Likelihood of ‘falling through the net’ relates to contemporary prevalence of gestational diabetes. Reply to Ikomi A, Mannan S, Anthony R, Kiss S

This project was not supported by any specific funding. Claire Meek receives salary funding from the European Union Seventh Framework Programme (FP7/2007-2013; grant agreement n° 266408) and from the Wellcome Trust Translational Medicine and Therapeutics Programme which is funded by the Wellcome Trust in association with Glaxo SmithKline.This is the author accepted manuscript. The final version is available from Springer via http://dx.doi.org/10.1007/s00125-015-3737-

Expected values for gastrointestinal and pancreatic hormone concentrations in healthy volunteers in the fasting and postprandial state.

BACKGROUND: Gastrointestinal hormones regulate intestinal transit, control digestion, influence appetite and promote satiety. Altered production or action of gut hormones, including glucagon-like peptide-1 (GLP-1), glucose-dependent insulinotropic polypeptide (GIP) and peptide YY (PYY), may contribute to the biological basis of obesity and altered glucose homeostasis. However, challenges in analytical methodology and lack of clarity on expected values for healthy individuals have limited progress in this field. The aim of this study was to describe expected concentrations of gastrointestinal and pancreatic hormones in healthy volunteers following a standardized meal test (SMT) or 75 g oral glucose tolerance test (OGTT). METHODS: A total of 28 healthy volunteers (12 men, 16 women; mean age 31.3 years; mean body mass index 24.9 kg/m2) were recruited to attend a hospital clinic on two occasions. Volunteers had blood sampling in the fasting state and were given, in randomized order, an oral glucose tolerance test (OGTT) and standardized mixed liquid meal test with venepuncture at timed intervals for 4 h after ingestion. Analytical methods for gut and pancreatic hormones were assessed and optimized. Concentrations of gut and pancreatic hormones were measured and used to compile ranges of expected values. RESULTS: Ranges of expected values were created for glucose, insulin, glucagon, GLP-1, GIP, PYY and free fatty acids in response to a standardized mixed liquid meal or OGTT. Intact proinsulin and C-peptide levels were also measured following the OGTT. CONCLUSIONS: These ranges of expected values can now be used to compare gut hormone concentrations between healthy individuals and patient groups

Integration of HIV Care with Primary Health Care Services: Effect on Patient Satisfaction and Stigma in Rural Kenya.

HIV departments within Kenyan health facilities are usually better staffed and equipped than departments offering non-HIV services. Integration of HIV services into primary care may address this issue of skewed resource allocation. Between 2008 and 2010, we piloted a system of integrating HIV services into primary care in rural Kenya. Before integration, we conducted a survey among returning adults ≥18-year old attending the HIV clinic. We then integrated HIV and primary care services. Three and twelve months after integration, we administered the same questionnaires to a sample of returning adults attending the integrated clinic. Changes in patient responses were assessed using truncated linear regression and logistic regression. At 12 months after integration, respondents were more likely to be satisfied with reception services (adjusted odds ratio, aOR 2.71, 95% CI 1.32-5.56), HIV education (aOR 3.28, 95% CI 1.92-6.83), and wait time (aOR 1.97 95% CI 1.03-3.76). Men's comfort with receiving care at an integrated clinic did not change (aOR = 0.46 95% CI 0.06-3.86). Women were more likely to express discomfort after integration (aOR 3.37 95% CI 1.33-8.52). Integration of HIV services into primary care services was associated with significant increases in patient satisfaction in certain domains, with no negative effect on satisfaction

Likelihood of 'falling through the net' relates to contemporary prevalence of gestational diabetes. Reply to Ikomi A, Mannan S, Anthony R, Kiss S [letter].

This project was not supported by any specific funding. Claire Meek receives salary funding from the European Union Seventh Framework Programme (FP7/2007-2013; grant agreement n° 266408) and from the Wellcome Trust Translational Medicine and Therapeutics Programme which is funded by the Wellcome Trust in association with Glaxo SmithKline.This is the author accepted manuscript. The final version is available from Springer via http://dx.doi.org/10.1007/s00125-015-3737-

The effect of encapsulated glutamine on gut peptide secretion in human volunteers.

CONTEXT: Weight loss and improved blood glucose control after bariatric surgery have been attributed in part to increased ileal nutrient delivery with enhanced release of glucagon-like peptide 1 (GLP-1). Non-surgical strategies to manage obesity are required. The aim of the current study was to assess whether encapsulated glutamine, targeted to the ileum, could increase GLP-1 secretion, improve glucose tolerance or reduce meal size. METHODS: A single-center, randomised, double blind, placebo-controlled, cross-over study was performed in 24 healthy volunteers and 8 patients with type 2 diabetes. Fasting participants received a single dose of encapsulated ileal-release glutamine (3.6 or 6.0 g) or placebo per visit with blood sampling at baseline and for 4h thereafter. Glucose tolerance and meal size were studied using a 75 g oral glucose tolerance test and ad libitum meal respectively. RESULTS: In healthy volunteers, ingestion of 6.0 g glutamine was associated with increased GLP-1 concentrations after 90 min compared with placebo (mean 10.6 pg/ml vs 6.9 pg/ml, p=0.004), increased insulin concentrations after 90 min (mean 70.9 vs 48.5, p=0.048), and increased meal size at 120 min (mean 542 g eaten vs 481 g, p=0.008). Ingestion of 6.0 g glutamine was not associated with significant differences in GLP-1, glucose or insulin concentrations after a glucose tolerance test in healthy or type 2 diabetic participants. CONCLUSIONS: Single oral dosing of encapsulated glutamine did not provoke consistent increases in GLP-1 and insulin secretion and was not associated with beneficial metabolic effects in healthy volunteers or patients with type 2 diabetes.This project was supported by a project grant from the European Union Seventh Framework Programme (FP7/2007-2013; grant agreement n° 266,408) as part of a larger collaboration called Full4Health. Claire Meek receives salary funding from the Wellcome Trust Translational Medicine and Therapeutics Programme which is funded by the Wellcome Trust in association with Glaxo SmithKline. FMG and FR were funded by the Wellcome Trust (WT088357/Z/09/Z and WT084210/Z/07/Z.)This is the author accepted manuscript. The final version is available from Elsevier via http://dx.doi.org/10.1016/j.peptides.2015.10.00

All the colours of the rainbow.

Our perception of colour has always been a source of fascination, so it's little wonder that studies of the phenomenon date back hundreds of years. What, though, can modern scientists learn from medieval literature — and how do we go about it

A comparative study of WASP-67b and HAT-P-38b from WFC3 data

Atmospheric temperature and planetary gravity are thought to be the main parameters affecting cloud formation in giant exoplanet atmospheres. Recent attempts to understand cloud formation have explored wide regions of the equilibrium temperature-gravity parameter space. In this study, we instead compare the case of two giant planets with nearly identical equilibrium temperature ($T_\mathrm{eq}$ $\sim 1050 \, \mathrm{K}$) and gravity ($g \sim 10 \, \mathrm{m \, s}^{-1})$. During $HST$ Cycle 23, we collected WFC3/G141 observations of the two planets, WASP-67 b and HAT-P-38 b. HAT-P-38 b, with mass 0.42 M$_\mathrm{J}$ and radius 1.4 $R_\mathrm{J}$, exhibits a relatively clear atmosphere with a clear detection of water. We refine the orbital period of this planet with new observations, obtaining $P = 4.6403294 \pm 0.0000055 \, \mathrm{d}$. WASP-67 b, with mass 0.27 M$_\mathrm{J}$ and radius 0.83 $R_\mathrm{J}$, shows a more muted water absorption feature than that of HAT-P-38 b, indicating either a higher cloud deck in the atmosphere or a more metal-rich composition. The difference in the spectra supports the hypothesis that giant exoplanet atmospheres carry traces of their formation history. Future observations in the visible and mid-infrared are needed to probe the aerosol properties and constrain the evolutionary scenario of these planets.Comment: 16 pages, 17 figures, 8 tables, accepted for publication in The Astronomical Journa

Evaluation of the n-alkane technique for estimating herbage dry matter intake of dairy cows offered herbage harvested at two different stages of growth in summer and autumn

peer-reviewedThe n-alkane technique for estimating herbage dry matter intake (DMI) of dairy cows was investigated in this experiment. Eight Holstein-Friesian dairy cows were offered perennial ryegrass ad libitum that had been harvested at two different herbage masses and during two different seasons, in order to assess the effect of herbage mass and season on the accuracy of the n-alkane technique. Two pre-harvested herbage mass treatments (low, target 1500 kg DM/ha versus high, target 4000 kg DM/ha, measured above 4 cm), were investigated in a crossover factorial arrangement within each of two seasons (summer versus autumn), in Ireland. Each season consisted of two periods, each 12 days in length. Cows were housed in individual metabolism stalls to allow for accurate determination of measured DMI. Herbage DMI was estimated, with the n-alkane technique, by dosing cows twice daily with a C32 n-alkane. Pre-harvest herbage mass and season did not affect the n-alkane estimated DMI, although lack of season and herbage mass effects may have been masked by variation that occurred between swards within the same herbage mass and season. However, there were a number of differences between summer and autumn in the fecal recovery rates of a number of n-alkanes suggesting that the effect of season requires further investigation prior to the application of recovery rates from literature values when investigating diet selection and botanical composition. Overall, the n-alkane technique provided good estimates of DMI; the discrepancy had a standard deviation due to sward of 1.2 and 1.0 kg DM/cow per day, and hence potential bias of up to twice this, and a measurement error standard deviation of 1.3 and 1.0 kg DM/cow per day, for the C33/C32 and C31/C32 n-alkane pair methods respectively. Two n-alkane pairs were tested, and C33/C32 n-alkane provided the most precise estimates of DMI, compared with the C31/C32 n-alkane pair. This research provides some strong evidence for future use of the n-alkane technique including that the accuracy of the technique has not been influenced by contemporary changes to herbage management, is not affected by seasonal changes, and overall is an accurate and precise technique for estimating DMI.This research was funded by Teagasc Core Funding (Ireland) and the Irish Dairy Levy Research fund (Ireland). The Department of Economic Development, Jobs, Transport and Resources (Australia), Dairy Australia (Australia) and The University of Melbourne (Australia) supported the travel costs in order to conduct this research

Expected values for gastrointestinal and pancreatic hormone concentrations in healthy volunteers in the fasting and postprandial state

Background: Gastrointestinal hormones regulate intestinal transit, control digestion, influence appetite and promote satiety. Altered production or action of gut hormones, including glucagon-like peptide-1 (GLP-1), glucose-dependent insulinotropic polypeptide (GIP) and peptide YY (PYY), may contribute to the biological basis of obesity and altered glucose homeostasis. However, challenges in analytical methodology and lack of clarity on expected values for healthy individuals have limited progress in this field. The aim of this study was to describe expected concentrations of gastrointestinal and pancreatic hormones in healthy volunteers following a standardized meal test (SMT) or 75 g oral glucose tolerance test (OGTT). Methods: A total of 28 healthy volunteers (12 men, 16 women; mean age 31.3 years; mean body mass index 24.9 kg/m2) were recruited to attend a hospital clinic on two occasions. Volunteers had blood sampling in the fasting state and were given, in randomized order, an oral glucose tolerance test (OGTT) and standardized mixed liquid meal test with venepuncture at timed intervals for 4 h after ingestion. Analytical methods for gut and pancreatic hormones were assessed and optimized. Concentrations of gut and pancreatic hormones were measured and used to compile ranges of expected values. Results: Ranges of expected values were created for glucose, insulin, glucagon, GLP-1, GIP, PYY and free fatty acids in response to a standardized mixed liquid meal or OGTT. Intact proinsulin and C-peptide levels were also measured following the OGTT. Conclusions: These ranges of expected values can now be used to compare gut hormone concentrations between healthy individuals and patient groups