Changes in endotoxin levels in T2DM subjects on anti-diabetic therapies

Introduction Chronic low-grade inflammation is a significant factor in the development of obesity associated diabetes. This is supported by recent studies suggesting endotoxin, derived from gut flora, may be key to the development of inflammation by stimulating the secretion of an adverse cytokine profile from adipose tissue. Aims The study investigated the relationship between endotoxin and various metabolic parameters of diabetic patients to determine if anti-diabetic therapies exerted a significant effect on endotoxin levels and adipocytokine profiles. Methods Fasting blood samples were collected from consenting Saudi Arabian patients (BMI: 30.2 ± (SD)5.6 kg/m2, n = 413), consisting of non-diabetics (ND: n = 67) and T2DM subjects (n = 346). The diabetics were divided into 5 subgroups based on their 1 year treatment regimes: diet-controlled (n = 36), metformin (n = 141), rosiglitazone (RSG: n = 22), a combined fixed dose of metformin/rosiglitazone (met/RSG n = 100) and insulin (n = 47). Lipid profiles, fasting plasma glucose, insulin, adiponectin, resistin, TNF-α, leptin, C-reactive protein (CRP) and endotoxin concentrations were determined. Results Regression analyses revealed significant correlations between endotoxin levels and triglycerides (R2 = 0.42; p < 0.0001); total cholesterol (R2 = 0.10; p < 0.001), glucose (R2 = 0.076; p < 0.001) and insulin (R2 = 0.032; p < 0.001) in T2DM subjects. Endotoxin showed a strong inverse correlation with HDL-cholesterol (R2 = 0.055; p < 0.001). Further, endotoxin levels were elevated in all of the treated diabetic subgroups compared with ND, with the RSG treated diabetics showing significantly lower endotoxin levels than all of the other treatment groups (ND: 4.2 ± 1.7 EU/ml, RSG: 5.6 ± 2.2 EU/ml). Both the met/RSG and RSG treated groups had significantly higher adiponectin levels than all the other groups, with the RSG group expressing the highest levels overall. Conclusion We conclude that sub-clinical inflammation in T2DM may, in part, be mediated by circulating endotoxin. Furthermore, that whilst the endotoxin and adipocytokine profiles of diabetic patients treated with different therapies were comparable, the RSG group demonstrated significant differences in both adiponectin and endotoxin levels. We confirm an association between endotoxin and serum insulin and triglycerides and an inverse relationship with HDL. Lower endotoxin and higher adiponectin in the groups treated with RSG may be related and indicate another mechanism for the effect of RSG on insulin sensitivity

Parenteral Phosphate and Amino Acids Supply Effect on the Growth of Extremely Preterm Infants: Accurate Measurements and Optimized Statistical Analysis are Important

info:eu-repo/semantics/publishedVersio

Rewarding the quantity of peer review could harm biomedical research

Voluntary peer review is generally provided by researchers as a duty or service to their disciplines. They commit their expertise, knowledge and time freely without expecting rewards or compensation. Peer review can be perceived as a reciprocal mission that aims to safeguard the quality of publications by helping authors improve their manuscripts. While voluntary peer review adds value to research, rewarding the quantity or the volume of peer review is likely to lure academics into providing poor quality peer review. Consequently, the quantity of peer review may increase, but at the expense of quality, which may lead to unintended consequences and might negatively affect the quality of biomedical publications. This paper aims to present evidence that while voluntary peer review may aid researchers, pressurized peer review may create a perverse incentive that negatively affects the integrity of the biomedical research record. We closely examine one of the proposed models for rewarding peer review based on the quantity of peer review reports. This article also argues that peer review should remain a voluntary mission, and should not be prompted by the need to attain tenure or promotion

Dengue encephalopathy or encephalitis? You decide

Awareness of neurological sequelae of dengue fever is increasing. However, as this case illustrates, there is a diagnostic conundrum in determining whether certain features are in keeping with dengue encephalopathy, or dengue encephalitis. Further consensus is required

Technical, Economic and Sustainability Considerations of a Solar PV Mini Grid as a Tool for Rural Electrification in Uganda

The challenges facing rural electrification in Uganda are diverse with less than 3% of the rural population having access to electricity. The establishment of mini-grids powered by renewable energy sources makes it possible to electrify remote areas at affordable rates. In this study, an assessment of a solar PV mini-grid system to provide electricity to forty households in rural Uganda was carried out. The considered system comprised six solar modules each rated 175 Wp, a controller, off-grid inverter and batteries with a capacity of 600 Ah. Manufactured by SMA, the Sunny Island inverter proposed for the mini-grid would ensure provision of grid-quality electricity. The study aimed to investigate the mini-grid’s technical design with focus on optimal distribution against constraints of voltage drops, electrical losses and increasing load. Customised load limiters shared between households using thermistors were included to reduce costs and limit consumption. The incomes of rural households are often seasonal and thus issues pertaining to affordability and sustainability were also considered. Results of the economic analysis showed a payback period of less than 5 years given an affordable fixed monthly tariff for the case study area

Benefits of using biogas in households experience from a user in Uganda

A Sendegeya, P J M Ssebuwufu and I P da SilvaMakerere University and Ssebuwufu AssociatesThis paper discusses the socio-economic benefits of using biogas based on the experience of a long term user as a typical example. A floating drum type of digester was installed with a capacity of 6.5 m3 in the year 2000 at a total cost of US$1,830. The gas generated is used exclusively for cooking. For the user, his typical kitchen day consists of three meals for a household of 8 people. Prior to the installation of the biogas plant, the user was using liquefied petroleum gas (LPG) supplied in 15 kg cylinders at an average cost of US$ 23 per cylinder and used to consume an average of 3 cylinders in 2 months bringing a monthly expenditure on the kitchen fuel of US$35 including transport costs for the cylinder. The user has now totally substituted LPG with biogas which translates into an annual average saving of US$ 420. At this rate of saving, the break-even point for the full recovery of the installation costs is about five years. Since installation the digester has not had any significant breakdown, so no major maintenance has been required. The water used for mixing the cow dung into slurry is harvested rainwater. Thus according to his experience it indicates that the use of biogas offers a substantial cost saving on domestic energy. In addition to the economic benefits, other benefits include increased organic agricultural production when the sludge is used as fertiliser. The use of the slurry as bio-fertiliser on his small vegetable farm (about 0.5 ha), has helped him to save money that would have been used to buy the imported artificial fertilisers. Fermenting the cow dung in a biogas digester instead of composting it in open air provides several other advantages, ranging from a foul odour-free environment to improvements in the general health conditions in the home. Thus, a reduction in the unhealthy smell from the compost dumps where the cow dung used to be deposited, as well as a reduction in free methane gas (one of the green house gases, GHG) which used to be emitted direct into the atmosphere by the decomposing dung.This paper discusses the socio-economic benefits of using biogas based on the experience of a long term user as a typical example. A floating drum type of digester was installed with a capacity of 6.5 m3 in the year 2000 at a total cost of US$1,830. The gas generated is used exclusively for cooking. For the user, his typical kitchen day consists of three meals for a household of 8 people. Prior to the installation of the biogas plant, the user was using liquefied petroleum gas (LPG) supplied in 15 kg cylinders at an average cost of US$ 23 per cylinder and used to consume an average of 3 cylinders in 2 months bringing a monthly expenditure on the kitchen fuel of US$35 including transport costs for the cylinder. The user has now totally substituted LPG with biogas which translates into an annual average saving of US$ 420. At this rate of saving, the break-even point for the full recovery of the installation costs is about five years. Since installation the digester has not had any significant breakdown, so no major maintenance has been required. The water used for mixing the cow dung into slurry is harvested rainwater. Thus according to his experience it indicates that the use of biogas offers a substantial cost saving on domestic energy. In addition to the economic benefits, other benefits include increased organic agricultural production when the sludge is used as fertiliser. The use of the slurry as bio-fertiliser on his small vegetable farm (about 0.5 ha), has helped him to save money that would have been used to buy the imported artificial fertilisers. Fermenting the cow dung in a biogas digester instead of composting it in open air provides several other advantages, ranging from a foul odour-free environment to improvements in the general health conditions in the home. Thus, a reduction in the unhealthy smell from the compost dumps where the cow dung used to be deposited, as well as a reduction in free methane gas (one of the green house gases, GHG) which used to be emitted direct into the atmosphere by the decomposing dung