Management of exercise-induced glycaemic imbalances in type 1 diabetes

Regular moderate-intensity exercise is strongly recommended for its beneficial effects in all people. In patients with type 1 diabetes, however, the exercise-associated glycemic imbalances remain an unresolved clinical challenge. Current guidelines require an in-depth understanding of the glycemic responses to exercise and each patient has to discover, by trial-and-error, his/her own strategy, several attempts being usually required to gain sufficient experience. Consequently, fear of hypoglycemia remains the strongest barrier to physical activity. This paper explores the potential strategies that may be employed to minimize the risk of exercise related glycemic imbalances. Moreover, a newly developed algorithm (ECRES, Exercise Carbohydrate Requirement Estimating Software) is described, which estimates on a patient-and situation-specific basis the glucose supplement required by the patient to maintain safe blood glucose levels. The algorithm was tested on 27 patients who performed three 1-hr constant intensity walks (each starting at a different time interval following insulin injection). Results showed that in 70.4% of the trials, independent of the time of day, the algorithm provided a satisfactory estimate of the carbohydrates needed by patients to complete the exercise with a glucose level within safe thresholds (i.e. 3.9 - 10 mmol\ub7L -1). Despite the algorithm requires further experimental testing to be applied by the majority of patients, these results indicate its potential usefulness as a tool for preventing immediate exercise-induced glycemic imbalances (i.e. during exercise) in type 1 diabetic patients, in particular for spontaneous activities not planned in advance, thus allowing all insulin-dependent patients to safely enjoy the benefits of exercise

Whole-body glucose oxidation rate during prolonged exercise in type 1 diabetic patients under usual life conditions

Objective Fuel oxidation during exercise was studied in type 1 insulin-dependent (T1DM) patients mainly under quite constant insulin and glycemia; these protocols, however, likely do not reflect patients' usual metabolic conditions. The glucose oxidation rate (GLUox) in T1DM patients under usual life conditions was thus investigated during prolonged exercise (3-h) and its behavior was described mathematically. Materials/Methods Whole-body GLUox was determined in eight T1DM patients (4/8 M; aged 35-59 years) and eight well-matched healthy subjects. Venous blood was drawn prior to and every 30 min until the end of exercise; glycemia, insulin, cortisol, and growth hormone concentrations were determined. Oxygen consumption, carbon dioxide production, and ventilation were measured at rest and thereafter every 30 min of the exercise. To prevent hypoglycemia, patients were given fruit fudge (93% sucrose) prior to / during exercise. Results Insulin concentration and glycemia were significantly higher in patients across the entire exercise period (group effect, p < 0.001 for both). GLUox decreased significantly with increasing exercise duration (time effect, p < 0.001), but no significant difference was detected between the two groups (group effect, p = NS). GLUox, expressed as the percentage of the starting value, was described by an exponential function showing a time constant of 90 min (n = 96; mean corrected R2 = 0.666). Conclusions GLUox in T1DM patients was not significantly different from the rate observed in the control subjects. The function describing the time course of GLUox may be useful to correct an estimated GLUox for the duration of exercise and help T1DM patients avoiding exercise-induced glycemic imbalances

Brazilian embauba (Cecropia pachystachya) extract reduces renal lesions in 5/6 nephrectomized rats

Introduction:Cecropia pachystachya (CP) is a plant rich in polyphenols which inhibits the angiotensin-converting enzyme (ACE) in vitro. Angiotensin II (AII) has an important role in the renal lesion provoked by 5/6 nephrectomy (NE). This study evaluated the CP extract effect on renal lesions provoked by 5/6 NE.Materials and methods: Male Wistar rats submitted to 5/6 NE were treated or not treated with CP extract and followed for 90 days. Systemic blood pressure (SBP), albuminuria, renal functional and structural parameters, ACE activity, urinary levels of monocyte chemoattrant protein-1 (MCP-1) and transforming growth factor (TGF-) were evaluated.Results: Albuminuria and hypertension were less intense in the treated (NE+CP) group compared to the untreated (NE) group. CP extract treatment reduced the fall in glomerular filtration rate observed in NE rats. Glomerulosclerosis, tubulointerstitial lesions, increase of macrophages and AII positive cells in the renal cortex, as well as increases in renal ACE activity, urinary levels of MCP-1 and TGF- were attenuated in NE rats by CP treatment.Conclusions: the treatment with CP extract reduced the SBP and functional and structural renal changes in 5/6 NE rats. These effects were associated with decreased AII expression, ACE activity and inflammation in the renal cortex.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Coordenacao de Aperfeicoamento de Pessoal do Nivel SuperiorUniv São Paulo, Dept Physiol, BR-14049900 São Paulo, BrazilUniv São Paulo, Dept Vet Med, BR-14049900 São Paulo, BrazilUniv São Paulo, Dept Pathol, BR-14049900 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Med, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Med, São Paulo, BrazilFAPESP: 11/50391-0Web of Scienc

Search for chargino-neutralino production with mass splittings near the electroweak scale in three-lepton final states in √s=13 TeV pp collisions with the ATLAS detector

A search for supersymmetry through the pair production of electroweakinos with mass splittings near the electroweak scale and decaying via on-shell W and Z bosons is presented for a three-lepton final state. The analyzed proton-proton collision data taken at a center-of-mass energy of √s=13  TeV were collected between 2015 and 2018 by the ATLAS experiment at the Large Hadron Collider, corresponding to an integrated luminosity of 139  fb−1. A search, emulating the recursive jigsaw reconstruction technique with easily reproducible laboratory-frame variables, is performed. The two excesses observed in the 2015–2016 data recursive jigsaw analysis in the low-mass three-lepton phase space are reproduced. Results with the full data set are in agreement with the Standard Model expectations. They are interpreted to set exclusion limits at the 95% confidence level on simplified models of chargino-neutralino pair production for masses up to 345 GeV

Search for new phenomena in final states with an energetic jet and large missing transverse momentum in pp collisions at √ s = 8 TeV with the ATLAS detector

Results of a search for new phenomena in final states with an energetic jet and large missing transverse momentum are reported. The search uses 20.3 fb−1 of √ s = 8 TeV data collected in 2012 with the ATLAS detector at the LHC. Events are required to have at least one jet with pT > 120 GeV and no leptons. Nine signal regions are considered with increasing missing transverse momentum requirements between Emiss T > 150 GeV and Emiss T > 700 GeV. Good agreement is observed between the number of events in data and Standard Model expectations. The results are translated into exclusion limits on models with either large extra spatial dimensions, pair production of weakly interacting dark matter candidates, or production of very light gravitinos in a gauge-mediated supersymmetric model. In addition, limits on the production of an invisibly decaying Higgs-like boson leading to similar topologies in the final state are presente

Measurement of the cross-section and charge asymmetry of WW bosons produced in proton-proton collisions at s=8\sqrt{s}=8 TeV with the ATLAS detector

This paper presents measurements of the $W^+ \rightarrow \mu^+\nu$ and $W^- \rightarrow \mu^-\nu$ cross-sections and the associated charge asymmetry as a function of the absolute pseudorapidity of the decay muon. The data were collected in proton--proton collisions at a centre-of-mass energy of 8 TeV with the ATLAS experiment at the LHC and correspond to a total integrated luminosity of 20.2~\mbox{fb^{-1}}. The precision of the cross-section measurements varies between 0.8% to 1.5% as a function of the pseudorapidity, excluding the 1.9% uncertainty on the integrated luminosity. The charge asymmetry is measured with an uncertainty between 0.002 and 0.003. The results are compared with predictions based on next-to-next-to-leading-order calculations with various parton distribution functions and have the sensitivity to discriminate between them.Comment: 38 pages in total, author list starting page 22, 5 figures, 4 tables, submitted to EPJC. All figures including auxiliary figures are available at https://atlas.web.cern.ch/Atlas/GROUPS/PHYSICS/PAPERS/STDM-2017-13

The International Dimension of "The Death of the Lion"

This essay reconsiders some critically established ‘germs’ for Henry James’s “The Death of the Lion” (1894), traced back to the 1893 demise of Guy de Maupassant and to the latter’s only visit to England in the summer of 1886. On this latter occasion, Maupassant was ‘chaperoned’ by his American friend Blanche Roosevelt, a well-known literary journalist in the London and Paris circles. The unexplored connection with Roosevelt invites a new reading which gives prominence to the American woman character in the tale (Fanny Hurter) and unveils an international subtheme within. In light of such a reading, as well as of authoritative studies which have analyzed “The Death of the Lion” against the rise of modern literary journalism, I will also re-examine the role of the first-person narrator, an unnamed ‘repented’ literary journalist, in thwarting the possible relation between Neil Paraday and his American admirer

"Daudet, James, and the Revision of the Nineteenth-Century Wifely Adultery Plot"

Although it is widely known that Henry James took inspiration from Alphonse Daudet’s L’Evangéliste (1883) for The Bostonians, and from Numa Roumestan (1881) for “The Liar,” the influence of the French novelist on James’s late fiction is still far from being fully grasped or acknowledged. In this essay I will read Daudet’s La petite paroisse. Moeurs conjugales (1895) together with James’s The Golden Bowl (1904) and discuss the similar ways in which these two works revised the nineteenth-century form of the “wifely adultery novel” (Overton 2002) within their respective literary and cultural contexts. My argument is that they challenged both the social stigmatization attached to the adulteress and what were taken to be ‘natural’ relations between husband and wife, and within the family circle

Who settles for less? Subjective dispositions, objective circumstances, and housing satisfaction

In recent years there has been growing interest in individuals’ self-perceptions of their wellbeing on the grounds that these complement well-established objective indicators of welfare. However, individuals’ assessments depend on both objective circumstances and subjective, idiosyncratic dispositions, such as aspirations and expectations. We add to the literature by formulating a modelling strategy that uncovers how these subjective dispositions differ across socio-demographic groups. This is then tested using housing satisfaction data from a large-scale household panel survey from Australia. We find that there are significant differences in the way in which individuals with different characteristics rate the same objective reality. For instance, male, older, migrant, and Indigenous individuals rate equal housing conditions more favourably than female, younger, Australian-born, and non-Indigenous individuals. These findings have important implications for how self-reported housing satisfaction, and wellbeing data in general, are to be used to inform evidence-based policy

Evaluating the Sustainability of a Small-Scale Low-Input Organic Vegetable Supply System in the United Kingdom

www.mdpi.com/journal/sustainabilit