bluuebunny/crossref_metadata_2025 huggingface dataset:
Prejuicios historiográficos sobre las verdaderas causas de la guerra del Peloponeso
Authors: Martín César Sierra
Published: June 2015

Neste trabalho, discutiremos duas tendências historiográficas ao redor das verdadeiras causas da Guerra do Peloponeso. Nesse sentido, a presença de uma tendência a favor e outra contra a opinião de Tucídides parece-nos uma abordagem obsoleta que precisa ser superada para o alcance de novas conclusões e a revitalização do debate.
Transformando a bomolochía: o prazer da ficção nas histórias verdadeiras
Authors: Sano Lucia
Published: June 2015

The aim of this paper is to discuss Lucian’s statement that his novel Verae Historiae provides both pleasure (ψυχαγωγία) and θεωρία to the readers. I suggest that Lucian addresses the question of the production of fiction narratives in prose and how they should be read while arguing that his work is an appropriate reading to the pepaideuménoi.
Vitamin D and Insulin Action and Secretion –An Overview of Current Understanding and Future Perspectives
Authors: Gulseth Hanne L , Wium Cecilie , Birkeland Kåre I ,   Post-doctoral Researcher and Resident in Endocrinology,   Research Fellow and Resident in Endocrinology,   Professor of Endocrinology and Head, Department of Endocrinology, Oslo University Hospital, Institute of Clinical Medicine, University of Oslo and Oslo Diabetes Research Centre
Published: June 2015

Impaired vitamin D status has been linked to the development of type 2 diabetes. This review summarises the current knowledge of the effects of vitamin D on insulin action and secretion. Animal andin vitrostudies suggest an effect of vitamin D on insulin action and secretion. The effects of vitamin D status in humans are not as clear, however, and cross-sectional data on insulin sensitivity and secretion are inconclusive. Intervention studies are few and often suffer from inadequate design including short duration, low sample power, low dose of vitamin D or use of indirect measures of insulin sensitivity and secretion. Despite some plausible biological mechanisms for an effect of vitamin D on both insulin secretion and action, more evidence is needed to decide whether vitamin D plays an important role in the pathophysiology of type 2 diabetes.
Gliptin Therapies for Inhibiting Dipeptidyl Peptidase-4 in Type 2 Diabetes
Authors: Green Brian D , Bailey Clifford J , Flatt Peter R ,   Senior Lecturer in Molecular Nutrition, and Deputy Director of Research, School of Biological Sciences, Queens University Belfast,   Professor of Clinical Science, and Head of Diabetes, School of Life and Health Sciences, Aston University, Birmingham,   Professor of Biomedical Sciences, and Head, Diabetes Research Group, School of Biomedical Sciences, University of Ulster
Published: June 2015

Discovery of the incretin hormones glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) has led to the clinical development of incretin-based therapies for type 2 diabetes. Incretins are intestinal peptide hormones that stimulate post-prandial insulin secretion and improve glycaemic control. Gliptins are drugs that inhibit a ubiquitous enzyme, dipeptidyl peptidase-4 (DPP-4), preventing the physiological breakdown of incretins and thereby enhancing endogenous incretin action. Three ‘gliptins’ have recently been introduced into clinical practice: sitagliptin, vildagliptin and saxagliptin. This review provides an overview of these new antidiabetic agents and comments on some exciting future prospects for incretins and agents that enhance incretin action.
Lanreotide Autogel Therapy in Patients with Acromegaly –Current Role and Perspectives for the Future
Authors: Marek Josef ,   Professor, Third Department of Medicine, First Faculty of Medicine, Charles University, and General Teaching Hospital, Prague
Published: June 2015

Lanreotide Autogel is a long-acting (effective for four to six weeks after a single injection) somatostatin analogue that normalises growth hormone (GH) and insulin-like growth factor I levels in about 50% of patients. It causes tumour volumes to shrink by more than 20% in 72–85% of patients. These effects are similar to those with octreotide long active release (LAR). Similarly, there are no differences between octreotide LAR and lanreotide Autogel in improvement of cardiac function, glycometabolic effects or occurrence of side effects, including cholelithiasis. In comparison to octreotide LAR, lanreotide Autogel has the advantage of being available in a convenient pre-filled syringe and it can be injected subcutaneously by patients or their care-givers/partners, omitting the necessity of injections by healthcare professionals. The efficacy of lanreotide can be increased by combination with dopamine agonists. Co-administration of lanreotide Autogel with pegvisomant appears to be safe and to improve hormonal control in a majority of patients with acromegaly partially controlled by somatostatin analogues alone.
Fractionated Stereotactic Radiotherapy as an Adjuvant Therapy for Pituitary Adenomas
Authors: Schalin-Jäntti Camilla ,   Senior Endocrinologist, Division of Endocrinology, Department of Medicine, Helsinki University Hospital
Published: June 2015

Pituitary adenomas characterised by excessive growth or hormonal overproduction despite surgical and medical interventions are a treatment challenge. This article discusses fractionated stereotactic radiotherapy (FSRT) as an adjuvant treatment for pituitary adenomas. Previously, management largely depended on conventional radiotherapy (RT). RT is effective but induces irradiation of surrounding healthy tissues, which has raised safety concerns. With the introduction of modern high-precision stereotactic techniques, irradiation of surrounding tissues can be avoided. The dose can be delivered in one (stereotactic radiosurgery) or several fractions (FSRT). While the use of radiosurgery is restricted to smaller tumours located away from the optic chiasm and nerves, there are no such restrictions for FSRT. FSRT provides an efficient and safe option for pituitary adenomas refractory to conventional treatments. The results seem to be at least as good as those achieved with RS but no direct comparison of these two techniques is yet available.
Developments in Digestive Tract Neuroendocrine Tumours and Pheochromocytomas/Paragangliomas – A Narrative Review
Authors: Ilias Ioannis , Pacak Karel ,   Endocrinologist, Department of Endocrinology, E Venizelou Hospital, Athens,   Chief and Senior Investigator, Section on Medical Neuroendocrinology, The Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health
Published: June 2015

Digestive neuroendocrine tumours (carcinoids) derive from serotonin-producing enterochromaffin cells. Biochemical screening (and follow-up) is performed with measurements of 5-hydroxyindoloacetic acid in urine. Other markers are also useful. Most digestive neuroendocrine tumours are better localised with functional imaging, i.e. nuclear medicine, compared with other modalities. The treatment of choice is surgical; non-resectable tumours are treated with somatostatin analogues (unlabelled and for more advanced disease radiolabelled) or chemotherapy. Most pheochromocytomas/paragangliomas are sporadic, however, and genetically caused tumours are much more common than previously thought. Biochemical proof of disease is best carried out with measurement of plasma metadrenaline. Imaging with computed tomography or magnetic resonance imaging (MRI) should be followed by functional imaging. Chromaffin tumour-specific methods are preferred.18F-fluoro-deoxyglucose positron emission tomography (18F-DOPA PET) should be used in patients with succinate-dehydrogenase-B-related metastatic pheochromocytoma/paraganglioma.18F-DOPA PET may become a modality of choice for the localisation of head and neck paragangliomas. If possible, treatment is surgical. For non-operable disease, other options are available and new drugs are under investigation or in clinical trials.
Diabetes Risk Scores in 2011
Authors: Balkau Beverley , Chen Lei ,   Director of Research, Inserm, CESP Centre for Research in Epidemiology and Population Health U1018, Epidemiology of Diabetes, Obesity and Chronic Kidney Disease Over the Lifecourse, and University Paris Sud 11, UMRS 1018, and Senior Research Fellow, Baker IDI Heart and Diabetes Institute,   Endocrinologist and Epidemiologist, Baker IDI Heart and Diabetes Institute
Published: June 2015

Diabetes risk scores can be used as pre-screening tools to detect those likely to have diabetes. Scores usually include clinical characteristics such as age, sex, family history of diabetes and hypertension. However, it is disputed whether screening for diabetes is cost-effective. The recently reported Anglo-Danish-Dutch Study of Intensive Treatment in People with Screen Detected Diabetes in Primary Care (ADDITION) study, in which diabetes was diagnosed following screening by a risk score, did not show that intensive treatment in such individuals was different from routine care in terms of cardiovascular outcomes. Risk scores are also used to identify those at risk of diabetes in the future, and at-risk individuals may then be encouraged to participate in diabetes prevention programmes. Risk scores from routine biology, in particular fasting glucose, have also been developed to improve prediction over clinical risk factors. Now more sophisticated approaches are being used to predict diabetes – multiple biomarkers, genetics, proteomics, lipidomics and metabolomics – with the idea that if individuals are identified a long time in advance of the onset of the disease, prevention can start much earlier when it may be more successful. Diabetes risk scores follow on from a long history of cardiovascular risk scores. Scores should be given with an uncertainly or prediction interval within which the score lies with 95% confidence.
Sodium–Glucose Co-transporter 2 Inhibition – A Novel Strategy for Glucose Control in Type 2 Diabetes
Authors: Norton Luke , DeFronzo Ralph A , Abdul-Ghani Muhammad A ,   Instructor,   Professor of Medicine and Chief,   Assistant Professor of Medicine, Division of Diabetes, University of Texas Health Science Center at San Antonio
Published: June 2015

In addition to its central role in the development of microvascular complications, hyperglycaemia plays an important role in the pathogenesis of type 2 diabetes, i.e. glucotoxicity. Thus, effective glycaemic control not only reduces the incidence of microvascular complications, but also corrects the metabolic abnormalities that contribute to the progression of the disease. Progressive beta-cell failure and side effects associated with therapy, such as hypoglycaemia and weight gain, present obstacles to the achievement of optimal durable glycaemic control in subjects with type 2 diabetes. Most recently, inhibitors of the renal sodium glucose co-transporter have been developed to produce glucosuria and reduce the plasma glucose concentration. Because the mechanism of action of these oral antidiabetic agents is independent of beta-cell and tissue sensitivity to insulin, they improve glycaemic control while avoiding hypoglycaemia and promoting weight loss. In this article, we will summarise the available data concerning the mechanism of action, efficacy and safety of this novel antidiabetic therapeutic approach.
Optimal Therapy of Growth Hormone Deficiency in the Child and Adolescent
Authors: Rose Susan R ,   Professor of Endocrinology, Division of Pediatric Endocrinology, Cincinnati Children’s Hospital Medical Center and University of Cincinnati
Published: June 2015

Optimal therapy of growth disorders depends on accurate diagnosis and clear goals for therapy. Understanding normal patterns of growth hormone (GH) and insulin-like growth factor (IGF) secretion are necessary to appreciate the different hormone pattern induced by therapy. Finally, monitoring efficacy and safety, identifying interfering factors and adjusting doses are all part of optimising GH therapy in childhood GH deficiency (GHD). Prevention of development of GHD would avoid the need for therapy. Options for optimising GH therapy in childhood GHD include initiating treatment as young as possible, facilitating adherence to a therapy plan and adjusting GH dose on an individual basis to achieve ‘target’ results. In addition, there can be consideration of regulating timing of puberty, use of higher GH doses and improving the process of transition from paediatric to adult care. Future prospects include improved depot GH preparations or alternative delivery systems. Development of depot GH-releasing hormone (GHRH)/peptide therapy could allow a more physiological pattern of GH secretion. GH therapy should be targeted to yield the best growth response, best safety profile and the best psychosocial adjustment.
Rituximab for the Treatment of Graves’ Orbitopathy
Authors: Salvi Mario , Vannucchi Guia , Beck-Peccoz Paolo ,   Senior Research Associate,   Investigator,   Professor of Endocrinology, Department of Medical Sciences, Endocrine Unit, University of Milan and Fondazione Cà Granda IRCCS, Milan
Published: June 2015

The contribution of B cells to human autoimmune disease has recently been underscored because of the therapeutic benefit of B-cell depleting therapies. B cells are involved in the production of autoantibodies and in CD4+ T-cell activation and control of T-cell function and inflammation, through cytokine production. B cells are also important antigen presenting cells. Rituximab (RTX) has been used off-label in various autoimmune disorders and has been shown to effectively deplete mature and memory CD20+ B cells, but not long-lived plasma cells. The rationale of RTX use in Graves’ disease (GD) and Graves’ orbitopathy (GO) relies on its putative effect on pathogenic autoantibodies causing hyperthyroidism. RTX in patients with active GO has been shown to significantly affect the inflammatory activity and severity of GO. Caution is suggested before proposing RTX as a novel therapeutic tool in this disease until randomised controlled studies are available. Should preliminary observations be confirmed, an optimal strategy for controlling the progression of GO would be to pursue B-cell depletion shortly after diagnosis and not as an additional therapeutic option when standard immunosuppression has failed.
Clinical Experience with Biphasic Insulin Aspart 30 (NovoMix® 30)
Authors: Ligthelm Robert ,   Endocrinologist, EHM Clinic, Hoofddorp
Published: June 2015

This editorial introduces four case studies examining the initiation of biphasic insulin aspart 30 (BIAsp 30), including one case in insulin initiation, two cases of switching from biphasic human insulin (BHI) and one case of intensifying basal insulin treatment.
Biphasic Insulin Aspart 30 in Insulin Initiation
Authors: Yang Wenying ,   Professor, Department of Endocrinology, China–Japan Friendship Hospital, Beijing
Published: June 2015

This case report concerns a patient with poor glycaemic control on oral antidiabetic drugs who initiated biphasic insulin aspart 30 (BIAsp 30), and reviews supporting clinical literature, alternative treatment choices and the options for intensification. During the six-month follow-up after initiation of BIAsp 30, glycosylated haemoglobin (HbA1c) was reduced from 10.2 % to 6.4 %, mean fasting blood glucose (FBG) was reduced from 9.0 mmol/l to 6.8 mmol/l and mean postprandial glucose (PPG) was reduced from 15.3 mmol/l to 8.8 mmol/l. Body weight increased by 4 kg. The patient experienced eight episodes of hypoglycaemia over the six-month period (four pre-lunch, one at bedtime and three nocturnal). The patient had six episodes with blood glucose (BG) <4.0 mmol/l but no episodes with BG <2.8 mmol/l. Insulin initiation with a premix insulin analogue offers a simple and convenient regimen of once- or twice-daily dosing and provides effective glycaemic control by providing coverage of both FBG and PPG.
Initiation of Biphasic Insulin Aspart in a Patient Failing Basal Insulin Treatment
Authors: Gumprecht Janusz ,   Professor, Department of Internal Diseases, Diabetology and Nephrology, Medical University of Silesia
Published: June 2015

This case illustrates insulin intensification from insulin glargine to biphasic insulin aspart 30 (BIAsp 30), reviews supporting clinical literature and discusses alternative therapeutic approaches. PL, a 56-year-old male with an eight-year history of type 2 diabetes, needed to intensify his insulin glargine treatment as he was not achieving appropriate blood glucose targets and recurrent hypoglycaemia limited further dose titration. With insulin glargine, his glycosylated haemoglobin (HbA1c) was 7.8 %, his fasting plasma glucose (FPG) ranged from 7.2 mmol/l to 8.0 mmol/l and his postprandial glucose (PPG) ranged from 8.9 mmol/l to 10.6 mmol/l, being especially high after dinner. At four months after the switch to BIAsp 30, his HbA1cwas 6.9 % and his FPG and PPG levels were at goal. The patient had not experienced any hypoglycaemic episodes. By addressing both PPG and FPG, intensification with BIAsp 30 provided improved glycaemic control without the hypoglycaemia experienced with insulin glargine.
Diabetes as a Paracrinopathy of the Islets of Langerhans
Authors: Lefèbvre Pierre ,   Emeritus Professor of Medicine, Division of Diabetes, Nutrition and Metabolic Disorders, Department of Medicine, University of Liège
Published: June 2015

The small clusters of cells scattered in the pancreas and discovered by Langerhans in 1869, currently known as the islets of Langerhans, are at the centre of the pathology of diabetes. Today they appear as sophisticated micro-organs in which various cell types function in a remarkably co-ordinated manner. Until recently, most of the interest has been centred on the β-cells, which synthesise, store and secrete insulin. Insulin deficiency is the hallmark of diabetes, with insulin resistance being associated with some forms of the disease. Although identified more than 40 years ago, a possible role of glucagon in the pathophysiology of diabetes has been largely neglected. Synthesised, stored and released by the α-cells of the islets of Langerhans, glucagon plays a key role in the main metabolic disturbances of diabetes that are hyperglycaemia and excessive lipolysis and ketogenesis. Suggested by Samols et al. decades ago, the possibility of close interactions between α- and β-cells within the islets of Langerhans has recently received considerable experimental support. Unger and Orci have proposed that such paracrine interactions within the pancreatic islets play a crucial role in a vital homoeostatic domain and that disruption or dysfunction of these interactions has to be considered as a key component in the pathophysiology of diabetes. This brief article will present arguments supporting the view of diabetes as a paracrinopathy of the islets of Langerhans.
Use of Continuous Glucose Monitoring Can Address Patient Fears and Facilitate Improved Glycaemic Management
Authors: Unger Jeff , Parkin Chris ,   Director of Metabolic Studies, Catalina Research Institute,   Director of Education Services, Health Management Resources, Inc.
Published: June 2015

Effective diabetes management can delay or prevent many of the complications of diabetes. Achieving optimal glycaemic control, however, often requires intensive insulin treatment, which is associated with an increased risk of severe hypoglycaemia. Many intensively managed patients are reluctant to follow and/or adjust their insulin regimens as needed because of fear of hypoglycaemia. This lack of adherence can result in exposure to chronic hyperglycaemia, oxidative stress and long-term complications. Severe hypoglycaemia can be prevented through vigilance in identifying patients at risk, using appropriate medications and medication regimens, and effective glucose monitoring strategies and technologies. This article reviews some evidence relevant to hypoglycaemia in intensively managed patients and discusses how tools such as continuous glucose monitoring (CGM) can help patients overcome their fear of hypoglycaemia and safely achieve optimal glycaemic control.
When Will We Agree on the Origin and Meaning of ‘Wellbeing’?
Authors: Blevins Lewis S , Knutzen Robert ,   Clinical Professor of Neurological Surgery and Medicine and Medical Director, California Center for Pituitary Disorders, University of San Francisco,   President and CEO, Pituitary Network Association
Published: June 2015

Quality of life is a nebulous term that is applied in medicine to assess the impact of disease states on the overall health of affected patients. It is difficult to measure, subject to interpretation based on the relative experiences of those assessing and reporting it, and there are no assessments or tools available to describe or determine the relative contributions of particular disease states and the affected person’s constitution and pre-morbid state or personality to their quality of life.
Lixisenatide—Once-daily Glucagon-like Peptide-1 Receptor Agonist in the Management of Type 2 Diabetes
Authors: Quianzon Celeste C L , Shomali Mansur E ,   Senior Fellow in Endocrinology, Diabetes and Metabolism,   Program Director, Endocrinology, Diabetes and Metabolism Training Program, Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Union Memorial Hospital
Published: June 2015

The glucagon-like peptide-1 receptor agonist diabetes medications have become important due to their unique features, such as their potency of glycosylated haemoglobin (HbA1C) lowering, durability of effect, glucose-depending insulin secretion resulting in a low risk of hypoglycaemia, glucagon suppression and weight loss. Lixisenatide is an investigational compound in this class, exhibits all of these features, and has some unique properties, which are highlighted in this review. The pharmacology of lixisenatide, the results of recent clinical trials investigating this agent, and its potential role in the management of type 2 diabetes will be discussed.
Early Glomerular Filtration Rate Loss as a Marker of Diabetic Nephropathy
Authors: Jerums George , Ekinci Elif , Panagiotopoulos Sianna , MacIsaac Richard J ,   Professor, Endocrine Centre, Austin Health and University of Melbourne, Heidelberg Repatriation Hospital,   Endocrinologist, Endocrine Centre, Austin Health and University of Melbourne, Heidelberg Repatriation Hospital,   Manager, Office for Research, Endocrine Centre, Austin Health and University of Melbourne, Heidelberg Repatriation Hospital,   Professor, St Vincent’s Hospital and University of Melbourne
Published: June 2015

In the early 1980s, studies in type 1 diabetes suggested that glomerular filtration rate (GFR) loss begins with the onset of macroalbuminuria. However, recent evidence indicates that up to one-quarter of subjects with diabetes reach a GFR of less than 60 ml/min/1.73 m2(chronic kidney disease [CKD] stage 3) before developing micro- or macroalbuminuria. Furthermore, the prospective loss of GFR can be detected in early diabetic nephropathy (DN) well before CKD stage 3. Early GFR loss usually reflects DN in type 1 diabetes but, in older patients with type 2 diabetes, the assessment of early GFR loss needs to take into account the effects of ageing. The assessment of GFR is now feasible at clinical level, using formulas based on serum creatinine, age, gender and ethnicity. Overall, the estimation of early GFR loss is more accurate with the Chronic Kidney Disease Epidemiology (CKD–EPI) formula than with the Modification of Diet in Renal Disease (MDRD) study formula, but there is some evidence that the CKD-EPI formula does not exhibit better performance than the MDRD formula for estimating GFR in diabetes. Both formulas underestimate GFR in the hyperfiltration range. Formulas based on the reciprocal of cystatin C can also be used to estimate GFR, but their cost and lack of assay standardisation have delayed their use at clinical level. In summary, early GFR loss is an important marker of DN as well as a potentially reversible target for interventions in DN.
Hormone Therapy plus mTOR Inhibitors in the Treatment of Endometrial Carcinoma
Authors: Stringer Erica M , Fleming Gini F ,   Fellow,   Professor of Medicine, Department of Medicine, Section of Hematology Oncology, University of Chicago Medical Center, Chicago, IL, US.
Published: June 2015

Hormonal therapies such as progestins have only modest activity in the treatment of advanced endometrial cancer. Mechanisms of resistance to progestin therapy are not well understood. However, activation of the PI3K/AKT/mammalian target of rapamycin (mTOR) pathway has been associated with resistance to hormonal therapy and alterations in components of the PI3K/AKT/mTOR pathway, including inactivating mutations in PTEN, activating mutations in PIK3CA and mutations in PIK3R1, are very common in endometrial carcinomas. mTOR inhibitors, including temsirolimus, everolimus and ridaforolimus, are also known to be active against endometrial cancer, and interest has been stimulated in combinations of hormonal treatment with mTOR inhibitors, as both therapies have single-agent activity, and it is hypothesised that mTOR inhibition would enhance sensitivity to hormonal therapy.
Extra-hepatic Acromegaly
Authors: Franck Sanne E , Lely Aart Jan van der , Neggers Sebastian ,   Department of Internal Medicine, Erasmus University MC, Rotterdam, the Netherlands,   Department of Internal Medicine, Erasmus University MC, Rotterdam, the Netherlands,   Department of Internal Medicine, Erasmus University MC, Rotterdam, the Netherlands
Published: June 2015

After the introduction of somatostatin analogs (LA-SMSA) and the growth hormone (GH) receptor antagonist, pegvisomant (Peg-v) normal serum insulin-like growth factor-1 (IGF-1) concentrations in virtually every patients with acromegaly is possible. The impact of these products on the GH–IGF1 axis is completely different. We advocate that LA-SMSA may normalize serum IGF1 levels in the presence of elevated GH actions in extrahepatic tissues. This results in persistent peripheral disease activity that we call ‘extra-hepatic acromegaly’. Peg-v competitively blocks systemic GH action and results in a GH serum level increase. Therefore high doses of Peg-v are necessary to control IGF-1. Since the mode of action differs between these products, it is questionable if identical IGF-1 levels, during Peg-v or LA-SMSA are really identical representations of the biochemical situation. With the traditional biomarkers medical treatment is therefore difficult to monitor with the traditional biomarkers. Additionally, Peg-v and LA-SMSA could be ideal combination since they have different mode of actions. We believe that the time has come to challenge the existing concepts of treatment and monitoring of patients with acromegaly.
The Importance of Energy Balance
Authors: Hill James O , Wyatt Holly R , Peters John C ,   Anschutz Health & Wellness Center, University of Colorado, Aurora, Colorado, US,   Anschutz Health & Wellness Center, University of Colorado, Aurora, Colorado, US,   Anschutz Health & Wellness Center, University of Colorado, Aurora, Colorado, US
Published: June 2015

Globally, bodyweight and obesity are rising in both the developing and developed world. To maintain a stable bodyweight, energy intake must, over time, exactly equal energy expenditure, a state known as energy balance. An understanding of the physiologic control of energy balance may be useful for designing interventions to tackle the obesity epidemic worldwide. Obesity occurs when the body’s energy balance is positive (i.e. when energy intake exceeds energy expenditure). Human physiology is biased towards maintaining energy balance at high levels of energy intake and expenditure. As a result, strategies to combat obesity should include a focus on increasing physical activity along with strategies for modifying food intake. An understanding of energy balance leads to the conclusion that prevention of weight gain should be easier than treatment of obesity. Components of energy balance are interdependent, and weight loss requires major behaviour changes, which trigger compensatory decreases in energy expenditure that facilitate weight regain. Prevention of weight gain can be accomplished by smaller behaviour changes. In addition to being easier to sustain than larger behaviour changes, smaller ones produce less compensation by the energy balance regulatory system. It has been estimated that relatively small changes in energy intake and expenditure totaling 100 kcal per day could arrest weight gain in most people. Interventions that advocate small changes have shown promising levels of success.
Diagnosis of Osteoporosis in Children and Adolescents
Authors: M Christine , Laine Tero ,   Consultant in Endocrinology, Institute of Medicine, Sahlgrenska University Hospital and University of Gothenburg, Gothenburg, Sweden,   Senior Consultant in Paediatric Orthopaedics, Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska University Hospital and University of Gothenburg, Gothenburg, Sweden
Published: June 2015

Osteoporosis is traditionally regarded as a disease of elderly women. However, this bone disorder occurs in patients of both sexes and of all ages and is also increasingly recognised in the paediatric setting. In particular, patients, including young children, with other chronic diseases are at risk of developing bone fragility. There are also several forms of hereditary osteoporosis, which should be identified at an early stage to ensure adequate treatment. The diagnosis of osteoporosis in children is challenging, since their bone mineral density (BMD) is affected by growth and pubertal development. In addition to low BMD, a child must also exhibit a significant proneness to fractures before the osteoporosis diagnosis can be made. Through early diagnosis and treatment for paediatric bone fragility, we can also ameliorate bone health in adulthood. In this article we review the aetiology, known risk factors and the diagnostic criteria of osteoporosis in the young.
Use of Automated Bolus Calculators for Diabetes Management
Authors: Schwartz Frank L , Marling Cynthia R ,   Professor of Endocrinology, The Diabetes Institute, Ohio University Heritage College of Osteopathic Medicine, Athens, Ohio, US,   Associate Professor, School of Electrical Engineering and Computer Science, Russ College of Engineering and Technology, Ohio University, Athens, Ohio, US
Published: June 2015

Fewer than 30 % of patients with diabetes who are on insulin therapy achieve target glycated haemoglobin (HbA1c) levels. Automated bolus calculators (ABCs) are now almost universally used for patients on insulin pump therapy to calculate pre-meal insulin doses. Use of ABCs in glucose monitors and smart phone applications have the potential to improve glucose control in a larger population of individuals with diabetes on insulin therapy by overcoming the fear of hypoglycaemia and assisting those with low numeracy skills.
The Role of Low-calorie Sweeteners in Diabetes
Authors: Johnston Craig A , Stevens Brian , Foreyt John P ,   Department of Medicine, Baylor College of Medicine, Houston, Texas, US,   United States Department of Agriculture/Agricultural Research Service (USDA/ARS) Children’s Nutrition Research Center, Department of Pediatrics-Nutrition, Baylor College of Medicine, Houston, Texas, US,   United States Department of Agriculture/Agricultural Research Service (USDA/ARS) Children’s Nutrition Research Center, Department of Pediatrics-Nutrition, Baylor College of Medicine, Houston, Texas, US.,   Department of Medicine, Baylor College of Medicine, Houston, Texas, US
Published: June 2015

As the incidence and prevalence of type 2 diabetes continue to rise, the identification of components that contribute to or are associated with this disease has become a priority. One of the main factors that has been linked to type 2 diabetes is excessive weight gain, and reduction in weight has been recommended for both diabetes prevention and management. Low-calorie sweeteners (LCS) provide an alternative to added sugars and may facilitate weight loss or maintenance by limiting caloric intake. Considerable attention has been given to the role of LCS and their relationship to type 2 diabetes. Research suggests that LCS can serve an important role in diabetes prevention and management. Substituting sugars with LCS provides patients with type 2 diabetes considerable flexibility in their health goals and personal dietary preferences.
Dual-release Hydrocortisone in Addison’s Disease – A Review of the Literature
Authors: Giordano Roberta , Guaraldi Federica , Berardelli Rita , Karamouzis Ioannis , Angelo Valentina D , Zichi Clizia , Grottoli Silvia , Ghigo Ezio , Arvat Emanuela ,   Department of Clinical and Biological Sciences,   Division of Endocrinology, Diabetology and Metabolism, Department of Medical Sciences,   Division of Endocrinology, Diabetology and Metabolism, Department of Medical Sciences,   Division of Endocrinology, Diabetology and Metabolism, Department of Medical Sciences,   Division of Endocrinology, Diabetology and Metabolism, Department of Medical Sciences,   Division of Endocrinology, Diabetology and Metabolism, Department of Medical Sciences,   Division of Endocrinology, Diabetology and Metabolism, Department of Medical Sciences,   Division of Endocrinology, Diabetology and Metabolism, Department of Medical Sciences,   Division of Oncological Endocrinology, Department of Medical Sciences, University of Turin, Turin, Italy Citation
Published: June 2015

In patients with adrenal insufficiency, glucocorticoids (GCs) are insufficiently secreted and GC replacement is essential for health and, indeed, life. Despite GC-replacement therapy, patients with adrenal insufficiency have a greater cardiovascular risk than the general population, and suffer from impaired health-related quality of life. Although the aim of the replacement GC therapy is to reproduce as much as possible the physiological pattern of cortisol secretion by the normal adrenal gland, the pharmacokinetics of available oral immediate-release hydrocortisone or cortisone make it impossible to fully mimic the cortisol rhythm. Therefore, there is an unmet clinical need for the development of novel pharmaceutical preparations of hydrocortisone, in order to guarantee a more physiological serum cortisol concentration time-profile, and to improve the long-term outcome in patients under GC substitution therapy.
Bone Involvement in Primary Hyperparathyroidism and Changes After Parathyroidectomy
Authors: Rolighed Lars , Rejnmark Lars , Christiansen Peer ,   Senior Resident, Department of Surgery P,   Consultant, Department of Endocrinology and Internal Medicine,   Professor and Consultant, Department of Surgery P, Aarhus University Hospital, Aarhus, Denmark
Published: June 2015

Parathyroid hormone (PTH) is produced and secreted by the parathyroid glands and has primary effects on kidney and bone. During the pathological growth of one or more parathyroid glands, the plasma level of PTH increases and causes primary hyperparathyroidism (PHPT). This disease is normally characterised by hyperparathyroid hypercalcaemia. In PHPT a continuously elevated PTH stimulates the kidney and bone causing a condition with high bone turnover, elevated plasma calcium and increased fracture risk. If bone resorption is not followed by a balanced formation of new bone, irreversible bone loss may occur in these patients. Medical treatment can help to minimise the loss of bone but the cure of PHPT is by parathyroidectomy. After operation, bone mineral density increases during the return to normal bone metabolism. Supplementation with calcium and vitamin D after operation may improve the normalisation to normal bone metabolism with a secondary reduction in fracture risk.
A Study of W2 - Curvature Tensor of a N(k) - Quasi Einstein Manifold
Authors: Dwivedi Mohit Kumar
Published: June 2015

In this paper, the study of W2 -curvature tensor in N(k) -quasi Einstein manifold satisfying ( , ). 0 2 2 W  X W  is carried out. Mathematics subject is classification : 53C25, 53D10, 53D15.
Vibrational and Quantum Chemical Study of Triphenylantimony (V) Benzilate SbPh3 [O2CC (OH) Ph2]2
Authors: Hasan Tanveer , Singh P. K. , Siddiqui Shamoon
Published: June 2015

A complete normal coordinate analysis was performed by two methods: a classical Wilson G-F matrix method and the Semi-empirical molecular orbital PM6 method, for a five coordinate Triphenylantimony (V) Benzilate SbPh3 [O2CC (OH) Ph2]2, known to be an in vitro antitumour molecule
Analytical Evaluations of Shaft Output on Different Rotor to Casing Diameter Ratios at Optimal Value of Vane and Injection Angles for a Multi-Vane Air Turbine
Authors: Singh Bharat Raj , Singh Onkar
Published: June 2015

The atmospheric air is freely available but once it is compressed, it develops the potential power source for running any prime mover as a zero pollutant. Thus air turbine proposed to be installed here on motorbike transforms the energy of the compressed air into shaft work in place of an internal combustion engine. This paper details a mathematical modeling and performance evaluation of an air driven vane type rotary novel air turbine / engine. The effect of isobaric admission and adiabatic expansion of high pressure air for different rotor to casing diameter ratios at optimum vane and injection angles as 450, 300 respectively have been considered and analyzed. The optimum work output is seen at some typical values of rotor / casing diameter ratios at moderate air consumptions. In this study, the power obtained along linear expansion (without excessive air consumption) as 6.0-7.6 kW (8-10 HP) between rotor to casing diameter ratios 0.85 to 0.80, at casing diameter of 200 mm, injection pressure of 90 psi (6 bar) and speed of rotation 2500 rpm which is enough to run any motorbike or light vehicle.
An Advanced Automatic Electronic Diagnosis System
Authors: Dubey Prabhakar , Kumar Mahendra
Published: June 2015

Every complex system is liable to faults and failures. In the most general terms, a fault is any change in a system that prevents it from operating in the proper manner. Here, the diagnosis of catastrophic defects in complex digital circuits. In fact, today the technical diagnosis is great challenge for design engineers because diagnostic problems are generally under determinate. It is also a deductive process with one set of data creating, in general, unlimited number of hypotheses among which one should try to get the solution. So the diagnosis methods are based on proprietary knowledge and personal experience, although they were built into integrated diagnostic equipment. The approach proposed here is an alternative to existing solutions, and it is expected to encompass all phases of the diagnostic process: symptom detection, hypotheses generation, and hypotheses discrimination.
A Risk Assessment Framework to Reduce Risk Level and Optimize Software Quality
Authors: Puri Sanjeev
Published: June 2015

Risk management for software projects is intended to minimize the chances of unexpected events, or more specifically to keep all possible outcomes under tight management control with making judgments about how risk events are to be treated, valued, compared and combined. It is necessary to have some well-founded infrastructure for the identification of software security risks as well as the application of appropriate controls to manage risks. To be truly beneficial, the risk analysis framework must be granular and practical enough to produce a customizable roadmap of which problems exist, and to rank them in order of severity. The paper a risk assessment framework for a precise, unambiguous and efficient risk analysis with qualitative risk analysis methodologies and tree based techniques by exploiting the synthesis of risk analysis methods with object-oriented modeling, semi-formal methods and tools, in order to improve the security risk analysis of software and security policy implementation of security-critical systems to reduce risk levels and optimize quality instructions.
Comparing Classical Encryption With Modern Techniques
Authors: Kumar Mohit , Mishra Reena , Pandey Rakesh Kr. , Singh Poonam
Published: June 2015

This document reviews some of the classical encryption and modern techniques which are widely used to solve the problem in open networked systems, where information is being received and misused by adversaries by means of facilitating attacks at various levels in the communication. In this paper we propose building the basics of classical encryption and modern techniques and atleast section of paper comparison has been done between each of them.
Evaluation of Energy Ratios for Karanja and Neem Biodiesel Life Cycles
Authors: Yadav Ashok , Singh Onkar , Kumar Naveen
Published: June 2015

Biodiesel is one of the best substitutes to the fossil diesel fuel today in the world. Owing to big climatic diversity, there are numerous oil bearing seed plants/trees available in India. Extraction of the oil from these plants and its conversion to bio-diesel involves energy consumption at various stages starting from the plantation to the end use in the compression ignition engine. This paper gives the systematic evaluation of the energy consumed by Karanja and Neem trees at each stage during the growth cycle and conversion its seed oils to bio-diesel fuels. Results obtained verify that the total energy consumption during life cycles of the plants under study is lower than the energy output during combustion in IC engine.
Sliding Mode Control Application in Wind Energy Conversion System Using DSTATCOM
Authors: Bajpai R. S. , Singh Amarjeet
Published: June 2015

This paper deals with sliding mode control of converter and its application to distributed generation. Sliding mode control is used to control the voltage source converter in voltage or current control mode. Modeling and control of H bridge converter system using sliding mode control is proposed. Easily implemented sliding surfaces provide prominent dynamic characteristics against changes in the load and in the input voltage. Distribution static compensator (DSTATCOM) is used to control the voltage of the bus to which it is connected to a balance sinusoid in respect of the harmonic distortion in supply or load side. A variable wind turbine generator is used to produces a variable DC voltage which is placed as input voltage source to converter of DSTATCOM. A control strategy for grid voltage control using DSTATCOM in voltage control mode has been implemented in respect of the wind variation. The results are validated using PSCAD/EMTDC simulation studies.
A Review on the Evolution of Vehicle Routing Problems
Authors: Dubey Rameshwar
Published: June 2015

This paper provides an indepth review on evolution of vehicle routing problems from savings matrix to time dependent vehicle routing problems. It is suggested that as to how VRPBH framework of Goetschalckx and Jacobs-Blecha has offered better solution to routing problems that Clarke-Wright Savings matrix and with the introduction of time -window concept the result of heuristic has improved drastically. This is further extended by latest work on time dependent variable vehicle routing algorithm.
Innovative Teaching Techniques for Improving Academic Performance - Key to Transform Excellent Engineers
Authors: Singh Bharat Raj , Singh G. D.
Published: June 2015

This paper is designed to examine the possibility of counseling through audio / visual training, feedback devices, study tips, cultural activities, physical fitness, time scheduling, preparing course material, fixing priorities, conduct of periodical tests etc. would result in positive changes in improving academic performance of students. Wellness is a framework within which children develop a productive and enjoyable life, much of which is developed within the teaching community during their education process. Thus step by step counseling to students makes complete and overall strength into them to perform social and globalized development for the society.
Emerging Trends in Energy Management
Authors: Singh Manoj Kumar , Yadav Sunil Kumar , Singh Bharat Raj
Published: June 2015

Energy is the measure of the development of any nation. Booming economic growth, rapid industrialization and high standard of living of the global population demand more and more energy in different forms. Since the quantity of available energy from conventional resources is depleting day by day, development of newer or renewable energy technologies and improvement of conventional technologies become necessary to meet the energy demand in the future. The world is undergoing a period of global climate change. Growing demand for energy despite limited fossil fuel reserves and growing environmental concerns due to increased emissions of carbon dioxide and methane, well-known green house gases, is undoubtedly the major challenge of the 21st century. It is of international importance that technological solutions can be brought to bear to solve these problems as well as providing alternative sources of power and energy. To achieve a sustainable development, the origin and the use of energy have to be addressed, and advanced energy technologies for both fossil and renewable energy carriers have to be developed. There is need to think globally but act locally. The adoption of new energy sources, energy carriers and better energy management will not only affectnthe energy market but will also have social economic and environmental impacts. New energy technologies and particular heating and cooling technologies are decentralized and will create markets and employment essentially at a local level and, therefore, will induce a modification of individual behavior. From an economic viewpoint, new energy technologies are capital intensive sources of energy and the present period is particularly interested in the development of such technologies and systems due to relatively low cost of money and high cost of energy. The scientific community has not only to think and develop advanced energy technologies but also to contribute in improving the existing ones. Even if renewable energies and new energy carriers, such as hydrogen, are promising solutions, our society still relies on fossil fuels as primary energy for many applications.
Design Considerations for Ultra-Low Energy Wireless Micro Sensor Nodes
Authors: Chourasia Khyati , Khare Anubhuti , Saxena Manish
Published: June 2015

This tutorial paper examines architectural and circuit design techniques for a micro sensor node operating at power levels low enough to enable the use of an energy harvesting source. These requirements place demands on all levels of the design. We propose architecture for achieving the required ultra-low energy operation and discuss the circuit techniques necessary to implement the system. Dedicated hardware implementations improve the efficiency for specific functionality, and modular partitioning permits fine-grained optimization and power-gating. We describe modeling and operating at the minimum energy point in the transmitter and the ADC. A micro sensor node using the techniques we describe can function in an energy-harvesting scenario
Inhibition of Corrosion of Carbon Steel by Resorcinol-Zn2+System in Well Water
Authors: Sherine Benita , Nasser A. Jamal Abdul , Rajendran S.
Published: June 2015

The inhibition efficiencies of inhibitor systems constituting various combinations of resorcinol and zinc ions in controlling corrosion of carbon steel immersed in well water have been evaluated by weight loss method. 75 ppm of zinc has 36% inhibition efficiency (Immersion period =7 days). When 100 ppm of resorcinol is added, the IE increases to 96%. The nature of the protective film formed on the metal surface has been analyzed by FTIR spectra, SEM and AFM analysis. The protective film is found to consist of Fe2+ - resorcinol complex and Zn(OH)2.