Postprandial Hypotension due to a Lack of Sympathetic Compensation in Patients with Diabetes Mellitus.

Postprandial hypotension is an important hemodynamic abnormality in diabetes mellitus, but few reports are available on the relationship between autonomic dysfunction and postprandial hypotension. Ten diabetic patients and 10 healthy volunteers were recruited for this study. Postural blood pressure and heart rate changes were measured before lunch, and then the hemodynamic responses to a standardized meal were investigated. Holter electrocardiogram (ECG) monitoring was conducted for assessing spectral powers and time-domain parameters of RR variations. Postural changes from the supine to the upright position decreased the systolic blood pressure of the diabetics from 133(+-)16 to 107(+-)20 mmHg (p<0.01), but did not decrease the systolic blood pressure of the controls. The heart rate remained constant in the diabetics but was increased in the controls. Food ingestion decreased systolic blood pressure in the diabetics, with a maximum reduction of 25(+-)5 mmHg. This decrease was not associated with any changes in the ratio of low frequency to high frequency, and yet the heart rate remained almost constant. Indexes involving parasympathetic tone were not affected. Food ingestion did not affect blood pressure in the control group. These findings suggest that lack of compensatory sympathetic activation is a factor contributing to postprandial hypotension in diabetics, and that parasympathetic drive does not make a significant contribution to this condition

lithological and mineralogical investigations

The thesis contains 6 chapter and mentions about the influences of sea level change, climate, tectonic into the sedimentary process. The results show that late Pleistocene facies mostly are weathered facies which content gibbsite-kaolinite, limonite. In transgression, facies assemblage includes lagoon, tidal and estuary. The composition are in-situ reworked minerals like illite, gypsum. In regression, facies are shallow marine, prodelta, delta front, distributary lobe, swamp, tidal and beach, channel infill, flood plain, lake. Abundant minerals are named like smectite, illite, chlorite, quartz, feldspar, rock fragments, gypsum.Gypsum is the evaporited mineral easily to be formed in coastal environment of Red River Delta. It is a good indicative mineral for distinguishing the deposits formed in dry season of monsoon regions. Smectite is good indicative mineral for sea environment which mostly related with the transference and low accumulation and new formed in climate with wet and dry periods. Kaolinite-gibbsite is an indicator of strong chemical weathering with high precipitation. The stratigraphy can be divide into trangressive systems tract (10-8.5 cal. kyr BP) and highstand systems tract with aggradational-progradational parasequence set (8.5-6.5 cal. kyr BP) and progradational parasequence set (6.5 cal. kyr BP-today, with subsets 6.5-4.0; 4.0-1.5; and 1.5-0.0 cal. kyr BP). The subsidence process which reflex in accumulation rate regarded to not only sea level change, tectonics but also human impact - dyke build plays the main role to increased sedimentary thickness...Nordvietnam, Holocene sediment, Red River Delta, sea level changethesi

Production of an Amorphous Fe_<75>Si_<10>B_<15> Sheet by a Metallic Mold Casting Method and its Properties

The application of a metallic mold casting method to an Fe_Si_B_ alloy with the largest glass-forming ability in (Fe, Co, Ni)-Si-B system was found to cause the formation of a mostly single amorphous phase in a sheet form with a thickness of 0.1 mm. No distinct difference in thermal stability (crystallization temperature and heat of crystallization), hardness, Curie temperature and magnetization is detected between the as-cast sheet and the melt-spun amorphous ribbon with a thickness of 0.02 mm. On the other hand, bending ductility, heat of relaxation (ΔH_r) and coercivity (H_c) which can be regarded as structure sensitive properties are significantly different from those for the amorphous ribbon. That is, the sheet sample fractures during bending deformation and has a smaller ΔH_r and a larger H_c. The difference is induced presumably because the sheet sample has a more relaxed atomic configuration on a short-range scale as compared with that for the amorphous ribbon sample

Urban-rural linkages: Effective solutions for achieving sustainable development in Ghana from an SDG interlinkage perspective

Urbanization and concomitant challenges pose a great threat to sustainable development. Urban and rural development interacts through the flows of people, materials, energy, goods, capital, and information. Without building sound urban–rural linkages, achieving development in one area could compromise it in another area. Achieving sustainable development needs customized policy prioritization and implementation in both urban and rural areas. Much literature exists in the research field of urban–rural linkages, but little has been done via a comprehensive analysis from an interlinkage perspective in the context of the Sustainable Development Goals (SDGs). Sustainable Development Goal 11 on sustainable cities and several targets embedded under other Goals provides a good framework for analyzing the urban–rural linkages. This paper contributes to this novel research perspective using Ghana as a case. The study applied an integrated approach by combining the results from a solution-scanning exercise with an SDG interlinkage analysis to identify the challenges and priority solutions and assess the synergies and trade-offs of the identified solutions. It extends the conventional solution-scanning approach by further assessing the synergies and trade-offs of the solutions from an SDG interlinkage perspective. It also enables a more practical SDG interlinkage analysis through the contributions from the multi-stakeholder consultations conducted in Ghana. The analyses show that prioritizing gender inclusion (Goal 5) will positively affect many social and well-being outcomes, including poverty elimination (Goal 1), hunger reduction (Goal 2), health improvement (Goal 3) and access to quality education (Goal 4) and basic services, such as water (Goal 6). However, gender inclusion could have potential trade-offs in the agricultural sector (Goal 2) in the case that women who dominate agricultural value chains could move to work in other sectors. Lack of proper infrastructure (Goal 9), such as transport, will hinder wide gender inclusion. An integrated approach that considers both the synergies and trade-offs of relevant solutions is critical for effective policymaking, specifically in developing countries

The glycated albumin to HbA1c ratio is elevated in patients with fulminant type 1 diabetes mellitus with onset during pregnancy

Fulminant type 1 diabetes mellitus (FT1DM) develops as a result of very rapid and almost complete destruction of pancreatic β cell. The most common form of type 1 diabetes mellitus with onset during pregnancy has been shown to be FT1DM at least in Japan. We previously reported that the ratio of glycated albumin (GA) to HbA1c (GA/HbA1c ratio) is elevated in FT1DM patients at the diagnosis. In the present study, we investigated whether the GA/HbA1c ratio is also elevated in FT1DM with onset during pregnancy (P-FT1DM). The study subjects consisted of 7 patients with P-FT1DM. Ten patients with untreated type 2 diabetes mellitus (T2DM) discovered during pregnancy (P-T2DM) and 9 non-pregnant women with untreated T2DM (NP-T2DM) were used as controls. All study patients satisfied HbA1c<8.7%, the diagnostic criteria for FT1DM. The GA/HbA1c ratio in the P-FT1DM patients at the diagnosis was significantly higher than that in the P-T2DM patients and the NP-T2DM patients. The GA/HbA1c ratio was ≥3.0 in all P-FT1DM patients, whereas it was <3.0 in 8 of 10 P-T2DM patients and all NP-T2DM patients. The GA/HbA1c ratio was also elevated in P-FT1DM patients at the diagnosis compared with T2DM with or without pregnancy

Single nucleotide variations in CLCN6 identified in patients with benign partial epilepsies in infancy and/or febrile seizures

Nucleotide alterations in the gene encoding proline-rich transmembrane protein 2 (PRRT2) have been identified in most patients with benign partial epilepsies in infancy (BPEI)/benign familial infantile epilepsy (BFIE). However, not all patients harbor these PRRT2 mutations, indicating the involvement of genes other than PRRT2. In this study, we performed whole exome sequencing analysis for a large family affected with PRRT2-unrelated BPEI. We identified a non-synonymous single nucleotide variation (SNV) in the voltage-sensitive chloride channel 6 gene (CLCN6). A cohort study of 48 BPEI patients without PRRT2 mutations revealed a different CLCN6 SNV in a patient, his sibling and his father who had a history of febrile seizures (FS) but not BPEI. Another study of 48 patients with FS identified an additional SNV in CLCN6. Chloride channels (CLCs) are involved in a multitude of physiologic processes and some members of the CLC family have been linked to inherited diseases. However, a phenotypic correlation has not been confirmed for CLCN6. Although we could not detect significant biological effects linked to the identified CLCN6 SNVs, further studies should investigate potential CLCN6 variants that may underlie the genetic susceptibility to convulsive disorders.Toshiyuki Yamamoto, Keiko Shimojima, Noriko Sangu, Yuta Komoike, Atsushi Ishii, Shinpei Abe, Shintaro Yamashita, Katsumi Imai, Tetsuo Kubota, Tatsuya Fukasawa, Tohru Okanishi, Hideo Enoki, Takuya Tanabe, Akira Saito, Toru Furukawa, Toshiaki Shimizu, Carol J. Milligan, Steven Petrou, Sarah E. Heron, Leanne M. Dibbens, Shinichi Hirose, Akihisa Okumur

The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J-SSCG 2016)

Background and purposeThe Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J-SSCG 2016), a Japanese-specific set of clinical practice guidelines for sepsis and septic shock created jointly by the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine, was first released in February 2017 and published in the Journal of JSICM, [2017; Volume 24 (supplement 2)] https://doi.org/10.3918/jsicm.24S0001 and Journal of Japanese Association for Acute Medicine [2017; Volume 28, (supplement 1)] http://onlinelibrary.wiley.com/doi/10.1002/jja2.2017.28.issue-S1/issuetoc.This abridged English edition of the J-SSCG 2016 was produced with permission from the Japanese Association of Acute Medicine and the Japanese Society for Intensive Care Medicine.MethodsMembers of the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine were selected and organized into 19 committee members and 52 working group members. The guidelines were prepared in accordance with the Medical Information Network Distribution Service (Minds) creation procedures. The Academic Guidelines Promotion Team was organized to oversee and provide academic support to the respective activities allocated to each Guideline Creation Team. To improve quality assurance and workflow transparency, a mutual peer review system was established, and discussions within each team were open to the public. Public comments were collected once after the initial formulation of a clinical question (CQ) and twice during the review of the final draft. Recommendations were determined to have been adopted after obtaining support from a two-thirds (> 66.6%) majority vote of each of the 19 committee members.ResultsA total of 87 CQs were selected among 19 clinical areas, including pediatric topics and several other important areas not covered in the first edition of the Japanese guidelines (J-SSCG 2012). The approval rate obtained through committee voting, in addition to ratings of the strengths of the recommendation, and its supporting evidence were also added to each recommendation statement. We conducted meta-analyses for 29 CQs. Thirty-seven CQs contained recommendations in the form of an expert consensus due to insufficient evidence. No recommendations were provided for five CQs.ConclusionsBased on the evidence gathered, we were able to formulate Japanese-specific clinical practice guidelines that are tailored to the Japanese context in a highly transparent manner. These guidelines can easily be used not only by specialists, but also by non-specialists, general clinicians, nurses, pharmacists, clinical engineers, and other healthcare professionals

Beam and SKS spectrometers at the K1.8 beam line

High-resolution spectrometers for both incident beams and scattered particles have been constructed at the K1.8 beam line of the Hadron Experimental Facility at J-PARC. A point-to-point optics is realized between the entrance and exit of QQDQQ magnets for the beam spectrometer. Fine-pitch wire chamber trackers and hodoscope counters are installed in the beam spectrometer to accept a high rate beam up to 107 Hz. The superconducting kaon spectrometer for scattered particles was transferred from KEK with modifications to the cryogenic system and detectors. A missing-mass resolution of 1.9 ± 0.1 MeV/c2 (FWHM) was achieved for the ∑ peaks of (π±, K+) reactions on a proton target in the first physics run of E19 in 2010