Educational weight loss interventions in obese and overweight adults with type 2 diabetes : a systematic review and meta‐analysis of randomized controlled trials

Aim The worldwide prevalence of type 2 diabetes mellitus is increasing, with most individuals with the disease being overweight or obese. Weight loss can reduce disease‐related morbidity and mortality and weight losses of 10–15 kg have been shown to reverse type 2 diabetes. This review aimed to determine the effectiveness of community‐based educational interventions for weight loss in type 2 diabetes. Methods This is a systematic review and meta‐analysis of randomized controlled trials (RCT) in obese or overweight adults, aged 18–75 years, with a diagnosis of type 2 diabetes. Primary outcomes were weight and/or BMI. CINAHL, MEDLINE, Embase, Scopus and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched from inception to June 2019. Trials were classified into specified a priori comparisons according to intervention type. A pooled standardized mean difference (SMD) (from baseline to follow‐up) and 95% confidence intervals (95% CI) between trial groups (difference‐in‐difference) were estimated through random‐effects meta‐analyses using the inverse variance method. Heterogeneity was quantified using I2 and publication bias was explored visually using funnel plots. Results Some 7383 records were screened; 228 full‐text articles were assessed and 49 RCTs (n = 12 461 participants) were included in this review, with 44 being suitable for inclusion into the meta‐analysis. Pooled estimates of education combined with low‐calorie, low‐carbohydrate meal replacements (SMD = –2.48, 95% CI –3.59, –1.49, I2 = 98%) or diets (SMD = –1.25, 95% CI –2.11, –0.39, I2 = 95%) or low‐fat meal replacements (SMD = –1.15, 95%CI –2.05, –1.09, I2 = 85%) appeared most effective. Conclusion Low‐calorie, low‐carbohydrate meal replacements or diets combined with education appear the most promising interventions to achieve the largest weight and BMI reductions in people with type 2 diabetes

Mott physics, sign structure, ground state wavefunction, and high-Tc superconductivity

In this article I give a pedagogical illustration of why the essential problem of high-Tc superconductivity in the cuprates is about how an antiferromagnetically ordered state can be turned into a short-range state by doping. I will start with half-filling where the antiferromagnetic ground state is accurately described by the Liang-Doucot-Anderson (LDA) wavefunction. Here the effect of the Fermi statistics becomes completely irrelevant due to the no double occupancy constraint. Upon doping, the statistical signs reemerge, albeit much reduced as compared to the original Fermi statistical signs. By precisely incorporating this altered statistical sign structure at finite doping, the LDA ground state can be recast into a short-range antiferromagnetic state. Superconducting phase coherence arises after the spin correlations become short-ranged, and the superconducting phase transition is controlled by spin excitations. I will stress that the pseudogap phenomenon naturally emerges as a crossover between the antiferromagnetic and superconducting phases. As a characteristic of non Fermi liquid, the mutual statistical interaction between the spin and charge degrees of freedom will reach a maximum in a high-temperature "strange metal phase" of the doped Mott insulator.Comment: 12 pages, 12 figure

Saltation transport on Mars

We present the first calculation of saltation transport and dune formation on Mars and compare it to real dunes. We find that the rate at which grains are entrained into saltation on Mars is one order of magnitude higher than on Earth. With this fundamental novel ingredient, we reproduce the size and different shapes of Mars dunes, and give an estimate for the wind velocity on Mars.Comment: 4 pages, 3 figure

Minimal size of a barchan dune

Barchans are dunes of high mobility which have a crescent shape and propagate under conditions of unidirectional wind. However, sand dunes only appear above a critical size, which scales with the saturation distance of the sand flux [P. Hersen, S. Douady, and B. Andreotti, Phys. Rev. Lett. {\bf{89,}} 264301 (2002); B. Andreotti, P. Claudin, and S. Douady, Eur. Phys. J. B {\bf{28,}} 321 (2002); G. Sauermann, K. Kroy, and H. J. Herrmann, Phys. Rev. E {\bf{64,}} 31305 (2001)]. It has been suggested by P. Hersen, S. Douady, and B. Andreotti, Phys. Rev. Lett. {\bf{89,}} 264301 (2002) that this flux fetch distance is itself constant. Indeed, this could not explain the proto size of barchan dunes, which often occur in coastal areas of high litoral drift, and the scale of dunes on Mars. In the present work, we show from three dimensional calculations of sand transport that the size and the shape of the minimal barchan dune depend on the wind friction speed and the sand flux on the area between dunes in a field. Our results explain the common appearance of barchans a few tens of centimeter high which are observed along coasts. Furthermore, we find that the rate at which grains enter saltation on Mars is one order of magnitude higher than on Earth, and is relevant to correctly obtain the minimal dune size on Mars.Comment: 11 pages, 10 figure

Particle dynamics of a cartoon dune

The spatio-temporal evolution of a downsized model for a desert dune is observed experimentally in a narrow water flow channel. A particle tracking method reveals that the migration speed of the model dune is one order of magnitude smaller than that of individual grains. In particular, the erosion rate consists of comparable contributions from creeping (low energy) and saltating (high energy) particles. The saltation flow rate is slightly larger, whereas the number of saltating particles is one order of magnitude lower than that of the creeping ones. The velocity field of the saltating particles is comparable to the velocity field of the driving fluid. It can be observed that the spatial profile of the shear stress reaches its maximum value upstream of the crest, while its minimum lies at the downstream foot of the dune. The particle tracking method reveals that the deposition of entrained particles occurs primarily in the region between these two extrema of the shear stress. Moreover, it is demonstrated that the initial triangular heap evolves to a steady state with constant mass, shape, velocity, and packing fraction after one turnover time has elapsed. Within that time the mean distance between particles initially in contact reaches a value of approximately one quarter of the dune basis length

Effects of Mineral Nutrition on Components of Reproduction in Clarkia ungucilata

An experiment was conducted to determine the effects of nutritional level and flower location on factors related to flower, pollen, and ovule production, and to determine what developmental patterns would be modified to mediate any observed changes. Plants subjected to high nutrient levels developed larger leaves, more branches, more flowers on both the main stem and the branches, and opened their first flowers 6 days sooner than plants at lower levels of nutrients. Total flower number increased from 72.2 to 626.8 per plant, with most of the increase produced on the primary branches. The number of pollen grains in the entire androecium averaged 14,685, but significantly increased with higher nutrient levels and decreased with the stage of plant maturity (nodal position on the plant). The number of ovules also increased with nutrient level and decreased with maturity stage. Average ovule number decreased from about 129 in flowers at nodes produced early in the growth cycle to about 100 in flowers produced at later nodes. Despite highly significant plasticity in numbers of both pollen and ovules, the Pollen/Ovule Ratio (average 132.7) did not vary significantly with either nutrient level or plant maturity stage. Path analysis, which decomposes correlation coefficients into direct and indirect effects of factors influencing development, indicated that nutrient level had a very strong direct effect on the number of primary branches and on the number of primary-branch flowers, as well as very strong indirect effects on the latter. The primary-branch flowers directly determined over 67% of the total flower number, and indirectly determined about 24% jointly with secondary-branch flowers, and over 3% jointly with main-stem flowers. The direct effects of secondary-branch flowers and mainstem flowers were 3.8% and 0.3%, respectively. The relationship among components of yield is slightly additive. Direct determination of yield was 74.6% by the number of flowers per plant, 0.6% by the number of ovules per flower, 3.8% by the number of seeds per ovule, and 1.1 % by the weight per seed. The proportion of yield jointly determined by flower number and the developed seeds per ovule was 15.3%. It was concluded that allocation of resources increases to both male and female functions under conditions of high nutrient levels, and pollen/ovule ratios are consistent within a plant despite significant plasticity in numbers of pollen grains and ovules

Dune formation on the present Mars

We apply a model for sand dunes to calculate formation of dunes on Mars under the present Martian atmospheric conditions. We find that different dune shapes as those imaged by Mars Global Surveyor could have been formed by the action of sand-moving winds occuring on today's Mars. Our calculations show, however, that Martian dunes could be only formed due to the higher efficiency of Martian winds in carrying grains into saltation. The model equations are solved to study saltation transport under different atmospheric conditions valid for Mars. We obtain an estimate for the wind speed and migration velocity of barchan dunes at different places on Mars. From comparison with the shape of bimodal sand dunes, we find an estimate for the timescale of the changes in Martian wind regimes.Comment: 16 pages, 12 figure