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Subcutaneous insulin resistance syndrome is a rare condition that causes difficulty in glycemic control due to severe resistance to subcutaneous insulin injections. We herein present a case of a 40-year-old woman with type 2 diabetes mellitus who had been diagnosed with subcutaneous insulin resistance syndrome since the age of 29 years, and had been persistently treated with continuous subcutaneous insulin infusion using a mixture of insulin lispro and heparin. The patient was switched from insulin lispro plus heparin to ultra-rapid insulin lispro; given that it contains treprostinil and citrate, it is expected to have similar effects as heparin, and shows similar glucose-lowering effects and insulin absorption. Our results suggest that treatment with ultra-rapid insulin lispro is effective for subcutaneous insulin resistance syndrome.

Background Severe hypoglycemia (SH) remains a central problem in the management of type 1 diabetes (T1D); however, little is known about the protective and risk factors associated with recurrent SH (RSH). This study aimed to identify the protective and risk factors for RSH in adults with T1D. Methods This cross-sectional study enrolled 287 adults with T1D (mean age: 50.3 ± 14.5 years, male: 36.2%, diabetes duration: 17.6 ± 11.2 years, mean HbA1c: 7.7 ± 0.9%) and divided them into non-SH (n = 262), solitary SH (n = 17), and RSH (n = 8) groups. Impaired awareness of hypoglycemia (IAH) assessed using the Gold’s method, diabetic complications, fear of hypoglycemia, diabetes distress, hypoglycemia problem solving abilities, and treatment data were collected. Results The overall SH rate was 16.7/100 person-years. The odds ratios of diabetic peripheral neuropathy and IAH were associated with an increased risk of RSH (odds ratio [OR]: 5.53 ,95% confidence interval [CI]: 1.18–25.98 and OR: 4.82 [95% CI:1.09–21.23], respectively); hypoglycemia problem-solving perception score was associated with a decreased risk of RSH (OR: 0.35 [95% CI: 0.18–0.69]). The rate of rtCGM use decreased as the SH category increased, but no difference was found in the rate of isCGM use. Conclusion We identified the protective factors, such as hypoglycemia problem-solving perception, in addition to the risk factors for RSH in adults with T1D. Trial registration: University hospital Medical Information Network (UMIN) Center: UMIN000039475)、Approval date 13 February 2020

This paper presents a case with type 2 diabetes mellitus on a very low-carbohydrate diet who developed euglycemic diabetic ketoacidosis (EDKA) 3 days after starting sodium-glucose cotransporter 2 inhibitors (SGLT2i). When initiating SGLT2i, healthcare providers should confirm the implementation of a low-carbohydrate diet and provide intensive guidance to prevent EDKA.

Background Hypoglycemia in type 1 diabetes (T1D) is associated with mortality and morbidity, especially when awareness of hypoglycemia is impaired. This study aimed to investigate the protective and risk factors for impaired awareness of hypoglycemia (IAH) in adults with T1D. Methods This cross-sectional study enrolled 288 adults with T1D (mean age, 50.4 ± 14.6 years; male, 36.5%; diabetes duration, 17.6 ± 11.2 years; mean HbA1c level, 7.7 ± 0.9%), who were divided into IAH and non-IAH (control) groups. A survey was conducted to assess hypoglycemia awareness using the Clarke questionnaire. Diabetes histories, complications, fear of hypoglycemia, diabetes distress, hypoglycemia problem-solving abilities, and treatment data were collected. Results The prevalence of IAH was 19.1%. Diabetic peripheral neuropathy was associated with an increased risk of IAH (odds ratio [OR] 2.63; 95% confidence interval [CI] 1.13–5.91; P = 0.014), while treatment with continuous subcutaneous insulin infusion and hypoglycemia problem-solving perception scores were associated with a decreased risk of IAH (OR, 0.48; 95% CI, 0.22–0.96; P = 0.030; and OR, 0.54; 95% CI, 0.37–0.78; P = 0.001, respectively). There was no difference in continuous glucose monitoring use between the groups. Conclusions We identified protective factors in addition to risk factors for IAH in adults with T1D. This information may help manage problematic hypoglycemia. Trial registration: University hospital Medical Information Network (UMIN) Center: UMIN000039475)、Approval date 13 February 2020

We conducted a randomized, crossover trial to compare intermittent-scanning continuous glucose monitoring (isCGM) device with structured education (Intervention) to self-monitoring of blood glucose (SMBG) (Control) in the reduction of time below range.This crossover trial involved 104 adults with type 1 diabetes mellitus (T1DM) using multiple daily injections. Participants were randomly allocated to either sequence Intervention/Control or sequence Control/Intervention. During the Intervention period which lasted 84 days, participants used the first-generation FreeStyle Libre (Abbott Diabetes Care, Alameda, CA, USA) and received structured education on how to prevent hypoglycemia based on the trend arrow and by frequent sensor scanning (≥10 times a day). Confirmatory SMBG was conducted before dosing insulin. The Control period lasted 84 days. The primary endpoint was the decrease in the time below range (TBR;70 mg/dL).The time below range was significantly reduced in the Intervention arm compared to the Control arm (2.42 ± 1.68 h/day [10.1 %±7.0 %] vs 3.10 ± 2.28 h/day [12.9 %±9.5 %], P = 0.012). The ratio of high-risk participants with low blood glucose index 5 was significantly reduced (8.6 % vs 23.7 %, P 0.001).The use of isCGM combined with structured education significantly reduced the time below range in patients with T1DM.

This university has published the "MMDAgent" voice interaction system toolkit as opensource software. MMDAgent enables users to develop voice interaction system easily by editing the voice interaction scenario based on Finite State Transducer (FST) format. For increase agent's vocabulary, it is important to describe a lot of voice interaction scenario. Until now, voice interaction scenario has been described by a small organization. So, it takes a high cost to describe a lot of voice interaction scenario. For solve this problem, we construct crowdsourcing model for creation voice interaction scenario. In this study, the works of creation of voice interaction scenario is devided and distributed to a large number of people via the internet.

The ability of microglia to produce/secrete glial cell line-derived neurotrophic factor (GDNF) in vitro was examined. Immunoblotting analysis revealed that nonstimulated microglia release limited amounts of GDNF with molecular sizes of 14 and 17 kDa. However, the secreted amounts significantly decreased when the microglia were activated with the endotoxin lipopolysaccharide (LPS). Comparison of the amounts of GDNF in the cells and the conditioned medium between the nonstimulated microglia and LPS-stimulated microglia clarified that the secretion of GDNF, but not its production, is strongly suppressed when the microglia are activated with LPS. The inhibitor experiments suggested that the GDNF secretion is depressed by a signaling cascade associated with protein kinase C alpha (PKCalpha) and/or mitogen-activated protein kinases (MAPKs). As expected from the above results, a PKC activator suppressed the secretion of GDNF in nonstimulated microglia. Taken together, these results demonstrated that microglia have the ability to produce and secrete GDNF in vitro, and that the secretion is suppressed by stimulation with endotoxin, probably due to a signaling mechanism involving PKCalpha and/or MAPKs.

This university has published the "MMDAgent" voice interaction system toolkit as open source software. Voice Interaction Agent, produced using MMDAgent, is active in various scenarios and provides voice interaction capability. Voice interaction agents produced using MMDAgent talk to people by loading a script file that describes a voice interaction scenario. To increase the agent's vocabulary, it is important to describe many voice interaction scenarios. To date, voice interaction scenarios have been described by a small organization. Therefore, they require high costs to describe many voice interaction scenarios. To resolve this problem, we construct a crowdsourcing[1] model for the creation of a voice interaction scenario. In this study, the works of creation of voice interaction scenario are divided and distributed to numerous people via the internet. Furthermore, we provide in this study a tool for creation voice interaction scenario and test operation of voice interaction agent as a web application service. We hereby reduce the cost of installation MMDAgent and provide a comfortable environment for the creation voice interaction scenario.

Various types of differently fluorinated-alkyl sulfate ionic liquids have been prepared; the hydrophobicity was dependent on the content ratio of the fluorine on the alkyl sulfate anion and 2,2,3,3,4,4,5,5-octafluoropentyl sulfate salts showed hydrophobic properties. Melting point and viscosity were also dependent on the fluorine contents of the anionic part, while conductivity was determined by the cationic part and not influenced by the fluorine contents. Efficient lipase-catalyzed transesterification was demonstrated using hydrophobic 1-butyl-3-methylimidazolim 2,2,3,3,4,4,5,5-octafluoropentyl sulfate ([bmim][C5F8]) as solvent.

地球温暖化の主要な原因の一つになっている，火力発電所からの排ガスに含有されるCO2をハニカム型ゼオライトを充填した回転式吸着塔を用いた，TSA方式で除去・濃縮するための基礎試験，パイロット試験およびシステム最適化のため吸脱着挙動のシミュレーション計算を行った．この結果，CO2の平衡吸着量は濃度と温度の関数としたLangmuir型で，また気–固間の物質移動と熱移動のJ因子はいずれもRe数の関数として一つの式で表示できることがわかった．次いで，実機を模擬した，内径460 mm，充填層高480 mmのパイロット試験により，CO2の回収率は80%以上可能であることを確認した．さらに，物質移動や熱移動などを考慮した回転式吸脱着装置のシミュレーション計算を実施した．まず，基礎試験結果およびパイロット試験結果とシミュレーション計算結果を比較することにより計算の妥当性を確認した．次いで，吸着，加熱再生，パージおよび冷却の各工程におけるCO2の吸脱着挙動を把握し，システム最適化への指針を得た．

This university has published the “MMDAgent” voice interaction system toolkit as opensource software. MMDAgent enables users to develop voice interaction system easily by editing the voice interaction scenario based on Finite State Transducer (FST) format. However, having numerous people edit it simultaneously is difficult. For that reason, tremendous labor costs are necessary to describe an abundant voice interaction scenario in an FST script. Therefore, in this study, we propose construction of a crowdsourcing environment for the creation of a voice interaction scenario for systems, facilitating the editing of a FST script by numerous people.

Osteopontin is a proinflammatory cytokine and monocyte chemoattractant implicated in the pathogenesis of diabetic nephropathy. Synthetic agonists for liver X receptors (LXRs) suppress the expression of proinflammatory genes, including osteopontin, but whether LXR activation modulates diabetic nephropathy is unknown. We administered the LXR agonist T0901317 to mice with streptozotocin-induced diabetes and evaluated its effects on diabetic nephropathy. The LXR agonist decreased urinary albumin excretion without altering blood glucose levels and substantially attenuated macrophage infiltration, mesangial matrix accumulation, and interstitial fibrosis. LXR activation suppressed the gene expression of inflammatory mediators, including osteopontin, in the kidney cortex. In vitro, LXR activation suppressed osteopontin expression in proximal tubular epithelial cells by inhibiting AP-1-dependent transcriptional activation of the osteopontin promoter. Taken together, these results suggest that inhibition of renal osteopontin by LXR agonists may have therapeutic potential for diabetic nephropathy.

Context: Vaspin is an adipokine with insulin-sensitizing effects identified from visceral adipose tissues of genetically obese rats. Objective: We investigated genetic and nongenetic factors that define serum concentrations of vaspin. Design, Setting and Participants: Vaspin levels were measured with RIA in Japanese subjects with normal fasting plasma glucose (NFG; n = 259) and type 2 diabetes patients (T2D; n = 275). Single nucleotide polymorphisms (SNP) at SERPINA12 (vaspin) gene locus were discovered, and five SNP were genotyped in the subjects with varied body mass index (n = 1138). Results: The level of serum vaspin in 93% of the samples was found to vary from 0.2 to nearly 2 ng/ml in NFG subjects (n = 259) and from 0.2 to nearly 3 ng/ml in T2D patients (n = 275) (Vaspin(Low) group), whereas a significant subpopulation (7%) in both groups displayed much higher levels of 10-40 ng/ml (Vaspin(High) group). In the Vaspin(Low) group, serum vaspin levels in T2D were significantly higher than healthy subjects (0.99 +/- 0.04 vs. 0.86 +/- 0.02 ng/ml; P < 0.01). Both in T2D and genotyped Japanese population, serum vaspin levels closely correlated with homeostasis model of assessment for insulin resistance rather than anthropometric parameters. By genotyping, rs77060950 tightly linked to serum vaspin levels, i.e. CC (0.6 +/- 0.4 ng/ml), CA (18.4 +/- 9.6 ng/ml), and AA (30.5 +/- 5.1 ng/ml) (P < 2 x 10(-16)). Putative GATA-2 and GATA-3 binding consensus site was found at rs77060950. Conclusions: Serum vaspin levels were related to insulin resistance, and higher levels of serum vaspin in 7% of the Japanese population are closely linked to minor allele sequence (A) of rs77060950. (J Clin Endocrinol Metab 97: E1202-E1207, 2012)

Background The objective of this study was to investigate the indigenous utilization of termite mounds and termites in a rain-fed rice growing village in the central plain of Laos, where rice production is low and varies year-to-year, and to assess the possibility of sustainable termite mound utilization in the future. This research was carried out from 2007 to 2009. Methods The termites were collected from their mounds and surrounding areas and identified. Twenty villagers were interviewed on their use of termites and their mounds in the village. Sixty-three mounds were measured to determine their dimensions in early March, early July and middle to late November, 2009. Results Eleven species of Termitidae were recorded during the survey period. It was found that the villagers use termite mounds as fertilizer for growing rice, vegetable beds and charcoal kilns. The villagers collected termites for food and as feed for breeding fish. Over the survey period, 81% of the mounds surveyed increased in volume; however, the volume was estimated to decrease by 0.114 m3 mound-1 year-1 on average due to several mounds being completely cut out. Conclusion It was concluded that current mound utilization by villagers is not sustainable. To ensure sustainable termite utilization in the future, studies should be conducted to enhance factors that promote mound restoration by termites. Furthermore, it will be necessary to improve mound conservation methods used by the villagers after changes in the soil mass of mounds in paddy fields and forests has been measured accurately. The socio-economic factors that affect mound utilization should also be studied.

OBJECTIVE Activation of the nuclear hormone receptor peroxisome proliferator–activated receptor (PPAR)-δ has been shown to improve insulin resistance, adiposity, and plasma HDL levels. Several studies have reported that activation of PPARδ is atheroprotective; however, the role of PPARδ in renal function remains unclear. Here, we report the renoprotective effects of PPARδ activation in a model of streptozotocin-induced diabetic nephropathy. RESEARCH DESIGN AND METHODS Eight-week-old male C57BL/6 mice were divided into three groups: 1) nondiabetic control mice, 2) diabetic mice, and 3) diabetic mice treated with the PPARδ agonist GW0742 (1 mg/kg/day). GW0742 was administered by gavage for 8 weeks after inducing diabetes. RESULTS GW0742 decreased urinary albumin excretion without altering blood glucose levels. Macrophage infiltration, mesangial matrix accumulation, and type IV collagen deposition were substantially attenuated by GW0742. The gene expression of inflammatory mediators in the kidney cortex, such as monocyte chemoattractant protein-1 (MCP-1) and osteopontin (OPN), was also suppressed. In vitro studies demonstrated that PPARδ activation increased the expression of anti-inflammatory corepressor B-cell lymphoma-6, which subsequently suppressed MCP-1 and OPN expression. CONCLUSIONS These findings uncover a previously unrecognized mechanism for the renoprotective effects of PPARδ agonists and support the concept that PPARδ agonists may offer a novel therapeutic approach for the treatment of diabetic nephropathy.

Localization of insulinomas by preoperative imaging is critical for successful surgical resection. However, the visualization and localization of small insulinomas by recent imaging modalities still remains a challenge. Here, we report a 77-year-old woman with a small insulinoma successfully localized by performing arterial stimulation and venous sampling (ASVS), and subsequent super-selective CTA (SSCTA). It was not visualized by routine non-invasive imaging tests such as digital subtraction angiography (DSA). The small size (1.0 cm) of the surgically removed tumor supports the usefulness of SSCTA for localizing very small insulinomas.

A three-dimensional finite-element model was used to analyse the effective thermal conductivity of dispersed systems of spheres of various sizes, and the results were compared with several known models. Among the known models considered, the Maxwell-Eucken model was shown to give a fairly good approximation for the effective thermal conductivity when the dispersed spheres were arrayed in a simple cubic lattice and a body-centred cubic lattice over a range of thermal-conductivity ratios of the spheres and the continuous phase, which varied between 0.01 and 100. The applicability of the Maxwell-Eucken model suggested by the finite-element analysis was confirmed by experimental measurements for gels in which solid paraffin particles or liquid paraffin droplets were dispersed.

The enzymatic saccharification of a model cellulosic substrate, Avicel PH-101, using an ionic liquid (IL), 1-ethyl-3-methylimidazolium diethylphosphate, was explored. After mixing the IL solution of cellulose with different volumes of 10 mM citrate buffer (pH 5.0), cellulase was directly added to the aqueous-IL mixture at 40 degrees C. When the volume of IL to water was greater than 3:2, little cellulase activity was observed. However, decreasing the volume ratio markedly enhanced enzymatic activity: an IL to water ratio of 1:4 (v/v) resulted in over 70% of the starting amount of cellulose (10 mg/ml) being converted to glucose and cellobiose.

Several types of imidazolium salt ionic liquids were prepared derived from poly(oxyethylene)alkyl sulfate and used as an additive or coating material for lipase-catalyzed transesterification in an organic solvent. A remarkably increased enantioselectivity was obtained when the salt was added at 3-10 mol % versus substrate in the Burkholderia cepacia lipase (lipase PS-C)-catalyzed transesterification of 1-phenylethanol by using vinyl acetate in diisopropyl ether or a hexane solvent system. In particular, a remarkable acceleration was accomplished by the ionic liquid coating with lipase PS in an iPr(2)O solvent system while maintaining excellent enantioselectivity; it reached approximately 500- to 1000-fold acceleration for some substrates with excellent enantioselectivity. A similar acceleration was also observed for IL 1-coated Candida rugosa lipase. MALDI-TOF mass spectrometry experiments of the ionic-liquid-coated lipase PS suggest that ionic liquid binds with lipase protein.

The molecular mechanism by which the deleterious cytokines interleukin 1 beta (IL-1beta) and tumor necrosis factor alpha (TNFalpha) are induced in endotoxin-stimulated microglia was investigated from the viewpoint of signal transduction. Neither cytokine is produced in nonstimulated rat microglia, but both are remarkably induced by stimulation with endotoxin lipopolysaccharide (LPS). LPS-inducible IL-1beta was significantly suppressed by pretreatment with the nuclear factor kappa B (NFkappaB) inhibitor ammonium pyrrolidine dithiocarbamate (APDC), but TNFalpha was not. APDC was actually confirmed to suppress the degradation of IkappaBalpha and IkappaBbeta in microglia, indicating a role for the inhibitor of NFkappaB activation. Taken together, these results suggest that the induction of IL-1beta and TNFalpha in endotoxin-stimulated microglia is differentially regulated at the level of NFkappaB activation.

Novel imidazolium salt ionic liquids were prepared derived from polyoxyethylene(10) cetyl sulfate and used as an additive for lipase-catalyzed transesterification in organic solvent; a remarkable enhanced enantioselectivity was obtained when the salt was added in 3 to 10 mol% vs. substrate in the Pseudomonas cepacia lipase-catalyzed transesterification of 1-phenylethanol using vinyl acetate in a diisopropyl ether or hexane solvent system. There was a remarkable acceleration when the lipase was coated with this novel ionic liquid and used as catalyst for transesterification in i-Pr2O or in hexane.