Laparoscopic greater curvature plication in morbidly obese women with type 2 diabetes:effects on glucose homeostasis, postprandial triglyceridemia and selected gut hormones

Background: Laparoscopic greater curvature plication (LGCP) is an emerging bariatric procedure that reduces the gastric volume without implantable devices or gastrectomy. The aim of this study was to explore changes in glucose homeostasis, postprandial triglyceridemia, and meal-stimulated secretion of selected gut hormones [glucose-dependent insulinotropic polypeptide (GIP), glucagon-like peptide-1 (GLP-1), ghrelin, and obestatin] in patients with type 2 diabetes mellitus (T2DM) at 1 and 6 months after the procedure. Methods: Thirteen morbidly obese T2DM women (mean age, 53.2 ± 8.76 years; body mass index, 40.1 ± 4.59 kg/m2) were prospectively investigated before the LGCP and at 1- and 6-month follow-up. At these time points, all study patients underwent a standardized liquid mixed-meal test, and blood was sampled for assessment of plasma levels of glucose, insulin, C-peptide, triglycerides, GIP, GLP-1, ghrelin, and obestatin. Results: All patients had significant weight loss both at 1 and 6 months after the LGCP (p≤0.002), with mean percent excess weight loss (%EWL) reaching 29.7 ;plusmn2.9 % at the 6-month follow-up. Fasting hyperglycemia and hyperinsulinemia improved significantly at 6 months after the LGCP (p<0.05), with parallel improvement in insulin sensitivity and HbA1c levels (p<0.0001). Meal-induced glucose plasma levels were significantly lower at 6 months after the LGCP (p<0.0001), and postprandial triglyceridemia was also ameliorated at the 6-month follow-up (p<0.001). Postprandial GIP plasma levels were significantly increased both at 1 and 6 months after the LGCP (p<0.0001), whereas the overall meal-induced GLP-1 response was not significantly changed after the procedure (p ;gt0.05). Postprandial ghrelin plasma levels decreased at 1 and 6 months after the LGCP (p<0.0001) with no significant changes in circulating obestatin levels. Conclusion: During the initial 6-month postoperative period, LGCP induces significant weight loss and improves the metabolic profile of morbidly obese T2DM patients, while it also decreases circulating postprandial ghrelin levels and increases the meal-induced GIP response. © 2013 Springer Science+Business Media New York.

High stability multiplexed fibre interferometer and its application on absolute displacement measurement and on-line surface metrology

We propose a self-reference multiplexed fibre interferometer (MFI) by using a tunable laser and fibre Bragg grating (FBG). The optical measurement system multiplexes two Michelson fibre interferometers with shared optical path in the main part of optical system. One fibre optic interferometer is used as a reference interferometer to monitor and control the high accuracy of the measurement system under environmental perturbations. The other is used as a measurement interferometer to obtain information from the target. An active phase tracking homodyne (APTH) technique is applied for signal processing to achieve high resolution. MFI can be utilised for high precision absolute displacement measurement with different combination of wavelengths from the tuneable laser. By means of Wavelength-Division-Multiplexing (WDM) technique, MFI is also capable of realising on-line surface measurement, in which traditional stylus scanning is replaced by spatial light-wave scanning so as to greatly improve the measurement speed and robustness. © 2004 Optical Society of America.

Modelling sustainability performance to achieve absolute reductions in socio-ecological systems

As the world’s natural resources dwindle and critical levels of environmental pollution are approached, sustainability becomes a key issue for governments, organisations and individuals. With the consequences of such an issue in mind, this paper introduces a unifying approach to measure the sustainability performance of socio-economic systems based on the interplay between two key variables: essentiality of consumption and environmental impact. This measure attributes to every system a ‘fitness’ value i.e. a quantity that reflects its ability to remain resilient/healthy by avoiding ecological, social and economic collapse as it consumes the available resources. This new measure is tested on a system where there is a limited supply of resources and four basic consumption types. The analysis has theoretical implications as well as practical importance as it can help countries, organisations or even individuals, in finding better ways to measure sustainability performance.