique et intégrée de gestion des risques avec la participation des différents parties prenantes; 2) d'étudier la possibilité et l'application des outils interactifs web-SIG d'aide à la décision pour l'analyse, la communication et l'échange d'informations entre les parties prenantes de la gestion des risques and 3) de proposer une approche novatrice pour améliorer potentiellement les activités de collaboration entre les parties prenantes grâce à des approches interactives et participatives. Les apports conceptuels de cette étude sont basés sur les premiers feedback, les entretiens semi- structurés et les observations obtenues lors des visites sur le terrain et des réunions avec les parties prenantes menées sur trois sites d'études en Europe, dans les régions de Voïvodie en Pologne, de Buzâu en Roumanie et du Frioul-Vénétie julienne en Italie. Même si certaines plates-formes existent dans les zones d'études, aucune n'a une plate-forme qui permet une approche flexible et collaborative pour formuler et la sélectionner des mesures de gestion des risques comme ce qui est tenté dans cette étude. De plus, la plupart des plates-formes existantes sont principalement concentrées sur l'inventaire des événements, la visualisation des risques et la diffusion de l'information. Dans cette recherche, un prototype est réalisé et centré sur l'analyse des risques, la formulation et la sélection des mesures potentielles en utilisant une interface interactive web-SIG intégrée à un outil d'évaluation multicritères (MCE). Cette plate-forme est considérée non seulement comme une plate-forme web pour le partage centralisé des informations des risques, mais aussi comme un outil pour assurer un cadre intégré où les parties prenantes concernées peuvent analyser les risques et évaluer les mesures de réduction des risques. Pour le développement du prototype, une architecture client-serveur à trois niveaux renforcée par Boundless (OpenGeo) a été appliquée avec son environnement de développement côté client. Ce prototype a été présenté aux parties prenantes locales et régionales des zones d'études. Leur feedback a été collecté pour comprendre leurs points de vue et déterminer si la plate-forme est utile et applicable pour leurs activités en matière de gestion des risques. Le prototype a également été évalué avec les étudiants pour obtenir des commentaires sur les différents aspects de la plate-forme et pour analyser la façon dont l'application des outils interactifs pourrait aider les étudiants à analyser et comprendre la gestion des risques. -- A collaborative web-GIS based décision support platform for risk management of natural hazards (Aye Zar Chi, ISTE) One of the main problems in risk management is the lack of good communication as well as efficient and effective collaboration between the agencies, services and organizations in charge of risk prévention, mitigation and management. The involvement of various stakeholder groups is an important component of risk prévention and mitigation. This calls for an integrated and coordinated approach which helps responsible stakeholders in managing risk, starting from risk identification to the decision-making process for achieving the best combination of risk réduction stratégies. As natural hazards and associated risks are spatial in nature, web-based décision support tools integrated with Géographie information systems (GIS) have been increasingly considered as useful instruments for providing décision support. Taking the advantages of modem web, spatial and open-source technologies to achieve a centralized and integrated framework, in this research, a web-GIS based collaborative décision support platform is proposed for risk management with involvement of various stakeholders. The principal purposes of this research are: (1) to conduct a systematic and integrated risk management approach with diverse involvement of différent stakeholders; (2) to explore the possibility and application of interactive web- GIS décision support tools for the analysis, communication and exchange of décision support information between risk management stakeholders and (3) to propose an innovative approach to potentially enhance collaboration activities between stakeholders through interactive and participatory approaches. The conceptual inputs of this study are based on the initial feedback, semi-structured interviews and observations obtained from the field visits and stakeholder meetings carried out in three case studies of Europe: the Malopolska Voivodeship of Poland, Buzâu County of Romania and the Friuli-Venezia-Giulia région of Italy. Even though some platforms exist in study areas, no single case has a platform at hand which enables as flexible and collaborative approach for the formulation and selection of risk management measures as attempted in this study. Moreover, most platforms have focused mainly on inventoiy of events, risk visualization and dissémination of information. In this research, a prototype is realized and focused on the risk analysis, formulation and selection of potential measures through the use of an interactive web-GIS based interface integrated with a Multi-Criteria Evaluation (MCE) tool. This platform is regarded not only as a web platform for centralized sharing of risk information but also for ensuring an integrated framework where involved stakeholders can analyse risk and evaluate risk réduction measures. For the prototype development, a three-tier client-server architecture backed up by Boundless (OpenGeo) was applied with its client side development environment. This developed prototype was presented to the local and régional stakeholders of the study areas and feedback was collected to understand their perspective in determining whether the platform is useful and applicable for their activities in risk management. The prototype was also further evaluated with students to obtain feedback on différent aspects of the platform as well as to analyse how the application of interactive tools could assist students in studying and understanding risk management

Does oil price uncertainty matter for stock returns in South Africa?

This paper examines the impact of oil price uncertainty on South Africa’s stock returns using weekly data that cover the period 1995:07:01 to 2014:08:30. The measure of oil price uncertainty is the conditional standard deviation of the one-step-ahead forecast error for the change in the price of oil. A bivariate GARCH-in-mean vector autoregressive model was used for analysis. The results with oil price in US Dollars show that oil price uncertainty had negative but marginally significant effect on stock returns. However, when oil price is converted to Rands, the effect is still negative effect but significant at 5%. The study also finds that accounting for oil price uncertainty in an oil price-stock returns equation tends to amplify the negative dynamic response of stock returns to a positive oil shock, while diminishing the response of stock returns to a negative oil price shock compared to a model which excludes oil price uncertainty from entering the oil price-stock returns equation. Furthermore, the response of stock returns to negative and positive oil price uncertainty shocks is asymmetric.http://www.businessperspectives.org/component/option,com_journals/id,4am2016Economic

Analysis of Maize Value Addition among Entrepreneurs in Taraba State, Nigeria

This study analyzed maize value addition among maize entrepreneurs in Taraba State, Nigeria. A multi-stage sampling procedure was used to collect primary data from two hundred and twelve respondents (212), using structured questionnaire. Data were analyzed using descriptive statistics, Value addition model, ANOVA, multinomial logistic regression, log likelihood test ratio and factor analysis. The result of the study revealed that most (62.3%) respondents were males. 61.3% were within the productive age of 21-40 years. Majority (71.1%) were married with household sizes of 6-10. The total of (32.8%) respondents of them had secondary school education, (46.6%) had processing experience of between 6-10 years in processing as their major occupation. proportionate (49.2%) of total respondents had non-farm income of N150,001 per annum. Results of the value addition analysis showed that maize processed as boiled maize is more profitable with a mean of N130, 900 per annum. The result from the multinomial logistic regression on choice of maize processing enterprises revealed that sex had negative coefficient, which implied that male respondents preferred grain production enterprise rather than processing into akamu, corn flour, massa and boiled maize. Also age had negative coefficient, implying that age increase tends to favour grain production than processing. In relation to processing constraints, the maize processing value chain was hampered by the following: inadequate processing facilities, inadequate credit/funds, high cost of transport and inadequate access to inputs. The study concluded that maize value addition is a profitable enterprise and entrepreneurs should be encouraged to venture into it. Also the Agricultural Development Project Programme should send extension agents to processors to encourage processing diversification especially into poultry feeds

Optimization of Phosphorus Fertilizer in Supplemental Feed‐Fed Based Nile Tilapia (Oreochromis niloticus) Ponds

An experiment was conducted in earthen ponds at the Asian Institute of Technology, Thailand to determine different phosphorus fertilizer dose effects on Nile tilapia production, water quality variables, nutrient utilization and cost‐benefit under supplemental feeding. Five phosphorus fertilization rates were used as treatments e.g. 100%, 75%, 50%, 25% and 0% of 7 kg P ha week−1. Nitrogen fertilization rate was fixed at 28 kg N ha week−1 for all the treatments. Sex‐reversed Nile tilapia were stocked at 3 fish m−2, and 30% CP floating feed fed at 50% satiation feeding rate. Nutrient budget showed higher phosphorus fertilizer input resulted in higher phosphorus sink in the sediment. Mean weight, mean weight gain, daily weight gain and net yield were not significantly different among treatments (P > 0.05). Total Kjeldahl nitrogen, total phosphorus and soluble reactive phosphorus were significantly different among treatments. Economic analysis showed phosphorus fertilization resulted in positive net returns. Though the gross income was not affected by different fertilization rates, significantly lowest cost was found in the treatment using 25% phosphorus fertilizer. It can be concluded from the research that 25% phosphorus fertilization might be used as an alternative strategy of Nile tilapia pond culture in terms of economic return and nutrient loss in sediment.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/115936/1/are12444.pd

The impact of COVID-19 and COVID vaccination on cardiovascular outcomes

COVID-19 is an independent risk factor for cardiovascular disease. COVID-19 vaccination may prevent this, but in some cases, COVID-19 vaccination may cause myocarditis or pericarditis. Patients with COVID-19 may present with non-specific symptoms that have a cardiac origin. This review examines the cardiovascular complications of COVID-19 infection and the impact of COVID-19 vaccination. COVID-19 cardiovascular complications include myocardial injury, pericarditis, coagulopathy, myocardial infarction, heart failure, arrhythmias, and persistent post-acute risk of adverse cardiovascular outcomes. Diagnostic and referral pathways for non-specific symptoms, such as dyspnoea and fatigue, remain unclear. COVID-19 vaccination is cardioprotective overall but is associated with myopericarditis in young males, though at a lower rate than following SARS-CoV-2 infection. Increased awareness among primary care physicians of potential cardiovascular causes of non-specific post-COVID-19 symptoms, including in younger adults, such as fatigue, dyspnoea, and chest pain, is essential. We recommend full vaccination with scheduled booster doses, optimal management of cardiovascular risk factors, rapid treatment of COVID-19, and clear diagnostic, referral, and management pathways for patients presenting with non-specific symptoms to rule out cardiac complications

Global Healthcare Resource Efficiency in the Management of COVID-19 Death and Infection Prevalence Rates

In this paper, we use a novel DEA approach, developed by You and Yan (2011), which accounts for both desirable outputs (recovered cases) and undesirable outputs (infections and deaths), to analyse the technical efficiency of the health systems of 36 most infected countries during the first 11 months since the COVID-19 outbreak. The average technical efficiency scores across the 3 Models is 52%. Specifically, 6 of the 36 (17%) countries in our sample largely used tests, doctors and health spending efficiently in managing the COVID-19 case-mortality and prevalence rates. The remaining 30 DMUs used their available resources inefficiently. Developing countries performed better than developed nations who were inefficient. Therefore, most countries literally “threw” resources at fighting the pandemic, thereby probably raising inefficiency through wasted resource use. The study also showed that developed countries could also draw lessons from developing countries in the management of pandemics. The latter countries mostly face pandemics on a daily basis, therefore, have developed strategies to manage them

Global Healthcare Resource Efficiency in the Management of COVID-19 Death and Infection Prevalence Rates

In this paper, we use a novel DEA approach, developed by You and Yan (2011), which accounts for both desirable outputs (recovered cases) and undesirable outputs (infections and deaths), to analyse the technical efficiency of the health systems of 36 most infected countries during the first 11 months since the COVID-19 outbreak. The average technical efficiency scores across the 3 Models is 52%. Specifically, 6 of the 36 (17%) countries in our sample largely used tests, doctors and health spending efficiently in managing the COVID-19 case-mortality and prevalence rates. The remaining 30 DMUs used their available resources inefficiently. Developing countries performed better than developed nations who were inefficient. Therefore, most countries literally “threw” resources at fighting the pandemic, thereby probably raising inefficiency through wasted resource use. The study also showed that developed countries could also draw lessons from developing countries in the management of pandemics. The latter countries mostly face pandemics on a daily basis, therefore, have developed strategies to manage them