Randomised controlled trial evaluating lifestyle interventions in people with impaired glucose tolerance

Aim

To evaluate the effectiveness of lifestyle interventions in people with impaired glucose tolerance (IGT).
Methods

Participants with IGT (n = 78), diagnosed on two consecutive oral glucose tolerance tests (OGTTs), were randomly assigned to a 2-year lifestyle intervention or to a control group. Main outcome measures were changes from baseline in: nutrient intake; physical activity; anthropometry, glucose tolerance and insulin sensitivity. Measurements were repeated at 6, 12 and 24 months follow-up.
Results

After 24 months follow-up, there was a significant fall in total fat consumption (difference in change between groups (Δ intervention − Δ control) = −17.9, 95% confidence interval (CI) −33.6 to −2.1 g/day) as a result of the intervention. Body mass was significantly lower in the intervention group compared with controls after 6 months (−1.6, 95% CI −2.9 to −0.4 kg) and 24 months (−3.3, 95% CI −5.7 to −0.89 kg). Whole body insulin sensitivity, assessed by the short insulin tolerance test (ITT), improved after 12 months in the intervention group (0.52, 95% CI 0.15–0.89%/min).
Conclusions

These findings complement the findings of the Finnish Diabetes Prevention Study and the American Diabetes Prevention Study, both of which tested intensive interventions, by showing that pragmatic lifestyle interventions result in improvements in obesity and whole body insulin sensitivity in individuals with IGT, without change in other cardiovascular risk factors.

Randomised controlled trial evaluating the effectiveness of behavioural interventions to modify cardiovascular risk factors in men and women with imparied glucose tolerance: outcomes at 6 months

Aims: To evaluate the efficacy of interventions to promote a healthy diet and physical activity in people with impaired glucose tolerance (IGT). Methods: A randomised controlled trial in Newcastle upon Tyne, UK, 1995–98. Participants included 67 adults (38 men; 29 women) aged 24–75 years with IGT. The intervention consisted of regular diet and physical activity counselling based on the stages of change model. Main outcome measures were changes between baseline and 6 months in nutrient intake; physical activity; anthropometric and physiological measurements including serum lipids; glucose tolerance; insulin sensitivity. Results: The difference in change in total fat consumption was significant between intervention and control groups (difference −21.8 (95% confidence interval (CI) −37.8 to −5.8) g/day, P=0.008). A significantly larger proportion of intervention participants reported taking up vigorous activity than controls (difference 30.1, (95% CI 4.3–52.7)%, P=0.021). The change in body mass index was significantly different between groups (difference −0.95 (95% CI −1.5 to −0.4) kg/m2, P=0.001). There was no significant difference in change in mean 2-h plasma glucose between groups (difference −0.19 (95% CI −1.1 to 0.71) mmol/l, NS) or in serum cholesterol (difference 0.02 (95% CI −0.26 to 0.31) mmol/l, NS). The difference in change in fasting serum insulin between groups was significant (difference −3.4 (95% CI −5.8 to −1.1) mU/l, P=0.005). Conclusions: After 6 months of intensive lifestyle intervention in participants with IGT, there were changes in diet and physical activity, some cardiovascular risk factors and insulin sensitivity, but not glucose tolerance. Further follow-up is in progress to investigate whether these changes are sustained or augmented over 2 years.

Fault detection in a cold forging process through feature extraction with a neural network

This paper investigates the application of neural networks to the recognition of lubrication defects typical to an industrial cold forging process employed by fastener manufacturers. The accurate recognition of lubrication errors, such as coating not being applied properly or damaged during material handling, is very important to the quality of the final product in fastener manufacture. Lubrication errors lead to increased forging loads and premature tool failure, as well as to increased defect sorting and the re-processing of the coated rod. The lubrication coating provides a barrier between the work material and the die during the drawing operation; moreover it needs be sufficiently robust to remain on the wire during the transfer to the cold forging operation. In the cold forging operation the wire undergoes multi-stage deformation without the application of any additional lubrication. Four types of lubrication errors, typical to production of fasteners, were introduced to a set of sample rods, which were subsequently drawn under laboratory conditions. The drawing force was measured, from which a limited set of features was extracted. The neural network based model learned from these features is able to recognize all types of lubrication errors to a high accuracy. The overall accuracy of the neural network model is around 98% with almost uniform distribution of errors between all four errors and the normal condition.

Fault-tolerant servers for anycast communication

Plenty of research has been done for any cast service, but few research touches the fault-tolerant problem based on the best of our knowledge. In this paper, we propose and analyse a fault-tolerant model, called twin server model, for anycast communication to provide reliable and continuous anycast services. We select a twin server in an anycast group for a given anycast server, the primary server. If the twin server suspects that its primary server is dead, it will take the unfinished job(s) of its primary server. We propose two algorithms: the server failure detecting algorithm and the server failure broadcasting algorithm. We then analyse the performance change when a primary server fails using queue theory and obtain some interesting conclusions. At the end, we summary the paper and present the future work.

The rising prevalence of diabetes and impaired glucose tolerance : the Australian diabetes, obesity and lifestyle study

OBJECTIVE—To determine the population-based prevalence of diabetes and other categories of glucose intolerance (impaired glucose tolerance [IGT] and impaired fasting glucose [IFG]) in Australia and to compare the prevalence with previous Australian data.

RESEARCH DESIGN AND METHODS—A national sample involving 11,247 participants aged >=25 years living in 42 randomly selected areas from the six states and the Northern Territory were examined in a cross-sectional survey using the 75-g oral glucose tolerance test to assess fasting and 2-h plasma glucose concentrations. The World Health Organization diagnostic criteria were used to determine the prevalence of abnormal glucose tolerance.

RESULTS—The prevalence of diabetes in Australia was 8.0% in men and 6.8% in women, and an additional 17.4% of men and 15.4% of women had IGT or IFG. Even in the youngest age group (25–34 years), 5.7% of subjects had abnormal glucose tolerance. The overall diabetes prevalence in Australia was 7.4%, and an additional 16.4% had IGT or IFG. Diabetes prevalence has more than doubled since 1981, and this is only partially explained by changes in age profile and obesity.

CONCLUSIONS—Australia has a rapidly rising prevalence of diabetes and other categories of abnormal glucose tolerance. The prevalence of abnormal glucose tolerance in Australia is one of the highest yet reported from a developed nation with a predominantly Europid background.

Abbreviations: 2hPG, 2-h plasma glucose • AusDiab, Australian Diabetes, Obesity and Lifestyle Study • CD, Census Collector District • FPG, fasting plasma glucose • IFG, impaired fasting glucose • IGT, impaired glucose tolerance • KDM, known diabetes mellitus • NDM, newly diagnosed diabetes mellitus • OGTT, oral glucose tolerance test • WHO, World Health Organization

A reactive system architecture for building fault-tolerant distributed applications

Most fault-tolerant application programs cannot cope with constant changes in their environments and user requirements because they embed policies and mechanisms together so that if the policies or mechanisms are  changed the whole programs have to be changed as well. This paper presents a reactive system approach to overcoming this limitation. The reactive system concepts are an attractive paradigm for system design, development and maintenance because they separate policies from mechanisms. In the paper we propose a generic reactive system architecture and use group communication primitives to model it. We then implement it as a generic package which can be applied in any distributed applications. The system performance shows that it can be used in a distributed environment effectively.

Fault Lines and Earthquakes of Maine 1568-2005

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