Metabolic and hormonal response to intermittent high-intensity and continuous moderate intensity exercise in individuals with type 1 diabetes: a randomised crossover study.

AIMS/HYPOTHESIS To investigate exercise-related fuel metabolism in intermittent high-intensity (IHE) and continuous moderate intensity (CONT) exercise in individuals with type 1 diabetes mellitus. METHODS In a prospective randomised open-label cross-over trial twelve male individuals with well-controlled type 1 diabetes underwent a 90 min iso-energetic cycling session at 50% maximal oxygen consumption ([Formula: see text]), with (IHE) or without (CONT) interspersed 10 s sprints every 10 min without insulin adaptation. Euglycaemia was maintained using oral (13)C-labelled glucose. (13)C Magnetic resonance spectroscopy (MRS) served to quantify hepatocellular and intramyocellular glycogen. Measurements of glucose kinetics (stable isotopes), hormones and metabolites complemented the investigation. RESULTS Glucose and insulin levels were comparable between interventions. Exogenous glucose requirements during the last 30 min of exercise were significantly lower in IHE (p = 0.02). Hepatic glucose output did not differ significantly between interventions, but glucose disposal was significantly lower in IHE (p < 0.05). There was no significant difference in glycogen consumption. Growth hormone, catecholamine and lactate levels were significantly higher in IHE (p < 0.05). CONCLUSIONS/INTERPRETATION IHE in individuals with type 1 diabetes without insulin adaptation reduced exogenous glucose requirements compared with CONT. The difference was not related to increased hepatic glucose output, nor to enhanced muscle glycogen utilisation, but to decreased glucose uptake. The lower glucose disposal in IHE implies a shift towards consumption of alternative substrates. These findings indicate a high flexibility of exercise-related fuel metabolism in type 1 diabetes, and point towards a novel and potentially beneficial role of IHE in these individuals. TRIAL REGISTRATION ClinicalTrials.gov NCT02068638 FUNDING: Swiss National Science Foundation (grant number 320030_149321/) and R&A Scherbarth Foundation (Switzerland).

Environmental and behavioral risk factors for moderate or severe rotavirus diarrhea in children less than 24 months

On a global basis rotaviruses are the most important agents involved in childhood diarrhea. In developing countries they account for 6% of all diarrheas and 20% of all diarrhea related deaths of children under 5 years of age, with over 1 billion episodes and over 4 million deaths annually. Given the disease burden, there is a need for better understanding the risk factors involved in rotavirus disease, to identify areas of intervention. In order to provide this information, two areas were developed: a review of the literature, examining the causal evidence for rotavirus diarrhea and a case comparison study. The case comparison study analyzed two areas: identifying climate factors and, identifying environmental and behavioral risk factors. The literature review showed that few analytical studies have identified specific risk factors such as home environment, and a winter seasonal trend for temperate areas, but in key areas evidence is contradictory. The case comparison study for climate factors demonstrated that seasonality occurs in a tropical country like Venezuela and that a complex interplay between weather conditions contribute to the seasonal pattern. A positive association between rain fall (OR 4.1); dew point (OR 2.3) and temperature differential during the day (OR 1.4) and, an inverse association with temperature (OR 0.5) and relative humidity (OR 0.8) was found. This information is useful in understanding the seasonal pattern of rotavirus and for planning health care needs. The second analysis demonstrated that environmental variables such as crowding (OR 14.3), contact with someone with an infectious disease (OR 4.9) and animal ownership (OR 2.3) were important. Restricting the analysis to animal owners demonstrated that living In a rural settling (OR 13.8), defecating in inappropriate places (OR 7.2), crowding(4.2) and indoor animals (4.0) are of importance. Behavioral variables identified were: lack of breast feeding (OR 4.0) and visiting when someone was sick (OR 3.4). Biological and demographic variables of importance were: age, with a dose response relationship; undernurishment (OR 11.3) and household per capita monthly income less than US $ 16.30 (OR 8.5). Using a diarrhea compeer group we found that, although some of the previous variables were of importance, no major differences were found. These findings are important in identifying paths for prevention and further research. ^

Impact of long-term moderate hypercapnia and elevated temperature on the energy budget of isolated gills and branchial in vivo and in vitro enzyme capacities of Atlantic cod (Gadus morhua)

Effects of severe hypercapnia have been extensively studied in marine fishes, while knowledge on the impacts of moderately elevated CO2 levels and their combination with warming is scarce. Here we investigate ion regulation mechanisms and energy budget in gills from Atlantic cod acclimated long-term to elevated PCO2 levels (2500 µatm) and temperature (18 °C). Isolated perfused gill preparations established to determine gill thermal plasticity during acute exposures (10-22 °C) and in vivo costs of Na+/K+-ATPase activity, protein and RNA synthesis. Maximum enzyme capacities of F1Fo-ATPase, H+-ATPase and Na+/K+-ATPase were measured in vitro in crude gill homogenates. After whole animal acclimation to elevated PCO2 and/or warming, branchial oxygen consumption responded more strongly to acute temperature change. The fractions of gill respiration allocated to protein and RNA synthesis remained unchanged. In gills of fish CO2-exposed at both temperatures, energy turnover associated with Na+/K+-ATPase activity was reduced by 30% below rates of control fish. This contrasted in vitro capacities of Na+/K+-ATPase, which remained unchanged under elevated CO2 at 10 °C, and earlier studies which had found a strong upregulation under severe hypercapnia. F1Fo-ATPase capacities increased in hypercapnic gills at both temperatures, whereas Na+/K+ATPase and H+-ATPase capacities only increased in response to elevated CO2 and warming indicating the absence of thermal compensation under CO2. We conclude that in vivo ion regulatory energy demand is lowered under moderately elevated CO2 levels despite the stronger thermal response of total gill respiration and the upregulation of F1Fo-ATPase. This effect is maintained at elevated temperature.

Vulnerability analysis of RC buildings with wide beams located in moderate seismicity regions

A significant number of short-to-mid height RC buildings with wide beams have been constructed in areas of moderate seismicity of Spain, mainly for housing and administrative use. The buildings have a framed structure with one-way slabs; the wide beams constitute the distinctive characteristic, their depth being equal to that of the rest of the slab, thus providing a flat lower surface, convenient for construction and the layout of facilities. Seismic behavior in the direction of the wide beams appears to be deficient because of: (i) low lateral strength, mainly because of the small effective depth of the beams, (ii) inherent low ductility of the wide beams, generated by high amount of reinforcement, (iii) the big strut compressive forces developed inside the column-beam connections due to the low height of the beams, and (iv) the fact that the wide beams are wider than the columns, meaning that the contribution of the outer zones to the resistance of the beam-column joints is unreliable because there is no torsion reinforcement. In the orthogonal direction, the behavior is worse since the only members of the slabs that contribute to the lateral resistance are the joists and the façade beams. Moreover, these buildings were designed with codes that did not include ductility requirements and required only a low lateral resistance; indeed, in many cases, seismic action was not considered at all. Consequently, the seismic capacity of these structures is not reliable. The objective of this research is to assess numerically this capability, whereas further research will aim to propose retrofit strategies. The research approach consists of: (i) selecting a number of 3-story and 6-story buildings that represent the vast majority of the existing ones and (ii) evaluating their vulnerability through three types of analyses, namely: code-type, push-over and nonlinear dynamic analysis. Given the low lateral resistance of the main frames, the cooperation of the masonry infill walls is accounted for; for each representative building, three wall densities are considered. The results of the analyses show that the buildings in question exhibit inadequate seismic behavior in most of the examined situations. In general, the relative performance is less deficient for Target Drift CP (Collapse Prevention) than for IO (Immediate Occupancy). Since these buildings are selected to be representative of the vast majority of buildings with wide beams that were constructed in Spain without accounting for any seismic consideration, our conclusions can be extrapolated to a broader scenario.

Intraoperative changes in platelet function in relation to moderate haemorrhage

Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved. Funding The study was funded by TENOVUS Scotland (G12/14). Jan Jansen is in receipt of salary support through the NHS Research Scotland (NRS) fellowship scheme. Acknowledgements The authors are extremely grateful for the expert assistance and contributions of Dr Neil Scott (Medical Statistician, University of Aberdeen), Win Culley (Research Nurse, Woodend Hospital), Dr Karen Cranfield (Consultant Anaesthetist), and Ms Sharon Wood, (Research Technician, Rowett Institute of Nutrition and Health) for fibrinogen measurement.

Impacts of coexisting bronchial asthma on severe exacerbations in mild-to-moderate COPD : results from a national database

Acknowledgments The authors would like to thank Kyungjoo Kim for the confident statistical analyses in this work. This study was supported by a grant (2014P3300300) from the Korea Centers for Disease Control and Prevention. The abstract of this paper was presented at the Asian Pacific Society of Respirology 20th Congress as an oral presentation with interim findings. The poster’s abstract was published in “Poster Abstracts” in Respirology

Does moderate alcohol consumption affect fertility? Follow up study among couples planning first pregnancy

Objective: To examine the effect of alcohol consumption on the probability of conception.