The efficacy and safety of imeglimin as add-on therapy in patientswith type 2 diabetes inadequately controlled with metformin monotherapy

OBJECTIVE - A 12-week study assessed the efficacy and safety of a new oral antidiabetic agent, imeglimin, as add-on therapy in type 2 diabetes patients inadequately controlled with metformin alone. RESEARCH DESIGN AND METHODS - A total of 156 patients were randomized 1:1 to receive imeglimin (1,500mg twice a day) or placebo added to a stable dose of metformin (1,500-2,000 mg/day). Change in A1C from baseline was the primary efficacy outcome; secondary outcomes included fasting plasma glucose (FPG) and proinsulin/insulin ratio. RESULTS - After 12 weeks, the placebo-subtracted decrease in A1C with metformin-imeglimin was 20.44% (P <0.001). Metformin-imeglimin also significantly improved FPG and the proinsulin/insulin ratio from baseline (20.91 mg/dL and 27.5, respectively) compared with metformin-placebo (0.36 mg/dL and 11.81). Metformin-imeglimin therapy was generally welltolerated with a comparable safety profile to metformin-placebo. CONCLUSIONS - Addition of imeglimin to metformin improved glycemic control and offers potential as a new treatment for type 2 diabetes. Copyright © 2013 by the American Diabetes Association.

Cyberstalking:a matter for community safety but the numbers do not add up

The advent of the internet has led to the new phenomenon of ‘cyberstalking’. This paper examines the extent of this problem. It is argued that all of the estimates commonly cited are flawed because they rely on inaccurate or outdated information or are based on a number of unproven assumptions. Although some estimates suggest that there may be as many as 10 million victims in the United States and Canada alone, available evidence supports a far smaller estimate. It is concluded that additional research is needed to arrive at more accurate and reliable estimates

First experimental demonstration of terabit interferometric drop, add and extract multiplexer

We present the first experimental implementation of an all-optical ROADM scheme for routing of individual channels within an all-optical OFDM superchannel. The interferometric technique demonstrated enables a fully flexible node, implementing the extraction, drop and addition of individual sub-channel.

A novel architecture for all-optical add-drop multiplexing of OFDM signals

We propose a novel architecture for all-optical add-drop multiplexing of OFDM signals. Extensive numerical simulations have been carried out to benchmark the performance of the architecture against critical design parameters.

Experimental implementation of an all-optical interferometric drop, add, and extract multiplexer for superchannels

We present the experimental implementation of an all-optical ROADM scheme for routing of an individual subchannel within an all-optical OFDM superchannel. The different functions required of optical node were demonstrated using interferometric technique with the extraction, drop, and addition of individual subchannel in a ten subchannels optically aggregated signal. The scheme we reported enables a fully flexible node compatible with future terabit per second superchannel transmission.

The efficacy and safety of imeglimin as add-on therapy in patients with type 2 diabetes inadequately controlled with sitagliptin monotherapy

OBJECTIVE: This 12-week study assessed the efficacy and tolerability of imeglimin as add-on therapy to the dipeptidyl peptidase-4 inhibitor sitagliptin in patients with type 2 diabetes inadequately controlled with sitagliptin monotherapy. RESEARCH DESIGN AND METHODS: In a multicenter, randomized, double-blind, placebo-controlled, parallel-group study, imeglimin (1,500 mg b.i.d.) or placebo was added to sitagliptin (100 mg q.d.) over 12weeks in 170 patientswith type 2 diabetes (mean age 56.8 years; BMI 32.2 kg/m2) that was inadequately controlled with sitagliptin alone (A1C ≥7.5%) during a 12-week run-in period. The primary ef ficacy end point was the change in A1C from baseline versus placebo; secondary end points included corresponding changes in fasting plasma glucose (FPG) levels, strati fication by baseline A1C, and percentage of A1C responders. RESULTS: Imeglimin reduced A1C levels (least-squares mean difference) from baseline (8.5%) by 0.60% compared with an increase of 0.12% with placebo (between-group difference 0.72%, P < 0.001). The corresponding changes in FPG were -0.93 mmol/L with imeglimin vs. -0.11 mmol/L with placebo (P = 0.014). With imeglimin, the A1C level decreased by ≥0.5% in 54.3% of subjects vs. 21.6% with placebo (P < 0.001), and 19.8%of subjects receiving imeglimin achieved a decrease in A1C level of ≤7% compared with subjects receiving placebo (1.1%) (P = 0.004). Imeglimin was generally well tolerated, with a safety pro file comparable to placebo and no related treatment-emergent adverse events. CONCLUSIONS: Imeglimin demonstrated incremental efficacy benefits as add-on therapy to sitagliptin, with comparable tolerability to placebo, highlighting the potential for imeglimin to complement other oral antihyperglycemic therapies. © 2014 by the American Diabetes Association.

All-optical add-drop multiplexing of OFDM signals

We discuss the recently proposed architecture for an all-optical add-drop multiplexer of OFDM signals and we summarize the results of its theoretical design and experimental implementation. © 2015 OSA.

All-optical add-drop multiplexer for OFDM signals

We summarize our research work on the design and development of an add-drop multiplexer for spectrally overlapping OFDM signals. The standard node functions of sub-channel drop, extraction and insertion were obtained whilst the signals remained fully in the optical domain. Numerical simulations have been carried out to identify the main sources of degradation and to benchmark the architectural performance against critical design parameters, whereas the experimental demonstration of the scheme has been achieved for both single quadrature and dual quadrature signals. The reported scheme enables a fully flexible node compatible with future terabit per second super-channel transmission.

Numerical investigation of all-optical add-drop multiplexing for spectrally overlapping OFDM signals

We propose a novel architecture for all-optical add-drop multiplexing of OFDM signals. Sub-channel extraction is achieved by means of waveform replication and coherent subtraction from the OFDM super-channel. Numerical simulations have been carried out to benchmark the performance of the architecture against critical design parameters.

Experimental demonstration of an all-optical interferometric drop, add, and extract multiplexer for OFDM super-channel

The experimental implementation of an all-optical node able of routing a channel contained in an all-optical OFDM super-channel is presented. The extract function is performed through channel selection, reshaping and interferometric suppression.

Relationship between changes in postprandial glucagon, patient characteristics, and response to lixisenatide as add-on to oral antidiabetics

Background and aims: Lixisenatide, a once-daily prandial glucagon-like peptide-1 receptor agonist, reduces postprandial (PP) glycaemic excursions and HbA 1c . We report an exploratory analysis of the GetGoal-M and S trials in patients with type 2 diabetes mellitus (T2DM) with different changes in PP glucagon levels in response to lixisenatide treatment. Materials and methods: Patients (n=423) were stratified by their change in 2 hour PP glucagon level between baseline evaluation and Week 24 of treat - ment with lixisenatide as add-on to oral antidiabetics (OADs) into groups of Greater Change (GC; n=213) or Smaller Change (SC; n=210) in plasma glucagon levels (median change -23.57 ng/L). ANOVA and Chi-squared tests were used for the comparison of continuous and categorical variables, respec - tively. Baseline and endpoint continuous measurements in each group were compared using paired t -tests. Results: Mean change from baseline in 2 hour PP glucagon levels for the GC vs SC groups was -47.19 vs -0.59 ng/L (p<0.0001), respectively. Patients in the GC group had a shorter mean duration of diabetes (7.3 vs 9.0 years; p=0.0036) and lesser OAD use (4.5 vs 5.7 years; p=0.0092) than those in the SC group. Patients in the GC group had a greater mean reduction in HbA 1c (-1.10 vs -0.67%; p<0.0001), fasting plasma glucose (FPG; -25.20 vs -9.30 mg/dL [p<0.0001]), PP plasma glucose (PPG; -129.40 vs -78.22 mg/dL [p<0.0001]), and a greater drop in weight (-2.27 vs -1.17 kg; p=0.0002) and body mass index (-0.84 vs -0.44 kg/m 2 ; p=0.0002) than those in the SC group. More patients in the GC group also achieved composite endpoints, including HbA 1c <7% with no symptomatic hypoglycaemia and no weight gain (40.38 vs 19.52%; p<0.0001), than in the SC group. Conclusion: Greater reductions in PP glucagon associated with lixisenatide as add-on to OADs in patients with T2DM are also associated with greater reductions in HbA1c, FPG, PPG, and greater weight loss, highlighting the importance of glucagon suppression on therapeutic response. Clinical Trial Registration Number: NCT00712673; NCT00713830 Supported by: Sanof

Florida International University School of Medicine to add $1 billion to South Florida's economy

Official Florida International University press release on the economic impact expected to result from the establishment of a School of Medicine in South Florida.

How Do Tourist Guides Add Value to An Ecotour? Interpreting Interpretation in the State of Amazonas, Brazil

In Ecotourism, interpretation by a guide creates or shapes the experience for the tourist, differentiating one episode from another. As such, the guide S interpretation adds value to the tourism product and contributes to the visitor S experience. This paper discussed the role of interpretation by guides in the State of Amazonas, Brazil, finding in them patterns from which lessons may be drawn. Given the intangibility of the Ecotourism product, this paper argues that it is the guide who defines the quality of the product. The guide may draw the tourist toward or away from sustainable practices, and significantly contributes to the success or failure of the escotouristic venture. The State of Amazonas in Brazil already has guides, but this study questions their education and training in interpretive skills as well as their professional organization and working conditions

Add language documentation to any ethnographic project in six steps

Peer reviewed

Energy and CO2 fluxes in temperate deciduous broadleaf forests: using local add-covariance data for a global optimization of ORCHIDEE model

Non peer reviewed