Sitagliptin and other ‘gliptins’ - why prescribe them?

Introduction In 2008, the Federal Drug Administration (FDA) required all new glucose-lowering therapies to show cardiovascular safety, and this applies to the dipeptidyl peptidase (DPP)-4 inhibitors (‘gliptins’). At present, there is contradictory evidence on whether the gliptins increase hospitalizations for heart failure. Areas covered This is an evaluation of the Trial Evaluating Cardiovascular Outcomes with Sitagliptin (TECOS) in high risk cardiovascular subjects with type 2 diabetes [1]. TECOS demonstrated non-inferiority for sitagliptin over placebo for the primary outcome, which was cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for unstable angina. There was no difference in the rate of hospitalization for heart failure between sitagliptin and placebo. Expert Opinion Despite the results of TECOS, debate over the effects of sitagliptin on the rates of hospitalizations for heart failure continues with some recent studies suggesting increased rates. Recently, empagliflozin (an inhibitor of sodium-glucose cotransporter 2) has been shown to reduce cardiovascular outcomes in subjects with type 2 diabetes, including the rates of hospitalization for heart failure. In our opinion, these positive findings with empagliflozin suggest that it should be prescribed in preference to the gliptins, including sitagliptin, unless any positive cardiovascular outcomes are reported for the gliptins.

Virus-Specific Cytolytic Antibodies to Nonstructural Protein 1 of Japanese Encephalitis Virus Effect Reduction of Virus Output from Infected Cells

We demonstrate the presence of nonstructural protein 1 (NS1)-specific antibodies in a significant proportion of convalescent-phase human serum samples obtained from a cohort in an area where Japanese encephalitis virus (JEV) is endemic. Sera containing antibodies to NS1 but not those with antibodies to other JEV proteins, such as envelope, brought about complement-mediated lysis of JEV-infected BHK-21 cells. Target cells infected with a recombinant poxvirus expressing JEV NS1 on the cell surface confirmed the NS1 specificity of cytolytic antibodies. Mouse anti-NS1 cytolytic sera caused a complement-dependent reduction in virus output from infected human cells, demonstrating their important role in viral control. Antibodies elicited by JEV NS1 did not cross lyse West Nile virus- or dengue virus-infected cells despite immunoprecipitating the NS1 proteins of these related flaviviruses. Additionally, JEV NS1 failed to bind complement factor H, in contrast to NS1 of West Nile virus, suggesting that the NS1 proteins of different flaviviruses have distinctly different mechanisms for interacting with the host. Our results also point to an important role for JEV NS1-specific human immune responses in protection against JE and provide a strong case for inclusion of the NS1 protein in next generation of JEV vaccines.

Space-Vector-Based Hybrid Pulsewidth Modulation Techniques for Reduced Harmonic Distortion and Switching Loss

Novel switching sequences can be employed in spacevector-based pulsewidth modulation (PWM) of voltage source inverters. Differentswitching sequences are evaluated and compared in terms of inverter switching loss. A hybrid PWM technique named minimum switching loss PWM is proposed, which reduces the inverter switching loss compared to conventional space vector PWM (CSVPWM) and discontinuous PWM techniques at a given average switching frequency. Further, four space-vector-based hybrid PWM techniques are proposed that reduce line current distortion as well as switching loss in motor drives, compared to CSVPWM. Theoretical and experimental results are presented.

Vapor-liquid equilibrium data for the systems diisopropyl ether-n-heptane and diisopropyl ether-carbon tetrachloride at medium pressures

Vapor-liquid equilibrium data for the systems diisopropyl ether-n-heptane and diisopropyl ether-carbon tetrachloride have been reported at pressures of 760, 1520, and 2280 mm. of Hg. The systems form ideal mixtures under the pressure range studied.

Spectrophotometric and potentiometric investigations of copper (II)-ethanolamine complexes - Part I. Monoethanolamine

Spectrophotometric and potentiometric investigations have been carried out on copper-monoethanolamine complexes. Job plots at 920, 760 and 620 mµ have indicated the formation of CuA++, CuA2/++ and CuA3 ++. The$$\bar n - pA$$ curves have been obtained by a slight modification of the method of corresponding solutions and by pH measurements. The$$\bar n$$ vs. pA curves obtained at different metal concentrations coincide indicating the formation of mononuclear complexes. Experiments conducted with 0·1. 0·2, 0·5 and 1·0 M monoethanolammonium ion indicate the formation of mononuclear hydroxy complexes above pH 6. The nature of E m vs pA curves is closely analogous to that of$$\bar n$$ vs. pA curves. Absorption spectra taken at pH 9·8 with different amounts of monoethanolamine has given evidence for the formation of (CuA3OH·A)+.$$\bar n - pA$$ curves have been analyzed and the values ofβ 1, 1,β 1, 2 andβ 1, 3 have been obtained. Curves showing the distribution of complexes and the absorption curves of the individual complexes (CuA++, CuA2/++, and CuA3/++) have been calculated.

Multi-criteria seismic hazard evaluation for Bangalore city, India

Different seismic hazard components pertaining to Bangalore city,namely soil overburden thickness, effective shear-wave velocity, factor of safety against liquefaction potential, peak ground acceleration at the seismic bedrock, site response in terms of amplification factor, and the predominant frequency, has been individually evaluated. The overburden thickness distribution, predominantly in the range of 5-10 m in the city, has been estimated through a sub-surface model from geotechnical bore-log data. The effective shear-wave velocity distribution, established through Multi-channel Analysis of Surface Wave (MASW) survey and subsequent data interpretation through dispersion analysis, exhibits site class D (180-360 m/s), site class C (360-760 m/s), and site class B (760-1500 m/s) in compliance to the National Earthquake Hazard Reduction Program (NEHRP) nomenclature. The peak ground acceleration has been estimated through deterministic approach, based on the maximum credible earthquake of M-W = 5.1 assumed to be nucleating from the closest active seismic source (Mandya-Channapatna-Bangalore Lineament). The 1-D site response factor, computed at each borehole through geotechnical analysis across the study region, is seen to be ranging from around amplification of one to as high as four times. Correspondingly, the predominant frequency estimated from the Fourier spectrum is found to be predominantly in range of 3.5-5.0 Hz. The soil liquefaction hazard assessment has been estimated in terms of factor of safety against liquefaction potential using standard penetration test data and the underlying soil properties that indicates 90% of the study region to be non-liquefiable. The spatial distributions of the different hazard entities are placed on a GIS platform and subsequently, integrated through analytical hierarchal process. The accomplished deterministic hazard map shows high hazard coverage in the western areas. The microzonation, thus, achieved is envisaged as a first-cut assessment of the site specific hazard in laying out a framework for higher order seismic microzonation as well as a useful decision support tool in overall land-use planning, and hazard management. (C) 2010 Elsevier Ltd. All rights reserved.

Porphyrin synthesis in drug induced hepatic porphyria

Liver δ-aminolaevulate (ALA) synthetase and ALA dehydratase are induced to a greater extent in 3,5-diethoxy carbonyl-1,4-dihydrocollidine (DDC) injected mice as compared to the allyl isopropyl acetamide (AIA) injected rats. DDC treated mice do not show an increase in porphobilinogen (PEG) levels commensurate with the increase in ALA levels and the two enzyme activities, but accumulate enormous quantities of protoporphyrin in the liver. Normal mouse liver has an inherent greater capacity to convert PBG to porphyrins as compared to that of the rat. This together with the inhibition of iron incorporation into protoporphyrin in vivo at later stages of DDC administration can account for the large accumulation of protoporphyrin in these animals.

Studies on induction of delta-aminolevulinic acid synthetase in mouse liver

Administration of 3,5-diethoxy carbonyl-1,4-dihydrocollidine (DDC) to mice resulted in a striking increase in the level of δ-aminolevulinic acid (ALA) synthetase in liver. Although the enzyme activity was primarily localized in mitochondria and postmicrosomal supernatant fluid, a significant level of activity was also detected in purified nuclei. The time course of induction showed a close parallelism between the bound and free enzyme activities with the former always accounting for a higher percentage of the total activity as compared to the latter. Studies with cycloheximide indicated a half-life of around 3 hr for both the bound and free ALA synthetase. Actinomycin D and hemin prevented enzyme induction when administered along with DDC, but when administered 12 hr after DDC treatment Actinomycin D did not lead to a decay of either the bound or free enzyme activity and hemin inhibited the bound enzyme activity but not the free enzyme level. The molecular sizes of the mitochondrial and cytosolic ALA synthetase(s) were found to be similar on sephadex columns.

Ecology of the Asian Elephant in Southern India. I. Movement and Habitat Utilization Patterns

The movement and habitat utilization patterns were studied in an Asian elephant population during 1981-83 within a 1130 km2 area in southern India (110 30' N to 120 0' N and 760 50' E to 770 15' E). The study area encompasses a diversity of vegetation types from dry thorn forest (250-400 m) through deciduous forest (400-1400 m) to stunted evergreen shola forest and grassland (1400-1800 m). Home range sizes of some identified elephants were between 105 and 320 km2. Based on the dry season distribution, five different elephant clans, each consisting of between 50 and 200 individuals and having overlapping home ranges, could be defined within the study area. Seaso- nal habitat preferences were related to the availability of water and the palatability of food plants. During the dry months (January-April) elephants congregated at high densities of up to five individuals kM-2 in river valleys where browse plants had a much higher protein content than the coarse tall grasses on hill slopes. With the onset of rains of the first wet season (May- August) they dispersed over a wider area at lower densities, largely into the tall grass forests, to feed on the fresh grasses, which then had a high protein value. During the second wet season (September-December), when the tall grasses became fibrous, they moved into lower elevation short grass open forests. The normal movement pattern could be upset during years of adverse environmental con- ditions. However, the movement pattern of elephants in this region has not basically changed for over a century, as inferred from descriptions recorded during the nineteenth century.

Structure of columbin, a diterpenoid furanolactone from Tinospora cordifolia Miers

(1S,4R,5R,8S, IOR,12S)-4-Hydroxy-15,16-epoxycleroda-2,13 (16), 14-trieno- 17,12:18,1-biscarbolactone,C20H2206, Mr = 358.2, m.p. = 453-454 K,orthorhombic, P212121, a = 7.3869 (6), b = 11.986 (1),c=19.896(2) A, V=1761.65A 3, Z=4, D x=1.351, Din(by flotation)= 1.349gem -3, 2(CuKa)=1.5418 A, /l = 8.36 cm -1, F(000) = 760, T= 295 K,R = 0.0432 for 1662 observed reflections. Two terpenerings, two ~-lactones, two methyl groups, a tertiary hydroxyl group and a fl-substituted furan ring are present in the structure. The H atoms at C(12) and C(8) are a- and fl-oriented. The terpene ring A is locked into a boat conformation by the C(1)-C(4) lactone bridge. The furan ring is attached equatoriaUy at atom C(12). The hydroxyl group is involved in intramolecular hydrogen bonding.

The Radiation, snow characteristics and albedo at summit (RASCALS) expedition report

The RASCALS expedition spent over three weeks at the Summit camp research station near the top of the Greenland Ice Sheet during polar summer 2010. During this time, detailed measurements of the physical and optical properties of Arctic perennial snow were carried out concurrently with snow albedo and reflectance measurements. Favorable weather conditions during the campaign enabled the collection of a large dataset on Arctic snow albedo and associated quantities for use in developing and validating remote sensing algorithms for snow albedo using satellites. This report provides a description of the measurements and conditions during the campaign. RASCALS-retkikunnan tehtävä oli tutkia Grönlannin mannerjäätikön lumen fysikaalisia ja optisia ominaisuuksia sekä Auringon valon vuorovaikutusta lumen kanssa. Retikunta vietti hieman yli kolme viikkoa mannerjäätikön keskellä sijaitsevalla Summit Camp-tutkimusasemalla tehden mittauksia. Sääolot suosivat kampanjaa, jonka seurauksena onnistuttiin keräämään laaja ja monipuolinen tietoaineisto mannerjäätikön lumen pintakerroksesta ja eritoten lumen heijastavuuden (albedon)käyttäytymisestä. Aineisto on hyödyllinen kehitettäessä ja varmennettaessa lumen albedon kaukokartoitusmenetelmiä satelliiteilla.

Structure of a steriod fungal metabolite

3a,7a, 14a-Trihydroxypregn-16-en-20-one, C21H3204, M r = 348.48, orthorhombic, P212121, a = 9.211 (1), b = 13.201 (1), c = 16.031 (1),~, V = 1949.28 (29)/~3, Z = 4, Dx = 1.187 g cm -3, A(Cu Ka), = 1.5418 ,~,/z = 6.07 cm-l, F(000) = 760, T= 293 K, R = 0.061 for 1337 observations. The A, B and C rings adopt normal chair conformations with the D ring in a 14a-envelope conformation. The molecules are held together by two hydrogen bonds [0(3)..'0(20) = 2.879 and O(7).--O(14)= 2.612 A,].

An actor-critic algorithm with function approximation for discounted cost constrained Markov decision processes

We develop in this article the first actor-critic reinforcement learning algorithm with function approximation for a problem of control under multiple inequality constraints. We consider the infinite horizon discounted cost framework in which both the objective and the constraint functions are suitable expected policy-dependent discounted sums of certain sample path functions. We apply the Lagrange multiplier method to handle the inequality constraints. Our algorithm makes use of multi-timescale stochastic approximation and incorporates a temporal difference (TD) critic and an actor that makes a gradient search in the space of policy parameters using efficient simultaneous perturbation stochastic approximation (SPSA) gradient estimates. We prove the asymptotic almost sure convergence of our algorithm to a locally optimal policy. (C) 2010 Elsevier B.V. All rights reserved.