Inhaled insulin for controlling blood glucose in patients with diabetes

Diabetes mellitus is a significant worldwide health problem, with the incidence of type 2 diabetes increasing at alarming rates. Insulin resistance and dysregulated blood glucose control are established risk factors for microvascular complications and cardiovascular disease. Despite the recognition of diabetes as a major health issue and the availability of a growing number of medications designed to counteract its detrimental effects, real and perceived barriers remain that prevent patients from achieving optimal blood glucose control. The development and utilization of inhaled insulin as a novel insulin delivery system may positively influence patient treatment adherence and optimal glycemic control, potentially leading to a reduction in cardiovascular complications in patients with diabetes

Iso-singlet Down Quark Mixing And CP Violation Experiments

We confront the new physics models with extra iso-singlet down quarks in the new CP violation experimental era with $\sin{(2\beta)}$ and $\epsilon'/\epsilon$ measurements, $K^+ \to \pi^+ \nu \bar{\nu}$ events, and $x_s$ limits. The closeness of the new experimental results to the standard model theory requires us to include full SM amplitudes in the analysis. In models allowing mixing to a new isosinglet down quark, as in E$_6$, flavor changing neutral currents are induced that allow a $Z^0$ mediated contribution to $B-\bar B$ mixing and which bring in new phases. In $(\rho,\eta)$, $(x_s,\sin{(\gamma)})$, and $(x_s, \sin{(2\phi_s)})$ plots we still find much larger regions in the four down quark model than in the SM, reaching down to $\eta \approx 0$, $0 \leq \sin{(\gamma)} \leq 1$, $-.75 \leq \sin{(2\alpha)} \leq 0.15$, and $\sin{(2\phi_s)}$ down to zero, all at 1$\sigma$. We elucidate the nature of the cancellation in an order $\lambda^5$ four down quark mixing matrix element which satisfies the experiments and reduces the number of independent angles and phases. We also evaluate tests of unitarity for the $3\times3$ CKM submatrix.Comment: 14 pages, 16 figures, REVTeX

Insulin and glucose metabolism with olanzapine and a combination of olanzapine and samidorphan: Exploratory phase 1 results in healthy volunteers

A combination of olanzapine and samidorphan (OLZ/SAM) received US Food and Drug Administration approval in May 2021 for the treatment of adults with schizophrenia or bipolar I disorder. OLZ/SAM provides the efficacy of olanzapine, while mitigating olanzapine-associated weight gain. This exploratory study characterized the metabolic profile of OLZ/SAM in healthy volunteers to gain mechanistic insights. Volunteers received once-daily oral 10 mg/10 mg OLZ/SAM, 10 mg olanzapine, or placebo for 21 days. Assessments included insulin sensitivity during an oral glucose tolerance test (OGTT), hyperinsulinemic-euglycemic clamp, other measures of glucose/lipid metabolism, and adverse event (AE) monitoring. Treatment effects were estimated with analysis of covariance. In total, 60 subjects were randomized (double-blind; placebo, n = 12; olanzapine, n = 24; OLZ/SAM, n = 24). Olanzapine resulted in hyperinsulinemia and reduced insulin sensitivity during an OGTT at day 19, changes not observed with OLZ/SAM or placebo. Insulin sensitivity, measured by hyperinsulinemic-euglycemic clamp, was decreased in all treatment groups relative to baseline, but this effect was greatest with olanzapine and OLZ/SAM. Although postprandial (OGTT) glucose and fasting cholesterol concentrations were similarly increased with olanzapine or OLZ/SAM, other early metabolic effects were distinct, including post-OGTT C-peptide concentrations and aspects of energy metabolism. Forty-nine subjects (81.7%) experienced at least 1 AE, most mild or moderate in severity. OLZ/SAM appeared to mitigate some of olanzapine\u27s unfavorable postprandial metabolic effects (e.g., hyperinsulinemia, elevated C-peptide) in this exploratory study. These findings supplement the body of evidence from completed or ongoing OLZ/SAM clinical trials supporting its role in the treatment of schizophrenia and bipolar I disorder

Effect of 6-months of physical exercise on the nitrate/nitrite levels in hypertensive postmenopausal women

<p>Abstract</p> <p>Background</p> <p>Evidences have showed that the incidence of arterial hypertension is greater in postmenopausal women as compared to premenopausal. Physical inactivity has been implicated as a major contributor to weight gain and abdominal obesity in postmenopausal women and the incidence of cardiovascular disease increases dramatically after menopause. Additionally, more women than men die each year of coronary heart disease and are twice as likely as men to die within the first year after a heart attack. A healthy lifestyle has been strongly associated with the regular physical activity and evidences have shown that physically active subjects have more longevity with reduction of morbidity and mortality. Nitric oxide (NO) produced by endothelial cells has been implicated in this beneficial effect with improvement of vascular relaxing and reduction in blood pressure in both laboratory animals and human. Although the effect of exercise training in the human cardiovascular system has been largely studied, the majority of these studies were predominantly conducted in men or young volunteers. Therefore, the aim of this work was to investigate the effects of 6 months of dynamic exercise training (ET) on blood pressure and plasma nitrate/nitrite concentration (NOx^-) in hypertensive postmenopausal women.</p> <p>Methods</p> <p>Eleven volunteers were submitted to the ET consisting in 3 days a week, each session of 60 minutes during 6 months at moderate intensity (50% of heart rate reserve). Anthropometric parameters, blood pressure, NOx^-concentration were measured at initial time and after ET.</p> <p>Results</p> <p>A significant reduction in both systolic and diastolic blood pressure values was seen after ET which was accompanied by markedly increase of NOx^-levels (basal: 10 ± 0.9; ET: 16 ± 2 μM). Total cholesterol was significantly reduced (basal: 220 ± 38 and ET: 178 ± 22 mg/dl), whereas triglycerides levels were not modified after ET (basal: 141 ± 89 and ET: 147 ± 8 mg/dl).</p> <p>Conclusion</p> <p>Our study shows that changing in lifestyle promotes reduction of arterial pressure which was accompanied by increase in nitrite/nitrate concentration. Therefore, 6-months of exercise training are an important approach in management arterial hypertension and play a protective effect in postmenopausal women.</p

End of life care: The experiences of advance care planning amongst family caregivers of people with advanced dementia - A qualitative study

Background: End of life decisions for people with advanced dementia are reported as often being difficult for families as they attempt to make appropriate and justified decisions. Aim: To explore the experiences of advance care planning amongst family caregivers of people with advanced dementia. Design: Qualitative research including a series of single cases (close family relatives). Methods: A purposive sample of 12 family caregivers within a specialist dementia unit was interviewed about their experiences of advance care planning between August 2009 and February 2010. Results/Findings: Family caregivers need encouragement to ask the right questions during advance care planning to discuss the appropriateness of nursing and medical interventions at the end of life. Conclusions: Advance care planning can be facilitated with the family caregiver in the context of everyday practice within the nursing home environment for older people with dementia

Generation tourism: towards a common identity

The purpose of this article is to highlight the implications of the indiscipline of tourism academia for a new generation of tourism academics. Generation Tourism is characterised by scholars with a multi-disciplinary education associated with a broad field of study and commonly considered to lack the advantages of a discipline-focused education with its strong theoretical and methodological foundations. The problem this article addresses relates to how new generations of scholars and their views on knowledge creation achieve ascendancy in ways that move on from existing paradigms and earlier cohorts of scholars. Our main argument is that Generation Tourism scholars would benefit from a more clearly developed and common academic identity. To begin the critical conversation around the identity of Generation Tourism we outline five possible points of departure. These points are: (1) learning from historical developments in parent disciplines; (2) spearheading inter-disciplinary scholarship; (3) working towards theoretical developments; (4) embracing mediating methodologies and (5) forming tourism nodes and networks. Recognising these as starting points rather than final statements, we hope that the conversation about Generation Tourism identity will continue in other forums

Direct Measurement of the Pseudoscalar Decay Constant fD+

The absolute branching fraction of $D^+ \to \mu^+ \nu$ has been directly measured by an analysis of a data sample of about 33 ${\rm pb^{-1}}$ collected around $\sqrt{s}=3.773$ GeV with the BES-II at the BEPC. At these energies, $D^-$ meson is produced in pair as $e^+e^-\to D^{+} D^{-}$. A total of $5321 \pm 149 \pm 160$ $D^-$ mesons are reconstructed from this data set. In the recoil side of the tagged $D^-$ mesons, $2.67\pm1.74$ purely leptonic decay events of $D^+ \to \mu^+ \nu$ are observed. This yields a branching fraction of $BF(D^+ \to \mu^+ \nu_{\mu}) = (0.122^{+0.111}_{-0.053}\pm 0.010)$, and a corresponding pseudoscalar decay constant $f_{D^+}=(371^{+129}_{-119}\pm 25)$ MeV.Comment: 7 pages, 8 figures, Submitted to Physics Letters B in October, 200

Regional patterns of U.S. household carbon emissions

Market-based policies to address fossil fuel-related externalities including climate change typically operate by raising the price of those fuels. Increases in energy prices have important consequences for a typical U.S. household that spent almost $4,000 per year on electricity, fuel oil, natural gas, and gasoline in 2005. A key question for policymakers is how these consequences vary over different regions and subpopulations across the country—especially as adjustment and compensation programs are designed to protect more vulnerable regions. To answer this question, we use non-publicly available data from the U.S. Consumer Expenditure Survey over the period 1984–2000 to estimate long-run geographic variation in household use of electricity, fuel oil, natural gas, and gasoline, as well as the associated incidence of a$10 per ton tax on carbon dioxide (ignoring behavioral response). We find substantial variation: incidence from the tax range from $97 dollars per year per household in New York County, New York to$235 per year per household in Tensas Parish, Louisiana. This variation can be explained by differences in energy use, carbon intensity of electricity generation, and electricity regulation