2,375 research outputs found
Hyperinsulinemia and insulin resistance : What comes first ?
Background

1)	Classical explanation :
Classical explanation of diabetic pathophysiology states that obesity induced insulin resistance develops first and is followed by compensatory hyperinsulinnemia. Further insulin resistance leads to prolonged, increased secretary demand on beta cells leading to subsequent secondary beta cell failure, giving rise to hyperglycaemia and diabetes^2^.

2)	 Neurobehavioral origin hypothesis :
The Neurobehavioral origin hypothesis suggests that insulin resistance mediates a shift from muscle dependent (soldier) to brain dependent (diplomat) strategies of making a livelihood. If nutrient limitation affects intrauterine development, brain development is the least affected among all the organs^4,5^. As a result, in IUGR babies muscle weight is poor but the brain is relatively well developed. Such a person is more likely to be a successful diplomat rather than a soldier and insulin resistance is adaptive for such an individual^3^. Since insulin is involved in brain development and cognitive functions, higher levels of insulin are needed. As insulin is having strong anti-lipolytic effect, hyperinsulinnemia is followed by subsequent excess fat accumulation. Also compensatory insulin resistance is needed to avoid hypoglycemia. This hypothesis predicts a reverse order of pathophysiology i.e. primary hyperinsulinnemia followed by compensatory insulin resistance^3^

Objective-
To determine in diabetes whether hyperinsulinnemia develops first or insulin resistance develops first.

Methods :
We searched literature for studies that investigated directly or indirectly the sequence of development of hyperinsulinnemia and insulin resistance in humans and animal models from an early stage. Meta-analysis was conducted on published data.

Results-
1)	In low birth weight neonates in humans as well as in rat models, hyperinsulinnemia is found at very early stage.^6^
2)	Development of insulin resistance is preceded by hyperinsulinnemia in mice, rats as well as in humans.^7, 8^
3)	In normoglycaemic hyperinsulinemia state if insulin production is suppressed insulin sensitivity increases rapidly maintaining the normoglycaemic state.^9,10^
4)	Beta cell expansion beginning in intrauterine life is independent of glucose, Insulin and Insulin receptors.^6^


Conclusion-
All the four lines of evidence indicate that hyperinsulinnemia precedes insulin resistance supporting the predictions of neurobehavioral origin hypothesis over the orthodox view.



References :
1)	DeFronzo RA, Ferrannini E (1991). Diabetes Care 14:173-194
2)	Kruszynska YT, Olefsky JM (1996). J Investig Med 44: 413-428.
3)	Watve MG, Yajnik CY (2007). BMC Evolutionary Biology.7: 61-74.
 4) Winick M, Rosso P, Waterlow JC (1970). Exp Neurol, 26:393-400.
 5) Winick M. (1969) J Pediatr,74:667-679.
 6) Chakravarthy MV et.al. (2008) Diabetes, 57:2698-2707.
 7) Ramin A et. al. (1998) J Clin Endo and Met, 83 :1911-1915.
 8) Hansen BC (1990) Am J Physiol Regul Integr Comp Physiol 259: 612-617.
 9) Stanley L (1981) Life Sciences, 28: 1829-1840.
 10) Ratzmann KP et. al. (1983) Int J Obes, 7 : 453-458


Online Algorithms for Dynamic Matching Markets in Power Distribution Systems
This paper proposes online algorithms for dynamic matching markets in power
distribution systems, which at any real-time operation instance decides about
matching -- or delaying the supply of -- flexible loads with available
renewable generation with the objective of maximizing the social welfare of the
exchange in the system. More specifically, two online matching algorithms are
proposed for the following generation-load scenarios: (i) when the mean of
renewable generation is greater than the mean of the flexible load, and (ii)
when the condition (i) is reversed. With the intuition that the performance of
such algorithms degrades with increasing randomness of the supply and demand,
two properties are proposed for assessing the performance of the algorithms.
First property is convergence to optimality (CO) as the underlying randomness
of renewable generation and customer loads goes to zero. The second property is
deviation from optimality, is measured as a function of the standard deviation
of the underlying randomness of renewable generation and customer loads. The
algorithm proposed for the first scenario is shown to satisfy CO and a
deviation from optimal that varies linearly with the variation in the standard
deviation. But the same algorithm is shown to not satisfy CO for the second
scenario. We then show that the algorithm proposed for the second scenario
satisfies CO and a deviation from optimal that varies linearly with the
variation in standard deviation plus an offset
Signal Reconstruction via H-infinity Sampled-Data Control Theory: Beyond the Shannon Paradigm
This paper presents a new method for signal reconstruction by leveraging
sampled-data control theory. We formulate the signal reconstruction problem in
terms of an analog performance optimization problem using a stable
discrete-time filter. The proposed H-infinity performance criterion naturally
takes intersample behavior into account, reflecting the energy distributions of
the signal. We present methods for computing optimal solutions which are
guaranteed to be stable and causal. Detailed comparisons to alternative methods
are provided. We discuss some applications in sound and image reconstruction
Non-Pauli Transitions From Spacetime Noncommutativity
There are good reasons to suspect that spacetime at Planck scales is
noncommutative. Typically this noncommutativity is controlled by fixed
"vectors" or "tensors" with numerical entries. For the Moyal spacetime, it is
the antisymmetric matrix . In approaches enforcing Poincar\'e
invariance, these deform or twist the method of (anti-)symmetrization of
identical particle state vectors. We argue that the earth's rotation and
movements in the cosmos are "sudden" events to Pauli-forbidden processes. They
induce (twisted) bosonic components in state vectors of identical spinorial
particles in the presence of a twist. These components induce non-Pauli
transitions. From known limits on such transitions, we infer that the energy
scale for noncommutativity is . This suggests a
new energy scale beyond Planck scale.Comment: 11 pages, 1 table, Slightly revised for clarity
Nepalese trekking guides: A quantitative study of sexual health knowledge and sexual behaviour
Background: Tourism, a global industry, brings with it a number of public health problems, one of which is the spread of sexually transmitted infections transmitted between travellers and hosts. Previous studies have largely focused on sex workers and sex tourists. This study assesses sexual behaviour, knowledge and condom use among male trekking guides in Nepal. Methods: A self-administered questionnaire survey (n=324) was conducted using snowball sampling amongst men working as mountain trekking guides in Nepal. Results: Most respondents (59%) had initiated sex before the age of 18. Most (84 %) reported sexual relations with a woman other than their partner, 46% reported foreign partners, 43% had Nepalese partners, and 28% had concurrent foreign and Nepalese partners. Most (70 %) reported ever having sex with a foreign woman and two-thirds had had sexual intercourse with foreign women in the previous 12 months. Participantsā age, education status, age of first sex, smoking and drinking habits and English proficiency were significant predictors of having sex with foreign women. About 60% reported condom use during their most recent occasion of extra-martial sex. A similar proportion had used a condom during last sexual intercourse with a foreign woman. The likelihood of condom use was associated with a guideās age, educational level, ethnicity, age of first sex and work experience. Conclusions: Most trekking guides reported sexual relations with foreign women as well as irregular use of condoms. Although sexual health knowledge about among trekking guides is high, some misconceptions still result in unsafe sex. Hence there is an urgent need to revise the existing training for trekking guides and implement appropriate health promotion programmes
A Minimal Incentive-based Demand Response Program With Self Reported Baseline Mechanism
In this paper, we propose a novel incentive based Demand Response (DR)
program with a self reported baseline mechanism. The System Operator (SO)
managing the DR program recruits consumers or aggregators of DR resources. The
recruited consumers are required to only report their baseline, which is the
minimal information necessary for any DR program. During a DR event, a set of
consumers, from this pool of recruited consumers, are randomly selected. The
consumers are selected such that the required load reduction is delivered. The
selected consumers, who reduce their load, are rewarded for their services and
other recruited consumers, who deviate from their reported baseline, are
penalized. The randomization in selection and penalty ensure that the baseline
inflation is controlled. We also justify that the selection probability can be
simultaneously used to control SO's cost. This allows the SO to design the
mechanism such that its cost is almost optimal when there are no recruitment
costs or at least significantly reduced otherwise. Finally, we also show that
the proposed method of self-reported baseline outperforms other baseline
estimation methods commonly used in practice
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