Background/ObjectivesThe changes in blood glucose concentrations that result from an oral glucose challenge are dependent on the rate of gastric emptying, the rate of glucose absorption and the rate of insulin-driven metabolism that include the incretins, glucose-dependent insulinotropic peptide (GIP) and glucagon-like peptide-1 (GLP-1). The rate of insulin-driven metabolism is clearly altered in obese subjects, but it is controversial which of these factors is predominant. We aimed to quantify gastric emptying, plasma insulin, C-peptide, glucagon and glucose responses, as well as incretin hormone secretions in obese subjects and healthy controls during increasing glucose loads.Subjects/MethodsThe study was conducted as a randomized, double-blind, parallel-group trial in a hospital research unit. A total of 12 normal weight (6 men and 6 women) and 12 non-diabetic obese (BMI > 30, 6 men and 6 women) participants took part in the study. Subjects received intragastric loads of 10 g, 25 g and 75 g glucose dissolved in 300 ml tap water.ResultsMain outcome measures were plasma GLP-1 and GIP, plasma glucagon, glucose, insulin, C-peptide and gastric emptying. The primary findings are: i) insulin resistance (P < 0.001) and hyperinsulinemia (P < 0.001); ii) decreased insulin disposal (P < 0.001); iii) trend for reduced GLP-1 responses at 75 g glucose; and iv) increased fasting glucagon levels (P < 0.001) in obese subjects.ConclusionsIt seems that, rather than changes in incretin secretion, fasting hyperglucagonemia and consequent hyperglycemia play a role in reduced disposal of insulin, contributing to hyperinsulinemia and insulin resistance.Trial RegistrationClinicalTrials.gov NCT01875575

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In this paper we consider the problem of tracking multiple acoustic sources in reverberant environments. The solution that we propose is based on the combination of two techniques. A blind source separation (BSS) method known as TRINICON [5] is applied to the signals acquired by the microphone arrays. The TRINICON de-mixing filters are used to obtain the Time Differences of Arrival (TDOAs), which are related to the source location through a nonlinear function. A particle filter is then applied in order to localize the sources. Particles move according to a swarm-like dynamics, which significatively reduces the number of particles involved with respect to traditional particle filter. We discuss results for the case of two sources and four microphone pairs. In addition, we propose a method, based on detecting source inactivity, which overcomes the ambiguities that intrinsically arise when only two microphone pairs are used. Experimental results demonstrate that the average localization error on a variety of pseudo-random trajectories is around 40cm when the T 60 reverberation time is 0.6s.

Intelligent interaction control is required in many fields of application, in which different operative situations have to be faced with different controllers. Being able to switch between optimized controllers is, indeed, of extreme importance to maximize the task performance in the different operative conditions (i.e., free-space motion and contact), especially when considering sensorless robots. To deal with the proposed context, a sensorless optimal switching impact/force (OSIF) controller is proposed. The low-level robot control is composed of an inner joint position controller, fed by an outer Cartesian impedance controller with a reference position. The estimation of the external wrench is implemented by means of an Extended Kalman Filter (EKF). The high-level controller (feeding the Cartesian impedance controller with the setpoint) is composed of an optimized impact controller (LQR-based controller), an optimized force controller (SDREbased controller), and a continuous switching mechanism (Fuzzy Logic-based). In addition, the output of the switching mechanism is used to adapt the Cartesian impedance control parameters (i.e., stiffness and damping parameters). Experimental tests have been performed on a Franka EMIKA panda robot to validate the proposed controller. Obtained results show the capabilities of the OSIF controller, being able to detect task phase transitions while satisfying the target performance.

Genetic Creutzfeldt-Jakob disease (gCJD) represents less than 15% of CJD cases, and its clinical picture may be either indistinguishable from that of sporadic CJD (sCJD) or be atypical, usually with younger onset and longer duration. We report a case of 59-year old Brazilian man who presented rapidly progressive cognitive decline and cerebellar ataxia. EEG revealed periodic activity. A brother and a cousin of the patient had CJD. A point mutation at codon 200 (E200K) of the prion protein gene (PRNP) was found and death occurred 11 months after onset of symptoms. Autopsy was not performed. The clinical presentation of gCJD associated with E200K, which is the most frequent PRNP mutation, is quite similar to sCDJ. This is the first report of E200K mutation in Brazil, and it is possible that a more systematic search for its occurrence may show it to be relatively frequent in Brazil.