Sophie Bernard

Body Composition and Epicardial Fat in Type 2 Diabetes Patients Following Insulin Detemir Versus Insulin Glargine Initiation.

The aim of the study was to compare body composition and epicardial fat thickness changes in insulin-naïve inadequately controlled patients with type 2 diabetes following basal insulin initiation with detemir vs. glargine. Six-month, open-label, interventional randomized pilot study was conducted. Dual-energy X-ray absorptiometry and echocardiography were used to estimate the body composition and epicardial fat thickness respectively. Thirty-six patients in the detemir group and 20 in the glargine group completed the study. Study groups baseline characteristics were comparable. At 6 months, for similar glycemic control, those on detemir significantly gained less total weight (0.6±2.5 vs. 4.2±4.1u2009kg, p=0.004), total fat mass (0.9±2.2 vs. 2.9±2.4u2009kg, p=0.02), and truncal fat mass (0.8±1.5 vs. 2.1±1.7u2009kg, p=0.02), with a loss in truncal lean mass (-u20090.8±1.9u2009kg vs. 0.3±1.7u2009kg; p=0.02). EFT significantly decreased from baseline in both group (detemir -u20091.7±0.52-mm, glargine -u20091.1±1.6-mm; p<0.05, without significant difference inter-groups). Within the detemir group, epicardial fat thickness change correlated with truncal fat and total fat mass changes (r=0.65, p=0.06 and r=0.60, p=0.07). In conclusion, detemir resulted in less fat mass gain, a trend for a more pronounced epicardial fat thickness reduction when compared with glargine.

Transboundary Movement of Waste: Second-Hand Markets and Illegal Shipments

In a stylized model of international trade, firms in the North indirectly export second-hand products to a representative firm in the South to be reused as intermediate goods, with potential trade gains. The level of reusability of waste products is a crucial choice variable in the North. This is because, in the presence of imperfect international monitoring, non-reusable waste can be illegally mixed with reusable waste. I explore the driving forces for illegal waste movement, with a particular focus on local waste regulations such as the EUs Directive on Waste Electrical and Electronic Equipment. Under mild conditions, it is shown that increasingly stringent regulations in the North induce Northern firms to reduce product reusability. Consequently, the flow of non-reusable waste to the South increases, magnifying the pollution haven effect.

Relative contribution of muscle and liver insulin resistance to dysglycemia in postmenopausal overweight and obese women: A MONET group study

OBJECTIVESnThe relative contribution of muscle and liver insulin resistance (IR) in the development of dysglycemia and metabolic abnormalities is difficult to establish. The present study aimed to investigate the relative contribution of muscle IR vs. liver IR to dysglycemia in non-diabetic overweight or obese postmenopausal women and to determine differences in body composition and cardiometabolic indicators associated with hepatic or muscle IR.nnnMATERIAL AND METHODSnSecondary analysis of 156 non-diabetic overweight or obese postmenopausal women. Glucose tolerance was measured using an oral glucose tolerance test. Whole-body insulin sensitivity (IS) was determined as glucose disposal rate during a euglycemic-hyperinsulinemic clamp. Muscle and liver IR have been calculated using Abdul-Ghani et al. OGTT-derived formulas. Participants body compositions as well as cardiometabolic risk indicators were also determined.nnnRESULTSnOverall, 57 (36.5%) of patients had dysglycemia, among them 25 (16.0%); 21 (13.5%); 11 (7.1%) had impaired fasting glycemia, impaired glucose tolerance and combined glucose intolerance respectively. Fifty-three (34.0%) participants were classified as combined IS while on the opposite 51 participants (32.7%) were classified as combined IR and 26 (16.7%) participants had either muscle IR or liver IR. For similar body mass index and total fat mass, participants with liver IR were more likely to have lower whole-body IS, dysglycemia and higher visceral fat, liver fat index, triglycerides and alanine aminotransferase than participants with muscle IR.nnnCONCLUSIONnIn the present study, the presence of liver IR is associated with a higher prevalence of dysglycemia, ectopic fat accumulation and metabolic abnormalities than muscle IR.

A Bi-dimensional Assessment to Measure the Performance of Circular Economy: A Case Study of Tires End-of-Life Management

Although circular initiatives emerge around the world, the process of decoupling the economic activity from resource consumption and environmental impacts is far of being achieved. The concept of circular economy embodies the opportunity to reconcile an improved resource use while reducing the environmental footprint. Appropriate assessment metrics and methodologies are needed to identify potential trade-off between these 2 sides of a single coin. In this paper, we apply the Material Circularity Indicator (MCI) and Life Cycle Assessment (LCA) to analyse tires end-of-life strategies aiming at improving the circular flow of all tire materials. Results reveal re-treading is interesting to produce trade-offs on environmental impacts while re-grooving offers a fully decoupled strategy that improves material circularity avoiding environmental burdens. Further improvements should integrate environmental assessment as well as economic factors to link micro scale to macro scale contributions to sustainable development.

Transboundary Movements of Waste

In a stylized model of international trade, a monopolist in the North exports second-hand products to a representative firm in the South to be reused as intermediate goods, with potential trade gains. The degree of reusability of waste products is a crucial choice variable in the North. This is because with a lack of international vigilance, non-reusable waste can be mixed illegally with the reusable waste. I explore the driving forces for the movement of illegal waste, paying particular attention to the role of local waste regulations, such as the EUs Waste Electrical and Electronic Equipment directive. Under mild conditions, it is shown that increased regulation stringency in the North leads its firm to reduce the degree of reusability of its products. As a result, the flow of non-reusable waste to the South increases, providing another channel for the Pollution Haven Hypothesis.