Remission of type 2 diabetes mellitus:Emerging concepts and proposed diagnostic criteria

The remission of type 2 diabetes mellitus(T2DM)is a topic that has been widely discussed recently,and it gives new hope for people with T2DM.Achievement of normal blood glucose levels or levels below the diagnostic threshold for T2DM without pharmacotherapy among people with T2DM after metabolic surgery and carbohydrate or calorie-restricted diet paved the way for more enthusiastic research in this area.There is a lot of confusion regarding the appropriate terminology and definition of remission of T2DM.In this short review,we briefly analyzed the emerging concepts and proposed criteria for diagnosing remission of T2DM,which will be helpful for healthcare providers and people with T2DM.

Therapeutic role of yoga in hypertension

Systemic hypertension is an established risk factor for coronary artery disease and cerebrovascular accident and control of blood pressure reduces the risk of a major cardiovascular event.Both non-pharmacological and pharmacological treatment options are available to treat hypertension.Yoga,recently received more attention as a treatment modality for various lifestyle disorders,even though practiced in India since ancient times.In this review,we are analyzing the role of yoga in the treatment of systemic hypertension.

192例乳腺癌患者创伤后症状及其影响因素分析

目的:研究乳腺癌患者创伤后症状及影响因素,为临床及护理干预提供参考。方法采用PTSD筛查量表、乳腺癌生活质量(FACT-B)对乳腺癌患者进行调查。结果192例乳腺癌患者创伤后症状总分为(37.91±12.71)分,再体验症状群、回避症状群、警觉性增高症状群3个因子得分分别为11.48±4.32、15.25±5.63、11.18±4.18;年龄、文化程度、婚姻状况、病理分期、患病时间是乳腺癌患者创伤后症状的影响因素(P<0.05)。乳腺癌患者创伤后症状与乳腺癌生活质量(FACT-B)总分、生理状况、功能状况及附加关注呈负相关(均P<0.05)。结论乳腺癌患者创伤后症状发生率较高,部分人口学变量及患病时间等特征会影响乳腺癌患者的创伤后症状。

Analytical solutions for dynamic pressures of coupling fluid-solid-porous medium due to P wave incidence

Wave reflection and refraction in layered media is a topic closely related to seismology,acoustics,geophysics and earthquake engineering.Analytical solutions for wave reflection and refraction coefficients in multi-layered media subjected to P wave incidence from the elastic half-space are derived in terms of displacement potentials.The system is composed of ideal fluid,porous medium,and underlying elastic solid.By numerical examples,the effects of porous medium and the incident wave angle on the dynamic pressures of ideal fluid are analyzed.The results show that the existence of the porous medium,especially in the partially saturated case,may significantly affect the dynamic pressures of the overlying fluid.

Anti-plane deformations around arbitrary-shaped canyons on a wedge-shape half-space:moment method solutions

The wave propagation behavior in an elastic wedge-shaped medium with an arbitrary shaped cylindrical canyon at its vertex has been studied.Numerical computation of the wave displacement field is carried out on and near the canyon surfaces using weighted-residuals(moment method).The wave displacement fields are computed by the residual method for the cases of elliptic,circular,rounded-rectangular and flat-elliptic canyons,The analysis demonstrates that the resulting surface displacement depends,as in similar previous analyses,on several factors including,but not limited,to the angle of the wedge,the geometry of the vertex,the frequencies of the incident waves,the angles of incidence,and the material properties of the media.The analysis provides intriguing results that help to explain geophysical observations regarding the amplification of seismic energy as a function of site conditions.

Performance-based seismic design of nonstructural building components:The next frontier of earthquake engineering

With the development and implementation of performance-based earthquake engineering,harmonization of performance levels between structural and nonstructural components becomes vital. Even if the structural components of a building achieve a continuous or immediate occupancy performance level after a seismic event,failure of architectural,mechanical or electrical components can lower the performance level of the entire building system. This reduction in performance caused by the vulnerability of nonstructural components has been observed during recent earthquakes worldwide. Moreover,nonstructural damage has limited the functionality of critical facilities,such as hospitals,following major seismic events. The investment in nonstructural components and building contents is far greater than that of structural components and framing. Therefore,it is not surprising that in many past earthquakes,losses from damage to nonstructural components have exceeded losses from structural damage. Furthermore,the failure of nonstructural components can become a safety hazard or can hamper the safe movement of occupants evacuating buildings,or of rescue workers entering buildings. In comparison to structural components and systems,there is relatively limited information on the seismic design of nonstructural components. Basic research work in this area has been sparse,and the available codes and guidelines are usually,for the most part,based on past experiences,engineering judgment and intuition,rather than on objective experimental and analytical results. Often,design engineers are forced to start almost from square one after each earthquake event: to observe what went wrong and to try to prevent repetitions. This is a consequence of the empirical nature of current seismic regulations and guidelines for nonstructural components. This review paper summarizes current knowledge on the seismic design and analysis of nonstructural building components,identifying major knowledge gaps that will need to be filled by future research. Furthermore,considering recent trends in earthquake engineering,the paper explores how performance-based seismic design might be conceived for nonstructural components,drawing on recent developments made in the field of seismic design and hinting at the specific considerations required for nonstructural components.

Phenotypic methods of greater accuracy to detect the mecA gene product for the recognition of MRSA in resource constraint settings

Objective:To evaluate the detection of methicillin resistant Staphylococcus aureus(MRSA) and analyze the performance of Mastalex MRSA(Mast,UK).Methods:Two hundred and ten Staphylococcus aureus(S.aureus) strains were isolated from different clinical samples and were tested for methicillin resistance by Oxacillin(1μg) and Cefoxitin(30μg) disc diffusion, oxacillin agar screen,and minimum inhibitory concentration of oxacillin and cefoxitin.S.aureus isolates were grown on the blood agar and mannitol salt agar with(2 mg/L) and without oxacillin for the analysis of Mastalex MRSA.Results:Out of 210 S.aureus strains tested,103 strains were detected as methicillin resistant by Cefoxitin disk diffusion,Cefoxitin minimal inhibitory concentration(MlC) and Mastalex MRSA test.Whereas oxacillin disc diffusion and oxacillin agar screen detected 91 and 97 MRSA respectively.The Cefoxitin MIC test performance was equivalent to Cefoxitin disc diffusion.103(100%) strains grown on blood agar without and with oxacillin,and 76(74%) and 93(91%) strains grown on mannitol salt agar without and with oxacillin shown positive agglutination with Mastalex MRSA test respectively.Conclusions:The cefoxitin disk diffusion/ Mastalex MRSA is very suitable for detection of MRSA and the tests can be an alternative to PCR for detection of MRSA in resource constraint settings.Mastalex test would be particularly useful when confirmation of resistance is urgently required.

Role of a probiotic (Saccharomyces boulardii) in management and prevention of diarrhoea

AIM： To assess the efficacy and safety of Saccharomyces boulardii （S. boulardii） in acute watery diarrhoea and its role in reducing the frequency of episodes of diarrhoea in subsequent two months. METHODS： Children from 2 mo to 12 years of age, with acute diarrhoea were selected according to inclusion criteria and randomised in S. boulardii group （treated with ORS, nutritional support and S. boulardii, 250 mg bid） and in control group （treated with ORS and nutritional support only）. Active treatment phase was 5 d and each child was followed for two months afterwards. Frequency and consistency of stools as well as safety of drug was assessed on every visit. A comparison of two groups was done in terms of number of diarrhoeal episode in subsequent two months. RESULTS： There were fifty patients in each group. Baseline characteristics such as mean age and the average frequency of stools were comparable in S. boulardii and control group at the time of inclusion in the trial. By d 3 it reduced to 2.7 and 4.2 stools per d respectively and by d 6 it reduced to 1.6 （5. boulardii Group） and 3.3 （control group）. The duration of diarrhoea was 3.6 d in S. boulardii group whereas it was 4.8 d in control group （P = 0.001）. In the following two months, S. boulardii group had a significantly lower frequency of 0.54 episodes as compared to 1.08 episodes in control group. The drug was well accepted and tolerated. There were no reports of the side effects during treatment period CONCLUSION： S. boulardii significantly reduces the frequency and duration of acute diarrhoea. The consistency of stool also improves. The drug is well-tolerated.

Seismic response analysis of arch dam-water-rock foundation systems

The effect of water compressibility on the seismic responses of arch dams is not well understood.In this paper,a numerical model is developed with rigorous representation of the dynamic interaction between arch dam-water- rock foundation.The model is applied to the seismic response analysis of an arch dam with a height of 292m designed to a seismic intensity of IX.It is shown that consideration of the water compressibility clearly decreases the stress responses at key positions of the dam,while the added mass model gives a conservative estimate.

Comparison of lipid profile in different grades of non-alcoholic fatty liver disease diagnosed on ultrasound

Objective:To detect and compare serum lipid abnormalities in patients diagnosed with different grades of non-alcoholic fatly liver on ultrasonography.Methods:A total of 70 cases which included 30 males and 40 females,diagnosed as nonalcoholic fatty liver disease(NAFLD)on ultrasound were investigated with serum lipid profile.Then a comparison of lipid abnormalities between different grades of fatty liver diagnosed on ultrasound was done.P value was calculated by using analysis of variance lest(ANOVA)and P value<0.05 was considered as statistically significant.Results:Out of 70 cases which were diagnosed as NAFLD on ultrasonography,gradeⅠNAFLD cases were 47.15%,gradeⅡwere 42.85%and gradeⅢwere 10%.The mean age of the patients was49.14 years.Male to female ratio was 3:4.Serum triglycerides,total cholesterol,LDL and VLDL levels were raised in 67.14%,45.71%34.28%,25.71%of cases respectively.Low serum HDL levels were seen in 62.85%of patients.On statistical analysis we found increasing grades of NAFLD were significantly associated with increasing values of total cholesterol(P value-0.001),LDL(P value-0.000)and VLDL(P value-0.003)and decreasing HDL(P value-0.000).Conclusion:Most of the patients of NAFLD in India is asymptomatic,non-diabetic and non-hypertensive.Though liver biopsy is the gold standard melhod for diagnosis of NAFLD,Ultrasonography which is non-invasive,simple tool,can be used for the early detection of NAFLD in asymptomatic patients.

Rangeland Privatization and Its Impacts on the Zoige Wetlands on the Eastern Tibetan Plateau

The high Zoige Basin （Ruoergai Plateau） on the eastern Tibetan Plateau is a fault depression formed during intensive uplifting of the Tibetan Plateau. The wetland is globally important in biodiversity and is composed of marshes, bogs, fens, wet meadows and shallow water interspersed with low hills and sub-alpine meadows. Most of the Zoige wetlands have long been one of the most important grazing lands in China. Recent rangeland policy has allowed grazing, and usable wetland areas have been being legally allocated to individuals or groups of households on a long-term lease basis. Privatizafion of the wetland has impacted the Zoige wetlands in aspects of hydrologic condition, landscape and biodiversity. The uneven spatial distribution of water resources onprivatelands has led to the practice of extracting ground water, which has decreased the perched water table in Zoige. Fencing off the rangelands and grazing on expanding sand dunes have affected landscapes. Variation in the water table has led to the changes in vegetation diversity, resulting in the changes in wildlife and aquatic diversities and ecosystem processes. Making use all year round of the pasture that was previously grazed only in summer has shrunk the daily activity space of wildlife, and the newly erected fences blocked the movement of wild animals looking for food in the snow to lower and open areas. To maintain the favorable conditions of the Zoige wetland ecosystem, the author suggests that, in addition to biophysical research and implementation of conservation practices, there is an immediate need to initiate an integrated management program, increase public awareness of wetland functions and provide better training for the local conservation staff.

Forecasting the number of zoonotic cutaneous leishmaniasis cases in south of Fars province, Iran using seasonal ARIMA time series method

Objective: To predict the trend of cutaneous leishmaniasis and assess the relationship between the disease trend and weather variables in south of Fars province using Seasonal Autoregressive Integrated Moving Average(SARIMA) model,Methods: The trend of cutaneous leishmaniasis was predicted using Mini tab software and SARIMA model,Besides,information about the disease and weather conditions was collected monthly based on time series design during January 2010 to March 2016,Moreover,various SARIMA models were assessed and the best one was selected,Then,the model's fitness was evaluated based on normality of the residuals' distribution,correspondence between the fitted and real amounts,and calculation of Akaike Information Criteria(AIC) and Bayesian Information Criteria(BIC),Results: The study results indicated that SARIMA model(4,1,4)(0,1,0)(12) in general and SARIMA model(4,1,4)(0,1,1)(12) in below and above 15 years age groups could appropriately predict the disease trend in the study area,Moreover,temperature with a three-month delay(lag3) increased the disease trend,rainfall with a four-month delay(lag4) decreased the disease trend,and rainfall with a nine-month delay(lag9) increased the disease trend,Conclusions: Based on the results,leishmaniasis follows a descending trend in the study area in case drought condition continues,SARIMA models can suitably measure the disease trend,and the disease follows a seasonal trend.

Seismic response of bridge pier on rigid caisson foundation in soil stratum

An analytical method to study the seismic response of a bridge pier supported on a rigid caisson foundation embedded in a deep soil stratum underlain by a homogeneous half space is developed. The method reproduces the kinematic and inertial responses, using translational and rotational distributed Winkler springs and dashpots to simulate the soil-caisson interaction. Closed-form solutions are given in the frequency domain for vertical harmonic S-wave excitation. Comparison with results from finite element （FE） analysis and other available solutions demonstrates the reliability of the model. Results from parametric studies are given for the kinematic and inertial responses. The modification of the fundamental period and damping ratio of the bridge due to soil-structure interaction is graphically illustrated.

Lateral load pattern in pushover analysis

The seismic capacity curves of three types of buildings including frame,frame-shear wall and shear wall ob- tained by pushover analysis under different lateral load patterns are compared with those from nonlinear time history analy- sis.Based on the numerical results obtained a two-phase load pattern:an inverted triangle(first mode)load pattern until the base shear force reaches β times its maximum value,V_(max)followed by a(x/H)~α form,here β and α being some coeffi- cients depending on the type of the structures considered,is proposed in the paper,which can provide excellent approxima- tion of the seismic capacity curve for low-to-mid-rise shear type buildings.Furthermore,it is shown both the two-phase load pattern proposed and the invariant uniform pattern can be used for low-to-mid-rise shear-bending type and low-rise bending type of buildings.No suitable load patterns have been found for high-rise buildings.

Changes in the U.S.2010 National Security Strategy——Based on Frequency of Word Usage

The National Security Strategy of the U.S.is an important document for understanding U.S.national security policy.This article uses Antconc software to analyze high-frequency word usage patterns in six U.S.National Security Strategy documents from 1990 to 2010.From the micro level of language use,we try to interpret the 2010 U.S.National Security Strategy and explore Washington's strategic motives.

Relationships between moment magnitude and fault parameters:theoretical and semi-empirical relationships

Fault parameters are important in earthquake hazard analysis.In this paper,theoretical relationships between moment magnitude and fault parameters including subsurface rupture length,downdip rupture width,rupture area,and average slip over the fault surface are deduced based on seismological theory.These theoretical relationships are further simplified by applying similarity conditions and an unique form is established.Then,combining the simplified theoretical relationships between moment magnitude and fault parameters with seismic source data selected in this study,a practical semi-empirical relationship is established.The seismic source data selected is also to used to derive empirical relationships between moment magnitude and fault parameters by the ordinary least square regression method.Comparisons between semi-empirical relationships and empirical relationships show that the former depict distribution trends of data better than the latter.It is also observed that downdip rupture widths of strike slip faults are saturated when moment magnitude is more than 7.0,but downdip rupture widths of dip slip faults are not saturated in the molnent magnitude rangcs of this study.

Bilateral sequential femoral neck stress fractures in young adult with HIV infection on antiretroviral therapy: A case report

BACKGROUND Femoral neck stress fractures are rarely encountered among young adults and are often associated with either repetitive excessive loading or underlying bone pathology.Preliminary research has indicated human immunodeficiency virus(HIV)/antiretroviral therapy(ART)as predisposing agents to osteopenia and osteoporosis related complications.We report a case of HIV/ART induced insufficiency fracture in a resource limited setting in Central India.Our aim is to increase awareness and promote screening of HIV/ART related osteopenia and osteoporosis in order to prevent catastrophic orthopaedic complications.CASE SUMMARY A 35-year-old HIV positive male presented with a stress fracture of left femoral neck.The patient was on ART and reported no comorbidities.He went on to be successfully managed surgically.However,during work-up osteopenia of the contralateral proximal femur was recognised using Singh’s Index.Six months post-op the patient presented with right-sided femoral-neck stress fracture.At this stage the patient was nonconcordant with ART and denied surgical fixation.CONCLUSION In the absence of co-morbidities,several mechanisms of HIV/antiretroviral therapy may have played a role in predisposing our patient towards such a presentation.We recommend routine screening all HIV-infected patients for osteopenia,especially in younger individuals.In low resource settings and district hospitals,pelvis radiograph&Singh’s index can be used for screening.

Full-scale dynamic testing of response-controlled buildings and their components:concepts,methods,and findings

A series of shake-table tests was conducted by inserting and replacing 4 different types of dampers,or by removing them in a full-scale 5-story steel frame building. The objective is to validate response-control technologies that are increasingly adopted for major Japanese buildings without being attested to-date by a major earthquake. Test results are briefly described,and good performance of the dampers and frame demonstrated. The concepts of the full-scale building tests and various contributions are discussed. The difficulty associated with full-scale dynamic testing is explained.

Earthquake engineering research needs in light of lessons learned from the 2011 Tohoku earthquake

Earthquake engineering research and development have received much attention since the first half of the twentieth century. This valuable research presented a huge step forward in understanding earthquake hazard mitigation,which resulted in appreciable reduction of the effects of past earthquakes. Nevertheless,the 2011 Tohoku earthquake and the subsequent tsunami resulted in major damage. This paper presents the timeline of earthquake mitigation and recovery,as seen by the authors. Possible research directions where the authors think that many open questions still remain are identified. These are primarily based on the important lessons learned from the 2011 Tohoku earthquake.