24-Hour Glycemic Variations in Drug-Naïve Patients with Type 2 Diabetes: A Continuous Glucose Monitoring (CGM)-Based Study

OBJECTIVE: To investigate a 24-hour glycemic variation in drug-naïve, type 2 diabetic patients by using CGM. METHODS: A total of 30 inpatients with type 2 diabetes were included in the study to analyze the 24-hour CGM data. RESULTS: The patients' median age was 58 years old (interquartile range: 42-66 years), and their median HbA1c value was 7.6 (6.7-8.8)%. The median time to postprandial peak glucose levels(Peak Time) for each meal was 70-85 minutes, with the range of postprandial glucose increases(Increase Range) for each meal being 83-109 mg/dL. There was a significant positive correlation between the HbA1c values and Increases Range, Peak Time observed after breakfast and dinner, respectively. When the patients were stratified by a median HbA1c value of 7.6% into 2 groups, Increases Range and Peak Time, after breakfast, were shown to be significantly higher in the high-HbA1c group (H) than in the low-HbA1c (L) group. When the subjects were divided into four groups according to HbA1c levels:1 (<7.0%, n = 8), 2 (7.0-7.9%, n = 8), 3 (8.0-8.9%, n = 8), and 4 (≥9%, n = 6), the average glucose level, pre-meal glucose level and postprandial peak glucose level increased steadily from group 1 to 4 in a stepwise manner. CONCLUSIONS: In drug-naïve, Japanese type 2 diabetic patients, the Peak Time and the Increase Range were maximal after dinner. It was shown that the greater the HbA1c values, the longer Peak time and the higher Increase Range after breakfast and dinner. The average glucose level, pre meal glucose level and postprandial peak glucose level increased steadily as HbA1c level increased

Partial Product Updates for Agents of Detectable Failure and Logical Obstruction to Task Solvability

The logical method proposed by Goubault, Ledent, and Rajsbaum provides a novel way to show the unsolvability of distributed tasks by means of a logical obstruction, which is an epistemic logic formula describing the reason of unsolvability. In this paper, we introduce the notion of partial product update, which refines that of product update in the original logical method, to encompass distributed tasks and protocols modeled by impure simplicial complexes. With this extended notion of partial product update, the original logical method is generalized so that it allows the application of logical obstruction to show unsolvability results in a distributed environment where the failure of agents is detectable. We demonstrate the use of the logical method by giving a concrete logical obstruction and showing that the consensus task is unsolvable by the single-round synchronous message-passing protocol

Web-based environment for user generation of spoken dialog for virtual assistants

In this paper, a web-based spoken dialog generation environment which enables users to edit dialogs with a video virtual assistant is developed and to also select the 3D motions and tone of voice for the assistant. In our proposed system, “anyone” can “easily” post/edit contents of the dialog for the dialog system. The dialog type corresponding to the system is limited to the question-and-answer type dialog, in order to avoid editing conflicts caused by editing by multiple users. The spoken dialog sharing service and FST generator generates spoken dialog content for the MMDAgent spoken dialog system toolkit, which includes a speech recognizer, a dialog control unit, a speech synthesizer, and a virtual agent. For dialog content creation, question-and-answer dialogs posted by users and FST templates are used. The proposed system was operated for more than a year in a student lounge at the Nagoya Institute of Technology, where users added more than 500 dialogs during the experiment. Images were also registered to 65% of the postings. The most posted category is related to “animation, video games, manga.” The system was subjected to open examination by tourist information staff who had no prior experience with spoken dialog systems. Based on their impressions of tourist use of the dialog system, they shortened the length of some of the system’s responses and added pauses to the longer responses to make them easier to understand

MMDAE : Dialog scenario editor for MMDAgent on the web browser

We have developed MMDAgent (a fully open-source toolkit for voice interaction systems), which runs on a variety of platforms such as personal computers and smartphones. From this, the editing environment of the dialog scenario also needs to be operated on various platforms. So, we develop a scenario editor that is implemented on a Web browser. The purpose of this paper also includes making it easy to edit the scenario. Experiments were conducted for subjects using the proposed scenario editor. It was found that our proposed system provides better readability of a scenario and allows easier editing

Applications of the new Remote Sensing Method to the Forest Biomass Estimation

For accurate measurement of forest biomass in the Akazawa Forest Reserve, this study analyzed texture measures derived from GeoEye-1 satellite data using the individual tree crown (ITC) method. On this basis, canopy area, tree tops and tree species of individual trees were delineated. Canopy area was used to calculate the DBH of trees in canopy layer based on canopy-DBH curve in this stand. In this study, the estimation models, between DBH and height, and between canopy area and DBH were developed by linear regression using forest survey data. Then according to the results of satellite data interpreted the biomass of every tree was calculated by biomass expansion factor (BEF). This method was verified against the survey data from old–growth Chamaecyparis obtusa stand composed of various cover types. For Chamaecyparis obtusa, the accuracy of biomass estimation was higher than 84%. However, the accuracy of Chamaecyparis pisifera was less than 60%, because some Chamaecyparis pisifera trees were misidentified as Chamaecyparis obtusa, and canopy area of Chamaecyparis pisifera was underestimated in the high-density stand. For Thujopsis dolabrata, the accuracy ranged from 22.4 % to 78.9%, and from 63.4% to 84.6% for broad-leaved trees, because many of them were understory. These results indicated that estimation of old-growth forest biomass based on high resolution satellite data, might be validated for estimating biomass at the individual tree level improved by developing and applying forest stratum–specific models with the ITC-survey data as a bridging reference in addition to spectral information. This approach is useful for biomass estimation whether is used to calculate biomass of individual tree or forest.ArticleThe International Journal of Sciences. 2(8):1-13 (2013)journal articl

Effect of Hemodialysis on Plasma Glucose Profile and Plasma Level of Liraglutide in Patients with Type 2 Diabetes Mellitus and End-Stage Renal Disease: A Pilot Study

The effect of hemodialysis on the plasma glucose profile and liraglutide level after liraglutide injection was investigated in patients with diabetes and end-stage renal disease (ESRD). Either 0.6 mg or 0.9 mg liraglutide was subcutaneously administered daily to 10 Japanese type 2 diabetic patients with ESRD. Hemodialysis was conducted on days 1 and 3. Plasma liraglutide and glucose concentrations were measured by enzyme-linked immunosorbent assay and a continuous glucose monitoring system, respectively. The safety profile of liraglutide was also assessed. Hemodialysis had no effect on the pharmacokinetic parameters of liraglutide in patients with diabetes and ESRD; the maximum plasma concentration (Cmax), tmax, area under the concentration-time curve (AUC), and CL/f were unaltered. Similarly, hemodialysis did not affect the mean or minimum glucose levels, AUC, or duration of hyperglycemia (>180 mg/dL) and hypoglycemia (<70 mg/dL) following liraglutide administration. However, significant increases in mean amplitude of glycemic excursions (MAGE) and standard deviation (SD) as markers of glucose fluctuation, and the maximum glucose level were observed during hemodialysis. No adverse events, including hypoglycemia, were observed after liraglutide injection, either off-hemodialysis (day 2) or on-hemodialysis (day 3). Liraglutide was well tolerated in patients with type 2 diabetes and ESRD undergoing hemodialysis. The present results suggested that hemodialysis did not affect the pharmacokinetic profile of liraglutide or most glycemic indices, with the exception of MAGE, SD, and the maximum glucose level. These results suggested that it may be possible to use liraglutide during hemodialysis for diabetes with ESRD, without dose adjustment. Trial Registration UMIN Clinical Trials Registry (UMIN-CTR) UMIN000010159.\ud \u

Large-cell neuroendocrine carcinoma of lung with epidermal growth factor receptor (EGFR) gene mutation and co-expression of adenocarcinoma markers: a case report and review of the literature

PURPOSE: A high rate of response to treatment with epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) has been observed in certain patients (women, of East Asian ethnicity, with non-smoking history and adenocarcinoma histology) with mutations in exons 18 to 21 of the tyrosine kinase domain of EGFR. Some cases of high-grade neuroendocrine carcinoma of the lung harboring mutations have been sporadically reported. METHODS: We describe the case of a 78-year-old woman with large-cell neuroendocrine carcinoma of the lung, with mutation in exon 21 L858R and co-expression of adenocarcinoma markers. RESULTS: A mass (3.0 cm in diameter) was identified in the inferior lobe of the left lung, accompanied by metastases into ipsilateral mediastinal lymph nodes and elevations of serum pro-gastrin-releasing peptide and carcinoembryonic antigen. Initial transbronchial brushing cytology suggested high-grade neuroendocrine carcinoma favoring small-cell carcinoma in poorly smeared and degenerated preparations, and revealed exon 21 L858R mutation. Re-enlargement of the cancer and bone metastases was observed after chemotherapy, and further testing suggested large-cell neuroendocrine carcinoma with immunoreactivity to markers of primary lung adenocarcinoma and L858R mutation. High-grade neuroendocrine carcinoma with mutations in the tyrosine kinase domain of EGFR may be associated with adenocarcinoma, as reviewed from the literature and may also apply to our case. CONCLUSIONS: EGFR-TKI could provide better quality of life and survival in patients with advanced or relapsed high-grade neuroendocrine carcinoma with EGFR gene mutations. Further studies in this respect are warranted