WorldWideScience

Sample records for kamchatka glare sglt

  1. Kamchatka

    Directory of Open Access Journals (Sweden)

    Alessandra Russo

    2005-02-01

    Full Text Available Photo prise de : http://cine.ciudad.com.ar/kamchatkalapelicula/castellano/fotos/fotos.htm « La péninsule du Kamchatka est située à l’extrême frontière orientale de la Fédération de Russie, au nord du Japon et au Sud-Ouest de l’Alaska. Celle-ci s’étire sur 1500 km du nord au sud et 470 km dans sa plus grande largeur entre les latitudes 50°51’N (hauteur de Bruxelles et 64°50’N». Qu’est-ce que tout cela a à voir avec le déchaînement de la dictature argentine ? En 1976 une famille porteña se voi...

  2. Temporal Glare

    DEFF Research Database (Denmark)

    Ritschel, Tobias; Ihrke, Matthias; Frisvad, Jeppe Revall

    2009-01-01

    Glare is a consequence of light scattered within the human eye when looking at bright light sources. This effect can be exploited for tone mapping since adding glare to the depiction of high-dynamic range (HDR) imagery on a low-dynamic range (LDR) medium can dramatically increase perceived contra...... to initially static HDR images. By conducting psychophysical studies, we validate that our method improves perceived brightness and that dynamic glare-renderings are often perceived as more attractive depending on the chosen scene.......Glare is a consequence of light scattered within the human eye when looking at bright light sources. This effect can be exploited for tone mapping since adding glare to the depiction of high-dynamic range (HDR) imagery on a low-dynamic range (LDR) medium can dramatically increase perceived contrast....... Even though most, if not all, subjects report perceiving glare as a bright pattern that fluctuates in time, up to now it has only been modeled as a static phenomenon. We argue that the temporal properties of glare are a strong means to increase perceived brightness and to produce realistic...

  3. Flying GLARE

    NARCIS (Netherlands)

    Beumler, T.

    2004-01-01

    At the end of the second millennium did the aircraft industry decide for the first time to apply the fiber metal laminate GLARE in a large quantity on a civil transport aircraft. It was focused on an application of the material on the pressurised fuselage, the decision driven by the demand for

  4. SGLT2 inhibitors.

    Science.gov (United States)

    Dardi, I; Kouvatsos, T; Jabbour, S A

    2016-02-01

    Diabetes mellitus is a serious health issue and an economic burden, rising in epidemic proportions over the last few decades worldwide. Although several treatment options are available, only half of the global diabetic population achieves the recommended or individualized glycemic targets. Sodium-glucose cotransporter 2 (SGLT2) inhibitors are a new class of antidiabetic agents with a novel insulin-independent action. SGLT2 is a transporter found in the proximal renal tubules, responsible for the reabsorption of most of the glucose filtered by the kidney. Inhibition of SGLT2 lowers the blood glucose level by promoting the urinary excretion of excess glucose. Due to their insulin-independent action, SGLT2 inhibitors can be used with any degree of beta-cell dysfunction or insulin resistance, related to a very low risk of hypoglycemia. In addition to improving glycemic control, SGLT2 inhibitors have been associated with a reduction in weight and blood pressure when used as monotherapy or in combination with other antidiabetic agents in patients with type 2 diabetes mellitus (T2DM). Treatment with SGLT2 inhibitors is usually well tolerated; however, they have been associated with an increased incidence of urinary tract and genital infections, although these infections are usually mild and easy to treat. SGLT2 inhibitors are a promising new option in the armamentarium of drugs for patients with T2DM. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Glare disability and driving safety.

    Science.gov (United States)

    Babizhayev, M A

    2003-01-01

    Increasing investigation of the visual elements of safe driving environments may be of great benefit to society. Visual disability appears to be only one of many visual factors related to traffic accidents. The purpose of this article was to examine the type of visual impairment mediated by the increased glare sensitivity in adult drivers using the original halometer glare test. In this article, the visual sensory, cognitive and motor functions relevant to driving, their measurement, the epidemiology and prevention of age-associated functional impairments and the relationship of functional impairments to both self-reported driving and the imposition of legal restrictions are reviewed. The problem of night and tunnel driving is the most urgent in relation to the effects of glare from vehicle headlights on motion perception of drivers. The reduced mesopic vision and increased sensitivity to glare are accompanied by an increased risk of nighttime accidents. Elderly drivers and patients with beginning cataract cannot sufficiently fulfill the criteria for night driving ability because of contrast and glare sensitivity. It is indispensable for the parameters mentioned to be carefully measured and for drivers to be informed that night driving ability may be impaired, even if visual acuity is sufficient. It would be advisable for traffic safety if simple tests for contrast and glare sensitivity were implemented for vehicles and/or were regularly added to the requirements for a driver's licence, at least for older drivers. The age, functional status and test result limits should be defined to avoid a risk factor in traffic. Copyright 2003 S. Karger AG, Basel

  6. Glare Spot Phase Doppler Anemometry

    OpenAIRE

    Hespel, Camille; Ren, Kuan Fang; Gréhan, Gérard; Onofri, Fabrice

    2006-01-01

    International audience; The Phase Doppler anemometry has been developed to measure simultaneously the velocity and the size of droplets. The measurement of the refractive index is also necessary since it depends on the temperature and the composition of the particle and its measurement permits both to increase the quality of the diameter measurement and to obtain information on the temperature and/or the composition of the droplets. In this paper, we introduce a Glare Spot Phase Doppler Anemo...

  7. Glare Spot Phase Doppler Anemometry

    Science.gov (United States)

    Hespel, Camille; Ren, Kuanfang; Gréhan, Gérard; Onofri, Fabrice

    2007-06-01

    The Phase Doppler anemometry has been developed to measure simultaneously the velocity and the size of droplets. The measurement of the refractive index would be also interesting since it depends on the temperature and the composition of the particle and its measurement permits both to increase the quality of the diameter measurement and to obtain information on the temperature and/or the composition of the droplets. In this paper, we introduce a Glare Spot Phase Doppler Anemometry which uses two large beams. In this case, the images of the particle formed by the reflected and refracted light, known as glare spots, are separated in space. When a particle passes in the probe volume, the two parts in a signal obtained by a detector in forward direction are then separated in time. If two detectors are used the phase differences between two signals, the distance and the intensity ratio of reflected and refracted parts can be obtained and they provide rich information about the particle diameter and its refractive index, as well as its velocity. This paper is devoted to the numerical study of such a configuration with two theoretical models: geometrical optics and rigorous electromagnetism solution.

  8. Macular pigment and visual performance in glare: benefits for photostress recovery, disability glare, and visual discomfort.

    Science.gov (United States)

    Stringham, James M; Garcia, Paul V; Smith, Peter A; McLin, Leon N; Foutch, Brian K

    2011-09-22

    One theory of macular pigment's (MP) presence in the fovea is to improve visual performance in glare. This study sought to determine the effect of MP level on three aspects of visual performance in glare: photostress recovery, disability glare, and visual discomfort. Twenty-six subjects participated in the study. Spatial profiles of MP optical density were assessed with heterochromatic flicker photometry. Glare was delivered via high-bright-white LEDs. For the disability glare and photostress recovery portions of the experiment, the visual task consisted of correct identification of a 1° Gabor patch's orientation. Visual discomfort during the glare presentation was assessed with a visual discomfort rating scale. Pupil diameter was monitored with an infrared (IR) camera. MP level correlated significantly with all the outcome measures. Higher MP optical densities (MPODs) resulted in faster photostress recovery times (average P disability glare contrast thresholds (average P visual discomfort (P = 0.002). Smaller pupil diameter during glare presentation significantly correlated with higher visual discomfort ratings (P = 0.037). MP correlates with three aspects of visual performance in glare. Unlike previous studies of MP and glare, the present study used free-viewing conditions, in which effects of iris pigmentation and pupil size could be accounted for. The effects described, therefore, can be extended more confidently to real-world, practical visual performance benefits. Greater iris constriction resulted (paradoxically) in greater visual discomfort. This finding may be attributable to the neurobiologic mechanism that mediates the pain elicited by light.

  9. Volcanic Eruptions in Kamchatka

    Science.gov (United States)

    2007-01-01

    [figure removed for brevity, see original site] [figure removed for brevity, see original site] Sheveluch Stratovolcano Click on the image for full resolution TIFF Klyuchevskoy Stratovolcano Click on the image for full resolution TIFF One of the most volcanically active regions of the world is the Kamchatka Peninsula in eastern Siberia, Russia. It is not uncommon for several volcanoes to be erupting at the same time. On April 26, 2007, the Advanced Spaceborne Thermal Emission and Reflection Radioneter (ASTER) on NASA's Terra spacecraft captured these images of the Klyuchevskoy and Sheveluch stratovolcanoes, erupting simultaneously, and 80 kilometers (50 miles) apart. Over Klyuchevskoy, the thermal infrared data (overlaid in red) indicates that two open-channel lava flows are descending the northwest flank of the volcano. Also visible is an ash-and-water plume extending to the east. Sheveluch volcano is partially cloud-covered. The hot flows highlighted in red come from a lava dome at the summit. They are avalanches of material from the dome, and pyroclastic flows. With its 14 spectral bands from the visible to the thermal infrared wavelength region, and its high spatial resolution of 15 to 90 meters (about 50 to 300 feet), ASTER images Earth to map and monitor the changing surface of our planet. ASTER is one of five Earth-observing instruments launched December 18, 1999, on NASA's Terra spacecraft. The instrument was built by Japan's Ministry of Economy, Trade and Industry. A joint U.S./Japan science team is responsible for validation and calibration of the instrument and the data products. The broad spectral coverage and high spectral resolution of ASTER provides scientists in numerous disciplines with critical information for surface mapping, and monitoring of dynamic conditions and temporal change. Example applications are: monitoring glacial advances and retreats; monitoring potentially active volcanoes; identifying crop stress; determining cloud morphology and

  10. Consensus and new improvements of disability glare

    Directory of Open Access Journals (Sweden)

    Yu-Wei Zheng

    2014-12-01

    Full Text Available Patients with early cataract may have normal visual acuity(VAbut complain that they have problems in driving at night, like seeing things through a veil. This phenomenon is defined as disability glare which maybe caused by growing stray light. Patients with intraocular lens following cataract surgery may complain about glare, halos and shadows in visual field, which are also resulted from dysphotopia. Disability glare is the VA loss due to disturbing luminance in visual field. In other words, it's the retinal contrast sensitivity reduction because of the straylight. This article contains the consensus and new progress of disability glare. It provides solutions according to its effect factors and offers clues for further study.

  11. Evaluation on Glare from Vehicle Lamps and Effectiveness of Road Components as Glare Barriers

    NARCIS (Netherlands)

    Mangkuto, R.A.; Paripurna, A.; Soelami, F.X.N.

    2009-01-01

    Vehicle lamps are vital components which are required to ensure the driver’s safety, particularly at nighttime. However, vehicle lamps may cause glare which can reduce visibility and create discomfort. The objectives of this research are to evaluate glare from car headlamp and motorcycle lamps; and

  12. Increase in SGLT1-mediated transport explains renal glucose reabsorption during genetic and pharmacological SGLT2 inhibition in euglycemia

    Science.gov (United States)

    Rieg, Timo; Masuda, Takahiro; Gerasimova, Maria; Mayoux, Eric; Platt, Kenneth; Powell, David R.; Thomson, Scott C.; Koepsell, Hermann

    2013-01-01

    In the kidney, the sodium-glucose cotransporters SGLT2 and SGLT1 are thought to account for >90 and ∼3% of fractional glucose reabsorption (FGR), respectively. However, euglycemic humans treated with an SGLT2 inhibitor maintain an FGR of 40–50%, mimicking values in Sglt2 knockout mice. Here, we show that oral gavage with a selective SGLT2 inhibitor (SGLT2-I) dose dependently increased urinary glucose excretion (UGE) in wild-type (WT) mice. The dose-response curve was shifted leftward and the maximum response doubled in Sglt1 knockout (Sglt1−/−) mice. Treatment in diet with the SGLT2-I for 3 wk maintained 1.5- to 2-fold higher urine glucose/creatinine ratios in Sglt1−/− vs. WT mice, associated with a temporarily greater reduction in blood glucose in Sglt1−/− vs. WT after 24 h (−33 vs. −11%). Subsequent inulin clearance studies under anesthesia revealed free plasma concentrations of the SGLT2-I (corresponding to early proximal concentration) close to the reported IC50 for SGLT2 in mice, which were associated with FGR of 64 ± 2% in WT and 17 ± 2% in Sglt1−/−. Additional intraperitoneal application of the SGLT2-I (maximum effective dose in metabolic cages) increased free plasma concentrations ∼10-fold and reduced FGR to 44 ± 3% in WT and to −1 ± 3% in Sglt1−/−. The absence of renal glucose reabsorption was confirmed in male and female Sglt1/Sglt2 double knockout mice. In conclusion, SGLT2 and SGLT1 account for renal glucose reabsorption in euglycemia, with 97 and 3% being reabsorbed by SGLT2 and SGLT1, respectively. When SGLT2 is fully inhibited by SGLT2-I, the increase in SGLT1-mediated glucose reabsorption explains why only 50–60% of filtered glucose is excreted. PMID:24226519

  13. SGLT-2 Inhibitors and Cardiovascular Risk

    DEFF Research Database (Denmark)

    Cavender, Matthew A; Norhammar, Anna; Birkeland, Kåre I

    2018-01-01

    BACKGROUND: Prior studies found patients treated with sodium-glucose co-transporter-2 inhibitors (SGLT-2i) had lower rates of death and heart failure (HF). Whether the benefits of SGLT-2i vary based upon the presence of cardiovascular disease (CVD) is unknown. OBJECTIVES: This study sought...... to determine the association between initiation of SGLT-2i therapy and HF or death in patients with and without CVD. METHODS: The CVD-REAL (Comparative Effectiveness of Cardiovascular Outcomes in New Users of SGLT-2 Inhibitors) study was a multinational, observational study in which adults with type 2 diabetes...... evidence regarding the benefit of SGLT-2i in patients without established CVD. (Comparative Effectiveness of Cardiovascular Outcomes in New Users of SGLT-2 Inhibitors [CVD-REAL]; NCT02993614)....

  14. November 1952 Kamchatka Peninsula, Russia Images

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The tsunami was generated by a magnitude 9.0 (Mw) earthquake on Kamchatka where it caused severe damage. The tsunami then struck Midway (3,000 kilometers away), the...

  15. SGLT2 Inhibitors May Predispose to Ketoacidosis.

    Science.gov (United States)

    Taylor, Simeon I; Blau, Jenny E; Rother, Kristina I

    2015-08-01

    Sodium glucose cotransporter 2 (SGLT2) inhibitors are antidiabetic drugs that increase urinary excretion of glucose, thereby improving glycemic control and promoting weight loss. Since approval of the first-in-class drug in 2013, data have emerged suggesting that these drugs increase the risk of diabetic ketoacidosis. In May 2015, the Food and Drug Administration issued a warning that SGLT2 inhibitors may lead to ketoacidosis. Using PubMed and Google, we conducted Boolean searches including terms related to ketone bodies or ketoacidosis with terms for SGLT2 inhibitors or phlorizin. Priority was assigned to publications that shed light on molecular mechanisms whereby SGLT2 inhibitors could affect ketone body metabolism. SGLT2 inhibitors trigger multiple mechanisms that could predispose to diabetic ketoacidosis. When SGLT2 inhibitors are combined with insulin, it is often necessary to decrease the insulin dose to avoid hypoglycemia. The lower dose of insulin may be insufficient to suppress lipolysis and ketogenesis. Furthermore, SGLT2 is expressed in pancreatic α-cells, and SGLT2 inhibitors promote glucagon secretion. Finally, phlorizin, a nonselective inhibitor of SGLT family transporters decreases urinary excretion of ketone bodies. A decrease in the renal clearance of ketone bodies could also increase the plasma ketone body levels. Based on the physiology of SGLT2 and the pharmacology of SGLT2 inhibitors, there are several biologically plausible mechanisms whereby this class of drugs has the potential to increase the risk of developing diabetic ketoacidosis. Future research should be directed toward identifying which patients are at greatest risk for this side effect and also to optimizing pharmacotherapy to minimize the risk to patients.

  16. Holocene Tsunamis in Avachinsky Bay, Kamchatka, Russia

    Science.gov (United States)

    Pinegina, Tatiana K.; Bazanova, Lilya I.; Zelenin, Egor A.; Bourgeois, Joanne; Kozhurin, Andrey I.; Medvedev, Igor P.; Vydrin, Danil S.

    2018-04-01

    This article presents results of the study of tsunami deposits on the Avachinsky Bay coast, Kurile-Kamchatka island arc, NW Pacific. We used tephrochronology to assign ages to the tsunami deposits, to correlate them between excavations, and to restore paleo-shoreline positions. In addition to using established regional marker tephra, we establish a detailed tephrochronology for more local tephra from Avachinsky volcano. For the first time in this area, proximal to Kamchatka's primary population, we reconstruct the vertical runup and horizontal inundation for 33 tsunamis recorded over the past 4200 years, 5 of which are historical events - 1737, 1792, 1841, 1923 (Feb) and 1952. The runup heights for all 33 tsunamis range from 1.9 to 5.7 m, and inundation distances from 40 to 460 m. The average recurrence for historical events is 56 years and for the entire study period 133 years. The obtained data makes it possible to calculate frequencies of tsunamis by size, using reconstructed runup and inundation, which is crucial for tsunami hazard assessment and long-term tsunami forecasting. Considering all available data on the distribution of historical and paleo-tsunami heights along eastern Kamchatka, we conclude that the southern part of the Kamchatka subduction zone generates stronger tsunamis than its northern part. The observed differences could be associated with variations in the relative velocity and/or coupling between the downgoing Pacific Plate and Kamchatka.

  17. Holocene Tsunamis in Avachinsky Bay, Kamchatka, Russia

    Science.gov (United States)

    Pinegina, Tatiana K.; Bazanova, Lilya I.; Zelenin, Egor A.; Bourgeois, Joanne; Kozhurin, Andrey I.; Medvedev, Igor P.; Vydrin, Danil S.

    2018-03-01

    This article presents results of the study of tsunami deposits on the Avachinsky Bay coast, Kurile-Kamchatka island arc, NW Pacific. We used tephrochronology to assign ages to the tsunami deposits, to correlate them between excavations, and to restore paleo-shoreline positions. In addition to using established regional marker tephra, we establish a detailed tephrochronology for more local tephra from Avachinsky volcano. For the first time in this area, proximal to Kamchatka's primary population, we reconstruct the vertical runup and horizontal inundation for 33 tsunamis recorded over the past 4200 years, 5 of which are historical events - 1737, 1792, 1841, 1923 (Feb) and 1952. The runup heights for all 33 tsunamis range from 1.9 to 5.7 m, and inundation distances from 40 to 460 m. The average recurrence for historical events is 56 years and for the entire study period 133 years. The obtained data makes it possible to calculate frequencies of tsunamis by size, using reconstructed runup and inundation, which is crucial for tsunami hazard assessment and long-term tsunami forecasting. Considering all available data on the distribution of historical and paleo-tsunami heights along eastern Kamchatka, we conclude that the southern part of the Kamchatka subduction zone generates stronger tsunamis than its northern part. The observed differences could be associated with variations in the relative velocity and/or coupling between the downgoing Pacific Plate and Kamchatka.

  18. Evaluation of Glare at the Ivanpah Solar Electric Generating System

    Energy Technology Data Exchange (ETDEWEB)

    Ho, Clifford K. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Sims, Cianan [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Christian, Joshua Mark [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2014-07-01

    The Ivanpah Solar Electric Generating System (ISEGS), located on I - 15 about 40 miles (60 km) south of Las Vegas, NV, consists of three power towers 459 ft (140 m) tall and over 170,000 reflective heliostats with a rated capacity of 390 MW. Reports of glare from the plant have been submitted by pilots and air traffic controllers and recorded by the Aviation Safety Reporting System and the California Energy Commission since 2013. Aerial and ground - based surveys of the glare were conducted in April, 2014, to identify the cause and to quantify the irradiance and potential ocular impact s of the glare . Results showed that the intense glare viewed from the airspace above ISEGS was caused by he liostats in standby mode that were aimed to the side of the receiver. Evaluation of the glare showed that the retinal irradiance and subtended source angle of the glare from the heliostats in standby were sufficient to cause significant ocular impact (pot ential for after - image) up to a distance of %7E6 miles (10 km), but the values were below the threshold for permanent eye damage . Glare from the receivers had a low potential for after - image at all ground - based monitoring locations outside of the site bound aries. A Letter to Airmen has been issued by the Federal Aviation Administration to notify pilots of the potential glare hazards. Additional measures to mitigate the potential impacts of glare from ISGES are also presented and discussed. This page intentionally left blank

  19. SGLT2 inhibitors: molecular design and potential differences in effect.

    Science.gov (United States)

    Isaji, Masayuki

    2011-03-01

    The physiological and pathological handling of glucose via sodium-glucose cotransporter-2 (SGLT2) in the kidneys has been evolving, and SGLT2 inhibitors have been focused upon as a novel drug for treating diabetes. SGLT2 inhibitors enhance renal glucose excretion by inhibiting renal glucose reabsorption. Consequently, SGLT2 inhibitors reduce plasma glucose insulin independently and improve insulin resistance in diabetes. To date, various SGLT2 inhibitors have been developed and evaluated in clinical studies. The potency and positioning of SGLT2 inhibitors as an antidiabetic drug are dependent on their characteristic profile, which induces selectivity, efficacy, pharmacokinetics, and safety. This profile decides which SGLT2 inhibitors can be expected for application of the theoretical concept of reducing renal glucose reabsorption for the treatment of diabetes. I review the structure and advancing profile of various SGLT2 inhibitors, comparing their similarities and differences, and discuss the expected SGLT2 inhibitors for an emerging category of antidiabetic drugs.

  20. The Na+-D-glucose cotransporters SGLT1 and SGLT2 are targets for the treatment of diabetes and cancer.

    Science.gov (United States)

    Koepsell, Hermann

    2017-02-01

    Orally applied SGLT2 (SLC5A2) inhibitors that enter the blood and decrease renal reabsorption of glucose have been approved as antidiabetic drugs. They decrease blood glucose levels, slightly reduce body weight and blood pressure, and decrease the risk for diabetic nephropathy. The SGLT2 inhibitor empagliflozin has been shown to reduce the risk of severe cardiac failure. This review summarizes knowledge about the functions of SGLT2 and the pathophysiology of type 2 diabetes (T2D) and diabetic follow-up diseases. In addition, proposed pathophysiological mechanisms of therapeutic effects and of side effects of SGLT2 inhibitors are described. A recently investigated strategy to employ orally applied SGLT1 (SLC5A1) inhibitors for treatment of diabetes is discussed. The SGLT1 inhibitors reduce glucose absorption and decrease blood glucose excursions after the intake of glucose-rich food. Knowledge concerning the expression of SGLT1 in different organs is compiled and potential side effects of SGLT1 inhibitors entering the blood are discussed. Because selective targeting of SGLT1 expression presents a strategy to decrease SGLT1-mediated glucose absorption, current knowledge about the regulation of SGLT1 is also discussed. This includes the possibility to decrease SGLT1 abundance in the small intestinal brush-border membrane by a peptide derived from protein RS1 (RSC1A1) that regulates membrane trafficking. Finally the possibility to employ SGLT1 and SGLT2 as targets for anticancer therapy is discussed. SGLT1 and SGLT2 are expressed in various tumors where they supply the tumor cells with glucose for euglycemic glycolysis. Tumor growth of carcinoma expressing SGLT2 can be slowed down by an SGLT2 inhibitor. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. SGLT2 Inhibitors and the Diabetic Kidney.

    Science.gov (United States)

    Fioretto, Paola; Zambon, Alberto; Rossato, Marco; Busetto, Luca; Vettor, Roberto

    2016-08-01

    Diabetic nephropathy (DN) is the most common cause of end-stage renal disease worldwide. Blood glucose and blood pressure control reduce the risk of developing this complication; however, once DN is established, it is only possible to slow progression. Sodium-glucose cotransporter 2 (SGLT2) inhibitors, the most recent glucose-lowering oral agents, may have the potential to exert nephroprotection not only through improving glycemic control but also through glucose-independent effects, such as blood pressure-lowering and direct renal effects. It is important to consider, however, that in patients with impaired renal function, given their mode of action, SGLT2 inhibitors are less effective in lowering blood glucose. In patients with high cardiovascular risk, the SGLT2 inhibitor empagliflozin lowered the rate of cardiovascular events, especially cardiovascular death, and substantially reduced important renal outcomes. Such benefits on DN could derive from effects beyond glycemia. Glomerular hyperfiltration is a potential risk factor for DN. In addition to the activation of the renin-angiotensin-aldosterone system, renal tubular factors, including SGLT2, contribute to glomerular hyperfiltration in diabetes. SGLT2 inhibitors reduce sodium reabsorption in the proximal tubule, causing, through tubuloglomerular feedback, afferent arteriole vasoconstriction and reduction in hyperfiltration. Experimental studies showed that SGLT2 inhibitors reduced hyperfiltration and decreased inflammatory and fibrotic responses of proximal tubular cells. SGLT2 inhibitors reduced glomerular hyperfiltration in patients with type 1 diabetes, and in patients with type 2 diabetes, they caused transient acute reductions in glomerular filtration rate, followed by a progressive recovery and stabilization of renal function. Interestingly, recent studies consistently demonstrated a reduction in albuminuria. Although these data are promising, only dedicated renal outcome trials will clarify whether

  2. An experimental investigation of glare and restructured fiber metal laminates

    Science.gov (United States)

    Benedict, Adelina Vanessa

    Fiber Metal Laminates (FMLs) are a group of materials fabricated by bonding glass/epoxy layers within metal layers. This class of materials can provide good mechanical properties, as well as weight savings. An FML known as Glass Laminate Aluminum Reinforced Epoxy (GLARE) was studied. An experimental investigation comprising of microscopy and tensile testing was carried out using different grades of GLARE. Microscopy revealed the construction details of GLARE, while tensile testing provided means of measuring and analyzing its stress-strain responses. Next, different metal surface pretreatment methods were explored. These included sandblasting, Phosphoric Acid Anodizing (PAA), and AC-130 Sol-Gel treatment. Woven S-2 glass, an epoxy adhesive, and aluminum alloy sheet metal were used to fabricate restructured FMLs using time and cost effective procedures. Additional microscopy and tensile testing allowed for comparisons with GLARE and aircraft grade aluminum alloys. The restructured FMLs showed similar behaviors to GLARE with potential significant improvements in fabrication efficiency.

  3. [Mechanisms and efficacy of SGLT2 inhibitors].

    Science.gov (United States)

    Shiba, Teruo

    2015-03-01

    SGLT2 is a low affinity, high capacity glucose co-transporter, almost exclusively expressed in the kidney cortex. Inhibition of SGLT2 has been shown to increase the daily 50g or more urinary glucose excretion, as compared to placebo, leading to a reduction in blood glucose levels and indicated only for the treatment of type 2 diabetes. In Japan 6 species of SGLT2 inhibitors have already been sold and reported to results in a decrease of FPG by 14.4 to 45.8 (mg/dL), in a reduction of HbA1c by 0.35 to 1.24% and in loss of body weight by 1.29 to 2.50(kg). There is less effect of the SGLT2 inhibitor in diabetic subjects with renal impairment and the reduction in HbA1c and FPG will be approximately half of the average in those with 30 ≤ eGFR ≤ 59. The position of SGLT2 inhibitors would be considered as the drug administered in combination or add-on therapy when the young obese type 2 diabetics without renal impairment has not yet reached to the glycemic target with other drugs although in AACE consensus statement of 2013, it has been shelved for inexperienced use with respect to the positioning of the SGLT2 inhibitors.

  4. Sredinnyy Khrebet, Kamchatka Peninsula, Russia

    Science.gov (United States)

    2002-01-01

    The Kamchatka Peninsula in eastern Russia is shown in this scene created from a preliminary elevation model derived from the first data collected during the Shuttle Radar Topography Mission (SRTM) on February 12, 2000. Sredinnyy Khrebet, the mountain range that makes up the spine of the peninsula, is a chain of active volcanic peaks. Pleistocene and recent glaciers have carved the broad valleys and jagged ridges that are common here. The relative youth of the volcanism is revealed by the topography as infilling and smoothing of the otherwise rugged terrain by lava, ash, and pyroclastic flows, particularly surrounding the high peaks in the south central part of the image. Elevations here range from near sea level up to 2,618 meters (8,590 feet). Two visualization methods were combined to produce this image: shading and color coding of topographic height. The shade image was derived by computing topographic slope in the north-south direction. Northern slopes appear bright and southern slopes appear dark. Color coding is directly related to topographic height, with green at the lower elevations, rising through yellow, red, and magenta, to white at the highest elevations. Elevation data used in this image were acquired by the Shuttle Radar Topography Mission (SRTM) aboard Space Shuttle Endeavour, launched on February 11, 2000. SRTM used the same radar instrument that comprised the Spaceborne Imaging Radar-C/X-Band Synthetic Aperture Radar (SIR-C/X-SAR) that flew twice on Space Shuttle Endeavour in 1994. SRTM was designed to collect three-dimensional measurements of Earth's surface. To collect the 3-D data, engineers added a 60-meter-long (200-foot) mast, installed additional C-band and X-band antennas, and improved tracking and navigation devices. The mission is a cooperative project between the National Aeronautics and Space Administration (NASA), the National Imagery and Mapping Agency (NIMA) of the U.S. Department of Defense, and the German and Italian space

  5. Macular pigment spatial distribution effects on glare disability.

    Science.gov (United States)

    Putnam, Christopher M; Bassi, Carl J

    2015-01-01

    This project explored the relationship of the macular pigment optical density (MPOD) spatial profile with measures of glare disability (GD) across the macula. A novel device was used to measure MPOD across the central 16° of retina along four radii using customized heterochromatic flicker photometry (cHFP)at eccentricities of 0°, 2°, 4°, 6° and 8°. MPOD was measured as discrete and integrated values at all measured retinal loci. GD was calculated as a difference in contrast sensitivity (CS) between no glare and glare conditions using identical stimuli presented at the same eccentricities. GD was defined as [(CSNo Glare-CSGlare)/CSNo Glare] in order to isolate the glare attenuation effects of MPOD by controlling for CS variability among the subject sample. Correlations of the discrete and integrated MPOD with GD were compared. The cHFP identified reliable MPOD spatial distribution maps demonstrating a 1st-order exponential decay as a function of increasing eccentricity. There was a significant negative correlation between both measures of foveal MPOD and GD using 6 cycles per degree (cpd) and 9 cpd stimuli. Significant correlations were found between corresponding parafoveal MPOD measures and GD at 2 and 4° of eccentricity using 9 cpd stimuli with greater MPOD associated with less glare disability. These results are consistent with the glare attenuation effects of MP at higher spatial frequencies and support the hypothesis that discrete and integrated measures of MPOD have similar correlations with glare attenuation effects across the macula. Additionally, peak foveal MPOD appears to influence GD across the macula. Copyright © 2014 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.

  6. SGLT2 inhibitors: are they safe?

    Science.gov (United States)

    Filippas-Ntekouan, Sebastian; Filippatos, Theodosios D; Elisaf, Moses S

    2018-01-01

    Sodium-glucose linked transporter type 2 (SGLT2) inhibitors are a relatively new class of antidiabetic drugs with positive cardiovascular and kidney effects. The aim of this review is to present the safety issues associated with SGLT2 inhibitors. Urogenital infections are the most frequently encountered adverse events, although tend to be mild to moderate and are easily manageable with standard treatment. Although no increased acute kidney injury risk was evident in the major trials, the mechanism of action of these drugs requires caution when they are administered in patients with extracellular volume depletion or with drugs affecting renal hemodynamics. Canagliflozin raised the risk of amputations and the rate of fractures in the CANVAS trial, although more data are necessary before drawing definite conclusions. The risk of euglycemic diabetic ketoacidosis seems to be minimal when the drugs are prescribed properly. Regarding other adverse events, SGLT2 inhibitors do not increase the risk of hypoglycemia even when co-administered with insulin, but a decrease in the dose of sulphonylureas may be needed. The available data do not point to a causative role of SGLT2 inhibitors on malignancy risk, however, these drugs should be used with caution in patients with known hematuria or history of bladder cancer. SGLT2 inhibitors seem to be safe and effective in the treatment of diabetes but more studies are required to assess their long-term safety.

  7. Mutnovo geothermal power complex at Kamchatka

    International Nuclear Information System (INIS)

    Britvin, O.V.; Povarov, O.A.; Klochkov, E.F.; Tomarov, G.V.; Koshkin, N.L.; Luzin, V.E.

    2001-01-01

    The data on geothermal resources at Kamchatka and experience in their application are presented. The description of the geothermal power complex objects at the Mutnovo deposit is given. The basic trends and stages of the prospective geothermal power development in this region are indicated. It is specified for unique huge geothermal heat reserves, which by different estimates may provide for the total electrical and thermal capacity, exceeding 2000 MW [ru

  8. Volcanism and Subduction: The Kamchatka Region

    Science.gov (United States)

    Eichelberger, John; Gordeev, Evgenii; Izbekov, Pavel; Kasahara, Minoru; Lees, Jonathan

    The Kamchatka Peninsula and contiguous North Pacific Rim is among the most active regions in the world. Kamchatka itself contains 29 active volcanoes, 4 now in a state of semi-continuous eruption, and I has experienced 14 magnitude 7 or greater earthquakes since accurate recording began in 1962. At its heart is the uniquely acute subduction cusp where the Kamchatka and Aleutian Arcs and Emperor Seamount Chain meet. Volcanism and Subduction covers coupled magmatism and tectonics in this spectacular region, where the torn North Pacific slab dives into hot mantle. Senior Russian and American authors grapple with the dynamics of the cusp with perspectives from the west and east of it, respectively, while careful tephrostratigraphy yields a remarkably precise record of behavior of storied volcanoes such as Kliuchevskoi and Shiveluch. Towards the south, Japanese researchers elucidate subduction earthquake processes with unprecedented geodetic resolution. Looking eastward, new insights on caldera formation, monitoring, and magma ascent are presented for the Aleutians. This is one of the first books of its kind printed in the English language. Students and scientists beginning research in the region will find in this book a useful context and introduction to the region's scientific leaders. Others who wish to apply lessons learned in the North Pacific to their areas of interest will find the volume a valuable reference.

  9. The mechanical behavior of GLARE laminates for aircraft structures

    Science.gov (United States)

    Wu, Guocai; Yang, J.-M.

    2005-01-01

    GLARE (glass-reinforced aluminum laminate) is a new class of fiber metal laminates for advanced aerospace structural applications. It consists of thin aluminum sheets bonded together with unidirectional or biaxially reinforced adhesive prepreg of high-strength glass fibers. GLARE laminates offer a unique combination of properties such as outstanding fatigue resistance, high specific static properties, excellent impact resistance, good residual and blunt notch strength, flame resistance and corrosion properties, and ease of manufacture and repair. GLARE laminates can be tailored to suit a wide variety of applications by varying the fiber/resin system, the alloy type and thickness, stacking sequence, fiber orientation, surface pretreatment technique, etc. This article presents a comprehensive overview of the mechanical properties of various GLARE laminates under different loading conditions.

  10. SGLT2 inhibition in the diabetic kidney – an update

    Science.gov (United States)

    Novikov, Aleksandra; Vallon, Volker

    2016-01-01

    Purpose of review The sodium glucose cotransporter SGLT2 reabsorbs most of the glucose filtered by the kidneys. SGLT2 inhibitors reduce glucose reabsorption thereby lowering blood glucose levels and have been approved as new anti-hyperglycemic drugs. While the therapeutic strategy is very promising, many questions remain. Recent findings Using validated antibodies SGLT2 expression was localized to the brush border of the early proximal tubule in human kidney and was found upregulated in genetic murine models of type 1 and 2 diabetes. SGLT2 may functionally interact with the Na/H exchanger NHE3 in the proximal tubule. SGLT1-mediated reabsorption explains the fractional glucose reabsorption of 40–50% during SGLT2 inhibition. SGLT2 is expressed on pancreatic alpha cells where its inhibition induces glucagon secretion. SGLT2 inhibition lowers GFR in hyperfiltering diabetic patients consistent with the tubular hypothesis of diabetic hyperfiltration. New data indicate a potential of SGLT2 inhibition for renal medullary hypoxia and ketoacidosis, but also for blood glucose effect-dependent and independent nephroprotective actions, renal gluconeogenesis inhibition, reduction in cardiovascular mortality, and cancer therapy. Summary The findings expand and refine our understanding of SGLT2 and its inhibition, have relevance for clinical practice, and will help interpret ongoing clinical trials on the long-term safety and cardiovascular effects of SGLT2 inhibitors. PMID:26575393

  11. Google Glass Glare: disability glare produced by a head-mounted visual display.

    Science.gov (United States)

    Longley, Chris; Whitaker, David

    2016-03-01

    Head mounted displays are a type of wearable technology - a market that is projected to expand rapidly over the coming years. Probably the most well known example is the device Google Glass (or 'Glass'). Here we investigate the extent to which the device display can interfere with normal visual function by producing monocular disability glare. Contrast sensitivity was measured in two normally sighted participants, 32 and 52 years of age. Data were recorded for the right eye, the left eye and then again in a binocular condition. Measurements were taken both with and without the Glass in place, across a range of stimulus luminance levels using a two-alternative forced-choice methodology. The device produced a significant reduction in contrast sensitivity in the right eye (>0.5 log units). The level of disability glare increased as stimulus luminance was reduced in a manner consistent with intraocular light scatter, resulting in a veiling retinal illuminance. Sensitivity in the left eye was unaffected. A significant reduction in binocular contrast sensitivity occurred at lower luminance levels due to a loss of binocular summation, although binocular sensitivity was not found to fall below the sensitivity of the better monocular level (binocular inhibition). Head mounted displays such as Google Glass have the potential to cause significant disability glare in the eye exposed to the visual display, particularly under conditions of low luminance. They can also cause a more modest binocular reduction in sensitivity by eliminating the benefits of binocular summation. © 2015 The Authors Ophthalmic & Physiological Optics © 2015 The College of Optometrists.

  12. Discomfort glare with complex fenestration systems and the impact on energy use when using daylighting control

    Energy Technology Data Exchange (ETDEWEB)

    Hoffmann, Sabine; McNeil, Andrew; Lee, Eleanor S.; Kalyanam, Raghuram

    2015-11-03

    Glare is a frequent issue in highly glazed buildings. A modelling approach is presented that uses discomfort glare probability and discomfort glare index as metrics to determine occupants’ behaviour. A glare control algorithm that actuated an interior shade for glare protection based on the predicted perception was implemented in a building simulation program. A reference case with a state-of-the-art base glazing was compared to the same glazing but with five different complex fenestration systems, i.e., exterior shades. The windows with exterior shades showed significant variations in glare frequencies. Energy use intensity in a prototypical office building with daylighting controls was greatly influenced for the systems with frequent glare occurrence. While the base glazing could benefit from glare control, some of the exterior shades showed significantly greater energy use when discomfort glare-based operation of interior shades was considered.

  13. Boreal Forests of Kamchatka: Structure and Composition

    OpenAIRE

    Eichhorn, Markus P.

    2010-01-01

    Central Kamchatka abounds in virgin old-growth boreal forest, formed primarily by Larix cajanderi and Betula platyphylla in varying proportions. A series of eight 0.25–0.30 ha plots captured the range of forests present in this region and their structure is described. Overall trends in both uplands and lowlands are for higher sites to be dominated by L. cajanderi with an increasing component of B. platyphylla with decreasing altitude. The tree line on wet sites is commonly formed by mono-domi...

  14. PARAMETERS OF KAMCHATKA SEISMICITY IN 2008

    Directory of Open Access Journals (Sweden)

    Vadim A. Saltykov

    2010-01-01

    Full Text Available The paper describes seismicity of Kamchatka for the period of 2008 and presents 2D distribution of background seismicity parameters calculated from data published in the Regional Catalogue of Kamchatka Earthquakes. Parameters under study are total released seismic energy, seismic activity A10, slope of recurrence graph γ, parameters of RTL, ΔS and Z-function methods, and clustering of earthquakes. Estimations of seismicity are obtained for a region bordered by latitude 50.5–56.5N, longitude 156E–167E, with depths to 300 km. Earthquakes of energy classes not less than 8.5 as per the Fedotov’s classification are considered. The total seismic energy released in 2008 is estimated. According to a function of annual seismic energy distribution, an amount of seismic energy released in 2008 was close to the median level (Fig. 1. Over 2/3 of the total amount of seismic energy released in 2008 resulted from three largest earthquakes (МW ≥ 5.9. About 5 percent of the total number of seismic events are comprised of grouped earthquakes, i.e. aftershocks and swarms. A schematic map of the largest earthquakes (МW ≥ 5.9 and grouped seismic events which occurred in 2008 is given in Fig. 2; their parameters are listed in Table 1. Grouped earthquakes are excluded from the catalogue. A map showing epicenters of independent earthquakes is given in Fig. 3. The slope of recurrence graph γ and seismic activity A10 is based on the Gutenberg-Richter law stating the fundamental property of seismic process. The recurrence graph slope is calculated from continuous exponential distribution of earthquakes by energy classes. Using γ is conditioned by observations that in some cases the slope of the recurrence graph decreases prior to a large earthquake. Activity A10 is calculated from the number of earthquakes N and recurrence graph slope γ. Average slopes of recurrence graph γ and seismic activity A10 for the area under study in 2008 are calculated; our

  15. Microbiology of Kamchatka Peninsula Hot Springs

    Science.gov (United States)

    Bonch-Osmolovsk, E.

    2005-12-01

    Hot springs of Uzon Caldera, Geyser Valley, Moutnovsky Volcano (Kamchatka Peninsula) served as the sources of isolation of numerous thermophilic prokaryotes, many of them representing new taxa. Among new isolates there were hyperthermophilic archaea - neutrophilic or acidophilic anaerobic organotrophs, able to use a wide range of polymeric organic substrates. Bacterial isolates were in majority represented by moderate thermophiles - organotrophs and lithoautotrophs. Latter group consisted of anaerobes oxidizing molecular hydrogen in the course of sulfate, sulfur or iron reduction, and of anaerobic CO-oxidizing, hydrogen-producing bacteria. Some of new isolates represented deep phylogenetic lineages in Bacteria domain. Microbial activity in Kamchatka hot springs was studied by means of radioisotopic tracing. The rates of methanogenesis, acetogenesis, inorganic carbon assimilation, acetate oxidation were determined in three different hot springs with pH ranging from 3.0 to 8.5 and water temeperature being in the range from 55 to 85oC. The results indicated the presence and activity of novel metabolic groups of thermophilic prokaryotes that so far have not been known in laboratory cultures.

  16. A real-time monitoring system for night glare protection

    Science.gov (United States)

    Ma, Jun; Ni, Xuxiang

    2010-11-01

    When capturing a dark scene with a high bright object, the monitoring camera will be saturated in some regions and the details will be lost in and near these saturated regions because of the glare vision. This work aims at developing a real-time night monitoring system. The system can decrease the influence of the glare vision and gain more details from the ordinary camera when exposing a high-contrast scene like a car with its headlight on during night. The system is made up of spatial light modulator (The liquid crystal on silicon: LCoS), image sensor (CCD), imaging lens and DSP. LCoS, a reflective liquid crystal, can modular the intensity of reflective light at every pixel as a digital device. Through modulation function of LCoS, CCD is exposed with sub-region. With the control of DSP, the light intensity is decreased to minimum in the glare regions, and the light intensity is negative feedback modulated based on PID theory in other regions. So that more details of the object will be imaging on CCD and the glare protection of monitoring system is achieved. In experiments, the feedback is controlled by the embedded system based on TI DM642. Experiments shows: this feedback modulation method not only reduces the glare vision to improve image quality, but also enhances the dynamic range of image. The high-quality and high dynamic range image is real-time captured at 30hz. The modulation depth of LCoS determines how strong the glare can be removed.

  17. SGLT2 Inhibitors: Benefit/Risk Balance.

    Science.gov (United States)

    Scheen, André J

    2016-10-01

    Inhibitors of sodium-glucose cotransporters type 2 (SGLT2) reduce hyperglycemia by increasing urinary glucose excretion. They have been evaluated in patients with type 2 diabetes treated with diet/exercise, metformin, dual oral therapy or insulin. Three agents are available in Europe and the USA (canagliflozin, dapagliflozin, empagliflozin) and others are commercialized in Japan or in clinical development. SGLT2 inhibitors reduce glycated hemoglobin, with a minimal risk of hypoglycemia. They exert favorable effects beyond glucose control with consistent body weight, blood pressure, and serum uric acid reductions. Empagliflozin showed remarkable reductions in cardiovascular/all-cause mortality and in hospitalization for heart failure in patients with previous cardiovascular disease. Positive renal outcomes were also shown with empagliflozin. Mostly reported adverse events are genital mycotic infections, while urinary tract infections and events linked to volume depletion are rather rare. Concern about a risk of ketoacidosis and bone fractures has been recently raised, which deserves caution and further evaluation.

  18. SGLT2 Protein Expression Is Increased in Human Diabetic Nephropathy

    Science.gov (United States)

    Wang, Xiaoxin X.; Levi, Jonathan; Luo, Yuhuan; Myakala, Komuraiah; Herman-Edelstein, Michal; Qiu, Liru; Wang, Dong; Peng, Yingqiong; Grenz, Almut; Lucia, Scott; Dobrinskikh, Evgenia; D'Agati, Vivette D.; Koepsell, Hermann; Kopp, Jeffrey B.; Rosenberg, Avi Z.; Levi, Moshe

    2017-01-01

    There is very limited human renal sodium gradient-dependent glucose transporter protein (SGLT2) mRNA and protein expression data reported in the literature. The first aim of this study was to determine SGLT2 mRNA and protein levels in human and animal models of diabetic nephropathy. We have found that the expression of SGLT2 mRNA and protein is increased in renal biopsies from human subjects with diabetic nephropathy. This is in contrast to db-db mice that had no changes in renal SGLT2 protein expression. Furthermore, the effect of SGLT2 inhibition on renal lipid content and inflammation is not known. The second aim of this study was to determine the potential mechanisms of beneficial effects of SGLT2 inhibition in the progression of diabetic renal disease. We treated db/db mice with a selective SGLT2 inhibitor JNJ 39933673. We found that SGLT2 inhibition caused marked decreases in systolic blood pressure, kidney weight/body weight ratio, urinary albumin, and urinary thiobarbituric acid-reacting substances. SGLT2 inhibition prevented renal lipid accumulation via inhibition of carbohydrate-responsive element-binding protein-β, pyruvate kinase L, SCD-1, and DGAT1, key transcriptional factors and enzymes that mediate fatty acid and triglyceride synthesis. SGLT2 inhibition also prevented inflammation via inhibition of CD68 macrophage accumulation and expression of p65, TLR4, MCP-1, and osteopontin. These effects were associated with reduced mesangial expansion, accumulation of the extracellular matrix proteins fibronectin and type IV collagen, and loss of podocyte markers WT1 and synaptopodin, as determined by immunofluorescence microscopy. In summary, our study showed that SGLT2 inhibition modulates renal lipid metabolism and inflammation and prevents the development of nephropathy in db/db mice. PMID:28196866

  19. Colored Height and Shaded Relief, Kamchatka Peninsula

    Science.gov (United States)

    2002-01-01

    Russia's Kamchatka Peninsula, lying between the Sea of Okhotsk to the west and the Bering Sea and Pacific Ocean to the east, is one of the most active volcanic regions along the Pacific Ring of Fire. It covers an area about the size of Colorado but contains more than 100 volcanoes stretching across the 1000-kilometer-long (620-mile-long) land mass. A dozen or more of these have active vents, with the youngest located along the eastern half of the peninsula. This color-coded shaded relief image, generated with data from the Shuttle Radar Topography Mission (SRTM), shows Kamchatka's volcanic nature to dramatic effect.Kliuchevskoi, one of the most active and renowned volcanoes in the world, dominates the main cluster of volcanoes called the Kliuchi group, visible as a circular feature in the center-right of the image. The two other main volcanic ranges lie along northeast-southwest lines, with the older, less active range occupying the center and western half of Kamchatka. The younger, more active belt begins at the southernmost point of the peninsula and continues upward along the Pacific coastline.Two visualization methods were combined to produce this image: shading and color coding of topographic height. The shade image was derived by computing topographic slope in the north-south direction, so northern slopes appear bright and southern slopes appear dark. Color coding is directly related to topographic height, with green at the lower elevations, rising through yellow and brown to white at the highest elevations.The Shuttle Radar Topography Mission flew aboard the Space Shuttle Endeavour, launched on February 11, 2000. The mission used the same radar instrument that comprised the Spaceborne Imaging Radar-C/X-Band Synthetic Aperture Radar that flew twice on the Space Shuttle Endeavour in 1994. The Shuttle Radar Topography Mission was designed to collect three-dimensional measurements of the Earth's surface. To collect the 3-D data, engineers added a 60-meter (200

  20. Wild reindeer of the Kamchatka Peninsula - past, present, and future

    Directory of Open Access Journals (Sweden)

    Vladimir Mosolov

    1996-01-01

    Full Text Available A unique subspecies of wild reindeer (Rangifer tarandus phylarchus Hollister that is endemic to the Kamchatka Peninsula has been declining in number since the 1950s due to commercial hunting, increasing industrial development and competition with domestic reindeer. The largest remaining herd of wild reindeer occurs in the Kronotsky Reserve in northeastern Kamchatka, and the reserve is now critical to the preservation of this subspecies of reindeer.

  1. Quantitative evaluation research of glare from automotive headlamps

    Science.gov (United States)

    Wang, Tiecheng; Qian, Rui; Cao, Ye; Gao, Mingqiu

    2018-01-01

    This study concerns the quantized evaluation research of glare from automotive headlamps. In the actual regulations, only one point in the test screen is set for judging whether driver can bear the light caused by headlamps of opposing vehicle. To evaluating practical effect of glare, we accept a glare zone with the probability distribution information of the oncoming driver's eye position. In this focus area, glare level of headlamp is represented by weighted luminous flux. To confirm the most comfortable illuminance value to human eyes at 50 m, we used test point B50L as observation position, and collected 1,000 subjective evaluation data from 20 test personnel in different ages during two months. Basing on the assessment results, we calculated 0.60 lx as recommended value for standardized testing procedure at 25 m. Then we figured out 0.38 lm as optimum value, and 0.25 / 1.20 lm as limiting values depending on regulations. We tested 40 sample vehicles with different levels to verify the sectional nonlinear quantitative evaluation method we designed, and analyzed the typical test results.

  2. Fatigue crack propagation and delamination growth in Glare

    NARCIS (Netherlands)

    Alderliesten, R.C.

    2005-01-01

    Fibre Metal Laminate Glare consists of thin aluminium layers bonded together with pre-impregnated glass fibre layers and shows an excellent fatigue crack growth behaviour compared to monolithic aluminium. The fibres are insensitive to the occurring fatigue loads and remain intact while the fatigue

  3. Technical Notes: Glare pollution in Urban areas | Gelan | Zede Journal

    African Journals Online (AJOL)

    Glare pollution is an unnatural element in the global environment that has emerged as a result of human beings inefficient and destructive use of technology and resources. It refers to the tangible and the intangible interaction of natural light reflecting off synthetic materials, for example sunlight on rooftops, walls, windows, ...

  4. Use of systems pharmacology modeling to elucidate the operating characteristics of SGLT1 and SGLT2 in renal glucose reabsorption in humans.

    Science.gov (United States)

    Lu, Yasong; Griffen, Steven C; Boulton, David W; Leil, Tarek A

    2014-01-01

    In the kidney, glucose in glomerular filtrate is reabsorbed primarily by sodium-glucose cotransporters 1 (SGLT1) and 2 (SGLT2) along the proximal tubules. SGLT2 has been characterized as a high capacity, low affinity pathway responsible for reabsorption of the majority of filtered glucose in the early part of proximal tubules, and SGLT1 reabsorbs the residual glucose in the distal part. Inhibition of SGLT2 is a viable mechanism for removing glucose from the body and improving glycemic control in patients with diabetes. Despite demonstrating high levels (in excess of 80%) of inhibition of glucose transport by SGLT2 in vitro, potent SGLT2 inhibitors, e.g., dapagliflozin and canagliflozin, inhibit renal glucose reabsorption by only 30-50% in clinical studies. Hypotheses for this apparent paradox are mostly focused on the compensatory effect of SGLT1. The paradox has been explained and the role of SGLT1 demonstrated in the mouse, but direct data in humans are lacking. To further explore the roles of SGLT1/2 in renal glucose reabsorption in humans, we developed a systems pharmacology model with emphasis on SGLT1/2 mediated glucose reabsorption and the effects of SGLT2 inhibition. The model was calibrated using robust clinical data in the absence or presence of dapagliflozin (DeFronzo et al., 2013), and evaluated against clinical data from the literature (Mogensen, 1971; Wolf et al., 2009; Polidori et al., 2013). The model adequately described all four data sets. Simulations using the model clarified the operating characteristics of SGLT1/2 in humans in the healthy and diabetic state with or without SGLT2 inhibition. The modeling and simulations support our proposition that the apparent moderate, 30-50% inhibition of renal glucose reabsorption observed with potent SGLT2 inhibitors is a combined result of two physiological determinants: SGLT1 compensation and residual SGLT2 activity. This model will enable in silico inferences and predictions related to SGLT1/2 modulation.

  5. Could Daylight Glare Be Defined Mathematically?Results of Testing the DGIN Method in Japan

    Science.gov (United States)

    Nazzal, Ali; Oki, Masato

    Discomfort glare from daylight is a common problem without valid prediction methods so far. A new mathematical DGIN (New Daylight Glare Index) method tries to respond the challenge. This paper reports on experiments carried out in daylit office environment in Japan to test applicability of the method. Slight positive correlation was found between the DGIN and the subjective evaluation. Additionally, a high Ladaptation value together with the small ratio of Lwindow to Ladaptation was obviously experienced sufficient to neutralize the effect of glare discomfort. However, subjective assessments are poor glare indicators and not reliable in testing glare prediction methods. DGIN is a good indicator of daylight glare, and when the DGIN value is analyzed together with the measured illuminance ratios, discomfort glare from daylight can be analyzed in a quantitative manner. The DGIN method could serve architects and lighting designers in testing daylighting systems, and also guide the action of daylight responsive lighting controls.

  6. Numerical stud of glare spot phase Doppler anemometry

    OpenAIRE

    Hespel , Camille; Ren , Kuan Fang; Gréhan , Gérard; Onofri , Fabrice

    2008-01-01

    International audience; The phase Doppler anemometry has (PDA) been developed to measure simultaneously the velocity and the size of droplets. When the concentration of particles is high, tightly focused beams must be used, as in the dual burst PDA. The latter permits an access to the refractive index of the particle, but the effect of wave front curvature of the incident beams becomes evident. In this paper, we introduce a glare spot phase Doppler anemometry which uses two large beams. The i...

  7. Recent Developments of C-Aryl Glucoside SGLT2 Inhibitors.

    Science.gov (United States)

    Zhang, Yang; Liu, Zhao-Peng

    2016-01-01

    Sodium-glucose cotransporter 2 (SGLT2) is almost exclusively expressed in the proximal renal tubules. It is responsible for about 90% of the glucose reabsorption from tubular fluid. Selective inhibition of SGLT2 is expected to favor in the normalization of plasma glucose levels in T2DM patients through the prevention of renal glucose reabsorption and the promotion of glucose excretion from urine. Selective SGLT2 inhibitors have the merits to minimize the gastrointestinal side effects associated with SGLT1 inhibition, and selective SGLT2 inhibition may have a low risk of hypoglycemia. Since the C-aryl glucosides are metabolically more stable than the O-glucosides, numerous efforts have been made in the development of potent and selective C-aryl glucoside SGLT2 inhibitors, and a number of them are now used as anti-diabetes drugs in clinic or at various stages of clinical developments. Based on their structural features, in this review, these SGLT2 inhibitors are classified as three types: the phenyl/arylmethylphenyl C-glucosides, with an emphasis on the modifications on the proximal and/or the distal phenyl ring, and the spacer; the heteroarylmethylphenyl Cglucosides, with a replacement of the distal phenyl ring by a heterocycle like pyridazine, pyrimidine, thiophene and benzothiophene, thiazole, 1,3,4-thiadiazole, and triazolopyridinone; and the glucose-modified Caryl glucosides, including the glucose C-1 derived O-spiroketals, C-4 gem-difluoro analogues, C-5 and C-6 modified derivatives, dioxa-bicyclo[3.2.1]octane bridged ketals, the thioglucosides, and carbasugars. The structure-activity relationships (SARs) of each type along with their inhibitory potency against human SGLT2 and selectivity over human SGLT1 are discussed.

  8. SGLT2 inhibitors in the treatment of type 2 diabetes.

    Science.gov (United States)

    Hasan, Farhad M; Alsahli, Mazen; Gerich, John E

    2014-06-01

    The kidney plays an important role in glucose homeostasis via its production, utilization, and, most importantly, reabsorption of glucose from glomerular filtrate which is largely mediated via the sodium glucose co-transporter 2 (SGLT2). Pharmacological inhibition of SGLT2 increases urinary glucose excretion and decreases plasma glucose levels in an insulin-independent manner. Agents that inhibit SGLT2 represent a novel class of drugs, which has recently become available for treatment of type 2 diabetes. This article summarizes the rationale for use of these agents and reviews available clinical data on their efficacy, safety, and risks/benefits. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  9. Boreal Forests of Kamchatka: Structure and Composition

    Directory of Open Access Journals (Sweden)

    Markus P. Eichhorn

    2010-09-01

    Full Text Available Central Kamchatka abounds in virgin old-growth boreal forest, formed primarily by Larix cajanderi and Betula platyphylla in varying proportions. A series of eight 0.25–0.30 ha plots captured the range of forests present in this region and their structure is described. Overall trends in both uplands and lowlands are for higher sites to be dominated by L. cajanderi with an increasing component of B. platyphylla with decreasing altitude. The tree line on wet sites is commonly formed by mono-dominant B. ermanii forests. Basal area ranged from 7.8–38.1 m2/ha and average tree height from 8.3–24.7 m, both being greater in lowland forests. Size distributions varied considerably among plots, though they were consistently more even for L. cajanderi than B. platyphylla. Upland sites also contained a dense subcanopy of Pinus pumila averaging 38% of ground area. Soil characteristics differed among plots, with upland soils being of lower pH and containing more carbon. Comparisons are drawn with boreal forests elsewhere and the main current threats assessed. These forests provide a potential baseline to contrast with more disturbed regions elsewhere in the world and therefore may be used as a target for restoration efforts or to assess the effects of climate change independent of human impacts.

  10. A specific pharmacophore model of sodium-dependent glucose co-transporter 2 (SGLT2) inhibitors.

    Science.gov (United States)

    Tang, Chunlei; Zhu, Xiaoyun; Huang, Dandan; Zan, Xin; Yang, Baowei; Li, Ying; Du, Xiaoyong; Qian, Hai; Huang, Wenlong

    2012-06-01

    Sodium-dependent glucose co-transporter 2 (SGLT2) plays a pivotal role in maintaining glucose equilibrium in the human body, emerging as one of the most promising targets for the treatment of diabetes mellitus type 2. Pharmacophore models of SGLT2 inhibitors have been generated with a training set of 25 SGLT2 inhibitors using Discovery Studio V2.1. The best hypothesis (Hypo1(SGLT2)) contains one hydrogen bond donor, five excluded volumes, one ring aromatic and three hydrophobic features, and has a correlation coefficient of 0.955, cost difference of 68.76, RMSD of 0.85. This model was validated by test set, Fischer randomization test and decoy set methods. The specificity of Hypo1(SGLT2) was evaluated. The pharmacophore features of Hypo1(SGLT2) were different from the best pharmacophore model (Hypo1(SGLT1)) of SGLT1 inhibitors we developed. Moreover, Hypo1(SGLT2) could effectively distinguish selective inhibitors of SGLT2 from those of SGLT1. These results indicate that a highly predictive and specific pharmacophore model of SGLT2 inhibitors has been successfully obtained. Then Hypo1(SGLT2) was used as a 3D query to screen databases including NCI and Maybridge for identifying new inhibitors of SGLT2. The hit compounds were subsequently subjected to filtering by Lipinski's rule of five. And several compounds selected from the top ranked hits have been suggested for further experimental assay studies.

  11. SGLT2 Inhibitors in Diabetes Mellitus Treatment.

    Science.gov (United States)

    Rosas-Guzman, Juan; Rosas-Saucedo, Juan; Romero-Garcia, Alma R J

    2017-01-01

    Type 2 Diabetes Mellitus (T2DM) is a chronic illness with high prevalence in Mexico, Latin- America, and the world and is associated to high morbidity, disability, and mortality rate, especially in developing countries. T2DM physiopathology is very complex; insulin resistance in the muscle, liver, and adipose tissue, a reduction in the production of incretins (mainly GLP-1) in the intestine, increased glucagon synthesis, an insufficient response of insulin generation, and increased glucose reabsorption in the kidney lead all together to an hyperglycemic state, which has been closely associated with the development of micro and macrovascular complications. Sodium Glucose Linked Transporter 2 inhibitors (SGLT2i) are the most recent therapeutic class available for treating T2DM. SGLT2i central effect is a glycosuric action, and they can reverse the deleterious effect of tubular reabsorption of glucose in the diabetic patient resulting in greater hyperglycemia. Because their mechanism of action is completely different to current drugs, they can be considered as monotherapy or in combination with any other oral or parenteral medication, including different types of insulin or its analogues. This therapeutic synergy accomplishes a greater percentage of patients achieving glycemic control goals. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  12. An extending island arc: The case of Kamchatka

    Science.gov (United States)

    Kozhurin, Andrey; Zelenin, Egor

    2017-06-01

    We report a first estimate of the extension rate of the onshore Kamchatka island arc, it central wider part. This average rate is 17 ± 3 mm/yr over mid-late Quaternary time. The extension is absorbed by slip on major normal active faults of Central Kamchatka, and graben-producing faulting in its volcanic belt. Probable extension of the underwater portion of the arc, its rate remaining unknown, may add up to the total value. The onshore extension rate, established by remote fault scarp measurements on DEMs resembles the numerical modelling estimate of Schellart et al. (2007), suggesting that the primary driving force responsible for the extension at Kamchatka is slab and trench retreat.

  13. Development of a novel non-radioactive cell-based method for the screening of SGLT1 and SGLT2 inhibitors using 1-NBDG.

    Science.gov (United States)

    Chang, Hung-Chi; Yang, Su-Fu; Huang, Ching-Chun; Lin, Tzung-Sheng; Liang, Pi-Hui; Lin, Chun-Jung; Hsu, Lih-Ching

    2013-08-01

    Sodium-coupled glucose co-transporters SGLT1 and SGLT2 play important roles in intestinal absorption and renal reabsorption of glucose, respectively. Blocking SGLT2 is a novel mechanism for lowering the blood glucose level by inhibiting renal glucose reabsorption and selective SGLT2 inhibitors are under development for treatment of type 2 diabetes. Furthermore, it has been reported that perturbation of SGLT1 is associated with cardiomyopathy and cancer. Therefore, both SGLT1 and SGLT2 are potential therapeutic targets. Here we report the development of a non-radioactive cell-based method for the screening of SGLT inhibitors using COS-7 cells transiently expressing human SGLT1 (hSGLT1), CHO-K1 cells stably expressing human SGLT2 (hSGLT2), and a novel fluorescent d-glucose analogue 1-NBDG as a substrate. Our data indicate that 1-NBDG can be a good replacement for the currently used isotope-labeled SGLT substrate, (14)C-AMG. The Michaelis constant of 1-NBDG transport (0.55 mM) is similar to that of d-glucose (0.51 mM) and AMG (0.40 mM) transport through hSGLT1. The IC50 values of a SGLT inhibitor phlorizin for hSGLT1 obtained using 1-NBDG and (14)C-AMG were identical (0.11 μM) in our cell-based system. The IC50 values of dapagliflozin, a well-known selective SGLT2 inhibitor, for hSGLT2 and hSGLT1 determined using 1-NBDG were 1.86 nM and 880 nM, respectively, which are comparable to the published results obtained using (14)C-AMG. Compared to (14)C-AMG, the use of 1-NBDG is cost-effective, convenient and potentially more sensitive. Taken together, a non-radioactive system using 1-NBDG has been validated as a rapid and reliable method for the screening of SGLT1 and SGLT2 inhibitors.

  14. Uranium and thorium in Cenozoic basaltods of Kamchatka

    International Nuclear Information System (INIS)

    Puzankov, Yu.M.

    1984-01-01

    Regularities in distribution of radioactive elements (RAE) in basaltoids of Kamchatka have been analyzed. The RAE concentration in samples was determined by γ-spectrometric method. The results compared with the instrumental neutron-activation analysis data are found to be in agreement. Results of evaluating the average contents of U, Th and roch-forming elements in ce-- nozoic basaltoids are presented. The radiogeochemical data enable to associate the origin of the Kamchatka Cenozoic basaltoids with both fractional melting of the upper mantle depleted of radioactive elements and the development of magmatic chambers in submerged blocks of the Pre-Cretaceous melanocratic basement the composition of which is close to oceanic tholeiite

  15. Verification of simple illuminance based measures for indication of discomfort glare from windows

    DEFF Research Database (Denmark)

    Karlsen, Line Røseth; Heiselberg, Per Kvols; Bryn, Ida

    2015-01-01

    predictions of discomfort glare from windows already in the early design stage when decisions regarding the façade are taken. This study focus on verifying if simple illuminance based measures like vertical illuminance at eye level or horizontal illuminance at the desk are correlated with the perceived glare...... reported by 44 test subjects in a repeated measure design occupant survey and if the reported glare corresponds with the predictions from the simple Daylight Glare Probability (DGPs) model. Large individual variations were seen in the occupants’ assessment of glare in the present study. Yet, the results...... confirm that there is a statistically significant correlation between both vertical eye illuminance and horizontal illuminance at the desk and the occupants’ perception of glare in a perimeter zone office environment, which is promising evidence towards utilizing such simple measures for indication...

  16. Are SGLT2 inhibitors reasonable antihypertensive drugs and renoprotective?

    Science.gov (United States)

    Lovshin, J A; Gilbert, R E

    2015-06-01

    By eliminating glucose in the urine, the sodium-glucose-linked cotransporter-2 (SGLT2) inhibitors act as osmotic diuretics to lower blood pressure in addition to reducing plasma glucose and assisting with weight loss. While not approved as antihypertensive agents, the ability of this new class of antihyperglycemic agents to lower blood pressure is not insubstantial, and while not used primarily for this indication, they may assist diabetic individuals in attaining currently recommended blood pressure targets. In addition to lowering systemic pressure, preclinical and exploratory human studies suggest that SGLT2 inhibitors may also lower intraglomerular pressure, potentially reducing the rate of GFR decline in patients with diabetic nephropathy. However, given the lack of clinically meaningful endpoint data, the use of SGLT2 inhibitors, primarily, as either antihypertensive or renoprotective agents would, at present, be premature. Fortunately, further insight will be garnered from large, randomized controlled trials that will assess the effects of various SGLT2 inhibitors on cardiovascular and renal outcomes.

  17. Viruses in acidic geothermal environments of the Kamchatka Peninsula

    DEFF Research Database (Denmark)

    Bize, Ariane; Peng, Xu; Prokofeva, Maria

    2008-01-01

    Screening for viruses in samples taken from acidic hot springs of Kamchatka (Russia) revealed a collection of morphotypes, including linear, spherical and complex fusiform shapes, which show partial similarity to those found in acidic geothermal environments in other geographical locations. One...

  18. Numerical study of glare spot phase Doppler anemometry

    Science.gov (United States)

    Hespel, C.; Ren, K. F.; Gréhan, G.; Onofri, F.

    2008-03-01

    The phase Doppler anemometry has (PDA) been developed to measure simultaneously the velocity and the size of droplets. When the concentration of particles is high, tightly focused beams must be used, as in the dual burst PDA. The latter permits an access to the refractive index of the particle, but the effect of wave front curvature of the incident beams becomes evident. In this paper, we introduce a glare spot phase Doppler anemometry which uses two large beams. The images of the particle formed by the reflected and refracted light, known as glare spots, are separated in space. When a particle passes through the probe volume, the two parts in a signal obtained by a detector in forward direction are then separated in time. If two detectors are used the phase differences and the intensity ratios between two signals, the distance between the reflected and refracted spots can be obtained. These measured values provide information about the particle diameter and its refractive index, as well as its two velocity components. This paper is devoted to the numerical study of such a configuration with two theoretical models: geometrical optics and rigorous electromagnetism solution.

  19. [Contributions of SGLT-2 and new drugs under investigation].

    Science.gov (United States)

    Mediavilla Bravo, J J

    2014-07-01

    DeFronzo spoke of the "ominous octet", in which he referred to the existence of distinct pathways and organs related to the physiopathology of type 2 diabetes mellitus (DM2). One of these key organs is the kidney, which plays an important role in regulating glucose metabolism through gluconeogenesis and through glomerular filtration and glucose reabsorption in the proximal convoluted tubules. Approximately 180 g of glucose are filtered to the renal tubule from the blood stream through the glomerulus. The filtrate is subsequently reabsorbed from the tubules to the peritubular capillaries through the action of sodium glucose cotransporters (SGLT). There are 2 main cotransporters in the kidney, SGLT1 and SGLT2, which reabsorb the glucose (10% and 90%, respectively) and return it to the blood. In persons with DM2, SGLT2 is increased, leading to greater renal absorption of glucose, which has adverse effects as it contributes to the maintenance of hyperglycemia. Selective pharmacological SGLT2 inhibition increases renal glucose excretion and secondarily reduces its plasma values. SGLT2 inhibitors act exclusively on the kidney, reduce glycosylated hemoglobin (HbA1c) by about 0.66%, decrease blood pressure, and induce a weight loss of approximately 1.8 kg. These drugs have a low risk of hypoglycemia but carry an increased risk of genitourinary infections. Several clinical trials have shown that dapagliflozin (10mg/day), the first SGLT2 inhibitor commercialized in Spain, produces a statistically significant reduction in HbA1c of 0.82-0.97%, both in monotherapy and in combination with metformin, glimepiride, pioglitazone, or insulin. Its use produces a weight loss of between 2 and 3 kg and reduces both systolic and diastolic blood pressure, while the risk of hypoglycemias is low. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Medicina Rural y Generalista (SEMERGEN). All rights reserved.

  20. Use systems pharmacology modeling to elucidate the operating characteristics of SGLT1 and SGLT2 in renal glucose reabsorption in humans

    Directory of Open Access Journals (Sweden)

    Yasong eLu

    2014-12-01

    Full Text Available In the kidney, glucose in glomerular filtrate is reabsorbed primarily by sodium-glucose cotransporters 1 (SGLT1 and 2 (SGLT2 along the proximal tubules. SGLT2 has been characterized as a high capacity, low affinity pathway responsible for reabsorption of the majority of filtered glucose in the early part of proximal tubules, and SGLT1 reabsorbs the residual glucose in the distal part. Inhibition of SGLT2 is a viable mechanism for removing glucose from the body and improving glycemic control in patients with diabetes. Despite demonstrating high levels (in excess of 80% of inhibition of glucose transport by SGLT2 in vitro, potent SGLT2 inhibitors, e.g., dapagliflozin and canagliflozin, inhibit renal glucose reabsorption by only 30-50% in clinical studies. Hypotheses for this apparent paradox are mostly focused on the compensatory effect of SGLT1. The paradox has been explained and the role of SGLT1 demonstrated in the mouse, but direct data in humans are lacking. To further explore the roles of SGLT1/2 in renal glucose reabsorption in humans, we developed a systems pharmacology model with emphasis on SGLT1/2 mediated glucose reabsorption and the effects of SGLT2 inhibition. The model was calibrated using robust clinical data in the absence or presence of dapagliflozin (DeFronzo et al. data (2013, and evaluated against clinical data from the literature (Mogensen, 1971;Wolf et al., 2009;Polidori et al., 2013. The model adequately described all four data sets. Simulations using the model clarified the operating characteristics of SGLT1/2 in humans in the healthy and diabetic state with or without SGLT2 inhibition. The modeling and simulations support our proposition that the apparent moderate, 30-50% inhibition of renal glucose reabsorption observed with potent SGLT2 inhibitors is a combined result of two physiological determinants: SGLT1 compensation and residual SGLT2 activity. This model will enable in silico inferences and predictions related to

  1. Use of systems pharmacology modeling to elucidate the operating characteristics of SGLT1 and SGLT2 in renal glucose reabsorption in humans

    Science.gov (United States)

    Lu, Yasong; Griffen, Steven C.; Boulton, David W.; Leil, Tarek A.

    2014-01-01

    In the kidney, glucose in glomerular filtrate is reabsorbed primarily by sodium-glucose cotransporters 1 (SGLT1) and 2 (SGLT2) along the proximal tubules. SGLT2 has been characterized as a high capacity, low affinity pathway responsible for reabsorption of the majority of filtered glucose in the early part of proximal tubules, and SGLT1 reabsorbs the residual glucose in the distal part. Inhibition of SGLT2 is a viable mechanism for removing glucose from the body and improving glycemic control in patients with diabetes. Despite demonstrating high levels (in excess of 80%) of inhibition of glucose transport by SGLT2 in vitro, potent SGLT2 inhibitors, e.g., dapagliflozin and canagliflozin, inhibit renal glucose reabsorption by only 30–50% in clinical studies. Hypotheses for this apparent paradox are mostly focused on the compensatory effect of SGLT1. The paradox has been explained and the role of SGLT1 demonstrated in the mouse, but direct data in humans are lacking. To further explore the roles of SGLT1/2 in renal glucose reabsorption in humans, we developed a systems pharmacology model with emphasis on SGLT1/2 mediated glucose reabsorption and the effects of SGLT2 inhibition. The model was calibrated using robust clinical data in the absence or presence of dapagliflozin (DeFronzo et al., 2013), and evaluated against clinical data from the literature (Mogensen, 1971; Wolf et al., 2009; Polidori et al., 2013). The model adequately described all four data sets. Simulations using the model clarified the operating characteristics of SGLT1/2 in humans in the healthy and diabetic state with or without SGLT2 inhibition. The modeling and simulations support our proposition that the apparent moderate, 30–50% inhibition of renal glucose reabsorption observed with potent SGLT2 inhibitors is a combined result of two physiological determinants: SGLT1 compensation and residual SGLT2 activity. This model will enable in silico inferences and predictions related to SGLT1

  2. SGLT2 Inhibitors as a Therapeutic Option for Diabetic Nephropathy

    Directory of Open Access Journals (Sweden)

    Daiji Kawanami

    2017-05-01

    Full Text Available Diabetic nephropathy (DN is a major cause of end-stage renal disease (ESRD worldwide. Glycemic and blood pressure (BP control are important but not sufficient to attenuate the incidence and progression of DN. Sodium–glucose cotransporter (SGLT 2 inhibitors are a new class of glucose-lowering agent suggested to exert renoprotective effects in glucose lowering-dependent and independent fashions. Experimental studies have shown that SGLT2 inhibitors attenuate DN in animal models of both type 1 diabetes (T1D and type 2 diabetes (T2D, indicating a potential renoprotective effect beyond glucose reduction. Renoprotection by SGLT2 inhibitors has been demonstrated in T2D patients with a high cardiovascular risk in randomized controlled trials (RCTs. These favorable effects of SGLT2 inhibitors are explained by several potential mechanisms, including the attenuation of glomerular hyperfiltration, inflammation and oxidative stress. In this review article, we discuss the renoprotective effects of SGLT2 inhibitors by integrating experimental findings with the available clinical data.

  3. SGLT2 Inhibitors as a Therapeutic Option for Diabetic Nephropathy.

    Science.gov (United States)

    Kawanami, Daiji; Matoba, Keiichiro; Takeda, Yusuke; Nagai, Yosuke; Akamine, Tomoyo; Yokota, Tamotsu; Sango, Kazunori; Utsunomiya, Kazunori

    2017-05-18

    Diabetic nephropathy (DN) is a major cause of end-stage renal disease (ESRD) worldwide. Glycemic and blood pressure (BP) control are important but not sufficient to attenuate the incidence and progression of DN. Sodium-glucose cotransporter (SGLT) 2 inhibitors are a new class of glucose-lowering agent suggested to exert renoprotective effects in glucose lowering-dependent and independent fashions. Experimental studies have shown that SGLT2 inhibitors attenuate DN in animal models of both type 1 diabetes (T1D) and type 2 diabetes (T2D), indicating a potential renoprotective effect beyond glucose reduction. Renoprotection by SGLT2 inhibitors has been demonstrated in T2D patients with a high cardiovascular risk in randomized controlled trials (RCTs). These favorable effects of SGLT2 inhibitors are explained by several potential mechanisms, including the attenuation of glomerular hyperfiltration, inflammation and oxidative stress. In this review article, we discuss the renoprotective effects of SGLT2 inhibitors by integrating experimental findings with the available clinical data.

  4. Anti-glare LED lamps with adjustable illumination light field.

    Science.gov (United States)

    Chen, Yung-Sheng; Lin, Chung-Yi; Yeh, Chun-Ming; Kuo, Chie-Tong; Hsu, Chih-Wei; Wang, Hsiang-Chen

    2014-03-10

    We introduce a type of LED light-gauge steel frame lamp with an adjustable illumination light field that does not require a diffusion plate. Base on the Monte Carlo ray tracing method, this lamp has a good glare rating (GR) of 17.5 at 3050 lm. Compared with the traditional LED light-gauge steel frame lamp (without diffusion plate), the new type has low GR. The adjustability of the illumination light field could improve the zebra effect caused by the inadequate illumination light field of the lamp. Meanwhile, we adopt the retinal image analysis to discuss the influence of GR on vision. High GR could reflect stray light on the retinal image, which will reduce vision clarity and hasten the feeling of eye fatigue.

  5. SGLT2 inhibitors: their potential reduction in blood pressure.

    Science.gov (United States)

    Maliha, George; Townsend, Raymond R

    2015-01-01

    The sodium glucose co-transporter 2 (SGLT2) inhibitors represent a promising treatment option for diabetes and its common comorbidity, hypertension. Emerging data suggests that the SGLT2 inhibitors provide a meaningful reduction in blood pressure, although the precise mechanism of the blood pressure drop remains incompletely elucidated. Based on current data, the blood pressure reduction is partially due to a combination of diuresis, nephron remodeling, reduction in arterial stiffness, and weight loss. While current trials are underway focusing on cardiovascular endpoints, the SGLT2 inhibitors present a novel treatment modality for diabetes and its associated hypertension as well as an opportunity to elucidate the pathophysiology of hypertension in diabetes. Copyright © 2015 American Society of Hypertension. Published by Elsevier Inc. All rights reserved.

  6. Anomalous changes of vertical geomagnetic field in Kamchatka

    Directory of Open Access Journals (Sweden)

    Moroz Yuriy

    2016-01-01

    Full Text Available Secular variations of the vertical geomagnetic field at Paratunka (Kamchatka, Kakioka (Honshu, Mamambetsu (Hokkaido and Patrony (Irkutsk are considered from 1968 to 2014. Comparative analysis of secular variations showed that from 1968 to 2001, similar variations with the intensity of first hundreds on nT are obvious at four observatories. For the following period from 2001 to 2014, the secular variation at Paratunka observatory differs from other observatories. This disagreement of the secular geomagnetic variation at Paratunka observatory is timed to the increase of seismicity at the depth of 400-700 km in South Kamchatka region. It is suggested that in the result of increase of the seismicity in the region of transition from the upper to lower mantle, physical and chemical processes became more active. That caused formation of a large geo-electrical inhomogeneity which affected the behavior of the vertical component of geomagnetic field.

  7. [Euglycemic ketoacidosis : a complication of SGLT2 inhibitors].

    Science.gov (United States)

    Mizuno, Aki; Lolachi, Sanaz; Pernet, Alain

    2017-05-31

    Sodium-glucose cotransporter 2 (SGLT2) inhibitors constitute a new category of oral antidiabetics recently indicated for the treatment of type 2 diabetes. Their mechanism of action (inhibition of renal reabsorption of glucose) and the fact that they do not induce hypoglycemia (as monotherapy) make their clinical use interesting. Various adverse events have however been reported regarding these drugs with the euglycemic ketoacidosis being the most serious. In this article we aim to review the possible mechanism of this side effect and recommendations for use of SGLT2 inhibitors by means of a case report.

  8. Sodium glucose transporter 2 (SGLT2 inhibition and ketogenesis

    Directory of Open Access Journals (Sweden)

    Sanjay Kalra

    2015-01-01

    Full Text Available Sodium glucose transporter 2 (SGLT2 inhibitors are a recently developed class of drug that have been approved for use in type 2 diabetes. Their unique extra-pancreatic glucuretic mode of action has encouraged their usage in type 1 diabetes as well. At the same time, reports of pseudo ketoacidosis and ketoacidosis related to their use have been published. No clear mechanism for this phenomenon has been demonstrated so far. This communication delves into the biochemical effects of SGLT2 inhibition, discusses the utility of these drugs and proposes steps to maximize safe usage of the molecules.

  9. Implications of advanced warning messages on eliminating sun glare disturbances at signalized intersections

    Directory of Open Access Journals (Sweden)

    Qing Li

    2016-08-01

    Full Text Available Due to sun glare disturbances, drivers encounter fatal threats on roadways, particularly at signalized intersections. Many studies have attempted to develop applicable solutions, such as avoiding sun positions, applying road geometric re-directions, and wearing anti-glare glasses. None of these strategies have fully solved the problem. As one of the “Connected Vehicle” practices proposed by the U.S. Department of Transportation, advanced warning messages (AWMs are capable of providing wireless information about traffic controls. AWM acts as a supplement to conventional signs and signals, which can be blocked by obstacles or natural disturbances, such as sun glare. The drivers' smart advisory system (DSAS can provide drivers with AWM. Using a driving simulator this research explores the effects of DSAS messages on driving behaviors under sun glare disturbance. Statistical analyses were applied to assess (1 the negative impacts of sun glare, (2 the compensation of the DSAS AWM to sun glare effects, and (3 the improvement in driving performance due to DSAS AWM. Four performance indexes were measured, including (1 half kinetic energy speed, (2 mean approach speed, (3 brake response time, and (4 braking distance. The effects of the socio-demographic factors, such as gender, age, educational background, and driving experience were also studied. The analytical results illustrate that the DSAS can compensate for reduced visibility due to sun glare and improve driving performance to a normal visual situation, particularly for left turn and through movement.

  10. Survey of discomfort glare from the headlamps of cars widely used in Iran.

    Science.gov (United States)

    Mehri, Ahmad; Farhang Dehghan, Somayeh; Hajizadeh, Roohalah; Zakerian, Seyed Abolfazl; Mohammadi, Hamzeh; Abbasi, Milad

    2017-10-03

    On 2-lane roads, discomfort glare can cause annoyance, discomfort, inconvenience, stress, and fatigue to drivers, posing a risk of accidents. The aim of this study is to evaluate discomfort glare from the headlamps of cars widely used in Iran. The discomfort glare of new vehicles including Pride Saba model GTX, Pride Model 131SL, Samand Soren, Peugeot 405, Megane, and Peugeot Pars was examined at distances of 5 to 100 m at a background luminance of 50 cd/m 2 (late twilight/early dawn lighting) and 1 cd/m 2 (nighttime) using Schmidt-Clausen and Bindels model and de Boer's subjective scale. According to the de Boer scale, at a background luminance of 50 cd/m 2 , the discomfort glare for all studied vehicles was between 1.98 and 4.05 in high-beam mode and between 3.5 and 5.4 in low-beam mode. At a background luminance of 1 cd/m 2 , discomfort glare was between 0.41 and 2.48 in high-beam mode and between 1.93 and 3.84 in low-beam mode. In high-beam mode, the average levels of discomfort glare of these vehicles gradually increased when the distance between cars was reduced by up to about 20 m. In low-beam mode, there was no discomfort glare up to a vehicle distance of 40 m. In addition, at an angle of 1.15°-5.73° between the line of sight and light of vehicles in high-beam mode, the level of discomfort glare was increased, but at an angle of 5.73°-22.9° the level of discomfort glare was reduced. In low-beam mode at an angle of 2.86°-22.9°, the level of discomfort glare was almost identical. The results show that in high-beam mode and with a 100-m distance between vehicles as well as in low-beam mode at intervals of less than 40 m between cars, discomfort glare is created. It can be concluded that by providing solutions such as installing road lighting system, an increase in luminance of roads, separating or widening road lanes, increasing the lateral distance between vehicles, and increasing the angle between lighted vehicles and drivers can noticeably

  11. Monitoring recreational impacts in wilderness of Kamchatka (on example of Kronotsky State Natural Biosphere Preserve)

    Science.gov (United States)

    Anya V. Zavadskaya

    2011-01-01

    This paper describes an assessment and monitoring program that was designed and initiated for monitoring recreational impacts in a wilderness in Kamchatka. The framework of the recreational assessment was tested through its application to a case study conducted during the summers of 2008 and 2009 in the Kronotsky State Natural Biosphere Preserve (Kamchatka peninsula,...

  12. Probing SGLT2 as a therapeutic target for diabetes: Basic physiology and consequences

    Science.gov (United States)

    Gallo, Linda A; Wright, Ernest M; Vallon, Volker

    2018-01-01

    Traditional treatments for type 1 and type 2 diabetes are often associated with side effects, including weight gain and hypoglycaemia that may offset the benefits of blood glucose lowering. The kidneys filter and reabsorb large amounts of glucose, and urine is almost free of glucose in normoglycaemia. The sodium-dependent glucose transporter (SGLT)-2 in the early proximal tubule reabsorbs the majority of filtered glucose. Remaining glucose is reabsorbed by SGLT1 in the late proximal tubule. Diabetes enhances renal glucose reabsorption by increasing the tubular glucose load and the expression of SGLT2 (as shown in mice), which maintains hyperglycaemia. Inhibitors of SGLT2 enhance urinary glucose excretion and thereby lower blood glucose levels in type 1 and type 2 diabetes. The load-dependent increase in SGLT1-mediated glucose reabsorption explains why SGLT2 inhibitors in normoglycaemic conditions only excrete ~50% of the filtered glucose. The role of SGLT1 in both renal and intestinal glucose reabsorption provides a rationale for the development of dual SGLT1/2 inhibitors. SGLT2 inhibitors lower blood glucose levels independent of insulin and induce pleiotropic actions that may be relevant in the context of lowering cardiovascular risk. Ongoing long-term clinical studies will determine whether SGLT2 inhibitors have a safety profile and exert cardiovascular benefits that are superior to traditional agents. PMID:25616707

  13. Renoprotective Effects of SGLT2 Inhibitors: Beyond Glucose Reabsorption Inhibition.

    Science.gov (United States)

    Tsimihodimos, V; Filippatos, T D; Filippas-Ntekouan, S; Elisaf, M

    2017-01-01

    Sodium-glucose co-transporter 2 (SGLT2) inhibitors are a new class of antidiabetic drugs that inhibit glucose and sodium reabsorption at proximal tubules. These drugs may exhibit renoprotective properties, since they prevent the deterioration of the glomerular filtration rate and reduce the degree of albuminuria in patients with diabetes-associated kidney disease. In this review we consider the pathophysiologic mechanisms that have been recently implicated in the renoprotective properties of SGLT2 inhibitors. The beneficial effects of SGLT2 inhibitors on the conventional risk factors for kidney disease (such as blood pressure, hyperglycaemia, body weight and serum uric acid levels) may explain, at least in part, the observed renal-protecting properties of these compounds. However, it has been hypothesized that the most important mechanisms for this phenomenon include the reduction in the intraglomerular pressure, the changes in the local and systemic degree of activation of the renin-aldosterone-angiotensin system and a shift in renal fuel consumption towards more efficient energy substrates such as ketone bodies. The beneficial effects of SGLT2 inhibitors on various aspects of renal function make them an attractive choice in patients with (and possibly without) diabetes-associated renal impairment. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  14. ColorChecker at the beach: dangers of sunburn and glare

    Science.gov (United States)

    McCann, John

    2014-01-01

    In High-Dynamic-Range (HDR) imaging, optical veiling glare sets the limits of accurate scene information recorded by a camera. But, what happens at the beach? Here we have a Low-Dynamic-Range (LDR) scene with maximal glare. Can we calibrate a camera at the beach and not be burnt? We know that we need sunscreen and sunglasses, but what about our cameras? The effect of veiling glare is scene-dependent. When we compare RAW camera digits with spotmeter measurements we find significant differences. As well, these differences vary, depending on where we aim the camera. When we calibrate our camera at the beach we get data that is valid for only that part of that scene. Camera veiling glare is an issue in LDR scenes in uniform illumination with a shaded lens.

  15. Influence of veiling glare in the image intensifier on cinefluorographic sensitometry

    International Nuclear Information System (INIS)

    Matsuda, Eiji; Sanada, Taizo; Hitomi, Go; Ishii, Koushi; Yoshida, Akira

    1998-01-01

    We have experienced variations in the shape of the cinesensitometric curve when the exposure field is greatly altered. The veiling glare that arises from the scattering of x-ray photons, electrons, and light in the x-ray image intensifier (X-I.I.) depends on the size of the exposure field. Also, the effect of adjacent chemicals that occurs during the development process depends on the size of the exposed area on film. The veiling glare in the X-I.I. and the adjacent chemical effect on cine film processing may be responsible for these phenomena. This study investigated the influences of veiling glare on the shape of the cinesensitometric curve. Results showed that the veiling glare of the X-I.I. acts to increase the sensitivity of the cinesensitometric curve on the X-I.I. when the exposed area on the X-I.I. is larger. (author)

  16. Influence of veiling glare in the image intensifier on cinefluorographic sensitometry

    Energy Technology Data Exchange (ETDEWEB)

    Matsuda, Eiji; Sanada, Taizo; Hitomi, Go; Ishii, Koushi [Kawasaki Medical School, Kurashiki, Okayama (Japan). Hospital; Yoshida, Akira

    1998-08-01

    We have experienced variations in the shape of the cinesensitometric curve when the exposure field is greatly altered. The veiling glare that arises from the scattering of x-ray photons, electrons, and light in the x-ray image intensifier (X-I.I.) depends on the size of the exposure field. Also, the effect of adjacent chemicals that occurs during the development process depends on the size of the exposed area on film. The veiling glare in the X-I.I. and the adjacent chemical effect on cine film processing may be responsible for these phenomena. This study investigated the influences of veiling glare on the shape of the cinesensitometric curve. Results showed that the veiling glare of the X-I.I. acts to increase the sensitivity of the cinesensitometric curve on the X-I.I. when the exposed area on the X-I.I. is larger. (author)

  17. Effects of a blue light-filtering intraocular lens on driving safety in glare conditions.

    Science.gov (United States)

    Gray, Rob; Hill, Warren; Neuman, Brooke; Houtman, Diane; Potvin, Richard

    2012-05-01

    To evaluate whether the previously established benefit of blue light-filtering intraocular lenses (IOLs) when driving in glare conditions is maintained in patients previously implanted with a blue light-filtering toric IOL. Department of Applied Psychology, Arizona State University, Mesa, Arizona, USA. Comparative case series. The study comprised patients with a blue light-filtering toric IOL (test IOL) or an ultraviolet (UV)-only filtering nontoric IOL (control IOL). All patients had good visual acuity and a valid driver's license. While wearing best spherocylindrical correction, patients performed left-turn maneuvers in front of oncoming traffic in a driving simulator. The safety margin was defined as the time to collision less the time taken to turn at an intersection with oncoming traffic. Measures were repeated with a glare source simulating low-angle sun conditions (daytime driving). Of the 33 evaluable patients, 18 had a test IOL and 15 had a control IOL. In the presence of glare, patients with test IOLs had significantly greater safety margins (mean 2.676 seconds ± 0.438 [SD]) than patients with control IOLs (mean 2.179 ± 0.343 seconds) and significantly lower glare susceptibility (P<.05). In no-glare and glare conditions, patients with test IOLs had significantly lower glare susceptibility than patients with control IOLs. The blue light-filtering toric IOL produced a significantly greater reduction in glare disability than the UV-only filtering nontoric IOL and increased the ability of drivers to safely execute left turns in low-sun conditions. Dr. Houtman is an employee of Alcon Laboratories, Inc. No other author has a financial or proprietary interest in any material or method mentioned. Copyright © 2012 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  18. The dark side of photovoltaic — 3D simulation of glare assessing risk and discomfort

    International Nuclear Information System (INIS)

    Rose, Thomas; Wollert, Alexander

    2015-01-01

    Photovoltaic (PV) systems form an important force in the implementation of renewable energies, but as we all know, the force has always its dark side. Besides efficiency considerations and discussions about architectures of power distribution networks, the increasing numbers of installations of PV systems for implementing renewable energies have secondary effects. PV systems can generate glare due to optical reflections and hence might be a serious concern. On the one hand, glare could affect safety, e.g. regarding traffic. On the other hand, glare is a constant source of discomfort in vicinities of PV systems. Hence, assessment of glare is decisive for the success of renewable energies near municipalities and traffic zones for the success of solar power. Several courts decided on the change of PV systems and even on their de-installation because of glare effects. Thus, location-based assessments are required to limit potential reflections and to avoid risks for public infrastructure or discomfort of residents. The question arises on how to calculate reflections accurately according to the environment's topography. Our approach is founded in a 3D-based simulation methodology to calculate and visualize reflections based on the geometry of the environment of PV systems. This computational model is implemented by an interactive tool for simulation and visualization. Hence, project planners receive flexible assistance for adjusting the parameters of solar panels amid the planning process and in particular before the installation of a PV system. - Highlights: • Solar panels cause glare that impacts neighborhoods and traffic infrastructures. • Glare might cause disability and discomfort. • 3D environment for the calculation of glare • Interactive tool to simulate and visualize reflections • Impact assessment of solar power plant farms

  19. The dark side of photovoltaic — 3D simulation of glare assessing risk and discomfort

    Energy Technology Data Exchange (ETDEWEB)

    Rose, Thomas; Wollert, Alexander

    2015-04-15

    Photovoltaic (PV) systems form an important force in the implementation of renewable energies, but as we all know, the force has always its dark side. Besides efficiency considerations and discussions about architectures of power distribution networks, the increasing numbers of installations of PV systems for implementing renewable energies have secondary effects. PV systems can generate glare due to optical reflections and hence might be a serious concern. On the one hand, glare could affect safety, e.g. regarding traffic. On the other hand, glare is a constant source of discomfort in vicinities of PV systems. Hence, assessment of glare is decisive for the success of renewable energies near municipalities and traffic zones for the success of solar power. Several courts decided on the change of PV systems and even on their de-installation because of glare effects. Thus, location-based assessments are required to limit potential reflections and to avoid risks for public infrastructure or discomfort of residents. The question arises on how to calculate reflections accurately according to the environment's topography. Our approach is founded in a 3D-based simulation methodology to calculate and visualize reflections based on the geometry of the environment of PV systems. This computational model is implemented by an interactive tool for simulation and visualization. Hence, project planners receive flexible assistance for adjusting the parameters of solar panels amid the planning process and in particular before the installation of a PV system. - Highlights: • Solar panels cause glare that impacts neighborhoods and traffic infrastructures. • Glare might cause disability and discomfort. • 3D environment for the calculation of glare • Interactive tool to simulate and visualize reflections • Impact assessment of solar power plant farms.

  20. Effects of anti-glare particles on sedation in mice

    Science.gov (United States)

    Wang, Hongyu; Hao, Shaojun; Liu, Xiaobin; Kong, Xuejun; Wang, Xidong; Li, Wenjun; Zhang, Zhengchen

    2018-04-01

    To investigate the effect of anti-glare particles on sedation of mice, 60 mice were randomly divided into 5 groups, were fed by Ant-dizzy Granule Suspension, saline, Yang Xue Qing Nao Granule suspension and the same volume of saline, and administered 1 times daily, for 7 days. The mice in the wilderness box, hang - 150W light bulbs in the box above, the light recording activities within 2 minutes. The wilderness box into the box after the number of mice, mice with limbs went to the 1 squares is around 1 in the same case, mouse location and method of wilderness case; each group was placed in the turn/bar with rotating speed of 40RPM, each time 5 Parallel experiment recorded the mouse stay time on the rotating rod, if the mouse fell within 2 minutes, immediately put it on the rotating rod to continue the experiment, recorded the mouse on the rotating rod accumulated stay time. If 10 minutes did not drop, press 10 minutes; eighty mice were divided into 5 groups. The number of each rat injected subthreshold dose of pentobarbital sodium in mice. The sleep recording liquid were recorded sleep latency and sleep time. The anti-vertigo granule can obviously reduce the spontaneous activity of mice (Pparticles have good sedative effect.

  1. A portable inspection system to estimate direct glare of various LED modules

    Science.gov (United States)

    Chen, Po-Li; Liao, Chun-Hsiang; Li, Hung-Chung; Jou, Shyh-Jye; Chen, Han-Ting; Lin, Yu-Hsin; Tang, Yu-Hsiang; Peng, Wei-Jei; Kuo, Hui-Jean; Sun, Pei-Li; Lee, Tsung-Xian

    2015-07-01

    Glare is caused by both direct and indirect light sources and discomfort glare produces visual discomfort, annoyance, or loss in visual performance and visibility. Direct glare is caused by light sources in the field of view whereas reflected glare is caused by bright reflections from polished or glossy surfaces that are reflected toward an individual. To improve visual comfort of our living environment, a portable inspection system to estimate direct glare of various commercial LED modules with the range of color temperature from 3100 K to 5300 K was developed in this study. The system utilized HDR images to obtain the illumination distribution of LED modules and was first calibrated for brightness and chromaticity and corrected with flat field, dark-corner and curvature by the installed algorithm. The index of direct glare was then automatically estimated after image capturing, and the operator can recognize the performance of LED modules and the possible effects on human being once the index was out of expecting range. In the future, we expect that the quick-response smart inspection system can be applied in several new fields and market, such as home energy diagnostics, environmental lighting and UGR monitoring and popularize it in several new fields.

  2. Glucose dynamics and mechanistic implications of SGLT2 inhibitors in animals and humans.

    Science.gov (United States)

    List, James F; Whaley, Jean M

    2011-03-01

    Glucose is freely filtered in the glomeruli before being almost entirely reabsorbed into circulation from the proximal renal tubules. The sodium-glucose cotransporter 2 (SGLT2), present in the S1 segment of the proximal tubule, is responsible for the majority of glucose reabsorption. SGLT2 inhibitors reduce glucose reabsorption and increase urinary glucose excretion. In animal models and humans with type 2 diabetes, this effect is associated with reduced fasting and postprandial blood glucose levels, and reduced hemoglobin A1c. Animal studies suggest that reduction of hyperglycemia with SGLT2 inhibitors may also improve insulin sensitivity and preserve β-cell function. Urinary excretion of excess calories with SGLT2 inhibitors is also associated with reduction in body weight. Modest reductions in blood pressure have been noted with SGLT2 inhibitors, consistent with a mild diuretic action. Some C-glucoside SGLT2 inhibitors, such as dapagliflozin, have pharmacokinetic properties that make them amenable to once-daily dosing.

  3. SGLT1-mediated transport in Caco-2 cells is highly dependent on cell bank origin

    DEFF Research Database (Denmark)

    Steffansen, B; Pedersen, Maria; Laghmoch, A M

    2017-01-01

    The Caco-2 cell line is a well-established in vitro model for studying transport phenomena for prediction of intestinal nutrient and drug absorption. However, for substances depending on transporters such predictions are complicated due to variable transporter expression and limited knowledge about...... transporter function during multiple cell passaging and cell thawings. In the case of SGLT1, a key transporter of oral absorption of D-glucose, one reason for compromised prediction could be inadequate expression of SGLT1 in Caco-2 cells and thereby limited sensitivity in the determination of SGLT1-mediated...... permeability (PSGLT1). Here, the objective was to characterize and compare SGLT1-mediated uptake in Caco-2 cells obtained from different cell banks. SGLT1-mediated uptake of the standard SGLT1 substrate, α-MDG, in Caco-2 cells was shown to be highly dependent on cell bank origin. The most robust and reliable...

  4. Variations of Background Seismic Noise Before Strong Earthquakes, Kamchatka.

    Science.gov (United States)

    Kasimova, V.; Kopylova, G.; Lyubushin, A.

    2017-12-01

    The network of broadband seismic stations of Geophysical Service (Russian Academy of Science) works on the territory of Kamchatka peninsula in the Far East of Russia. We used continuous records on Z-channels at 21 stations for creation of background seismic noise time series in 2011-2017. Average daily parameters of multi-fractal spectra of singularity have been calculated at each station using 1-minute records. Maps and graphs of their spatial distribution and temporal changes were constructed at time scales from days to several years. The analysis of the coherent behavior of the time series of the statistics was considered. The technique included the splitting of seismic network into groups of stations, taking into account the coastal effect, the network configuration and the main tectonic elements of Kamchatka. Then the time series of median values of noise parameters from each group of stations were made and the frequency-time diagrams of the evolution of the spectral measure of the coherent behavior of four time series were analyzed. The time intervals and frequency bands of the maximum values showing the increase of coherence in the changes of all statistics were evaluated. The strong earthquakes with magnitudes M=6.9-8.3 occurred near the Kamchatka peninsula during the observations. The synchronous variations of the background noise parameters and increase in the coherent behavior of the median values of statistical parameters was shown before two earthquakes 2013 (February 28, Mw=6.9; May 24, Mw=8.3) within 3-9 months and before earthquake of January 30, 2016, Mw=7.2 within 3-6 months. The maximum effect of increased coherence in the range of periods 4-5.5 days corresponds to the time of preparation of two strong earthquakes in 2013 and their aftershock processes. Peculiarities in changes of statistical parameters at stages of preparation of strong earthquakes indicate the attenuation in high-amplitude outliers and the loss of multi-fractal properties in

  5. [Acidosis without marked hyperglycemia : Euglycemic diabetic ketoacidosis associated with SGLT2-Inhibitors].

    Science.gov (United States)

    Valek, R; Von der Mark, J

    2017-03-01

    Sodium-glucose cotransporter 2 (SGLT2) inhibitors are new antidiabetic drugs that regulate blood glucose levels by increasing urinary glucose excretion. In May 2015, the U.S. Food and Drug Administration (FDA) issued a warning that SGLT2 inhibitors may lead to ketoacidosis. In this report, we describe a case of life-threatening euglycemic ketoacidosis associated with SGLT2 inhibition and evaluate possible mechanisms and triggers.

  6. SGLT2 Inhibitor-associated Diabetic Ketoacidosis: Clinical Review and Recommendations for Prevention and Diagnosis.

    Science.gov (United States)

    Goldenberg, Ronald M; Berard, Lori D; Cheng, Alice Y Y; Gilbert, Jeremy D; Verma, Subodh; Woo, Vincent C; Yale, Jean-François

    2016-12-01

    Sodium-glucose cotransporter 2 (SGLT2) inhibitors are the newest class of antihyperglycemic agents available on the market. Regulator warnings and concerns regarding the risk of developing diabetic ketoacidosis (DKA), however, have dampened enthusiasm for the class despite the combined glycemic, blood pressure, and occasional weight benefits of SGLT2 inhibitors. With the goal of improving patient safety, a cross-Canada expert panel and writing group were convened to review the evidence to-date on reported SGLT2 inhibitor-related DKA incidents and to offer recommendations for preventing and recognizing patients with SGLT2 inhibitor-associated DKA. Reports covering DKA events in subjects taking SGLT2 inhibitors that were published in PubMed, presented at professional conferences, or in the public domain from January 2013 to mid-August 2016 were reviewed by the group independently and collectively. Practical recommendations for diagnosis and prevention were established by the panel. DKA is rarely associated with SGLT2 inhibitor therapy. Patients with SGLT2 inhibitor-associated DKA may be euglycemic (plasma glucose level SGLT2 inhibitor-associated DKA may be prevented by withholding SGLT2 inhibitors when precipitants develop, avoiding insulin omission or inappropriate insulin dose reduction, and by following sick day protocols as recommended. Preventive strategies should help avoid SGLT2 inhibitor-associated DKA. All SGLT2 inhibitor-treated patients presenting with signs or symptoms of DKA should be suspected to have DKA and be investigated for DKA, especially euglycemic patients. If DKA is diagnosed, SGLT2 inhibitor treatment should be stopped, and the DKA should be treated with a traditional treatment protocol. Copyright © 2016 Elsevier HS Journals, Inc. All rights reserved.

  7. Why Do SGLT2 inhibitors inhibit only 30-50% of renal glucose reabsorption in humans?

    Science.gov (United States)

    Liu, Jiwen Jim; Lee, TaeWeon; DeFronzo, Ralph A

    2012-09-01

    Sodium glucose cotransporter 2 (SGLT2) inhibition is a novel and promising treatment for diabetes under late-stage clinical development. It generally is accepted that SGLT2 mediates 90% of renal glucose reabsorption. However, SGLT2 inhibitors in clinical development inhibit only 30-50% of the filtered glucose load. Why are they unable to inhibit 90% of glucose reabsorption in humans? We will try to provide an explanation to this puzzle in this perspective analysis of the unique pharmacokinetic and pharmacodynamic profiles of SGLT2 inhibitors in clinical trials and examine possible mechanisms and molecular properties that may be responsible.

  8. MAP17 Is a Necessary Activator of Renal Na+/Glucose Cotransporter SGLT2

    Science.gov (United States)

    Coady, Michael J.; El Tarazi, Abdulah; Santer, René; Bissonnette, Pierre; Sasseville, Louis J.; Calado, Joaquim; Lussier, Yoann; Dumayne, Christopher; Bichet, Daniel G.

    2017-01-01

    The renal proximal tubule reabsorbs 90% of the filtered glucose load through the Na+-coupled glucose transporter SGLT2, and specific inhibitors of SGLT2 are now available to patients with diabetes to increase urinary glucose excretion. Using expression cloning, we identified an accessory protein, 17 kDa membrane-associated protein (MAP17), that increased SGLT2 activity in RNA-injected Xenopus oocytes by two orders of magnitude. Significant stimulation of SGLT2 activity also occurred in opossum kidney cells cotransfected with SGLT2 and MAP17. Notably, transfection with MAP17 did not change the quantity of SGLT2 protein at the cell surface in either cell type. To confirm the physiologic relevance of the MAP17–SGLT2 interaction, we studied a cohort of 60 individuals with familial renal glucosuria. One patient without any identifiable mutation in the SGLT2 coding gene (SLC5A2) displayed homozygosity for a splicing mutation (c.176+1G>A) in the MAP17 coding gene (PDZK1IP1). In the proximal tubule and in other tissues, MAP17 is known to interact with PDZK1, a scaffolding protein linked to other transporters, including Na+/H+ exchanger 3, and to signaling pathways, such as the A-kinase anchor protein 2/protein kinase A pathway. Thus, these results provide the basis for a more thorough characterization of SGLT2 which would include the possible effects of its inhibition on colocalized renal transporters. PMID:27288013

  9. A cell-based fluorescent glucose transporter assay for SGLT2 inhibitor discovery

    Directory of Open Access Journals (Sweden)

    Yi Huan

    2013-04-01

    Full Text Available The sodium/glucose cotransporter 2 (SGLT2 is responsible for the majority of glucose reabsorption in the kidney, and currently, SGLT2 inhibitors are considered as promising hypoglycemic agents for the treatment of type 2 diabetes mellitus. By constructing CHO cell lines that stably express the human SGLT2 transmembrane protein, along with a fluorescent glucose transporter assay that uses 2-[N-(7-nitrobenz-2-oxa-1,3-diazol-4-ylamino]2-deoxyglucose (2-NBDG as a glucose analog, we have developed a nonradioactive, cell-based assay for the discovery and characterization of SGLT2 inhibitors.

  10. Why Do SGLT2 Inhibitors Inhibit Only 30–50% of Renal Glucose Reabsorption in Humans?

    Science.gov (United States)

    Liu, Jiwen (Jim); Lee, TaeWeon; DeFronzo, Ralph A.

    2012-01-01

    Sodium glucose cotransporter 2 (SGLT2) inhibition is a novel and promising treatment for diabetes under late-stage clinical development. It generally is accepted that SGLT2 mediates 90% of renal glucose reabsorption. However, SGLT2 inhibitors in clinical development inhibit only 30–50% of the filtered glucose load. Why are they unable to inhibit 90% of glucose reabsorption in humans? We will try to provide an explanation to this puzzle in this perspective analysis of the unique pharmacokinetic and pharmacodynamic profiles of SGLT2 inhibitors in clinical trials and examine possible mechanisms and molecular properties that may be responsible. PMID:22923645

  11. Design of SGLT2 Inhibitors for the Treatment of Type 2 Diabetes: A History Driven by Biology to Chemistry.

    Science.gov (United States)

    Cai, Wenqing; Jiang, Linlin; Xie, Yafei; Liu, Yuqiang; Liu, Wei; Zhao, Guilong

    2015-01-01

    A brief history of the design of sodium-dependent glucose cotransporter 2 (SGLT2) inhibitors is reviewed. The design of O-glucoside SGLT2 inhibitors by structural modification of phlorizin, a naturally occurring O-glucoside, in the early stage was a process mainly driven by biology with anticipation of improving SGLT2/SGLT1 selectivity and increasing metabolic stability. Discovery of dapagliflozin, a pioneering C-glucoside SGLT2 inhibitor developed by Bristol-Myers Squibb, represents an important milestone in this history. In the second stage, the design of C-glycoside SGLT2 inhibitors by modifications of the aglycone and glucose moiety of dapagliflozin, an original structural template for almost all C-glycoside SGLT2 inhibitors, was mainly driven by synthetic organic chemistry due to the challenge of designing dapagliflozin derivatives that are patentable, biologically active and synthetically accessible. Structure-activity relationships (SAR) of the SGLT2 inhibitors are also discussed.

  12. Mutnovsky and Gorely Volcanoes, Kamchatka as Planetary Analogue Sites

    Science.gov (United States)

    Evdokimova, N.; Izbekov, P. E.; Krupskaya, V.; Muratov, A.

    2016-12-01

    Recent advances in Mars studies suggest that volcanic rocks, which dominated Martian surface in the past, have been exposed to alteration processes in a water-bearing environment during Noachian, before 3.7 Gy. Active volcanoes on Earth are natural laboratories, where volcanic processes and their associated products can be studied directly. This is particularly important for studying of alteration of juvenile volcanic products in aqueous environment because of the transient nature of some of the alteration products, as well as the environment itself. Terrestrial analogues help us to better understand processes on Mars; they are particularly useful as a test sites for preparation to future Mars missions. In this presentation we describe planetary analogue sites at Mutnovsky and Gorely Volcanoes in Kamchatka, which might be helpful for comparative studies and preparation to future Mars missions. Mutnovsky and Gorely Volcanoes are located 75 km south of Petropavlovsk-Kamchatsky, in the southern part of the Kamchatka Peninsula, Russia. The modern volcanic landscape in the area was shaped in Holocene (recent 10,000 years) through intermittent eruption of magmas ranging in composition from basalts to dacites and rhyodacites, with basaltic andesite lavas dominating in the modern relief. Two localities could be of a particular interest: (1) Mutnovsky NW thermal field featuring processes of active hydrothermal alteration of lavas of basaltic andesite and (2) dry lake at the bottom of Gorely caldera featuring products of mechanical disintegration of basaltic andesite lavas by eolian processes with short seasonal sedimentation in aqueous environment.

  13. Microbial diversity and autotrophic activity in Kamchatka hot springs.

    Science.gov (United States)

    Merkel, Alexander Yu; Pimenov, Nikolay V; Rusanov, Igor I; Slobodkin, Alexander I; Slobodkina, Galina B; Tarnovetckii, Ivan Yu; Frolov, Evgeny N; Dubin, Arseny V; Perevalova, Anna A; Bonch-Osmolovskaya, Elizaveta A

    2017-03-01

    Microbial communities of Kamchatka Peninsula terrestrial hot springs were studied using molecular, radioisotopic and cultural approaches. Analysis of 16S rRNA gene fragments performed by means of high-throughput sequencing revealed that aerobic autotrophic sulfur-oxidizing bacteria of the genus Sulfurihydrogenibium (phylum Aquificae) dominated in a majority of streamers. Another widely distributed and abundant group was that of anaerobic bacteria of the genus Caldimicrobium (phylum Thermodesulfobacteria). Archaea of the genus Vulcanisaeta were abundant in a high-temperature, slightly acidic hot spring, where they were accompanied by numerous Nanoarchaeota, while the domination of uncultured Thermoplasmataceae A10 was characteristic for moderately thermophilic acidic habitats. The highest rates of inorganic carbon assimilation determined by the in situ incubation of samples in the presence of 14 C-labeled bicarbonate were found in oxygen-dependent streamers; in two sediment samples taken from the hottest springs this process, though much weaker, was found to be not dependent on oxygen. The isolation of anaerobic lithoautotrophic prokaryotes from Kamchatka hot springs revealed a wide distribution of the ability for sulfur disproportionation, a new lithoautotrophic process capable to fuel autonomous anaerobic ecosystems.

  14. Diabetes and kidney disease: the role of sodium-glucose cotransporter-2 (SGLT-2) and SGLT-2 inhibitors in modifying disease outcomes.

    Science.gov (United States)

    Mende, Christian W

    2017-03-01

    Patients with type 2 diabetes (T2D) often have coexisting chronic kidney disease (CKD). However, healthy renal function is crucial in maintaining glucose homeostasis, assuring that almost all of the filtered glucose is reabsorbed by the sodium glucose cotransporters (SGLTs) SGLT-1 and SGLT-2. In diabetes, an increased amount of glucose is filtered by the kidneys and SGLT-2 is upregulated, leading to increased glucose absorption and worsening hyperglycemia. Prolonged hyperglycemia contributes to the development of CKD by inducing metabolic and hemodynamic changes in the kidneys. Due to the importance of SGLT-2 in regulating glucose levels, investigation into SGLT-2 inhibitors was initiated as a glucose-dependent mechanism to control hyperglycemia, and there are three agents currently approved for use in the United States: dapagliflozin, canagliflozin, and empagliflozin. SGLT-2 inhibitors have been shown to reduce glycated hemoglobin (A1C), weight, and blood pressure, which not only affects glycemic control, but may also help slow the progression of renal disease by impacting the underlying mechanisms of kidney injury. In addition, SGLT-2 inhibitors have shown reductions in albuminuria, uric acid, and an increase in magnesium. Caution is advised when prescribing SGLT-2 inhibitors to patients with moderately impaired renal function and those at risk for volume depletion and hypotension. Published data on slowing of the development, as well as progression of CKD, is a hopeful indicator for the possible renal protection potential of this drug class. This narrative review provides an in-depth discussion of the interplay between diabetes, SGLT-2 inhibitors, and factors that affect kidney function.

  15. Effects of SGLT2 inhibition in human kidney proximal tubular cells--renoprotection in diabetic nephropathy?

    Directory of Open Access Journals (Sweden)

    Usha Panchapakesan

    Full Text Available Sodium/glucose cotransporter 2 (SGLT2 inhibitors are oral hypoglycemic agents used to treat patients with diabetes mellitus. SGLT2 inhibitors block reabsorption of filtered glucose by inhibiting SGLT2, the primary glucose transporter in the proximal tubular cell (PTC, leading to glycosuria and lowering of serum glucose. We examined the renoprotective effects of the SGLT2 inhibitor empagliflozin to determine whether blocking glucose entry into the kidney PTCs reduced the inflammatory and fibrotic responses of the cell to high glucose. We used an in vitro model of human PTCs. HK2 cells (human kidney PTC line were exposed to control 5 mM, high glucose (HG 30 mM or the profibrotic cytokine transforming growth factor beta (TGFβ1; 0.5 ng/ml in the presence and absence of empagliflozin for up to 72 h. SGLT1 and 2 expression and various inflammatory/fibrotic markers were assessed. A chromatin immunoprecipitation assay was used to determine the binding of phosphorylated smad3 to the promoter region of the SGLT2 gene. Our data showed that TGFβ1 but not HG increased SGLT2 expression and this occurred via phosphorylated smad3. HG induced expression of Toll-like receptor-4, increased nuclear deoxyribonucleic acid binding for nuclear factor kappa B (NF-κB and activator protein 1, induced collagen IV expression as well as interleukin-6 secretion all of which were attenuated with empagliflozin. Empagliflozin did not reduce high mobility group box protein 1 induced NF-κB suggesting that its effect is specifically related to a reduction in glycotoxicity. SGLT1 and GLUT2 expression was not significantly altered with HG or empagliflozin. In conclusion, empagliflozin reduces HG induced inflammatory and fibrotic markers by blocking glucose transport and did not induce a compensatory increase in SGLT1/GLUT2 expression. Although HG itself does not regulate SGLT2 expression in our model, TGFβ increases SGLT2 expression through phosphorylated smad3.

  16. Analysis of the efficacy of SGLT2 inhibitors using semi-mechanistic model

    Science.gov (United States)

    Demin, Oleg; Yakovleva, Tatiana; Kolobkov, Dmitry; Demin, Oleg

    2014-01-01

    The Renal sodium-dependent glucose co-transporter 2 (SGLT2) is one of the most promising targets for the treatment of type 2 diabetes. Two SGLT2 inhibitors, dapagliflozin, and canagliflozin, have already been approved for use in USA and Europe; several additional compounds are also being developed for this purpose. Based on the in vitro IC50 values and plasma concentration of dapagliflozin measured in clinical trials, the marketed dosage of the drug was expected to almost completely inhibit SGLT2 function and reduce glucose reabsorption by 90%. However, the administration of dapagliflozin resulted in only 30–50% inhibition of reabsorption. This study was aimed at investigating the mechanism underlying the discrepancy between the expected and observed levels of glucose reabsorption. To this end, systems pharmacology models were developed to analyze the time profile of dapagliflozin, canagliflozin, ipragliflozin, empagliflozin, and tofogliflozin in the plasma and urine; their filtration and active secretion from the blood to the renal proximal tubules; reverse reabsorption; urinary excretion; and their inhibitory effect on SGLT2. The model shows that concentration levels of tofogliflozin, ipragliflozin, and empagliflozin are higher than levels of other inhibitors following administration of marketed SGLT2 inhibitors at labeled doses and non-marketed SGLT2 inhibitors at maximal doses (approved for phase 2/3 studies). All the compounds exhibited almost 100% inhibition of SGLT2. Based on the results of our model, two explanations for the observed low efficacy of SGLT2 inhibitors were supported: (1) the site of action of SGLT2 inhibitors is not in the lumen of the kidney's proximal tubules, but elsewhere (e.g., the kidneys proximal tubule cells); and (2) there are other transporters that could facilitate glucose reabsorption under the conditions of SGLT2 inhibition (e.g., other transporters of SGLT family). PMID:25352807

  17. Analysis of efficacy of SGLT2 inhibitors using semi-mechanistic model

    Directory of Open Access Journals (Sweden)

    Oleg eDemin Jr

    2014-10-01

    Full Text Available Renal sodium-dependent glucose co-transporter 2 (SGLT2 is one of the most promising targets for the treatment of type 2 diabetes. Two SGLT2 inhibitors, dapagliflozin and canagliflozin, have already been approved for use in USA and Europe; several additional compounds are also being developed for this purpose. Based on the in vitro IC50 values and plasma concentration of dapagliflozin measured in clinical trials, the marketed dosage of the drug was expected to almost completely inhibit SGLT2 function and reduce glucose reabsorption by 90%. However, the administration of dapagliflozin resulted in only 30–50% inhibition of reabsorption. This study was aimed at investigating the mechanism underlying the discrepancy between the expected and observed levels of glucose reabsorption. To this end, systems pharmacology models were developed to analyze the time profile of dapagliflozin, canagliflozin, ipragliflozin, empagliflozin, and tofogliflozin in the plasma and urine; their filtration and active secretion from the blood to the renal proximal tubules; reverse reabsorption; urinary excretion; and their inhibitory effect on SGLT2. The model shows that concentration levels of tofogliflozin, ipragliflozin, and empagliflozin are higher than levels of other inhibitors following administration of marketed SGLT2 inhibitors at labeled doses and non-marketed SGLT2 inhibitors at maximal doses (approved for phase 2/3 studies. All the compounds exhibited almost 100% inhibition of SGLT2. Based on the results of our model, two explanations for the observed low efficacy of SGLT2 inhibitors were supported: 1 the site of action of SGLT2 inhibitors is not in the lumen of the kidney’s proximal tubules, but elsewhere (e.g., the kidneys proximal tubule cells; and 2 there are other transporters that could facilitate glucose reabsorption under the conditions of SGLT2 inhibition (e.g., other transporters of SGLT family.

  18. Visual Fatigue Evaluation: Improvement of Reflected Glare on Touch Screen for Nuclear Power Plant

    International Nuclear Information System (INIS)

    Liu, Kang Hung; Yang, Chih Wei; Hwang, Sheue Ling; Liou, Jin Liang

    2014-01-01

    The purpose of this research is to evaluate the visual fatigue of operators caused by glare problems in the main control room of nuclear power plant. Within the limitation in the main control room, reflectors were set under the light source which generates reflected glare on touch screens. Through avoiding the light directly shines on touch screens, reflected glare were eliminated. This research matched up the setting process of reflectors, evaluated the visual fatigue of operators, and collected user's opinions before reflector setting, after the first setting, and after the second setting. The design of reflectors could refer the result of evaluations and the collection of opinions. Nevertheless, the improvement of reflected glare on touch screens could be verified by this evaluations. The result showed that setting reflectors under the light source could eliminate reflected glare effectively, and the visual fatigue was reduced both on subject and object evaluations. However, the setting direction of reflectors has potential effect on operators' visual fatigue, so the real setting of reflectors still need to be evaluated completely. The near point accommodation could reflect the effect of visual fatigue caused by changes of lighting environment. Thus, the verification of new lighting environment according to the near point accommodation is suggested

  19. SGLT2 inhibitors in the management of type 2 diabetes.

    Science.gov (United States)

    Monica Reddy, R P; Inzucchi, Silvio E

    2016-08-01

    The glucose-lowering pharmacopeia continues to grow for patients with type 2 diabetes. The latest drug category, the SGLT2 inhibitors reduce glycated hemoglobin concentrations by increasing urinary excretion of glucose. They are used mainly in combination with metformin and other antihyperglycemic agents, including insulin. Their glucose-lowering potency is modest. Advantages include lack of hypoglycemia as a side effect, and mild reduction in blood pressure and body weight. Side effects include increased urinary frequency, owing to their mild diuretic action, symptoms of hypovolemia, genitourinary infections. There are also recent reports of rare cases of diabetic ketoacidosis occurring in insulin-treated patients. Recently, a large cardiovascular outcome trial reported that a specific SGLT2 inhibitor, empagliflozin, led to a reduction in the primary endpoint of major cardiovascular events. This effect was mainly the result of a surprising 38 % reduction in cardiovascular death, and the drug was also associated with nearly as large a reduction in heart failure hospitalization. These findings were notable because most drugs used in type 2 diabetes have not been shown to improve cardiovascular outcomes. Accordingly, there is growing interest in empagliflozin and the entire SGLT2 inhibitor class as drugs that could potentially change the manner in which we approach the management of hyperglycemia in patients with type 2 diabetes.

  20. Synthesis and biological evaluation of novel dioxa-bicycle C-aryl glucosides as SGLT2 inhibitors.

    Science.gov (United States)

    Yan, Qi; Ding, Ning; Li, Yingxia

    2016-02-08

    A series of novel C-aryl glucosides containing dioxa-bicycle were synthesized and evaluated for inhibition activity against hSGLT2. Among the compounds tested, compound 6a showed moderate SGLT2 inhibition activities at 700 nM. The results could benefit the discovery of new SGLT2 inhibitors. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. A 100-YEAR ANNIVERSARY OF THE RUSSIAN GEOGRAPHIC SOCIETY EXPEDITION TO KAMCHATKA (1908–1910

    Directory of Open Access Journals (Sweden)

    Vladimir Kotlyakov

    2010-01-01

    Full Text Available For three centuries, the main task of geography in Russia was gathering information about the geographical features of the country. The unique image of the Russian Geographical Society (RGS is largely due to its expeditionary activities. The RGS Kamchatka Complex Expedition of 1908-1910 was to explore and examine the flora and fauna of the Kamchatka peninsula, mainly in the area of volcanoes. The expedition to Kamchatka played a significant role in promoting science in the Russian Far East. Important scientific and public institutions were founded in this region as a result of this endeavor. Two institutions directly associated with the expedition are the Kamchatka branch of the RGS and the Institute of Volcanology and Seismology (Far Eastern Branch of the Russian Academy of Sciences. These institutions are important members of the Russian scientific community and are well known around the world.

  2. Isotonic transport by the Na+-glucose cotransporter SGLT1 from humans and rabbit

    DEFF Research Database (Denmark)

    Zeuthen, T; Meinild, A K; Loo, D D

    2001-01-01

    water transport was divided about equally between cotransport, osmosis across the SGLT1 and osmosis across the native oocyte membrane. 6. Coexpression of AQP1 with the SGLT1 increased the water permeability more than 10-fold and steady state isotonic transport was achieved after less than 2 s of sugar......1. In order to study its role in steady state water transport, the Na+-glucose cotransporter (SGLT1) was expressed in Xenopus laevis oocytes; both the human and the rabbit clones were tested. The transport activity was monitored as a clamp current and the flux of water followed optically...... as the change in oocyte volume. 2. SGLT1 has two modes of water transport. First, it acts as a molecular water pump: for each 2 Na+ and 1 sugar molecule 264 water molecules were cotransported in the human SGLT1 (hSGLT1), 424 for the rabbit SGLT1 (rSGLT1). Second, it acts as a water channel. 3. The cotransport...

  3. Molecular analysis of the SGLT2 gene in patients with renal glucosuria

    DEFF Research Database (Denmark)

    Santer, René; Kinner, Martina; Lassen, Christoph L.

    2003-01-01

    The role of SGLT2 (the gene for a renal sodium-dependent glucose transporter) in renal glucosuria was evaluated. Therefore, its genomic sequence and its intron-exon organization were determined, and 23 families with index cases were analyzed for mutations. In 21 families, 21 different SGLT2 mutat...

  4. [Sodium Glucose Co-transporter Type 2 (SGLT2) Inhibitors in CKD].

    Science.gov (United States)

    Insalaco, Monica; Zanoli, Luca; Rastelli, Stefania; Lentini, Paolo; Rapisarda, Francesco; Fatuzzo, Pasquale; Castellino, Pietro; Granata, Antonio

    2015-01-01

    Among the new drugs used for the treatment of Diabetes Mellitus type 2, sodium-glucose cotransporter 2 (SGLT2) inhibitors represent a promising therapeutic option. Since their ability to lower glucose is proportional to GFR, their effect is reduced in patients with chronic kidney disease (CKD). The antidiabetic mechanism of these drugs is insulin-independent and, therefore, complimentary to that of others antihyperglicaemic agents. Moreover, SGLT2 inhibitors are able to reduce glomerular hyperfiltration, systemic and intraglomerular pressure and uric acid levels, with consequent beneficial effects on the progression of kidney disease in non diabetic patients as well. Only few studies have been performed to evaluate the effects of SGLT2 inhibitors in patients with CKD. Therefore, safety and efficacy of SGLT2 inhibitors should be better clarified in the setting of CKD. In this paper, we will review the use of SGLT2 inhibitors in diabetic patients, including those with CKD.

  5. Case Reports That Illustrate the Efficacy of SGLT2 Inhibitors in the Type 1 Diabetic Patient

    Directory of Open Access Journals (Sweden)

    David S. H. Bell

    2015-01-01

    Full Text Available SGLT2 inhibitors are only approved for use in adults with type 2 diabetes. However, because SGLT2 inhibitors have a mechanism of action that does not require the presence of endogenous insulin, these drugs should also be efficacious in type 1 diabetes where endogenous insulin production is greatly reduced or absent. Herein, I present five cases which illustrate the benefits of utilizing an SGLT2 inhibitor with type 1 diabetes. In these cases the use of SGLT2 inhibitors resulted not only in better glycemic control in most patients but also in some patients’ less hypoglycemia, weight loss, and decreased doses of insulin. In type 1 diabetes Candida albicans vaginitis and balanitis may occur more frequently than in type 2 diabetes. These cases show that a large randomized clinical trial of SGLT2 inhibitors in type 1 diabetes needs to be performed.

  6. Numerical investigation of the effect of delaminations on fracture characteristics of glare

    Science.gov (United States)

    Bhat, Sunil; Narayanan, S.

    2013-10-01

    A finite element examination of the effect of delaminations on fracture characteristics of fibre metal laminate (Glare), by comparing energy release rates of normal cracks in laminates with and without delaminations, is presented in the paper. Glare comprising thin cracked 2024-T3 aerospace aluminum alloy layers alternately bonded with E-glass fibre based composite prepregs is considered for the analysis. Delaminations are modeled with interface cohesive elements. Energy release rates of normal cracks in laminates with delaminations are found to be higher than those in the laminates without delaminations.

  7. Mobile computing device configured to compute irradiance, glint, and glare of the sun

    Science.gov (United States)

    Gupta, Vipin P; Ho, Clifford K; Khalsa, Siri Sahib

    2014-03-11

    Described herein are technologies pertaining to computing the solar irradiance distribution on a surface of a receiver in a concentrating solar power system or glint/glare emitted from a reflective entity. A mobile computing device includes at least one camera that captures images of the Sun and the entity of interest, wherein the images have pluralities of pixels having respective pluralities of intensity values. Based upon the intensity values of the pixels in the respective images, the solar irradiance distribution on the surface of the entity or glint/glare corresponding to the entity is computed by the mobile computing device.

  8. ANOMALOUS CHANGES OF THE GEOMAGNETIC FIELD VERTICAL COMPONENT IN KAMCHATKA

    Directory of Open Access Journals (Sweden)

    Y. F. Moroz

    2016-11-01

    Full Text Available Secular changes of the lithospheric electric conductivity were analyzed based on the monitoring data of the Earth’s electric field over the period from 2001 to 2014. Those measures were carried out in Verchniya Paratunka, Tundroviy, and Shipunskiy that are located alongside the coastline of the Avacha Bay of Kamchatka and where the catastrophic earthquake is to be expected according the long-term forecast. It is noticed that the changes in behavior of the secular movements of the lithospheric electric conductivity sannual average values represented with changes at along and transverse directions of the seismic focal zone extension. A great many of such changes were detected on the Shipunskiy peninsula.

  9. InSAR data analysis at Kamchatka during 2016

    Directory of Open Access Journals (Sweden)

    Larionov Igor

    2017-01-01

    Full Text Available Geophysical monitoring in seismically active areas depends on geodeformation processes in the earth's crust. Observations of earth's crust strain-stress using gps-measurements, laser interferometers give only an opportunity to analyze the dynamics in time without the possibility of extrapolation to adjacent areas. In this regard, it is useful to apply a radar interferometry technology to measure the displacements of the earth's surface. The report includes the results of processing the radar data of the Sentinel-1A satellite. Several qualitative interferometric pairs were obtained during the period from June to October 2016. A high coherence coefficient is observed in open areas in the vicinity of volcanic structures and adjacent territories, as well as on the west coast of Kamchatka, where there is no high vegetation. The main factor that significantly reduces the coherence of images is the forest cover. Possibility of estimating the surface displacement at regions with a high coherence coefficient is discussed.

  10. Influence of dirt, age and poor aim on glare and illumination intensities of car headlamps in practice

    NARCIS (Netherlands)

    Alferdinck, J.W.A.M.; Padmos, P.

    1987-01-01

    Luminous intensities of dipped car headlamps in directions of the eyes of drivers of oncoming cars (glare intensity) and the right roadside (illumination intensity) were measured (404 cars). The often too high glare intensities are mainly due to dirt and lamp age; the often too low illumination

  11. MAP17 and SGLT1 protein expression levels as prognostic markers for cervical tumor patient survival.

    Directory of Open Access Journals (Sweden)

    Marco Perez

    Full Text Available MAP17 is a membrane-associated protein that is overexpressed in human tumors. Because the expression of MAP17 increases reactive oxygen species (ROS generation through SGLT1 in cancer cells, in the present work, we investigated whether MAP17 and/or SGLT1 might be markers for the activity of treatments involving oxidative stress, such as cisplatin or radiotherapy. First, we confirmed transcriptional alterations in genes involved in the oxidative stress induced by MAP17 expression in HeLa cervical tumor cells and found that Hela cells expressing MAP17 were more sensitive to therapies that induce ROS than were parental cells. Furthermore, MAP17 increased glucose uptake through SGLT receptors. We then analyzed MAP17 and SGLT1 expression levels in cervical tumors treated with cisplatin plus radiotherapy and correlated the expression levels with patient survival. MAP17 and SGLT1 were expressed in approximately 70% and 50% of cervical tumors of different types, respectively, but they were not expressed in adenoma tumors. Furthermore, there was a significant correlation between MAP17 and SGLT1 expression levels. High levels of either MAP17 or SGLT1 correlated with improved patient survival after treatment. However, the patients with high levels of both MAP17 and SGLT1 survived through the end of this study. Therefore, the combination of high MAP17 and SGLT1 levels is a marker for good prognosis in patients with cervical tumors after cisplatin plus radiotherapy treatment. These results also suggest that the use of MAP17 and SGLT1 markers may identify patients who are likely to exhibit a better response to treatments that boost oxidative stress in other cancer types.

  12. Targeting renal glucose reabsorption to treat hyperglycaemia: the pleiotropic effects of SGLT2 inhibition.

    Science.gov (United States)

    Vallon, Volker; Thomson, Scott C

    2017-02-01

    Healthy kidneys filter ∼160 g/day of glucose (∼30% of daily energy intake) under euglycaemic conditions. To prevent valuable energy from being lost in the urine, the proximal tubule avidly reabsorbs filtered glucose up to a limit of ∼450 g/day. When blood glucose levels increase to the point that the filtered load exceeds this limit, the surplus is excreted in the urine. Thus, the kidney provides a safety valve that can prevent extreme hyperglycaemia as long as glomerular filtration is maintained. Most of the capacity for renal glucose reabsorption is provided by sodium glucose cotransporter (SGLT) 2 in the early proximal tubule. In the absence or with inhibition of SGLT2, the renal reabsorptive capacity for glucose declines to ∼80 g/day (the residual capacity of SGLT1), i.e. the safety valve opens at a lower threshold, which makes it relevant to glucose homeostasis from day-to-day. Several SGLT2 inhibitors are now approved glucose lowering agents for individuals with type 2 diabetes and preserved kidney function. By inducing glucosuria, these drugs improve glycaemic control in all stages of type 2 diabetes, while their risk of causing hypoglycaemia is low because they naturally stop working when the filtered glucose load falls below ∼80 g/day and they do not otherwise interfere with metabolic counterregulation. Through glucosuria, SGLT2 inhibitors reduce body weight and body fat, and shift substrate utilisation from carbohydrates to lipids and, possibly, ketone bodies. Because SGLT2 reabsorbs sodium along with glucose, SGLT2 blockers are natriuretic and antihypertensive. Also, because they work in the proximal tubule, SGLT2 inhibitors increase delivery of fluid and electrolytes to the macula densa, thereby activating tubuloglomerular feedback and increasing tubular back pressure. This mitigates glomerular hyperfiltration, reduces the kidney's demand for oxygen and lessens albuminuria. For reasons that are less well understood, SGLT2 inhibitors are

  13. Session IV. Problem Solving. Vehicle lighting system. Four steps in glare reduction.

    NARCIS (Netherlands)

    Schreuder, D.A.

    1972-01-01

    A number of proposals are described that may help to reduce glare. The systems are either only a partial improvement, or they are expensive, or their introduction raises severe problems. One solution, already widely in use, is applica- tion of overhead lighting. In order to really improve the

  14. Detection and Evaluation of Pre-Preg Gaps and Overlaps in Glare Laminates

    Science.gov (United States)

    Nardi, Davide; Abouhamzeh, Morteza; Leonard, Rob; Sinke, Jos

    2018-03-01

    Gaps and overlaps between pre-preg plies represent common flaws in composite materials that can be introduced easily in an automated fibre placement manufacturing process and are potentially detrimental for the mechanical performances of the final laminates. Whereas gaps and overlaps have been addressed for full composite material, the topic has not been extended to a hybrid composite material such as Glare, a member of the family of Fibre Metal Laminates (FMLs). In this paper/research, the manufacturing, the detection, and the optical evaluation of intraply gaps and overlaps in Glare laminates are investigated. As part of an initial assessment study on the effect of gaps and overlaps on Glare, only the most critical lay-up has been considered. The experimental investigation started with the manufacturing of specimens having gaps and overlaps with different widths, followed by a non-destructive ultrasonic-inspection. An optical evaluation of the gaps and overlaps was performed by means of microscope image analysis of the cross sections of the specimens. The results from the non-destructive evaluations show the effectiveness of the ultrasonic detection of gaps and overlaps both in position, shape, width, and severity. The optical inspections confirm the accuracy of the non-destructive evaluation also adding useful insights about the geometrical features due to the presence of gaps and overlaps in the final Glare laminates. All the results justify the need for a further investigation on the effect of gaps and overlaps on the mechanical properties.

  15. Out-of-autoclave manufacturing of GLARE panels using resistance heating

    NARCIS (Netherlands)

    Muller, B.; Palardy, G.; Teixeira De Freitas, S.; Sinke, J.

    2017-01-01

    Autoclave manufacturing of fibre metal laminates, such as GLARE, is an expensive process.Therefore, there is an increasing interest to find cost effective out-of-autoclave manufacturing processes without diminishing the laminate quality. The aim of this study is to

  16. The Glare Effect Test and the Impact of Age on Luminosity Thresholds

    Directory of Open Access Journals (Sweden)

    Alessio Facchin

    2017-06-01

    Full Text Available The glare effect (GE is an illusion in which a white region appears self-luminous when surrounded by linearly decreasing luminance ramps. It has been shown that the magnitude of the luminosity effect can be modulated by manipulating the luminance range of the gradients. In the present study we tested the thresholds for the GE on two groups of adults: young (20–30 years old and elderly (60–75 years old. Purpose of our perspective study was to test the possibility of transforming the GE into a test that could easily measure thresholds for luminosity and discomfort glare. The Glare Effect Test (GET consisted in 101 printed cards that differed from each other for the range of luminance ramps. Participants were assessed with GET and a battery of visual tests: visual acuity, contrast sensitivity, illusion of length perception, and Ishihara test. Specifically in the GET, participants were required to classify cards on the basis of two reference cards (solid black-no gradient; full range black to white gradient. PSEs of the GE show no correlation with the other visual tests, revealing a divergent validity. A significant difference between young and elderly was found: contrary to our original expectations, luminosity thresholds of GE for elderly were higher than those for young, suggesting a non-direct relationship between luminosity perception and discomfort glare.

  17. The renal effects of SGLT2 inhibitors and a mini-review of the literature.

    Science.gov (United States)

    Andrianesis, Vasileios; Glykofridi, Spyridoula; Doupis, John

    2016-12-01

    Sodium-glucose linked transporter 2 (SGLT2) inhibitors are a new and promising class of antidiabetic agents which target renal tubular glucose reabsorption. Their action is based on the blockage of SGLT2 sodium-glucose cotransporters that are located at the luminal membrane of tubular cells of the proximal convoluted tubule, inducing glucosuria. It has been proven that they significantly reduce glycated hemoglobin (HbA1c), along with fasting and postprandial plasma glucose in patients with type 2 diabetes mellitus (T2DM). The glucosuria-induced caloric loss as well as the osmotic diuresis significantly decrease body weight and blood pressure, respectively. Given that SGLT2 inhibitors do not interfere with insulin action and secretion, their efficacy is sustained despite the progressive β-cell failure in T2DM. They are well tolerated, with a low risk of hypoglycemia. Their most frequent adverse events are minor: genital and urinal tract infections. Recently, it was demonstrated that empagliflozin presents a significant cardioprotective effect. Although the SGLT2 inhibitors' efficacy is affected by renal function, new data have been presented that some SGLT2 inhibitors, even in mild and moderate renal impairment, induce significant HbA1c reduction. Moreover, recent data indicate that SGLT2 inhibition has a beneficial renoprotective effect. The role of this review paper is to explore the current evidence on the renal effects of SGLT2 inhibitors.

  18. SGLT2-I in the Hospital Setting: Diabetic Ketoacidosis and Other Benefits and Concerns.

    Science.gov (United States)

    Levine, Joshua A; Karam, Susan L; Aleppo, Grazia

    2017-07-01

    Sodium-glucose cotransporter 2 (SGLT2) inhibitors are the newest class of antihyperglycemic agents. They are increasingly being prescribed in the outpatient diabetic population. In this review, we examine the risks and benefits of continuation and initiation of SGLT2 inhibitors in the inpatient setting. There are currently no published data regarding safety and efficacy of SGLT2 inhibitor use in the hospital. Outpatient data suggests that SGLT2 inhibitors have low hypoglycemic risk. They also decrease systolic blood pressure and can prevent cardiovascular death. The EMPA-REG study also showed a decrease in admissions for acute decompensated heart failure. There have been increasing cases of diabetic ketoacidosis, and specifically the euglycemic manifestation, associated with SGLT2 inhibitors use. We present two cases of inpatient SGLT2 inhibitor use, one of continuation of outpatient therapy and one of new initiation of therapy. We then discuss potential risks and methods to mitigate these as well as benefits of these medications in the inpatient setting. We cautiously suggest the use of SGLT2 inhibitors in the hospital. However, these must be used judiciously and the practitioner must be aware of euglycemic diabetic ketoacidosis and its risk factors in this population.

  19. Update on developments with SGLT2 inhibitors in the management of type 2 diabetes.

    Science.gov (United States)

    Nauck, Michael A

    2014-01-01

    The importance of the kidney's role in glucose homeostasis has gained wider understanding in recent years. Consequently, the development of a new pharmacological class of anti-diabetes agents targeting the kidney has provided new treatment options for the management of type 2 diabetes mellitus (T2DM). Sodium glucose co-transporter type 2 (SGLT2) inhibitors, such as dapagliflozin, canagliflozin, and empagliflozin, decrease renal glucose reabsorption, which results in enhanced urinary glucose excretion and subsequent reductions in plasma glucose and glycosylated hemoglobin concentrations. Modest reductions in body weight and blood pressure have also been observed following treatment with SGLT2 inhibitors. SGLT2 inhibitors appear to be generally well tolerated, and have been used safely when given as monotherapy or in combination with other oral anti-diabetes agents and insulin. The risk of hypoglycemia is low with SGLT2 inhibitors. Typical adverse events appear to be related to the presence of glucose in the urine, namely genital mycotic infection and lower urinary tract infection, and are more often observed in women than in men. Data from long-term safety studies with SGLT2 inhibitors and from head-to-head SGLT2 inhibitor comparator studies are needed to fully determine their benefit-risk profile, and to identify any differences between individual agents. However, given current safety and efficacy data, SGLT2 inhibitors may present an attractive option for T2DM patients who are failing with metformin monotherapy, especially if weight is part of the underlying treatment consideration.

  20. Natural Products as Lead Compounds for Sodium Glucose Cotransporter (SGLT) Inhibitors.

    Science.gov (United States)

    Blaschek, Wolfgang

    2017-08-01

    Glucose homeostasis is maintained by antagonistic hormones such as insulin and glucagon as well as by regulation of glucose absorption, gluconeogenesis, biosynthesis and mobilization of glycogen, glucose consumption in all tissues and glomerular filtration, and reabsorption of glucose in the kidneys. Glucose enters or leaves cells mainly with the help of two membrane integrated transporters belonging either to the family of facilitative glucose transporters (GLUTs) or to the family of sodium glucose cotransporters (SGLTs). The intestinal glucose absorption by endothelial cells is managed by SGLT1, the transfer from them to the blood by GLUT2. In the kidney SGLT2 and SGLT1 are responsible for reabsorption of filtered glucose from the primary urine, and GLUT2 and GLUT1 enable the transport of glucose from epithelial cells back into the blood stream.The flavonoid phlorizin was isolated from the bark of apple trees and shown to cause glucosuria. Phlorizin is an inhibitor of SGLT1 and SGLT2. With phlorizin as lead compound, specific inhibitors of SGLT2 were developed in the last decade and some of them have been approved for treatment mainly of type 2 diabetes. Inhibition of SGLT2 eliminates excess glucose via the urine. In recent times, the dual SGLT1/SGLT2 inhibitory activity of phlorizin has served as a model for the development and testing of new drugs exhibiting both activities.Besides phlorizin, also some other flavonoids and especially flavonoid enriched plant extracts have been investigated for their potency to reduce postprandial blood glucose levels which can be helpful in the prevention and supplementary treatment especially of type 2 diabetes. Georg Thieme Verlag KG Stuttgart · New York.

  1. What Are The Benefits In The Association Of SGLT2 Inhibitors And Other Drugs?

    Directory of Open Access Journals (Sweden)

    Deici Aparecida Gomes Rodrigues

    2017-11-01

    Full Text Available The SGLT2 inhibitors are a class of drugs that blocks the sodium-glucose co-transport, which is responsible for 90% of the nephron glucose. Objective: To show the benefits of the SGLT2 inhibitors in monotherapy and in association with other drugs. Results: The association of SGLT2 inhibitors and other drugs has shown several additional benefits after their interaction, including weight loss, reduction of body fat, reduction of triglycerides level, decrease of glycated hemoglobin, decrease in postprandial glucose level, reduction of arterial pressure, decrease of hypoglycemia risk and improvement of glucose metabolism. Therefore, this is a promising interaction for type 2 diabetes.

  2. Sodium-glucose cotransporter 2 (SGLT-2) inhibitors for patients with Type 2 diabetes

    DEFF Research Database (Denmark)

    Røder, Michael Einar; Storgaard, Heidi; Rungby, Jørgen

    2016-01-01

    The sodium-glucose cotransporter 2 inhibitor (SGLT-2i)-class is efficacious as monotherapy and as add-on therapy with an expected lowering of the glycated haemoglobin (HbA1c) concentration of approximately 7 mmol/mol. Side effects relate to the mode of action, genital infections are the main...... problem. Extremely rare cases of ketoacidosis are reported, mostly in patients with Type 1 diabetes. One SGLT-2i, empagliflozin, has been shown to reduce cardiovascular mortality and progression of kidney disease in patients with Type 2 diabetes and cardiovascular disease. Outcome trials for other SGLT-2i...... are pending. SGLT-2i are now in guidelines as a possible second-line therapy or in case of metformin intolerance....

  3. Sodium-glucose cotransporter (SGLT)-2-inhibitorer til patienter med type 2-diabetes

    DEFF Research Database (Denmark)

    Røder, Michael Einar; Storgaard, Heidi; Rungby, Jørgen

    2016-01-01

    The sodium-glucose cotransporter 2 inhibitor (SGLT-2i)-class is efficacious as monotherapy and as add-on therapy with an expected lowering of the glycated haemoglobin (HbA1c) concentration of approximately 7 mmol/mol. Side effects relate to the mode of action, genital infections are the main...... problem. Extremely rare cases of ketoacidosis are reported, mostly in patients with Type 1 diabetes. One SGLT-2i, empagliflozin, has been shown to reduce cardiovascular mortality and progression of kidney disease in patients with Type 2 diabetes and cardiovascular disease. Outcome trials for other SGLT-2i...... are pending. SGLT-2i are now in guidelines as a possible second-line therapy or in case of metformin intolerance....

  4. Role of SGLT2 Inhibitors in Patients with Diabetes Mellitus and Heart Failure.

    Science.gov (United States)

    Verbrugge, Frederik H

    2017-08-01

    This review aims to summarize the evidence on cardiovascular risks and benefits of glucose-lowering drugs in diabetic patients, with a particular focus on the role of sodium-glucose transporter-2 (SGLT-2) inhibitors and their promising potential as a heart failure treatment. The SGLT-2 inhibitor empagliflozin has emerged as the first glucose-lowering drug to lower cardiovascular mortality in diabetes with an unprecedented 38% relative risk reduction. In addition, empagliflozin significantly reduced the rate of heart failure admissions with 35% when compared to placebo in diabetic patients with established atherosclerosis. SGLT-2 inhibitors should be considered as a first-line drug to achieve glycemic control in diabetic patients at high risk for cardiovascular diseases and heart failure in particular. As SGLT-2 inhibitors target different pathophysiological pathways in heart failure, they might even be considered in the broader population without diabetes, but this remains the topic of further study.

  5. Predicted consequences of diabetes and SGLT inhibition on transport and oxygen consumption along a rat nephron

    Science.gov (United States)

    Vallon, Volker; Edwards, Aurélie

    2016-01-01

    Diabetes increases the reabsorption of Na+ (TNa) and glucose via the sodium-glucose cotransporter SGLT2 in the early proximal tubule (S1-S2 segments) of the renal cortex. SGLT2 inhibitors enhance glucose excretion and lower hyperglycemia in diabetes. We aimed to investigate how diabetes and SGLT2 inhibition affect TNa and sodium transport-dependent oxygen consumption QO2active along the whole nephron. To do so, we developed a mathematical model of water and solute transport from the Bowman space to the papillary tip of a superficial nephron of the rat kidney. Model simulations indicate that, in the nondiabetic kidney, acute and chronic SGLT2 inhibition enhances active TNa in all nephron segments, thereby raising QO2active by 5–12% in the cortex and medulla. Diabetes increases overall TNa and QO2active by ∼50 and 100%, mainly because it enhances glomerular filtration rate (GFR) and transport load. In diabetes, acute and chronic SGLT2 inhibition lowers QO2active in the cortex by ∼30%, due to GFR reduction that lowers proximal tubule active TNa, but raises QO2active in the medulla by ∼7%. In the medulla specifically, chronic SGLT2 inhibition is predicted to increase QO2active by 26% in late proximal tubules (S3 segments), by 2% in medullary thick ascending limbs (mTAL), and by 9 and 21% in outer and inner medullary collecting ducts (OMCD and IMCD), respectively. Additional blockade of SGLT1 in S3 segments enhances glucose excretion, reduces QO2active by 33% in S3 segments, and raises QO2active by SGLT2 blockade in diabetes lowers cortical QO2active and raises medullary QO2active, particularly in S3 segments. PMID:26764207

  6. Variations of atmospheric electric field and meteorological parameters in Kamchatka in 1997-2016

    Directory of Open Access Journals (Sweden)

    Smirnov Sergey

    2017-01-01

    Full Text Available Analysis of seasonal and annual variations of aero-electric field at a midlatitudinal observatory Paratunka in Kamchatka was carried out for 1997-2016. Stable seasonal intervals of the highest and the lowest values are observed. Changeability of the annual trend of aero-electric field in the near ground air layer at the observatory located in an active geodynamic region is shown. A large positive trend was changed by a smooth negative one. It is likely to be associated either with radon emanation intensity change in the observatory region or with volcanic activity change in Kamchatka.

  7. Sodium glucose co-transporter 2 (SGLT2) inhibitors: novel antidiabetic agents.

    Science.gov (United States)

    Washburn, William N

    2012-05-01

    Maintenance of glucose homeostasis in healthy individuals involves SGLT2 (sodium glucose co-transporter 2)-mediated recovery of glucose from the glomerular filtrate which otherwise would be excreted in urine. Clinical studies indicate that SGLT2 inhibitors provide an insulin-independent means to reduce the hyperglycemia that is the hallmark of type 2 diabetes mellitus (T2DM) with minimal risk of hypoglycemia. The pharmacophore common to the SGLT2 inhibitors currently in development is a diarylmethane C-glucoside which is discussed in this review. The focus is how this pharmacophore was further modified as inferred from the patents publishing from 2009 to 2011. The emphasis is on the strategy that each group employed to circumvent the constraints imposed by prior art and how the resulting SGLT2 potency and selectivity versus SGLT1 compared with that of the lead clinical compound dapagliflozin. SGLT2 inhibitors offer a new fundamentally different approach for treatment of diabetes. To date, the clinical results suggest that for non-renally impaired patients this class of inhibitors could be safely used at any stage of T2DM either alone or in combination with other marketed antidiabetic medications.

  8. SGLT2 inhibitors: a promising new therapeutic option for treatment of type 2 diabetes mellitus.

    Science.gov (United States)

    Misra, Monika

    2013-03-01

    Hyperglycemia is an important pathogenic component in the development of microvascular and macrovascular complications in type 2 diabetes mellitus. Inhibition of renal tubular glucose reabsorption that leads to glycosuria has been proposed as a new mechanism to attain normoglycemia and thus prevent and diminish these complications. Sodium glucose cotransporter 2 (SGLT2) has a key role in reabsorption of glucose in kidney. Competitive inhibitors of SGLT2 have been discovered and a few of them have also been advanced in clinical trials for the treatment of diabetes. To discuss the therapeutic potential of SGLT2 inhibitors currently in clinical development. A number of preclinical and clinical studies of SGLT2 inhibitors have demonstrated a good safety profile and beneficial effects in lowering plasma glucose levels, diminishing glucotoxicity, improving glycemic control and reducing weight in diabetes. Of all the SGLT2 inhibitors, dapagliflozin is a relatively advanced compound with regards to clinical development. SGLT2 inhibitors are emerging as a promising therapeutic option for the treatment of diabetes. Their unique mechanism of action offers them the potential to be used in combination with other oral anti-diabetic drugs as well as with insulin. © 2012 The Author. JPP © 2012 Royal Pharmaceutical Society.

  9. The potential of SGLT2 inhibitors in phase II clinical development for treating type 2 diabetes.

    Science.gov (United States)

    Pafili, K; Maltezos, E; Papanas, N

    2016-10-01

    There is now an abundance of anti-diabetic agents. However, only few patients achieve glycemic targets. Moreover, current glucose-lowering agents mainly depend upon insulin secretion or function. Sodium glucose co-transporter type 2 (SGLT2) inhibitors present a novel glucose-lowering therapy, inducing glycosuria in an insulin-independent fashion. In this review, the authors discuss the key efficacy and safety data from phase II clinical trials in type 2 diabetes mellitus (T2DM) of the main SGLT2 inhibitors approved or currently in development, and provide a rationale for their use in T2DM. Despite the very promising characteristics of this new therapeutic class, a number of issues await consideration. One important question is what to expect from head-to-head comparison data. We also need to know if dual inhibition of SGLT1/SGLT2 is more efficacious in reducing HbA1c and how this therapy affects metabolic and cardiovascular parameters. Additionally, several SGLT2 agents that have not yet come to market have hitherto been evaluated in Asian populations, whereas approved SGLT2 inhibitors have been frequently studied in other populations, including Caucasian subjects. Thus, we need more information on the potential role of ethnicity on their efficacy and safety.

  10. SGLT2 inhibitors in the pipeline for the treatment of diabetes mellitus in Japan.

    Science.gov (United States)

    Ito, Hiroyuki; Shinozaki, Masahiro; Nishio, Shinya; Abe, Mariko

    2016-10-01

    Sodium glucose cotransporter 2 (SGLT2) inhibitors have been available for the treatment of type 2 diabetes (T2DM) in Japan since April 2014. The prescription rate in Japan is low in comparison to Western countries. We summarize the results obtained from the phase 3 clinical trials and clinical studies involving Japanese T2DM patients. We also discuss the current situation and the future prospects of SGLT2 inhibitors in Japan. Unexpected adverse events, such as cerebral infarction and diabetic ketoacidosis have been reported from clinics shortly after the initiation of SGLT2 inhibitor treatment. However, the reductions in blood glucose levels and body weight have been demonstrated in phase 3 trials using 6 types of SGLT2 inhibitors, while observational studies of Japanese T2DM patients, which were performed in the clinical setting, showed that the incidence of adverse drug reactions, such as severe hypoglycemia, was low. SGLT2 inhibitors are also considered to be effective for treating Japanese patients with T2DM. When prescribing SGLT2 inhibitors, it is necessary to ensure that they are used appropriately because the Japanese T2DM patient population has a high proportion of elderly individuals and a high incidence of cerebrovascular disease.

  11. Ketosis and diabetic ketoacidosis in response to SGLT2 inhibitors: Basic mechanisms and therapeutic perspectives.

    Science.gov (United States)

    Qiu, Hongyu; Novikov, Aleksandra; Vallon, Volker

    2017-07-01

    Inhibitors of the sodium-glucose cotransporter SGLT2 are a new class of antihyperglycemic drugs that have been approved for the treatment of type 2 diabetes mellitus (T2DM). These drugs inhibit glucose reabsorption in the proximal tubules of the kidney thereby enhancing glucosuria and lowering blood glucose levels. Additional consequences and benefits include a reduction in body weight, uric acid levels, and blood pressure. Moreover, SGLT2 inhibition can have protective effects on the kidney and cardiovascular system in patients with T2DM and high cardiovascular risk. However, a potential side effect that has been reported with SGLT2 inhibitors in patients with T2DM and particularly during off-label use in patients with type 1 diabetes is diabetic ketoacidosis. The US Food and Drug Administration recently warned that SGLT2 inhibitors may result in euglycemic ketoacidosis. Here, we review the basic metabolism of ketone bodies, the triggers of diabetic ketoacidosis, and potential mechanisms by which SGLT2 inhibitors may facilitate the development of ketosis or ketoacidosis. This provides the rationale for measures to lower the risk. We discuss the role of the kidney and potential links to renal gluconeogenesis and uric acid handling. Moreover, we outline potential beneficial effects of modestly elevated ketone body levels on organ function that may have therapeutic relevance for the observed beneficial effects of SGLT2 inhibitors on the kidney and cardiovascular system. Copyright © 2017 John Wiley & Sons, Ltd.

  12. Comparison of glare in YAG-damaged intraocular lenses: injection-molded versus lathe-cut.

    Science.gov (United States)

    Bath, P E; Dang, Y; Martin, W H

    1986-11-01

    A comparative analysis of YAG laser intraocular lens (IOL) damage was undertaken on injection-molded and lathe-cut IOLs. Damage sites were evaluated with polarized light. A consistent positive polarization was observed in the damage sites of lathe-cut IOLs. A consistent negative polarization was observed in the damage sites of injection-molded IOLs. The presence of positive polarization in IOL damage sites may be correlated with increased potential for glare. Results and clinical implications are discussed.

  13. CALCULATION OF A GLARE STOP FOR TWO-MIRROR EXTRA-FOCAL OBJECTIVE

    Directory of Open Access Journals (Sweden)

    L. F. Zambrano

    2017-01-01

    Full Text Available Recently, efforts to improve optical characteristics in canonical mirror systems, including aspherical surfaces and corrective aberration capabilities. At the same time, much attention is paid to the development of new optical schemes of two-mirror objectives. Development measures to protect the image plane from stray light and harmful flows with minimal vignetting and screening is one of the most perspective ways for improving the image quality objectives. The only method to eliminate or even reduce these non-constructive rays is to set glare stops. The aim of the work was an improving method for constructing a glare stop to protect the image plane and the creation of a calculation algorithm of glare stop for protecting the image plane based on two-mirror extra-focal objectives.The study was conducted in two stages. In the course of the first stage, the positions of screening and intermediate image plane were obtained, as well as the central screening coefficient. At the second stage, an arrangement for the position of glare stop is proposed using the algorithm calculation. Thus, mathematical expressions were achieved by geometric constructions. The relation of the screening coefficient with the distance between the surfaces of the mirrors and the height of the paraxial rays is established. А representation of vignetting diagram for two-mirror extra-focal objective with D/f´ = 1 : 1,3 and 2ω = 4° was realized. The Q estimation of vignetting of inclined light beams is k= 0,56.

  14. Review of Efforts to Develop a Low-Luminance-Level Disability Glare Tester

    Science.gov (United States)

    2009-09-01

    persists when the image of the glare source falls on the optic nerve head ,” an area without receptors and lateral neural connections. Fry and Alpern...non-neural, scatter-only hypothesis. Around 1965, the CIE asked Vos to head a committee to update the Holladay-Stiles formula. He had recently...Tripathi, and Tripathi, 1997). It grows by increased layering throughout life. The crystalline lens is suspended, like a trampoline , by the zonule

  15. The design and synthesis of novel SGLT2 inhibitors: C-glycosides with benzyltriazolopyridinone and phenylhydantoin as the aglycone moieties.

    Science.gov (United States)

    Guo, Cheng; Hu, Min; DeOrazio, Russell J; Usyatinsky, Alexander; Fitzpatrick, Kevin; Zhang, Zhenjun; Maeng, Jun-Ho; Kitchen, Douglas B; Tom, Susan; Luche, Michele; Khmelnitsky, Yuri; Mhyre, Andrew J; Guzzo, Peter R; Liu, Shuang

    2014-07-01

    The sodium glucose co-transporter 2 (SGLT2) has received considerable attention in recent years as a target for the treatment of type 2 diabetes mellitus. This report describes the design, synthesis and structure-activity relationship (SAR) of C-glycosides with benzyltriazolopyridinone and phenylhydantoin as the aglycone moieties as novel SGLT2 inhibitors. Compounds 5p and 33b demonstrated high potency in inhibiting SGLT2 and high selectivity against SGLT1. The in vitro ADMET properties of these compounds will also be discussed. Copyright © 2014 Elsevier Ltd. All rights reserved.

  16. Lower Risk of Death With SGLT2 Inhibitors in Observational Studies: Real or Bias?

    Science.gov (United States)

    Suissa, Samy

    2018-01-01

    Two recent observational studies reported a remarkably lower rate of all-cause death associated with sodium-glucose cotransporter 2 inhibitor (-SGLT2i) use in all patients with type 2 diabetes and not only those at increased cardiovascular risk. The >50% lower mortality rates reported in these studies are much greater than those found in the BI 10773 (Empagliflozin) Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients (EMPA-REG OUTCOME) and CANagliflozin cardioVascular Assessment Study (CANVAS) randomized trials. We show that these observational studies are affected by time-related biases, including immortal time bias and time-lag bias, which tend to exaggerate the benefits observed with a drug. The Comparative Effectiveness of Cardiovascular Outcomes in New Users of SGLT-2 Inhibitors (CVD-REAL) study, based on 166,033 users of SGLT2i and 1,226,221 users of other glucose-lowering drugs (oGLD) identified from health care databases of six countries, was affected by immortal time bias. Indeed, the immortal time between the first oGLD prescription and the first SGLT2i prescription was omitted from the analysis, which resulted in increasing the rate of death in the oGLD group and thus producing the appearance of a lower risk of death with SGLT2i use. The Swedish study compared 10,879 SGLT2i/dipeptidyl peptidase 4 inhibitor (DPP-4i) users with 10,879 matched insulin users. Such comparisons involving second-line therapies with a third-line therapy can introduce time-lag bias, as the patients may not be at the same stage of diabetes. This bias is compounded by the fact that the users of insulin had already started their insulin before cohort entry, unlike the new users of SGLT2i. Finally, the study also introduces immortal time bias with respect to the effects of SGLT2i relative to DPP-4i. In conclusion, the >50% lower rate of death with SGLT2i in type 2 diabetes reported by two recent observational studies is likely exaggerated by immortal time and time

  17. Plant diversity changes and succession along resource availability and disturbance gradients in Kamchatka

    Czech Academy of Sciences Publication Activity Database

    Doležal, Jiří; Yakubov, V.; Hara, T.

    2013-01-01

    Roč. 214, č. 3 (2013), s. 477-488 ISSN 1385-0237 R&D Projects: GA ČR GA13-13368S Institutional support: RVO:67985939 Keywords : Species-area curves * Intermediate disturbance hypothesis * Kamchatka Subject RIV: EH - Ecology, Behaviour Impact factor: 1.640, year: 2013

  18. Isotopic composition of carbon of natural gases in the sedimentary basins of Kamchatka and Chukotka

    Energy Technology Data Exchange (ETDEWEB)

    Lobkov, V.A.; Kudriavtseva, E.I.

    1981-01-01

    A study was carried out on the chemical and isotopic compositions of carbon of natural gases, which are prospective for oil and gas structures. An isotopic composition of the carbon of gases, covered by wells in possible oil and gas bearing basins (Eastern Kamchatka Central Kamchatka, Western Kamchatka, Anadyrsk, and Khatyrsk), created by terrigenic rock of the cretaceous, paleogenic, and neogenic ages, with dimensions of three to six kilometers, is presented. Investigation is made of the isotopic carbon of methane, ethane, and propane in 36 gas specimens. The plan of the distribution of the tested structures is shown, and an analysis is given of the chemical and isotopic composition of carbon of the prospected areas of Kamchatka and Chukotka and the interconnection of the isotopic composition of the carbon of methane with ethane and propane. A supposition is made concerning the existence of a single equilibrious volumetric system of CH/sub 4/--C/sub 2/H/sub 6/--C/sub 3/H/sub 8/--CO/sub 2/, in which ethane and propane are by-products, and owing to this, equilibrium establish according to this more slowly. The study of the isotopic composition of carbon of methane shows, that at various areas of depth formation of hydrocarbon gases is different. A conclusion is made that the gases formed at high temperatures. This points to a significant distance in the vertical migration of gases in the given region.

  19. [Plant biomorphology and seed germination of pioneer species of the Kamchatka volcanoes].

    Science.gov (United States)

    Voronkova, N M; Kholina, A B; Verkholat, V P

    2008-01-01

    Biomorphology, quantitative characters and seed germination of 17 pioneer plant species friable materials of volcanic eruptions (Kamchatka Peninsula) were studied. Adaptive trends in survival stress conditions are discussed. To evaluate a possibility of the cryogenic seed storage, their response to ultra low temperatures (-196 degrees C) was determine.

  20. Pharmacokinetics, Pharmacodynamics and Clinical Use of SGLT2 Inhibitors in Patients with Type 2 Diabetes Mellitus and Chronic Kidney Disease.

    Science.gov (United States)

    Scheen, André J

    2015-07-01

    Inhibitors of sodium-glucose cotransporters type 2 (SGLT2) are proposed as a novel approach for the management of type 2 diabetes mellitus. SGLT2 cotransporters are responsible for reabsorption of 90 % of the glucose filtered by the kidney. The glucuretic effect resulting from SGLT2 inhibition contributes to reduce hyperglycaemia and also assists weight loss and blood pressure reduction. Several SGLT2 inhibitors are already available in many countries (dapagliflozin, canagliflozin, empagliflozin) and in Japan (ipragliflozin, tofogliflozin). These SGLT2 inhibitors share similar pharmacokinetic characteristics with a rapid oral absorption, a long elimination half-life allowing once-daily administration, an extensive hepatic metabolism mainly via glucuronidation to inactive metabolites and a low renal elimination as a parent drug. Pharmacokinetic parameters are slightly altered in the case of chronic kidney disease (CKD). While no dose adjustment is required in the case of mild CKD, SGLT2 inhibitors may not be used or only at a lower daily dose in patients with moderate CKD. Furthermore, the pharmacodynamic response to SGLT2 inhibitors as assessed by urinary glucose excretion declines with increasing severity of renal impairment as assessed by a reduction in the estimated glomerular filtration rate. Nevertheless, the glucose-lowering efficacy and safety of SGLT2 inhibitors are almost comparable in patients with mild CKD as in patients with normal kidney function. In patients with moderate CKD, the efficacy tends to be dampened and safety concerns may occur. In patients with severe CKD, the use of SGLT2 inhibitors is contraindicated. Thus, prescribing information should be consulted regarding dosage adjustments or restrictions in the case of renal dysfunction for each SGLT2 inhibitor. The clinical impact of SGLT2 inhibitors on renal function and their potential to influence the course of diabetic nephropathy deserve attention because of preliminary favourable results

  1. Incidence of diabetic ketoacidosis among patients with type 2 diabetes mellitus treated with SGLT2 inhibitors and other antihyperglycemic agents.

    Science.gov (United States)

    Wang, Yiting; Desai, Mehul; Ryan, Patrick B; DeFalco, Frank J; Schuemie, Martijn J; Stang, Paul E; Berlin, Jesse A; Yuan, Zhong

    2017-06-01

    To estimate and compare incidence of diabetes ketoacidosis (DKA) among patients with type 2 diabetes who are newly treated with SGLT2 inhibitors (SGLT2i) versus non-SGLT2i antihyperglycemic agents (AHAs) in actual clinical practice. A new-user cohort study design using a large insurance claims database in the US. DKA incidence was compared between new users of SGLT2i and new users of non-SGLT2i AHAs pair-matched on exposure propensity scores (EPS) using Cox regression models. Overall, crude incidence rates (95% CI) per 1000 patient-years for DKA were 1.69 (1.22-2.30) and 1.83 (1.58-2.10) among new users of SGLT2i (n=34,442) and non-SGLT2i AHAs (n=126,703). These rates more than doubled among patients with prior insulin prescriptions but decreased by more than half in analyses that excluded potential autoimmune diabetes (PAD). The hazard ratio (95% CI) for DKA comparing new users of SGLT2i to new users of non-SGLT2i AHAs was 1.91 (0.94-4.11) (p=0.09) among the 30,196 EPS-matched pairs overall, and 1.13 (0.43-3.00) (p=0.81) among the 27,515 EPS-matched pairs that excluded PAD. This was the first observational study that compared DKA risk between new users of SGLT2i and non-SGLT2i AHAs among patients with type 2 diabetes, and overall no statistically significant difference was detected. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  2. Acute Kidney Injury in Patients on SGLT2 Inhibitors: A Propensity-Matched Analysis.

    Science.gov (United States)

    Nadkarni, Girish N; Ferrandino, Rocco; Chang, Alexander; Surapaneni, Aditya; Chauhan, Kinsuk; Poojary, Priti; Saha, Aparna; Ferket, Bart; Grams, Morgan E; Coca, Steven G

    2017-11-01

    Sodium-glucose cotransporter-2 (SGLT2) inhibitors are new medications that improve cardiovascular and renal outcomes in patients with type 2 diabetes (T2D). However, the Food and Drug Administration has issued alerts regarding increased acute kidney injury (AKI) risk with canagliflozin and dapagliflozin. We aimed to assess the real-world risk of AKI in new SGLT2 inhibitor users in two large health care utilization cohorts of patients with T2D. We used longitudinal data from the Mount Sinai chronic kidney disease registry and the Geisinger Health System cohort. We selected SGLT inhibitor users and nonusers (patients with T2D without SGLT2 inhibitor prescription). We determined AKI by the KDIGO (Kidney Disease: Improving Global Outcomes) definition (AKI KDIGO ). We performed 1:1 nearest-neighbor propensity matching and calculated unadjusted hazard ratios (HRs) and adjusted HRs (aHRs; accounting for covariates poorly balanced) for AKI in primary and sensitivity analyses. We identified 377 SGLT2 inhibitor users and 377 nonusers in the Mount Sinai cohort, of whom 3.8 and 9.7%, respectively, had an AKI KDIGO event over a median follow-up time of 14 months. The unadjusted hazards of AKI KDIGO were 60% lower in users (HR 0.4 [95% CI 0.2-0.7]; P = 0.01), which was unchanged (aHR 0.4 [95% CI 0.2-0.7]; P = 0.004) postadjustment. Similarly, we identified 1,207 SGLT2 inhibitor users and 1,207 nonusers in the Geisinger cohort, of whom 2.2 and 4.6% had an AKI KDIGO event. AKI KDIGO unadjusted hazards were lower in users (HR 0.5 [95% CI 0.3-0.8]; P SGLT2 inhibitor use in patients with T2D in two large health systems. © 2017 by the American Diabetes Association.

  3. Update on SGLT2 Inhibitors-New Data Released at the American Diabetes Association.

    Science.gov (United States)

    Lee, Sara

    2017-09-01

    Sodium-glucose cotransporter 2 (SGLT2) inhibitors are one of the newer classes of antiglycemic agents approved for the management of patients with type 2 diabetes mellitus. Due to their unique mechanism of action, SGLT2 inhibitors have shown to be beneficial beyond glucose control. The improvement in cardiovascular (CV) outcomes was first observed in the landmark EMPA-REG OUTCOMES study. Following these results, numerous CV outcome trials were designed to identify whether the beneficial CV and renal effects observed with empagliflozin are unique or a drug class effect. The benefit of SGLT2 inhibition was confirmed by the CANagliflozin cardioVascular Assessment Study (CANVAS) Program, presented at the American Diabetes Association 77th Scientific Sessions. With over 10,000 patients, the CANVAS Program integrated data from two large CV outcome studies. Canagliflozin achieved a 14% reduction in the composite endpoint of CV mortality, nonfatal myocardial infarction (MI), or nonfatal stroke, and a 33% reduction in the risk of hospitalization for heart failure (HF) compared with placebo. Potential renal protective effects were also observed with canagliflozin; however, an increased risk of amputation with canagliflozin was seen in both CANVAS studies. The class effect of SGLT2 inhibitors was also confirmed in new analyses of the The Comparative Effectiveness of Cardiovascular Outcomes (CVD-REAL) study, which aimed to evaluate SGLT2 inhibitors (dapagliflozin, canagliflozin, and empagliflozin) in broader patient populations with type 2 diabetes mellitus. In patients who were new to SGLT2 inhibitors, significant reductions in rates of CV death and hospitalization for HF were observed compared with any other glucose-lowering agents. SGLT2 inhibitors were also associated with lower rates in hospitalization for HF in patients with and without CV disease. In addition, substudies of the EMPA-REG OUTCOME trial further provided insight on the efficacy of empagliflozin across

  4. Update on developments with SGLT2 inhibitors in the management of type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Nauck MA

    2014-09-01

    Full Text Available Michael A Nauck Department of Internal Medicine, Diabeteszentrum Bad Lauterberg, Bad Lauterberg im Harz, Germany Abstract: The importance of the kidney's role in glucose homeostasis has gained wider understanding in recent years. Consequently, the development of a new pharmacological class of anti-diabetes agents targeting the kidney has provided new treatment options for the management of type 2 diabetes mellitus (T2DM. Sodium glucose co-transporter type 2 (SGLT2 inhibitors, such as dapagliflozin, canagliflozin, and empagliflozin, decrease renal glucose reabsorption, which results in enhanced urinary glucose excretion and subsequent reductions in plasma glucose and glycosylated hemoglobin concentrations. Modest reductions in body weight and blood pressure have also been observed following treatment with SGLT2 inhibitors. SGLT2 inhibitors appear to be generally well tolerated, and have been used safely when given as monotherapy or in combination with other oral anti-diabetes agents and insulin. The risk of hypoglycemia is low with SGLT2 inhibitors. Typical adverse events appear to be related to the presence of glucose in the urine, namely genital mycotic infection and lower urinary tract infection, and are more often observed in women than in men. Data from long-term safety studies with SGLT2 inhibitors and from head-to-head SGLT2 inhibitor comparator studies are needed to fully determine their benefit–risk profile, and to identify any differences between individual agents. However, given current safety and efficacy data, SGLT2 inhibitors may present an attractive option for T2DM patients who are failing with metformin monotherapy, especially if weight is part of the underlying treatment consideration. Keywords: anti-diabetes agents, efficacy, hyperglycemia, safety, sodium glucose co-transporter type 2 inhibitors, type 2 diabetes mellitus

  5. POTENTIAL PLACE OF SGLT2 INHIBITORS IN TREATMENT PARADIGMS FOR TYPE 2 DIABETES MELLITUS.

    Science.gov (United States)

    Handelsman, Yehuda

    2015-09-01

    Following the first Food and Drug Administration (FDA) approval in 2013, sodium glucose cotransporter 2 (SGLT2) inhibitors have generated much interest among physicians treating patients with type 2 diabetes mellitus (T2DM). Here, the role in treatment with this drug class is considered in the context of T2DM treatment paradigms. The clinical trials for the SGLT2 inhibitors are examined with a focus on canagliflozin, dapagliflozin, and empagliflozin. Evidence from clinical trials in patients with T2DM supports the use of SGLT2 inhibitors either as monotherapy or in addition to other glucose-lowering treatments as adjuncts to diet and exercise, and we have gained significant clinical experience in a relatively short time. The drugs appear to be useful in a variety of T2DM populations, contingent primarily on renal function. Most obviously, SGLT2 inhibitors appear to be well suited for patients with potential for hypoglycemia or weight gain. In clinical trials, patients treated with SGLT2 inhibitors have experienced moderate weight loss and a low risk of hypoglycemic events except when used in combination with an insulin secretagogue. In addition, SGLT2 inhibitors have been shown to reduce blood pressure, so they may be beneficial in patients with T2DM complicated by hypertension. SGLT2 inhibitors were incorporated into the 2015 American Diabetes Association (ADA)/European Association for the Study of Diabetes (EASD) position statement on the management of hyperglycemia and received an even more prominent position in the American Association of Clinical Endocrinologists (AACE)/American College of Endocrinology (ACE) comprehensive diabetes management guidelines and algorithm.

  6. Complex Anisotropic Structure of the Mantle Wedge Beneath Kamchatka Volcanoes

    Science.gov (United States)

    Levin, V.; Park, J.; Gordeev, E.; Droznin, D.

    2002-12-01

    A wedge of mantle material above the subducting lithospheric plate at a convergent margin is among the most dynamic environments of the Earth's interior. Deformation and transport of solid and volatile phases within this region control the fundamental process of elemental exchange between the surficial layers and the interior of the planet. A helpful property in the study of material deformation and transport within the upper mantle is seismic anisotropy, which may reflect both microscopic effects of preferentialy aligned crystals of olivine and orthopyroxene and macroscopic effects of systematic cracks, melt lenses, layering etc. Through the mapping of anisotropic properties within the mantle wedge we can establish patterns of deformation. Volatile content affects olivine alignment, so regions of anomalous volatile content may be evident. Indicators of seismic anisotropy commonly employed in upper mantle studies include shear wave birefringence and mode-conversion between compressional and shear body waves. When combined together, these techniques offer complementary constraints on the location and intensity of anisotropic properties. The eastern coast of southern Kamchatka overlies a vigorous convergent margin where the Pacific plate descends at a rate of almost 80 mm/yr towards the northwest. We extracted seismic anisotropy indicators from two data sets sensitive to the anisotropic properties of the uppermost mantle. Firstly, we evaluated teleseismic receiver functions for a number of sites, and found ample evidence for anisotropicaly-influenced P-to-S mode conversion. Secondly, we measured splitting in S waves of earthquakes with sources within the downgoing slab. The first set of observations provides constraints on the depth ranges where strong changes in anisotropic properties take place. The local splitting data provides constraints on the cumulative strength of anisotropic properties along specific pathways through the mantle wedge and possibly parts of

  7. Substrate binding to SGLT1 investigated by single molecule force spectroscopy

    International Nuclear Information System (INIS)

    Neundlinger, I. J.

    2010-01-01

    D-glucose serves as one of the most important fuels in various organism due to its fundamental role in ATP-, protein and lipid synthesis. Thus, sustaining glucose homeostasis is a crucial issue of life as disorders can cause severe malfunctions such as glucose-galactose-malabsorbtion (GGM). Sodium-glucose co-transporter, SGLTs, especially the high affinity transporter SGLT1, play a crucial role in accumulation of glucose in the cell as they facilitate transport of the sugar into the cytoplasma across the cell membrane by a Na+-electrochemical potential. Even recently, members of the SGLT transporter family have become a therapeutic target for the treatment of hyperglycemia in type 2 diabetes. Hence, it is of particular importance to gain insights on the dynamic behavior of SGLTs during substrate binding and transport across the cell membrane on the single molecular level. In the present study, the Atomic Force Microscope (AFM) was employed to investigate the dynamic properties of the sodium-glucose co-transporter SGLT1 upon substrate binding under nearly physiological conditions. Hereto, new glucose derivatives were synthesized in order to probe the recognition efficiency of these molecules to SGLT1 embedded in the plasma membrane of living cells. A well established coupling protocol was used to covalently link (i) amino-modified D-glucose owning a conserved pyranose ring, (ii) 1-thio-β-D-glucose having a sulphur atom at C1 of the pyranose ring and (iii) the competitive inhibitor phlorizin to the AFM tip via poly(ethylene)glycol (PEG)-tether using different functional end groups and varying lengths. Binding characteristics, e.g. binding probability, interaction forces, influence of substances (glucose, phlorizin, sodium) and of molecule-linker compounds were obtained by performing single molecular recognition force spectroscopy (SMRFS) measurements. Moreover, temperature controlled radioactive binding/transport assays and SMRFS experiments yielded insights into

  8. SGLT-2 inhibitors and the risk of lower-limb amputation: Is this a class effect?

    Science.gov (United States)

    Khouri, Charles; Cracowski, Jean-Luc; Roustit, Matthieu

    2018-06-01

    Inhibitors of the sodium-glucose co-transporter-2 (SGLT-2) are a novel class of glucose-lowering agents that show promising results. However, the use of canagliflozin has been associated with an increased risk of lower-limb amputation. Whether this risk concerns other SGLT-2 inhibitors is unclear, and our objective was to address this issue. We performed a disproportionality analysis using the WHO global database of individual case safety reports (VigiBase). Among the 8 293 886 reports available between January 2013 and December 2017, we identified 79 reports of lower-limb amputation that were associated with SGLT-2 inhibitors. Among all blood glucose lowering drugs, the proportional reporting ratio (PRR) was increased only for SGLT-2 inhibitors (5.55 [4.23, 7.29]). While we observed an expected signal for canagliflozin (7.09 [5.25, 9.57]), the PRR was also high for empagliflozin (4.96 [2.89, 8.50]) and, for toe amputations only, for dapagliflozin (2.62 [1.33, 5.14]). In conclusion, our results reveal a positive disproportionality signal for canagliflozin, and also for empagliflozin, and, for toe amputations only, for dapagliflozin. However, our analysis relies on a limited number of cases and is exposed to the biases inherent to pharmacovigilance studies. Further prospective data are therefore needed to better characterize the risk of amputations with different SGLT-2 inhibitors. © 2018 John Wiley & Sons Ltd.

  9. A comparative safety review between GLP-1 receptor agonists and SGLT2 inhibitors for diabetes treatment.

    Science.gov (United States)

    Consoli, Agostino; Formoso, Gloria; Baldassarre, Maria Pompea Antonia; Febo, Fabrizio

    2018-03-01

    Glucagon-like peptide-1 receptor agonists (GLP-1RA) and sodium glucose cotransporter 2 inhibitors (SGLT2i) are of particular interest in type 2 diabetes treatment strategies, due to their efficacy in reducing HbA1c with a low risk of hypoglycaemia, to their positive effects on body weight and blood pressure and in light of their effects on cardiovascular risk and on nephroprotection emerged from the most recent cardiovascular outcome trials. Since it is therefore very likely that GLP-1RA and SGLT2i use will become more and more common, it is more and more important to gather and discuss information about their safety profile. Area Covered: adverse events and the safety concerns most often emerged in trials with GLP-1RA namely, exenatide long acting release (LAR), dulaglutide, liraglutide, semaglutide, lixisenatide or SGLT2i, namely empagliflozin, dapagliflozin, canagliflozin and SGLT2i with an attempt at comparing the safety profiles of molecules of these two classes. Expert opinion: GLP-1RA and SGLT2i, although each associated with different specific side effects, share a 'similar' safety profile and are both drugs relatively easy to handle. The potentially complementary mechanisms of action, the cardio and nephroprotective effects demonstrated by molecules of both classes, make these drugs potentially useful even in add on to each other.

  10. SGLT2 inhibitors with cardiovascular benefits: Transforming clinical care in Type 2 diabetes mellitus.

    Science.gov (United States)

    d'Emden, Michael; Amerena, John; Deed, Gary; Pollock, Carol; Cooper, Mark E

    2018-02-01

    Cardiovascular risk reduction in individuals with Type 2 diabetes mellitus (T2DM) is a key part of clinical management. Sodium-glucose co-transporter (SGLT2) inhibitors improve glycaemic control, reduce body weight and decrease blood pressure. In addition, the SGLT2 inhibitors empagliflozin and canagliflozin reduced the risk of composite cardiovascular events in high-risk individuals with T2DM in the EMPA-REG OUTCOME trial and the CANVAS Program, respectively. Empagliflozin also reduced cardiovascular deaths and improved renal outcomes. This class of agents should be considered in people with established cardiovascular disease, usually in combination with other glucose lowering medications, when satisfactory glycaemic control has not been achieved. The dose of insulin or sulfonylureas may need to be lowered when used with SGLT2 inhibitors, to reduce the risk of hypoglycaemia. Genitourinary infections can occur with SGLT2 inhibitors in a small proportion of people. In people with osteoporosis or prior amputation, it may be prudent to use empagliflozin rather than canagliflozin, based on the increased risk for bone fractures and amputations observed with canagliflozin in the CANVAS Program. SGLT2 inhibitors have the potential to transform the clinical care of persons with T2DM by not only improving glycaemic control but also reducing blood pressure, body weight and diabetes-related end-organ complications. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. A Review on the Relationship between SGLT2 Inhibitors and Cancer

    Directory of Open Access Journals (Sweden)

    Hao-Wen Lin

    2014-01-01

    Full Text Available Risk of increasing breast and bladder cancer remains a safety issue of SGLT2 (sodium glucose cotransporter type 2 inhibitors, a novel class of antidiabetic agent. We reviewed related papers published before January 29, 2014, through Pubmed search. Dapagliflozin and canagliflozin are the first two approved SGLT2 inhibitors for diabetes therapy. Although preclinical animal toxicology did not suggest a cancer risk of dapagliflozin and overall tumor did not increase, excess numbers of female breast cancer and male bladder cancer were noted in preclinical trials (without statistical significance. This concern of cancer risk hindered its approval by the US FDA in January, 2012. New clinical data suggested that the imbalance of bladder and breast cancer might be due to early diagnosis rather than a real increase of cancer incidence. No increased risk of overall bladder or breast cancer was noted for canagliflozin. Therefore, the imbalance observed with dapagliflozin treatment should not be considered as a class effect of SGLT2 inhibitors and the relationship with cancer for each specific SGLT2 inhibitor should be examined individually. Relationship between SGLT2 inhibition and cancer formation is still inconclusive and studies with larger sample size, longer exposure duration, and different ethnicities are warranted.

  12. SGLT-2 Inhibitors: Is There a Role in Type 1 Diabetes Mellitus Management?

    Science.gov (United States)

    Ahmed-Sarwar, Nabila; Nagel, Angela K; Leistman, Samantha; Heacock, Kevin

    2017-09-01

    The purpose of this review is to identify and evaluate disease management of patients with type 1 diabetes mellitus (T1DM) who were treated with a sodium-glucose cotransporter 2 (SGLT-2) inhibitor as an adjunct to insulin therapy. A PubMed (1969 to March 2017) and Ovid (1946 to March 2017) search was performed for articles published utilizing the following MESH terms: canagliflozin, empagliflozin, dapagliflozin, type 1 diabetes mellitus, insulin dependent diabetes, insulin, sodium-glucose transporter 2. There were no limitations placed on publication type. All English-language articles were evaluated for association of SGLT-2 inhibitors and type 1 diabetes. Further studies were identified by review of pertinent manuscript bibliographies. All 3 SGLT-2 inhibitors, when combined with insulin, resulted in an overall reduction of hemoglobin A1C (up to 0.49%), lower total daily insulin doses, and a reduction in weight (up to 2.7 kg). The combination therapy of insulin and SGLT-2 inhibitors also resulted in a lower incidence of hypoglycemia. Study duration varied from 2 to 18 weeks. A review of the identified literature indicated that there is a potential role for the combination of SGLT-2 inhibitors with insulin in T1DM for improving glycemic control without increasing the risk of hypoglycemia. The short duration and small sample sizes limit the ability to fully evaluate the incidences of diabetic ketoacidosis and urogenital infections. The risks associated with this combination of medications require further evaluation.

  13. EMPAGLIFLOZIN (SGLT2 INHIBITOR IN TYPE 2 DIABETES MELLITUS

    Directory of Open Access Journals (Sweden)

    Mohammed Umar Farooque

    2017-05-01

    Full Text Available BACKGROUND To study the analysis of metabolic parameters in patients with type 2 diabetes mellitus on empagliflozin, which is a SGLT2 inhibitor. MATERIALS AND METHODS This study was a prospective study of 120 patients with uncontrolled type 2 diabetes mellitus who were admitted as outpatients in JLNMCH Hospital, Bhagalpur. This study was conducted from February 2017 to April 2017. Informed consent was taken from each patient who participated in the study and the study protocol was approved by the institutions ethics and review board. Inclusion Criteria- Patients with type 2 diabetes mellitus and HbA1c >8% meeting any one of the criteria- Patients who were on dual therapy (metformin + sulfonylurea/DPP4 inhibitor; patients who were on triple therapy (metformin + sulfonylurea + DPP4 inhibitor; patients who were on insulin and triple oral therapy (metformin + sulfonylurea + DPP4 inhibitor. Exclusion Criteria- Patients who had history of genital mycotic infections, recurrent urinary tract infections, pyelonephritis, acute illness, type 1 diabetes, pregnant or lactating women, those patients who were with an eGFR below 45. RESULTS The mean age, duration of diabetes, weight and HbA1c in the study population was 54.36 ± 0.88 years, 14.2 ± 3.6 years, 76.25 ± 2.11 kgs and 9.66 ± 0.22%, respectively. The changes in weight and HbA1c were statistically significant across all groups. In 5% of the patients, genital pruritus was reported. Mycotic genital infection was seen in none of the patients on examination. All the four groups chose to discontinue the use of empagliflozin as a result of pruritus at follow up. The baseline daily insulin dose was 42 ± 25 units, and at 4 months, it was reduced to 34 ± 20 units. At follow up, the reduction in insulin level was 19.1% when compared to baseline. CONCLUSION This study showed that there was an improvement in glycaemic control and body weight with minimal side effects when SGLT2 inhibitor was added at any

  14. Design of the GLARE tool. A grease lubrication apparatus for research and education

    International Nuclear Information System (INIS)

    Rawlings, B.

    2012-01-01

    The GLARE: Grease Lubrication Apparatus for Research and Education was designed as a fourth year thesis project with the University of Ontario Institute of Technology (UOIT). The purpose of the apparatus is to train Ontario Power Generation Nuclear (OPGN) staff to properly lubricate bearings with grease and to help detect early equipment failures. Proper re-lubrication is critical to the nuclear industry as equipment may be inaccessible for long periods of time. A secondary purpose for the tool is for UOIT research and undergraduate laboratories.This abstract provides an overview of the project and its application to the nuclear industry. (author)

  15. A technique of scatter and glare correction for videodensitometric studies in digital subtraction videoangiography

    International Nuclear Information System (INIS)

    Shaw, C.G.; Ergun, D.L.; Myerowitz, P.D.; Van Lysel, M.S.; Mistretta, C.A.; Zarnstorff, W.C.; Crummy, A.B.

    1982-01-01

    The logarithmic amplification of video signals and the availability of data in digital form make digital subtraction videoangiography a suitable tool for videodensitometric estimation of physiological quantities. A system for this purpose was implemented with a digital video image processor. However, it was found that the radiation scattering and veiling glare present in the image-intensified video must be removed to make meaningful quantitations. An algorithm to make such a correction was developed and is presented. With this correction, the videodensitometry system was calibrated with phantoms and used to measure the left ventricular ejection fraction of a canine heart

  16. Sodium Glucose Cotransporter 2 (SGLT2 Plays as a Physiological Glucose Sensor and Regulates Cellular Contractility in Rat Mesangial Cells.

    Directory of Open Access Journals (Sweden)

    Masanori Wakisaka

    Full Text Available Mesangial cells play an important role in regulating glomerular filtration by altering their cellular tone. We report the presence of a sodium glucose cotransporter (SGLT in rat mesangial cells. This study in rat mesangial cells aimed to evaluate the expression and role of SGLT2.The SGLT2 expression in rat mesangial cells was assessed by Western blotting and reverse transcription-polymerase chain reaction (RT-PCR. Changes in the mesangial cell surface area at different glucose concentrations and the effects of extracellular Na+ and Ca2+ and of SGLT and Na+/Ca2+ exchanger (NCX inhibitors on cellular size were determined. The cellular sizes and the contractile response were examined during a 6-day incubation with high glucose with or without phlorizin, an SGLT inhibitor.Western blotting revealed an SGLT2 band, and RT-PCR analysis of SGLT2 revealed the predicted 422-bp band in both rat mesangial and renal proximal tubular epithelial cells. The cell surface area changed according to the extracellular glucose concentration. The glucose-induced contraction was abolished by the absence of either extracellular Na+ or Ca2+ and by SGLT and NCX inhibitors. Under the high glucose condition, the cell size decreased for 2 days and increased afterwards; these cells did not contract in response to angiotensin II, and the SGLT inhibitor restored the abolished contraction.These data suggest that SGLT2 is expressed in rat mesangial cells, acts as a normal physiological glucose sensor and regulates cellular contractility in rat mesangial cells.

  17. SGLT5 Reabsorbs Fructose in the Kidney but Its Deficiency Paradoxically Exacerbates Hepatic Steatosis Induced by Fructose

    Science.gov (United States)

    Fukuzawa, Taku; Fukazawa, Masanori; Ueda, Otoya; Shimada, Hideaki; Kito, Aki; Kakefuda, Mami; Kawase, Yosuke; Wada, Naoko A.; Goto, Chisato; Fukushima, Naoshi; Jishage, Kou-ichi; Honda, Kiyofumi; King, George L.; Kawabe, Yoshiki

    2013-01-01

    Although excessive fructose intake is epidemiologically linked with dyslipidemia, obesity, and diabetes, the mechanisms regulating plasma fructose are not well known. Cells transfected with sodium/glucose cotransporter 5 (SGLT5), which is expressed exclusively in the kidney, transport fructose in vitro; however, the physiological role of this transporter in fructose metabolism remains unclear. To determine whether SGLT5 functions as a fructose transporter in vivo, we established a line of mice lacking the gene encoding SGLT5. Sodium-dependent fructose uptake disappeared in renal brush border membrane vesicles from SGLT5-deficient mice, and the increased urinary fructose in SGLT5-deficient mice indicated that SGLT5 was the major fructose reabsorption transporter in the kidney. From this, we hypothesized that urinary fructose excretion induced by SGLT5 deficiency would ameliorate fructose-induced hepatic steatosis. To test this hypothesis we compared SGLT5-deficient mice with wild-type mice under conditions of long-term fructose consumption. Paradoxically, however, fructose-induced hepatic steatosis was exacerbated in the SGLT5-deficient mice, and the massive urinary fructose excretion was accompanied by reduced levels of plasma triglycerides and epididymal fat but fasting hyperinsulinemia compared with fructose-fed wild-type mice. There was no difference in food consumption, water intake, or plasma fructose between the two types of mice. No compensatory effect by other transporters reportedly involved in fructose uptake in the liver and kidney were indicated at the mRNA level. These surprising findings indicated a previously unrecognized link through SGLT5 between renal fructose reabsorption and hepatic lipid metabolism. PMID:23451068

  18. Sodium-Glucose linked transporter 2 (SGLT2) inhibitors--fighting diabetes from a new perspective.

    Science.gov (United States)

    Angelopoulos, Theodoros P; Doupis, John

    2014-06-01

    Sodium-Glucose linked transporter 2 (SGLT2) inhibitors are a new family of antidiabetic pharmaceutical agents whose action is based on the inhibition of the glucose reabsorption pathway, resulting in glucosuria and a consequent reduction of the blood glucose levels, in patients with type 2 diabetes mellitus. Apart from lowering both fasting and postprandial blood glucose levels, without causing hypoglycemia, SGLT2 inhibitors have also shown a reduction in body weight and the systolic blood pressure. This review paper explores the renal involvement in glucose homeostasis providing also the latest safety and efficacy data for the European Medicines Agency and U.S. Food and Drug Administration approved SGLT2 inhibitors, looking, finally, into the future of this novel antidiabetic category of pharmaceutical agents.

  19. Glaring IPO

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    China Everbright Bank dazzles the domestic stock market with China’s second largest IPO this year As it launched its initial public offering(IPO) in Shanghai on August 18, 2010,China Everbright Bank Co. Ltd. was greeted with a warm welcome- shares of the mid-sized bank closed at 3.66 yuan($0.54) on its first trading date, jumping 18 percent from the IPO price of 3.1 yuan($0.46).

  20. Visual ergonomic aspects of glare on computer displays: glossy screens and angular dependence

    Science.gov (United States)

    Brunnström, Kjell; Andrén, Börje; Konstantinides, Zacharias; Nordström, Lukas

    2007-02-01

    Recently flat panel computer displays and notebook computer are designed with a so called glare panel i.e. highly glossy screens, have emerged on the market. The shiny look of the display appeals to the costumers, also there are arguments that the contrast, colour saturation etc improves by using a glare panel. LCD displays suffer often from angular dependent picture quality. This has been even more pronounced by the introduction of Prism Light Guide plates into displays for notebook computers. The TCO label is the leading labelling system for computer displays. Currently about 50% of all computer displays on the market are certified according to the TCO requirements. The requirements are periodically updated to keep up with the technical development and the latest research in e.g. visual ergonomics. The gloss level of the screen and the angular dependence has recently been investigated by conducting user studies. A study of the effect of highly glossy screens compared to matt screens has been performed. The results show a slight advantage for the glossy screen when no disturbing reflexes are present, however the difference was not statistically significant. When disturbing reflexes are present the advantage is changed into a larger disadvantage and this difference is statistically significant. Another study of angular dependence has also been performed. The results indicates a linear relationship between the picture quality and the centre luminance of the screen.

  1. LX4211 increases serum glucagon-like peptide 1 and peptide YY levels by reducing sodium/glucose cotransporter 1 (SGLT1)-mediated absorption of intestinal glucose.

    Science.gov (United States)

    Powell, David R; Smith, Melinda; Greer, Jennifer; Harris, Angela; Zhao, Sharon; DaCosta, Christopher; Mseeh, Faika; Shadoan, Melanie K; Sands, Arthur; Zambrowicz, Brian; Ding, Zhi-Ming

    2013-05-01

    LX4211 [(2S,3R,4R,5S,6R)-2-(4-chloro-3-(4-ethoxybenzyl)phenyl)-6-(methylthio)tetrahydro-2H-pyran-3,4,5-triol], a dual sodium/glucose cotransporter 1 (SGLT1) and SGLT2 inhibitor, is thought to decrease both renal glucose reabsorption by inhibiting SGLT2 and intestinal glucose absorption by inhibiting SGLT1. In clinical trials in patients with type 2 diabetes mellitus (T2DM), LX4211 treatment improved glycemic control while increasing circulating levels of glucagon-like peptide 1 (GLP-1) and peptide YY (PYY). To better understand how LX4211 increases GLP-1 and PYY levels, we challenged SGLT1 knockout (-/-) mice, SGLT2-/- mice, and LX4211-treated mice with oral glucose. LX4211-treated mice and SGLT1-/- mice had increased levels of plasma GLP-1, plasma PYY, and intestinal glucose during the 6 hours after a glucose-containing meal, as reflected by area under the curve (AUC) values, whereas SGLT2-/- mice showed no response. LX4211-treated mice and SGLT1-/- mice also had increased GLP-1 AUC values, decreased glucose-dependent insulinotropic polypeptide (GIP) AUC values, and decreased blood glucose excursions during the 6 hours after a challenge with oral glucose alone. However, GLP-1 and GIP levels were not increased in LX4211-treated mice and were decreased in SGLT1-/- mice, 5 minutes after oral glucose, consistent with studies linking decreased intestinal SGLT1 activity with reduced GLP-1 and GIP levels 5 minutes after oral glucose. These data suggest that LX4211 reduces intestinal glucose absorption by inhibiting SGLT1, resulting in net increases in GLP-1 and PYY release and decreases in GIP release and blood glucose excursions. The ability to inhibit both intestinal SGLT1 and renal SGLT2 provides LX4211 with a novel dual mechanism of action for improving glycemic control in patients with T2DM.

  2. Plastic pollution of the Kuril-Kamchatka Trench area (NW pacific)

    Science.gov (United States)

    Fischer, Viola; Elsner, Nikolaus O.; Brenke, Nils; Schwabe, Enrico; Brandt, Angelika

    2015-01-01

    During the German-Russian expedition KuramBio (Kuril-Kamchatka Biodiversity Studies) to the northwest Pacific Kuril-Kamchatka Trench and its adjacent abyssal plain, we found several kinds and sizes of plastic debris ranging from fishing nets and packaging to microplastic in the sediment of the deep-sea floor. Microplastics were ubiquitous in the smaller fractions of the box corer samples from every station from depths between 4869 and 5766 m. They were found on the abyssal plain and in the sediments of the trench slope on both sides. The amount of microplastics differed between the stations, with lowest concentration of 60 pieces per m2 and highest concentrations of more than 2000 pieces per m2. Around 75% of the microplastics (defined here as particles plastic debris we found, as a documentation of human impact into the deep sea of this region of the Northwest Pacific.

  3. SGLT2 inhibitors to control glycemia in type 2 diabetes mellitus: a new approach to an old problem.

    Science.gov (United States)

    Jabbour, Serge A

    2014-01-01

    Sodium-glucose cotransporter 2 (SGLT2) inhibitors are a new class of antidiabetic agents with a novel insulin-independent mechanism of action. The SGLT2 is a transporter found in the proximal tubule of the kidney and is responsible for approximately 90% of renal glucose reabsorption. The SGLT2 inhibitors reduce reabsorption of glucose in the kidney, resulting in glucose excretion in the urine (50-90 g of ~180 g filtered by the kidneys daily), which in turn lowers plasma glucose levels in people with diabetes. The insulin-independent mechanism of action of SGLT2 inhibitors dictates that they are associated with a very low risk of hypoglycemia and can be used in patients with any degree of β-cell function or insulin sensitivity. Clinical trials have shown that SGLT2 inhibitors are effective at reducing blood glucose levels, body weight, and blood pressure when used as monotherapy or in combination with other antidiabetic agents in patients with type 2 diabetes mellitus. Treatment with SGLT2 inhibitors is generally well tolerated, although these agents have been associated with an increased incidence of genital infections. The SGLT2 inhibitors have become a valuable addition to the armory of drugs used to treat patients with type 2 diabetes mellitus, and several agents within the class are currently under investigation in phase III clinical trials.

  4. Sodium-glucose co-transporter (SGLT) and glucose transporter (GLUT) expression in the kidney of type 2 diabetic subjects.

    Science.gov (United States)

    Norton, Luke; Shannon, Christopher E; Fourcaudot, Marcel; Hu, Cheng; Wang, Niansong; Ren, Wei; Song, Jun; Abdul-Ghani, Muhammad; DeFronzo, Ralph A; Ren, Jimmy; Jia, Weiping

    2017-09-01

    The sodium-glucose co-transporters (SGLTs) are responsible for the tubular reabsorption of filtered glucose from the kidney into the bloodstream. The inhibition of SGLT2-mediated glucose reabsorption is a novel and highly effective strategy to alleviate hyperglycaemia in patients with type 2 diabetes mellitus (T2DM). However, the effectiveness of SGLT2 inhibitor therapy is diminished due, in part, to a compensatory increase in the maximum reabsorptive capacity (Tm) for glucose in patients with T2DM. We hypothesized that this increase in Tm could be explained by an increase in the tubular expression of SGLT and glucose transporters (GLUT) in these patients. To examine this, we obtained human kidney biopsy specimens from patients with or without T2DM and examined the mRNA expression of SGLTs and GLUTs. The expression of SGLT1 is markedly increased in the kidney of patients with T2DM, and SGLT1 mRNA is highly and significantly correlated with fasting and postprandial plasma glucose and HbA1c. In contrast, our data demonstrate that the levels of SGLT2 and GLUT2 mRNA are downregulated in diabetic patients, but not to a statistically significant level. These important findings are clinically significant and may have implications for the treatment of T2DM using strategies that target SGLT transporters in the kidney. © 2017 John Wiley & Sons Ltd.

  5. SGLT2-inhibitors: a novel class for the treatment of type 2 diabetes introduction of SGLT2-inhibitors in clinical practice.

    Science.gov (United States)

    Cuypers, J; Mathieu, C; Benhalima, K

    2013-01-01

    Treatment of type 2 diabetes (T2DM) continues to present challenges, with significant proportion of patients failing to achieve and maintain glycemic targets. Despite the availability of many oral antidiabetic agents, therapeutic efficacy is offset by side effects such as weight gain and hypoglycemia. Therefore, the search for novel therapeutic agents with an improved benefit-risk profile continues. Recent research has focused on the kidney as a potential therapeutic target, especially because maximal renal glucose reabsorption is increased in T2DM. Under normal physiological conditions, nearly all filtered glucose is reabsorbed in the proximal tubule of the nephron, principally via the sodium-glucose cotransporter 2 (SGLT2). SGLT2-inhibitors are a new class of oral antidiabetics, which reduce hyperglycemia by increasing urinary glucose excretion independently of insulin secretion or action. Clinical results are promising with significant lowering of HbA1c without increased risk of hypoglycemia, reduction of body weight and reduction of systolic blood pressure. Dapagliflozin is the first highly selective SGLT2-inhibitor approved by the European Medecine Agency. Canagliflozin and empagliflozin are undergoing phase III trials. Actual safety issues are an increased risk for genital- and urinary tract infections and a possible increased risk for bladder and breast cancer. This led to refusal of dapagliflozin by the Food and Drug Administration (FDA). A large randomized control trial is therefore warranted by the FDA. This review provides an overview of the current evidence available so far on the therapeutic potential of the SGLT2-inhibitors for the treatment of T2DM.

  6. Ipragliflozin and other sodium-glucose cotransporter-2 (SGLT2) inhibitors in the treatment of type 2 diabetes: preclinical and clinical data.

    Science.gov (United States)

    Kurosaki, Eiji; Ogasawara, Hideaki

    2013-07-01

    Sodium-glucose cotransporter-2 (SGLT2) is expressed in the proximal tubules of the kidneys and plays a key role in renal glucose reabsorption. A novel class of antidiabetic medications, SGLT2-selective inhibitors attempt to improve glycemic control in diabetics by preventing glucose from being reabsorbed through SGLT2 and re-entering circulation. Ipragliflozin is an SGLT2 inhibitor in Phase 3 clinical development for the treatment of type 2 diabetes mellitus (T2DM). In this review, we summarize recent animal and human studies on ipragliflozin and other SGLT2 inhibitors including dapagliflozin, canagliflozin, empagliflozin, tofogliflozin, and luseogliflozin. These agents all show potent and selective SGLT2 inhibition in vitro and reduce blood glucose levels and HbA1c in both diabetic animal models and patients with T2DM. SGLT2 inhibitors offer several advantages over other classes of hypoglycemic agents. Due to their insulin-independent mode of action, SGLT2 inhibitors provide steady glucose control without major risk for hypoglycemia and may also reverse β-cell dysfunction and insulin resistance. Other favorable effects of SGLT2 inhibitors include a reduction in both body weight and blood pressure. SGLT2 inhibitors are safe and well tolerated and can easily be combined with other classes of antidiabetic medications to achieve tighter glycemic control. The long-term safety and efficacy of these agents are under evaluation. Copyright © 2013 Elsevier Inc. All rights reserved.

  7. Evaluating SGLT2 inhibitors for type 2 diabetes: pharmacokinetic and toxicological considerations.

    Science.gov (United States)

    Scheen, André J

    2014-05-01

    Inhibitors of sodium-glucose cotransporters type 2 (SGLT2), which increase urinary glucose excretion independently of insulin, are proposed as a novel approach for the management of type 2 diabetes mellitus (T2DM). An extensive literature search was performed to analyze the pharmacokinetic characteristics, toxicological issues and safety concerns of SGLT2 inhibitors in humans. This review focuses on three compounds (dapagliflozin, canagliflozin, empagliflozin) with results obtained in healthy volunteers (including drug-drug interactions), patients with T2DM (single dose and multiple doses) and special populations (those with renal or hepatic impairment). The three pharmacological agents share an excellent oral bioavailability, long half-life allowing once-daily administration, low accumulation index and renal clearance, the absence of active metabolites and a limited propensity to drug-drug interactions. No clinically relevant changes in pharmacokinetic parameters were observed in T2DM patients or in patients with mild/moderate renal or hepatic impairment. Adverse events are a slightly increased incidence of mycotic genital and rare benign urinary infections. SGLT2 inhibitors have the potential to reduce several cardiovascular risk factors, and cardiovascular outcome trials are currently ongoing. The best positioning of SGLT2 inhibitors in the armamentarium for treating T2DM is still a matter of debate.

  8. [SGLT2 inhibitors: a new therapeutic class for the treatment of type 2 diabetes mellitus].

    Science.gov (United States)

    Dagan, Amir; Dagan, Bracha; SegaL, Gad

    2015-03-01

    SGLT2 (Sodium Glucose co-Transporter 2 Inhibitors) inhibitors are a new group of oral medications for the treatment of type 2 diabetes mellitus patients. These medications interfere with the process of glucose reabsorption in the proximal convoluted tubules in the kidneys, therefore increasing both glucose and water diuresis. SGLT2 inhibitors were found to be effective in lowering HbA1c levels in double-blinded studies, both as monotherapy and in combination with other oral hypoglycemic medications of various other mechanisms of action. SGLT2 Inhibitors are not a risk factor for hypoglycemia and are suitable for combination with insulin therapy. Their unique mode of action, relying on glomerular filtration, make these medication unsuitable for usage as treatment for type 2 diabetes patients who are also suffering from moderate to severe renal failure. Their main adverse effects are increased risk for urinary and genital tract infections. The following review describes the relevant pathophysiology addressed by these novel medications, evidence for efficacy and the safety profile of SGLT2 Inhibitors.

  9. Use of SGLT-2 inhibitors in the treatment of type 2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Leyna Leite Santos

    Full Text Available Summary Introduction: Diabetes mellitus is one of the most common chronic diseases in the world, with high morbidity and mortality rates, resulting in a greatly negative socioeconomic impact. Although there are several classes of oral antidiabetic agents, most of the patients are outside the therapeutic goal range. Objective: To review the use of SGLT-2 inhibitors in the treatment of type 2 diabetes mellitus, focusing on their favorable and unfavorable effects, as well as on cardiovascular profile. Method: A literature search on Pubmed database was performed using the following keywords: "SGLT-2 inhibitors," "dapagliflozin," "empagliflozin," "canagliflozin." Results: SGLT-2 inhibitors are a class of oral antidiabetic drugs directed to the kidney. Their mechanism of action is to reduce blood glucose by inducing glycosuria. Extra-glycemic benefits have been described, such as weight loss, decline in blood pressure and levels of triglycerides and uric acid, and they can slow the progression of kidney disease. Genitourinary infections are the main side effects. There is a low risk of hypotension and hypoglycemia. Diabetic ketoacidosis is a serious adverse effect, although rare. Empagliflozin has already had its cardiovascular benefit demonstrated and studies with other drugs are currently being performed. Conclusion: SGLT-2 inhibitors are a new treatment option for type 2 diabetes mellitus, acting independently of insulin. They have potential benefits other than the reduction of blood glucose, but also carry a risk for adverse effects.

  10. SGLT2 inhibitors: a novel choice for the combination therapy in diabetic kidney disease.

    Science.gov (United States)

    Zou, Honghong; Zhou, Baoqin; Xu, Gaosi

    2017-05-16

    Diabetic kidney disease (DKD) is the most common cause of end stage renal disease. The comprehensive management of DKD depends on combined target-therapies for hyperglycemia, hypertension, albuminuria, and hyperlipaemia, etc. Sodium-glucose co-transporter 2 (SGLT2) inhibitors, the most recently developed oral hypoglycemic agents acted on renal proximal tubules, suppress glucose reabsorption and increase urinary glucose excretion. Besides improvements in glycemic control, they presented excellent performances in direct renoprotective effects and the cardiovascular (CV) safety by decreasing albuminuria and the independent CV risk factors such as body weight and blood pressure, etc. Simultaneous use of SGLT-2 inhibitors and renin-angiotensin-aldosterone system (RAAS) blockers are novel strategies to slow the progression of DKD via reducing inflammatory and fibrotic markers induced by hyperglycaemia more than either drug alone. The available population and animal based studies have described SGLT2 inhibitors plus RAAS blockers. The present review was to systematically review the potential renal benefits of SGLT2 inhibitors combined with dipeptidyl peptidase-4 inhibitors, glucagon-like peptide-1 receptor agonists, mineralocorticoid receptor antagonists, and especially the angiotensin-converting enzyme inhibitors/angiotensin receptor blockers.

  11. The mechanisms and therapeutic potential of SGLT2 inhibitors in diabetes mellitus.

    Science.gov (United States)

    Vallon, Volker

    2015-01-01

    The kidneys in normoglycemic humans filter 160-180 g of glucose per day (∼30% of daily calorie intake), which is reabsorbed and returned to the systemic circulation by the proximal tubule. Hyperglycemia increases the filtered and reabsorbed glucose up to two- to three-fold. The sodium glucose cotransporter SGLT2 in the early proximal tubule is the major pathway for renal glucose reabsorption. Inhibition of SGLT2 increases urinary glucose and calorie excretion, thereby reducing plasma glucose levels and body weight. The first SGLT2 inhibitors have been approved as a new class of antidiabetic drugs in type 2 diabetes mellitus, and studies are under way to investigate their use in type 1 diabetes mellitus. These compounds work independent of insulin, improve glycemic control in all stages of diabetes mellitus in the absence of clinically relevant hypoglycemia, and can be combined with other antidiabetic agents. By lowering blood pressure and diabetic glomerular hyperfiltration, SGLT2 inhibitors may induce protective effects on the kidney and cardiovascular system beyond blood glucose control.

  12. Does SGLT2 inhibition with dapagliflozin overcome individual therapy resistance to RAAS inhibition?

    NARCIS (Netherlands)

    Petrykiv, Sergei; Laverman, Gozewijn D.; de Zeeuw, Dick; Heerspink, Hiddo J. L.

    Individual patients show a large variation in their response to renin-angiotensin-aldosteron system (RAAS) inhibition (RAASi), both in surrogates such as albuminuria and in hard renal outcomes. Sodium-glucose co-transporter 2 inhibitors (SGLT2) have been shown to lower albuminuria and to confer

  13. Sodium glucose CoTransporter 2 (SGLT2) inhibitors: Current status and future perspective.

    Science.gov (United States)

    Madaan, Tushar; Akhtar, Mohd; Najmi, Abul Kalam

    2016-10-10

    Diabetes mellitus is a disease that affects millions of people worldwide and its prevalence is estimated to rise in the future. Billions of dollars are spent each year around the world in health expenditure related to diabetes. There are several anti-diabetic drugs in the market for the treatment of non-insulin dependent diabetes mellitus. In this article, we will be talking about a relatively new class of anti-diabetic drugs called sodium glucose co-transporter 2 (SGLT2) inhibitors. This class of drugs has a unique mechanism of action focusing on inhibition of glucose reabsorption that separates it from other classes. This article covers the mechanism of glucose reabsorption in the kidneys, the mechanism of action of SGLT2 inhibitors, several SGLT2 inhibitors currently available in the market as well as those in various phases of development, their individual pharmacokinetics as well as the discussion about the future role of SGLT2 inhibitors, not only for the treatment of diabetes, but also for various other diseases like obesity, hepatic steatosis, and cardiovascular disorders. Copyright © 2016 Elsevier B.V. All rights reserved.

  14. Historical and paleo-tsunami deposits on Kamchatka, Russia: long-term chronologies and long-distance correlations

    Directory of Open Access Journals (Sweden)

    T. K. Pinegina

    2001-01-01

    Full Text Available Along the eastern coast of Kamchatka, at a number of localities, we have identified and attempted to assign ages to deposits of both historic and prehistoric (paleo- tsunamis. These deposits are dated and correlated using tephrochronology from Holocene marker tephra and local volcanic ash layers. Because the historical record of earthquakes and tsunamis on Kamchatka is so short, these investigations can make important contributions to evaluating tsunami hazards. Moreover, because even the historical record is spotty, our work helps add to and evaluate tsunami catalogues for Kamchatka. Furthermore, tsunami deposits provide a proxy record for large earthquakes and thus are important paleoseismological tools. The combined, preserved record of tsunami deposits and of numerous marker tephra on Kamchatka offers an unprecedented opportunity to study tsunami frequency. Using combined stratigraphic sections, we can examine both the average frequency of events for each locality, and also changes in frequency through time. Moreover, using key marker tephra as time lines, we can compare tsunami frequency and intensity records along the Kamchatka subduction zone. Preliminary results suggest real variations in frequency on a millennial time scale, with the period from about 0 to 1000 A.D. being particularly active at some localities.

  15. Rainbow glare after laser-assisted in situ keratomileusis: a review of literature

    Directory of Open Access Journals (Sweden)

    Moshirfar M

    2016-11-01

    Full Text Available Majid Moshirfar,1,2 Jordan D Desautels,3 Tyler S Quist,4 David F Skanchy,5 Mark T Williams,6 Ryan T Wallace7 1Department of Ophthalmology and Visual Sciences, John A Moran Eye Center, University of Utah School of Medicine, Salt Lake City, UT, 2HDR Research Center, Hoopes Vision, Draper, UT, 3Tufts University School of Medicine, Boston, MA, 4University of Utah School of Medicine, Salt Lake City, UT, 5McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, 6University of California, San Francisco School of Medicine, San Francisco, CA, 7Brigham Young University, Provo, UT, USA Abstract: This article reviews the current literature pertaining to rainbow glare (RG, including incidence rate, clinical presentation, etiology, prognosis, and management. RG is a rare optical complication of femtosecond laser-assisted in situ keratomileusis that results in patients seeing an array of spectral bands surrounding point sources of light under mesopic and scotopic conditions. The mechanism is thought to be a consequence of the formation of a transmissive diffraction grating on the posterior surface of the corneal flap created by the FS laser. RG has a good prognosis and is usually self-limiting. Persistent RG with concomitant residual refractive error may warrant lifting the flap and photoablating the posterior surface of the flap. Patients with persistent RG and no residual refractive error should be considered candidates for phototherapeutic keratectomy on the posterior flap surface. Keywords: rainbow glare, femtosecond, LASIK, keratomileusis, phototherapeutic keratectomy

  16. ["Glare vision". I. Physiological principles of vision change with increased test field luminance].

    Science.gov (United States)

    Hauser, B; Ochsner, H; Zrenner, E

    1992-02-01

    Clinical tests of visual acuity are an important measure of visual function. However visual acuity is usually determined only in narrow range of luminance levels between 160 and 320 cd/m2; therefore losses of visual acuity in other ranges of light intensity can not be detected. In a distance of 80 cm from the patients eyes, Landolt rings of varying sizes were presented on a small test field whose light intensity can be varied between 0.1 and 30,000 cd/m2. Thereby an acuity-luminance-function can be obtained. We studied such functions under different conditions of exposure time both with constant and with increasing luminance of the test field. We found that persons with normal vision can increase their visual acuity with increasing test field luminance up to a range of 5000 cd/m2. The maximum values of visual acuity under optimal lightening conditions lie (varying with age) between 2.2 and 0.9. Under pathological conditions visual acuity falls at high luminances accompanied by sensations of glare. Tests of glare sensitivity as a function of exposure time showed 4 sec to be a critical time of exposure since after 4 sec normal persons just reach their maximum visual acuity at high luminances. The underlying physiological mechanisms lead us to suppose that patients with neuronal light adaptation disturbances display a greater visual loss as a result of decreased time of exposure than those with disturbances in the ocular media. Visual acuity as well as the capacity to increase the patients visual acuity under optimal conditions of lighting were both found to be strongly age-dependent.(ABSTRACT TRUNCATED AT 250 WORDS)

  17. The Sodium Glucose Cotransporter SGLT1 Is an Extremely Efficient Facilitator of Passive Water Transport.

    Science.gov (United States)

    Erokhova, Liudmila; Horner, Andreas; Ollinger, Nicole; Siligan, Christine; Pohl, Peter

    2016-04-29

    The small intestine is void of aquaporins adept at facilitating vectorial water transport, and yet it reabsorbs ∼8 liters of fluid daily. Implications of the sodium glucose cotransporter SGLT1 in either pumping water or passively channeling water contrast with its reported water transporting capacity, which lags behind that of aquaporin-1 by 3 orders of magnitude. Here we overexpressed SGLT1 in MDCK cell monolayers and reconstituted the purified transporter into proteoliposomes. We observed the rate of osmotic proteoliposome deflation by light scattering. Fluorescence correlation spectroscopy served to assess (i) SGLT1 abundance in both vesicles and plasma membranes and (ii) flow-mediated dilution of an aqueous dye adjacent to the cell monolayer. Calculation of the unitary water channel permeability, pf, yielded similar values for cell and proteoliposome experiments. Neither the absence of glucose or Na(+), nor the lack of membrane voltage in vesicles, nor the directionality of water flow grossly altered pf Such weak dependence on protein conformation indicates that a water-impermeable occluded state (glucose and Na(+) in their binding pockets) lasts for only a minor fraction of the transport cycle or, alternatively, that occlusion of the substrate does not render the transporter water-impermeable as was suggested by computational studies of the bacterial homologue vSGLT. Although the similarity between the pf values of SGLT1 and aquaporin-1 makes a transcellular pathway plausible, it renders water pumping physiologically negligible because the passive flux would be orders of magnitude larger. © 2016 by The American Society for Biochemistry and Molecular Biology, Inc.

  18. Novel Hypothesis to Explain Why SGLT2 Inhibitors Inhibit Only 30–50% of Filtered Glucose Load in Humans

    Science.gov (United States)

    Abdul-Ghani, Muhammad A.; DeFronzo, Ralph A.; Norton, Luke

    2013-01-01

    Inhibitors of sodium-glucose cotransporter 2 (SGLT2) are a novel class of antidiabetes drugs, and members of this class are under various stages of clinical development for the management of type 2 diabetes mellitus (T2DM). It is widely accepted that SGLT2 is responsible for >80% of the reabsorption of the renal filtered glucose load. However, maximal doses of SGLT2 inhibitors fail to inhibit >50% of the filtered glucose load. Because the clinical efficacy of this group of drugs is entirely dependent on the amount of glucosuria produced, it is important to understand why SGLT2 inhibitors inhibit <50% of the filtered glucose load. In this Perspective, we provide a novel hypothesis that explains this apparent puzzle and discuss some of the clinical implications inherent in this hypothesis. PMID:24065789

  19. Novel hypothesis to explain why SGLT2 inhibitors inhibit only 30-50% of filtered glucose load in humans.

    Science.gov (United States)

    Abdul-Ghani, Muhammad A; DeFronzo, Ralph A; Norton, Luke

    2013-10-01

    Inhibitors of sodium-glucose cotransporter 2 (SGLT2) are a novel class of antidiabetes drugs, and members of this class are under various stages of clinical development for the management of type 2 diabetes mellitus (T2DM). It is widely accepted that SGLT2 is responsible for >80% of the reabsorption of the renal filtered glucose load. However, maximal doses of SGLT2 inhibitors fail to inhibit >50% of the filtered glucose load. Because the clinical efficacy of this group of drugs is entirely dependent on the amount of glucosuria produced, it is important to understand why SGLT2 inhibitors inhibit <50% of the filtered glucose load. In this Perspective, we provide a novel hypothesis that explains this apparent puzzle and discuss some of the clinical implications inherent in this hypothesis.

  20. Fluorine-Directed Glycosylation Enables the Stereocontrolled Synthesis of Selective SGLT2 Inhibitors for Type II Diabetes.

    Science.gov (United States)

    Sadurní, Anna; Kehr, Gerald; Ahlqvist, Marie; Wernevik, Johan; Sjögren, Helena Peilot; Kankkonen, Cecilia; Knerr, Laurent; Gilmour, Ryan

    2018-02-26

    Inhibition of the sodium-glucose co-transporters (SGLT1 and SGLT2) is a validated strategy to address the increasing prevalence of type II diabetes mellitus. However, achieving selective inhibition of human SGLT1 or SGLT2 remains challenging. Orally available small molecule drugs based on the d-glucose core of the natural product Gliflozin have proven to be clinically effective in this regard, effectively impeding glucose reabsorption. Herein, we disclose the influence of molecular editing with fluorine at the C2 position of the pyranose ring of Phlorizin analogues Remogliflozin Etabonate and Dapagliflozin (Farxiga ® ) to concurrently direct β-selective glycosylation, as is required for biological efficacy, and enhance aspects of the physicochemical profile. Given the abundance of glycosylated pharmaceuticals in diabetes therapy that contain a β-configured d-glucose nucleus, it is envisaged that this strategy may prove to be expansive. © 2018 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

  1. Lycium barbarum L. Polysaccharide (LBP Reduces Glucose Uptake via Down-Regulation of SGLT-1 in Caco2 Cell

    Directory of Open Access Journals (Sweden)

    Huizhen Cai

    2017-02-01

    Full Text Available Lycium barbarum L. polysaccharide (LBP is prepared from Lycium barbarum L. (L. barbarum, which is a traditional Chinese medicine. LPB has been shown to have hypoglycemic effects. In order to gain some mechanistic insights on the hypoglycemic effects of LBP, we investigated the uptake of LBP and its effect on glucose absorption in the human intestinal epithelial cell line Caco2 cell. The uptake of LBP through Caco2 cell monolayer was time-dependent and was inhibited by phloridzin, a competitive inhibitor of SGLT-1. LPB decreased the absorption of glucose in Caco2 cell, and down-regulated the expression of SGLT-1. These results suggest that LBP might be transported across the human intestinal epithelium through SGLT-1 and it inhibits glucose uptake via down-regulating SGLT-1.

  2. Influence of the Metal Volume Fraction on the permanent dent depth and energy absorption of GLARE plates subjected to low velocity impact

    Science.gov (United States)

    Bikakis, GSE; Savaidis, A.; Zalimidis, P.; Tsitos, S.

    2016-11-01

    Fiber-metal laminates are hybrid composite materials, consisting of alternating metal layers bonded to fiber-reinforced prepreg layers. GLARE (GLAss REinforced) belongs to this new family of materials. GLARE is the most successful fiber-metal laminate up to now and is currently being used for the construction of primary aerospace structures, such as the fuselage of the Airbus A380 air plane. Impact properties are very important in aerospace structures, since impact damage is caused by various sources, such as maintenance damage from dropped tools, collision between service cars or cargo and the structure, bird strikes and hail. The principal objective of this article is to evaluate the influence of the Metal Volume Fraction (MVF) on the low velocity impact response of GLARE fiber-metal laminates. Previously published differential equations of motion are employed for this purpose. The low velocity impact behavior of various circular GLARE plates is predicted and characteristic values of impact variables, which represent the impact phenomenon, are evaluated versus the corresponding MVF of the examined GLARE material grades. The considered GLARE plates are subjected to low velocity impact under identical impact conditions. A strong effect of the MVF on the maximum impact load and a significant effect on the maximum plate deflection of GLARE plates has been found.

  3. Influence of the Metal Volume Fraction on the maximum deflection and impact load of GLARE plates subjected to low velocity impact

    Science.gov (United States)

    Bikakis, GSE; Savaidis, A.; Zalimidis, P.; Tsitos, S.

    2016-11-01

    Fiber-metal laminates are hybrid composite materials, consisting of alternating metal layers bonded to fiber-reinforced prepreg layers. GLARE (GLAss REinforced) belongs to this new family of materials. GLARE is the most successful fiber-metal laminate up to now and is currently being used for the construction of primary aerospace structures, such as the fuselage of the Airbus A380 air plane. Impact properties are very important in aerospace structures, since impact damage is caused by various sources, such as maintenance damage from dropped tools, collision between service cars or cargo and the structure, bird strikes and hail. The principal objective of this article is to evaluate the influence of the Metal Volume Fraction (MVF) on the low velocity impact response of GLARE fiber-metal laminates. Previously published differential equations of motion are employed for this purpose. The low velocity impact behavior of various circular GLARE plates is predicted and characteristic values of impact variables, which represent the impact phenomenon, are evaluated versus the corresponding MVF of the examined GLARE material grades. The considered GLARE plates are subjected to low velocity impact under identical impact conditions. A strong effect of the MVF on the maximum impact load and a significant effect on the maximum plate deflection of GLARE plates has been found.

  4. C-Aryl glucoside SGLT2 inhibitors containing a biphenyl motif as potential anti-diabetic agents.

    Science.gov (United States)

    Ding, Yuyang; Mao, Liufeng; Xu, Dengfeng; Xie, Hui; Yang, Ling; Xu, Hongjiang; Geng, Wenjun; Gao, Yong; Xia, Chunguang; Zhang, Xiquan; Meng, Qingyi; Wu, Donghai; Zhao, Junling; Hu, Wenhui

    2015-07-15

    A series of highly active C-aryl glucoside SGLT2 inhibitors containing a biphenyl motif were designed and synthesized for biological evaluation. Among the compounds tested, compound 16l demonstrated high inhibitory activity against SGLT2 (IC50=1.9 nM) with an excellent pharmacokinetic profile. Further study indicated that the in vivo efficacy of compound 16l was comparable to that of dapagliflozin, suggesting that further development would be worthwhile. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. SGLT5 Reabsorbs Fructose in the Kidney but Its Deficiency Paradoxically Exacerbates Hepatic Steatosis Induced by Fructose

    OpenAIRE

    Fukuzawa, Taku; Fukazawa, Masanori; Ueda, Otoya; Shimada, Hideaki; Kito, Aki; Kakefuda, Mami; Kawase, Yosuke; Wada, Naoko A.; Goto, Chisato; Fukushima, Naoshi; Jishage, Kou-ichi; Honda, Kiyofumi; King, George L.; Kawabe, Yoshiki

    2013-01-01

    Although excessive fructose intake is epidemiologically linked with dyslipidemia, obesity, and diabetes, the mechanisms regulating plasma fructose are not well known. Cells transfected with sodium/glucose cotransporter 5 (SGLT5), which is expressed exclusively in the kidney, transport fructose in vitro; however, the physiological role of this transporter in fructose metabolism remains unclear. To determine whether SGLT5 functions as a fructose transporter in vivo, we established a line of mic...

  6. Knockout of Na-glucose transporter SGLT2 attenuates hyperglycemia and glomerular hyperfiltration but not kidney growth or injury in diabetes mellitus

    Science.gov (United States)

    Rose, Michael; Gerasimova, Maria; Satriano, Joseph; Platt, Kenneth A.; Koepsell, Hermann; Cunard, Robyn; Sharma, Kumar; Thomson, Scott C.; Rieg, Timo

    2013-01-01

    The Na-glucose cotransporter SGLT2 mediates high-capacity glucose uptake in the early proximal tubule and SGLT2 inhibitors are developed as new antidiabetic drugs. We used gene-targeted Sglt2 knockout (Sglt2−/−) mice to elucidate the contribution of SGLT2 to blood glucose control, glomerular hyperfiltration, kidney growth, and markers of renal growth and injury at 5 wk and 4.5 mo after induction of low-dose streptozotocin (STZ) diabetes. The absence of SGLT2 did not affect renal mRNA expression of glucose transporters SGLT1, NaGLT1, GLUT1, or GLUT2 in response to STZ. Application of STZ increased blood glucose levels to a lesser extent in Sglt2−/− vs. wild-type (WT) mice (∼300 vs. 470 mg/dl) but increased glucosuria and food and fluid intake to similar levels in both genotypes. Lack of SGLT2 prevented STZ-induced glomerular hyperfiltration but not the increase in kidney weight. Knockout of SGLT2 attenuated the STZ-induced renal accumulation of p62/sequestosome, an indicator of impaired autophagy, but did not attenuate the rise in renal expression of markers of kidney growth (p27 and proliferating cell nuclear antigen), oxidative stress (NADPH oxidases 2 and 4 and heme oxygenase-1), inflammation (interleukin-6 and monocyte chemoattractant protein-1), fibrosis (fibronectin and Sirius red-sensitive tubulointerstitial collagen accumulation), or injury (renal/urinary neutrophil gelatinase-associated lipocalin). SGLT2 deficiency did not induce ascending urinary tract infection in nondiabetic or diabetic mice. The results indicate that SGLT2 is a determinant of hyperglycemia and glomerular hyperfiltration in STZ-induced diabetes mellitus but is not critical for the induction of renal growth and markers of renal injury, inflammation, and fibrosis. PMID:23152292

  7. Sodium-Glucose Cotransporter 2 (SGLT2) Inhibitors from Natural Products: Discovery of Next-Generation Antihyperglycemic Agents.

    Science.gov (United States)

    Choi, Chang-Ik

    2016-08-27

    Diabetes mellitus is a chronic condition associated with the metabolic impairment of insulin actions, leading to the development of life-threatening complications. Although many kinds of oral antihyperglycemic agents with different therapeutic mechanisms have been marketed, their undesirable adverse effects, such as hypoglycemia, weight gain, and hepato-renal toxicity, have increased demand for the discovery of novel, safer antidiabetic drugs. Since the important roles of the sodium-glucose cotransporter 2 (SGLT2) for glucose homeostasis in the kidney were recently elucidated, pharmacological inhibition of SGLT2 has been considered a promising therapeutic target for the treatment of type 2 diabetes. Since the discovery of the first natural SGLT2 inhibitor, phlorizin, several synthetic glucoside analogs have been developed and introduced into the market. Furthermore, many efforts to find new active constituents with SGLT2 inhibition from natural products are still ongoing. This review introduces the history of research on the development of early-generation SGLT2 inhibitors, and recent progress on the discovery of novel candidates for SGLT2 inhibitor from several natural products that are widely used in traditional herbal medicine.

  8. Sodium-Glucose Cotransporter 2 (SGLT2 Inhibitors from Natural Products: Discovery of Next-Generation Antihyperglycemic Agents

    Directory of Open Access Journals (Sweden)

    Chang-Ik Choi

    2016-08-01

    Full Text Available Diabetes mellitus is a chronic condition associated with the metabolic impairment of insulin actions, leading to the development of life-threatening complications. Although many kinds of oral antihyperglycemic agents with different therapeutic mechanisms have been marketed, their undesirable adverse effects, such as hypoglycemia, weight gain, and hepato-renal toxicity, have increased demand for the discovery of novel, safer antidiabetic drugs. Since the important roles of the sodium-glucose cotransporter 2 (SGLT2 for glucose homeostasis in the kidney were recently elucidated, pharmacological inhibition of SGLT2 has been considered a promising therapeutic target for the treatment of type 2 diabetes. Since the discovery of the first natural SGLT2 inhibitor, phlorizin, several synthetic glucoside analogs have been developed and introduced into the market. Furthermore, many efforts to find new active constituents with SGLT2 inhibition from natural products are still ongoing. This review introduces the history of research on the development of early-generation SGLT2 inhibitors, and recent progress on the discovery of novel candidates for SGLT2 inhibitor from several natural products that are widely used in traditional herbal medicine.

  9. Cardioprotective effects of SGLT2 inhibitors are possibly associated with normalization of the circadian rhythm of blood pressure.

    Science.gov (United States)

    Rahman, Asadur; Hitomi, Hirofumi; Nishiyama, Akira

    2017-06-01

    Improvement in cardiovascular (CV) morbidity and mortality in the EMPA-REG OUTCOME study provides new insight into the therapeutic use of sodium-dependent glucose cotransporter 2 (SGLT2) inhibitors in patients with type 2 diabetes. Although SGLT2 inhibitors have several pleiotropic effects, the underlying mechanism responsible for their cardioprotective effects remains undetermined. In this regard, the absence of a nocturnal fall in blood pressure (BP), that is, non-dipping BP, is a common phenomenon in type 2 diabetes and has a crucial role in the pathogenesis of CV morbidity and mortality. In most clinical trials, SGLT2 inhibitors reduce both systolic BP (~3-5 mm Hg) and diastolic BP (~2 mm Hg) in patients with type 2 diabetes. In addition, recent clinical and animal studies have revealed that SGLT2 inhibitors enable the change in BP circadian rhythm from a non-dipper to a dipper type, which is possibly associated with the improvement in CV outcomes in patients with type 2 diabetes. In this review, recent data on the effect of SGLT2 inhibitors on the circadian rhythm of BP will be summarized. The possible underlying mechanisms responsible for the SGLT2 inhibitor-induced improvement in the circadian rhythm of BP will also be discussed.

  10. Combined HQSAR, topomer CoMFA, homology modeling and docking studies on triazole derivatives as SGLT2 inhibitors.

    Science.gov (United States)

    Yu, Shuling; Yuan, Jintao; Zhang, Yi; Gao, Shufang; Gan, Ying; Han, Meng; Chen, Yuewen; Zhou, Qiaoqiao; Shi, Jiahua

    2017-06-01

    Sodium-glucose cotransporter 2 (SGLT2) is a promising target for diabetes therapy. We aimed to develop computational approaches to identify structural features for more potential SGLT2 inhibitors. In this work, 46 triazole derivatives as SGLT2 inhibitors were studied using a combination of several approaches, including hologram quantitative structure-activity relationships (HQSAR), topomer comparative molecular field analysis (CoMFA), homology modeling, and molecular docking. HQSAR and topomer CoMFA were used to construct models. Molecular docking was conducted to investigate the interaction of triazole derivatives and homology modeling of SGLT2, as well as to validate the results of the HQSAR and topomer CoMFA models. The most effective HQSAR and topomer CoMFA models exhibited noncross-validated correlation coefficients of 0.928 and 0.891 for the training set, respectively. External predictions were made successfully on a test set and then compared with previously reported models. The graphical results of HQSAR and topomer CoMFA were proven to be consistent with the binding mode of the inhibitors and SGLT2 from molecular docking. The models and docking provided important insights into the design of potent inhibitors for SGLT2.

  11. Reprint of "Seismic monitoring of the Plosky Tolbachik eruption in 2012-2013 (Kamchatka Peninsula Russia)"

    Science.gov (United States)

    Senyukov, S. L.; Nuzhdina, I. N.; Droznina, S. Ya.; Garbuzova, V. T.; Kozhevnikova, T. Yu.; Sobolevskaya, O. V.; Nazarova, Z. A.; Bliznetsov, V. E.

    2015-12-01

    The active basaltic volcano Plosky Tolbachik (Pl. Tolbachik) is located in the southern part of the Klyuchevskoy volcano group on the Kamchatka Peninsula. The previous 1975-1976 Great Tolbachik Fissure Eruption (1975-1976 GTFE) occurred in the southern sector of Pl. Tolbachik. It was preceded by powerful earthquakes with local magnitudes between 2.5 and 4.9 and it was successfully predicted with a short-term forecast. The Kamchatka Branch of Geophysical Survey (KBGS) of the Russian Academy of Science (RAS) began to publish the results of daily seismic monitoring of active Kamchatka volcanoes on the Internet in 2000. Unlike the 1975-1976 GTFE precursor, (1) seismicity before the 2012-2013 Tolbachik Fissure Eruption (2012-2013 TFE) was relatively weak and earthquake magnitudes did not exceed 2.5. (2) Precursory earthquake hypocenters at 0-5 km depth were concentrated mainly under the southeastern part of the volcano. (3) The frequency of events gradually increased in September 2012, and rose sharply on the eve of the eruption. (4) According to seismic data, the explosive-effusive 2012-2013 TFE began at 05 h 15 min UTC on November 27, 2012; the outbreak occurred between the summit of the Pl. Tolbachik and the Northern Breakthrough of the 1975-1976 GTFE. (5) Because of bad weather, early interpretations of the onset time and the character of the eruption were made using seismological data only and were confirmed later by other monitoring methods. The eruption finished in early September 2013. This article presents the data obtained through real-time seismic monitoring and the results of retrospective analysis, with additional comments on the future monitoring of volcanic activity.

  12. SGLT-2 Inhibitors: Are They a Promising Treatment Option in T2DM Patients with NAFLD?

    Directory of Open Access Journals (Sweden)

    Dimitrios Patoulias

    2018-04-01

    Full Text Available Sodium glucose co-transporter type 2 inhibitors (SGLT-2 inhibitors are a class of antidiabetics, recently approved for the treatment of patients with T2DM. They feature cardioprotective and renoprotective action, while they exert beneficial effects on metabolic parameters. Non-alcoholic fatty liver disease (NAFLD is a frequent co-morbidity in diabetic patients. Its prevalence reaches up to 70%. Since there is no specific treatment approved for NAFLD, both experimental and clinical studies have been recently conducted highlighting the efficacy and safety of SGLT-2 inhibitors mainly in animal models and secondarily in patients with T2DM and NAFLD. This class of antidiabetics seems very attractive, improving both glycemic control and liver function tests, while inhibiting NAFLD progression. However, further investigation is required to establish them as a first-line treatment option in T2DM patients with NAFLD, after thorough assessment of their efficacy and safety in clinical practice.

  13. A Novel Therapeutic Agent for Type 2 Diabetes Mellitus: SGLT2 Inhibitor

    Directory of Open Access Journals (Sweden)

    Chang Hee Jung

    2014-08-01

    Full Text Available Type 2 diabetes mellitus (T2DM is a complex endocrine and metabolic disorder, and a major public health problem that is rapidly increasing in prevalence. Although a wide range of pharmacotherapies for glycemic control is now available, management of T2DM remains complex and challenging. The kidneys contribute immensely to glucose homeostasis by reabsorbing glucose from the glomerular filtrate. Sodium-glucose cotransporter 2 (SGLT2 inhibitors, a new class of antidiabetic agents that inhibit glucose absorption from the kidney independent of insulin, offer a unique opportunity to improve the outcomes of patients with T2DM. In this review, we provide an overview of two globally-approved SGLT2 inhibitors, dapagliflozin and canagliflozin, and discuss their effects and safety. This information will help clinicians to decide whether these drugs will benefit their patients.

  14. Benefits of SGLT2 Inhibitors beyond glycemic control - A focus on metabolic, cardiovascular, and renal outcomes.

    Science.gov (United States)

    Minze, Molly G; Will, Kayley; Terrell, Brian T; Black, Robin L; Irons, Brian K

    2017-08-16

    Sodium-glucose co-transporter 2 (SGLT2) inhibitors are a new pharmacotherapeutic class for the treatment of type 2 diabetes mellitus (T2DM). To evaluate beneficial effects of the SGLT2 inhibitors on metabolic, cardiovascular, and renal outcomes. A Pub-Med search (1966 to July 2017) was performed of published English articles using keywords sodium-glucose co-transporter 2 inhibitors, canagliflozin, dapagliflozin, and empagliflozin. A review of literature citations provided further references. The search identified 17clinical trials and 2 meta-analysis with outcomes of weight loss and blood pressure reduction with dapagliflozin, canagliflozin, or empagliflozin. Three randomized trials focused on either empagliflozin or canagliflozin and reduction of cardiovascular disease and progression of renal disease. SGLT2 inhibitors have a beneficial profile in the treatment of T2DM. They have evidence of reducing weight between 2.9 kilograms when used as monotherapy to 4.7 kilograms when used in combination with metformin, and reduce systolic blood pressure between 3 to 5 mmHg and reduce diastolic blood pressure approximately 2 mmHg. To date, reduction of cardiovascular events was seen specifically with empagliflozin in patients with T2DM and a history of cardiovascular disease. In the same population, empagliflozin was associated with slowing the progression of kidney disease. Moreover, patients with increased risk of cardiovascular disease treated with canagliflozin has decreased risk of death from cardiovascular causes, nonfatal MI, or nonfatal stroke. Data regarding these outcomes with dapagliflozin are underway. SGLT2 inhibitors demonstrate some positive metabolic effects. In addition, empagliflozin specifically has demonstrated reduction in cardiovascular events and delay in the progression of kidney disease in patients with T2DM and a history of cardiovascular disease. Further data is needed to assess if this is a class effect. Copyright© Bentham Science Publishers

  15. Sodium glucose co-transporter 2 (SGLT2) inhibitors: new among antidiabetic drugs.

    Science.gov (United States)

    Opie, L H

    2014-08-01

    Type 2 diabetes is characterized by decreased insulin secretion and sensitivity. The available oral anti-diabetic drugs act on many different molecular sites. The most used of oral anti-diabetic agents is metformin that activates glucose transport vesicles to the cell surface. Others are: the sulphonylureas; agents acting on the incretin system; GLP-1 agonists; dipetidylpeptidase-4 inhibitors; meglinitide analogues; and the thiazolidinediones. Despite these many drugs acting by different mechanisms, glycaemic control often remains elusive. None of these drugs have a primary renal mechanism of action on the kidneys, where almost all glucose excreted is normally reabsorbed. That is where the inhibitors of glucose reuptake (sodium-glucose cotransporter 2, SGLT2) have a unique site of action. Promotion of urinary loss of glucose by SGLT2 inhibitors embodies a new principle of control in type 2 diabetes that has several advantages with some urogenital side-effects, both of which are evaluated in this review. Specific approvals include use as monotherapy, when diet and exercise alone do not provide adequate glycaemic control in patients for whom the use of metformin is considered inappropriate due to intolerance or contraindications, or as add-on therapy with other anti-hyperglycaemic medicinal products including insulin, when these together with diet and exercise, do not provide adequate glycemic control. The basic mechanisms are improved β-cell function and insulin sensitivity. When compared with sulphonylureas or other oral antidiabetic agents, SGLT2 inhibitors provide greater HbA1c reduction. Urogenital side-effects related to the enhanced glycosuria can be troublesome, yet seldom lead to discontinuation. On this background, studies are analysed that compare SGLT2 inhibitors with other oral antidiabetic agents. Their unique mode of action, unloading the excess glycaemic load, contrasts with other oral agents that all act to counter the effects of diabetic

  16. The kidney as a new target for antidiabetic drugs: SGLT2 inhibitors.

    Science.gov (United States)

    Cangoz, S; Chang, Y-Y; Chempakaseril, S J; Guduru, R C; Huynh, L M; John, J S; John, S T; Joseph, M E; Judge, R; Kimmey, R; Kudratov, K; Lee, P J; Madhani, I C; Shim, P J; Singh, S; Singh, S; Ruchalski, C; Raffa, R B

    2013-10-01

    A novel class of antidiabetic drugs - SGLT2 (Na(+) /glucose cotransporter type 2) inhibitors - target renal reabsorption of glucose and promote normal glucose levels, independent of insulin production or its action at receptors. We review this new mechanistic approach and the reported efficacy and safety of clinical testing of lead compounds. Information was obtained from various bibliographic sources, including PubMed and others, on the basic science and the clinical trials of SGLT2 inhibitors. The information was then summarized and evaluated from the perspective of contribution to a fuller understanding of the potential and current status of the lead clinical candidates. Diabetes mellitus is a spectrum of disorders that involves inadequate insulin function resulting in adverse health sequelae due to acute and chronic hyperglycaemia. Current antidiabetic pharmacotherapy primarily addresses either insulin production at the pancreatic β-cells or insulin action at insulin receptors. These drugs have less than full clinical effectiveness and sometimes therapy-limiting adverse effects. The third major component of glucose balance, namely elimination, has not been a significant therapeutic target to date. SGLT2 inhibitors are a novel approach. A sufficient number of clinical trials have been conducted on sufficiently chemically diverse SGLT2 inhibitors to reasonably conclude that they have efficacy (HbA1c reductions of 0·4-1%), and thus far, the majority of adverse effects have been mild and transitory or treatable, with the caveat of possible association with increased risk of breast cancer in women and bladder cancer in men. © 2013 John Wiley & Sons Ltd.

  17. SGLT2 inhibitors as adjunct therapy to insulin in type 1 diabetes: Meta analysis

    Directory of Open Access Journals (Sweden)

    Jiao CHEN

    2017-02-01

    Full Text Available Objective To evaluate the efficacy and safety of sodium glucose co-transporter-2 (SGLT-2 inhibitors as adjunct therapy to insulin in type 1 diabetes (T1DM. Methods The PubMed, The Cochrane Library, EMbase, CENTRRAI, CBM, CNKI, VIP and WangFang database were searched from inception to April 5, 2016 for systematic reviews, references screen was performed manually. The trials of SGLT2 inhibitors versus placebo add to insulin carried out in patients with T1DM were collected, and their bias risk was assessed and meta-analysis was conducted by using RevMan 5.3 software. Results Four randomized control trials (RCTs were yielded for meta-analysis, including 529 patients. Compared with control group, SGLT2 inhibitors as adjunct therapy to insulin significantly reduced fasting plasma glucose (FPG [weighted mean difference (WMD=–0.65mmol/L, 95% confidence interval (CI=–1.30 to –0.08, P<0.05], glycated hemoglobin A1C (HbA1c (WMD=–0.37%, 95%CI=–0.54 to –0.20, P<0.00001, body weight (WMD=–2.54kg, 95%CI=–3.48 to –1.60, P<0.0001 and total daily insulin dose (WMD=–6.23IU, 95% CI=–8.05 to –4.40, P<0.0001, but the total adverse events (AEs, hypoglycemia, genital and urinary infections showed no significant difference. Conclusions Based on current studies, SGLT-2 inhibitors are effective as adjunct therapy to insulin in T1DM, may improve glycemic control, reduce body weight and total daily insulin dose without increase of total AEs, hypoglycemia, and genital and urinary infections. DOI: 10.11855/j.issn.0577-7402.2016.12.15

  18. SGLT2 inhibitors provide an effective therapeutic option for diabetes complicated with insulin antibodies.

    Science.gov (United States)

    Hayashi, Akinori; Takano, Koji; Kawai, Sayuki; Shichiri, Masayoshi

    2016-01-01

    Diabetes mellitus complicated with insulin antibodies is rare in clinical practice but usually difficult to control. A high amount of insulin antibodies, especially with low affinity and high binding capacity, leads to unstable glycemic control characterized by hyperglycemia unresponsive to large volume of insulin and unanticipated hypoglycemia. There are several treatment options, such as changing insulin preparation, immunosupression with glucocorticoids, and plasmapheresis, most of which are of limited efficacy. Sodium-glucose cotransporter 2 (SGLT2) inhibitors are a novel class of drug which decrease renal glucose reabsorption and lowers plasma glucose level independent of insulin action. We report here a case with diabetes complicated with insulin antibodies who was effectively controlled by an SGLT2 inhibitor. A 47-year-old man with type 2 diabetes treated with insulin had very poor glycemic control characterized by postprandial hyperglycemia unresponsive to insulin therapy and repetitive hypoglycemia due to insulin antibodies. Treatment with ipragliflozin, an SGLT2 inhibitor, improved HbA1c from 8.4% to 6.0% and glycated albumin from 29.4% to 17.9%. Continuous glucose monitoring revealed improvement of glycemic profile (average glucose level from 212 mg/dL to 99 mg/dL and glycemic standard deviation from 92 mg/dL to 14 mg/dL) with disappearance of hypoglycemic events. This treatment further ameliorated the characteristics of insulin antibodies and resulted in reduced insulin requirement. SGLT2 inhibitors may offer an effective treatment option for managing the poor glycemic control in diabetes complicated with insulin antibodies.

  19. Investigation into the Fiber Orientation Effect on the Formability of GLARE Materials in the Stamp Forming Process

    Science.gov (United States)

    Liu, Shichen; Lang, Lihui; Sherkatghanad, Ehsan; Wang, Yao; Xu, Wencai

    2018-04-01

    Glass-reinforced aluminum laminate (GLARE) is a new class of fiber metal laminates (FMLs) which has the advantages such as high tensile strength, outstanding fatigue, impact resistance, and excellent corrosion properties. GLARE has been extensively applied in advanced aerospace and automobile industries. However, the deformation behavior of the glass fiber during forming must be studied to the benefits of the good-quality part we form. In this research, we focus on the effect of fiber layer orientation on the GLARE laminate formability in stamp forming process. Experimental and numerical analysis of stamping a hemisphere part in different fiber orientation is investigated. The results indicate that unidirectional and multi-directional fiber in the middle layer make a significant effect on the thinning and also surface forming quality of the three layer sheet. Furthermore, the stress-strain distribution of the aluminum alloy and the unique anisotropic property of the fiber layer exhibit that fiber layer orientation can also affect the forming depths as well as the fracture modes of the laminate. According to the obtained results, it is revealed that multi-directional fiber layers are a good alternative compared to the unidirectional fibers especially when a better formability is the purpose.

  20. Robust brightness enhancement across a luminance range of the glare illusion.

    Science.gov (United States)

    Tamura, Hideki; Nakauchi, Shigeki; Koida, Kowa

    2016-01-01

    The glare illusion refers to brightness enhancement and the perception of a self-luminous appearance that occurs when a central region is surrounded by a luminance gradient. The center region appears to be a light source, with its light dispersing into the surrounding region. If the luminous edge is critical for generating the illusion, modulating the perceived luminance of the image, and switching its appearance from luminous to nonluminous, would have a strong impact on lightness and brightness estimation. Here, we quantified the illusion in two ways, by assessing brightness enhancement and examining whether the center region appeared luminous. Thus, we could determine whether the two effects occurred jointly or independently. We examined a wide luminance range of center regions, from 0 to 200% relative to background. Brightness enhancement in the illusion was observed for a wide range of luminances (20% to 200% relative to background), while a luminous-white appearance was observed when the center region luminance was 145% of the background. These results exclude the possibility that brightness enhancement occurs because the stimuli appear self-luminous. We suggest that restoring the original image intensity precedes the perceptual process of lightness estimation.

  1. SGLT2 Inhibitors: Glucotoxicity and Tumorigenesis Downstream the Renal Proximal Tubule?

    Science.gov (United States)

    Bertinat, Romina; Nualart, Francisco; Yáñez, Alejandro J

    2016-08-01

    At present, diabetes mellitus is the main cause of end-stage renal disease. Effective glycaemic management is the most powerful tool to delay the establishment of diabetic complications, such as diabetic kidney disease. Together with reducing blood glucose levels, new anti-diabetic agents are expected not only to control the progression but also to restore known defects of the diabetic kidney. Sodium-glucose co-transporter 2 (SGLT2) inhibitors are promising anti-diabetic agents that reduce hyperglycaemia by impairing glucose reabsorption in proximal tubule of the kidney and increasing glucosuria. SGLT2 inhibitors have shown to reduce glucotoxicity in isolated proximal tubule cells and also to attenuate expression of markers of overall kidney damage in experimental animal models of diabetes, but the actual renoprotective effect for downstream nephron segments is still unknown and deserves further attention. Here, we briefly discuss possible undesired effects of enhanced glucosuria and albuminuria in nephron segments beyond the proximal tubule after SGLT2 inhibitor treatment, offering new lines of research to further understand the renoprotective action of these anti-diabetic agents. Strategies blocking glucose reabsorption by renal proximal tubule epithelial cells (RPTEC) may be protective for RPTEC, but downstream nephron segments will still be exposed to high glucose and albumin levels through the luminal face. The actual effect of constant enhanced glucosuria over distal nephron segments remains to be established. J. Cell. Physiol. 231: 1635-1637, 2016. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

  2. The Role of the Kidney and SGLT2 Inhibitors in Type 2 Diabetes.

    Science.gov (United States)

    Katz, Pamela M; Leiter, Lawrence A

    2015-12-01

    Effective glycemic control reduces the risk for diabetes-related complications. However, the majority of patients with type 2 diabetes still do not achieve glycemic targets. Beyond metformin therapy, current practice guidelines for the management of type 2 diabetes recommend individualized treatment based on patient and agent characteristics. The sodium glucose cotransporter type 2 (SGLT2) inhibitors represent a novel treatment strategy, independent of impaired beta-cell function and insulin resistance. SGLT2 inhibitors decrease renal glucose reabsorption, thereby increasing urinary glucose excretion with subsequent reduction in plasma glucose levels and glycosylated hemoglobin concentrations. Current evidence suggests that they are effective as monotherapy or as add-ons to metformin either alone, or in combination with other oral glucose-lowering agents or insulin. They are generally well tolerated, though rates of lower urinary tract and genital mycotic infections are slightly increased. The advantages of this class include modest reductions in body weight and blood pressure, and low risk for hypoglycemia. Long-term safety data and results of ongoing cardiovascular outcome studies are awaited so we can fully understand the role that SGLT2 inhibitors will play in the comprehensive management of type 2 diabetes. Copyright © 2015 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

  3. Effects of Incretin-Based Therapies and SGLT2 Inhibitors on Skeletal Health.

    Science.gov (United States)

    Egger, Andrea; Kraenzlin, Marius E; Meier, Christian

    2016-12-01

    Anti-diabetic drugs are widely used and are essential for adequate glycemic control in patients with type 2 diabetes. Recently, marketed anti-diabetic drugs include incretin-based therapies (GLP-1 receptor agonists and DPP-4 inhibitors) and sodium-glucose co-transporter 2 (SGLT2) inhibitors. In contrast to well-known detrimental effects of thiazolidinediones on bone metabolism and fracture risk, clinical data on the safety of incretin-based therapies is limited. Based on meta-analyses of trials investigating the glycemic-lowering effect of GLP-1 receptor agonists and DPP4 inhibitors, it seems that incretin-based therapies are not associated with an increase in fracture risk. Sodium-glucose co-transporter 2 inhibitors may alter calcium and phosphate homeostasis as a result of secondary hyperparathyroidism induced by increased phosphate reabsorption. Although these changes may suggest detrimental effects of SGLT-2 inhibitors on skeletal integrity, treatment-related direct effects on bone metabolism seem unlikely. Observed changes in BMD, however, seem to result from increased bone turnover in the early phase of drug-induced weight loss. Fracture risk, which is observed in older patients with impaired renal function and elevated cardiovascular disease risk treated with SGLT2 inhibitors, seems to be independent of direct effects on bone but more likely to be associated with falls and changes in hydration status secondary to osmotic diuresis.

  4. The kidney and type 2 diabetes mellitus: therapeutic implications of SGLT2 inhibitors.

    Science.gov (United States)

    Weir, Matthew R

    2016-01-01

    Understanding the role of the kidneys in type 2 diabetes mellitus (T2DM) has taken on an increased importance in recent years with the arrival of sodium-glucose co-transporter 2 (SGLT2) inhibitors - antihyperglycemic agents (AHAs) that specifically target the kidneys. This review includes an update on the physiology of the kidneys, their role in the pathophysiology of T2DM, and the mechanisms implicated in the development and progression of diabetic kidney disease, such as glomerular hyperfiltration and inflammation. It also discusses renal issues that could influence the choice of AHA for patients with T2DM, including special populations such as patients with concomitant chronic kidney disease. The most recent data published on the clinical efficacy and safety of the SGLT2 inhibitors canagliflozin, dapagliflozin, and empagliflozin and their effects on renal function are presented, showing how the renally mediated mechanisms of action of these agents translate into clinical benefits, including the potential for renoprotection. The observed positive effects of these agents on measures such as glucose control, estimated glomerular filtration rate, albumin-to-creatinine ratio, blood pressure, and body weight in patients both with and without impaired renal function suggest that SGLT2 inhibitors represent an important extension to the diabetes treatment armamentarium.

  5. Effects of SGLT2 inhibitors on weight loss in patients with type 2 diabetes mellitus.

    Science.gov (United States)

    Ribola, F A; Cançado, F B; Schoueri, J H M; De Toni, V F; Medeiros, V H R; Feder, D

    2017-01-01

    SGLT2 (sodium-glucose cotransporter type 2) inhibitors are a new class of drugs which reversibly block the glucose reabsorption that occurs in the kidneys. Since their mechanisms of action do not rely on insulin secretion, they constitute a complementary alternative to the classic treatment of type 2 diabetes mellitus. A glycemic level reduction in patients who used SGLT2 inhibitors due to the reversible block of their transporters could be observed. Associated with this, there was a reduction in body weight and blood pressure (BP) caused by osmotic diuresis. Few adverse effects and low drug interaction combined with antihyperglycemic effects are some of the benefits of these inhibitors widely discussed in clinical trials. Patients with history of urogenital infections or those on diuretics must be carefully evaluated before the administration of these drugs. While a promising class of drugs indicated as a treatment for patients with type 2 diabetes mellitus, SGLT2 inhibitors should not be prescribed for individuals with severe renal or hepatic impairment. Therefore, as there are only a few situations in which they should not be indicated, the efficacy, safety and tolerability of these inhibitors allow them to be used in a wide range of patients. Nevertheless, further researches are required so that the possible long-term risks can be studied and the benefits associated with their use can be more objectively elucidated.

  6. Relevance of sodium/glucose cotransporter-1 (SGLT1) to diabetes mellitus and obesity in dogs.

    Science.gov (United States)

    Batchelor, D J; German, A J; Shirazi-Beechey, S P

    2013-04-01

    Glucose transport across the enterocyte brush border membrane by sodium/glucose cotransporter-1 (SGLT1, coded by Slc5a1) is the rate-limiting step for intestinal glucose transport. The relevance of SGLT1 expression in predisposition to diabetes mellitus and to obesity was investigated in dogs. Cultured Caco-2/TC7 cells were shown to express SGLT1 in vitro. A 2-kbp fragment of the Slc5a1 5' flanking region was cloned from canine genomic DNA, ligated into reporter gene plasmids, and shown to drive reporter gene expression in these cells above control (P obesity (Labrador retriever and cocker spaniel). The Slc5a1 5' flanking region was amplified from 10 healthy individuals of each of these breeds by high-fidelity PCR with the use of breed-labeled primers and sequenced by pyrosequencing. The sequence of the Slc5a1 5' flanking region in all individuals of all breeds tested was identical. On this evidence, variations in Slc5a1 promoter sequence between dogs do not influence the pathogenesis of diabetes mellitus or obesity in these breeds. Copyright © 2013 Elsevier Inc. All rights reserved.

  7. Geophysical Observatory in Kamchatka region for monitoring of phenomena connected with seismic activity

    Science.gov (United States)

    Uyeda, S.; Nagao, T.; Hattori, K.; Hayakawa, M.; Miyaki, K.; Molchanov, O.; Gladychev, V.; Baransky, L.; Chtchekotov, A.; Fedorov, E.; Pokhotelov, O.; Andreevsky, S.; Rozhnoi, A.; Khabazin, Y.; Gorbatikov, A.; Gordeev, E.; Chebrov, V.; Sinitzin, V.; Lutikov, A.; Yunga, S.; Kosarev, G.; Surkov, V.; Belyaev, G.

    Regular monitoring of some geophysical parameters in association with seismicity has been carried out since last year at the Japan-Russian Complex Geophysical Observatory in the Kamchatka region. This observatory was organized in connection with the ISTC project in Russia and was motivated by the results of the FRONTIER/RIKEN and FRONTIER/NASDA research projects in Japan. The main purpose of the observations is to investigate the electromagnetic and acoustic phenomena induced by the lithosphere processes (especially by seismic activity). The seismicity of the Kamchatka area is analyzed and a description of the observatory equipment is presented. At present, the activity of the observatory includes the seismic (frequency range ∆F = 0.5 - 40 Hz) and meteorological recordings, together with seismo-acoustic (∆F = 30 - 1000 Hz) and electromagnetic observations: three-component magnetic ULF variations ( ∆F = 0.003 - 30 Hz), three-component electric potential variations ( ∆F < 1.0 Hz), and VLF transmitter's signal perturbations ( ∆F ~ 10 - 40 kHz).

  8. Geophysical Observatory in Kamchatka region for monitoring of phenomena connected with seismic activity

    Directory of Open Access Journals (Sweden)

    S. Uyeda

    2001-01-01

    Full Text Available Regular monitoring of some geophysical parameters in association with seismicity has been carried out since last year at the Japan-Russian Complex Geophysical Observatory in the Kamchatka region. This observatory was organized in connection with the ISTC project in Russia and was motivated by the results of the FRONTIER/RIKEN and FRONTIER/NASDA research projects in Japan. The main purpose of the observations is to investigate the electromagnetic and acoustic phenomena induced by the lithosphere processes (especially by seismic activity. The seismicity of the Kamchatka area is analyzed and a description of the observatory equipment is presented. At present, the activity of the observatory includes the seismic (frequency range ∆F = 0.5 – 40 Hz and meteorological recordings, together with seismo-acoustic (∆F = 30 – 1000 Hz and electromagnetic observations: three-component magnetic ULF variations ( ∆F = 0.003 – 30 Hz, three-component electric potential variations ( ∆F 1.0 Hz, and VLF transmitter’s signal perturbations ( ∆F ~ 10 – 40 kHz.

  9. RECREATION MONITORING OF RESOURCE CONDITIONS IN THE KRONOTSKY STATE NATURAL BIOSPHERE PRESERVE (KAMCHATKA: AN INITIAL ASSESSMENT

    Directory of Open Access Journals (Sweden)

    Anna Zavadskaya

    2011-01-01

    Full Text Available The paper describes assessment and monitoring program which has been designed and initiated for monitoring recreational impacts in some wildernesses areas of Kamchatka. The framework of the recreational assessment was tested through its application in a case study conducted during the summer 2008 in the Kronotsky State Natural Biosphere Preserve (the Kamchatka peninsula, Russia. The overall objective of the case study was to assess the existing campsite and trail recreation impacts and to establish a network of key sites for the subsequent long-term impact monitoring. The detailed assessment of different components of natural complexes of the Kronotsky State Natural Preserve and the obtained maps of their ecological conditions showed that some sites had been highly disturbed. The results of these works have given rise to a concern that the intensive use of these areas would make an unacceptable impact on the nature. Findings of our initial work corroborate the importance of founding wilderness management programs on knowledge about the trail and campsite impacts and emphasize the necessity of adopting the recreational assessment and monitoring framework to the practice of decision-making.

  10. VARIABILITY OF THE WINTER SNOWINESS AT THE SOUTHEAST OF KAMCHATKA PENINSULA

    Directory of Open Access Journals (Sweden)

    A. A. Grits

    2012-01-01

    Full Text Available Analyses of the snow cover depth for several years in the southeast ofKamchatkaPeninsulashow some possibilities for development of skiing, tourism and mountaineering. We found four types of winters in 1935–2006: high-snowy, mid-snowy, little-snowy, and unstable snowy. The average depth of snow for 71 years is133 cmwith minimum of60 cmin 1939 and maximum of272 cmin 2005. The exceptional snowiness gives opportunity to use this territory even in summer months. In some years inKamchatka, the mountain-skiing season lasts a round year. The average date of forming the steady snow cover in the lowlands areas is November 12, and the middle date of the highest snow is May 22. The most comfortable time for recreation on the peninsula in wintertime are observed from the middle of March until the middle of April. During this time, we have the maximum snow, large duration of sunshine and air temperature closed to zero degrees.

  11. Comparative estimates of Kamchatka territory development in the context of northern territories of foreign countries

    Directory of Open Access Journals (Sweden)

    Andrey Gennadyevich Shelomentsev

    2014-06-01

    Full Text Available The article promotes an approach to assess the prospects of regional development on the basis of the synthesis of comparative and historical methods of research. According to the authors, the comparative analysis of the similar functioning of the socio-economic systems forms deeper understanding what part factors and methods of state regulation play in regional development, and also their place in socio-economic and geopolitical space. The object of the research is Kamchatka territory as the region playing strategically important role in socio-economic development of Russia and also northern territories of the other countries comparable with Kamchatka on the bass if environmental conditions such as Iceland, Greenland, USA (Alaska, Canada (Yukon, and Japan (Hokkaido. On the basis of allocation of the general signs of regional socio-economic systems and creation of the regional development models forming the basis for comparative estimates, the article analyses the territories, which are comparable on the base of climatic, geographic, economic, geopolitical conditions, but thus significantly different due to the level of economic familiarity. The generalization of the extensive statistical material characterizing various spheres of activity at these territories, including branch structure of the economy, its infrastructure security, demographic situation, the budgetary and financial sphere are given. It allows defining the crucial features of the regional economy development models. In the conclusion, the authors emphasize that ignoring of the essential relations among the regional system elements and internal and external factors deprives a research of historical and socio-economic basis.

  12. Positive geothermal anomalies in oceanic crust of Cretaceous age offshore Kamchatka

    Directory of Open Access Journals (Sweden)

    G. Delisle

    2011-09-01

    Full Text Available Heat flow measurements were carried out in 2009 offshore Kamchatka during the German-Russian joint-expedition KALMAR. An area with elevated heat flow in oceanic crust of Cretaceous age – detected ~30 yr ago in the course of several Russian heat flow surveys – was revisited. One previous interpretation postulated anomalous lithospheric conditions or a connection between a postulated mantle plume at great depth (>200 km as the source for the observed high heat flow. However, the positive heat flow anomaly – as our bathymetric data show – is closely associated with the fragmentation of the western flank of the Meiji Seamount into a horst and graben structure initiated during descent of the oceanic crust into the subduction zone offshore Kamchatka. This paper offers an alternative interpretation, which connects high heat flow primarily with natural convection of fluids in the fragmented rock mass and, as a potential additional factor, high rates of erosion, for which evidence is available from our collected bathymetric image. Given high erosion rates, warm rock material at depth rises to nearer the sea floor, where it cools and causes temporary elevated heat flow.

  13. Kamchatka subduction zone, May 2013: the Mw 8.3 deep earthquake, preceding shallow swarm and numerous deep aftershocks

    Czech Academy of Sciences Publication Activity Database

    Špičák, Aleš; Vaněk, Jiří

    2014-01-01

    Roč. 58, č. 1 (2014), s. 76-83 ISSN 0039-3169 Institutional support: RVO:67985530 Keywords : Kamchatka * deep earthquake * earthquake swarm * Wadati-Benioff zone Subject RIV: DC - Siesmology, Volcanology, Earth Structure Impact factor: 0.806, year: 2014

  14. The oil and gas presence of Sakhalin, Kamchatka and Chukotsk. Neftegazonosnost' Sakhalina, Kamchatki i Chukotki

    Energy Technology Data Exchange (ETDEWEB)

    Yusupov, B.Kh.

    1983-01-01

    A characterization of the geological structure and the prospects for oil and gas presence in Sakhalin, Kamchatka and Chukotka are given. The possibilities of using a transformed field of gravity for studying the oil and gas bearing series of Sakhalin and methods for oil field geophysics are analyzed in an example of the Okruzhnoy oil formation.

  15. Targeting Type 2 Diabetes with C-Glucosyl Dihydrochalcones as Selective Sodium Glucose Co-Transporter 2 (SGLT2) Inhibitors: Synthesis and Biological Evaluation.

    Science.gov (United States)

    Jesus, Ana R; Vila-Viçosa, Diogo; Machuqueiro, Miguel; Marques, Ana P; Dore, Timothy M; Rauter, Amélia P

    2017-01-26

    Inhibiting glucose reabsorption by sodium glucose co-transporter proteins (SGLTs) in the kidneys is a relatively new strategy for treating type 2 diabetes. Selective inhibition of SGLT2 over SGLT1 is critical for minimizing adverse side effects associated with SGLT1 inhibition. A library of C-glucosyl dihydrochalcones and their dihydrochalcone and chalcone precursors was synthesized and tested as SGLT1/SGLT2 inhibitors using a cell-based fluorescence assay of glucose uptake. The most potent inhibitors of SGLT2 (IC 50 = 9-23 nM) were considerably weaker inhibitors of SGLT1 (IC 50 = 10-19 μM). They showed no effect on the sodium independent GLUT family of glucose transporters, and the most potent ones were not acutely toxic to cultured cells. The interaction of a C-glucosyl dihydrochalcone with a POPC membrane was modeled computationally, providing evidence that it is not a pan-assay interference compound. These results point toward the discovery of structures that are potent and highly selective inhibitors of SGLT2.

  16. Synthesis and biological evaluation of novel tetrahydroisoquinoline-C-aryl glucosides as SGLT2 inhibitors for the treatment of type 2 diabetes.

    Science.gov (United States)

    Pan, Xuan; Huan, Yi; Shen, Zhufang; Liu, Zhanzhu

    2016-05-23

    A series of novel tetrahydroisoquinoline-C-aryl glucosides has been synthesized and evaluated for the inhibition of human SGLT2. Compared with dapagliflozin, compound 13h exhibited equivalent in vitro inhibitory activity against SGLT2, which might become a promising candidate for the treatment of type 2 diabetes. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  17. Sodium-glucose co-transporter 2 (SGLT2 inhibitors: a growing class of anti-diabetic agents

    Directory of Open Access Journals (Sweden)

    Eva M Vivian

    2014-12-01

    Full Text Available Although several treatment options are available to reduce hyperglycemia, only about half of individuals with diagnosed diabetes mellitus (DM achieve recommended glycemic targets. New agents that reduce blood glucose concentrations by novel mechanisms and have acceptable safety profiles are needed to improve glycemic control and reduce the complications associated with type 2 diabetes mellitus (T2DM. The renal sodium-glucose co-transporter 2 (SGLT2 is responsible for reabsorption of most of the glucose filtered by the kidney. Inhibitors of SGLT2 lower blood glucose independent of the secretion and action of insulin by inhibiting renal reabsorption of glucose, thereby promoting the increased urinary excretion of excess glucose. Canagliflozin, dapagliflozin, and empagliflozin are SGLT2 inhibitors approved as treatments for T2DM in the United States, Europe, and other countries. Canagliflozin, dapagliflozin, and empagliflozin increase renal excretion of glucose and improve glycemic parameters in patients with T2DM when used as monotherapy or in combination with other antihyperglycemic agents. Treatment with SGLT2 inhibitors is associated with weight reduction, lowered blood pressure, and a low intrinsic propensity to cause hypoglycemia. Overall, canagliflozin, dapagliflozin, and empagliflozin are well tolerated. Cases of genital infections and, in some studies, urinary tract infections have been more frequent in canagliflozin-, dapagliflozin-, and empagliflozin-treated patients compared with those receiving placebo. Evidence from clinical trials suggests that SGLT2 inhibitors are a promising new treatment option for T2DM.

  18. Characterization and comparison of SGLT2 inhibitors: Part 3. Effects on diabetic complications in type 2 diabetic mice.

    Science.gov (United States)

    Tahara, Atsuo; Takasu, Toshiyuki; Yokono, Masanori; Imamura, Masakazu; Kurosaki, Eiji

    2017-08-15

    In this study, we investigated and compared the effects of all six sodium-glucose cotransporter (SGLT) 2 inhibitors commercially available in Japan on diabetes-related diseases and complications in type 2 diabetic mice. Following 4-week repeated administration to diabetic mice, all SGLT2 inhibitors showed significant improvement in diabetes-related diseases and complications, including obesity; abnormal lipid metabolism; steatohepatitis; inflammation; endothelial dysfunction; and nephropathy. While all SGLT2 inhibitors exerted comparable effects in reducing hyperglycemia, improvement of these diabetes-related diseases and complications was more potent with the two long-acting drugs (ipragliflozin and dapagliflozin) than with the four intermediate-acting four drugs (tofogliflozin, canagliflozin, empagliflozin, and luseogliflozin), albeit without statistical significance. These findings demonstrate that SGLT2 inhibitors alleviate various diabetic pathological conditions in type 2 diabetic mice, and suggest that SGLT2 inhibitors, particularly long-acting drugs, might be useful not only for hyperglycemia but also in diabetes-related diseases and complications, including nephropathy in type 2 diabetes. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. Volcanic-glacial interactions: GIS applications to the assessment of lahar hazards (case study of Kamchatka

    Directory of Open Access Journals (Sweden)

    Ya. D. Muraviev

    2014-01-01

    Full Text Available On the Kamchatka peninsula, lahars or volcanogenic mudflows arise as a result of intensive snow melting caused by incandescent material ejected by volcanoes onto the surface. Such flows carrying volcanic ash and cinders together with lava fragments and blocks move with a speed up to 70 km/h that can result in significant destructions and even human victims. Formation of such water flows is possible during the whole year.Large-scale GIS «Hazards of lahars (volcanogenic mudflows» has been developed for some volcano group as well as for individual volcanoes on the peninsula in framework of the GIS «Volcanic hazard of the Kuril-Kamchatka island arc». Main components of this database are the following: physic-geographical information on region of active volcanism and adjacent areas, on human settlements; data on the mudflow activity; data on distribution of the snow and ice reserves. This database is aimed at mapping of surrounding territories and estimating a hazard of lahars.For illustration the paper presents a map of the lahar hazards, results of calculations of the distances of ejects and maximal area of ejected material spreading in dependence on a character and power of an eruption. In future we plan to perform operational calculations of maximal possible volumes of such flows and areas of their spreading. The calculations will be made on the basis of the GIS «Volcanic hazard of the Kuril-Kamchatka island arc».A volume of hard material carried by lahars onto slopes and down to foot of the Kluchevskaya volcanic massif is estimated on the basis of data on the snow and ice reserves on volcano slopes. On the average for many years, the snow accumulation in zones of the mudflow formations their volume often reaches 15–17 millions of cubic meters. Depending on the snowfall activity in different years this value may vary within 50% relative to the norm. Further on, calculations of maximal possible volume of such flows will be performed in a

  20. Self-potential monitoring around wells in Mutnovsky geothermal field, Kamchatka; Kamchatka hanto mutnovsky deno chinetsui shuhen no shizen den`i monitoring

    Energy Technology Data Exchange (ETDEWEB)

    Matsushima, N.; Tosha, T.; Ishito, K. [Geological Survey of Japan Ibaragi (Japan); Delemen, I.; Kiryukhin, A. [Institute of Volcanology Far East Branch Russia Academy of Sciences (Russia)

    1997-07-01

    Mutnovsky is a geothermal field which lies to the south of and about 80km away from Petropavlovsk, Kamchatsky, the state capital of Kamchatka. The geothermal survey has been conducted since 1978 in this field. In this study, the self-potential variation was observed by monitoring the potential difference between places near and far from a well in the same region. Then, the self-potential associated with spurting vapor from a well was analyzed using a model of the self-potential generated from the steaming current coupled with the flow of hot water in the porous medium. As results of an experiment on the spurt of stream, vapor containing 80% stream in weight was exhausted at a mass flow rate of 30kg/sec at 100degC from wells. Since the specific enthalpy of this vapor is 2225kJ/kg, the underground geothermal storage layer was estimated to be a state of liquid and vapor two-phase. 9 refs., 6 figs.

  1. Isotopic composition of late neogene K-Na alkaline basalts of eastern Kamchatka: indicators of the heterogeneity of the Mantle magma sources

    International Nuclear Information System (INIS)

    Volynets, O.N.; Karpenko, S.F.; Kehj, R.U.; Gorring, M.

    1997-01-01

    Isotopic composition of Sr, O, Nd, and Pb was determined in K-Na alkaline gabbroids and basaltoids that formed in eastern Kamchatka during Middle Miocene (gabbroids of the sub volcanic complex) and Late Miocene (basaltoids of the volcanic complex) time, before the origin of the Eastern Kamchatka Volcanic Belt. Isotopic data provide further evidence that the sources of the late Cenozoic volcanics of the within-plate and island-arc geochemical types were different

  2. The "Tsunami Earthquake" of 13 April 1923 in Northern Kamchatka: Seismological and Hydrodynamic Investigations

    Science.gov (United States)

    Salaree, Amir; Okal, Emile A.

    2018-04-01

    We present a seismological and hydrodynamic investigation of the earthquake of 13 April 1923 at Ust'-Kamchatsk, Northern Kamchatka, which generated a more powerful and damaging tsunami than the larger event of 03 February 1923, thus qualifying as a so-called "tsunami earthquake". On the basis of modern relocations, we suggest that it took place outside the fault area of the mainshock, across the oblique Pacific-North America plate boundary, a model confirmed by a limited dataset of mantle waves, which also confirms the slow nature of the source, characteristic of tsunami earthquakes. However, numerical simulations for a number of legitimate seismic models fail to reproduce the sharply peaked distribution of tsunami wave amplitudes reported in the literature. By contrast, we can reproduce the distribution of reported wave amplitudes using an underwater landslide as a source of the tsunami, itself triggered by the earthquake inside the Kamchatskiy Bight.

  3. New insights into the abyssal sponge fauna of the Kurile-Kamchatka plain and Trench region (Northwest Pacific)

    Science.gov (United States)

    Downey, Rachel V.; Janussen, Dorte

    2015-01-01

    The under-explored abyssal depths of the Kurile-Kamchatka region have been re-examined during the KuramBio (Kurile-Kamchatka Biodiversity Study) expedition. Combining new KuramBio data with previous expedition data in this region has enhanced our understanding abyssal sponge fauna, in particular, the patchiness, rarity, and exceptional richness of the Cladorhizidae family. In total, 14 sponge species, from 7 genera, in 5 families, within two classes (Demospongiae and Hexactinellida) were collected. Of the 14 species, 29% (4 spp.) have been found previously in this region, 36% (5 spp.) were new to the regional abyssal fauna, and 21% (3 spp.) were new to science. The number of abyssal species in this region has now been increased by 26% (8 spp.) and genera by nearly 15% (2 genera). Rarity is a prominent feature of this abyssal fauna, with more than half of species only found at one station, and 83% (19 spp.) of species found previously in this region were not re-found during KuramBio. Cladorhizid sponges dominate demosponge species and genera richness in the abyssal Kurile-Kamchatka region; accounting for 87% (20 spp.) of all demosponge species, and accounting for over 60% (5 genera) of all demosponge genera. Sponge richness in this region is potentially aided by the productivity of the ocean waters, the geological age of the Pacific Ocean, low population densities, and the varied topographic features (ridges, trenches, and seamounts) found in this region. Unusually, the dominance of demosponges in the Kurile-Kamchatka sponge faunal composition is not replicated in other well-sampled abyssal regions, which tend to be richer in deep-sea hexactinellid fauna. Broad depth, latitudinal and longitudinal ranges in Kurile-Kamchatka abyssal fauna are a key characteristic of this faunal assemblage. Strong abyssal faunal connectivity is found between the Kurile-Kamchatka region and North Pacific abyssal fauna, with weaker faunal connections found with the adjacent semi

  4. Multi-disciplinary approach in volcanic areas: case study of Kamchatka, Far East of Russia

    Science.gov (United States)

    Kuznetsova, Elena

    2017-04-01

    Volcanic ash is associated with a considerable proportion of the Earth's land surface. At the same time, it is estimated that 15% of the land surface is affected by permafrost and glacial ice. As a consequences volcanic ash may play an important role in the aggradation and degradation of cold regions (Kellerer-Pirklbauer et al., 2007; Froese et al., 2008). An understanding of the influence of volcanic ash on these frozen areas allows for more accurate prediction of their stability in the future and provides a better knowledge of the factors affecting past climates, soils and soil stability. Vital to making accurate predictions is an understanding of the thermal properties of volcanic ash (Juen et al., 2013). For example, even for the same region of Kamchatka in eastern Russia volcanic ash may have not only different ages, different chemical composition of the glass, but also different weathering stages, mineralogical composition, and water saturation, furthermore, these ashes may be permanently frozen or unfrozen, all of which may affect their thermal properties (Kuznetsova & Motenko, 2014). These differences might be the reason why the critical thickness of tephra, at which the effect on ice and snow is rather insulating than ablative, for the volcanic material from different volcanoes may vary so much. The determined values of critical thickness deviate from 24 mm reported by Driedger (1980) for the glaciers at Mt. St. Helens, USA, and by (Manville et al., 2000) for tephra erupted in 1996 by Mt. Ruapehu, New Zealand, to weathering and new minerals formation (e.g. allophane, palagonite). The special properties of volcanic ash are critically reviewed particularly in relation to recent research in Kamchatka in the Far East of Russia. Of particular importance are the thermal properties and the unfrozen water contents of ash layers and the rate at which the weathering of volcanic glass takes place.

  5. [Scattered light and glare sensitivity after wavefront-guided photorefractive keratectomy (WFG-PRK) and laser in situ keratomileusis (WFG-LASIK)].

    Science.gov (United States)

    Vignal, R; Tanzer, D; Brunstetter, T; Schallhorn, S

    2008-05-01

    To compare glare sensitivity measured by the intraocular scattered light between WFG-PRK and WFG-LASIK at 12 months follow-up and to assess its correlation to patients' complaints. Prospective and randomized study on 13 patients treated with WFG-LASIK, 13 patients with WFG-PRK and a control group of 35 patients. The intraocular stray light was measured by the Oculus C-Quant 12 months after surgery and before surgery for the control group. Photopic and mesopic contrast acuity and glare symptoms were reported pre- and postoperatively. Stray light values were normal in 79% of patients after WFG-LASIK and PRK and 86% in the control group, with mean values of 1.05 log, 1.03 log, and 0.99 log, respectively (p>0.05). All the patients with significant glare complaints had impaired stray light values versus 31.5% in the no-complaint group. Photopic and mesopic contrast acuity and glare symptoms were improved 1 year after surgery compared to preoperatively (no significant difference between groups). WFG-LASIK and PRK are safe and equivalent procedures regarding quality of vision. The measurement of stray light can be a discriminative test to assessing patients' glare complaints.

  6. Blood pressure effects of sodium-glucose co-transport 2 (SGLT2) inhibitors.

    Science.gov (United States)

    Oliva, Raymond V; Bakris, George L

    2014-05-01

    Management of hypertension in diabetes is critical for reduction of cardiovascular mortality and morbidity. While blood pressure (BP) control has improved over the past two decades, the control rate is still well below 50% in the general population of patients with type 2 diabetes mellitus (T2DM). A new class of oral glucose-lowering agents has recently been approved; the sodium-glucose co-transporter 2 (SGLT2) inhibitors, which act by eliminating large amounts of glucose in the urine. Two agents, dapagliflozin and canagliflozin, are currently approved in the United States and Europe, and empagliflozin and ipragliflozin have reported Phase 3 trials. In addition to glucose lowering, SGLT2 inhibitors are associated with weight loss and act as osmotic diuretics, resulting in a lowering of BP. While not approved for BP-lowering, they may potentially aid BP goal achievement in people within 7-10 mm Hg of goal. It should be noted that the currently approved agents have side effects that include an increased incidence of genital infections, predominantly in women. The approved SGLT2 inhibitors have limited use based on kidney function and should be used only in those with an estimated glomerular filtration rate (eGFR) > 60 mL/min/1.73 m2 for dapagliflozin and ≥45 mL/min/1.73 m2 for canagliflozin. Cardiovascular outcome trials are ongoing with these agents and will be completed within the next 4-5 years. Copyright © 2014 American Society of Hypertension. Published by Elsevier Inc. All rights reserved.

  7. Possible Increase in Serum FABP4 Level Despite Adiposity Reduction by Canagliflozin, an SGLT2 Inhibitor.

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    Masato Furuhashi

    Full Text Available Fatty acid-binding protein 4 (FABP4/A-FABP/aP2 is secreted from adipocytes in association with catecholamine-induced lipolysis, and elevated serum FABP4 level is associated with obesity, insulin resistance and atherosclerosis. Secreted FABP4 as a novel adipokine leads to insulin resistance via increased hepatic glucose production (HGP. Sodium-glucose cotransporter 2 (SGLT2 inhibitors decrease blood glucose level via increased urinary glucose excretion, though HGP is enhanced. Here we investigated whether canagliflozin, an SGLT2 inhibitor, modulates serum FABP4 level.Canagliflozin (100 mg/day was administered to type 2 diabetic patients (n = 39 for 12 weeks. Serum FABP4 level was measured before and after treatment.At baseline, serum FABP4 level was correlated with adiposity, renal dysfunction and noradrenaline level. Treatment with canagliflozin significantly decreased adiposity and levels of fasting glucose and HbA1c but increased average serum FABP4 level by 10.3% (18.0 ± 1.0 vs. 19.8 ± 1.2 ng/ml, P = 0.008, though elevation of FABP4 level after treatment was observed in 26 (66.7% out of 39 patients. Change in FABP4 level was positively correlated with change in levels of fasting glucose (r = 0.329, P = 0.044, HbA1c (r = 0.329, P = 0.044 and noradrenaline (r = 0.329, P = 0.041 but was not significantly correlated with change in adiposity or other variables.Canagliflozin paradoxically increases serum FABP4 level in some diabetic patients despite amelioration of glucose metabolism and adiposity reduction, possibly via induction of catecholamine-induced lipolysis in adipocytes. Increased FABP4 level by canagliflozin may undermine the improvement of glucose metabolism and might be a possible mechanism of increased HGP by inhibition of SGLT2.UMIN-CTR Clinical Trial UMIN000018151.

  8. Positioning SGLT2 Inhibitors/Incretin-Based Therapies in the Treatment Algorithm.

    Science.gov (United States)

    Wilding, John P H; Rajeev, Surya Panicker; DeFronzo, Ralph A

    2016-08-01

    Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are the most recent addition to the therapeutic options available for the treatment of type 2 diabetes and became available after the introduction of incretin-based therapies, dipeptidyl peptidase 4 inhibitors and glucagon-like peptide 1 receptor agonists (GLP-1 RAs). These agents have potential advantages with regard to their weight loss-promoting effect, low risk of hypoglycemia, reduction in blood pressure, and reduction in cardiovascular events in high-risk patients (with empagliflozin). Apart from these clinically important outcomes, they may also correct core defects present in type 2 diabetes (i.e., improvement in β-cell function and insulin sensitivity). They do, however, have some adverse effects, notably, nausea with GLP-1 RAs and genital tract infections and potential for volume depletion with SGLT2i. Whether incretin-based therapies are associated with an increased risk of pancreatitis is unclear. Most recently, diabetic ketoacidosis has been reported with SGLT2i. Therefore, a key clinical question in relation to guidelines is whether these clinical advantages, in the context of the adverse effect profile, outweigh the additional cost compared with older, more established therapies. This article reviews the therapeutic rationale for the use of these newer drugs for diabetes treatment, considers their place in current guidelines, and discusses how this may change as new data emerge about their long-term efficacy and safety from ongoing outcome trials. © 2016 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

  9. Unmasking a sustained negative effect of SGLT2 inhibition on body fluid volume in the rat.

    Science.gov (United States)

    Masuda, Takahiro; Watanabe, Yuko; Fukuda, Keiko; Watanabe, Minami; Onishi, Akira; Ohara, Ken; Imai, Toshimi; Koepsell, Hermann; Muto, Shigeaki; Vallon, Volker; Nagata, Daisuke

    2018-05-23

    The chronic intrinsic diuretic and natriuretic tone of sodium-glucose cotransporter 2 (SGLT2) inhibitors is incompletely understood, because their effect on body fluid volume (BFV) has not been fully evaluated and because they often increase food and fluid intake at the same time. Here we first compared the effect of the SGLT2 inhibitor ipragliflozin (Ipra, 0.01% in diet for 8 weeks) and vehicle (Veh) in Spontaneously Diabetic Torii rat, a non-obese type 2 diabetic model, and non-diabetic Sprague-Dawley rats. In non-diabetic rats, Ipra increased urinary excretion of Na+ (UNaV) and fluid (UV) associated with increased food and fluid intake. Diabetes increased these 4 parameters, but Ipra had no further effect; probably due to its antihyperglycemic effect, such that glucosuria and as a consequence food and fluid intake were unchanged. Fluid balance and BFV, determined by bioimpedance spectroscopy, were similar among the 4 groups. To study the impact of food and fluid intake, non-diabetic rats were treated for 7 days with Veh, Ipra or Ipra+pair-feeding+pair-drinking (Pair-Ipra). Pair-Ipra maintained a small increase in UV and UNaV versus Veh despite similar food and fluid intake. Pair-Ipra induced a negative fluid balance and decreased BFV, while Ipra or Veh had no significant effect compared with basal values. In conclusion, SGLT2 inhibition induces a sustained diuretic and natriuretic tone. Homeostatic mechanisms are activated to stabilize body fluid volume, including compensatory increases in fluid and food intake.

  10. Sodium-glucose cotransporter 2 (SGLT2) inhibitors and fracture risk in patients with type 2 diabetes mellitus: A meta-analysis.

    Science.gov (United States)

    Ruanpeng, Darin; Ungprasert, Patompong; Sangtian, Jutarat; Harindhanavudhi, Tasma

    2017-09-01

    Sodium-glucose cotransporter 2 (SGLT2) inhibitors could potentially alter calcium and phosphate homeostasis and may increase the risk of bone fracture. The current meta-analysis was conducted to investigate the fracture risk among patients with type 2 diabetes mellitus treated with SGLT2 inhibitors. Randomized controlled trials that compared the efficacy of SGLT2 inhibitors to placebo were identified. The risk ratios of fracture among patients who received SGLT2 inhibitors versus placebo were extracted from each study. Pooled risk ratios and 95% confidence intervals were calculated using a random-effect, Mantel-Haenszel analysis. A total of 20 studies with 8286 patients treated with SGLT2 inhibitors were included. The pooled risk ratio of bone fracture in patients receiving SGLT2 inhibitors versus placebo was 0.67 (95% confidence interval, 0.42-1.07). The pooled risk ratio for canagliflozin, dapagliflozin, and empagliflozin was 0.66 (95% confidence interval, 0.37-1.19), 0.84 (95% confidence interval, 0.22-3.18), and 0.57 (95% confidence interval, 0.20-1.59), respectively. Increased risk of bone fracture among patients with type 2 diabetes mellitus treated with SGLT2 inhibitors compared with placebo was not observed in this meta-analysis. However, the results were limited by short duration of treatment/follow-up and low incidence of the event of interest. Copyright © 2017 John Wiley & Sons, Ltd.

  11. Safety of Sodium-Glucose Cotransporter 2 Inhibitors (SGLT2-I During the Month of Ramadan in Muslim Patients with Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Alaaeldin Bashier

    2018-03-01

    Full Text Available Objectives: Sodium-glucose cotransporter 2 inhibitors (SGLT2-I are a new class of antidiabetic drugs that might increase the risk of dehydration and hypoglycemia, particularly during the month of Ramadan in which Muslims abstain from eating and drinking for 14–16 hours daily. We aimed to provide real-life evidence about the safety of SGLT2-I during Ramadan. Methods: All patients over the age of 18 years on SGLT2-I before Ramadan 2016 who would be fasting during Ramadan were included. Demographic data, detailed medical history including comorbidities and medication profile, and laboratory results were collected before and after Ramadan. We also conducted a phone interview to evaluate the frequency and severity of hypoglycemia and dehydration. Results: Of the total of 417 patients, 113 (27.0% experienced hypoglycemic events, and 93 of these (82.3% checked their blood glucose using a glucometer. Confirmed hypoglycemia (< 70 mg/dL was observed in 78 (83.8%. The hypoglycemic events were significantly more frequent in the SGLT2-I plus insulin-treated group than in those treated with SGLT2-I plus oral hypoglycemic agents group (p < 0.001. Confirmed hypoglycemic events were more frequent in those using SGLT2-I plus intensive insulin compared to those using SGLT2-I plus basal insulin (p = 0.020. Symptoms of dehydration were seen in 9.3% (n = 39 of the total population. We observed statistically significant reductions in glycated hemoglobin and weight by the end of Ramadan (p < 0.001. There were no significant changes in lipid profile and creatinine levels by the end of the study. Conclusions: The use of insulin in combination with SGLT2-I increases the risk of hypoglycemia during Ramadan. Hypoglycemic events were mild and did not require hospital admission. However, careful monitoring during prolonged fasting is warranted. No significant harmful effects on renal function result from treatment with SGLT2-I during Ramadan.

  12. SGLT2 inhibitor empagliflozin reduces renal growth and albuminuria in proportion to hyperglycemia and prevents glomerular hyperfiltration in diabetic Akita mice

    Science.gov (United States)

    Gerasimova, Maria; Rose, Michael A.; Masuda, Takahiro; Satriano, Joseph; Mayoux, Eric; Koepsell, Hermann; Thomson, Scott C.; Rieg, Timo

    2013-01-01

    Our previous work has shown that gene knockout of the sodium-glucose cotransporter SGLT2 modestly lowered blood glucose in streptozotocin-diabetic mice (BG; from 470 to 300 mg/dl) and prevented glomerular hyperfiltration but did not attenuate albuminuria or renal growth and inflammation. Here we determined effects of the SGLT2 inhibitor empagliflozin (300 mg/kg of diet for 15 wk; corresponding to 60–80 mg·kg−1·day−1) in type 1 diabetic Akita mice that, opposite to streptozotocin-diabetes, upregulate renal SGLT2 expression. Akita diabetes, empagliflozin, and Akita + empagliflozin similarly increased renal membrane SGLT2 expression (by 38–56%) and reduced the expression of SGLT1 (by 33–37%) vs. vehicle-treated wild-type controls (WT). The diabetes-induced changes in SGLT2/SGLT1 protein expression are expected to enhance the BG-lowering potential of SGLT2 inhibition, and empagliflozin strongly lowered BG in Akita (means of 187–237 vs. 517–535 mg/dl in vehicle group; 100–140 mg/dl in WT). Empagliflozin modestly reduced GFR in WT (250 vs. 306 μl/min) and completely prevented the diabetes-induced increase in glomerular filtration rate (GFR) (255 vs. 397 μl/min). Empagliflozin attenuated increases in kidney weight and urinary albumin/creatinine ratio in Akita in proportion to hyperglycemia. Empagliflozin did not increase urinary glucose/creatinine ratios in Akita, indicating the reduction in filtered glucose balanced the inhibition of glucose reabsorption. Empagliflozin attenuated/prevented the increase in systolic blood pressure, glomerular size, and molecular markers of kidney growth, inflammation, and gluconeogenesis in Akita. We propose that SGLT2 inhibition can lower GFR independent of reducing BG (consistent with the tubular hypothesis of diabetic glomerular hyperfiltration), while attenuation of albuminuria, kidney growth, and inflammation in the early diabetic kidney may mostly be secondary to lower BG. PMID:24226524

  13. Computed vs. conventional radiography for detecting fatigue cracks in riveted lap joints of aeronautical grade hybrid fiber-metal laminate Glare

    International Nuclear Information System (INIS)

    Tarpani, J.R.; Hideki Shinohara, A.; Da Silva, R.R.; Do Val Lacerda, N.

    2007-01-01

    This study aimed at assessing the capability of three different radiographic approaches (two computed or digital, and one conventional or analogous) for imaging fatigue cracks in riveted lap joints of composite fiber-metal laminate Glare. These structural joints are unique in the sense that fatigue cracks develop mainly at the faying surfaces of Glare sheets, so that visual detection is largely prevented and nondestructive inspection becomes mandatory. For this purpose, a round-robin programme comprising several industrial and research centers that employ X-ray radiography routinely to inspect high-demanding equipments, components and structures was conducted. (authors)

  14. Canagliflozin, an SGLT2 inhibitor, attenuates the development of hepatocellular carcinoma in a mouse model of human NASH.

    Science.gov (United States)

    Shiba, Kumiko; Tsuchiya, Kyoichiro; Komiya, Chikara; Miyachi, Yasutaka; Mori, Kentaro; Shimazu, Noriko; Yamaguchi, Shinobu; Ogasawara, Naomi; Katoh, Makoto; Itoh, Michiko; Suganami, Takayoshi; Ogawa, Yoshihiro

    2018-02-05

    Sodium glucose cotransporter 2 (SGLT2) inhibitors, an antidiabetic drug, promotes urinary excretion of glucose by blocking its reabsorption in the renal proximal tubules. It is unclear whether SGLT2 inhibition could attenuate nonalcoholic steatohepatitis (NASH) and NASH-associated hepatocellular carcinoma. We examined the preventive effects of an SGLT2 inhibitor canagliflozin (CANA) in Western diet (WD)-fed melanocortin 4 receptor-deficient (MC4R-KO) mice, a mouse model of human NASH. An eight-week CANA treatment attenuated hepatic steatosis in WD-fed MC4R-KO mice, with increased epididymal fat mass without inflammatory changes. CANA treatment for 20 weeks inhibited the development of hepatic fibrosis in WD-fed MC4R-KO mice. After one year of CANA treatment, the number of liver tumors was significantly reduced in WD-fed MC4R-KO mice. In adipose tissue, CANA suppressed the ratio of oxidative to reduced forms of glutathiones (GSSG/GSH) in WD-fed MC4R-KO mice. Treatment with GSH significantly attenuated the H 2 O 2 -induced upregulation of genes related to NADPH oxidase in 3T3-L1 adipocytes, and that of Il6, Tgfb, and Pdgfb in RAW264.7 cells. This study provides evidence that SGLT2 inhibitors represent the unique class of drugs that can attenuate or delay the onset of NASH and eventually hepatocellular carcinoma, at least partly, through "healthy adipose expansion".

  15. Molecular Modeling Studies of Thiophenyl C-Aryl Glucoside SGLT2 Inhibitors as Potential Antidiabetic Agents

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    Mukesh C. Sharma

    2014-01-01

    Full Text Available A QSAR study on thiophenyl derivatives as SGLT2 inhibitors as potential antidiabetic agents was performed with thirty-three compounds. Comparison of the obtained results indicated the superiority of the genetic algorithm over the simulated annealing and stepwise forward-backward variable method for feature selection. The best 2D QSAR model showed satisfactory statistical parameters for the data set (r2=0.8499, q2=0.8267, and pred_r2=0.7729 with four descriptors describing the nature of substituent groups and the environment of the substitution site. Evaluation of the model implied that electron-rich substitution position improves the inhibitory activity. The good predictive 3D-QSAR models by k-nearest neighbor (kNN method for molecular field analysis (MFA have cross-validated coefficient q2 value of 0.7663 and predicted r2 value of 0.7386. The results have showed that thiophenyl groups are necessary for activity and halogen, bulky, and less bulky groups in thiophenyl nucleus enhanced the biological activity. These studies are promising for the development of novel SGLT2 inhibitor, which may have potent antidiabetic activity.

  16. The SGLT2 Inhibitor Dapagliflozin Significantly Improves the Peripheral Microvascular Endothelial Function in Patients with Uncontrolled Type 2 Diabetes Mellitus.

    Science.gov (United States)

    Sugiyama, Seigo; Jinnouchi, Hideaki; Kurinami, Noboru; Hieshima, Kunio; Yoshida, Akira; Jinnouchi, Katsunori; Nishimura, Hiroyuki; Suzuki, Tomoko; Miyamoto, Fumio; Kajiwara, Keizo; Jinnouchi, Tomio

    2018-03-30

    Objective Sodium-glucose cotransporter-2 (SGLT2) inhibitors reduce cardiovascular events and decrease the body fat mass in patients with type 2 diabetes mellitus (T2DM). We examined whether or not the SGLT2-inhibitor dapagliflozin can improve the endothelial function associated with a reduction in abdominal fat mass. Methods We prospectively recruited patients with uncontrolled (hemoglobin A1c [HbA1c] >7.0%) T2DM who were not being treated by SGLT2 inhibitors. Patients were treated with add-on dapagliflozin (5 mg/day) or non-SGLT2 inhibitor medicines for 6 months to improve their HbA1c. We measured the peripheral microvascular endothelial function as assessed by reactive hyperemia peripheral arterial tonometry (RH-PAT) and calculated the natural logarithmic transformed value of the RH-PAT index (LnRHI). We then investigated changes in the LnRHI and abdominal fat area using computed tomography (CT). Results The subjects were 54 patients with uncontrolled T2DM (72.2% men) with a mean HbA1c of 8.1%. The HbA1c was significantly decreased in both groups, with no significant difference between the groups. Dapagliflozin treatment, but not non-SGLT2 inhibitor treatment, significantly increased the LnRHI. The changes in the LnRHI were significantly greater in the dapagliflozin group than in the non-SGLT2 inhibitor group. Dapagliflozin treatment, but not non-SGLT2 inhibitor treatment, significantly decreased the abdominal visceral fat area, subcutaneous fat area (SFA), and total fat area (TFA) as assessed by CT and significantly increased the plasma adiponectin levels. The percentage changes in the LnRHI were significantly correlated with changes in the SFA, TFA, systolic blood pressure, and adiponectin. Conclusion Add-on treatment with dapagliflozin significantly improves the glycemic control and endothelial function associated with a reduction in the abdominal fat mass in patients with uncontrolled T2DM.

  17. Constraining recent Shiveluch volcano eruptions (Kamchatka, Russia by means of dendrochronology

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    O. Solomina

    2008-10-01

    Full Text Available Shiveluch (N 56°38´, E 161°19´; elevation: active dome ~2500 m, summit of Old Shiveluch 3283 m is one of the most active volcanoes in Kamchatka. The eruptions of Shiveluch commonly result in major environmental damage caused by debris avalanches, hot pyroclastic flows, tephra falls and lahars. Constraining these events in time and space is important for the understanding and prediction of these natural hazards. The last major eruption of Shiveluch occurred in 2005; earlier ones, dated by instrumental, historical, 14C and tephrochronological methods, occurred in the last millennium around AD 1030, 1430, 1650, 1739, 1790–1810, 1854, 1879–1883, 1897–1898, 1905, 1927–1929, 1944–1950, and 1964. A lava dome has been growing in the 1964 crater since 1980, occasionally producing tephra falls and pyroclastic flows. Several Shiveluch eruptions (~AD 1050, 1650, 1854, 1964 may have been climatically effective and are probably recorded in the Greenland ice cores.

    Previously, most dates for eruptions before AD 1854 were obtained by tephrochronology and constrained by radiocarbon dating with an accuracy of several decades or centuries. In this paper we report tree-ring dates for a recent pyroclastic flow in Baidarnaia valley. Though the wood buried in these deposits is carbonized, fragile and poorly preserved, we were able to measure ring-width using standard tree-ring equipment or photographs and to cross-date these samples against the regional Kamchatka larch ring-width chronology. The dates of the outer rings indicate the date of the eruptions. In the Baidarnaia valley the eruption occurred shortly after AD 1756, but not later than AD 1758. This date coincides with the decrease of ring-width in trees growing near Shiveluch volcano in 1758–1763 in comparison with the control "non-volcanic" chronology. The pyroclastic flow in Kamenskaia valley, although similar in appearance to the one in Baidarnaia valley, definitively

  18. Pharmacodynamics, efficacy and safety of sodium-glucose co-transporter type 2 (SGLT2) inhibitors for the treatment of type 2 diabetes mellitus.

    Science.gov (United States)

    Scheen, André J

    2015-01-01

    Inhibitors of sodium-glucose co-transporter type 2 (SGLT2) are proposed as a novel approach for the management of type 2 diabetes mellitus (T2DM). Several compounds are already available in many countries (dapagliflozin, canagliflozin, empagliflozin and ipragliflozin) and some others are in a late phase of development. The available SGLT2 inhibitors share similar pharmacokinetic characteristics, with a rapid oral absorption, a long elimination half-life allowing once-daily administration, an extensive hepatic metabolism mainly via glucuronidation to inactive metabolites, the absence of clinically relevant drug-drug interactions and a low renal elimination as parent drug. SGLT2 co-transporters are responsible for reabsorption of most (90 %) of the glucose filtered by the kidneys. The pharmacological inhibition of SGLT2 co-transporters reduces hyperglycaemia by decreasing renal glucose threshold and thereby increasing urinary glucose excretion. The amount of glucose excreted in the urine depends on both the level of hyperglycaemia and the glomerular filtration rate. Results of numerous placebo-controlled randomised clinical trials of 12-104 weeks duration have shown significant reductions in glycated haemoglobin (HbA1c), resulting in a significant increase in the proportion of patients reaching HbA1c targets, and a significant lowering of fasting plasma glucose when SGLT2 inhibitors were administered as monotherapy or in addition to other glucose-lowering therapies including insulin in patients with T2DM. In head-to-head trials of up to 2 years, SGLT2 inhibitors exerted similar glucose-lowering activity to metformin, sulphonylureas or sitagliptin. The durability of the glucose-lowering effect of SGLT2 inhibitors appears to be better; however, this remains to be more extensively investigated. The risk of hypoglycaemia was much lower with SGLT2 inhibitors than with sulphonylureas and was similarly low as that reported with metformin, pioglitazone or sitagliptin

  19. Dapagliflozin, a selective SGLT2 Inhibitor, attenuated cardiac fibrosis by regulating the macrophage polarization via STAT3 signaling in infarcted rat hearts.

    Science.gov (United States)

    Lee, Tsung-Ming; Chang, Nen-Chung; Lin, Shinn-Zong

    2017-03-01

    During myocardial infarction, infiltrated macrophages have pivotal roles in cardiac remodeling and delayed M1 toward M2 macrophage phenotype transition is considered one of the major factors for adverse ventricular remodeling. We investigated whether dapagliflozin, a sodium-glucose cotransporter 2 (SGLT2) inhibitor, attenuates cardiac fibrosis via regulating macrophage phenotype by a reactive oxygen and nitrogen species (RONS)/STAT3-dependent pathway in postinfarcted rats. Normoglycemic male Wistar rats were subjected to coronary ligation and then randomized to either saline, dapagliflozin (a specific SGLT2 inhibitor), phlorizin (a nonspecific SGLT1/2 inhibitor), dapagliflozin + S3I-201 (a STAT3 inhibitor), or phlorizin + S3I-201 for 4 weeks. There were similar infarct sizes among the infarcted groups at the acute and chronic stages of infarction. At day 3 after infarction, post-infarction was associated with increased levels of superoxide and nitrotyrosine, which can be inhibited by administering either dapagliflozin or phlorizin. SGLT2 inhibitors significantly increased STAT3 activity, STAT3 nuclear translocation, myocardial IL-10 levels and the percentage of M2 macrophage infiltration. At day 28 after infarction, SGLT2 inhibitors were associated with attenuated myofibroblast infiltration and cardiac fibrosis. Although phlorizin decreased myofibroblast infiltration, the effect of dapagliflozin on attenuated myofibroblast infiltration was significantly higher than phlorizin. The effects of SGLT2 inhibitors on cardiac fibrosis were nullified by adding S3I-201. Furthermore, the effects of dapagliflozin on STAT3 activity and myocardial IL-10 levels can be reversed by 3-morpholinosydnonimine, a peroxynitrite generator. Taken together, these observations provide a novel mechanism of SGLT2 inhibitors-mediated M2 polarization through a RONS-dependent STAT3-mediated pathway and selective SGLT2 inhibitors are more effective in attenuating myofibroblast infiltration during

  20. Use of SGLT2 inhibitors for diabetes and risk of infection: Analysis using general practice records from the NPS MedicineWise MedicineInsight program.

    Science.gov (United States)

    Gadzhanova, Svetla; Pratt, Nicole; Roughead, Elizabet

    2017-08-01

    To explore the feasibility of MedicineInsight data to support risk management plan evaluation, focusing on sodium glucose co-transporter 2 (SGLT2) inhibitors for type 2 diabetes. A retrospective study using de-identified electronic general practitioner records. Patients who initiated SGLT2 inhibitor between 1 Jan 2012 to 1 Sep 2015 were compared to patients who initiated dipeptidyl peptidase 4 (DPP-4) inhibitors. The two cohorts were followed-up for six months. Risk of urinary-tract (UT) and genital infections was evaluated. The indication for use of SGLT2 inhibitors, recommended prior diabetes therapies and recommended monitoring were investigates. There were 1977 people in the SGLT2 cohort (with 93% initiated on dapagliflozin) and 1964 people in the DPP-4 cohort. Of the SGLT2 initiators, 54% had a documented indication for use as type 2 diabetes; 86% had used metformin and/or a sulfonylurea in the prior 12months. Renal function monitoring was documented for only 25% in the 6months initiation. The frequency of UTI in the 6months post SGLT2 initiation was not significantly increased compared to the DPP-4 cohort (3.6%vs 4.9%; aHR=0.90, 95% CI 0.66-1.24). Genital infection were more frequent in the SGLT2 than in the DPP-4 cohort (2.9% vs 0.9%, aHR=3.50, 95% CI 1.95-5.89). Similar to existing evidence, we found a higher risk of genital infection associated with SGLT2 inhibitors (primarily dapagliflozin) but no increased risk of UTIs compared to DPP-4 use. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  1. Elevated serum magnesium associated with SGLT2 inhibitor use in type 2 diabetes patients: a meta-analysis of randomised controlled trials.

    Science.gov (United States)

    Tang, Huilin; Zhang, Xi; Zhang, Jingjing; Li, Yufeng; Del Gobbo, Liana C; Zhai, Suodi; Song, Yiqing

    2016-12-01

    By analysing available evidence from randomised controlled trials (RCTs), we aimed to examine whether and to what extent sodium-glucose cotransporter 2 (SGLT2) inhibitors affect serum electrolyte levels in type 2 diabetes patients. We searched PubMed, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL) and ClinicalTrials.gov up to 24 May 2016 for published RCTs of SGLT2 inhibitors that reported changes in serum electrolyte levels. Weighted mean differences (WMD) between each SGLT2 inhibitor and placebo were calculated using a random-effects model. Dose-dependent relationships for each SGLT2 inhibitor were evaluated using meta-regression analysis. Eighteen eligible RCTs, including 15,309 patients and four SGLT2 inhibitors (canagliflozin, dapagliflozin, empagliflozin and ipragliflozin) were evaluated. In patients without chronic kidney disease, each SGLT2 inhibitor significantly increased serum magnesium levels compared with placebo (canagliflozin: WMD 0.06 mmol/l for 100 mg and 0.09 mmol/l for 300 mg; dapagliflozin: WMD 0.1 mmol/l for 10 mg; empagliflozin: WMD 0.04 mmol/l for 10 mg and 0.07 mmol/l for 25 mg; and ipragliflozin: WMD 0.05 mmol/l for 50 mg). Canagliflozin increased serum magnesium in a linear dose-dependent manner (p = 0.10). Serum phosphate was significantly increased by dapagliflozin. Serum sodium appeared to significantly differ by SGLT2 inhibitor type. No significant changes in serum calcium and potassium were observed. Findings were robust after including trials involving patients with chronic kidney disease. SGLT2 inhibitors marginally increased serum magnesium levels in type 2 diabetes patients indicating a drug class effect. Further investigations are required to examine the clinical significance of elevated magnesium levels in individuals with type 2 diabetes.

  2. SGLT-2 inhibitors and their potential in the treatment of diabetes

    Directory of Open Access Journals (Sweden)

    Rosenwasser RF

    2013-11-01

    Full Text Available Rebecca F Rosenwasser,1 Senan Sultan,2 David Sutton,2 Rushab Choksi,1 Benjamin J Epstein3 1East Coast Institute for Research, Jacksonville, FL, USA; 2Northeast Florida Endocrine and Diabetes Associates, Jacksonville, FL, USA; 3Department of Pharmacotherapy and Translational Research, University of Florida College of Pharmacy, Gainesville, FL, USA Abstract: Diabetes remains a burgeoning global problem, necessitating ongoing efforts on the part of pharmaceutical and device manufacturers, patients, and society to curb the frightening trends in morbidity and mortality attributable to the malady. Since 1835 when phlorizin was discovered, sodium glucose co-transporter 2 (SGLT-2 inhibitors have rested tantalizingly on the horizon, promising a more physiological approach to glucose control. These agents lower glucose by enhancing its excretion by blocking reabsorption in the renal tubules, thus eliminating glucose from the body along with the molecules' attendant effects on caloric balance, plasma osmolality, and lipids. Consequently, SGLT-2 inhibitors improve glucose control to an extent comparable to other hypoglycemic agents while simultaneously reducing body weight, blood pressure, and cholesterol – an admirable portfolio. One agent, canagliflozin, has recently been approved by the US Food and Drug Administration (FDA and two other agents have progressed through Phase III trials, including dapagliflozin and empagliflozin. Collectively, when used as monotherapy, these agents have demonstrated reductions in hemoglobin A1c (HbA1c, body weight, and blood pressure of –0.34% to –1.03%, –2.0 to -3.4 kg, and –1.7 to –6.4 mmHg/–0.3 to –2.6 mmHg (systolic blood pressure/diastolic blood pressure, respectively. SGLT-2 inhibitors have been well tolerated, with hypoglycemia (0.9% to 4.3% occurring infrequently in clinical trials. Safety signals related to breast and bladder cancer have arisen with dapagliflozin, though these are unsubstantiated

  3. Evaluating Drug Cost per Response with SGLT2 Inhibitors in Patients with Type 2 Diabetes Mellitus.

    Science.gov (United States)

    Lopez, Janice M S; Macomson, Brian; Ektare, Varun; Patel, Dipen; Botteman, Marc

    2015-09-01

    The sodium-glucose cotransporter 2 (SGLT2) inhibitors, which include canagliflozin, dapagliflozin, and empagliflozin, represent a new class of antihyperglycemic agents. Few studies have assessed their cost per response, with "cost per response" being the total cost of a select drug, divided by the resulting change in glycated hemoglobin (HbA1c) levels. To examine the drug cost of SGLT2 inhibitors per a reduction in placebo-adjusted 1% HbA1c in patients with type 2 diabetes mellitus who received treatment during 26 weeks with canagliflozin, dapagliflozin, or empagliflozin. The drug cost per response for each of the 3 agents individually was assessed based on data from a subset of clinical trials discussed in the prescribing information for each drug that were all placebo-controlled studies evaluating each drug as monotherapy, dual therapy (combined with metformin), and triple therapy (combined with metformin and a sulfonylurea) in patients with uncontrolled, type 2 diabetes mellitus. The US 2015 wholesale acquisition cost for each drug was used to calculate each drug's treatment costs over 26 weeks. The average cost per response for each drug was defined as the prescription drug cost of each SGLT2 inhibitor, divided by the average, placebo-adjusted HbA1c reduction at 26 weeks. The drug cost per unit dose was the same for canagliflozin (100 mg or 300 mg), dapagliflozin (5 mg or 10 mg), and empagliflozin (10 mg or 25 mg), at $11.43. The drug cost per placebo-adjusted 1% HbA1c reduction varied by agent and by dose, as a result of the differences in the treatment responses for each of the 3 drugs. The costs per response for canagliflozin 100 mg as monotherapy, dual therapy, and triple therapy regimens ranged from $2286 to $3355, and for canagliflozin 300 mg, from $1793 to $2702. The costs per response for dapagliflozin 5 mg as monotherapy and dual therapy (triple therapy was not available at the time of the study) ranged from $4161 to $5201; the cost for dapagliflozin

  4. Disturbances in groundwater chemical parameters related to seismic and volcanic activity in Kamchatka (Russia

    Directory of Open Access Journals (Sweden)

    P. F. Biagi

    2004-01-01

    Full Text Available Starting from 1992 geochemical data are being collected with a mean sampling frequency of three days in the form of the pH value and of the most common ions and gases in the groundwater in one deep well located in Petropavlovsk, the capital city of Kamchatka (Russia. On 1 January 1996 a strong eruption started from the Karymsky volcano, that is located about 100km far from the well, in the north-northeastern direction. At the same time, a large earthquake (M=6.9 occurred in the Karymsky area. On 5 December 1997 a very large earthquake (M=7.7 occurred offshore, at a distance of 350km from the well and towards the same direction. The analysis of the geochemical data shows clear variations in the raw temporal trends on both cases. For the first event, a clear premonitory phase appeared; for the second one, some pre-seismic variations could be revealed but permanent modifications of the chemistry of the water subsequent to the earthquake are very clear. In both cases the feature of the geochemical variations is consistent with an afflux of new water in the aquifer connected with the well and with an escape of the Carbon dioxide gas from the ground in different directions. A schematic model able to justify such a phenomenology and the connections of the geochemical variations with the previous tectonic activities is proposed.

  5. Radioactive emanations in fumarole gases of a series of volcanoes in Kamchatka

    International Nuclear Information System (INIS)

    Adamchuk, Yu.V.; Firstov, P.P.

    1986-01-01

    The results of measurements of volume activity of emanations in fumarole gases of a series of acting volcanoes in Kamchatka during 1980-1983 are presented. The value of radon concentration in Avachinski volcano fumaroles equal ∼ 2 emanes did not change substantially as compared with the data for 1966. The highest activity (11.5±0.4 emanes) is registered in the Bezymyannyj volcano fumaroles. The emanation site survey of fumarole fields of the second cone of the Great fractured Tolbachinski eruption (GFTE) revealed the narrowly localized zone of radioactive emanation emissions. The radon emission in the above zone in 1981 constitutes (2.3 ± 0.4)x10 -6 Ci/s. Using this estimation, time (34-42 days) and average rate (2.5-3.0 m/h) of depth gases hoisting from magmatic focus are calculated as well as filtration rock characteristics in the narrowly localized near-mouth zone of the second cone of GCTE North outburst in the post eruptive period: permeability coefficient (0.1-4.3 darci), porosity (3-15 %) and mean value of cracks and pores opening (0.6-2.0)x10 -3 cm). The found characteristic values proved to be compared with parameters of crushing zone near epicenters of underground nuclear explosions

  6. Lipid Biomarkers and Stable Isotope Signatures of Microbial Mats in Hot Springs of Kamchatka, Russia

    Science.gov (United States)

    Romanek, C. S.; Mills, G. L.; Jones, M. E.; Paddock, L.; Li, Y.; Zhang, C. L.; Wiegel, J.

    2004-12-01

    Various hot springs of the Uzon Caldera, Kamchatka, were analyzed for their chemical and stable isotope composition to better understand the relationship(s) between thermophilic microorganisms and the environments in which they live. The springs had water temperatures ranging from 40-90\\deg C and pH ranging from 5.6-5.9. Gases that emanated from the springs were composed predominantly of CO2 (20 to 90%), with lesser amounts of CH4, (Archaea. Results of PLFA showed 16:0 as the most abundant fatty acid (33-44%), which is universal in all living organisms. Other significant biomarkers included 18:1ω (19 to 24%), 18:2ω (5 to 13%), 16:1ω (3 to 12%), and 18:0 (2 to 7%). These biomarkers are characteristic of cyanobacteria, green-sulfur bacteria, and green non-sulfur bacteria, respectively, which are common autotrophic organisms in terrestrial hot springs. On the other hand, biomarkers of heterotrophic bacteria, such as iso- and anteiso-15:0 were low (2-8%), indicating that the bacterial carbon cycle was dominated by autotrophic organisms. Analogous archaeal constituents were present in significant abundance in the ether lipids fraction.

  7. Microbial diversity in acidic thermal pools in the Uzon Caldera, Kamchatka.

    Science.gov (United States)

    Mardanov, Andrey V; Gumerov, Vadim M; Beletsky, Alexey V; Ravin, Nikolai V

    2018-01-01

    Microbial communities of four acidic thermal pools in the Uzon Caldera, Kamchatka, Russia, were studied using amplification and pyrosequencing of 16S rRNA gene fragments. The sites differed in temperature and pH: 1805 (60 °C, pH 3.7), 1810 (90 °C, pH 4.1), 1818 (80 °C, pH 3.5), and 1807 (86 °C, pH 5.6). Archaea of the order Sulfolobales were present among the dominant groups in all four pools. Acidilobales dominated in pool 1818 but were a minor fraction at the higher temperature in pool 1810. Uncultivated Archaea of the Hot Thaumarchaeota-related clade were present in significant quantities in pools 1805 and 1807, but they were not abundant in pools 1810 and 1818, where high temperatures were combined with low pH. Nanoarchaeota were present in all pools, but were more abundant in pools 1810 and 1818. A similar abundance pattern was observed for Halobacteriales. Thermophilic Bacteria were less diverse and were mostly represented by aerobic hydrogen- and sulfur-oxidizers of the phylum Aquificae and sulfur-oxidising Proteobacteria of the genus Acidithiobacillus. Thus we showed that extremely acidic hot pools contain diverse microbial communities comprising different metabolic groups of prokaryotes, including putative lithoautotrophs using energy sources of volcanic origin, and various facultative and obligate heterotrophs.

  8. SGLT2 inhibitors – an insulin-independent therapeutic approach for treatment of type 2 diabetes: focus on canagliflozin

    Directory of Open Access Journals (Sweden)

    Seufert J

    2015-11-01

    Full Text Available Jochen SeufertDepartment of Endocrinology and Diabetology, Clinic for Internal Medicine II, Freiburg University Hospital, Freiburg, GermanyAbstract: Despite the availability of a great variety of medications, a significant proportion of people with type 2 diabetes mellitus (T2DM are not able to achieve or maintain adequate glycemic control. Beyond improved glucose control, novel treatments would ideally provide a reduction of cardiovascular risk, with a favorable impact on excess weight, and a low intrinsic hypoglycemia risk, as well as a synergistic mechanism of action for broad combination therapy. With the development of sodium glucose cotransporter 2 (SGLT2 inhibitors, an antidiabetic pharmacologic option has recently become available that comes close to meeting these requirements. For the first time, SGLT2 inhibitors offer a therapeutic approach acting directly on the kidneys without requiring insulin secretion or action. Canagliflozin, dapagliflozin, and empagliflozin are the SGLT2 inhibitors approved to date. Taken once a day, these medications can be combined with all other antidiabetic medications including insulin, due to their insulin-independent mechanism of action, with only a minimal risk of hypoglycemia. SGLT2 inhibitors provide additional reductions in body weight and blood pressure due to the therapeutically induced excretion of glucose and sodium through the kidneys. These "concomitant effects" are particularly interesting with regard to the increased cardiovascular risk in T2DM. In many cases, T2DM treatment requires a multidimensional approach where the treatment goals have to be adapted to the individual patient. While there is a consensus on the use of metformin as a first-line drug therapy, various antidiabetics are used for treatment intensification. New mechanisms of action like that of SGLT2 inhibitors such as canagliflozin, which can be used both in early and late stages of diabetes, are a welcome addition to expand

  9. Role of SGLT2 inhibitors in the treatment of type 2 diabetes mellitus.

    Science.gov (United States)

    Solini, Anna

    2016-12-01

    In the last ten years, knowledge on pathophysiology of type 2 diabetes (T2DM) has significantly increased, with multiple failures (decreased incretin effect, increased lipolysis, increased glucagon secretion, neurotransmitters dysfunction) recognized as important contributors, together with decreased insulin secretion and reduced peripheral glucose uptake. As a consequence, the pharmacologic therapy of T2DM has been progressively enriched by several novel classes of drugs, trying to overcome these defects. The last, intriguing compounds come into the market are SGLT2 inhibitors, framing the kidney in a different scenario, not as site of a harmful disease complication, but rather as the means to correct hyperglycemia and fight the disease. This review aims to offer a short, updated overview of the role of these compounds in the treatment of T2DM, focusing on efficacy, ancillary albeit relevant clinical effects, safety, potential cardiovascular protection, positioning in common therapeutic algorithms.

  10. ACE and SGLT2 inhibitors: the future for non-diabetic and diabetic proteinuric renal disease.

    Science.gov (United States)

    Perico, Norberto; Ruggenenti, Piero; Remuzzi, Giuseppe

    2017-04-01

    Most chronic nephropathies progress relentlessly to end-stage kidney disease. Research in animals and humans has helped our understanding of the mechanisms of chronic kidney disease progression. Current therapeutic strategies to prevent or revert renal disease progression focus on reduction of urinary protein excretion and blood pressure control. Blockade of the renin-angiotensin system (RAS) with angiotensin-converting enzyme inhibitors and/or angiotensin II type 1 receptor blockers is the most effective treatment to achieve these purposes in non-diabetic and diabetic proteinuric renal diseases. For those individuals in which nephroprotection by RAS blockade is only partial, sodium-glucose linked cotransporter-2 (SGLT2) inhibitors could be a promising new class of drugs to provide further renoprotective benefit when added on to RAS blockers. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. A comprehensive review of the pharmacodynamics of the SGLT2 inhibitor empagliflozin in animals and humans

    Science.gov (United States)

    Michel, Martin C.

    2018-01-01

    Empagliflozin (formerly known as BI 10773) is a potent, competitive, and selective inhibitor of the sodium glucose transporter SGLT2, which mediates glucose reabsorption in the early proximal tubule and most of the glucose reabsorption by the kidney, overall. Accordingly, empagliflozin treatment increased urinary glucose excretion. This has been observed across multiple species including humans and was reported under euglycemic conditions, in obesity and, most importantly, in type 2 diabetic patients and multiple animal models of type 2 diabetes and of type 1 diabetes. This led to a reduction in blood glucose, smaller blood glucose excursions during oral glucose tolerance tests, and, upon chronic treatment, a reduction in HbA1c in animal models and patients. In rodents, such effects were observed in early and late phases of experimental diabetes and were associated with preservation of pancreatic β-cell function. Combination studies in animals demonstrated that beneficial metabolic effects of empagliflozin may also manifest when added to other types of anti-hyperglycemic treatments including linagliptin and pioglitazone. While some anti-hyperglycemic drugs lead to weight gain, empagliflozin treatment was associated with reduced body weight in normoglycemic obese and non-obese animals despite an increased food intake, largely due to a loss of adipose tissue; on the other hand, empagliflozin preserved body weight in models of type 1 diabetes. Empagliflozin improved endothelial dysfunction in diabetic rats and arterial stiffness, reduced blood pressure in diabetic patients, and attenuated early signs of nephropathy in diabetic animal models. Taken together, the SGLT2 inhibitor empagliflozin improves glucose metabolism by enhancing urinary glucose excretion; upon chronic administration, at least in animal models, the reductions in blood glucose levels are associated with beneficial effects on cardiovascular and renal complications of diabetes. PMID:26108304

  12. Major adverse cardiovascular event reduction with GLP-1 and SGLT2 agents: evidence and clinical potential

    Science.gov (United States)

    Røder, Michael E.

    2017-01-01

    Treatment of patients with type 2 diabetes is directed against treating symptoms of hyperglycemia, minimizing the risk of hypoglycemia, and the risk of microvascular and macrovascular complications. The majority of patients with type 2 diabetes die from cardiovascular or cerebrovascular disease. Future therapies should therefore focus on reducing cardiovascular morbidity in this high-risk population. Glucagon-like peptide-1 receptor agonists (GLP-1RA) and sodium-glucose co-transporter 2 inhibitors (SGLT2-i) are two drug classes with proven antihyperglycemic effect in type 2 diabetes. However, these drugs seem to have other effects such as weight reduction, low risk of hypoglycemia, and blood pressure reduction. Emerging evidence suggests pleiotropic effects, which potentially could be important in reducing cardiovascular risk. Prompted by regulatory authorities demanding cardiovascular outcome trials (CVOTs) assessing the cardiovascular safety of new antihyperglycemic drug candidates, many CVOTs are ongoing and a few of these are finalized. Somewhat surprising recent CVOTs in both drug classes have shown promising data on cardiovascular morbidity and mortality in patients with a very high risk of cardiovascular events. It is uncertain whether this is a class effect of the two drug classes, and it is yet unproven whether long-term cardiovascular benefits of these drugs can be extrapolated to populations at lower risk of cardiovascular disease. The aim of the present review is to give an overview of our current knowledge of the GLP-1RA and SGLT2-i classes, with specific focus on mechanisms of action, effects on cardiovascular risk factors and cardiovascular morbidity and mortality from the CVOTs presently available. The clinical potential of these data is discussed. PMID:29344329

  13. [Dapagliflozin, the first SGLT-2 inhibitor in the treatment of type 2 diabetes].

    Science.gov (United States)

    Albarrán, Olga González; Ampudia-Blasco, F Javier

    2013-09-01

    Dapagliflozin is the first novel sodium-glucose co-transporter-2 (SGLT2) inhibitor approved by the European Medicines Agency (EMA) for the treatment of type 2 diabetes. By inhibiting SGLT2, dapagliflozin blocks reabsorption of filtered glucose in the kidney, increasing urinary glucose excretion and reducing blood glucose levels. Its mechanism of action is independent of pancreatic β cell function and modulation of insulin sensitivity. The results of phase III clinical trials showed that dapagliflozin, at a dose of 5 or 10mg/day for 24 weeks as monotherapy in previously untreated patients, or as add-on combination therapy with metformin, glimepiride, pioglitazone or insulin-based therapy, significantly reduced both HbA1c and fasting plasma glucose levels compared with placebo. In addition, dapagliflozin was noninferior to glipizide, in terms of glycemic control after 52 weeks, when used as add-on therapy in patients with type 2 diabetes inadequately controlled with metformin. In most clinical trials, dapagliflozin reduced body weight. The combination of both effects (improved glycemic control and weight loss) is achieved to a greater extent in treatments that include dapaglifozin. Longer-term extension studies indicated that the efficacy of dapagliflozin on the glycemic control and weight reducción is maintained for up to 2 and 4 years. Dapagliflozin was well tolerated. Genital infections and urinary tract infections were more frequent in patients who received dapagliflozin than in placebo recipients. Hypoglycemic episodes were scarce with dapagliflozin. In conclusion, dapagliflozin is a novel option for the management of type 2 diabetes, particularly when used as add-on therapy. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  14. Sediment transport in headwaters of a volcanic catchment—Kamchatka Peninsula case study

    Science.gov (United States)

    Chalov, Sergey R.; Tsyplenkov, Anatolii S.; Pietron, Jan; Chalova, Aleksandra S.; Shkolnyi, Danila I.; Jarsjö, Jerker; Maerker, Michael

    2017-09-01

    Due to specific environmental conditions, headwater catchments located on volcanic slopes and valleys are characterized by distinctive hydrology and sediment transport patterns. However, lack of sufficient monitoring causes that the governing processes and patterns in these areas are rarely well understood. In this study, spatiotemporal water discharge and sediment transport from upstream sources was investigated in one of the numerous headwater catchments located in the lahar valleys of the Kamchatka Peninsula Sukhaya Elizovskaya River near Avachinskii and Koryakskii volcanoes. Three different subcatchments and corresponding channel types (wandering rivers within lahar valleys, mountain rivers within volcanic slopes and rivers within submountain terrains) were identified in the studied area. Our measurements from different periods of observations between years 2012-2014 showed that the studied catchment was characterized by extreme diurnal fluctuation of water discharges and sediment loads that were influenced by snowmelt patterns and high infiltration rates of the easily erodible lahar deposits. The highest recorded sediment loads were up to 9•104 mg/L which was related to an increase of two orders of magnitude within a one day of observations. Additionally, to get a quantitative estimate of the spatial distribution of the eroded material in the volcanic substrates we applied an empirical soil erosion and sediment yield model-modified universal soil loss equation (MUSLE). The modeling results showed that even if the applications of the universal erosion model to different non-agricultural areas (e.g., volcanic catchments) can lead to irrelevant results, the MUSLE model delivered might be acceptable for non-lahar areas of the studied volcanic catchment. Overall the results of our study increase our understanding of the hydrology and associated sediment transport for prediction of risk management within headwater volcanic catchments.

  15. De novo expression of sodium-glucose cotransporter SGLT2 in Bowman's capsule coincides with replacement of parietal epithelial cell layer with proximal tubule-like epithelium.

    Science.gov (United States)

    Tabatabai, Niloofar M; North, Paula E; Regner, Kevin R; Kumar, Suresh N; Duris, Christine B; Blodgett, Amy B

    2014-08-01

    In kidney nephron, parietal epithelial cells line the Bowman's capsule and function as a permeability barrier for the glomerular filtrate. Bowman's capsule cells with proximal tubule epithelial morphology have been found. However, the effects of tubular metaplasia in Bowman's capsule on kidney function remain poorly understood. Sodium-glucose cotransporter 2 (SGLT2) plays a major role in reabsorption of glucose in the kidney and is expressed on brush border membrane (BBM) of epithelial cells in the early segment of the proximal tubule. We hypothesized that SGLT2 is expressed in tubularized Bowman's capsule and used our novel antibody to test this hypothesis. Immunohistochemical analysis was performed with our SGLT2 antibody on C57BL/6 mouse kidney prone to have tubularized Bowman's capsules. Cell membrane was examined with periodic acid-Schiff (PAS) stain. The results showed that SGLT2 was localized on BBM of the proximal tubules in young and adult mice. Bowman's capsules were lined mostly with normal brush border-less parietal epithelial cells in young mice, while they were almost completely covered with proximal tubule-like cells in adult mice. Regardless of age, SGLT2 was expressed on BBM of the tubularized Bowman's capsule but did not co-localize with nephrin in the glomerulus. SGLT2-expressing tubular cells expanded from the urinary pole toward the vascular pole of the Bowman's capsule. This study identified the localization of SGLT2 in the Bowman's capsule. Bowman's capsules with tubular metaplasia may acquire roles in reabsorption of filtered glucose and sodium.

  16. Promising cardiovascular and blood pressure effects of the SGLT2 inhibitors: a new class of antidiabetic drugs.

    Science.gov (United States)

    Chrysant, S G

    2017-03-01

    Patients with type 2 diabetes mellitus (T2DM) exhibit an increased risk of cardiovascular (CV) events. Treatment of these patients with traditional as well as newer glucose-lowering drugs has not demonstrated superiority in CV outcomes compared to placebo, despite effective control of diabetes. However, the recently FDA-approved sodium-glucose cotransporter 2 (SGLT2) inhibitors for the treatment of T2DM have demonstrated promising CV-protecting and blood pressure-lowering effects in addition to their effectiveness in glucose lowering, making them a novel class of drugs for the treatment of T2DM. So far, there are three SGLT2 inhibitors approved by the FDA and EMA for the treatment of T2DM: canagliflozin, dapagliflozin and empagliflozin. They exert their antihyperglycemic effect through inhibition of SGLT2 in the kidney and significantly reduce glucose reabsorption from the proximal renal tubule. By blocking glucose reabsorption, they lead to loss of calories, weight, abdominal and total body fat, blood pressure and CV complications. One CV outcomes randomized trial and several short-term studies have shown reductions in CV events and blood pressure in patients with T2DM. It is the hope that large ongoing long-term outcome studies will provide further much-needed information, when they are completed. Copyright 2017 Clarivate Analytics.

  17. Quality of methodological reporting of randomized clinical trials of sodium-glucose cotransporter-2 (sglt2 inhibitors

    Directory of Open Access Journals (Sweden)

    Hadeel Alfahmi

    2017-01-01

    Full Text Available Sodium-glucose cotransporter-2 (SGLT2 inhibitors are a new class of medicines approved recently for the treatment of type 2 diabetes. To improve the quality of randomized clinical trial (RCT reports, the Consolidated Standards of Reporting Trials (CONSORT statement for methodological features was created. For achieving our objective in this study, we assessed the quality of methodological reporting of RCTs of SGLT2 inhibitors according to the 2010 CONSORT statement. We reviewed and analyzed the methodology of SGLT2 inhibitors RCTs that were approved by the Food & Drug Administration (FDA. Of the 27 trials, participants, eligibility criteria, and additional analyses were reported in 100% of the trials. In addition, trial design, interventions, and statistical methods were reported in 96.3% of the trials. Outcomes were reported in 93.6% of the trials. Settings were reported in 85.2% of the trials. Blinding and sample size were reported in 66.7 and 59.3% of the trials, respectively. Sequence allocation and the type of randomization were reported in 63 and 74.1% of the trials, respectively. Besides those, a few methodological items were inadequate in the trials. Allocation concealment was inadequate in most of the trials. It was reported only in 11.1% of the trials. The majority of RCTs have high percentage adherence for more than half of the methodological items of the 2010 CONSORT statement.

  18. The Emerging Role of SGLT2 Inhibitors in the Treatment of Type 2 Diabetes. Focus on Dapagliflozin

    Directory of Open Access Journals (Sweden)

    Timar Bogdan

    2016-03-01

    Full Text Available Type 2 diabetes is a progressive metabolic disorder, accounting for more than 90% of all cases of diabetes. Treatment strategies target blood glucose reduction and non-glycemic effects that can reduce long-term complications, such as cardiovascular disease. Although metformin is often initially effective as monotherapy, the progressive nature of diabetes frequently requires additional therapies. Sodium-glucose transporter 2 (SGLT2 became a very attractive therapeutic target in diabetes management. The mechanism of action of SGLT2 inhibitors is not dependent on insulin, thus making them attractive options anytime over the course of the disease. Dapagliflozin is a stable and highly selective inhibitor of SGLT2. The reductions in fasting plasma glucose concentration and bodyweight recorded during the first week of treatment in the dapagliflozin groups continued over weeks and years of treatment. Early weight loss with dapagliflozin might be partly due to a mild osmotic diuresis, while the gradual progressive reduction in bodyweight is consistent with a reduction of fat mass. Although dapagliflozin is well tolerated, signs and symptoms suggestive for urinary and/or genital infections were reported during clinical trials in more patients assigned to the drug than in placebo groups.

  19. Multiparameter monitoring of short-term earthquake precursors and its physical basis. Implementation in the Kamchatka region

    Directory of Open Access Journals (Sweden)

    Pulinets Sergey

    2016-01-01

    Full Text Available We apply experimental approach of the multiparameter monitoring of short-term earthquake precursors which reliability was confirmed by the Lithosphere-Atmosphere-Ionosphere Coupling (LAIC model created recently [1]. A key element of the model is the process of Ion induced Nucleation (IIN and formation of cluster ions occurring as a result of the ionization of near surface air layer by radon emanating from the Earth's crust within the earthquake preparation zone. This process is similar to the formation of droplet’s embryos for cloud formation under action of galactic cosmic rays. The consequence of this process is the generation of a number of precursors that can be divided into two groups: a thermal and meteorological, and b electromagnetic and ionospheric. We demonstrate elements of prospective monitoring of some strong earthquakes in Kamchatka region and statistical results for the Chemical potential correction parameter for more than 10 years of observations for earthquakes with M≥6. As some experimental attempt, the data of Kamchatka volcanoes monitoring will be demonstrated.

  20. Isotope ratio of carbon in lipids of the zooplankton from the Kuril-Kamchatka region of the Pacific Ocean

    International Nuclear Information System (INIS)

    Bordovskij, O.K.; Shirinskij, V.G.; Akhmet'eva, E.A.; AN SSSR, Novosibirsk. Inst. Geokhimii)

    1976-01-01

    Isotopic composition has been studied of carbon of lipids of zooplancton in Kuril-Kamchatka region in the depth range from the surface down to 7km. The main task of the research is the investigation of isotopic composition variations along the vertical line - in producing and consuming zones under fairly uniform thermal conditions. The study has revealed that biochemical content of plancton in Kuril-Kamchatka region is characterized by elevated content of organic matter, the quantity of which, expressed in Csup(org), comprises from 41.9 to 59.5% of the dry weigth, that is 1.5-2 times more than Csup(org) preservation in zooplancton in the tropical part of the Indian Ocean. The plancton at the depth of 100-200 m from the cold intermediate layer and from that of 1000-2000 m has proved to be the richest in organic matter and lipids. As for the lipids content and fractionation, the greatest differences are observed between the surface plancton and that located lower, including the maximal depth, that is, between the producing and consuming zones

  1. A comparison of effects of DPP-4 inhibitor and SGLT2 inhibitor on lipid profile in patients with type 2 diabetes.

    Science.gov (United States)

    Cha, Seon-Ah; Park, Yong-Moon; Yun, Jae-Seung; Lim, Tae-Seok; Song, Ki-Ho; Yoo, Ki-Dong; Ahn, Yu-Bae; Ko, Seung-Hyun

    2017-04-13

    Previous studies suggest that dipeptidyl peptidase-4 (DPP-4) inhibitors and sodium glucose cotransporter 2 (SGLT2) inhibitors have different effects on the lipid profile in patients with type 2 diabetes. We investigated the effects of DPP-4 inhibitors and SGLT2 inhibitors on the lipid profile in patients with type 2 diabetes. From January 2013 to December 2015, a total of 228 patients with type 2 diabetes who were receiving a DPP-4 inhibitor or SGLT2 inhibitor as add-on therapy to metformin and/or a sulfonylurea were consecutively enrolled. We compared the effects of DPP-4 inhibitors and SGLT2 inhibitors on the lipid profile at baseline and after 24 weeks of treatment. To compare lipid parameters between the two groups, we used the analysis of covariance (ANCOVA). A total of 184 patients completed follow-up (mean age: 53.1 ± 6.9 years, mean duration of diabetes: 7.1 ± 5.7 years). From baseline to 24 weeks, HDL-cholesterol (HDL-C) levels were increased by 0.5 (95% CI, -0.9 to 2.0) mg/dl with a DPP-4 inhibitor and by 5.1 (95% CI, 3.0 to 7.1) mg/dl with an SGLT2 inhibitor (p = 0.001). LDL-cholesterol (LDL-C) levels were reduced by 8.4 (95% CI, -14.0 to -2.8) mg/dl with a DPP-4 inhibitor, but increased by 1.3 (95% CI, -5.1 to 7.6) mg/dl with an SGLT2 inhibitor (p = 0.046). There was no significant difference in the mean hemoglobin A1c (8.3 ± 1.1 vs. 8.0 ± 0.9%, p = 0.110) and in the change of total cholesterol (TC) (p = 0.836), triglyceride (TG) (p = 0.867), apolipoprotein A (p = 0.726), apolipoprotein B (p = 0.660), and lipoprotein (a) (p = 0.991) between the DPP-4 inhibitor and the SGLT2 inhibitor. The SGLT2 inhibitor was associated with a significant increase in HDL-C and LDL-C after 24 weeks of SGLT2 inhibitor treatment in patients with type 2 diabetes compared with those with DPP-4 inhibitor treatment in this study. This study was conducted by retrospective medical record review.

  2. Comparison between SGLT2 inhibitors and DPP4 inhibitors added to insulin therapy in type 2 diabetes: a systematic review with indirect comparison meta-analysis.

    Science.gov (United States)

    Min, Se Hee; Yoon, Jeong-Hwa; Hahn, Seokyung; Cho, Young Min

    2017-01-01

    Both sodium glucose cotransporter 2 (SGLT2) inhibitors and dipeptidyl peptidase-4 (DPP4) inhibitors can be used to treat patients with type 2 diabetes mellitus (T2DM) that is inadequately controlled with insulin therapy, and yet there has been no direct comparison of these two inhibitors. We searched MEDLINE, EMBASE, LILACS, the Cochrane Central Register of Controlled Trials and ClinicalTrials.gov through June 2015. Randomized controlled trials published in English that compare SGLT2 inhibitor plus insulin (SGLT2i/INS) with placebo plus insulin or DPP4 inhibitor plus insulin (DPP4i/INS) with placebo plus insulin in patients with T2DM were selected. Data on the study characteristics, efficacy and safety outcomes were extracted. We compared the efficacy and safety between SGLT2i/INS and DPP4i/INS indirectly with covariates adjustment. Risk of potential bias was assessed. Fourteen eligible randomized controlled trials comprising 6980 patients were included (five SGLT2 inhibitor studies and nine DPP4 inhibitor studies). Covariate-adjusted indirect comparison using meta-regression analyses revealed that SGLT2i/INS achieved greater reduction in HbA 1c [weighted mean difference (WMD) -0.24%, 95% confidence interval (CI) -0.43 to -0.05%], fasting plasma glucose (WMD -18.0 mg/dL, 95% CI -28.5 to -7.6 mg/dL) and body weight (WMD -2.38 kg, 95% CI -3.18 to -1.58 kg) from baseline than DPP4i/INS without increasing the risk of hypoglycaemia (relative risks 1.19, 95% CI 0.78 to 1.82). Sodium glucose cotransporter 2 inhibitors achieved better glycaemic control and greater weight reduction than DPP4 inhibitors without increasing the risk of hypoglycaemia in patients with T2DM that is inadequately controlled with insulin. There has been no direct comparison of SGLT2 inhibitors and DPP4 inhibitors in patients with T2DM inadequately controlled with insulin therapy. In this study, we performed indirect meta-analysis comparing SGLT2 inhibitors and DPP4 inhibitors added to insulin

  3. Effect of sodium-glucose cotransporter 2 (SGLT2) inhibition on weight loss is partly mediated by liver-brain-adipose neurocircuitry.

    Science.gov (United States)

    Sawada, Yoshikazu; Izumida, Yoshihiko; Takeuchi, Yoshinori; Aita, Yuichi; Wada, Nobuhiro; Li, EnXu; Murayama, Yuki; Piao, Xianying; Shikama, Akito; Masuda, Yukari; Nishi-Tatsumi, Makiko; Kubota, Midori; Sekiya, Motohiro; Matsuzaka, Takashi; Nakagawa, Yoshimi; Sugano, Yoko; Iwasaki, Hitoshi; Kobayashi, Kazuto; Yatoh, Shigeru; Suzuki, Hiroaki; Yagyu, Hiroaki; Kawakami, Yasushi; Kadowaki, Takashi; Shimano, Hitoshi; Yahagi, Naoya

    2017-11-04

    Sodium-glucose cotransporter 2 (SGLT2) inhibitors have both anti-diabetic and anti-obesity effects. However, the precise mechanism of the anti-obesity effect remains unclear. We previously demonstrated that the glycogen depletion signal triggers lipolysis in adipose tissue via liver-brain-adipose neurocircuitry. In this study, therefore, we investigated whether the anti-obesity mechanism of SGLT2 inhibitor is mediated by this mechanism. Diet-induced obese mice were subjected to hepatic vagotomy (HVx) or sham operation and loaded with high fat diet containing 0.015% tofogliflozin (TOFO), a highly selective SGLT2 inhibitor, for 3 weeks. TOFO-treated mice showed a decrease in fat mass and the effect of TOFO was attenuated in HVx group. Although both HVx and sham mice showed a similar level of reduction in hepatic glycogen by TOFO treatment, HVx mice exhibited an attenuated response in protein phosphorylation by protein kinase A (PKA) in white adipose tissue compared with the sham group. As PKA pathway is known to act as an effector of the liver-brain-adipose axis and activate triglyceride lipases in adipocytes, these results indicated that SGLT2 inhibition triggered glycogen depletion signal and actuated liver-brain-adipose axis, resulting in PKA activation in adipocytes. Taken together, it was concluded that the effect of SGLT2 inhibition on weight loss is in part mediated via the liver-brain-adipose neurocircuitry. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Evaluation of Workpiece Temperature during Drilling of GLARE Fiber Metal Laminates Using Infrared Techniques: Effect of Cutting Parameters, Fiber Orientation and Spray Mist Application

    Science.gov (United States)

    Giasin, Khaled; Ayvar-Soberanis, Sabino

    2016-01-01

    The rise in cutting temperatures during the machining process can influence the final quality of the machined part. The impact of cutting temperatures is more critical when machining composite-metal stacks and fiber metal laminates due to the stacking nature of those hybrids which subjects the composite to heat from direct contact with metallic part of the stack and the evacuated hot chips. In this paper, the workpiece surface temperature of two grades of fiber metal laminates commercially know as GLARE is investigated. An experimental study was carried out using thermocouples and infrared thermography to determine the emissivity of the upper, lower and side surfaces of GLARE laminates. In addition, infrared thermography was used to determine the maximum temperature of the bottom surface of machined holes during drilling GLARE under dry and minimum quantity lubrication (MQL) cooling conditions under different cutting parameters. The results showed that during the machining process, the workpiece surface temperature increased with the increase in feed rate and fiber orientation influenced the developed temperature in the laminate. PMID:28773757

  5. Evaluation of Uniformity and Glare Improvement with Low Energy Efficiency Losses in Street Lighting LED Luminaires Using Laser-Sintered Polyamide-Based Diffuse Covers

    Directory of Open Access Journals (Sweden)

    Alfonso Gago-Calderón

    2018-04-01

    Full Text Available Energy saving in street lighting is garnering more interest and has become a priority in municipal management. Therefore, LED luminaires are gradually becoming prevalent in our cities. Beyond their energy/economic saving potential, quality in public lighting installations concerns aspects such as uniformity and glare which must be maintained if not improved in any installation renewal project using this technology. The high light intensity generated in a discrete point in LED packages and its directional nature result in significant deficiencies in these last two parameters. To soften these effects, translucent covers are being used as one of the most common solutions with the drawback of significant light intensity losses. The objective of this paper is to evaluate the behavior of LED luminaire’s polyamide-based optical covers manufactured with a laser-sintered process. These are designed to improve glare and uniformity output, to minimize light output reductions, and to be industrially manufactured with no increment of cost for their lighting equipment compared to conventional transparent polycarbonate solutions. A laboratory and field lighting test study has been applied to different covers with the same LED lamp and luminaire to compare the performance of three different solutions built with different polymeric materials and with different light transmission surface textures. The photometric results have been observed and discussed to demonstrate the ability to significantly improve the lighting performance of LED luminaires—illuminance and uniformity levels and discomfort and disability glare indexes— using an improved optic cover.

  6. Taxonomy of the early life stages of arrowtooth flounder (Atheresthes stomias) and Kamchatka flounder (A. evermanni) in the eastern Bering Sea, with notes on distribution and condition

    Science.gov (United States)

    De Forest, Lisa; Duffy-Anderson, J. T.; Heintz, R. A.; Matarese, A. C.; Siddon, E. C.; Smart, T. I.; Spies, I. B.

    2014-11-01

    Arrowtooth flounder (Atheresthes stomias) and Kamchatka flounder (A. evermanni) are closely related flatfish species that co-occur in the eastern Bering Sea. As adults, arrowtooth flounder can be distinguished from Kamchatka flounder; however, larvae and early juveniles can only be indentified to the genus level due to morphological similarities. This has precluded studies of ecology for the early life stages of both species in the eastern Bering Sea. In this study, we developed a genetic technique to identify the larvae and early juveniles of the two species using mtDNA cytochrome oxidase subunit I (COI). Genetically identified specimens were then examined to determine a visual identification method based on pigment patterns and morphology. Specimens 6.0-12.0 mm SL and≥18.0 mm SL can be identified to the species level, but species identification of individuals 12.1-17.9 mm SL by visual means alone remains elusive. The distribution of larvae (<25.0 mm SL) of both arrowtooth flounder and Kamchatka flounder is similar in the eastern Bering Sea; however, juvenile (≥25.0 mm SL) Kamchatka flounder occur closer to the shelf break and in deeper water than juvenile arrowtooth flounder. Condition was determined for larvae and juveniles of each species by analyzing lipid content (%) and energy density (kJ/g dry mass). Kamchatka flounder larvae on average had higher lipid content than arrowtooth flounder larvae, but were also larger on average than arrowtooth flounder larvae in the summer. When corrected for length, both species had similar lipid content in the larval and juvenile stages.

  7. High incidence of rainbow glare after femtosecond laser assisted-LASIK using the upgraded FS200 femtosecond laser.

    Science.gov (United States)

    Zhang, Yu; Chen, Yue-Guo

    2018-03-05

    To compare the incidence of rainbow glare (RG) after femtosecond laser assisted-LASIK (FS-LASIK) using the upgraded FS200 femtosecond laser with different flap cut parameter settings. A consecutive series of 129 patients (255 eyes) who underwent FS-LASIK for correcting myopia and/or astigmatism using upgraded WaveLight FS200 femtosecond laser with the original settings was included in group A. Another consecutive series of 129 patients (255 eyes) who underwent FS-LASIK using upgraded WaveLight FS200 femtosecond laser with flap cut parameter settings changed (decreased pulse energy, spot and line separation) was included in group B. The incidence and fading time of RG, confocal microscopic image and postoperative clinical results were compared between the two groups. There were no differences between the two groups in age, baseline refraction, excimer laser ablation depth, postoperative uncorrected visual acuity and refraction. The incidence rate of RG in group A (35/255, 13.73%) was significantly higher than that in group B (4/255, 1.57%) (P  0.05).The confocal microscopic images showed wider laser spot spacing in group A than group B. The incidence of RG was significantly correlated with age and grouping (P laser with original flap cut parameter settings could increase the incidence of RG. The narrower grating size and lower pulse energy could ameliorate this side effect.

  8. The 1997 Kronotsky earthquake and tsunami and their predecessors, Kamchatka, Russia

    Science.gov (United States)

    Bourgeois, Joanne; Pinegina, Tatiana K.

    2018-01-01

    The northern part of the Kamchatka subduction zone (KSZ) experienced three tsunamigenic earthquakes in the 20th century - February 1923, April 1923, December 1997 - events that help us better understand the behavior of this segment. A particular focus of this study is the nature and location of the 5 December 1997 Kronotsky rupture (Mw ˜ 7.8) as elucidated by tsunami runup north of Kronotsky Peninsula in southern to central Kamchatsky Bay. Some studies have characterized the subduction zone off Kronotsky Peninsula as either more locked or more smoothly slipping than surrounding areas and have placed the 1997 rupture south of this promontory. However, 1997 tsunami runup north of the peninsula, as evidenced by our mapping of tsunami deposits, requires the rupture to extend farther north. Previously reported runup (1997 tsunami) on Kronotsky Peninsula was no more than 2-3 m, but our studies indicate tsunami heights for at least 50 km north of Kronotsky Peninsula in Kamchatsky Bay, ranging from 3.4 to 9.5 m (average 6.1 m), exceeding beach ridge heights of 5.3 to 8.3 m (average 7.1 m). For the two 1923 tsunamis, we cannot distinguish among their deposits in southern to central Kamchatsky Bay, but the deposits are more extensive than the 1997 deposit. A reevaluation of the April 1923 historical tsunami suggests that its moment magnitude could be revised upward, and that the 1997 earthquake filled a gap between the two 1923 earthquake ruptures. Characterizing these historical earthquakes and tsunamis in turn contributes to interpreting the prehistoric record, which is necessary to evaluate recurrence intervals for such events. Deeper in time, the prehistoric record back to ˜ AD 300 in southern to central Kamchatsky Bay indicates that during this interval, there were no local events significantly larger than those of the 20th century. Together, the historic and prehistoric tsunami record suggests a more northerly location of the 1997 rupture compared to most other

  9. Deposits, petrology and mechanism of the 2010-2013 eruption of Kizimen volcano in Kamchatka, Russia

    Science.gov (United States)

    Auer, A.; Belousov, A.; Belousova, M.

    2018-04-01

    Kizimen volcano in Kamchatka is well known as a source of highly heterogeneous poorly mingled magmas ranging from dacites to basaltic andesites. In 2010-2013, the volcano produced its first historical magmatic eruption with the deposition of 0.27 km3 of block and ash pyroclastic flows accompanied by slow extrusion of a 200-m-thick, highly viscous (1010-1011 Pa s) block lava flow with a volume of 0.3 km3. The total volume of erupted magma comprised approximately 0.4 km3 DRE. We provide description of the eruption chronology, as well as the lithology and petrology of eruptive products. The erupted material is represented by banded dacite and high-silica andesite. The dacitic magma was formed during a long dormancy after the previous magmatic eruption several hundred years ago with mineral compositions indicating average pre-eruptive temperatures of 810 °C, fO2 of 0.9-1.6 log units above the nickel-nickel oxide (NNO) buffer and shallow crustal storage conditions at 123 MPa. The silica-rich andesite represents a hybrid magma, which shows signs of recent thermal and compositional disequilibrium. We suggest that the hybrid magma started to form in 1963 when a swarm of deep earthquakes indicated an input of mafic magma from depth into the 6-11-km-deep silicic magma chamber. It took the following 46 years until the magma filling the chamber reached an eruptible state. Poor mingling of the two melts is attributed to its unusually high viscosity that could be associated with the pre-eruptive long-term leakage of volatiles from the chamber through a regional tectonic fault. Our investigations have shown that shallow magma chambers of dormant volcanoes demonstrating strong persistent fumarolic activity can contain highly viscous, degassed magma of evolved composition. Reactivation of such magma chambers by injection of basic magma takes a long time (several decades). Thus, eruption forecasts at such volcanoes should include a possibility of long time lag between a swarm of

  10. The 1997 Kronotsky earthquake and tsunami and their predecessors, Kamchatka, Russia

    Directory of Open Access Journals (Sweden)

    J. Bourgeois

    2018-01-01

    Full Text Available The northern part of the Kamchatka subduction zone (KSZ experienced three tsunamigenic earthquakes in the 20th century – February 1923, April 1923, December 1997 – events that help us better understand the behavior of this segment. A particular focus of this study is the nature and location of the 5 December 1997 Kronotsky rupture (Mw ∼ 7.8 as elucidated by tsunami runup north of Kronotsky Peninsula in southern to central Kamchatsky Bay. Some studies have characterized the subduction zone off Kronotsky Peninsula as either more locked or more smoothly slipping than surrounding areas and have placed the 1997 rupture south of this promontory. However, 1997 tsunami runup north of the peninsula, as evidenced by our mapping of tsunami deposits, requires the rupture to extend farther north. Previously reported runup (1997 tsunami on Kronotsky Peninsula was no more than 2–3 m, but our studies indicate tsunami heights for at least 50 km north of Kronotsky Peninsula in Kamchatsky Bay, ranging from 3.4 to 9.5 m (average 6.1 m, exceeding beach ridge heights of 5.3 to 8.3 m (average 7.1 m. For the two 1923 tsunamis, we cannot distinguish among their deposits in southern to central Kamchatsky Bay, but the deposits are more extensive than the 1997 deposit. A reevaluation of the April 1923 historical tsunami suggests that its moment magnitude could be revised upward, and that the 1997 earthquake filled a gap between the two 1923 earthquake ruptures. Characterizing these historical earthquakes and tsunamis in turn contributes to interpreting the prehistoric record, which is necessary to evaluate recurrence intervals for such events. Deeper in time, the prehistoric record back to ∼ AD 300 in southern to central Kamchatsky Bay indicates that during this interval, there were no local events significantly larger than those of the 20th century. Together, the historic and prehistoric tsunami record suggests a more northerly location of

  11. SRTM Colored Height and Shaded Relief: Sredinnyy Khrebet, Kamchatka Peninsula, Russia

    Science.gov (United States)

    2001-01-01

    The Kamchatka Peninsula in eastern Russia is shown in this scene created from a preliminary elevation model derived from the first data collected during the Shuttle Radar Topography Mission (SRTM) on February 12, 2000. Sredinnyy Khrebet, the mountain range that makes up the spine of the peninsula, is a chain of active volcanic peaks. Pleistocene and recent glaciers have carved the broad valleys and jagged ridges that are common here. The relative youth of the volcanism is revealed by the topography as infilling and smoothing of the otherwise rugged terrain by lava, ash, and pyroclastic flows, particularly surrounding the high peaks in the south central part of the image. Elevations here range from near sea level up to 2,618 meters (8,590 feet).Two visualization methods were combined to produce this image: shading and color coding of topographic height. The shade image was derived by computing topographic slope in the north-south direction. Northern slopes appear bright and southern slopes appear dark. Color coding is directly related to topographic height, with green at the lower elevations, rising through yellow, red, and magenta, to white at the highest elevations.Elevation data used in this image was acquired by the Shuttle Radar Topography Mission (SRTM) aboard Space Shuttle Endeavour, launched on February 11,2000. SRTM used the same radar instrument that comprised the Spaceborne Imaging Radar-C/X-Band Synthetic Aperture Radar (SIR-C/X-SAR) that flew twice on Space Shuttle Endeavour in 1994. SRTM was designed to collect three-dimensional measurements of Earth's surface. To collect the 3-D data, engineers added a 60-meter-long (200-foot) mast, installed additional C-band and X-band antennas, and improved tracking and navigation devices. The mission is a cooperative project between the National Aeronautics and Space Administration (NASA), the National Imagery and Mapping Agency (NIMA) of the U.S. Department of Defense, and the German and Italian space agencies

  12. The cardiovascular safety trials of DPP-4 inhibitors, GLP-1 agonists, and SGLT2 inhibitors.

    Science.gov (United States)

    Secrest, Matthew H; Udell, Jacob A; Filion, Kristian B

    2017-04-01

    In this paper, we review the results of large, double-blind, placebo-controlled randomized trials mandated by the US Food and Drug Administration to examine the cardiovascular safety of newly-approved antihyperglycemic agents in patients with type 2 diabetes. The cardiovascular effects of dipeptidyl peptidase-4 (DPP-4) inhibitors remain controversial: while these drugs did not reduce or increase the risk of primary, pre-specified composite cardiovascular outcomes, one DPP-4 inhibitor (saxagliptin) increased the risk of hospitalization for heart failure in the overall population; another (alogliptin) demonstrated inconsistent effects on heart failure hospitalization across subgroups of patients, and a third (sitagliptin) demonstrated no effect on heart failure. Evidence for cardiovascular benefits of glucagon-like peptide-1 (GLP-1) agonists has been similarly heterogeneous, with liraglutide and semaglutide reducing the risk of composite cardiovascular outcomes, but lixisenatide having no reduction or increase in cardiovascular risk. The effect of GLP-1 agonists on retinopathy remains a potential concern. In the only completed trial to date to assess a sodium-glucose cotransporter-2 (SGLT2) inhibitor, empagliflozin reduced the risk of composite cardiovascular endpoints, predominantly through its impact on cardiovascular mortality and heart failure hospitalization. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Water permeation through the sodium-dependent galactose cotransporter vSGLT.

    Science.gov (United States)

    Choe, Seungho; Rosenberg, John M; Abramson, Jeff; Wright, Ernest M; Grabe, Michael

    2010-10-06

    It is well accepted that cotransporters facilitate water movement by two independent mechanisms: osmotic flow through a water channel in the protein and flow driven by ion/substrate cotransport. However, the molecular mechanism of transport-linked water flow is controversial. Some researchers believe that it occurs via cotransport, in which water is pumped along with the transported cargo, while others believe that flow is osmotic in response to an increase in intracellular osmolarity. In this letter, we report the results of a 200-ns molecular dynamics simulation of the sodium-dependent galactose cotransporter vSGLT. Our simulation shows that a significant number of water molecules cross the protein through the sugar-binding site in the presence as well as the absence of galactose, and 70-80 water molecules accompany galactose as it moves from the binding site into the intracellular space. During this event, the majority of water molecules in the pathway are unable to diffuse around the galactose, resulting in water in the inner half of the transporter being pushed into the intracellular space and replaced by extracellular water. Thus, our simulation supports the notion that cotransporters act as both passive water channels and active water pumps with the transported substrate acting as a piston to rectify the motion of water. Copyright © 2010 Biophysical Society. Published by Elsevier Inc. All rights reserved.

  14. Holocene environmental changes in southern Kamchatka, Far Eastern Russia, inferred from a pollen and testate amoebae peat succession record

    Science.gov (United States)

    Klimaschewski, A.; Barnekow, L.; Bennett, K. D.; Andreev, A. A.; Andrén, E.; Bobrov, A. A.; Hammarlund, D.

    2015-11-01

    High resolution palaeoenvironmental records in Far-Eastern Russia are rare, and the Kamchatka Peninsula is among the least studied areas of the region. This paper describes a record spanning the last ca. 11,000 yr, obtained from a bog in the southern part of Kamchatka. The radiocarbon dated core was analysed for pollen, testate amoebae, charcoal and loss-on-ignition (LOI). The vegetation during the early Holocene was dominated by grasses (Poaceae), birch (Betula) and heath (Ericaceae p. p.). Around 10,300 cal yr BP there was a substantial change in the vegetation cover to shrub alder (Alnus viridis s.l.) stands with sedges and ferns (Polypodiophyta) as well as herbs such as meadow rue (Thalictrum) in the understory. In the surroundings of Utka peatlands started to form. The variations in the vegetation cover were most probably caused by climatic changes. At the beginning of sediment accumulation, before 10,300 cal yr BP, the composition of the vegetation points to cooler summers and/or decreased annual precipitation. Around 10,300 cal yr BP, changes in vegetation occurred due to rising temperatures and/or changed water regimes. Increased abundancies of dry indicating testate amoebae after 9100 cal yr BP point to intermediate to dry soil conditions. Between 8600 and 7700 cal yr BP tree alder (Alnus incana) was widely spread at the site which probably indicates optimal environmental conditions. The tephra layer at 381-384.5 cm (ca. 8500 cal yr BP) produces a strong impact on the testate amoebae assemblages. At 7700 cal yr BP there was a sudden drop of A. incana in the local vegetation. From this time on, A. incana and also A. viridis decrease continuously whereas Betula gradually increases. The upper part of the sequence (after 6300 cal yr BP) shows higher abundancies of meadowsweet (Filipendula) and sweet gale (Myrica) pollen. After 6300 cal yr BP, changes in testate amoebae demonstrate variable soil moisture conditions at the site. Between 3700 and 1800 cal yr BP

  15. Drug-drug interactions with sodium-glucose cotransporters type 2 (SGLT2) inhibitors, new oral glucose-lowering agents for the management of type 2 diabetes mellitus.

    Science.gov (United States)

    Scheen, André J

    2014-04-01

    Inhibitors of sodium-glucose cotransporters type 2 (SGLT2) reduce hyperglycaemia by decreasing renal glucose threshold and thereby increasing urinary glucose excretion. They are proposed as a novel approach for the management of type 2 diabetes mellitus. They have proven their efficacy in reducing glycated haemoglobin, without inducing hypoglycaemia, as monotherapy or in combination with various other glucose-lowering agents, with the add-on value of promoting some weight loss and lowering arterial blood pressure. As they may be used concomitantly with many other drugs, we review the potential drug-drug interactions (DDIs) regarding the three leaders in the class (dapagliglozin, canagliflozin and empagliflozin). Most of the available studies were performed in healthy volunteers and have assessed the pharmacokinetic interferences with a single administration of the SGLT2 inhibitor. The exposure [assessed by peak plasma concentrations (Cmax) and area under the concentration-time curve (AUC)] to each SGLT2 inhibitor tested was not significantly influenced by the concomitant administration of other glucose-lowering agents or cardiovascular agents commonly used in patients with type 2 diabetes. Reciprocally, these medications did not influence the pharmacokinetic parameters of dapagliflozin, canagliflozin or empagliflozin. Some modest changes were not considered as clinically relevant. However, drugs that could specifically interfere with the metabolic pathways of SGLT2 inhibitors [rifampicin, inhibitors or inducers of uridine diphosphate-glucuronosyltransferase (UGT)] may result in significant changes in the exposure of SGLT2 inhibitors, as shown for dapagliflozin and canagliflozin. Potential DDIs in patients with type 2 diabetes receiving chronic treatment with an SGLT2 inhibitor deserve further attention, especially in individuals treated with several medications or in more fragile patients with hepatic and/or renal impairment.

  16. Efficacy and Safety of SGLT2 Inhibitors in Patients with Type 1 Diabetes: A Meta-analysis of Randomized Controlled Trials.

    Science.gov (United States)

    Yang, Yingying; Pan, Hui; Wang, Bo; Chen, Shi; Zhu, Huijuan

    2017-04-10

    Objective To assess the efficiency and safety of a novel sodium-glucose co-transporter 2 (SGLT2) inhibitor-SGLT2 inhibitors, in combination with insulin for type 1 diabetes mellitus (T1DM). Methods We searched Medline, Embase, and the Cochrane Collaboration Library to identify the eligible studies published between January 2010 and July 2016 without restriction of language. The Food and Drug Administration (FDA) data and ClinicalTrials (http://www.clinicaltrials.gov) were also searched. The included studies met the following criteria: randomized controlled trials; T1DM patients aged between 18 and 65 years old; patients were treated with insulin plus SGLT2 inhibitors for more than 2 weeks; patients' glycosylated hemoglobin (HbA1c) levels were between 7% and 12%. The SGLT2 inhibitors group was treated with SGLT2 inhibitors plus insulin, and the placebo group received placebo plus insulin treatment. The outcomes should include one of the following items: fasting blood glucose, HbA1c, glycosuria, or adverse effects. Data were analyzed by two physicians independently. The risk of bias was evaluated by using the Cochrane Collaboration's Risk of Bias tool and heterogeneity among studies was assessed using Chi-square test. Random effect model was used to analyze the treatment effects with Revman 5.3.Results Three trials including 178 patients were enrolled. As compared to the placebo group, SGLT2 inhibitor absolutely decreased fasting blood glucose [mean differences (MD) -2.47 mmol/L, 95% confidence interval (CI) -3.65 to -1.28, PSGLT2 inhibitors could also increase the excretion of urine glucose (MD 131.09 g/24 h, 95%CI 91.79 to 170.39, PSGLT2 inhibitors combined with insulin might be an efficient and safe treatment modality for T1DM patients.

  17. SGLT2 inhibitors and renal outcomes in type 2 diabetes with or without renal impairment: A systematic review and meta-analysis.

    Science.gov (United States)

    Seidu, Samuel; Kunutsor, Setor K; Cos, Xavier; Gillani, Syed; Khunti, Kamlesh

    2018-06-01

    Sodium-glucose co-transporter 2 (SGLT2) inhibitors may have renal protective effects in people with impaired kidney function. We assessed the use of SGLT2 inhibitors in people with type 2 diabetes with or without renal impairment [defined as estimated glomerular filtration rate (eGFR) of ≥30 and 300 and ≤5000mg/g] by conducting a systematic review and meta-analysis of available studies. Randomised controlled trials (RCTs) were identified from MEDLINE, EMABASE, Web of Science, the Cochrane Library, and search of bibliographies to March 2017. No relevant observational study was identified. Summary measures were presented as mean differences and narrative synthesis performed for studies that could not be pooled. 42 articles which included 40 RCTs comprising 29,954 patients were included. In populations with renal impairment, SGLT2 inhibition compared with placebo was consistently associated with an initial decrease in eGFR followed by an increase and return to baseline levels. In pooled analysis of 17 studies in populations without renal impairment, there was no significant change in eGFR comparing SGLT2 inhibitors with placebo (mean difference, 0.51ml/min/1.73m 2 ; 95% CI: -0.69, 1.72; p=403). SGLT2 inhibition relative to placebo was associated with preservation in serum creatinine levels or initial increases followed by return to baseline levels in patients with renal impairment, but levels were preserved in patients without renal impairment. In populations with or without renal impairment, SGLT2 inhibitors (particularly canagliflozin and empagliflozin) compared with placebo were associated with decreased urine albumin, improved albuminiuria, slowed progression to macroalbuminuria, and reduced the risk of worsening renal impairment, the initiation of kidney transplant, and death from renal disease. Emerging data suggests that with SGLT2 inhibition, renal function seems to be preserved in people with diabetes with or without renal impairment. Furthermore, SGLT2

  18. Empagliflozin: a new sodium-glucose co-transporter 2 (SGLT2 inhibitor for the treatment of type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Joshua J Neumiller

    2014-06-01

    Full Text Available Type 2 diabetes is increasing in prevalence worldwide, and hyperglycemia is often poorly controlled despite a number of therapeutic options. Unlike previously available agents, sodium-glucose co-transporter 2 (SGLT2 inhibitors offer an insulin-independent mechanism for improving blood glucose levels, since they promote urinary glucose excretion (UGE by inhibiting glucose reabsorption in the kidney. In addition to glucose control, SGLT2 inhibitors are associated with weight loss and blood pressure reductions, and do not increase the risk of hypoglycemia. Empagliflozin is a selective inhibitor of SGLT2, providing dose-dependent UGE increases in healthy volunteers, with up to 90 g of glucose excreted per day. It can be administered orally, and studies of people with renal or hepatic impairment indicated empagliflozin needed no dose adjustment based on pharmacokinetics. In Phase II trials in patients with type 2 diabetes, empagliflozin provided improvements in glycosylated hemoglobin (HbA1c and other measures of glycemic control when given as monotherapy or add-on to metformin, as well as reductions in weight and systolic blood pressure. As add-on to basal insulin, empagliflozin not only improved HbA1c levels but also reduced insulin doses. Across studies, empagliflozin was generally well tolerated with a similar rate of hypoglycemia to placebo; however, patients had a slightly increased frequency of genital infections, but not urinary tract infections, versus placebo. Phase III studies have also reported a good safety profile along with significant improvements in HbA1c, weight and blood pressure, with no increased risk of hypoglycemia versus placebo. Based on available data, it appears that empagliflozin may be a useful option in a range of patients; however, clinical decisions will be better informed by the results of ongoing studies, in particular, a large cardiovascular outcome study (EMPA-REG OUTCOME™.

  19. SGLT2 inhibitor lowers serum uric acid through alteration of uric acid transport activity in renal tubule by increased glycosuria

    Science.gov (United States)

    Chino, Yukihiro; Samukawa, Yoshishige; Sakai, Soichi; Nakai, Yasuhiro; Yamaguchi, Jun-ichi; Nakanishi, Takeo; Tamai, Ikumi

    2014-01-01

    Sodium glucose cotransporter 2 (SGLT2) inhibitors have been reported to lower the serum uric acid (SUA) level. To elucidate the mechanism responsible for this reduction, SUA and the urinary excretion rate of uric acid (UEUA) were analysed after the oral administration of luseogliflozin, a SGLT2 inhibitor, to healthy subjects. After dosing, SUA decreased, and a negative correlation was observed between the SUA level and the UEUA, suggesting that SUA decreased as a result of the increase in the UEUA. The increase in UEUA was correlated with an increase in urinary d-glucose excretion, but not with the plasma luseogliflozin concentration. Additionally, in vitro transport experiments showed that luseogliflozin had no direct effect on the transporters involved in renal UA reabsorption. To explain that the increase in UEUA is likely due to glycosuria, the study focused on the facilitative glucose transporter 9 isoform 2 (GLUT9ΔN, SLC2A9b), which is expressed at the apical membrane of the kidney tubular cells and transports both UA and d-glucose. It was observed that the efflux of [14C]UA in Xenopus oocytes expressing the GLUT9 isoform 2 was trans-stimulated by 10 mm d-glucose, a high concentration of glucose that existed under SGLT2 inhibition. On the other hand, the uptake of [14C]UA by oocytes was cis-inhibited by 100 mm d-glucose, a concentration assumed to exist in collecting ducts. In conclusion, it was demonstrated that the UEUA could potentially be increased by luseogliflozin-induced glycosuria, with alterations of UA transport activity because of urinary glucose. PMID:25044127

  20. Variations in the Parameters of Background Seismic Noise during the Preparation Stages of Strong Earthquakes in the Kamchatka Region

    Science.gov (United States)

    Kasimova, V. A.; Kopylova, G. N.; Lyubushin, A. A.

    2018-03-01

    The results of the long (2011-2016) investigation of background seismic noise (BSN) in Kamchatka by the method suggested by Doct. Sci. (Phys.-Math.) A.A. Lyubushin with the use of the data from the network of broadband seismic stations of the Geophysical Survey of the Russian Academy of Sciences are presented. For characterizing the BSN field and its variability, continuous time series of the statistical parameters of the multifractal singularity spectra and wavelet expansion calculated from the records at each station are used. These parameters include the generalized Hurst exponent α*, singularity spectrum support width Δα, wavelet spectral exponent β, minimal normalized entropy of wavelet coefficients En, and spectral measure of their coherent behavior. The peculiarities in the spatiotemporal distribution of the BSN parameters as a probable response to the earthquakes with M w = 6.8-8.3 that occurred in Kamchatka in 2013 and 2016 are considered. It is established that these seismic events were preceded by regular variations in the BSN parameters, which lasted for a few months and consisted in the reduction of the median and mean α*, Δα, and β values estimated over all the stations and in the increase of the En values. Based on the increase in the spectral measure of the coherent behavior of the four-variate time series of the median and mean values of the considered statistics, the effect of the enhancement of the synchronism in the joint (collective) behavior of these parameters during a certain period prior to the mantle earthquake in the Sea of Okhotsk (May 24, 2013, M w = 8.3) is diagnosed. The procedures for revealing the precursory effects in the variations of the BSN parameters are described and the examples of these effects are presented.

  1. FIRST RESULTS ON THE DIRECTION STATISTICS OF PAIRS OF EPICENTERS OF NEIGHBOR EARTHQUAKES ON KAMCHATKA

    Directory of Open Access Journals (Sweden)

    A. A. Gusev

    2016-01-01

    Full Text Available Small earthquakes, often treated as “background seismicity”, are not distributed in space-time in a random manner. Often, space-time clustering is studied, that manifests itself as aftershock sequences and swarms. These phenomena can be described as a deviation (increase of probability of short interevent distances and times as compared to the reference “pure random” or Poisson case; this tendency manifests itself in statistics of distances between epicenters. In the present work, we study the statistics of directions for vectors connecting pairs of epicenters of such small earthquakes which are close in space-time. Components of such pairs will be called “neighbors”, and the mentioned vectors will be called “link vectors”. A study of this kind is of interest from a number of viewpoints, such as: discovering new properties of statistical structure of observed fields of epicenters; establishing interactions between earthquake sources of small earthquakes, revealing geometrical properties of the pattern of active faults of a low rank. We will show that directions of link vectors clearly deviate from isotropy, and have instead non-uniform, often spiked, distribution of directions.Pairs of neighbors are extracted from the catalogue of small (ML=3.5–5.0 shallow earthquakes of the Kamchatka subduction zone. То define neighbors, bounds are set on the distance (10–60 km and relative delay (0.5 day between members of a pair. Before pair extraction, the work catalog was decimated to reduce space-time event density within dense clusters. With the catalog of pairs at hand, we constructed distributions of azimuths of link vectors (rose diagrams of directions. In Fig. 3 one can see example histograms and corresponding rose diagrams for two 10-year periods (see Table 1 for definitions and labels of the periods; processing was done using two variants of maximum delay: 0.5 and 5 days. Angles (modified azimuths, n in all histograms and rose

  2. Initial H2O content and conditions of parent magma origin for Gorely volcano (Southern Kamchatka) estimated by trace element thermobarometry

    Science.gov (United States)

    Nazarova, D. P.; Portnyagin, M. V.; Krasheninnikov, S. P.; Mironov, N. L.; Sobolev, A. V.

    2017-01-01

    The formation conditions of the parental magmas of Gorely volcano, which is located behind a volcanic front in Southern Kamchatka, have been evaluated using the modern methods of micro-element thermobarometry. These magmas contained 1.7 ± 0.8 (2σ) wt % of H2O, the majority (82%) of which has been lost from inclusions. They crystallized at 1121 ± 17°C and an oxygen fugacity of ΔQFM 1.2 ± 0.2, and could have been produced by about 11% melting of an enriched MORB source (E-DMM) at a temperature of about 1270°C, and a pressure of about 1.5 GPa. A distinctive feature of Gorely volcano, compared with frontal volcanoes of Kamchatka, is the unusually high temperature (925 ± 20°C) of formation of the subduction component corresponding to the region of existence of water-bearing melts.

  3. A double-blind, placebo-controlled study on the effects of lutein and zeaxanthin on photostress recovery, glare disability, and chromatic contrast.

    Science.gov (United States)

    Hammond, Billy R; Fletcher, Laura M; Roos, Franz; Wittwer, Jonas; Schalch, Wolfgang

    2014-12-02

    Past studies have shown that higher macular pigment optical density (MPOD) and lutein (L) and zeaxanthin (Z) supplementation are related to improvements in glare disability, photostress recovery, and chromatic contrast. This study assessed those links using a randomized, double-blind, placebo-controlled design. The visual effects of 1 year of supplementing L (10 mg/d) and Z (2 mg/d) were investigated. One hundred fifteen young, healthy subjects were recruited and randomized into the study (58 received placebo, 57 L+Z). Several dependent measures were collected at baseline and then once every 3 months: serum L and Z measured by HPLC chromatography; MPOD measured using customized heterochromatic flicker photometry; photostress recovery assessed by measuring the time needed to recover visual acquisition of a grating target after 30 seconds of an intense xenon white flash exposure; glare disability evaluated as the energy in a surrounding annulus necessary to veil a central grating target; and chromatic contrast assessed by measuring thresholds for a yellow grating target superposed on a 460-nm background. Macular pigment optical density increased significantly versus placebo at all eccentricities (10, 30, 60, and 105 minutes from the center of the macula). Serum L and Z also increased significantly by the first follow-up visit (at 3 months), and remained elevated throughout the intervention period of 1 year. Chromatic contrast and photostress recovery time improved significantly versus placebo. Glare disability was correlated with macular pigment density throughout the study period but did not increase significantly in the treated group. Daily supplementation with L+Z resulted in significant increase in serum levels and MPOD and improvements in chromatic contrast and recovery from photostress. These results are consistent with past studies showing that increasing MPOD leads to improved visual performance. (ClinicalTrials.gov number, NCT00909090.). Copyright 2014 The

  4. D/N and /sup 18/O//sup 16/O in magmatic waters and gases of the Great Tolbachik fissure eruption, Kamchatka

    Energy Technology Data Exchange (ETDEWEB)

    Menyailov, I A; Vetshtein, V E; Nikitina, L P; Artemchuk, V G [AN SSSR, Petropavlovsk-Kamchatskii. Inst. Vulkanologii; AN Ukrainskoj SSR, Kiev. Inst. Geokhimii i Fiziki Mineralov)

    1981-01-01

    Isotope content of magmatic gases and their condensates (magmatic waters) is studied on the basis of the Great Tolbachik fissure eruption, Kamchatka. The phenomenon of regular increase of deuterium content in magmatic water and protium content in gases is found out. It is supposed that this fact is conditioned by isotope fractionation during phase transitions in liquid-steam-gas system in the process of the formation of magmatic hearth and gas release from magma during eruption.

  5. Curtain with vista. Office tower with an effective solar and glare protection; Vorhang mit Durchblick. Buerohochhaus mit effektiven Sonnen- und Blendschutz

    Energy Technology Data Exchange (ETDEWEB)

    Anon.

    2012-05-15

    The Kennedydamm in Duesseldorf (Federal Republic of Germany) has a new landmark: the 89-meter-high Sky Office characterizes the entire surrounding metropolitan area and provides high-value jobs with popular outlook. In order to maintain this even when the sun is low, the planner have decided for a solar and glare protection solution from WAREMA Renkhoff SE (Marktheidenfeld, Federal Republic of Germany). A sophisticated control system combines the two components with the weather conditions, the path of the sun and the point of compass.

  6. AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS AND AMERICAN COLLEGE OF ENDOCRINOLOGY POSITION STATEMENT ON THE ASSOCIATION OF SGLT-2 INHIBITORS AND DIABETIC KETOACIDOSIS.

    Science.gov (United States)

    Handelsman, Yehuda; Henry, Robert R; Bloomgarden, Zachary T; Dagogo-Jack, Sam; DeFronzo, Ralph A; Einhorn, Daniel; Ferrannini, Ele; Fonseca, Vivian A; Garber, Alan J; Grunberger, George; LeRoith, Derek; Umpierrez, Guillermo E; Weir, Matthew R

    2016-06-01

    AACE = American Association of Clinical Endocrinologists ACE = American College of Endocrinology DKA = diabetic ketoacidosis EMA = European Medicines Agency FDA = U.S. Food and Drug Administration SGLT-2 = sodium glucosecotransporter 2 T1D = type 1 diabetes T2D = type 2 diabetes.

  7. Development and application of a fluorescent glucose uptake assay for the high-throughput screening of non-glycoside SGLT2 inhibitors.

    Science.gov (United States)

    Wu, Szu-Huei; Yao, Chun-Hsu; Hsieh, Chieh-Jui; Liu, Yu-Wei; Chao, Yu-Sheng; Song, Jen-Shin; Lee, Jinq-Chyi

    2015-07-10

    Sodium-dependent glucose co-transporter 2 (SGLT2) inhibitors are of current interest as a treatment for type 2 diabetes. Efforts have been made to discover phlorizin-related glycosides with good SGLT2 inhibitory activity. To increase structural diversity and better understand the role of non-glycoside SGLT2 inhibitors on glycemic control, we initiated a research program to identify non-glycoside hits from high-throughput screening. Here, we report the development of a novel, fluorogenic probe-based glucose uptake system based on a Cu(I)-catalyzed [3+2] cycloaddition. The safer processes and cheaper substances made the developed assay our first priority for large-scale primary screening as compared to the well-known [(14)C]-labeled α-methyl-D-glucopyranoside ([(14)C]-AMG) radioactive assay. This effort culminated in the identification of a benzimidazole, non-glycoside SGLT2 hit with an EC50 value of 0.62 μM by high-throughput screening of 41,000 compounds. Copyright © 2015 Elsevier B.V. All rights reserved.

  8. Na+-glucose cotransporter SGLT1 protein in salivary glands: potential involvement in the diabetes-induced decrease in salivary flow.

    Science.gov (United States)

    Sabino-Silva, R; Freitas, H S; Lamers, M L; Okamoto, M M; Santos, M F; Machado, U F

    2009-03-01

    Oral health complications in diabetes include decreased salivary secretion. The SLC5A1 gene encodes the Na(+)-glucose cotransporter SGLT1 protein, which not only transports glucose, but also acts as a water channel. Since SLC5A1 expression is altered in kidneys of diabetic subjects, we hypothesize that it could also be altered in salivary glands, contributing to diabetic dysfunction. The present study shows a diabetes-induced decrease (p salivary secretion, which was accompanied by enhanced (p diabetic rats revealed that SGLT1 protein expression increased in the luminal membrane of ductal cells, which can stimulate water reabsorption from primary saliva. Furthermore, SGLT1 protein was reduced in myoepithelial cells of the parotid from diabetic animals, and that, by reducing cellular contractile activity, might also be related to reduced salivary flux. Six-day insulin-treated diabetic rats reversed all alterations. In conclusion, diabetes increases SLC5A1 gene expression in salivary glands, increasing the SGLT1 protein content in the luminal membrane of ductal cells, which, by increasing water reabsorption, might explain the diabetes-induced decrease in salivary secretion.

  9. Rates of myocardial infarction and stroke in patients initiated on SGLT2-inhibitors versus other glucose-lowering agents in real-world clinical practice

    DEFF Research Database (Denmark)

    Kosiborod, Mikhail; Birkeland, Kåre I; Cavender, Matthew A

    2018-01-01

    The multinational, observational CVD-REAL study recently showed that initiation of sodium-glucose co-transporter-2 inhibitors (SGLT-2i) was associated with significantly lower rates of death and heart failure vs. other glucose-lowering drugs (oGLDs). This sub-analysis of CVD-REAL sought to determ...

  10. The effects of GLP-1 analogues, DPP-4 inhibitors and SGLT2 inhibitors on the renal system.

    Science.gov (United States)

    Schernthaner, Guntram; Mogensen, Carl Erik; Schernthaner, Gerit-Holger

    2014-09-01

    Diabetic nephropathy (DN) affects an estimated 20%-40% of patients with type 2 diabetes mellitus (T2DM). Key modifiable risk factors for DN are albuminuria, anaemia, dyslipidaemia, hyperglycaemia and hypertension, together with lifestyle factors, such as smoking and obesity. Early detection and treatment of these risk factors can prevent DN or slow its progression, and may even induce remission in some patients. DN is generally preceded by albuminuria, which frequently remains elevated despite treatment in patients with T2DM. Optimal treatment and prevention of DN may require an early, intensive, multifactorial approach, tailored to simultaneously target all modifiable risk factors. Regular monitoring of renal function, including urinary albumin excretion, creatinine clearance and glomerular filtration rate, is critical for following any disease progression and making treatment adjustments. Dipeptidyl peptidase (DPP)-4 inhibitors and sodium-glucose cotransporter 2 (SGLT2) inhibitors lower blood glucose levels without additional risk of hypoglycaemia, and may also reduce albuminuria. Further investigation of the potential renal benefits of DPP-4 and SGLT2 inhibitors is underway. © The Author(s) 2014.

  11. A Medical Literature Review on Canagliflozin and Dapagliflozin and the Role of SGLT2 inhibitors in Diabetic Management

    Directory of Open Access Journals (Sweden)

    Deepu Daniel

    2015-04-01

    Full Text Available Diabetes is one of the most common diseases encountered in both the outpatient and inpatient settings. According to data from the 2011 National Diabetes Fact Sheet, approximately 8.3% (25.8 million of the entire American population have diabetes. Of this population, about 72.9% (18.8 million have been clinically diagnosed while an estimated 27.1% (7.0 million remain undiagnosed. According to the study Economic Costs of Diabetes in the U.S. in 2012, the total national cost of diagnosed diabetes, including direct medical cost and reduced productivity was nearly $245 billion. Extensive research efforts have gone into developing new pharmacologic agents to treat diabetes. The newest medications recently approved by the FDA are the SGLT2 inhibitors. This article will explain the mechanism of the action of this class of drugs along with their specific role in diabetic management. This article will focus on canagliflozin and dapagliflozin, the two most well researched and studied drugs of SGLT2 inhibitors, both of which have been approved for use by the Food and Drug Administration. Some of the major trials concerning both of these drugs will be presented in this article.

  12. Mass determination of moment magnitudes M w and establishing the relationship between M w and M L for moderate and small Kamchatka earthquakes

    Science.gov (United States)

    Abubakirov, I. R.; Gusev, A. A.; Guseva, E. M.; Pavlov, V. M.; Skorkina, A. A.

    2018-01-01

    The average relationship is established between the basic magnitude for the Kamchatka regional catalog, M L , and modern moment magnitude M w. The latter is firmly tied to the value of the source seismic moment M 0 which has a direct physical meaning. M L magnitude is not self-reliant but is obtained through the conversion of the traditional Fedotov's S-wave energy class, K S1,2 F68 . Installation of the digital seismographic network in Kamchatka in 2006-2010 permitted mass estimates of M 0 and M w to be obtained from the regional data. In this paper we outline a number of techniques to estimate M 0 for the Kamchatka earthquakes using the waveforms of regional stations, and then compare the obtained M w estimates with each other and with M L , based on several hundred earthquakes that took place in 2010-2014. On the average, for M w = 3.0-6.0, M w = M L -0.40; this relationship allows obtaining M w estimates (proxy- M w) for a large part of the regional earthquake catalog with M L = 3.4-6.4 ( M w = 3.0-6.0).

  13. Predicted radionuclide release from reactor-related unenclosed solid objects dumped in the Sea of Japan and the Pacific Ocean, east coast of Kamchatka

    International Nuclear Information System (INIS)

    Mount, M.E.; Lynn, N.M.; Warden, J.M.

    1996-06-01

    Between 1978 and 1991 reactor-related solid radioactive waste was dumped by the former Soviet Union as unenclosed objects in the Pacific Ocean, east coast of Kamchatka, and the Sea of Japan. This paper presented estimates for the current (1994) inventory of activation and corrosion products contained in the reactor-related unenclosed solid objects. In addition, simple models derived for prediction of radionuclide release from marine reactors dumped in the Kara Sea are applied to certain of the dumped objects to provide estimates of radionuclide release to the Pacific Ocean, east coast of Kamchatka, and Sea of Japan environments. For the Pacific Ocean, east coast of Kamchatka, total release rates start below 0.01 GBq yr -1 and over 1,000 years, fall to 100 Bq yr -1 . In the Sea of Japan, the total release rate starts just above 1 GBq yr - 1 , dropping off to a level less than 0.1 GBq yr -1 , extending past the year 4,000

  14. Expression of Na+/glucose co-transporter 1 (SGLT1) is enhanced by supplementation of the diet of weaning piglets with artificial sweeteners.

    Science.gov (United States)

    Moran, Andrew W; Al-Rammahi, Miran A; Arora, Daleep K; Batchelor, Daniel J; Coulter, Erin A; Daly, Kristian; Ionescu, Catherine; Bravo, David; Shirazi-Beechey, Soraya P

    2010-09-01

    In an intensive livestock production, a shorter suckling period allows more piglets to be born. However, this practice leads to a number of disorders including nutrient malabsorption, resulting in diarrhoea, malnutrition and dehydration. A number of strategies have been proposed to overcome weaning problems. Artificial sweeteners, routinely included in piglets' diet, were thought to enhance feed palatability. However, it is shown in rodent models that when included in the diet, they enhance the expression of Na+/glucose co-transporter (SGLT1) and the capacity of the gut to absorb glucose. Here, we show that supplementation of piglets' feed with a combination of artificial sweeteners saccharin and neohesperidin dihydrochalcone enhances the expression of SGLT1 and intestinal glucose transport function. Artificial sweeteners are known to act on the intestinal sweet taste receptor T1R2/T1R3 and its partner G-protein, gustducin, to activate pathways leading to SGLT1 up-regulation. Here, we demonstrate that T1R2, T1R3 and gustducin are expressed together in the enteroendocrine cells of piglet intestine. Furthermore, gut hormones secreted by the endocrine cells in response to dietary carbohydrates, glucagon-like peptides (GLP)-1, GLP-2 and glucose-dependent insulinotrophic peptide (GIP), are co-expressed with type 1 G-protein-coupled receptors (T1R) and gustducin, indicating that L- and K-enteroendocrine cells express these taste elements. In a fewer endocrine cells, T1R are also co-expressed with serotonin. Lactisole, an inhibitor of human T1R3, had no inhibitory effect on sweetener-induced SGLT1 up-regulation in piglet intestine. A better understanding of the mechanism(s) involved in sweetener up-regulation of SGLT1 will allow the identification of nutritional targets with implications for the prevention of weaning-related malabsorption.

  15. Transition from phreatic to phreatomagmatic explosive activity of Zhupanovsky volcano (Kamchatka) in 2013-2016 due to volcanic cone collapse

    Science.gov (United States)

    Gorbach, Natalia; Plechova, Anastasiya; Portnyagin, Maxim

    2017-04-01

    .13140/RG.2.1.5179.4001.[2] Gorbach N.V. et al., 2015. Bulletin of Kamchatka Regional Association "Educational-scientific Center". Earth Sciences. 3/27:5-11. [3] Samoilenko S.B. et al., 2014. Bulletin of Kamchatka Regional Association "Educational-scientific Center". Earth Sciences. 1/23:21-26.

  16. Assessment of geomorphic risks and attractiveness to recreational systems: a case of Nalychevo Nature Park (Kamchatka, Russia).

    Science.gov (United States)

    Blinova, I.; Bredikhin, A.

    2012-04-01

    Attractiveness of relief, diversity and rareness were always the basic features of overall recreational attractiveness of a territory. Mountainous regions with high geomorphic diversity served as model for first recreation and tourism researches. The above features often favoured sustainability of touristic system. Unique relief forms are commonly referred to natural sites. They differ from the others in structure or have some morphological and morphometric characteristics not found in other forms of the earth's surface. Such monuments form the main natural functional kernel for a recreation system which is created and exists around them. In general, functions of geomorphological sites in recreation can be divided into socio-cultural and economic. Socio-cultural function is the principal function of recreation. It responds to the cultural or spiritual needs of people such as the knowledge in the broader sense, knowledge of the world and their place in it. The economic function is to create consumer demand for goods and services, and sometimes an entire economy sector. Natural sites are particularly vulnerable to dangerous occurrence of endogenous and exogenous processes as guarantee of environmental stability is an essential condition for a proper system functioning. This requires a comprehensive study of relief dynamics, monitoring and forecasting its evolution in recreation areas. Nowadays educational and environmental tourism in Russia develop rapidly. The unique tectonic position of Kamchatka Peninsula (the active geodynamic area dedicated to the subduction zone) formed a variety of landscapes, attracting visitors from all over the world. Recreational development of this region is slow due to remoteness and poor transport accessibility. However, there are 3 state federal reserves and one federal wildlife sanctuary, 4 natural parks of regional significance, 23 nature preserves of regional significance, and 105 natural monuments officially marked in this region

  17. FY1998 research report on the basic research on geothermal district heating in Kamchatka, Russia; 1998 nendo Roshia Renpo Kamchatka shu ni okeru chinetsu riyo ni yoru chiiki danbo ni kansuru kiso chosa hokokusho

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-05-01

    Petropavlovsk-Kamchatky (P-K) city in Kamchatka, Russia is operating hot-water district heating using heavy oil boilers and waste hot water of thermal power plants as heat sources. Feasibility study was made on district heating using natural geothermal hot water and/or geothermal heat pump systems as heat sources of hot water supply for reduction of greenhouse effect gas emission. Among 3 areas including geothermal hot water, use of hot water in K area was impossible because of lower temperature and less spring water. Use of hot water in P and UP areas was impossible as primary hot water because of temperature drop to 64 degrees C during hot water supply toward P-K city. The building heating operation test was carried out using the geothermal heat pump system installed in a newly drilled heat exchange well of 100m deep. As a result, sufficient heat recovery was achieved for heating. If all of 49 boiler houses for heating are replaced with such geothermal heat pump systems, CO{sub 2} reduction was estimated to be 520,000t/y. (NEDO)

  18. Network-Based Detection and Classification of Seismovolcanic Tremors: Example From the Klyuchevskoy Volcanic Group in Kamchatka

    Science.gov (United States)

    Soubestre, Jean; Shapiro, Nikolai M.; Seydoux, Léonard; de Rosny, Julien; Droznin, Dmitry V.; Droznina, Svetlana Ya.; Senyukov, Sergey L.; Gordeev, Evgeniy I.

    2018-01-01

    We develop a network-based method for detecting and classifying seismovolcanic tremors. The proposed approach exploits the coherence of tremor signals across the network that is estimated from the array covariance matrix. The method is applied to four and a half years of continuous seismic data recorded by 19 permanent seismic stations in the vicinity of the Klyuchevskoy volcanic group in Kamchatka (Russia), where five volcanoes were erupting during the considered time period. We compute and analyze daily covariance matrices together with their eigenvalues and eigenvectors. As a first step, most coherent signals corresponding to dominating tremor sources are detected based on the width of the covariance matrix eigenvalues distribution. Thus, volcanic tremors of the two volcanoes known as most active during the considered period, Klyuchevskoy and Tolbachik, are efficiently detected. As a next step, we consider the daily array covariance matrix's first eigenvector. Our main hypothesis is that these eigenvectors represent the principal components of the daily seismic wavefield and, for days with tremor activity, characterize dominant tremor sources. Those daily first eigenvectors, which can be used as network-based fingerprints of tremor sources, are then grouped into clusters using correlation coefficient as a measure of the vector similarity. As a result, we identify seven clusters associated with different periods of activity of four volcanoes: Tolbachik, Klyuchevskoy, Shiveluch, and Kizimen. The developed method does not require a priori knowledge and is fully automatic; and the database of the network-based tremor fingerprints can be continuously enriched with newly available data.

  19. Targeting the kidney and glucose excretion with dapagliflozin: preclinical and clinical evidence for SGLT2 inhibition as a new option for treatment of type 2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Whaley JM

    2012-07-01

    Full Text Available Jean M Whaley,1 Mark Tirmenstein,2 Timothy P Reilly,2 Simon M Poucher,3 JoAnne Saye,4 Shamik Parikh,5 James F List61Bristol-Myers Squibb, Metabolic Disease Discovery Biology, Research and Development, Princeton, NJ, USA; 2Bristol-Myers Squibb, Drug Safety Evaluation, Research and Development, New Brunswick and Princeton, NJ, USA; 3AstraZeneca, Cardiovascular and Gastrointestinal Innovative Medicines Science Unit, Alderley Park, Macclesfield, Cheshire, UK; 4AstraZeneca, Global Safety Assessment, Research and Development, Wilmington, DE, USA; 5AstraZeneca, Cardiovascular, Clinical Development, Wilmington, DE, USA; 6Bristol-Myers Squibb, Global Clinical Development, Research and Development, Princeton, NJ, USAAbstract: Sodium-glucose cotransporter-2 (SGLT2 inhibitors are a novel class of glucuretic, antihyperglycemic drugs that target the process of renal glucose reabsorption and induce glucuresis independently of insulin secretion or action. In patients with type 2 diabetes mellitus, SGLT2 inhibitors have been found to consistently reduce measures of hyperglycemia, including hemoglobin A1c, fasting plasma glucose, and postprandial glucose, throughout the continuum of disease. By inducing the renal excretion of glucose and its associated calories, SGLT2 inhibitors reduce weight and have the potential to be disease modifying by addressing the caloric excess that is believed to be one of the root causes of type 2 diabetes mellitus. Additional benefits, including the possibility for combination with insulin-dependent antihyperglycemic drugs, a low potential for hypoglycemia, and the ability to reduce blood pressure, were anticipated from the novel mechanism of action and have been demonstrated in clinical studies. Mechanism-related risks include an increased incidence of urinary tract and genital infections and the possibility of over-diuresis in volume-sensitive patients. Taken together, the results of Phase III clinical studies generally point to a

  20. Renal effects and nephroprotection induced by SGLT2 inhibitor Empagliflozin in patients with Diabetes Mellitus: a literature review

    Directory of Open Access Journals (Sweden)

    Luis E. Morales-Buenrostro

    2017-01-01

    Full Text Available Chronic kidney disease is a frequent comorbidity in patients with diabetes mellitus (DM and it increases their cardiovascular risk; chronic hyperglycemia in patients with DM leads to direct and indirect disorders in kidney's structure and function, and it is the principal risk factor for the development of diabetic nephropathy and end-stage renal disease. In the current review, results of studies are exposed in which high tolerability of empagliflozin is exposed in diabetic patients with kidney disease. Empagliflozin by inhibiting SGLT2 provides a novel therapy with benefic effects, not only in glycemic control, but it also has cardiovascular and renal benefits, which they have been demonstrated in the EMPA-REG OUTCOME trial, and continue in evaluation in other studies.

  1. Euglycemic Diabetic Ketoacidosis with Elevated Acetone in a Patient Taking a Sodium-Glucose Cotransporter-2 (SGLT2) Inhibitor.

    Science.gov (United States)

    Andrews, Tory J; Cox, Robert D; Parker, Christina; Kolb, James

    2017-02-01

    Sodium-glucose cotransporter-2 (SGLT2) inhibitor medications are a class of antihyperglycemic agents that increase urinary glucose excretion by interfering with the reabsorption of glucose in the proximal renal tubules. In May of 2015, the U.S. Food and Drug Administration released a warning concerning a potential increased risk of ketoacidosis and ketosis in patients taking these medications. We present a case of a 57-year-old woman with type 2 diabetes mellitus taking a combination of canagliflozin and metformin who presented with progressive altered mental status over the previous 2 days. Her work-up demonstrated a metabolic acidosis with an anion gap of 38 and a venous serum pH of 7.08. The serum glucose was 168 mg/dL. The urinalysis showed glucose > 500 mg/dL and ketones of 80 mg/dL. Further evaluation demonstrated an elevated serum osmolality of 319 mOsm/kg and an acetone concentration of 93 mg/dL. She was treated with intravenous insulin and fluids, and the metabolic abnormalities and her altered mental status resolved within 36 h. This was the first episode of diabetic ketoacidosis (DKA) for this patient. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Diabetic patients on SGLT2 inhibitor medications are at risk for ketoacidosis. Due to the renal glucose-wasting properties of these drugs, they may present with ketoacidosis with only mild elevations in serum glucose, potentially complicating the diagnosis. Acetone is one of the three main ketone bodies formed during DKA and it may be present at considerable concentrations, contributing to the serum osmolality. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. CoMFA and CoMSIA studies on C-aryl glucoside SGLT2 inhibitors as potential anti-diabetic agents.

    Science.gov (United States)

    Vyas, V K; Bhatt, H G; Patel, P K; Jalu, J; Chintha, C; Gupta, N; Ghate, M

    2013-01-01

    SGLT2 has become a target of therapeutic interest in diabetes research. CoMFA and CoMSIA studies were performed on C-aryl glucoside SGLT2 inhibitors (180 analogues) as potential anti-diabetic agents. Three different alignment strategies were used for the compounds. The best CoMFA and CoMSIA models were obtained by means of Distill rigid body alignment of training and test sets, and found statistically significant with cross-validated coefficients (q²) of 0.602 and 0.618, respectively, and conventional coefficients (r²) of 0.905 and 0.902, respectively. Both models were validated by a test set of 36 compounds giving satisfactory predicted correlation coefficients (r² pred) of 0.622 and 0.584 for CoMFA and CoMSIA models, respectively. A comparison was made with earlier 3D QSAR study on SGLT2 inhibitors, which shows that our 3D QSAR models are better than earlier models to predict good inhibitory activity. CoMFA and CoMSIA models generated in this work can provide useful information to design new compounds and helped in prediction of activity prior to synthesis.

  3. An evaluation of US patent 2015065565 (A1) for a new class of SGLT2 inhibitors for treatment 1 of type II diabetes mellitus.

    Science.gov (United States)

    Jiang, Meiyan; Steyger, Peter S

    2015-01-01

    Type 2 diabetes mellitus (T2DM) is a growing and serious global health problem. Pharmacological inhibition of the sodium-glucose cotransporter-2 (SGLT2; SLC5A2) increases urinary glucose excretion, decreasing plasma glucose levels in an insulin-independent manner. Agents that inhibit SGLT2 have recently become available for clinical therapy of T2DM. The patent claims a new class of SGLT2 inhibitors: derivatives of dioxa-bicyclo[3.2.1]octane-2,3,4-triol (including ertugliflozin; PF-04971729). The invention describes the design, synthesis and pharmacological tests related to ertugliflozin, which could ultimately lead to efficacious therapy for T2DM alone or in combination with other anti-diabetic agents. Ertugliflozin is likely to be of great clinical significance in the near future. Continued analysis of ertugliflozin derivatives to now validate safe and efficacious treatment of T2DM in a larger number of clinical subjects over an extended period is needed to further support clinical utility. Identification, and discussion, of likely contra-indications is also needed.

  4. SGLT2 Inhibition by Empagliflozin Promotes Fat Utilization and Browning and Attenuates Inflammation and Insulin Resistance by Polarizing M2 Macrophages in Diet-induced Obese Mice

    Directory of Open Access Journals (Sweden)

    Liang Xu

    2017-06-01

    Full Text Available Sodium-glucose cotransporter (SGLT 2 inhibitors increase urinary glucose excretion (UGE, leading to blood glucose reductions and weight loss. However, the impacts of SGLT2 inhibition on energy homeostasis and obesity-induced insulin resistance are less well known. Here, we show that empagliflozin, a SGLT2 inhibitor, enhanced energy expenditure and attenuated inflammation and insulin resistance in high-fat-diet-induced obese (DIO mice. C57BL/6J mice were pair-fed a high-fat diet (HFD or a HFD with empagliflozin for 16 weeks. Empagliflozin administration increased UGE in the DIO mice, whereas it suppressed HFD-induced weight gain, insulin resistance, and hepatic steatosis. Moreover, empagliflozin shifted energy metabolism towards fat utilization, elevated AMP-activated protein kinase and acetyl-CoA carbolxylase phosphorylation in skeletal muscle, and increased hepatic and plasma fibroblast growth factor 21 levels. Importantly, empagliflozin increased energy expenditure, heat production, and the expression of uncoupling protein 1 in brown fat and in inguinal and epididymal white adipose tissue (WAT. Furthermore, empagliflozin reduced M1-polarized macrophage accumulation while inducing the anti-inflammatory M2 phenotype of macrophages within WAT and liver, lowering plasma TNFα levels and attenuating obesity-related chronic inflammation. Thus, empagliflozin suppressed weight gain by enhancing fat utilization and browning and attenuated obesity-induced inflammation and insulin resistance by polarizing M2 macrophages in WAT and liver.

  5. Environmental conditions and biological community of the Penzhina and Talovka hypertidal estuary (northwest Kamchatka) in the ice-free season

    Science.gov (United States)

    Koval, M. V.; Gorin, S. L.; Romanenko, F. A.; Lepskaya, E. V.; Polyakova, A. A.; Galyamov, R. A.; Esin, E. V.

    2017-07-01

    New data on the abiotic conditions; species composition; abundance, distribution, and migrations of fauna; and feeding interactions in an estuary ecosystem were obtained during expeditions in the mouths of Penzhina and Talovka rivers (northwest Kamchatka). It is revealed that in the ice-free season, the hydrological regime of the estuary is determined by seasonal fluctuations of river runoff, as well as fortnightly and daily variation of tides. The estuary is characterized by hypertidal fluctuations (up to 10-12 m); strong reverse flows (up to 1.0-1.5 m/s), considerable tidal variations in salinity (from 0 to 6-9‰ at the river boundary and from 6-8 to 14-16‰ at the offshore boundary), and high water turbidity (up to 1 000 NTU or more). Based on the spatial structure of the community, three ecological zones with mobile boundaries are distinguished: freshwater (salinity 0-0.1‰), estuarine (0-12.3‰), and neritic (11.2-18.9‰). High turbidity prevents the development of phytoplankton in the estuarine zone (EZ), and the local benthic community is significantly depleted due to the desalination and wide spread of aleuritic silts. Neritic copepods and nektobenthic brackish- water crustaceans generate the maximum abundance and biomass here. The species that have adapted to the local extreme hydrologic conditions dominate and form the basis of the estuarine food chain. Dominant among the EZ vertebrates are such groups as anadromous fishes (smelts, pacific salmons, charrs, and sticklebacks); waterfowl (terns, kittiwakes, cormorants, fulmars, puffins, guillemots, auklets, and wadepipers); and predatory marine mammals (larga, ringed seal, bearded seal, and white whale). The total abundance and biomass of these animals are much higher in the pelagic EZ in comparison to neighboring zones.

  6. Pre-eruption deformation caused by dike intrusion beneath Kizimen volcano, Kamchatka, Russia, observed by InSAR

    Science.gov (United States)

    Ji, Lingyun; Lu, Zhong; Dzurisin, Daniel; Senyukov, Sergey

    2013-01-01

    Interferometric synthetic aperture radar (InSAR) images reveal a pre-eruption deformation signal at Kizimen volcano, Kamchatka, Russia, where an ongoing eruption began in mid-November, 2010. The previous eruption of this basaltic andesite-to-dacite stratovolcano occurred in 1927–1928. InSAR images from both ascending and descending orbital passes of Envisat and ALOS PALSAR satellites show as much as 6 cm of line-of-sight shortening from September 2008 to September 2010 in a broad area centered at Kizimen. About 20 cm of opening of a nearly vertical dike provides an adequate fit to the surface deformation pattern. The model dike is approximately 14 km long, 10 km high, centered 13 km beneath Kizimen, and strikes NE–SW. Time-series analysis of multi-temporal interferograms indicates that (1) intrusion started sometime between late 2008 and July 2009, (2) continued at a nearly constant rate, and (3) resulted in a volume expansion of 3.2 × 107 m3 by September 2010, i.e., about two months before the onset of the 2010 eruption. Earthquakes located above the tip of the dike accompanied the intrusion. Eventually, magma pressure in the dike exceeded the confining strength of the host rock, triggering the 2010 eruption. Our results provide insight into the intrusion process that preceded an explosive eruption at a Pacific Rim stratovolcano following nearly a century of quiescence, and therefore have implications for monitoring and hazards assessment at similar volcanoes elsewhere.

  7. Deep down: Isopod biodiversity of the Kuril-Kamchatka abyssal area including a comparison with data of previous expeditions of the RV Vityaz

    Science.gov (United States)

    Elsner, Nikolaus O.; Malyutina, Marina V.; Golovan, Olga A.; Brenke, Nils; Riehl, Torben; Brandt, Angelika

    2015-01-01

    This study focusses on the isopod biodiversity in the abyssal area southeast of the Kuril-Kamchatka Trench. The KuramBio (Kuril-Kamchatka Biodiversity Studies) expedition in summer 2012 collected altogether 10,169 isopods from 21 C-EBS hauls at 12 stations, belonging to 19 families, 73 genera and 207 species from the depth range between 4830 and 5780 m. Munnopsidae and Desmosomatidae were the most abundant and species-rich families, Eurycope (Munnopsidae) and Macrostylis (Macrostylidae) the most abundant genera. An nMDS plot on the basis of the Cosine similarity index reveals no clear pattern and all hauls to be different from each other. We compared our data with 12 stations from the same depth range sampled by the Russian RV Vityaz about 50 years ago and were able to identify several species collected by the RV Vityaz. The identified isopod species belonged to the families Munnopsidae, Macrostylidae, Haploniscidae, Desmosomatidae, Ischnomesidae and Nannoniscidae. Of the 333 individuals collected by the RV Vityaz, Haploniscidae and Munnopsidae were the most abundant families. Desmosomatidae were only represented by rarefaction curves of both the KuramBio and the Vityaz samples are not approaching an asymptote, indicating that even after repeated sampling just a part of the local fauna has been recorded so far.

  8. KALMAR - "Kurile-Kamchatka and Aleutean Marginal Sea-Island Arc Systems: Geodynamic and Climate Interaction in Space and Time" - an integrated science approach between Russia and Germany

    Science.gov (United States)

    Dullo, Wolf-Christian; Baranov, Boris; van den Bogaard, Christel

    2010-05-01

    The exploration of the arctic seas require an integrated approach applying different infrastructures. In Fall 2009 German and Russian scientists performed a geo marine cruise off Kamchatka and in the western Bering Sea within the frame of the KALMAR-Project. Two main research subjects formed the scientific backbone of the cruise: The first objective focuses on the geodynamic and volcanological-magmatic development of the Kuril-Kamchatka island arc system and the Kamchatka Aleutean Islands Triple-Junction. Very little is known about the composition of the mantle and the oceanic crust as well as of the seamounts including their ages. The best studied site is the Volcanologist's Massif located between the Bering- and the Alpha Fracture Zone (Tsvetkov 1990, Volynets et al. 1992, Yogodzinsky et al. 1994), which structurally belongs to the Komandorsky Basin. The oldest rocks of the Volcanologist's Massif show very similar trace element and isotope signatures like those rocks cropping out in the volcanoes on Kamchatka in the prolongation of the Alpha Fracture Zone (Portnyagin et al. 2005a), indicating similar conditions of magma formation. The top of the Volcanologist's Massif is characterized by the young (Emperor-Seamount chain, having an age of probably > 85 Ma. The only existing basement rocks from this seamount were gained during DSDP Leg 19. These are basalts with MORB like trace element and isotope signatures (Keller et al. 2000, Regelous et al. 2003). These data indicate that the Hawaii-Hotspot was at a MOR in Cretaceous time and that large volumes of depleted mantle material played a role during the magma formation. The second objective focuses on paleo-oceanographic investigations concentrating on the sediments along the eastern continental slope of Kamchatka, in the Komandorsky Basin, and on the Shirshov Ridge in order to explore paleoclimate archives to better understand the subpolar water mass transfer and the oceanographic and climatic development in the

  9. Thermal-permeability structure and recharge conditions of the Mutnovsky high-temperature geothermal field (Kamchatka, Russia)

    Science.gov (United States)

    Kiryukhin, A. V.; Polyakov, A. Y.; Usacheva, O. O.; Kiryukhin, P. A.

    2018-05-01

    The Mutnovsky geothermal area is part of the Eastern Kamchatka active volcano belt. Mutnovsky, 80 kY old and an aging strato-volcano (a complex of 4 composite volcanic cones), acts as a magma- and water-injector into the 25-km-long North Mutnovsky extension zone. Magmatic injection events (dykes) are associated with plane-oriented MEQ (Micro Earth Quakes) clusters, most of them occurring in the NE sector of the volcano (2 × 10 km2) at elevations from -4 to -2 km, while some magmatic injections occur at elevations from -6.0 to -4.0 km below the Mutnovsky production field. Water recharge of production reservoirs is from the Mutnovsky volcano crater glacier (+1500 to +1800 masl), which was confirmed by water isotopic data (δD, δ18O) of production wells at an earlier stage of development. The Mutnovsky (Dachny) 260-310 °C high-temperature production geothermal reservoir with a volume of 16 km3 is at the junction of NNE- and NE-striking normal faults, which coincides with the current dominant dyke injection orientation. TOUGH2-modeling estimates of the reservoir properties are as follows: the reservoir permeability is 90-600 e-15 m2, the deep upflow recharge is 80 kg/s and the enthalpy is 1420 kJ/kg. Modeling was used to reproduce the history of the Mutnovsky (Dachny) reservoir exploitation since 1983 with an effective power of 48 MWe by 2016. Modeling also showed that the reservoir is capable of yielding 65-83 MWe of sustainable production until 2055, if additional production drilling in the SE part of the field is performed. Moreover, this power value may increase to 87-105 MWe if binary technologies are applied. Modeling also shows that the predicted power is sensitive to local meteoric water influx during development. Conceptual iTOUGH2-EOS1sc thermal hydrodynamic modeling of the Mutnovsky magma-hydrothermal system as a whole reasonably explains its evolution over the last 1500-5000 years in terms of heat recharge (dyke injection from the Mutnovsky-4 funnel) and

  10. Unexpectedly higher metazoan meiofauna abundances in the Kuril-Kamchatka Trench compared to the adjacent abyssal plains

    Science.gov (United States)

    Schmidt, Christina; Martínez Arbizu, Pedro

    2015-01-01

    We studied meiofauna standing stocks and community structure in the Kuril-Kamchatka Trench and its adjacent abyssal plains in the northwestern Pacific Ocean. In general, the Nematoda were dominant (93%) followed by the Copepoda (4%). Nematode abundances ranged from 87% to 96%; those of copepods from 2% to 7%. The most diverse deployment yielded 17 taxa: Acari, Amphipoda, Annelida, Bivalvia, Coelenterata, Copepoda, Cumacea, Gastrotricha, Isopoda, Kinorhyncha, Loricifera, Nematoda, Ostracoda, Priapulida, Tanaidacea, Tantulocarida, and Tardigrada. Nauplii were also present. Generally, the trench slope and the southernmost deployments had the highest abundances (850-1392 individuals/cm2). The results of non-metric multidimensional scaling indicated that these deployments were similar to each other in meiofauna community structure. The southernmost deployments were located in a zone of higher particulate organic carbon (POC) flux (g Corg m-2 yr-1), whereas the trench slope should have low POC flux due to depth attenuation. Also, POC and abundance were significantly correlated in the abyssal plains. This correlation may explain the higher abundances at the southernmost deployments. Lateral transport was also assumed to explain high meiofauna abundances on the trench slope. Abundances were generally higher than expected from model results. ANOSIM revealed significant differences between the trench slope and the northern abyssal plains, between the central abyssal plains and the trench slope, between the trench slope and the southern abyssal plains, between the central and the southern abyssal plains, and between the central and northern deployments. The northern and southern abyssal plains did not differ significantly. In addition, a U-test revealed highly significant differences between the trench-slope and abyssal deployments. The taxa inhabited mostly the upper 0-3 cm of the sediment layer (Nematoda 80-90%; Copepoda 88-100%). The trench-slope and abyssal did not differ

  11. Ziminaite, Fe3+VO4, a new howardevansite-group mineral from the Bezymyannyi volcano, Kamchatka, Russia

    Science.gov (United States)

    Pekov, Igor V.; Siidra, Oleg I.; Yapaskurt, Vasiliy O.; Polekhovsky, Yury S.; Kartashov, Pavel M.

    2018-06-01

    The new mineral ziminaite, ideally Fe3+VO4, was found in fumarole sublimates at the Bezymyannyi volcano, Kamchatka, Russia. Ziminaite occurs as lamellar, tabular or flattened prismatic crystals up to 10 × 30 × 50 μm typically epitaxially overgrowing koksharovite, and as aggregates (up to 0.15 mm) associated with bannermanite in cavities in volcanic scoria. The mineral is translucent, yellowish-brown with an adamantine luster. The calculated density is 3.45 g cm- 3. In reflected light, ziminaite is light grey. Bireflectance is weak, internal reflections are deep yellow. The reflectance values [ R max -R min, % (λ, nm)] are: 17.7-16.3 (470), 15.7-14.1 (546), 15.1-13.8 (589), 14.7-13.6 (650). Chemical composition (wt%) is: MgO 2.20, CaO 0.01, Al2O3 7.81, Fe2O3 27.18, TiO2 4.50, SiO2 0.26, P2O5 0.09, V2O5 57.01, total 99.06. The empirical formula, based on 24 O atoms, is: (Fe3 + 3.29Al1.48Ti0.54Mg0.53)Σ5.84(V6.05Si0.04P0.01)Σ6.10O24 (Z = 1). Ziminaite is triclinic, P \\overline {1}, a 8.012(4), b 9.345(5), c 6.678(3) Å, α 106.992(10), β 101.547(8), γ 96.594(11)º, V 460.4(4) Å3, Z = 6. The strongest reflections of the powder X-ray diffraction pattern [ d,Å( I)( hkl)] are: 3.751(17)(1-21, 12 - 1), 3.539(86)(120), 3.270(67)(01-2), 3.209(100)(2-20), 3.090(20)(2-11, 002), 3.041(18)(03 - 1, 02-2), 2.934(14)(12 - 2, 030) and 1.665(24)(023, 12 - 4). The crystal structure, solved from single-crystal data ( R 1 = 0.085), is based upon heteropolyhedral framework built by VO4 tetrahedra and Fe3+-centred octahedra and five-fold polyhedra. Ziminaite belongs to the howardevansite group being its first member without species-defining uni- or divalent cations and with all large cation sites vacant. The mineral is named after the Zimina volcano situated near the discovery locality.

  12. Lack of evidence for a harmful effect of sodium-glucose co-transporter 2 (SGLT2) inhibitors on fracture risk among type 2 diabetes patients: a network and cumulative meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Tang, H L; Li, D D; Zhang, J J; Hsu, Y H; Wang, T S; Zhai, S D; Song, Y Q

    2016-12-01

    To evaluate the comparative effects of sodium-glucose co-transporter 2 (SGLT2) inhibitors on risk of bone fracture in patients with type 2 diabetes mellitus (T2DM). PubMed, EMBASE, CENTRAL and ClinicalTrials.gov were systematically searched from inception to 27 January 2016 to identify randomized controlled trials (RCTs) reporting the outcome of fracture in patients with T2DM treated with SGLT2 inhibitors. Pairwise and network meta-analyses, as well as a cumulative meta-analysis, were performed to calculate odds ratios (ORs) and 95% confidence intervals (CIs). A total of 38 eligible RCTs (10 canagliflozin, 15 dapagliflozin and 13 empagliflozin) involving 30 384 patients, with follow-ups ranging from 24 to 160 weeks, were included. The fracture event rates were 1.59% in the SGLT2 inhibitor groups and 1.56% in the control groups. The incidence of fracture events was similar among these three SGLT2 inhibitor groups. Compared with placebo, canagliflozin (OR 1.15; 95% CI 0.71-1.88), dapagliflozin (OR 0.68; 95% CI 0.37-1.25) and empagliflozin (OR 0.93; 95% CI 0.74-1.18) were not significantly associated with an increased risk of fracture. Our cumulative meta-analysis indicated the robustness of the null findings with regard to SGLT2 inhibitors. Our meta-analysis based on available RCT data does not support the harmful effect of SGLT2 inhibitors on fractures, although future safety monitoring from RCTs and real-world data with detailed information on bone health is warranted. © 2016 John Wiley & Sons Ltd.

  13. Non-severe Hypoglycemia Risk Difference between Sulfonylurea and Sodium-Glucose Cotransporter-2 Inhibitors (SGLT2-I) as an Add-On to Metformin in Randomized Controlled Trials.

    Science.gov (United States)

    Farahani, Pendar

    2017-05-23

    Non-severe hypoglycemia reduces well-being, lowers quality of life, reduces productivity and increases treatment costs. The non-severe hypoglycemia rate, attributable to sulfonylurea (SU) utilization compared with newer classes such as SGLT2-I, could be of clinical significance. To explore the non-severe hypoglycemia risk difference (RD) for SU use compared with SGLT2-I in randomized controlled trials (RCTs) as an add on to metformin. A search was conducted for RCTs of SGLT2-I. PubMed database were utilized for this search. The search was limited to RCTs reported in English language for canagliflozin, dapagliflozin, and empagliflozin. SU dose comparison was utilized to convert the dose of SUs to glimepiride equivalent doses. Totally, 118 RCTs were reviewed; 6 articles had an arm for a SU as add on to metformin. Six articles belong to 3 RCTs, which reported results for 52 weeks and 104 weeks. Average non-severe hypoglycemia rate for SU arm was 30% (5.5%) [Mean (SD)] for 52 weeks and 35.6% (6.1%) for 104 weeks. RD for non-severe hypoglycemia events for SU compared to SGLT2-I was 26.7% (4.9%) for 52 weeks (p-value less than 0.001) and 30.6% (5.5%) for 104 weeks (p-value less than 0.001). There was a significant correlation between dose of SU and hypoglycemia rate (Pearson correlation 0.995; R-square 99%). This study illustrated that a large proportion of patients who had exposure to SU in RCTs of SGLT2-I experienced non-severe hypoglycemia compared to SGLT2-I. There was a close relation between SU dose and increased probability of non-severe hypoglycemia events. © 2017 Journal of Population Therapeutics and Clinical Pharmacology. All rights reserved.

  14. Protective effects of SGLT2 inhibitor luseogliflozin on pancreatic β-cells in obese type 2 diabetic db/db mice

    Energy Technology Data Exchange (ETDEWEB)

    Okauchi, Seizo, E-mail: okauchi@med.kawasaki-m.ac.jp; Shimoda, Masashi; Obata, Atsushi; Kimura, Tomohiko; Hirukawa, Hidenori; Kohara, Kenji; Mune, Tomoatsu; Kaku, Kohei; Kaneto, Hideaki

    2016-02-12

    It is well known that Sodium-Glucose Co-transporter 2 (SGLT2) inhibitors, new hypoglycemic agents, improve glycemic control by increasing urine glucose excretion, but it remained unclear how they exert protective effects on pancreatic β-cells. In this study, we examined the effects of SGLT2 inhibitor luseogliflozin on β-cell function and mass using obese type 2 diabetic db/db mice. Ten-week-old male diabetic db/db mice were treated with luseogliflozin 0.0025% or 0.01% in chow (Luse 0.0025% or Luse 0.01%) or vehicle (control) for 4 weeks. Urinary glucose excretion was increased in Luse groups (0.0025% and 0.01%) compared to control mice 3 days after the intervention. Fasting blood glucose levels were significantly lower in mice treated with Luse compared to control mice. Fasting serum insulin concentrations were significantly higher in mice treated with Luse compared to control mice. Triglyceride levels tended to be lower in Luse groups compared to control mice. In immunohistochemical study using pancreas tissues, β-cell mass was larger in Luse groups compared to control group which was due to the increase of β-cell proliferation and decrease of β-cell apoptosis. Furthermore, in gene analysis using isolated islets, insulin 1, insulin 2, MafA, PDX-1 and GLUT2 gene expression levels were significantly higher in Luse groups compared to control group. In contrast, expression levels of fibrosis-related gene such as TGFβ, fibronectin, collagen I and collagen III were significantly lower in Luse groups. In conclusion, SGLT2 inhibitor luseogliflozin ameliorates glycemic control and thus exerts protective effects on pancreatic β-cell mass and function. - Highlights: • SGLT2 inhibitor luseogliflozin ameliorates glycemic control in db/db mice. • Luseogliflozin increases β-cell proliferation and decreases β-cell apoptosis. • Luseogliflozin preserves various β-cell-specific gene expression. • Luseogliflozin decreases various fibrosis-related factors in db

  15. Protective effects of SGLT2 inhibitor luseogliflozin on pancreatic β-cells in obese type 2 diabetic db/db mice

    International Nuclear Information System (INIS)

    Okauchi, Seizo; Shimoda, Masashi; Obata, Atsushi; Kimura, Tomohiko; Hirukawa, Hidenori; Kohara, Kenji; Mune, Tomoatsu; Kaku, Kohei; Kaneto, Hideaki

    2016-01-01

    It is well known that Sodium-Glucose Co-transporter 2 (SGLT2) inhibitors, new hypoglycemic agents, improve glycemic control by increasing urine glucose excretion, but it remained unclear how they exert protective effects on pancreatic β-cells. In this study, we examined the effects of SGLT2 inhibitor luseogliflozin on β-cell function and mass using obese type 2 diabetic db/db mice. Ten-week-old male diabetic db/db mice were treated with luseogliflozin 0.0025% or 0.01% in chow (Luse 0.0025% or Luse 0.01%) or vehicle (control) for 4 weeks. Urinary glucose excretion was increased in Luse groups (0.0025% and 0.01%) compared to control mice 3 days after the intervention. Fasting blood glucose levels were significantly lower in mice treated with Luse compared to control mice. Fasting serum insulin concentrations were significantly higher in mice treated with Luse compared to control mice. Triglyceride levels tended to be lower in Luse groups compared to control mice. In immunohistochemical study using pancreas tissues, β-cell mass was larger in Luse groups compared to control group which was due to the increase of β-cell proliferation and decrease of β-cell apoptosis. Furthermore, in gene analysis using isolated islets, insulin 1, insulin 2, MafA, PDX-1 and GLUT2 gene expression levels were significantly higher in Luse groups compared to control group. In contrast, expression levels of fibrosis-related gene such as TGFβ, fibronectin, collagen I and collagen III were significantly lower in Luse groups. In conclusion, SGLT2 inhibitor luseogliflozin ameliorates glycemic control and thus exerts protective effects on pancreatic β-cell mass and function. - Highlights: • SGLT2 inhibitor luseogliflozin ameliorates glycemic control in db/db mice. • Luseogliflozin increases β-cell proliferation and decreases β-cell apoptosis. • Luseogliflozin preserves various β-cell-specific gene expression. • Luseogliflozin decreases various fibrosis-related factors in db

  16. Physical and lithological properties Oligocene-Miocene formations of the Okhotsk-Kamchatka Basin (to 85-th Anniversary of Professor Yuri Konstantinovich Burlin

    Directory of Open Access Journals (Sweden)

    E.E. Karnyushina

    2017-05-01

    Full Text Available The purpose of the investigation was the prediction of physical and lithological properties of volcanogenic-sedimentary formations at different depths. For this purpose Oligocene-Miocene sediments from a number of wells within the Icha and Kolpakovsky depressions of Okhotsk-Kamchatka oil and gas basin have been studied. Relationship between temperature and fluid conditions of the katagenesis zone and the change in the rocks composition, their porosity, permeability, density, thermal conductivity were identified. Superposed phenomena and characteristics of the reservoir rocks transformations within the water-hydrocarbon contacts in the gas and gas condensate pools have been considered. The relationship between volcanogenic-sedimentary rocks physical and lithological properties and the formation of non-stationary geothermal regime has been shown. The article is devoted to the head of these investigations – Professor Yuri Konstantinovich Burlin (1931-2011. 12 Oktober this year, he would have turned his 85 years.

  17. Deformation patterns, magma supply, and magma storage at Karymsky Volcanic Center, Kamchatka, Russia, 2000-2010, revealed by InSAR

    Science.gov (United States)

    Ji, Lingyun; Izbekov, Pavel; Senyukov, Sergey; Lu, Zhong

    2018-02-01

    Under a complex geological region influenced by the subduction of the Pacific plate, Kamchatka Peninsula is one of the most active volcanic arcs in the Pacific Rim. Due to logistical difficulty in instrumentation, shallow magma plumbing systems beneath some of the Kamchatkan volcanoes are poorly understood. InSAR offers a safe and quick method for monitoring volcanic deformation with a high spatial resolution. In this study, a group of satellite radar interferograms that span the time interval from 2000 to 2010 shows eruptive and non-eruptive deformation at Karymsky Volcanic Center (KVC), Kamchatka, Russia. All the interferograms provide details of the activity around the KVC during 2000-2010, as follows: (1) from 2000 to 2004, the Karymsky-AN (Akademia Nauk) area deflated and the MS (Maly Semyachik) area inflated, (2) from 2004 to 2006, the Karymsky-AN area deflated with ongoing eruption, while the MS area subsided without eruption, (3) from 2006 to 2008, as with 2000-2004, the Karymsky-AN area deflated and the MS area inflated, (4) from 2008 to 2010, the Karymsky-AN area inflated up to 3 cm, and the MS area subsided. Point source models suggest that two magma reservoirs provide a good fit to the observed deformation. One source is located beneath the area between Karymsky and AN at a depth of approximately 7.0 km, and the other one is situated beneath MS at a depth of around 5.8 km. Synchronous deformation patterns suggest that two magma systems are fed from the same deep magma source and connected by a fracture zone. The InSAR results are consistent with GPS ground deformation measurements, seismic data, and petrological constraints.

  18. Mapping resource use over a Russian landscape: an integrated look at harvesting of a non-timber forest product in central Kamchatka

    International Nuclear Information System (INIS)

    Hitztaler, Stephanie K; Bergen, Kathleen M

    2013-01-01

    Small-scale resource use became an important adaptive mechanism in remote logging communities in Russia at the onset of the post-Soviet period in 1991. We focused on harvesting of a non-timber forest product, lingonberry (Vaccinium vitis-idaea), in the forests of the Kamchatka Peninsula (Russian Far East). We employed an integrated geographical approach to make quantifiable connections between harvesting and the landscape, and to interpret these relationships in their broader contexts. Landsat TM images were used for a new classification; the resulting land-cover map was the basis for linking non-spatial data on harvesters’ gathering behaviors to spatial data within delineated lingonberry gathering sites. Several significant relationships emerged: (1) mature forests negatively affected harvesters’ initial choice to gather in a site, while young forests had a positive effect; (2) land-cover type was critical in determining how and why gathering occurred: post-disturbance young and maturing forests were significantly associated with higher gathering intensity and with the choice to market harvests; and (3) distance from gathering sites to villages and main roads also mattered: longer distances were significantly correlated to more time spent gathering and to increased marketing of harvests. We further considered our findings in light of the larger ecological and social dynamics at play in central Kamchatka. This unique study is an important starting point for conservation- and sustainable development-based work, and for additional research into the drivers of human–landscape interactions in the Russian Far East. (letter)

  19. Eruption dynamics and explosive-effusive transitions during the 1400 cal BP eruption of Opala volcano, Kamchatka, Russia

    Science.gov (United States)

    Andrews, Benjamin J.; Dufek, Josef; Ponomareva, Vera

    2018-05-01

    Deposits and pumice from the 1400 cal BP eruption of Opala volcano record activity that occurred at the explosive-effusive transition, resulting in intermittent, or stop-start, behavior, where explosive activity resumed following a pause. The eruption deposited distinctive, biotite-bearing rhyolite tephra across much of Kamchatka, and its stratigraphy consists of a lithic-rich pumice fall, overlain by pumice falls and pyroclastic density deposits, with the proportion of the latter increasing with height. This sequence repeats such that the middle of the total deposit is marked by a lithic-rich fall with abundant obsidian clasts. Notably, the eruptive pumice are poorly vesiculated, with vesicle textures that record fragmentation of a partially collapsed magmatic foam. The eruption vent, Baranii Amphitheater is filled with obsidian lavas of the same composition as the rhyolite tephra. Based upon the stratigraphic and compositional relations, we divide the eruption into four phases. Phase I initiated with eruption of a lithic-rich pumice fall, followed by eruption of Plinian falls and pyroclastic density currents. During Phase II, the eruption paused for at least 5-6 h; in this time, microlites nucleated and began to grow in the magma. Phase III essentially repeated the Phase I sequence. Obsidian lavas were emplaced during Phase IV. The pumice textures suggest that the magma ascended very near the threshold decompression rate for the transition between explosive (fast) and effusive (slow) behavior. The pause during Phase II likely occurred as decompression slowed enough for the magma to develop sufficient permeability for gas to escape resulting in collapse of the magmatic foam, stopping the eruption and temporarily sealing the conduit. After about 5-6 h, eruption resumed with, once again, magma decompressing very near the explosive-effusive transition. Phase III ended when the decompression rate slowed and lava dome emplacement began. Distributions of pumice and

  20. Multiphotonic Confocal Microscopy 3D imaging: Application to mantle sulfides in sub-arc environment (Avacha Volcano, Kamchatka)

    Science.gov (United States)

    Antoine, Bénard; Luc-Serge, Doucet; Sabine, Palle; Dmitri A., Ionov

    2010-05-01

    Petrogenetic relations in igneous rocks are usually studied in natural samples using classical optical microscopy and subsequent geochemical data acquisition. Multiphotonic Laser Scanning Confocal Microscopy (MLSCM) can be a powerful tool to section geological materials optically with sub-micrometric resolution and then generate a three-dimensional (3D) reconstruction (ca. 106 μm3 stack). MLSCM is used here to investigate textural relations of Monosulfide Solid Solution (MSS) with silicate phases in fresh spinel harzburgite xenoliths from the andesitic Avacha volcano (Kamchatka, Russia). The xenoliths contain MSS disseminated in olivine and orthopyroxene (opx) neoblasts as well as MSS-rich quenched magmatic opx veins [1]. First, Reflection Mode (RM) was tested on vein sulfides in resin-impregnated thick (120 μm) polished rock sections. Then we used a combination of Differential Interference Contrast (DIC) with a transmitted light detector, two photons-excited fluorescence (2PEF) and Second Harmonic Generation (SHG). Sequential imaging feature of the Leica TCS-SP2 software was applied. The excitation laser used for 2PEF was a COHERENT MIRA 900 with a 76Hz repetition rate and 800nm wavelength. Image stacks were analysed using ImageJ software [2]. The aim of the tests was to try to discriminate sulfides in silicate matrix as a tool for a better assessment of equilibrium conditions between the two phases. Preliminary results show that Fe-Ni rich MSS from vein and host rock have a strong auto-fluorescence in the Near UV-VIS domain (392-715 nm) whereas silicate matrix is only revealed through DIC. SHG is obtained only from dense nanocentrosymmetrical structures such as embedded medium (organic matter like glue and resin). The three images were recorded sequentially enabling efficient discrimination between the different components of the rock slices. RM permits reconstruction of the complete 3D structure of the rock slice. High resolution (ca. 0.2 μm along X-Y axis vs

  1. Effects of reducing blood pressure on cardiovascular outcomes and mortality in patients with type 2 diabetes: Focus on SGLT2 inhibitors and EMPA-REG OUTCOME.

    Science.gov (United States)

    Scheen, André J

    2016-11-01

    Empagliflozin, a sodium-glucose cotransporter type 2 (SGLT2) inhibitor, has shown a remarkable reduction in cardiovascular and all-cause mortality in patients with type 2 diabetes (T2D) and antecedents of cardiovascular disease in the EMPA-REG OUTCOME trial. This effect has been attributed to a hemodynamic rather than a metabolic effect, partly due to the osmotic/diuretic effect of empagliflozin and to the reduction in arterial blood pressure. The present review will: (1) summarize the results of specific studies having tested the blood pressure lowering effects of SGLT2 inhibitors; (2) describe the results of meta-analyses of trials having evaluated the effects on mortality and cardiovascular outcomes of lowering blood pressure in patients with T2D, with a special focus on baseline and target blood pressures; (3) compare the cardiovascular outcome results in EMPA-REG OUTCOME versus other major trials with antihypertensive agents in patients with T2D; and (4) evaluate post-hoc analyses from EMPA-REG OUTCOME, especially subgroups of patients of special interest regarding the blood pressure lowering hypothesis. Although BP reduction associated to empagliflozin therapy may partly contribute to the benefits reported in EMPA-REG OUTCOME, other mechanisms most probably play a greater role in the overall CV protection and reduction in mortality observed in this trial. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  2. Effects of reducing blood pressure on renal outcomes in patients with type 2 diabetes: Focus on SGLT2 inhibitors and EMPA-REG OUTCOME.

    Science.gov (United States)

    Scheen, A J; Delanaye, P

    2017-04-01

    Empagliflozin, a sodium-glucose cotransporter type 2 (SGLT2) inhibitor, has enabled remarkable reductions in cardiovascular and all-cause mortality as well as in renal outcomes in patients with type 2 diabetes (T2D) and a history of cardiovascular disease in the EMPA-REG OUTCOME. These results have been attributed to haemodynamic rather than metabolic effects, in part due to the osmotic/diuretic action of empagliflozin and the reduction in arterial blood pressure (BP). The present narrative review includes the results of meta-analyses of trials evaluating the effects on renal outcomes of lowering BP in patients with T2D, with a special focus on the influence of baseline and achieved systolic BP, and compares the renal outcome results of the EMPA-REG OUTCOME with those of other major trials with inhibitors of the renin-angiotensin system in patients with T2D and the preliminary findings with other SGLT2 inhibitors, and also evaluates post hoc analyses from the EMPA-REG OUTCOME of special interest as regards the BP-lowering hypothesis and renal function. While systemic BP reduction associated to empagliflozin therapy may have contributed to the renal benefits reported in EMPA-REG OUTCOME, other local mechanisms related to kidney homoeostasis most probably also played a role in the overall protection observed in the trial. Copyright © 2017. Published by Elsevier Masson SAS.

  3. Promising Diabetes Therapy Based on the Molecular Mechanism for Glucose Toxicity: Usefulness of SGLT2 Inhibitors as well as Incretin-Related Drugs.

    Science.gov (United States)

    Kaneto, Hideaki; Obata, Atsushi; Shimoda, Masashi; Kimura, Tomohiko; Hirukawa, Hidenori; Okauchi, Seizo; Matsuoka, Taka-Aki; Kaku, Kohei

    2016-01-01

    Pancreatic β-cell dysfunction and insulin resistance are the main characteristics of type 2 diabetes. Chronic exposure of β-cells to hyperglycemia leads to the deterioration of β-cell function. Such phenomena are well known as pancreatic β-cell glucose toxicity. MafA, a strong transactivator of insulin gene, is particularly important for the maintenance of mature β-cell function, but its expression level is significantly reduced under diabetic conditions which is likely associated with β-cell failure. Reduction of incretin receptor expression level in β-cells in diabetes is also likely associated with β-cell failure. On the other hand, incretin-related drugs and sodium-glucose co-transporter 2 (SGLT2) inhibitors are promising diabetes therapy based on the mechanism for pancreatic β-cell glucose toxicity. Indeed, it was shown that incretin-related drugs exerted protective effects on β-cells through the augmentation of IRS-2 expression especially in the presence of pioglitazone. It was also shown that incretin-related drug and/or pioglitazone exerted more protective effects on β-cells at the early stage of diabetes compared to the advanced stage. SGLT2 inhibitors, new hypoglycemic agents, also exert beneficial effects for the protection of pancreatic β-cells as well as for the reduction of insulin resistance in various insulin target tissues. Taken together, it is important to select appropriate therapy based on the molecular mechanism for glucose toxicity.

  4. Effects of sodium-glucose co-transporter 2 (SGLT2 inhibition on renal function and albuminuria in patients with type 2 diabetes: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Lubin Xu

    2017-06-01

    Full Text Available Aim To evaluate the effects of sodium-glucose co-transporter 2 (SGLT2 inhibition on renal function and albuminuria in patients with type 2 diabetes. Methods We conducted systematic searches of PubMed, Embase and Cochrane Central Register of Controlled Trials up to June 2016 and included randomized controlled trials of SGLT2 inhibitors in adult type 2 diabetic patients reporting estimated glomerular filtration rate (eGFR and/or urine albumin/creatinine ratio (ACR changes. Data were synthesized using the random-effects model. Results Forty-seven studies with 22,843 participants were included. SGLT2 inhibition was not associated with a significant change in eGFR in general (weighted mean difference (WMD, −0.33 ml/min per 1.73 m2, 95% CI [−0.90 to 0.23] or in patients with chronic kidney disease (CKD (WMD −0.78 ml/min per 1.73 m2, 95% CI [−2.52 to 0.97]. SGLT2 inhibition was associated with eGFR reduction in short-term trials (WMD −0.98 ml/min per 1.73 m2, 95% CI [−1.42 to −0.54], and with eGFR preservation in long-term trials (WMD 2.01 ml/min per 1.73 m2, 95% CI [0.86 to 3.16]. Urine ACR reduction after SGLT2 inhibition was not statistically significant in type 2 diabetic patients in general (WMD −7.24 mg/g, 95% CI [−15.54 to 1.06], but was significant in patients with CKD (WMD −107.35 mg/g, 95% CI [−192.53 to −22.18]. Conclusions SGLT2 inhibition was not associated with significant changes in eGFR in patients with type 2 diabetes, likely resulting from a mixture of an initial reduction of eGFR and long-term renal function preservation. SGLT2 inhibition was associated with statistically significant albuminuria reduction in type 2 diabetic patients with CKD.

  5. Renal and Cardiovascular Effects of sodium–glucose cotransporter 2 (SGLT2) inhibition in combination with loop Diuretics in diabetic patients with Chronic Heart Failure (RECEDE-CHF): protocol for a randomised controlled double-blind cross-over trial

    Science.gov (United States)

    Mordi, Natalie A; Mordi, Ify R; Singh, Jagdeep S; Baig, Fatima; Choy, Anna-Maria; McCrimmon, Rory J; Struthers, Allan D; Lang, Chim C

    2017-01-01

    Introduction Type 2 diabetes (T2D) and heart failure (HF) are a frequent combination, where treatment options remain limited. There has been increasing interest around the sodium–glucose cotransporter 2 (SGLT2) inhibitors and their use in patients with HF. Data on the effect of SGLT2 inhibitor use with diuretics are limited. We hypothesise that SGLT2 inhibition may augment the effects of loop diuretics and the benefits of SGLT2 inhibitors may extend beyond those of their metabolic (glycaemic parameters and weight loss) and haemodynamic parameters. The effects of SGLT2 inhibitors as an osmotic diuretic and on natriuresis may underlie the cardiovascular and renal benefits demonstrated in the recent EMPA-REG study. Methods and analysis To assess the effect of SGLT2 inhibitors when used in combination with a loop diuretic, the RECEDE-CHF (Renal and Cardiovascular Effects of SGLT2 inhibition in combination with loop Diuretics in diabetic patients with Chronic Heart Failure) trial is a single-centre, randomised, double-blind, placebo-controlled, cross-over trial conducted in a secondary care setting within NHS Tayside, Scotland. 34 eligible participants, aged between 18 and 80 years, with stable T2D and CHF will be recruited. Renal physiological testing will be performed at two points (week 1 and week 6) on each arm to assess the effect of 25 mg empagliflozin, on the primary and secondary outcomes. Participants will be enrolled in the trial for a total period between 14 and 16 weeks. The primary outcome will assess the effect of empagliflozin versus placebo on urine output. The secondary outcomes are to assess the effect of empagliflozin on glomerular filtration rate, cystatin C, urinary sodium excretion, urinary protein/creatinine ratio and urinary albumin/creatinine ratio when compared with placebo. Ethics and dissemination Ethics approval was obtained by the East of Scotland Research Ethics Service. Results of the trial will be submitted for publication in a peer

  6. Efficacy of Body Weight Reduction on the SGLT2 Inhibitor in People with Type 2 Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Hyun A Cho

    2017-06-01

    Full Text Available Background : Dapagliflozin, a sodium-glucose cotransporter-2 inhibitor, reduces hyperglycemia and body weight by inhibiting renal glucose reabsorption. However, only a few studies have demonstrated efficacy of dapagliflozin for type 2 diabetic patients in Korea. We evaluated the efficacy and safety of dapagliflozin for Korean type 2 diabetes patients. Methods : This is a retrospective study that included data from 61 patients who received 12 months of dapagliflozin therapy and who visited a single medical center between January 2015 and July 2016. Patients were separated into three groups: dual combination of dapagliflozin and metformin, triple combination of dapagliflozin and metformin with sulfonylurea, or dipeptidyl peptidase IV inhibitors, and quadriple combination of dapagliflozin, metformin, and sulfonylurea with dipeptidyl peptidase IV inhibitors. Patients who achieved ≥5% body weight reduction were classified as responders, and those who achieved <5% body weight reduction were classified as non-responders. Results : After 12 months, the mean change from baseline body weight was -3.4±2.6 kg (P<0.001 for all patients, -3.4±3.1 kg (P<0.001 for group 1, -2.7±2.0 kg (P=0.008 for group 2, and -4.0±2.3 kg (P<0.001 for group 3. Fasting C-peptide level was higher in the responder group than in the non-responder group (3.25±1.07 ng/mL vs. 2.62±1.02 ng/mL, P=0.023. In total, reductions in HbA1c, PP2, and FPG levels were -0.61±0.82% (P=0.000, -35.4±62 mg/dL (P=0.000, and -21.3±56.2 mg/dL (P=0.012, respectively. They had mild adverse events included orthostatic dizziness and urinary tract infection. Conclusion : SGLT2 inhibitor improved glycemic control and reduced body weight in a safe manner for patients with type 2 diabetes mellitus.

  7. A single dose of dapagliflozin, an SGLT-2 inhibitor, induces higher glycosuria in GCK- and HNF1A-MODY than in type 2 diabetes mellitus.

    Science.gov (United States)

    Hohendorff, J; Szopa, M; Skupien, J; Kapusta, M; Zapala, B; Platek, T; Mrozinska, S; Parpan, T; Glodzik, W; Ludwig-Galezowska, A; Kiec-Wilk, B; Klupa, T; Malecki, M T

    2017-08-01

    SGLT2 inhibitors are a new class of oral hypoglycemic agents used in type 2 diabetes (T2DM). Their effectiveness in maturity onset diabetes of the young (MODY) is unknown. We aimed to assess the response to a single dose of 10 mg dapagliflozin in patients with Hepatocyte Nuclear Factor 1 Alpha (HNF1A)-MODY, Glucokinase (GCK)-MODY, and type 2 diabetes. We examined 14 HNF1A-MODY, 19 GCK-MODY, and 12 type 2 diabetes patients. All studied individuals received a single morning dose of 10 mg of dapagliflozin added to their current therapy of diabetes. To assess the response to dapagliflozin we analyzed change in urinary glucose to creatinine ratio and serum 1,5-Anhydroglucitol (1,5-AG) level. There were only four patients with positive urine glucose before dapagliflozin administration (one with HNF1A-MODY, two with GCK-MODY, and one with T2DM), whereas after SGLT-2 inhibitor use, glycosuria occurred in all studied participants. Considerable changes in mean glucose to creatinine ratio after dapagliflozin administration were observed in all three groups (20.51 ± 12.08, 23.19 ± 8.10, and 9.84 ± 6.68 mmol/mmol for HNF1A-MODY, GCK-MODY, and T2DM, respectively, p MODY, respectively), but not between the two MODY forms (p = 0.7231). Significant change in serum 1,5-AG was noticed only in T2DM and it was -6.57 ± 7.34 mg/ml (p = 0.04). A single dose of dapagliflozin, an SGLT-2 inhibitor, induces higher glycosuria in GCK- and HNF1A-MODY than in T2DM. Whether flozins are a valid therapeutic option in these forms of MODY requires long-term clinical studies.

  8. Water transport by Na+-coupled cotransporters of glucose (SGLT1) and of iodide (NIS). The dependence of substrate size studied at high resolution

    DEFF Research Database (Denmark)

    Zeuthen, Thomas; Belhage, Bo; Zeuthen, Emil

    2005-01-01

    and osmosis at the membrane with diffusion in the cytoplasm. The combination of high resolution measurements and precise modelling showed that water transport across the membrane can be explained by cotransport of water in the membrane proteins and that intracellular unstirred layers effects are minute.......The relation between substrate and water transport was studied in Na+-coupled cotransporters of glucose (SGLT1) and of iodide (NIS) expressed in Xenopus oocytes. The water transport was monitored from changes in oocyte volume at a resolution of 20 pl, more than one order of magnitude better than...... previous investigations. The rate of cotransport was monitored as the clamp current obtained from two-electrode voltage clamp. The high resolution data demonstrated a fixed ratio between the turn-over of the cotransporter and the rate of water transport. This applied to experiments in which the rate...

  9. A new record of Chironomus (Chironomus) acidophilus Keyl (Diptera, Chironomidae) from the Uzon volcanic caldera (Kronotsky Reserve, Kamchatka Peninsula, Russia), its karyotype, ecology and biology.

    Science.gov (United States)

    Orel, Oksana V; Lobkova, Ludmila E; Zhirov, Sergey V; Petrova, Ninel A

    2015-07-03

    Morphology, cytology, ecology and biology of Holarctic Chironomus (Chironomus) acidophilus Keyl, 1960 (Diptera, Chironomidae) was examined from material collected in the geothermal Vosmerka Lake (pH=2.0-2.5). An illustrated redescription of C. acidophilus is given on the basis of adult males reared from field-collected pupae, and of simultaneously collected larvae. Additional larvae belonging to the pseudothummi-complex were identified as C. acidophilus on the basis of their karyotype. The karyotype of C. acidophilus (2n=8) and detailed mapping of the 4 chromosome arms A, E, D and F are provided. The population of C. acidophilus from Kamchatka was found to be karyologically monomorphic. Information on distribution and ecology of C. acidophilus from Vosmerka Lake (total mineralization 1583.5 mg/l) is also given. Chironomus acidophilus is the only species of aquatic insects recorded in this lake. Lack of competition and a richness of food resources contribute to the high abundance (35161 ind./m2) and biomass (11.342 g/m2) of the larvae of C. acidophilus in Vosmerka Lake.

  10. Evolutionary relationships among sympatric life history forms of Dolly Varden inhabiting the landlocked Kronotsky Lake, Kamchatka, and a neighboring anadromous population

    Science.gov (United States)

    Ostberg, C.O.; Pavlov, S.D.; Hauser, L.

    2009-01-01

    We investigated the evolutionary relationships among five sympatric morphs of Dolly Varden Salvelinus malma (white, Schmidti, longhead, river, and dwarf) inhabiting landlocked Kronotsky Lake on the Kamchatka Peninsula, Russia, and an anadromous population below the barrier waterfall on the outflowing Kronotsky River. Morphological analyses indicated phenotypic differentiation corresponding to preferred habitat, the longhead (a limnetic piscivorous morph) having a fusiform body, long jaw, and short fins and the Schmidti (a benthic morph) having a robust body, small jaw, and long fins. Analysis of molecular variance among the Kronotsky Lake morphs indicated that contemporary gene flow is restricted both among morphs within locations and among locations within morphs. Gene flow from Kronotsky Lake into the anadromous population also appears to be restricted. Our findings indicate that there are two divergent evolutionary lineages, one consisting of the white, Schmidti, river, and dwarf morphs and the other of the longhead morph and the anadromous population, which suggests that Kronotsky Lake was subject to separate waves of immigration. The Kronotsky Lake Dolly Varden morphs may represent an example of ecological speciation in progress, and we present a working hypothesis for the diversification of morphs within Kronotsky Lake.

  11. Retrieving robust noise-based seismic velocity changes from sparse data sets: synthetic tests and application to Klyuchevskoy volcanic group (Kamchatka)

    Science.gov (United States)

    Gómez-García, C.; Brenguier, F.; Boué, P.; Shapiro, N. M.; Droznin, D. V.; Droznina, S. Ya; Senyukov, S. L.; Gordeev, E. I.

    2018-05-01

    Continuous noise-based monitoring of seismic velocity changes provides insights into volcanic unrest, earthquake mechanisms and fluid injection in the sub-surface. The standard monitoring approach relies on measuring travel time changes of late coda arrivals between daily and reference noise cross-correlations, usually chosen as stacks of daily cross-correlations. The main assumption of this method is that the shape of the noise correlations does not change over time or, in other terms, that the ambient-noise sources are stationary through time. These conditions are not fulfilled when a strong episodic source of noise, such as a volcanic tremor for example, perturbs the reconstructed Green's function. In this paper we propose a general formulation for retrieving continuous time series of noise-based seismic velocity changes without the requirement of any arbitrary reference cross-correlation function. Instead, we measure the changes between all possible pairs of daily cross-correlations and invert them using different smoothing parameters to obtain the final velocity change curve. We perform synthetic tests in order to establish a general framework for future applications of this technique. In particular, we study the reliability of velocity change measurements versus the stability of noise cross-correlation functions. We apply this approach to a complex dataset of noise cross-correlations at Klyuchevskoy volcanic group (Kamchatka), hampered by loss of data and the presence of highly non-stationary seismic tremors.

  12. Rationale, Design, and Baseline Characteristics of the Utopia Trial for Preventing Diabetic Atherosclerosis Using an SGLT2 Inhibitor: A Prospective, Randomized, Open-Label, Parallel-Group Comparative Study.

    Science.gov (United States)

    Katakami, Naoto; Mita, Tomoya; Yoshii, Hidenori; Shiraiwa, Toshihiko; Yasuda, Tetsuyuki; Okada, Yosuke; Umayahara, Yutaka; Kaneto, Hideaki; Osonoi, Takeshi; Yamamoto, Tsunehiko; Kuribayashi, Nobuichi; Maeda, Kazuhisa; Yokoyama, Hiroki; Kosugi, Keisuke; Ohtoshi, Kentaro; Hayashi, Isao; Sumitani, Satoru; Tsugawa, Mamiko; Ohashi, Makoto; Taki, Hideki; Nakamura, Tadashi; Kawashima, Satoshi; Sato, Yasunori; Watada, Hirotaka; Shimomura, Iichiro

    2017-10-01

    Sodium-glucose co-transporter-2 (SGLT2) inhibitors are anti-diabetic agents that improve glycemic control with a low risk of hypoglycemia and ameliorate a variety of cardiovascular risk factors. The aim of the ongoing study described herein is to investigate the preventive effects of tofogliflozin, a potent and selective SGLT2 inhibitor, on the progression of atherosclerosis in subjects with type 2 diabetes (T2DM) using carotid intima-media thickness (IMT), an established marker of cardiovascular disease (CVD), as a marker. The Study of Using Tofogliflozin for Possible better Intervention against Atherosclerosis for type 2 diabetes patients (UTOPIA) trial is a prospective, randomized, open-label, blinded-endpoint, multicenter, and parallel-group comparative study. The aim was to recruit a total of 340 subjects with T2DM but no history of apparent CVD at 24 clinical sites and randomly allocate these to a tofogliflozin treatment group or a conventional treatment group using drugs other than SGLT2 inhibitors. As primary outcomes, changes in mean and maximum IMT of the common carotid artery during a 104-week treatment period will be measured by carotid echography. Secondary outcomes include changes in glycemic control, parameters related to β-cell function and diabetic nephropathy, the occurrence of CVD and adverse events, and biochemical measurements reflecting vascular function. This is the first study to address the effects of SGLT2 inhibitors on the progression of carotid IMT in subjects with T2DM without a history of CVD. The results will be available in the very near future, and these findings are expected to provide clinical data that will be helpful in the prevention of diabetic atherosclerosis and subsequent CVD. Kowa Co., Ltd. UMIN000017607.

  13. De novo expression of sodium-glucose cotransporter SGLT2 in Bowman’s capsule coincides with replacement of parietal epithelial cell layer with proximal tubule-like epithelium

    OpenAIRE

    Tabatabai, Niloofar M.; North, Paula E.; Regner, Kevin R.; Kumar, Suresh N.; Duris, Christine B.; Blodgett, Amy B.

    2014-01-01

    In kidney nephron, parietal epithelial cells line the Bowman’s capsule and function as a permeability barrier for the glomerular filtrate. Bowman’s capsule cells with proximal tubule epithelial morphology have been found. However, the effects of tubular metaplasia in Bowman’s capsule on kidney function remain poorly understood. Sodium-glucose cotransporter 2 (SGLT2) plays a major role in reabsorption of glucose in the kidney and is expressed on brush border membrane of epithelial cells in the...

  14. Neural network approach to the prediction of seismic events based on low-frequency signal monitoring of the Kuril-Kamchatka and Japanese regions

    Directory of Open Access Journals (Sweden)

    Irina Popova

    2013-08-01

    Full Text Available Very-low-frequency/ low-frequency (VLF/LF sub-ionospheric radiowave monitoring has been widely used in recent years to analyze earthquake preparatory processes. The connection between earthquakes with M ≥5.5 and nighttime disturbances of signal amplitude and phase has been established. Thus, it is possible to use nighttime anomalies of VLF/LF signals as earthquake precursors. Here, we propose a method for estimation of the VLF/LF signal sensitivity to seismic processes using a neural network approach. We apply the error back-propagation technique based on a three-level perceptron to predict a seismic event. The back-propagation technique involves two main stages to solve the problem; namely, network training, and recognition (the prediction itself. To train a neural network, we first create a so-called ‘training set’. The ‘teacher’ specifies the correspondence between the chosen input and the output data. In the present case, a representative database includes both the LF data received over three years of monitoring at the station in Petropavlovsk-Kamchatsky (2005-2007, and the seismicity parameters of the Kuril-Kamchatka and Japanese regions. At the first stage, the neural network established the relationship between the characteristic features of the LF signal (the mean and dispersion of a phase and an amplitude at nighttime for a few days before a seismic event and the corresponding level of correlation with a seismic event, or the absence of a seismic event. For the second stage, the trained neural network was applied to predict seismic events from the LF data using twelve time intervals in 2004, 2005, 2006 and 2007. The results of the prediction are discussed.

  15. N-Acetylcarnosine sustained drug delivery eye drops to control the signs of ageless vision: Glare sensitivity, cataract amelioration and quality of vision currently available treatment for the challenging 50,000-patient population

    Directory of Open Access Journals (Sweden)

    Mark A Babizhayev

    2008-10-01

    Full Text Available Mark A Babizhayev1, Leslie Burke2, Philip Micans3, Stuart P Richer4,51Innovative Vision Products, Inc., County of New Castle, Delaware, USA; 2Wise Choice Products LLC, London, England, United Kingdom; 3IAS Group, Sark, United Kingdom; 4Eye Clinic DVA Medical Center, North Chicago, Illinois, USA; 5Department of Family and Preventive Medicine, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, USABackground: Innovative Vision Products, Inc. (IVP’s scientists developed the lubricant eye drops (Can-C™ designed as 1% N-acetylcarnosine (NAC prodrug of L-carnosine containing a mucoadhesive cellulose-based compound combined with corneal absorption promoters in a sustained drug delivery system. Only the natural L-isomeric form of NAC raw material was specifically synthesized at the cGMP facility and employed for the manufacturing of Can-C™ eye drops.Objective and study design: In the present clinical study the authors assessed vision before and after 9 month term of topical ocular administration of NAC lubricant eye drops or placebo in 75 symptomatic patients with age-related uncomplicated cataracts in one or both eyes, with acuity in one eye of 20/40 or worse (best-corrected distance, and no previous cataract surgery in either eye and no other ocular abnormality and 72 noncataract subjects ranged in age from 54 to 78 years.Setting: Subjects in these subsample groups have reported complaints of glare and wanted to administer eye drops to get quick eye relief and quality of vision for their daily activities including driving and computer works. Following 9 months of treatment with NAC lubricant eye drops, most patients’ glare scores were improved or returned to normal in disability glare tests with Halometer DG. Improvement in disability glare was accompanied with independent improvement in acuity. Furthermore, patients with the poorest pretreatment vision were as likely to regain certain better visual function after 9

  16. SGLT2 inhibitors or GLP-1 receptor agonists as second-line therapy in type 2 diabetes: patient selection and perspectives

    Directory of Open Access Journals (Sweden)

    Gurgle HE

    2016-06-01

    Full Text Available Holly E Gurgle, Karen White, Carrie McAdam-Marx Department of Pharmacotherapy, University of Utah College of Pharmacy, Salt Lake City, UT, USA Abstract: Controversy exists regarding the selection of second-line therapy for patients with type 2 diabetes mellitus (T2DM who are unable to achieve glycemic control with metformin therapy alone. Newer pharmacologic treatments for T2DM include glucagon-like peptide-1 receptor agonists and sodium–glucose cotransporter 2 inhibitors. Both the classes of medication are efficacious, exhibit positive effects on weight, and are associated with minimal risk of hypoglycemia. The purpose of this review is to compare the clinical trial and real-world effectiveness data of glucagon-like peptide-1 receptor agonists versus sodium–glucose cotransporter 2 inhibitors related to A1c reduction, weight loss, cost-effectiveness, cardiovascular outcomes, and safety in patients with T2DM. This review summarizes comparative evidence for providers who are determining which of the two classes may be the most appropriate for a specific patient. Keywords: type 2 diabetes mellitus, GLP-1 receptor agonist, SGLT2 inhibitor, A1c, weight loss, adverse effect

  17. Recognizing subtle evidence for silicic magma derivation from petrochemically-similar arc crust: Isotopic and chemical evidence for the bimodal volcanic series of Gorely Volcanic Center, Kamchatka, Russia

    Science.gov (United States)

    Seligman, A. N.; Bindeman, I. N.; Ellis, B. S.; Ponomareva, V.; Leonov, V.

    2012-12-01

    The Kamchatka Peninsula is home to some of the most prolific subduction related volcanic activity in the world. Gorely caldera and its central volcano are located in the rear of its currently active Eastern Volcanic Front. Recent work determined the presence of explosive ignimbrite eruptions sourced from Gorely volcano during the Pleistocene. We studied 32 eruptive units, including tephrochronologically-dated Holocene tephra, stratigraphically-arranged ignimbrites, as well as pre- and post-caldera lavas. We analyzed oxygen isotope ratios of pyroxene and plagioclase grains by laser fluorination, and major and trace element compositions of whole rocks. In addition, we determined 87Sr/86Sr and 143Nd/144Nd ratios of caldera-forming ignimbrite eruptions. Chemical compositions show that Gorely eruptive units range from basalt to basaltic andesite in the "Pra-Gorely" stages prior to caldera formation and the modern Gorely stages forming its current edifice. In contrast, eruptive material from earlier ignimbrites exposed at Opasny Ravine consists primarily of dacite. Whole rock analyses for Gorely indicate that silicic rocks and ignimbrites volumetrically dominate all other products, forming separate bimodal peaks in our SiO2-frequency diagram. In addition, trace element concentrations and ratios define two trends, one for more silicic and another for more mafic material. δ18Omelt values range from a low of 4.85 up to 6.22‰, where the lowest value was found in the last caldera forming eruption, suggesting incorporation of hydrothermally-altered material from earlier eruptions. 87Sr/86Sr and 143Nd/144Nd ratios range from 0.70328 to 0.70351 and from 0.51303 to 0.51309 respectively, with higher and more diverse values being characteristic of earlier ignimbrite units; again suggesting incorporation of surrounding crustal material. In contrast to these results, MELTS modeling using a variety of likely primitive basalts from Gorely shows it is possible to obtain silicic

  18. Are U-Series Disequilibria Transparent to Crustal Processing of Magma? A Case Study at Bezymianny and Klyuchevskoy Volcanoes, Kamchatka, Russia

    Science.gov (United States)

    Kayzar, T. M.; Nelson, B. K.; Bachmann, O.; Portnyagin, M.; Ponomareva, V.

    2010-12-01

    Disequilibria in the short-lived uranium-series isotopic system can provide timescales of magma production, modification and transport in all tectonic settings. In volcanic arcs, the field has converged on the concept that (238U/230Th) and (226Ra/230Th) activities greater than one are a result of fluid fluxing from the slab to mantle wedge, and that the preservation of (226Ra/230Th) disequilibria requires rapid transport of melts from the mantle wedge to the surface (226Ra returns to equilibrium with 230Th in ~8000 years). The need for rapid transport coupled with the incompatibility of U-series elements suggest that U-series fractionation is not measurably affected by crustal processes. However, some well-studied arc systems, including the very productive Central Kamchatka Depression (CKD) of the Kamchatkan volcanic arc, show U-series data that are in conflict with this commonly accepted model. Our study focuses on two neighboring volcanic systems, Bezymianny and Klyuchevskoy volcanoes in the CKD. Separated by ~10km, these two systems are thought to share the same mantle source. Klyuchevskoy has primitive compositions (51-56 wt%) while Bezymianny erupts more differentiated andesites (57-63 wt% SiO2); therefore, by examining the U-series signals in these two systems it is possible to decouple a primary signal from one having undergone crustal processing. We record whole rock (238U/230Th) values for Bezymianny ranging from 0.94 to 0.96 in modern eruptive products, while (226Ra/230Th) are >1. We also observe a similar signal in older (212-6791BP) tephra deposits from Klyuchevskoy, measuring (238U/230Th) of 0.92-0.99 (unpublished data, collaborative research with the KALMAR project). (238U/230Th) local bulk rock or partial melts to fractionate U, Th, and Ra from one another. In particular, we focus on minor mineral phases, such as apatite and magnetite, which are present during early stages of differentiation (andesites) and may fractionate U from Th. We measure U and

  19. Parametric analysis of lava dome-collapse events and pyroclastic deposits at Shiveluch volcano, Kamchatka, using visible and infrared satellite data

    Science.gov (United States)

    Krippner, Janine B.; Belousov, Alexander B.; Belousova, Marina G.; Ramsey, Michael S.

    2018-04-01

    For the years 2001 to 2013 of the ongoing eruption of Shiveluch volcano, a combination of different satellite remote sensing data are used to investigate the dome-collapse events and the resulting pyroclastic deposits. Shiveluch volcano in Kamchatka, Russia, is one of the world's most active dome-building volcanoes, which has produced some of the largest known historical block-and-ash flows (BAFs). Globally, quantitative data for deposits resulting from such large and long-lived dome-forming eruptions, especially like those at Shiveluch, are scarce. We use Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER) thermal infrared (TIR), shortwave infrared (SWIR), and visible-near infrared (VNIR) data to analyze the dome-collapse scars and BAF deposits that were formed during eruptions and collapse events in 2001, 2004, 2005, 2007, 2009, 2010, and two events in 2013. These events produced flows with runout distances of as far as 19 km from the dome, and with aerial extents of as much as 22.3 km2. Over the 12 years of this period of investigation, there is no trend in deposit area or runout distances of the flows through time. However, two potentially predictive features are apparent in our data set: 1) the largest dome-collapse events occurred when the dome exceeded a relative height (from dome base to top) of 500 m; 2) collapses were preceded by thermal anomalies in six of the cases in which ASTER data were available, although the areal extent of these precursory thermal areas did not generally match the size of the collapse events as indicated by scar area (volumes are available for three collapse events). Linking the deposit distribution to the area, location, and temperature profiles of the dome-collapse scars provides a basis for determining similar future hazards at Shiveluch and at other dome-forming volcanoes. Because of these factors, we suggest that volcanic hazard analysis and mitigation at volcanoes with similar BAF emplacement behavior may

  20. The enthalpy of the heat-carrying fluids and the energy of eruption of velican geyser, Kamchatka, U.S.S.R.

    Science.gov (United States)

    Steinberg, G. S.

    1980-10-01

    The enthalphy of the heat carrying fluids liquid water or mixture of water plus steam) which feeds the biggest Kamchatka geyser, Velican is obtained from the critical quantity of heat Q critical, which is the net heat lost during the previous eruption and must be resupplied (stored) to trigger the next eruption. There are two unknowns in the heat balance equation for the geyser that cannot be determined from observations on the geyser in its natural state: critical and the enthalpy of the heat-carrying fluids Io. In order to obtain a system of two equations for unambiguous determination of these parameters, we made temporary physical changes that affected the natural interval between geyser eruptions and constructed the heat balance equations for the different regimes (i.e., natural and induced intervals). The changes in interval of Velican geyser were achieved by changing the area of its surface pool, using dams. For geysers with large surface pool areas, the heat loss from the surface (mainly through evaporation) is of the same order and sometimes larger than the losses from discharge of hot water. The change of surface pool area for Velican geyser from 12 m 2 (in natural state) to 4.5 and 36.7 m 2 in experiments leads to changes of its interval from an average of 5 hours and 35 minutes in natural state to 4 hours and 59 minutes and 8 hours and 8 minutes, respectively. From the three independent equations of heat balance we obtained three sets cf values for the enthalpy, Io and the critical energy, Q critical, which differ from each other by less than 1%: Io= 176 kcal/kg ∗, Q critical = 3.78 × 10 6 kcal. The interval between eruptions of Velican geyser tends to change linearly with vent area (within our experimental range). The range or interval values (the difference between maximal and minimal periods) also depends linearly on vent area. These two systematics are due to the facts that the increase of vent surface area causes increased heat loss by

  1. Geochemistry of the late Holocene rocks from the Tolbachik volcanic field, Kamchatka: Quantitative modelling of subduction-related open magmatic systems

    Science.gov (United States)

    Portnyagin, Maxim; Duggen, Svend; Hauff, Folkmar; Mironov, Nikita; Bindeman, Ilya; Thirlwall, Matthew; Hoernle, Kaj

    2015-12-01

    We present new major and trace element, high-precision Sr-Nd-Pb (double spike), and O-isotope data for the whole range of rocks from the Holocene Tolbachik volcanic field in the Central Kamchatka Depression (CKD). The Tolbachik rocks range from high-Mg basalts to low-Mg basaltic trachyandesites. The rocks considered in this paper represent mostly Late Holocene eruptions (using tephrochronological dating), including historic ones in 1941, 1975-1976 and 2012-2013. Major compositional features of the Tolbachik volcanic rocks include the prolonged predominance of one erupted magma type, close association of middle-K primitive and high-K evolved rocks, large variations in incompatible element abundances and ratios but narrow range in isotopic composition. We quantify the conditions of the Tolbachik magma origin and evolution and revise previously proposed models. We conclude that all Tolbachik rocks are genetically related by crystal fractionation of medium-K primary magmas with only a small range in trace element and isotope composition. The primary Tolbachik magmas contain 14 wt.% of MgO and 4% wt.% of H2O and originated by partial melting ( 6%) of moderately depleted mantle peridotite with Indian-MORB-type isotopic composition at temperature of 1250 °C and pressure of 2 GPa. The melting of the mantle wedge was triggered by slab-derived hydrous melts formed at 2.8 GPa and 725 °C from a mixture of sediments and MORB- and Meiji-type altered oceanic crust. The primary magmas experienced a complex open-system evolution termed Recharge-Evacuation-Fractional Crystallization (REFC). First the original primary magmas underwent open-system crystal fractionation combined with periodic recharge of the magma chamber with more primitive magma, followed by mixing of both magma types, further fractionation and finally eruption. Evolved high-K basalts, which predominate in the Tolbachik field, and basaltic trachyandesites erupted in 2012-2013 approach steady-state REFC liquid

  2. N-Acetylcarnosine sustained drug delivery eye drops to control the signs of ageless vision: glare sensitivity, cataract amelioration and quality of vision currently available treatment for the challenging 50,000-patient population.

    Science.gov (United States)

    Babizhayev, Mark A; Burke, Leslie; Micans, Philip; Richer, Stuart P

    2009-01-01

    Innovative Vision Products, Inc. (IVP)'s scientists developed the lubricant eye drops (Can-C) designed as 1% N-acetylcarnosine (NAC) prodrug of L-carnosine containing a mucoadhesive cellulose-based compound combined with corneal absorption promoters in a sustained drug delivery system. Only the natural L-isomeric form of NAC raw material was specifically synthesized at the cGMP facility and employed for the manufacturing of Can-C eye drops. In the present clinical study the authors assessed vision before and after 9 month term of topical ocular administration of NAC lubricant eye drops or placebo in 75 symptomatic patients with age-related uncomplicated cataracts in one or both eyes, with acuity in one eye of 20/40 or worse (best-corrected distance), and no previous cataract surgery in either eye and no other ocular abnormality and 72 noncataract subjects ranged in age from 54 to 78 years. Subjects in these subsample groups have reported complaints of glare and wanted to administer eye drops to get quick eye relief and quality of vision for their daily activities including driving and computer works. Following 9 months of treatment with NAC lubricant eye drops, most patients' glare scores were improved or returned to normal in disability glare tests with Halometer DG. Improvement in disability glare was accompanied with independent improvement in acuity. Furthermore, patients with the poorest pretreatment vision were as likely to regain certain better visual function after 9 months of treatment with N-acetylcarnosine lubricant eye drops as those with the worth pretreatment vision. The authors made a reference to electronic records of the product sales to patients who have been made the repurchase of the Can-C eye drops since December 2001. Based on this analysis of recorded adjustments to inventory, various parameters were analyzed during the continued repurchase behavior program, including testimonials from buyers. With these figures, researchers judged on the

  3. Glacier size changes in Kronotsky Peninsula and Alney-Chashakondzha Massif, Kamchatka Peninsula in the second half of XX century and the beginning of XXI century

    Directory of Open Access Journals (Sweden)

    A. Ya. Muravjev

    2014-01-01

    Full Text Available As it is known from recent investigations 448 glaciers are situated on the Kamchatka Peninsula, their total area are about 905 km2 [8]. More than 80% of them are glaciers of the Sredinny Range and the Klyuchevskaya group that is explained by large altitudes of them. Glaciers of the Kronotsky Penisula are less studied since this territory is practically not influenced by present-day volcanic processes. This paper presents results of investigation of changes in glaciations of the Kronotsky Peninsula and the mountain mass Alney-Chashakondzha (Fig. 1.The following materials are used: 1 the Landsat satellite picture of September 2nd, 2013; 2 pictures from satellite WorldView-2 of July 20th, 2010, and of August 1st, 2012 with spatial resolution of about 1 m; 3 aerial photographs made in August of 1950; 4 topographic maps of the 1:100 000 scale; 5 data from the USSR Glacier Inventory; 6 results of observations at hydrometeorological stations (HMS Klyuchi and Kronoki (1950–2006 (www.meteo.ru.According to data from the USSR Glacier Inventory 32 glaciers were situated on the Kronotsky Peninsula, their total area 91.9 km2. By 2013, six glaciers disintegrated. Deciphering of the Landsat pictures did show 50 glaciers. Among them 23 glaciers are presented in the Inventory and they still hold their wholeness; 13 glaciers are segments of six disintegrated ones; 14 glaciers found in the pictures are not presented in the Inventory. Changes in areas of the Kronotsky Peninsula glaciers for period 1950–2013 in dependence on their sizes and expositions are shown in Tables 1 and 2.According to the Inventory 26 glaciers were situated in region of the Alney-Chashakondzha massif, their total area 61.4 km2. By 2010, four of them disintegrated. Deciphering of the World-View-2 picture of July 2010 did show 45 glaciers: 20 glaciers are consistent with the Inventory, and they hold their wholeness; 9 glaciers are segments of four disintegrated ones; 16 glaciers found in

  4. Dulaglutide as add-on therapy to SGLT2 inhibitors in patients with inadequately controlled type 2 diabetes (AWARD-10): a 24-week, randomised, double-blind, placebo-controlled trial.

    Science.gov (United States)

    Ludvik, Bernhard; Frías, Juan P; Tinahones, Francisco J; Wainstein, Julio; Jiang, Honghua; Robertson, Kenneth E; García-Pérez, Luis-Emilio; Woodward, D Bradley; Milicevic, Zvonko

    2018-05-01

    Glucagon-like peptide-1 (GLP-1) receptor agonists and sodium-glucose co-transporter-2 (SGLT2) inhibitors improve glycaemic control and reduce bodyweight in patients with type 2 diabetes through different mechanisms. We assessed the safety and efficacy of the addition of the once-weekly GLP-1 receptor agonist dulaglutide to the ongoing treatment regimen in patients whose diabetes is inadequately controlled with SGLT2 inhibitors, with or without metformin. AWARD-10 was a phase 3b, double-blind, parallel-arm, placebo-controlled, 24-week study done at 40 clinical sites in Austria, Czech Republic, Germany, Hungary, Israel, Mexico, Spain, and the USA. Eligible adult patients (≥18 years) with inadequately controlled type 2 diabetes (HbA 1c concentration ≥7·0% [53 mmol/mol] and ≤9·5% [80 mmol/mol]), a BMI of 45 kg/m 2 or less, and taking stable doses (>3 months) of an SGLT2 inhibitor (with or without metformin) were randomly assigned (1:1:1) via an interactive web-response system to subcutaneous injections of either dulaglutide 1·5 mg, dulaglutide 0·75 mg, or placebo once per week for 24 weeks. Patients and investigators were masked to dulaglutide and placebo assignment, and those assessing outcomes were masked to study drug assignment. The primary objective was to test for the superiority of dulaglutide (1·5 mg or 0·75 mg) versus placebo for change in HbA 1c concentration from baseline at 24 weeks. All analyses were done in the intention-to-treat population, defined as all randomly assigned patients who received at least one dose of study drug. This study is registered with ClinicalTrials.gov, number NCT02597049. Between Dec 7, 2015, and Feb 3, 2017, 424 patients were randomly assigned to dulaglutide 1·5 mg (n=142), dulaglutide 0·75 mg (n=142), and placebo (n=140). One patient in the dulaglutide 0·75 mg group was excluded from the analysis because they did not receive any dose of the study drug. The reduction in HbA 1c concentration at 24 weeks was larger

  5. Putting the Glare of Publicity on International Arms Sales.

    Science.gov (United States)

    Hartman, William

    1992-01-01

    Reports on a United Nations committee recommendation that the Security Council establish a universal register of arms. Suggests that such a register would limit the destabilizing influence of major arms sales on developing nations. Argues that visibility of arms sales may help reduce their number. (DK)

  6. Modeling study of the Pauzhetsky geothermal field, Kamchatka, Russia

    Energy Technology Data Exchange (ETDEWEB)

    Kiryukhin, A.V. [Institute of Volcanology, Kamchatsky (Russian Federation); Yampolsky, V.A. [Kamchatskburgeotermia State Enterprise, Elizovo (Russian Federation)

    2004-08-01

    Exploitation of the Pauzhetsky geothermal field started in 1966 with a 5 MW{sub e} power plant. A hydrogeological model of the Pauzhetsky field has been developed based on an integrated analysis of data on lithological units, temperature, pressure, production zones and natural discharge distributions. A one-layer 'well by well' model with specified vertical heat and mass exchange conditions has been used to represent the main features of the production reservoir. Numerical model development was based on the TOUGH2 code [Pruess, 1991. TOUGH2 - A General Purpose Numerical Simulator for Multiphase Fluid and Heat Flow, Lawrence Berkeley National Laboratory Report, Berkeley, CA; Pruess et al., 1999. TOUGH2 User's Guide, Version 2.0, Report LBNL-43134, Lawrence Berkeley National Laboratory, Berkeley, CA] coupled with tables generated by the HOLA wellbore simulator [Aunzo et al., 1991. Wellbore Models GWELL, GWNACL, and HOLA, Users Guide, Draft, 81 pp.]. Lahey Fortran-90 compiler and computer graphical packages (Didger-3, Surfer-8, Grapher-3) were also used to model the development process. The modeling study of the natural-state conditions was targeted on a temperature distribution match to estimate the natural high-temperature upflow parameters: the mass flow-rate was estimated at 220 kg/s with enthalpy of 830-920 kJ/kg. The modeling study for the 1964-2000 exploitation period of the Pauzhetsky geothermal field was targeted at matching the transient reservoir pressure and flowing enthalpies of the production wells. The modeling study of exploitation confirmed that 'double porosity' in the reservoir, with a 10-20% active volume of 'fractures', and a thermo-mechanical response to reinjection (including changes in porosity due to compressibility and expansivity), were the key parameters of the model. The calibrated model of the Pauzhetsky geothermal field was used to forecast reservoir behavior under different exploitation scenarios for the central part of the field. The basic scenario assumes that the wellhead pressures of the eight exploitation wells and the injection rates of the three reinjection wells are maintained at the same conditions as of December 2000. In the base case, the model predicts a 12% decline in steam production rate (at 2.7 bar) during the next 30 years, even as the steam supply for the 5 MW{sub e} power plant is maintained. The modeling study confirmed that 30-60 kg/s is an optimal reinjection rate. An increase in the exploitation load has no significant effect on steam production from the central section of the Pauzhetsky field during the 30-year exploitation period; load doubling (eight additional exploitation wells) leads to a mere 16-27% increase in steam production. (author)

  7. The rockets' red glare, the bombs bursting in air: fireworks-related injuries to children.

    Science.gov (United States)

    Smith, G A; Knapp, J F; Barnett, T M; Shields, B J

    1996-07-01

    To describe the epidemiology of fireworks-related injuries to children treated in a pediatric emergency department. A descriptive study of a consecutive series of patients. The emergency department of a large urban children's hospital. Children treated for injuries associated with fireworks during the 22-year period from 1972 through 1993. Three hundred sixteen children were treated for fireworks-related injuries. Ninety-five percent of patients were injured during the 3-week period of June 22 to July 14 during the study years. Seventy-one percent of patients were male, and the average age was 8.5 years, with a range of 1 month to 17 years. The child was a bystander in 26% of cases, and adult supervision was present in 54% of cases. One patient died, and 11% of children required admission to the hospital, with an average length of stay of 7.8 days (range, 1 to 37 days). Fifteen children (5%) went to the operating room for treatment of injuries. Thirty-three patients (10%) had permanent sequelae from their injuries, including 7 children (2%) with complete or partial loss of vision in one eye. The eyes were injured in 29% of cases, followed by hands and fingers (22%), other head and face sites (18%), and lower extremities (16%). The primary injury was a burn in 72% of cases. Firecrackers were associated with 42% of injuries, followed by bottle rockets (12%), other types of rockets (7%), Roman candles (11%), sparklers (7%), fountains (5%), jumping jacks (4%), and class B (illegal) fireworks (4%). Sixty-seven percent of sparkler-related injuries occurred among children 5 years and younger (Fisher's exact test, P = .000002; odds ratio [OR] = 10.00, 95% confidence interval 3.52 rockets than eye injuries caused by other types of fireworks (Fisher's exact test, P = .03; OR = 6.72, 95% confidence interval 1.18 < OR < 38.18). Charges for medical care of a fireworks-related injury averaged $1385 per patient (range, $44 to $15 071). Fireworks are associated with serious injuries. Findings of this large consecutive series describe the epidemiology of these injuries. Children and their families should be encouraged to enjoy fireworks at public fireworks displays conducted by professionals. Fireworks for individual private use should be banned.

  8. The Rocket’s Red Glaringly Apparent Intent: The Dazzling Effects of Firework Naming

    Directory of Open Access Journals (Sweden)

    James O. Butler

    2018-03-01

    Full Text Available This article provides a preliminary investigation into the naming practices of a unique product group: pyrotechnics. It is conducted through a comprehensive survey of units made available in the UK marketplace (of 2015 during peak seasonal availability (end of October through early November, when fireworks can easily be purchased from non-specialist retailers. The semantic content underpinning effective branding is shown as being predominantly focused on the sensory impact of the explosions, which provides the primary naming impetus. The analysis is conducted through a statistical assessment against thematic grouping — this approach is typical for the statistical assessment of brand names linguistic categorisation. The author introduces a range of twelve thematic categories that correspond to the semantic fields used as the associative basis for each name. This analysis features a dedicated assessment of two specific categories: Rockets (which provide a statistically-representative snapshot of the entire range and Sparklers (which were omitted from the quantitative data. The article shows that most often firework names are retrieved from military and cosmic thematic groups and point mainly to the expected visual effects. Besides providing relevant quantitative data, the paper demonstrates the qualitative linguistic versatility of firework names, arguing that they hold significant analytic opportunities for examining the role of associative semantics in the commercial naming of entertainment products.

  9. 77 FR 27118 - Safety Zone; Rocketts Red Glare Fireworks, Ancarrows Landing Park, James River, Richmond, VA

    Science.gov (United States)

    2012-05-09

    ... waters of the James River centered on position 37[deg]31'13.1'' N/077[deg]25'07.84'' W (NAD 1983). Due to... are technical standards (e.g., specifications of materials, performance, design, or operation; test... cumulatively have a significant effect on the human environment. This rule is categorically excluded, under...

  10. Hygrotermal effects evaluation using the losipescu shear test for glare laminates

    OpenAIRE

    Botelho, Edson Cocchieri [UNESP; Rezende, Mirabel C.; Pardini, Luis Claudio

    2008-01-01

    Fiber-metal laminates (FML) composed of alternating layers of unidirectional fibers-reinforced plastic (FRP) laminae and aluminum-alloy sheets offer some superior mechanical properties, compared with either conventional laminates consisting of only, FRP laminae or high-strength monolithic aluminum alloys. The environmental factors can limit the applications of composites by deteriorating the mechanical properties during service. Usually, polymeric matrix absorbs moisture when exposed to humid...

  11. Hygrotermal effects evaluation using the iosipescu shear test for glare laminates

    OpenAIRE

    Botelho, Edson C.; Rezende, Mirabel C.; Pardini, Luis Claudio

    2008-01-01

    Fiber-metal laminates (FML) composed of alternating layers of unidirectional fiber-reinforced plastic (FRP) laminae and aluminum-alloy sheets offer some superior mechanical properties, compared with either conventional laminates consisting of only FRP laminae or high-strength monolithic aluminum alloys. The environmental factors can limit the applications of composites by deteriorating the mechanical properties during service. Usually, polymeric matrix absorbs moisture when exposed to humid e...

  12. Climatic factors affecting radial growth of Betula ermanii and Betula platypylla in Kamchatka

    Czech Academy of Sciences Publication Activity Database

    Doležal, Jiří; Ishii, H.; Kyncl, Tomáš; Takahashi, K.; Vetrova, V. P.; Homma, K.; Sumida, A.; Hara, T.

    2010-01-01

    Roč. 40, č. 2 (2010), s. 273-285 ISSN 0045-5067 R&D Projects: GA ČR GA206/05/0119; GA AV ČR IAA600050802 Institutional research plan: CEZ:AV0Z60050516 Keywords : tree-ring widths * boreal forest * Central Japan Subject RIV: EF - Botanics Impact factor: 1.574, year: 2010

  13. Biodiversity of thermophilic prokaryotes with hydrolytic activities in hot springs of Uzon Caldera, Kamchatka (Russia).

    Science.gov (United States)

    Kublanov, Ilya V; Perevalova, Anna A; Slobodkina, Galina B; Lebedinsky, Aleksander V; Bidzhieva, Salima K; Kolganova, Tatyana V; Kaliberda, Elena N; Rumsh, Lev D; Haertlé, Thomas; Bonch-Osmolovskaya, Elizaveta A

    2009-01-01

    Samples of water from the hot springs of Uzon Caldera with temperatures from 68 to 87 degrees C and pHs of 4.1 to 7.0, supplemented with proteinaceous (albumin, casein, or alpha- or beta-keratin) or carbohydrate (cellulose, carboxymethyl cellulose, chitin, or agarose) biological polymers, were filled with thermal water and incubated at the same sites, with the contents of the tubes freely accessible to the hydrothermal fluid. As a result, several enrichment cultures growing in situ on different polymeric substrates were obtained. Denaturing gradient gel electrophoresis (DGGE) analysis of 16S rRNA gene fragments obtained after PCR with Bacteria-specific primers showed that the bacterial communities developing on carbohydrates included the genera Caldicellulosiruptor and Dictyoglomus and that those developing on proteins contained members of the Thermotogales order. DGGE analysis performed after PCR with Archaea- and Crenarchaeota-specific primers showed that archaea related to uncultured environmental clones, particularly those of the Crenarchaeota phylum, were present in both carbohydrate- and protein-degrading communities. Five isolates obtained from in situ enrichments or corresponding natural samples of water and sediments represented the bacterial genera Dictyoglomus and Caldanaerobacter as well as new archaea of the Crenarchaeota phylum. Thus, in situ enrichment and consequent isolation showed the diversity of thermophilic prokaryotes competing for biopolymers in microbial communities of terrestrial hot springs.

  14. ANOMALOUS CHANGES OF THE GEOMAGNETIC FIELD VERTICAL COMPONENT IN KAMCHATKA

    Directory of Open Access Journals (Sweden)

    Smirnov, S.E.

    2016-11-01

    Full Text Available Statistical estimates of the effect in the electric field of the surface layer of the atmosphere parameters, such as time of the beginning, time of a maximum, its intensity and duration, were obtained. It was shown experimentally that the diurnal variation maximum of atmospheric electric field intensity is associated with air temperature height distribution. Power spectra of time variations of electric field intensity in the near ground atmosphere and of the horizontal component of geomagnetic field were under study. It was shown that there are oscillations with the periods of T _ 2, 0–2,5 hours in the power spectra of these parameters during a day. A possible mechanism of generation of these oscillations was proposed. It is associated with vortex motion of convective cells arising during the sunrise in the atmosphere exchange layer.

  15. Linking two centuries of tree growth and glacier dynamics with climate changes in Kamchatka

    Czech Academy of Sciences Publication Activity Database

    Doležal, Jiří; Altman, Jan; Vetrova, V. P.; Hara, T.

    2014-01-01

    Roč. 124, 1-2 (2014), s. 207-220 ISSN 0165-0009 R&D Projects: GA ČR GA13-13368S Institutional research plan: CEZ:AV0Z60050516 Institutional support: RVO:67985939 Keywords : climate change * Little Ice Age * tree ring reconstruction Subject RIV: EH - Ecology, Behaviour Impact factor: 3.430, year: 2014

  16. Inverse modeling and forecasting for the exploitation of the Pauzhetsky geothermal field, Kamchatka, Russia

    Energy Technology Data Exchange (ETDEWEB)

    Kiryukhin, Alexey V. [Institute of Volcanology and Seismology FEB RAS, Piip-9, P-Kamchatsky 683006 (Russian Federation); Asaulova, Natalia P. [Kamchatskburgeotemia Enterprise, Krasheninnikova-1, Thermalny, Kamchatka 684035 (Russian Federation); Finsterle, Stefan [Lawrence Berkeley National Laboratory, MS 90-1116, One Cyclotron Road, Berkeley, CA 94720 (United States)

    2008-10-15

    A three-dimensional numerical model of the Pauzhetsky geothermal field has been developed based on a conceptual hydrogeological model of the system. It extends over a 13.6-km{sup 2} area and includes three layers: (1) a base layer with inflow; (2) a geothermal reservoir; and (3) an upper layer with discharge and recharge/infiltration areas. Using the computer program iTOUGH2 [Finsterle, S., 2004. Multiphase inverse modeling: review and iTOUGH2 applications. Vadose Zone J. 3, 747-762], the model is calibrated to a total of 13,675 calibration points, combining natural-state and 1960-2006 exploitation data. The principal model parameters identified and estimated by inverse modeling include the fracture permeability and fracture porosity of the geothermal reservoir, the initial natural upflow rate, the base-layer porosity, and the permeabilities of the infiltration zones. Heat and mass balances derived from the calibrated model helped identify the sources of the geothermal reserves in the field. With the addition of five make-up wells, simulation forecasts for the 2007-2032 period predict a sustainable average steam production of 29 kg/s, which is sufficient to maintain the generation of 6.8 MWe at the Pauzhetsky power plant. (author)

  17. Microbial Diversity and Biochemical Potential Encoded by Thermal Spring Metagenomes Derived from the Kamchatka Peninsula

    Directory of Open Access Journals (Sweden)

    Bernd Wemheuer

    2013-01-01

    Full Text Available Volcanic regions contain a variety of environments suitable for extremophiles. This study was focused on assessing and exploiting the prokaryotic diversity of two microbial communities derived from different Kamchatkian thermal springs by metagenomic approaches. Samples were taken from a thermoacidophilic spring near the Mutnovsky Volcano and from a thermophilic spring in the Uzon Caldera. Environmental DNA for metagenomic analysis was isolated from collected sediment samples by direct cell lysis. The prokaryotic community composition was examined by analysis of archaeal and bacterial 16S rRNA genes. A total number of 1235 16S rRNA gene sequences were obtained and used for taxonomic classification. Most abundant in the samples were members of Thaumarchaeota, Thermotogae, and Proteobacteria. The Mutnovsky hot spring was dominated by the Terrestrial Hot Spring Group, Kosmotoga, and Acidithiobacillus. The Uzon Caldera was dominated by uncultured members of the Miscellaneous Crenarchaeotic Group and Enterobacteriaceae. The remaining 16S rRNA gene sequences belonged to the Aquificae, Dictyoglomi, Euryarchaeota, Korarchaeota, Thermodesulfobacteria, Firmicutes, and some potential new phyla. In addition, the recovered DNA was used for generation of metagenomic libraries, which were subsequently mined for genes encoding lipolytic and proteolytic enzymes. Three novel genes conferring lipolytic and one gene conferring proteolytic activity were identified.

  18. Magmatic Complexes of the Vetlovaya Marginal Sea Paleobasin (Kamchatka): Composition and Geodynamic Setting

    Science.gov (United States)

    Tsukanov, N. V.; Saveliev, D. P.; Kovalenko, D. V.

    2018-01-01

    This study presents new geochemical and isotope data on igneous rocks of the Vetlovaya marginal sea paleobasin (part of the Late Mesozoic-Cenozoic margin of the northwestern Pacific). The results show that the rock complexes of this marginal sea basin comprise igneous rocks with geochemical compositions similar to those of normal oceanic tholeiites, enriched transitional tholeiites, and ocean island and back-arc basin basalts. Island-arc tholeiitic basalts are present only rarely. The specific geochemical signatures of these rocks are interpreted as being related to mantle heterogeneity and the geodynamic conditions in the basin.

  19. New Data on the Composition of Ophiolite Complexes on Karaginskii Island (Eastern Kamchatka)

    Science.gov (United States)

    Skolotnev, S. G.; Tsukanov, N. V.; Sidorov, E. G.

    2018-03-01

    The geochemistry and composition of peridotite rock-forming minerals from blocks in the serpentinite mélange of Karaginskii Island have been studied. The composition features of the rock-forming minerals are indicative of the fact that they represent abyssal peridotites of the mid-oceanic ridges that did not undergo remelting under suprasubduction conditions. According to the geochemical data, these rocks were subject to metasomatic alterations under mantle conditions in the suprasubduction setting, which were caused by metasomatizing melts and/or fluids generated in the subduction zone.

  20. Inverse modeling and forecasting for the exploitation of the Pauzhetsky geothermal field, Kamchatka, Russia

    Energy Technology Data Exchange (ETDEWEB)

    Finsterle, Stefan; Kiryukhin, A.V.; Asaulova, N.P.; Finsterle, S.

    2008-04-01

    A three-dimensional numerical model of the Pauzhetsky geothermal field has been developed based on a conceptual hydrogeological model of the system. It extends over a 13.6-km2 area and includes three layers: (1) a base layer with inflow; (2) a geothermal reservoir; and (3) an upper layer with discharge and recharge/infiltration areas. Using the computer program iTOUGH2 (Finsterle, 2004), the model is calibrated to a total of 13,675 calibration points, combining natural-state and 1960-2006 exploitation data. The principal model parameters identified and estimated by inverse modeling include the fracture permeability and fracture porosity of the geothermal reservoir, the initial natural upflow rate, the base-layer porosity, and the permeabilities of the infiltration zones. Heat and mass balances derived from the calibrated model helped identify the sources of the geothermal reserves in the field. With the addition of five makeup wells, simulation forecasts for the 2007-2032 period predict a sustainable average steam production of 29 kg/s, which is sufficient to maintain the generation of 6.8 MWe at the Pauzhetsky power plant.

  1. Approved CAR T cell therapies : Ice bucket challenges on glaring safety risks and long-term impacts

    NARCIS (Netherlands)

    P.P. Zheng (Pingpin); J.M. Kros (Johan); J. Li (Jin)

    2018-01-01

    textabstractTwo autologous chimeric antigen receptor (CAR) T cell therapies (Kymriah™ and Yescarta™) were recently approved by the FDA. Kymriah™ is for the treatment of pediatric patients and young adults with refractory or relapse (R/R) B cell precursor acute lymphoblastic leukemia and Yescarta™ is

  2. The Effect of Glare on Regan Contrast Letter Acuity Scores Using Dye-Based and Reflective Laser Eye Protection

    National Research Council Canada - National Science Library

    Ghani, Nadeem

    2001-01-01

    Current laser eye protection devices (LEPDs) are dye-based or reflective. While both technologies block the laser wavelengths, reflective LEPDs generally transmit more visible light than do dye-based LEPDs...

  3. [New SGLT2 inhibitor empagliflozin: modern and safe treatment of diabetes].

    Science.gov (United States)

    Rušavý, Zdeněk

    2014-11-01

    Empagliflozin is agent of new antidiabetic drugs that cause glycosuria blocking the glucose reuptake in the proxi-mal tubule. The loss of 50-100 g of glucose / 24 hours in the urine results in a reduction of fasting glucose, especially post-prandial glucose, the energy expenditure of 200-400 kcal / day and blood pressure lowering. Treatment efficacy does not decrease over time, as it is not dependent on its own insulin production. The work evaluates the safety of modern treatment with empagliflozin which will soon appear in the portfolio of antidiabetic agents in the Czech Republic. The conducted studies with a special focus on empagliflozin treatment have shown high efficacy, safety and good tolerability of drug. It has been described a higher incidence of genital infections with non-severe course, especially in women. The drug does not cause hypoglycaemia. In combination with sulfonylurea hypoglycaemia may occur. Empagliflozin does not cause clinically significant dehydration or hypotension in patients about 60 years of age, but some caution in empagliflozin treatment should be in elderly and fragile patients. The big convenience of empagliflozin is its clinically non-significant interactions with other drugs and simple dosage of 1 tablet / day orally. In conclusion, empagliflozin is highly effective oral antidiabetic agent with a potential of wide application in all stages of type 2 diabetes in monotherapy or combined with other medication. The treatment is associated with weight loss and blood pressure lowering. The drug is effective and safe until eGFR 45 ml / s, in lower values the treatment should be discontinued. The occurrence of side effects is rare, except increased incidence of genital infections especially in women and increased risk of hypoglycaemia when empagliflozin is combined with sulfonylurea.

  4. SGLT2 Inhibition in the Diabetic Kidney—From Mechanisms to Clinical Outcome

    Science.gov (United States)

    Muskiet, Marcel H.A.; Tonneijck, Lennart; Kramer, Mark H.H.; Nieuwdorp, Max; van Raalte, Daniel H.

    2017-01-01

    Diabetic kidney disease not only has become the leading cause for ESRD worldwide but also, highly contributes to increased cardiovascular morbidity and mortality in type 2 diabetes. Despite increased efforts to optimize renal and cardiovascular risk factors, like hyperglycemia, hypertension, obesity, and dyslipidemia, they are often insufficiently controlled in clinical practice. Although current drug interventions mostly target a single risk factor, more substantial improvements of renal and cardiovascular outcomes can be expected when multiple factors are improved simultaneously. Sodium-glucose cotransporter type 2 in the renal proximal tubule reabsorbs approximately 90% of filtered glucose. In type 2 diabetes, the maladaptive upregulation of sodium-glucose cotransporter type 2 contributes to the maintenance of hyperglycemia. Inhibiting these transporters has been shown to effectively improve glycemic control through inducing glycosuria and is generally well tolerated, although patients experience more genital infections. In addition, sodium-glucose cotransporter type 2 inhibitors favorably affect body weight, BP, serum uric acid, and glomerular hyperfiltration. Interestingly, in the recently reported first cardiovascular safety trial with a sodium-glucose cotransporter type 2 inhibitor, empagliflozin improved both renal and cardiovascular outcomes in patients with type 2 diabetes and established cardiovascular disease. Because the benefits were seen rapidly after initiation of therapy and other glucose-lowering agents, with the exception of liraglutide and semaglutide, have not been able to improve cardiovascular outcome, these observations are most likely explained by effects beyond glucose lowering. In this mini review, we present the drug class of sodium-glucose cotransporter type 2 inhibitors, elaborate on currently available renal and cardiovascular outcome data, and discuss how the effects of these agents on renal physiology may explain the data. PMID:28254770

  5. Conformational Dynamics of hSGLT1 during Na+/Glucose Cotransport

    DEFF Research Database (Denmark)

    Loo, D. D.; Hirayama, B. A.; Karakossian, M. H.

    2006-01-01

    at the expense of outward-facing conformations. The simulations predict, and we have observed experimentally, that presteady-state currents are blocked by saturating sugar, but not the changes in fluorescence. Thus we have isolated an electroneutral conformational change that has not been previously described......) was totally abolished, whereas Fmax was only reduced 50%. Phlorizin reduced both Qmax and Fmax (Ki 0.4 µM), with no changes in V0.5's or relaxation time constants. Simulations using an eight-state kinetic model indicate that external sugar increases the occupancy probability of inward-facing conformations...

  6. Biodiversity of Thermophilic Prokaryotes with Hydrolytic Activities in Hot Springs of Uzon Caldera, Kamchatka (Russia)▿ †

    OpenAIRE

    Kublanov, Ilya V.; Perevalova, Anna A.; Slobodkina, Galina B.; Lebedinsky, Aleksander V.; Bidzhieva, Salima K.; Kolganova, Tatyana V.; Kaliberda, Elena N.; Rumsh, Lev D.; Haertlé, Thomas; Bonch-Osmolovskaya, Elizaveta A.

    2008-01-01

    Samples of water from the hot springs of Uzon Caldera with temperatures from 68 to 87°C and pHs of 4.1 to 7.0, supplemented with proteinaceous (albumin, casein, or α- or β-keratin) or carbohydrate (cellulose, carboxymethyl cellulose, chitin, or agarose) biological polymers, were filled with thermal water and incubated at the same sites, with the contents of the tubes freely accessible to the hydrothermal fluid. As a result, several enrichment cultures growing in situ on different polymeric su...

  7. Airborne photogrammetry and geomorphological analysis of the 2001-2012 exogenous dome growth at Molodoy Shiveluch Volcano, Kamchatka

    Science.gov (United States)

    Shevchenko, A. V.; Dvigalo, V. N.; Svirid, I. Yu.

    2015-10-01

    In 2001, after a six-year pause in extrusive activity, lava dome growth resumed at Molodoy Shiveluch Volcano. The new period of dome growth (2001-present) has morphological features that were uncommon during the previous periods of the dome formation (1980-1981, 1993-1995): numerous lava lobes and crease structures. Thus, the current dome growth is mostly of an exogenous type with short periods of endogenous growth that occurred in 2003, 2005, and 2010. Geomorphological interpretation of stereo photo images has revealed elements of the dome that are hardly distinguishable in single photographs. We have made detailed descriptions of the dome morphology covering all the dates of the available images. By using photogrammetric processing of aerial photographs, we created Digital Terrain Models and topographic maps of the lava dome and defined its volumes for 2001 (0.19 km3), 2003 (0.47 km3), 2005 (0.48 km3), 2010 (0.54 km3), and 2012 (0.63 km3). We also defined other morphometric characteristics: absolute and relative heights, as well as the dimensions of the dome and its elements for the investigated period. Taking into account large partial failures of the dome in 2005 (>0.11 km3) and 2010 (0.28 km3), we suggest that the volume of the extruded material for the whole 1980-2012 period was no less than 1.02 km3. The average extrusion rate over the 2001-2012 period exceeded 225,000 m3/day. The transition from endogenous to exogenous dome growth was possibly caused by change in extruded material physical properties due to an increase of SiO2. On the basis of geomorphological analysis of the current lava dome features, we suggest the possible process of the exogenous dome formation at Molodoy Shiveluch. The crease structures detected at Molodoy Shiveluch were classified into three groups according to their shapes: radial, bilaterally symmetrical, and irregular. These crease structures are morphologically similar to those formed at Unzen Volcano during the 1990-1995 eruption. Some revealed morphological features of the crease structures show that the role of gravity is insignificant in their formation. We assume that the crease structures at Molodoy Shiveluch were formed by inner stresses due to thermal and solidification gradients.

  8. Practical Application and Obstacles of AVHRR Thermal Data for Estimation of Effusion Rates at Tolbachik Volcano, Kamchatka Peninsula, Russian Federation

    Science.gov (United States)

    McAlpin, D. B.; Meyer, F. J.; Webley, P. W.

    2017-12-01

    Using thermal data from Advanced Very High Resolution Radiometer (AVHRR) sensors, we investigated algorithms to estimate the effusive volume of lava flows from the 2012-13 eruption of Tolbachik Volcano with high temporal resolution. AVHRR are polar orbiting, radiation detection instruments that provide reflectance and radiance data in six spectral bands with a ground resolution of 1.1 km². During the Tolbachik eruption of 2012-13, active AVHRR instruments were available aboard four polar orbiting platforms. Although the primary purpose of the instruments is climate and ocean studies, their multiple platforms provide global coverage at least twice daily, with data for all regions of the earth no older than six hours. This frequency makes the AVHRR instruments particularly suitable for the study of volcanic activity. While methods for deriving effusion rates from thermal observations have been previously published, a number of topics complicate their practical application. In particular, these include (1) unknown material parameters used in the estimation process; (2) relatively coarse resolution of thermal sensors; (3) optimizing a model to describe the number of thermal regimes within each pixel and (4) frequent saturation issues in thermal channels. We present ongoing investigations into effusion rate estimation from AVHRR data using the 2012-13 eruption of Tolbachik Volcano as a test event. For this eruption we studied approaches for coping with issues (1) - (4) to pave the way to a more operational implementation of published techniques. To address (1), we used Monte Carlo simulations to understand the sensitivity of effusion rate estimates to changes in material parameters. To study (2) and (3) we compared typical two-component (exposed lava on ambient background) and three-component models (exposed lava, cooled crust, ambient background) for their relative performance. To study issue (4), we compared AVHRR-derived effusion rates to reference data derived from multi-temporal digital elevation models. In our workflow, we correct for scan angle of the sensor and the transmissivity of the atmosphere before including include corrected temperatures in heat equations to determine the effusion volume necessary to satisfy the equations.

  9. The Glaring Socioeconomic Meltdown in Post-Soviet Ukraine, Moldova, and Belarus: A Distorted Mindset in Search of a Way Out

    Directory of Open Access Journals (Sweden)

    Olesea Ghedrovici

    2013-07-01

    Full Text Available Cultural and historical values and assumptions deeply imprint all aspects of people’s lives, including their role in social, economic, and political transformation. Many of the former Soviet states are still going through a painful metamorphosis on a confusing path toward acceptance of freedom and democratic values. The idea we wish to highlight there is the impact of the Soviet moral and psychological legacy on the socioeconomic transition now under way in the East European countries that once were republics of the Soviet Union. It is important to shed light on the reasons why, after 20 years of formal independence, the region is still struggling to find its way forward.

  10. Adverse Effects and Safety of SGLT2 Inhibitor Use among Patients with Type 2 Diabetes: Findings from RCT Evidence

    OpenAIRE

    Tang, Huilin; Zhang, Jingjing; Song, Yiqing

    2017-01-01

    Sodium-glucose cotransporter 2 (SGTL2) inhibitors, a novel class of glucose-lowering agents, act in an insulin-independent manner by increasing urinary glucose excretion. In addition to reduce hyperglycemia, SGTL2 inhibitor exerts beneficial effects on cardiovascular risk factors (e.g., lower blood pressure and enhance weigh loss), which may confer additional health benefits for type 2 diabetes patients. The EMPA-REG OUTCOME trial showed that empagliflozin not only reduced the risk of major a...

  11. Recent and emerging therapeutic medications in type 2 diabetes mellitus: incretin-based, Pramlintide, Colesevelam, SGLT2 Inhibitors, Tagatose, Succinobucol.

    Science.gov (United States)

    Lo, Margaret C; Lansang, M Cecilia

    2013-01-01

    Nearly 285 million people worldwide, with 10% being Americans, suffer from diabetes mellitus and its associated comorbidities. This is projected to increase by 6.5% per year, with 439 million inflicted by year 2030. Both morbidity and mortality from diabetes stem from the consequences of microvascular and macrovascular complications. Of the 285 million with diabetes, over a quarter of a million die per year from related complications, making diabetes the fifth leading cause of death in high-income countries. These startling statistics illustrate the therapeutic failure of current diabetes drugs to retard the progression of diabetes. These statistics further illustrate the continual need for further research and development of alternative drugs with novel mechanisms to slow disease progression and disease complications. The treatment algorithm updated in 2008 by American Diabetes Association and the European Association for the Study of Diabetes currently recommends the traditional medications of metformin, either as monotherapy or in combination with sulfonylurea or insulin, as the preferred choice in the tier 1 option. The algorithm only suggests addition of alternative medications such as pioglitazone and incretin-based drugs as second-line agents in the tier 2 "less well-validated" option. However, these traditional medications have not proven to delay the progressive course of diabetes as evidence of increasing need over time for multiple drug therapy to maintain sufficient glycemic control. Because current diabetes medications have limited efficacy and untoward side effects, the development of diabetes mellitus drugs with newer mechanisms of action continues. This article will review the clinical data on the newly available incretin-based drugs on the market, including glucagon-like peptide agonists and of dipeptidyl peptidase type-4 inhibitors. It will also discuss 2 unique medications: pramlintide, which is indicated for both type and type-2 diabetes, and colesevelam, which is approved by the United States Food and Drug Administration for both type-2 diabetes and hyperlipidemia. It will further review the clinical data on the novel emerging agents of sodium-glucose cotransporter-2 inhibitors, tagatose, and succinobucol, all currently in phase III clinical trials. This review article can serve as an aid for clinicians to identify clinical indications in which these new agents can be applied in the treatment algorithm.

  12. Effect of gemfibrozil, rifampicin, or probenecid on the pharmacokinetics of the SGLT2 inhibitor empagliflozin in healthy volunteers.

    Science.gov (United States)

    Macha, Sreeraj; Koenen, Rüdiger; Sennewald, Regina; Schöne, Katja; Hummel, Noemi; Riedmaier, Stephan; Woerle, Hans J; Salsali, Afshin; Broedl, Uli C

    2014-02-01

    Empagliflozin is a potent, oral, selective inhibitor of sodium glucose cotransporter 2 in development for the treatment of type 2 diabetes mellitus. The goal of these studies was to investigate potential drug-drug interactions between empagliflozin and gemfibrozil (an organic anion-transporting polypeptide 1B1 [OATP1B1]/1B3 and organic anion transporter 3 [OAT3] inhibitor), rifampicin (an OATP1B1/1B3 inhibitor), or probenecid (an OAT3 and uridine diphosphate glucuronosyltransferase inhibitor). Two open-label, randomized, crossover studies were undertaken in healthy subjects. In the first study, 18 subjects received the following in 1 of 2 randomized treatment sequences: a single dose of empagliflozin 25 mg alone and gemfibrozil 600 mg BID for 5 days with a single dose of empagliflozin 25 mg on the third day. In the second study, 18 subjects received a single dose of empagliflozin 10 mg, a single dose of empagliflozin 10 mg coadministered with a single dose of rifampicin 600 mg, and probenecid 500 mg BID for 4 days with a single dose of empagliflozin 10 mg on the second day in 1 of 6 randomized treatment sequences. In the gemfibrozil study, 11 subjects were male, mean age was 35.1 years and mean body mass index (BMI) was 23.47 kg/m(2). In the rifampicin/probenecid study, 10 subjects were male, mean age was 32.7 years and mean BMI was 23.03 kg/m(2). Exposure to empagliflozin was increased by coadministration with gemfibrozil (AUC0-∞: geometric mean ratio [GMR], 158.50% [90% CI, 151.77-165.53]; Cmax: GMR, 115.00% [90% CI, 106.15-124.59]), rifampicin (AUC0-∞: GMR, 135.20% [90% CI, 129.58-141.06]; Cmax: GMR, 175.14% [90% CI, 160.14-191.56]), and probenecid (AUC0-∞: GMR, 153.47% [90% CI, 146.41-160.88]; Cmax: GMR, 125.60% [90% CI, 113.67-138.78]). All treatments were well tolerated. Increases in empagliflozin exposure were gemfibrozil, rifampicin, or probenecid. ClinicalTrials.gov identifiers: NCT01301742 and NCT01634100. Copyright © 2014 Elsevier HS Journals, Inc. All rights reserved.

  13. Dgroup: DG01248 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available liflozin L-proline (JAN) ... Antidiabetic agent ... DG01794 ... SGLT2 inhibitor Unclassified ... DG02044 ... Hypoglycemic...s ... DG01794 ... SGLT2 inhibitor ... Antidiabetics, SGLT2 inhibitors SLC5A2 (SGLT2) [HSA:6524] [KO:K14382] ...

  14. Geochemical and geo-electrical study of mud pools at the Mutnovsky volcano (South Kamchatka, Russia): Behavior of elements, structures of feeding channels and a model of origin

    International Nuclear Information System (INIS)

    Bessonova, E.P.; Bortnikova, S.B.; Gora, M.P.; Manstein, Yu.A.; Shevko, A.Ya.; Panin, G.L.; Manstein, A.K.

    2012-01-01

    This study presents data on the geochemical composition of boiling mud pools at the Mutnovsky volcano. The physicochemical characteristics of the pools and the concentrations of major, minor and trace elements in pool solutions vary widely. A comparison of the geochemical compositions of host rocks and solutions indicates that leaching from rocks is not the only source of chemicals in thermal solutions. Geophysical studies reveal the inner structure of thermal fields, which reflect the shapes of the underground reservoirs and feed channels. Using geophysical methods (electrical resistivity tomography and frequency domain investigations), it was shown that the vertical structure and complex geochemical zonation of the feed channels leads to a high contrast in the compositions of the mud solutions. These findings answer questions about the origin and composition of surface manifestations. To elucidate the mechanisms of solution formation, an attempt was made to describe the magmatic fluid evolution and the resulting mixing of waters by physical and mathematical models. The model illustrates fluid migration from a magma chamber to the surface. It is shown that the formation of brines corresponding to the mud pool composition is possible during secondary boiling.

  15. Deep Structure of the Zone of Tolbachik Fissure Eruptions (Kamchatka, Klyuchevskoy Volcano Group): Evidence from a Complex of Geological and Geophysical Data

    Science.gov (United States)

    Kugaenko, Yu. A.; Saltykov, V. A.; Gorvatikov, A. V.; Stepanova, M. Yu.

    2018-05-01

    With the use of the method of low-frequency microseismic sounding, the configuration of the magmatic feeding system of the Tolbachinsky Dol—a regional zone of areal basaltic volcanism in the southern part of the Klyuchevskoy volcano group in Kamchatka—is studied. The initial data are obtained by a stepby-step recording of the background microseismic noise in 2010-2015 within a thoroughly marked-out survey area covering the zones of fissure eruptions in 1975-1976 and 2012-2013 and, partly, the edifice of the Ploskii (flat) Tolbachik volcano. The depth sections reflecting the distributions of the relative velocities of seismic waves in the Earth's crust are constructed. For a more reliable interpretation of the revealed deep anomalies, the results of independent geological and geophysical studies are used. The ascertained low-velocity structures are closely correlated to the manifestations of present-day volcanism. It is shown that the feeding structure of the Tolbachinsky Dol is spatially heterogeneous, incorporating subvertical and lateral pipeshaped magma conduits, closely spaced magma feeding channels, and shallow magma reservoirs. A longlived local transcrustal magma conducting zone is revealed, and regularities in the deep structure of the feeding systems of fissure eruptions are identified. The configuration of the established subvertical magma conduits permits basalts moving to rise to the surface by different paths, which, inter alia, explains the contrasting magma compositions observed during a single eruption. Thus, based on the instrumental data, it is shown that the magmatic feeding structure of the Tolbachinsky Dol has a number of specific peculiarities and is significantly more complicated than has been previously thought about the areal volcanic fields.

  16. Названия рыбных блюд в говорах камчадалов (материалы к Камчатскому областному словарю)

    OpenAIRE

    Малоземлина, Оксана

    2009-01-01

    This article studies the lexical fragment of Kamchatka's dialects (food). The empirical data was collected by two ways: by selection from the card file of the regional ethno-linguistic laboratory of Vitus Bering Kamchatka State University and by author's data gatherings during expeditions to the villages of the Kamchatka's region. This material has a practical value and becomes a part of the Kamchatka's regional dictionary. The work on this dictionary compiling is in intensive stage of develo...

  17. Dgroup: DG00122 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available Dapagliflozin propanediol (USAN); Dapagliflozin propylene glycolate hydrate (JAN) ... Antidiabetic agent ... DG0...1794 ... SGLT2 inhibitor Unclassified ... DG02044 ... Hypoglycemics ... DG01794 ... SGLT2 inhibitor ATC code: A10BK01 Antidiabetic

  18. Sodium Glucose Cotransporter 2 Inhibitors in the Treatment of Diabetes Mellitus : Cardiovascular and Kidney Effects, Potential Mechanisms, and Clinical Applications

    NARCIS (Netherlands)

    Heerspink, Hiddo J. L.; Perkins, Bruce A.; Fitchett, David H.; Husain, Mansoor; Cherney, David Z. I.

    2016-01-01

    Sodium-glucose cotransporter-2 (SGLT2) inhibitors, including empagliflozin, dapagliflozin, and canagliflozin, are now widely approved antihyperglycemic therapies. Because of their unique glycosuric mechanism, SGLT2 inhibitors also reduce weight. Perhaps more important are the osmotic diuretic and

  19. A 96-well automated method to study inhibitors of human sodium-dependent D-glucose transport.

    Science.gov (United States)

    Castaneda, Francisco; Kinne, Rolf K-H

    2005-12-01

    The sodium-dependent D-glucose transporter (SGLT) family is involved in glucose uptake via intestinal absorption (SGLT1) or renal reabsorption (SGLT1 and SGLT2). Current methods for the screening of inhibitors of SGLT transporters are complex, expensive and very labor intensive, and have not been applied to human SGLT transporters. The purpose of the present study was to develop an alternative 96-well automated method to study the activity of human SGLT1 and SGLT2. Chinese hamster ovary (CHO) Flp-In cells were stably transfected with pcDNA5-SGLT1 or pcDNA5-SGLT2 plasmid and maintained in hygromycin-selection Ham's F12 culture medium until hygromycin-resistant clones were developed. SGLT1 and SGLT2 gene expression was evaluated by relative real-time reverse transcription-polymerase chain reaction (RT-PCR) quantification, Western blotting, and immunocytochemical analysis. The clones with higher expression of SGLT1 and SGLT2 were used for transport studies using [14C]-methyl-alpha-D-glucopyranoside ([14C]AMG). The advantage of using the 96-well format is the low amount of radioactive compounds and inhibitory substances required, and its ability to establish reproducibility because repetition into the assay. This method represents an initial approach in the development of transport-based high-throughput screening in the search for inhibitors of glucose transport. The proposed method can easily be performed to yield quantitative data regarding key aspects of glucose membrane transport and kinetic studies of potential inhibitors of human SGLT1 and SGLT2.

  20. Glucose stimulates neurotensin secretion from the rat small intestine by mechanisms involving SGLT1 and GLUT2 leading to cell depolarization and calcium influx

    DEFF Research Database (Denmark)

    Kuhre, Rune Ehrenreich; Bechmann, Louise Ellegaard; Hartmann, Bolette

    2015-01-01

    of secretion. Luminal glucose (20% wt/vol) stimulated secretion but vascular glucose (5, 10, or 15 mmol/l) was without effect. The underlying mechanisms depend on membrane depolarization and calcium influx, since the voltage-gated calcium channel inhibitor nifedipine and the KATP channel opener diazoxide......, suggesting that glucose stimulates secretion by initial uptake by this transporter. However, secretion was also sensitive to GLUT2 inhibition (by phloretin) and blockage of oxidative phosphorylation (2-4-dinitrophenol). Direct KATP channel closure by sulfonylureas stimulated secretion. Therefore, glucose...

  1. SGLT2-inhibitor and DPP-4 inhibitor improve brain function via attenuating mitochondrial dysfunction, insulin resistance, inflammation, and apoptosis in HFD-induced obese rats.

    Science.gov (United States)

    Sa-Nguanmoo, Piangkwan; Tanajak, Pongpan; Kerdphoo, Sasiwan; Jaiwongkam, Thidarat; Pratchayasakul, Wasana; Chattipakorn, Nipon; Chattipakorn, Siriporn C

    2017-10-15

    Dipeptidyl peptidase-4 inhibitor (vildagliptin) has been shown to exert beneficial effects on insulin sensitivity and neuroprotection in obese-insulin resistance. Recent studies demonstrated the neuroprotection of the sodium-glucose co-transporter 2 inhibitor (dapagliflozin) in diabetes. However, the comparative effects of both drugs and a combination of two drugs on metabolic dysfunction and brain dysfunction impaired by the obese-insulin resistance have never been investigated. Forty male Wistar rats were divided into two groups, and received either a normal-diet (ND, n=8) or a high-fat diet (HFD, n=32) for 16weeks. At week 13, the HFD-fed rats were divided into four subgroups (n=8/subgroup) to receive either a vehicle, vildagliptin (3mg/kg/day) dapagliflozin (1mg/kg/day) or combined drugs for four weeks. ND rats were given a vehicle for four weeks. Metabolic parameters and brain function were investigated. The results demonstrated that HFD rats developed obese-insulin resistance and cognitive decline. Dapagliflozin had greater efficacy on improved peripheral insulin sensitivity and reduced weight gain than vildagliptin. Single therapy resulted in equally improved brain mitochondrial function, insulin signaling, apoptosis and prevented cognitive decline. However, only dapagliflozin improved hippocampal synaptic plasticity. A combination of the drugs had greater efficacy in improving brain insulin sensitivity and reducing brain oxidative stress than the single drug therapy. These findings suggested that dapagliflozin and vildagliptin equally prevented cognitive decline in the obese-insulin resistance, possibly through some similar mechanisms. Dapagliflozin had greater efficacy than vildagliptin for preserving synaptic plasticity, thus combined drugs could be the best therapeutic approach for neuroprotection in the obese-insulin resistance. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. SGLT2 inhibitors or GLP-1 receptor agonists as second-line therapy in type 2 diabetes: patient selection and perspectives.

    Science.gov (United States)

    Gurgle, Holly E; White, Karen; McAdam-Marx, Carrie

    2016-01-01

    Controversy exists regarding the selection of second-line therapy for patients with type 2 diabetes mellitus (T2DM) who are unable to achieve glycemic control with metformin therapy alone. Newer pharmacologic treatments for T2DM include glucagon-like peptide-1 receptor agonists and sodium-glucose cotransporter 2 inhibitors. Both the classes of medication are efficacious, exhibit positive effects on weight, and are associated with minimal risk of hypoglycemia. The purpose of this review is to compare the clinical trial and real-world effectiveness data of glucagon-like peptide-1 receptor agonists versus sodium-glucose cotransporter 2 inhibitors related to A1c reduction, weight loss, cost-effectiveness, cardiovascular outcomes, and safety in patients with T2DM. This review summarizes comparative evidence for providers who are determining which of the two classes may be the most appropriate for a specific patient.

  3. Safety, tolerability, pharmacokinetics and pharmacodynamics of single doses of empagliflozin, a sodium glucose cotransporter 2 (SGLT2) inhibitor, in healthy Japanese subjects.

    Science.gov (United States)

    Sarashina, Akiko; Koiwai, Kazuki; Seman, Leo J; Yamamura, Norio; Taniguchi, Atsushi; Negishi, Takahiro; Sesoko, Shogo; Woerle, Hans J; Dugi, Klaus A

    2013-01-01

    This randomized, placebo-controlled within dose groups, double-blind, single rising dose study investigated the safety, tolerability, pharmacokinetics and pharmacodynamics of 1 mg to 100 mg doses of empagliflozin in 48 healthy Japanese male subjects. Empagliflozin was rapidly absorbed, reaching peak levels in 1.25 to 2.50 h; thereafter, plasma concentrations declined in a biphasic fashion, with mean terminal elimination half-life ranging from 7.76 to 11.7 h. Increase in empagliflozin exposure was proportional to dose. Oral clearance was dose independent and ranged from 140 to 172 mL/min. In the 24 h following 100 mg empagliflozin administration, the mean (%CV) amount of glucose excreted in urine was 74.3 (17.1) g. The amount and the maximum rate of glucose excreted via urine increased with dose of empagliflozin. Nine adverse events, all of mild intensity, were reported by 8 subjects (7 with empagliflozin and 1 with the placebo). No hypoglycemia was reported. In conclusion, 1 mg to 100 mg doses of empagliflozin had a good safety and tolerability profile in healthy Japanese male subjects. Exposure to empagliflozin was dose proportional. The amount and rate of urinary glucose excretion were higher with empagliflozin than with the placebo, and increased with empagliflozin dose.

  4. Pharmacokinetics and Pharmacodynamics of Luseogliflozin, a Selective SGLT2 Inhibitor, in Japanese Patients With Type 2 Diabetes With Mild to Severe Renal Impairment.

    Science.gov (United States)

    Samukawa, Yoshishige; Haneda, Masakazu; Seino, Yutaka; Sasaki, Takashi; Fukatsu, Atsushi; Kubo, Yusuke; Sato, Yuri; Sakai, Soichi

    2018-04-25

    This open-label, parallel-group, multicenter study aimed to assess the effects of renal impairment on the pharmacokinetics, pharmacodynamics, and safety of luseogliflozin. A single 5-mg dose of luseogliflozin was administered to Japanese patients with type 2 diabetes mellitus in the following groups: G1, normal renal function; G2, mild renal impairment; G3a, mild to moderate impairment; G3b, moderate to severe impairment; G4, severe impairment, based on estimated glomerular filtration rate (eGFR; ≥90, 60-89, 45-59, 30-44, 15-29 mL/min/1.73 m 2 , respectively). While luseogliflozin pharmacokinetics were similar for patients across all renal function groups, the increase in plasma concentration was slightly slower and maximum concentration was slightly reduced in the lower eGFR groups compared with the other groups. However, luseogliflozin pharmacodynamics were affected by the severity of renal impairment. Urinary glucose excretion (UGE) increased in all groups relative to baseline levels, but the degree of UGE increase was smaller in the lower eGFR groups. Moreover, plasma glucose AUC changes from baseline tended to be smaller in the lower eGFR groups. No clear trends were observed between eGFR and incidence, type, or severity of adverse events. Thus, luseogliflozin administration should be carefully considered, as patients with renal impairment may show an insufficient response to treatment. © 2018 The Authors. Clinical Pharmacology in Drug Development Published by Wiley Periodicals, Inc. on behalf of The American College of Clinical Pharmacology.

  5. Diabetic Ketoacidosis in a Patient with Type 2 Diabetes After Initiation of Sodium-Glucose Cotransporter 2 Inhibitor Treatment

    DEFF Research Database (Denmark)

    Storgaard, Heidi; Bagger, Jonatan I; Knop, Filip K

    2016-01-01

    Sodium-glucose cotransporter 2 inhibitors (SGLT2i) were recently introduced for the treatment of type 2 diabetes (T2D). SGLT2i lower plasma glucose by inhibiting the renal reuptake of glucose leading to glucosuria. Generally, these drugs are considered safe to use. However, recently, SGLT2i have...... been suggested to predispose to ketoacidosis. Here, we present a case of diabetic ketoacidosis (DKA) developed in an obese, poorly controlled male patient with T2D treated with the SGLT2i dapagliflozin. He was admitted with DKA 5 days after the initiation of treatment with the SGLT2i dapagliflozin...... 72 hr with insulin as the only glucose-lowering therapy. After 1 month, dapagliflozin was reintroduced as add-on to insulin with no recurrent signs of ketoacidosis. During acute illness or other conditions with increased insulin demands in diabetes, SGLT2i may predispose to the formation of ketone...

  6. In vitro characterization of luseogliflozin, a potent and competitive sodium glucose co-transporter 2 inhibitor: Inhibition kinetics and binding studies

    Directory of Open Access Journals (Sweden)

    Saeko Uchida

    2015-05-01

    Full Text Available In this study, we evaluated an inhibition model of luseogliflozin on sodium glucose co-transporter 2 (SGLT2. We also analyzed the binding kinetics of the drug to SGLT2 protein using [3H]-luseogliflozin. Luseogliflozin competitively inhibited human SGLT2 (hSGLT2-mediated glucose uptake with a Ki value of 1.10 nM. In the absence of glucose, [3H]-luseogliflozin exhibited a high affinity for hSGLT2 with a Kd value of 1.3 nM. The dissociation half-time was 7 h, suggesting that luseogliflozin dissociates rather slowly from hSGLT2. These profiles of luseogliflozin might contribute to the long duration of action of this drug.

  7. Long-term efficacy and safety of sodium-glucose cotransporter-2 inhibitors as add-on to metformin treatment in the management of type 2 diabetes mellitus

    Science.gov (United States)

    Li, Jian; Gong, Yanping; Li, Chunlin; Lu, Yanhui; Liu, Yu; Shao, Yinghong

    2017-01-01

    Abstract Background: Drug intensification is often required for patients with type 2 diabetes mellitus on stable metformin therapy. Among the potential candidates for a combination therapy, sodium-glucose transporter-2 (SGLT2) inhibitors have shown promising outcomes. This meta-analysis was performed to compare the efficacy and safety of SGLT2 inhibitors with non-SGLT2 combinations as add-on treatment to metformin. Methods: Literature search was carried out in multiple electronic databases for the acquisition of relevant randomized controlled trials (RCTs) by following a priori eligibility criteria. After the assessment of quality of the included RCTs, meta-analyses of mean differences or odds ratios (OR) were performed to achieve overall effect sizes of the changes from baseline in selected efficacy and safety endpoints reported in the individual studies. Between-studies heterogeneity was estimated with between-studies statistical heterogeneity (I2) index. Results: Six RCTs fulfilled the eligibility criteria. SGLT2 inhibitors as add-on to metformin treatment reduced % HbA1c significantly more than non-SGLT2 combinations after 52 weeks (P = .002) as well as after 104 weeks (P SGLT2 inhibitors also reduced fasting plasma glucose levels, body weight, systolic, and diastolic blood pressures after 52 weeks and 104 weeks significantly (P SGLT2 combinations. Incidence of hypoglycemia was significantly lower (P = .02) but incidence of suspected or confirmed genital tract infections was significantly higher (P SGLT2 inhibitors treated in comparison with non-SGLT2 combinations. Conclusion: As add-on to metformin treatment, SGLT2 inhibitors are found significantly more efficacious than non-SGLT2 inhibitor combinations in the management of type 2 diabetes mellitus, although, SGLT2 inhibitor therapy is associated with significantly higher incidence of suspected or confirmed genital tract infections. PMID:28682870

  8. Experimental type II diabetes and related models of impaired glucose metabolism differentially regulate glucose transporters at the proximal tubule brush border membrane.

    Science.gov (United States)

    Chichger, Havovi; Cleasby, Mark E; Srai, Surjit K; Unwin, Robert J; Debnam, Edward S; Marks, Joanne

    2016-06-01

    What is the central question of this study? Although SGLT2 inhibitors represent a promising treatment for patients suffering from diabetic nephropathy, the influence of metabolic disruption on the expression and function of glucose transporters is largely unknown. What is the main finding and its importance? In vivo models of metabolic disruption (Goto-Kakizaki type II diabetic rat and junk-food diet) demonstrate increased expression of SGLT1, SGLT2 and GLUT2 in the proximal tubule brush border. In the type II diabetic model, this is accompanied by increased SGLT- and GLUT-mediated glucose uptake. A fasted model of metabolic disruption (high-fat diet) demonstrated increased GLUT2 expression only. The differential alterations of glucose transporters in response to varying metabolic stress offer insight into the therapeutic value of inhibitors. SGLT2 inhibitors are now in clinical use to reduce hyperglycaemia in type II diabetes. However, renal glucose reabsorption across the brush border membrane (BBM) is not completely understood in diabetes. Increased consumption of a Western diet is strongly linked to type II diabetes. This study aimed to investigate the adaptations that occur in renal glucose transporters in response to experimental models of diet-induced insulin resistance. The study used Goto-Kakizaki type II diabetic rats and normal rats rendered insulin resistant using junk-food or high-fat diets. Levels of protein kinase C-βI (PKC-βI), GLUT2, SGLT1 and SGLT2 were determined by Western blotting of purified renal BBM. GLUT- and SGLT-mediated d-[(3) H]glucose uptake by BBM vesicles was measured in the presence and absence of the SGLT inhibitor phlorizin. GLUT- and SGLT-mediated glucose transport was elevated in type II diabetic rats, accompanied by increased expression of GLUT2, its upstream regulator PKC-βI and SGLT1 protein. Junk-food and high-fat diet feeding also caused higher membrane expression of GLUT2 and its upstream regulator PKC

  9. Comparison of luminance based metrics in different lighting conditions

    DEFF Research Database (Denmark)

    Wienold, J.; Kuhn, T.E.; Christoffersen, J.

    In this study, we evaluate established and newly developed metrics for predicting glare using data from three different research studies. The evaluation covers two different targets: 1. How well the user’s perception of glare magnitude correlates to the prediction of the glare metrics? 2. How well...... do the glare metrics describe the subjects’ disturbance by glare? We applied Spearman correlations, logistic regressions and an accuracy evaluation, based on an ROC-analysis. The results show that five of the twelve investigated metrics are failing at least one of the statistical tests. The other...... seven metrics CGI, modified DGI, DGP, Ev, average Luminance of the image Lavg, UGP and UGR are passing all statistical tests. DGP, CGI, DGI_mod and UGP have largest AUC and might be slightly more robust. The accuracy of the predictions of afore mentioned seven metrics for the disturbance by glare lies...

  10. The Effects of Dapagliflozin on Urinary Metabolites in Patients with Type 2 Diabetes

    NARCIS (Netherlands)

    Pena, Michelle

    2017-01-01

    Introduction: The cardiovascular and possibly kidney protective effects of SGLT2 inhibition are hypothesized in part due to improved mitochondrial function in the heart and kidney. To test this, we assessed the effects of dapagliflozin, an SGLT2 inhibitor, on a pre-specified panel of 13 urinary

  11. Efficacy and Safety of Canagliflozin in Patients with Type 2 Diabetes and Stage 3 Nephropathy

    NARCIS (Netherlands)

    Yamout, Hala; Perkovic, Vlado; Davies, Melanie; Woo, Vincent; de Zeeuw, Dick; Mayer, Cristiana; Vijapurkar, Ujjwala; Kline, Irina; Usiskin, Keith; Meininger, Gary; Bakris, George

    2014-01-01

    Background/Aims: Some sodium glucose co-transporter 2 (SGLT2) inhibitors are approved for the treatment of patients with type 2 diabetes mellitus (T2DM) with an estimated glomerular filtration rate (eGFR) of >= 45 ml/mm/1.73 m(2). The efficacy and safety of canagliflozin, an approved SGLT(2)

  12. Dynamic Visual Acuity Assessment Through Visors

    National Research Council Canada - National Science Library

    Pinkus, Alan

    2004-01-01

    ..., and aircraft windscreens. Transparency attributes that can be investigated include transmission coefficient, reflection coefficient, glare, light level, target contrast, target type, resolution, spectral transmission, haze...

  13. Die europaeische Intergration in der Schieflage: Das Desintegrationpotential der Europaeischen Union (European Integration in a Quandary: The Potential for the Disintegration of the European Union)

    National Research Council Canada - National Science Library

    Strohmeier, Gerd

    2001-01-01

    .... Strohmeier hurriedly reviews the logic behind the integration, then patiently proceeds to dismantle it, citing the following glaring asymmetry of economic, political, and social integration; 1...

  14. Structural and functional significance of water permeation through cotransporters

    DEFF Research Database (Denmark)

    Zeuthen, Thomas; Gorraitz, Edurne; Her, Ka

    2016-01-01

    Membrane transporters, in addition to their major role as specific carriers for ions and small molecules, can also behave as water channels. However, neither the location of the water pathway in the protein nor their functional importance is known. Here, we map the pathway for water and urea...... through the intestinal sodium/glucose cotransporter SGLT1. Molecular dynamics simulations using the atomic structure of the bacterial transporter vSGLT suggest that water permeates the same path as Na+ and sugar. On a structural model of SGLT1, based on the homology structure of vSGLT, we identified...... to be due to alterations in steric hindrance to water and urea, and/or changes in protein folding caused by mismatching of side chains in the water pathway. Water permeation through SGLT1 and other transporters bears directly on the structural mechanism for the transport of polar solutes through...

  15. Impact of sodium–glucose cotransporter 2 inhibitors on blood pressure

    Science.gov (United States)

    Reed, James W

    2016-01-01

    SGLT2 inhibitors are glucose-lowering agents used to treat type 2 diabetes mellitus (T2DM). These agents target the kidney to promote urinary glucose excretion, resulting in improved blood glucose control. SGLT2-inhibitor therapy is also associated with weight loss and blood pressure (BP) lowering. Hypertension is a common comorbidity in patients with T2DM, and is associated with excess morbidity and mortality. This review summarizes data on the effect of SGLT2 inhibitors marketed in the US (namely canagliflozin, dapagliflozin, or empagliflozin) on BP in patients with T2DM. Boolean searches were conducted that included terms related to BP or hypertension with terms for SGLT2 inhibitors, canagliflozin, dapagliflozin, or empagliflozin using PubMed, Google, and Google Scholar. Data from numerous randomized controlled trials of SGLT2 inhibitors in patients with T2DM demonstrated clinically relevant reductions in both systolic and diastolic BP, assessed via seated office measurements and 24-hour ambulatory BP monitoring. Observed BP lowering was not associated with compensatory increases in heart rate. Circadian BP rhythm was also maintained. The mechanism of SGLT2 inhibitor-associated BP reduction is not fully understood, but is assumed to be related to osmotic diuresis and natriuresis. Other factors that may also contribute to BP reduction include SGLT2 inhibitor-associated decreases in body weight and reduced arterial stiffness. Local inhibition of the renin–angiotensin–aldosterone system secondary to increased delivery of sodium to the juxtaglomerular apparatus during SGLT2 inhibition has also been postulated. Although SGLT2 inhibitors are not indicated as BP-lowering agents, the modest decreases in systolic and diastolic BP observed with SGLT2 inhibitors may provide an extra clinical advantage for the majority of patients with T2DM, in addition to improving blood glucose control. PMID:27822054

  16. Tofogliflozin, a potent and highly specific sodium/glucose cotransporter 2 inhibitor, improves glycemic control in diabetic rats and mice.

    Science.gov (United States)

    Suzuki, Masayuki; Honda, Kiyofumi; Fukazawa, Masanori; Ozawa, Kazuharu; Hagita, Hitoshi; Kawai, Takahiro; Takeda, Minako; Yata, Tatsuo; Kawai, Mio; Fukuzawa, Taku; Kobayashi, Takamitsu; Sato, Tsutomu; Kawabe, Yoshiki; Ikeda, Sachiya

    2012-06-01

    Sodium/glucose cotransporter 2 (SGLT2) is the predominant mediator of renal glucose reabsorption and is an emerging molecular target for the treatment of diabetes. We identified a novel potent and selective SGLT2 inhibitor, tofogliflozin (CSG452), and examined its efficacy and pharmacological properties as an antidiabetic drug. Tofogliflozin competitively inhibited SGLT2 in cells overexpressing SGLT2, and K(i) values for human, rat, and mouse SGLT2 inhibition were 2.9, 14.9, and 6.4 nM, respectively. The selectivity of tofogliflozin toward human SGLT2 versus human SGLT1, SGLT6, and sodium/myo-inositol transporter 1 was the highest among the tested SGLT2 inhibitors under clinical development. Furthermore, no interaction with tofogliflozin was observed in any of a battery of tests examining glucose-related physiological processes, such as glucose uptake, glucose oxidation, glycogen synthesis, hepatic glucose production, glucose-stimulated insulin secretion, and glucosidase reactions. A single oral gavage of tofogliflozin increased renal glucose clearance and lowered the blood glucose level in Zucker diabetic fatty rats. Tofogliflozin also improved postprandial glucose excursion in a meal tolerance test with GK rats. In db/db mice, 4-week tofogliflozin treatment reduced glycated hemoglobin and improved glucose tolerance in the oral glucose tolerance test 4 days after the final administration. No blood glucose reduction was observed in normoglycemic SD rats treated with tofogliflozin. These findings demonstrate that tofogliflozin inhibits SGLT2 in a specific manner, lowers blood glucose levels by increasing renal glucose clearance, and improves pathological conditions of type 2 diabetes with a low hypoglycemic potential.

  17. Impact of sodium–glucose cotransporter 2 inhibitors on blood pressure

    Directory of Open Access Journals (Sweden)

    Reed JW

    2016-10-01

    Full Text Available James W Reed Morehouse School of Medicine, Atlanta, GA, USA Abstract: SGLT2 inhibitors are glucose-lowering agents used to treat type 2 diabetes mellitus (T2DM. These agents target the kidney to promote urinary glucose excretion, resulting in improved blood glucose control. SGLT2-inhibitor therapy is also associated with weight loss and blood pressure (BP lowering. Hypertension is a common comorbidity in patients with T2DM, and is associated with excess morbidity and mortality. This review summarizes data on the effect of SGLT2 inhibitors marketed in the US (namely canagliflozin, dapagliflozin, or empagliflozin on BP in patients with T2DM. Boolean searches were conducted that included terms related to BP or hypertension with terms for SGLT2 inhibitors, canagliflozin, dapagliflozin, or empagliflozin using PubMed, Google, and Google Scholar. Data from numerous randomized controlled trials of SGLT2 inhibitors in patients with T2DM demonstrated clinically relevant reductions in both systolic and diastolic BP, assessed via seated office measurements and 24-hour ambulatory BP monitoring. Observed BP lowering was not associated with compensatory increases in heart rate. Circadian BP rhythm was also maintained. The mechanism of SGLT2 inhibitor-associated BP reduction is not fully understood, but is assumed to be related to osmotic diuresis and natriuresis. Other factors that may also contribute to BP reduction include SGLT2 inhibitor-associated decreases in body weight and reduced arterial stiffness. Local inhibition of the renin–angiotensin–aldosterone system secondary to increased delivery of sodium to the juxtaglomerular apparatus during SGLT2 inhibition has also been postulated. Although SGLT2 inhibitors are not indicated as BP-lowering agents, the modest decreases in systolic and diastolic BP observed with SGLT2 inhibitors may provide an extra clinical advantage for the majority of patients with T2DM, in addition to improving blood glucose

  18. Using the Freiburg Acuity and Contrast Test to measure visual performance in USAF personnel after PRK.

    Science.gov (United States)

    Dennis, Richard J; Beer, Jeremy M A; Baldwin, J Bruce; Ivan, Douglas J; Lorusso, Frank J; Thompson, William T

    2004-07-01

    Photorefractive keratectomy (PRK) may be an alternative to spectacle and contact lens wear for United States Air Force (USAF) aircrew and may offer some distinct advantages in operational situations. However, any residual corneal haze or scar formation from PRK could exacerbate the disabling effects of a bright glare source on a complex visual task. The USAF recently completed a longitudinal clinical evaluation of the long-term effects of PRK on visual performance, including the experiment described herein. After baseline data were collected, 20 nonflying active duty USAF personnel underwent PRK. Visual performance was then measured at 6, 12, and 24 months after PRK. Visual acuity (VA) and contrast sensitivity (CS) data were collected by using the Freiburg Acuity and Contrast Test (FrACT), with the subject viewing half of the runs through a polycarbonate windscreen. Experimental runs were completed under 3 glare conditions: no glare source and with either a broadband or a green laser (532-nm) glare annulus (luminance approximately 6090 cd/m) surrounding the Landolt C stimulus. Systematic effects of PRK on VA relative to baseline were not identified. However, VA was almost 2 full Snellen lines worse with the laser glare source in place versus the broadband glare source. A significant drop-off was observed in CS performance after PRK under conditions of no glare and broadband glare; this was the case both with and without the windscreen. As with VA, laser glare disrupted CS performance significantly and more than broadband glare did. PRK does not appear to have affected VA, but the changes in CS might represent a true decline in visual performance. The greater disruptive effects from laser versus broadband glare may be a result of increased masking from coherent spatial noise (speckle) surrounding the laser stimulus.

  19. Ocular Straylight and Artificial Lenses

    NARCIS (Netherlands)

    G.M. Łabuz (Grzegorz)

    2017-01-01

    markdownabstractDisability glare has often been related to visual symptoms that appear under different light conditions. Disability glare originates from light scattering (straylight) that takes place in the eye, and is a consequence of the projection of the scattered (unwanted) light onto the

  20. Characterisation of fibre metal laminates under thermomechanical loadings

    NARCIS (Netherlands)

    Hagenbeek, M.

    2005-01-01

    Fibre metal laminates, such as Arall or Glare, can offer improved properties compared to monolithic materials. Glare for example shows improved fatigue, residual strength, burn-through, impact and corrosion properties with respect to aluminium 2024, together with a considerable weight reduction and

  1. Degradation Behavior of Epoxy Resins in Fibre Metal Laminates Under Thermal Conditions

    NARCIS (Netherlands)

    Zhu, G.; Xiao, Y.; Yang, Y.; Wang, J.; Sun, B.; Boom, R.

    2012-01-01

    GLARE (glass fibre/epoxy reinforced aluminum laminate) is a member of the fiber metal laminate (FML) family, and is built up of alternating metal and fiber layers. About 500m2 GLARE is employed in each Airbus A380 because of the superior mechanical properties over the monolithic aluminum alloys,

  2. Scalability in Production System Programs

    Science.gov (United States)

    1994-01-01

    met this tall, stooping, mostly bald man who glared at me through large glasses . I guess I must have liked being glared at because within a few days, he...yes) < ceill >) {(cell Aid <id> ^modified no) <cell2>) (modify <celll> ^modified no) (remove <ce12>)) (p stage-computation-O (flag compaite-cells

  3. Funktionelle Erfordernisse für Systeme der Blendungsbegrenzung.

    NARCIS (Netherlands)

    Schreuder, D.A.

    1975-01-01

    A general survey is provided of the fundamental features which must be taken into account with glare and thus with anti- dazzle measures. In this connection it turns out that all glare phenomena can in principle be tracked back to the same causes. It also becomes clear that in many cases there is a

  4. Sodium-Glucose Linked Transporter-2 Inhibitors in Chronic Kidney Disease

    Directory of Open Access Journals (Sweden)

    L. Zanoli

    2015-01-01

    Full Text Available SGLT2 inhibitors are new antihyperglycaemic agents whose ability to lower glucose is directly proportional to GFR. Therefore, in chronic kidney disease (CKD the blood glucose lowering effect is reduced. Unlike many current therapies, the mechanism of action of SGLT2 inhibitors is independent of insulin action or beta-cell function. In addition, the mechanism of action of SGLT2 inhibitors is complementary and not alternative to other antidiabetic agents. SGLT2 inhibitors could be potentially effective in attenuating renal hyperfiltration and, consequently, the progression of CKD. Moreover, the reductions in intraglomerular pressure, systemic blood pressure, and uric acid levels induced by SGLT inhibition may potentially be of benefit in CKD subjects without diabetes. However, at present, only few clinical studies were designed to evaluate the effects of SGLT2 inhibitors in CKD. Consequently, safety and potential efficacy beyond blood glucose lowering should be better clarified in CKD. In this paper we provide an updated review of the use of SGLT2 inhibitors in clinical practice, with particular attention on subjects with CKD.

  5. Functional expression of sodium-glucose transporters in cancer

    Science.gov (United States)

    Scafoglio, Claudio; Hirayama, Bruce A.; Kepe, Vladimir; Liu, Jie; Ghezzi, Chiara; Satyamurthy, Nagichettiar; Moatamed, Neda A.; Huang, Jiaoti; Koepsell, Hermann; Barrio, Jorge R.; Wright, Ernest M.

    2015-01-01

    Glucose is a major metabolic substrate required for cancer cell survival and growth. It is mainly imported into cells by facilitated glucose transporters (GLUTs). Here we demonstrate the importance of another glucose import system, the sodium-dependent glucose transporters (SGLTs), in pancreatic and prostate adenocarcinomas, and investigate their role in cancer cell survival. Three experimental approaches were used: (i) immunohistochemical mapping of SGLT1 and SGLT2 distribution in tumors; (ii) measurement of glucose uptake in fresh isolated tumors using an SGLT-specific radioactive glucose analog, α-methyl-4-deoxy-4-[18F]fluoro-d-glucopyranoside (Me4FDG), which is not transported by GLUTs; and (iii) measurement of in vivo SGLT activity in mouse models of pancreatic and prostate cancer using Me4FDG-PET imaging. We found that SGLT2 is functionally expressed in pancreatic and prostate adenocarcinomas, and provide evidence that SGLT2 inhibitors block glucose uptake and reduce tumor growth and survival in a xenograft model of pancreatic cancer. We suggest that Me4FDG-PET imaging may be used to diagnose and stage pancreatic and prostate cancers, and that SGLT2 inhibitors, currently in use for treating diabetes, may be useful for cancer therapy. PMID:26170283

  6. Sodium glucose co-transporter 2 inhibitors: blocking renal tubular reabsorption of glucose to improve glycaemic control in patients with diabetes.

    Science.gov (United States)

    Jabbour, S A; Goldstein, B J

    2008-08-01

    The kidney plays a central role in the regulation of plasma glucose levels, although until recently this has not been widely appreciated or considered a target for therapeutic intervention. The sodium glucose co-transporter type 2 (SGLT2) located in the plasma membrane of cells lining the proximal tubule mediates the majority of renal glucose reabsorption from the tubular fluid, which normally prevents the loss of glucose in the urine. Competitive inhibitors of SGLT2 that provoke the renal excretion of glucose have been discovered, thereby providing a unique mechanism to potentially lower the elevated blood glucose levels in patients with diabetes. To explore the physiology of SGLT2 action and discuss several SGLT2 inhibitors that have entered early clinical development. All publicly available data were identified by searching the internet for 'SGLT2' and 'SGLT2 inhibitor' through 1 November 2007. Published articles, press releases and abstracts presented at national and international meetings were considered. Sodium glucose co-transporter type 2 inhibition is a novel treatment option for diabetes, which has been studied in preclinical models and a few potent and selective SGLT2 inhibitors have been reported and are currently in clinical development. These agents appear to be safe and generally well tolerated, and will potentially be a beneficial addition to the growing battery of oral antihyperglycaemic agents.

  7. Metabolic and hemodynamic effects of sodium-dependent glucose cotransporter 2 inhibitors on cardio-renal protection in the treatment of patients with type 2 diabetes mellitus.

    Science.gov (United States)

    Kashiwagi, Atsunori; Maegawa, Hiroshi

    2017-07-01

    The specific sodium-glucose cotransporter 2 inhibitors (SGLT2 inhibitors) inhibit glucose reabsorption in proximal renal tubular cells, and both fasting and postprandial glucose significantly decrease because of urinary glucose loss. As a result, pancreatic β-cell function and peripheral insulin action significantly improve with relief from glucose toxicity. Furthermore, whole-body energy metabolism changes to relative glucose deficiency and triggers increased lipolysis in fat cells, and fatty acid oxidation and then ketone body production in the liver during treatment with SGLT2 inhibitors. In addition, SGLT2 inhibitors have profound hemodynamic effects including diuresis, dehydration, weight loss and lowering blood pressure. The most recent findings on SGLT2 inhibitors come from results of the Empagliflozin, Cardiovascular Outcomes and Mortality in Type 2 Diabetes trial. SGLT2 inhibitors exert extremely unique and cardio-renal protection through metabolic and hemodynamic effects, with long-term durability on the reduction of blood glucose, bodyweight and blood pressure. Although a site of action of SGLT2 inhibitors is highly specific to inhibit renal glucose reabsorption, whole-body energy metabolism, and hemodynamic and renal functions are profoundly modulated during the treatment of SGLT2 inhibitors. Previous studies suggest multifactorial clinical benefits and safety concerns of SGLT2 inhibitors. Although ambivalent clinical results of this drug are still under active discussion, the present review summarizes promising recent evidence on the cardio-renal and metabolic benefits of SGLT2 inhibitors in the treatment of type 2 diabetes. © 2017 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.

  8. Na(+)-D-glucose cotransporter in the kidney of Squalus acanthias: molecular identification and intrarenal distribution.

    Science.gov (United States)

    Althoff, Thorsten; Hentschel, Hartmut; Luig, Jutta; Schütz, Hendrike; Kasch, Myriam; Kinne, Rolf K-H

    2006-04-01

    Using primers against conserved regions of mammalian Na(+)-d-glucose cotransporters (SGLT), a cDNA was cloned from the kidney of spiny dogfish shark (Squalus acanthias). On the basis of comparison of amino acid sequence, membrane topology, and putative glycosylation and phosphorylation sites, the cDNA could be shown to belong to the family of sglt genes. Indeed, Na(+)-dependent d-glucose uptake could be demonstrated after expression of the gene in Xenopus laevis oocytes. In a dendrogram, the SGLT from shark kidney has a high homology to the mammalian SGLT2. Computer analysis revealed that the elasmobranch protein is most similar to the mammalian proteins in the transmembrane regions and contains already all the amino acids identified to be functionally important, suggesting early conservation during evolution. Extramembraneous loops show larger variations. This holds especially for loop 13, which has been implied as a phlorizin-binding domain. Antibodies were generated and the intrarenal distribution of the SGLT was studied in cryosections. In parallel, the nephron segments were identified by lectins. Positive immunoreactions were found in the proximal tubule in the early parts PIa and PIb and the late segment PIIb. The large PIIa segment of the proximal tubule showed no reaction. In contrast to the mammalian kidney also the late distal tubule, the collecting tubule, and the collecting duct showed immunoreactivity. The molecular information confirms previous vesicle studies in which a low affinity SGLT with a low stoichiometry has been observed and supports the notion of a similarity of the shark kidney SGLT to the mammalian SGLT2. Despite its presence in the late parts of the nephron, the absence of SGLT in the major part of the proximal tubule, the relatively low affinity, and in particular the low stoichiometry might explain the lack of a T(m) for d-glucose in the shark kidney.

  9. Sodium-glucose cotransporter 2 inhibition and health benefits: The Robin Hood effect.

    Science.gov (United States)

    Kalra, Sanjay; Jain, Arpit; Ved, Jignesh; Unnikrishnan, A G

    2016-01-01

    This review discusses two distinct, yet related, mechanisms of sodium-glucose cotransporter 2 (SGLT2) inhibition: Calorie restriction mimicry (CRM) and pro-ketogenic effect, which may explain their cardiovascular benefits. We term these adaptive CRM and pro-ketogenic effects of SGLT2 inhibition, the Robin Hood hypothesis. In English history, Robin Hood was a "good person," who stole from the rich and helped the poor. He supported redistribution of resources as he deemed fit for the common good. In a similar fashion, SGLT2 inhibition provides respite to the overloaded glucose metabolism while utilizing lipid stores for energy production.

  10. Sodium-glucose cotransporter 2 inhibition and health benefits: The Robin Hood effect

    Directory of Open Access Journals (Sweden)

    Sanjay Kalra

    2016-01-01

    Full Text Available This review discusses two distinct, yet related, mechanisms of sodium-glucose cotransporter 2 (SGLT2 inhibition: Calorie restriction mimicry (CRM and pro-ketogenic effect, which may explain their cardiovascular benefits. We term these adaptive CRM and pro-ketogenic effects of SGLT2 inhibition, the Robin Hood hypothesis. In English history, Robin Hood was a "good person," who stole from the rich and helped the poor. He supported redistribution of resources as he deemed fit for the common good. In a similar fashion, SGLT2 inhibition provides respite to the overloaded glucose metabolism while utilizing lipid stores for energy production.

  11. Sodium-glucose cotransporter 2 inhibitor use: A pharmaco-ergonomic qualification tool

    Directory of Open Access Journals (Sweden)

    Sanjay Kalra

    2017-01-01

    Full Text Available Pharmaco-ergonomics implies tailoring the drug therapy to an individual patient's requirement(s. The development of sodium-glucose cotransporter 2 inhibitor (SGLT2-i agents has impelled multiple clinical considerations, in the management of type-2 diabetes. This paper attempts to summarize the pharmaco-ergonomic considerations for these agents, in the form of an SGLT2-i qualification tool, based on a clinical score. This tool may serve as a simple and inexpensive practical guide, to optimize the risk-benefit considerations for SGLT2-i agents.

  12. Childhood in National Consciousness and National Consciousness in Childhood.

    Science.gov (United States)

    Koester, David

    1997-01-01

    Examines the place of national imagery and the experience of the nation in childhood. Draws a comparison between such experiences in Iceland and Kamchatka, Russia. Describes ways in which these experiences become resources for expressing a distinct national identity. (EV)

  13. Risk and Safety in Post-Soviet Russia

    Science.gov (United States)

    2008-09-01

    Landslides , landslips 5 Excessive frost 3 Avalanches 2.5 Droughts 2 Icy crusts, karst collapses 1 Volcanic eruptions ə Others about 5 22 In...recurrence, the area involved, and the damage produced . The death toll is also high: 18 deaths in 1993 and 40 in 1994. Volcanic eruptions are a serious...threat to the population of Kamchatka and the Kuril Islands. There are 29 volcanoes at a dangerous stage of activity on Kamchatka and 39 on the Kuril

  14. Lower risk of heart failure and death in patients initiated on sodium-glucose cotransporter-2 inhibitors versus other glucose-lowering drugs

    DEFF Research Database (Denmark)

    Kosiborod, Mikhail; Cavender, Matthew A.; Fu, Alex Z.

    2017-01-01

    and death in patients newly initiated on any SGLT-2i versus other glucose-lowering drugs in 6 countries to determine if these benefits are seen in real-world practice and across SGLT-2i class. METHODS: Data were collected via medical claims, primary care/hospital records, and national registries from...... for Germany. RESULTS: After propensity matching, there were 309 056 patients newly initiated on either SGLT-2i or other glucose-lowering drugs (154 528 patients in each treatment group). Canagliflozin, dapagliflozin, and empagliflozin accounted for 53%, 42%, and 5% of the total exposure time in the SGLT-2i...... class, respectively. Baseline characteristics were balanced between the 2 groups. There were 961 HHF cases during 190 164 person-years follow-up (incidence rate, 0.51/100 person-years). Of 215 622 patients in the United States, Norway, Denmark, Sweden, and the United Kingdom, death occurred in 1334...

  15. Dgroup: DG01794 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available rtugliflozin (USAN/INN) D10669 ... Sotagliflozin (USAN/INN) Antidiabetic agent Uncla...ssified ... DG02044 ... Hypoglycemics ATC code: A10BK Antidiabetics SLC5A2 (SGLT2) [HSA:6524] [KO:K14382] ...

  16. The effects of sodium-glucose co-transporter 2 inhibitors in patients with type 2 diabetes

    DEFF Research Database (Denmark)

    Storgaard, Heidi; Gluud, Lise Lotte; Christensen, Mikkel

    2014-01-01

    INTRODUCTION: Sodium-glucose co-transporter 2 inhibitors (SGLT-2i) increase urinary glucose excretion through a reduced renal glucose reabsorption. We plan to perform a systematic review of SGLT-2i for treatment of type 2 diabetes. METHODS AND ANALYSIS: A systematic review with meta......-analyses of randomised clinical trials on SGLT-2i versus placebo, other oral glucose lowering drugs or insulin for patients with type 2 diabetes will be performed. The primary end point will be the glycated haemoglobin. Secondary end points will include changes in body weight, body mass index, fasting plasma glucose...... to the knowledge regarding the beneficial and harmful effects of SGLT-2i in patients with type 2 diabetes. We plan to publish the study irrespective of the results. RESULTS: The study will be disseminated by peer-review publication and conference presentation. TRIAL REGISTRATION NUMBER: PROSPERO CRD42014008960...

  17. Clinical potential of sodium-glucose cotransporter 2 inhibitors in the management of type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Kim Y

    2012-08-01

    Full Text Available Yoojin Kim, Ambika R BabuDivision of Endocrinology, John Stroger Jr Hospital of Cook County and Rush University, Chicago, IL, USABackground: The kidney plays an important role in glucose metabolism, and has been considered a target for therapeutic intervention. The sodium-glucose cotransporter type 2 (SGLT2 mediates most of the glucose reabsorption from the proximal renal tubule. Inhibition of SGLT2 leads to glucosuria and provides a unique mechanism to lower elevated blood glucose levels in diabetes. The purpose of this review is to explore the physiology of SGLT2 and discuss several SGLT2 inhibitors which have clinical data in patients with type 2 diabetes.Methods: We performed a PubMed search using the terms "SGLT2" and "SGLT2 inhibitor" through April 10, 2012. Published articles, press releases, and abstracts presented at national and international meetings were considered.Results: SGLT2 inhibitors correct a novel pathophysiological defect, have an insulin-independent action, are efficacious with glycosylated hemoglobin reduction ranging from 0.5% to 1.5%, promote weight loss, have a low incidence of hypoglycemia, complement the action of other antidiabetic agents, and can be used at any stage of diabetes. They are generally well tolerated. However, due to side effects, such as repeated urinary tract and genital infections, increased hematocrit, and decreased blood pressure, appropriate patient selection for drug initiation and close monitoring after initiation will be important. Results of ongoing clinical studies of the effect of SGLT2 inhibitors on diabetic complications and cardiovascular safety are crucial to determine the risk-benefit ratio. A recent decision by the Committee for Medicinal Products for Human Use of the European Medicines Agency has recommended approval of dapagliflozin for the treatment of type 2 diabetes as an adjunct to diet and exercise, in combination with other glucose-lowering medicinal products, including

  18. The effect of building facade reflectivity on urban dwellers in tropics.

    Science.gov (United States)

    Ishak, N. M.; Hien, W. N.; Jenatabadi, H. S.; Ignatius, M.; Yaman, R.

    2018-02-01

    With the rapid growth and use of modern architecture practices for high-rise buildings, highly reflective materials have been adopted extensively for aesthetical reasons. However, outdoor glare from highly reflective facades might cause thermal and visual problems towards the occupants of neighbouring buildings and outdoor dwellers, particularly pedestrians. In tropical countries, this negative impact can be greater due to the higher solar radiation received throughout the year. At the present, there are few building guidelines limiting outdoor glare, or daylight reflectance from a building facade. This study aims to introduce a framework for outdoor glare studies that focus on perceived glare from highly reflective facades by pedestrians in Singapore. The introduced framework includes age, glare time, glare duration, avoidance and sensitiveness. For this study, the survey is carried out with the application of Structural Equation Modelling (SEM). This paper is helpful for planners, designers, and engineers to estimate the sensitivity of pedestrians’ discomfort glare and towards the creation of sustainable architecture in Singapore.

  19. Sodium-Glucose Cotransporter 2 Inhibitor and a Low Carbohydrate Diet Affect Gluconeogenesis and Glycogen Content Differently in the Kidney and the Liver of Non-Diabetic Mice.

    Science.gov (United States)

    Atageldiyeva, Kuralay; Fujita, Yukihiro; Yanagimachi, Tsuyoshi; Mizumoto, Katsutoshi; Takeda, Yasutaka; Honjo, Jun; Takiyama, Yumi; Abiko, Atsuko; Makino, Yuichi; Haneda, Masakazu

    2016-01-01

    A low carbohydrate diet (LCHD) as well as sodium glucose cotransporter 2 inhibitors (SGLT2i) may reduce glucose utilization and improve metabolic disorders. However, it is not clear how different or similar the effects of LCHD and SGLT2i are on metabolic parameters such as insulin sensitivity, fat accumulation, and especially gluconeogenesis in the kidney and the liver. We conducted an 8-week study using non-diabetic mice, which were fed ad-libitum with LCHD or a normal carbohydrate diet (NCHD) and treated with/without the SGLT-2 inhibitor, ipragliflozin. We compared metabolic parameters, gene expression for transcripts related to glucose and fat metabolism, and glycogen content in the kidney and the liver among the groups. SGLT2i but not LCHD improved glucose excursion after an oral glucose load compared to NCHD, although all groups presented comparable non-fasted glycemia. Both the LCHD and SGLT2i treatments increased calorie-intake, whereas only the LCHD increased body weight compared to the NCHD, epididimal fat mass and developed insulin resistance. Gene expression of certain gluconeogenic enzymes was simultaneously upregulated in the kidney of SGLT2i treated group, as well as in the liver of the LCHD treated group. The SGLT2i treated groups showed markedly lower glycogen content in the liver, but induced glycogen accumulation in the kidney. We conclude that LCHD induces deleterious metabolic changes in the non-diabetic mice. Our results suggest that SGLT2i induced gluconeogenesis mainly in the kidney, whereas for LCHD it was predominantly in the liver.

  20. Summary of Synoptic Meteorological Observations. Siberian Coastal Marine Areas. Volume 3. Area 15 - Okhotsk Sea NE, Area 16 - West Coast Kamchatka, Area 17 - Tatar Strait N, Area 18 - Tatar Strait S, Area 19 - Okhotsk Sea SW, Area 20 - Sakhalin Island SE, Area 21 - Okhotsk Sea SE

    Science.gov (United States)

    1975-10-01

    8217 " ■., . "■ ’■<*. PEKIODI IPRIDARY) 1939-197* (OVER-ALL) 1907-197* 1UCUST TtlU 17 ADEl 0016 HtST COAST KtMCHAUA 9A.AN 15J.JE rCT ntQ 0f AIR...8217—■ ■- ^"’"’""ÜIBMÜMIÜlffifattllll i^iuiimb&m<miiM& *J W \\j- \\j PEKIQOI (DVER-4LLI 1961-1974 OCTUBE« TABLE U (CONTI «Kt» 0016 HtST CUA$T ««^CHJTK» S4.1N

  1. Sodium-glucose cotransporter 2 inhibitors with insulin in type 2 diabetes: Clinical perspectives

    Directory of Open Access Journals (Sweden)

    Mathew John

    2016-01-01

    Full Text Available The treatment of type 2 diabetes is a challenging problem. Most subjects with type 2 diabetes have progression of beta cell failure necessitating the addition of multiple antidiabetic agents and eventually use of insulin. Intensification of insulin leads to weight gain and increased risk of hypoglycemia. Sodium-glucose cotransporter 2 (SGLT2 inhibitors are a class of antihyperglycemic agents which act by blocking the SGLT2 in the proximal tubule of the kidney. They have potential benefits in terms of weight loss and reduction of blood pressure in addition to improvements in glycemic control. Further, one of the SGLT2 inhibitors, empagliflozin has proven benefits in reducing adverse cardiovascular (CV outcomes in a CV outcome trial. Adding SGLT2 inhibitors to insulin in subjects with type 2 diabetes produced favorable effects on glycemic control without the weight gain and hypoglycemic risks associated with insulin therapy. The general risks of increased genital mycotic infections, urinary tract infections, volume, and osmosis-related adverse effects in these subjects were similar to the pooled data of individual SGLT2 inhibitors. There are subsets of subjects with type 2 diabetes who may have insulin deficiency, beta cell autoimmunity, or is prone to diabetic ketoacidosis. In these subjects, SGLT2 inhibitors should be used with caution to prevent the rare risks of ketoacidosis.

  2. Characterization and comparison of sodium-glucose cotransporter 2 inhibitors in pharmacokinetics, pharmacodynamics, and pharmacologic effects

    Directory of Open Access Journals (Sweden)

    Atsuo Tahara

    2016-03-01

    Full Text Available The sodium-glucose cotransporter (SGLT 2 offer a novel approach to treating type 2 diabetes by reducing hyperglycaemia via increased urinary glucose excretion. In the present study, the pharmacokinetic, pharmacodynamic, and pharmacologic properties of all six SGLT2 inhibitors commercially available in Japan were investigated and compared. Based on findings in normal and diabetic mice, the six drugs were classified into two categories, long-acting: ipragliflozin and dapagliflozin, and intermediate-acting: tofogliflozin, canagliflozin, empagliflozin, and luseogliflozin. Long-acting SGLT2 inhibitors exerted an antihyperglycemic effect with lower variability of blood glucose level via a long-lasting increase in urinary glucose excretion. In addition, ipragliflozin and luseogliflozin exhibited superiority over the others with respect to fast onset of pharmacological effect. Duration and onset of the pharmacologic effects seemed to be closely correlated with the pharmacokinetic properties of each SGLT2 inhibitor, particularly with respect to high distribution and long retention in the target organ, the kidney. While all six SGLT2 inhibitors were significantly effective in increasing urinary glucose excretion and reducing hyperglycemia, our findings suggest that variation in the quality of daily blood glucose control associated with duration and onset of pharmacologic effects of each SGLT2 inhibitor might cause slight differences in rates of improvement in type 2 diabetes.

  3. 4-acetoxyscirpendiol of Paecilomyces tenuipes inhibits Na(+)/D-glucose cotransporter expressed in Xenopus laevis oocytes.

    Science.gov (United States)

    Yoo, Ocki; Son, Joo-Hiuk; Lee, Dong-Hee

    2005-03-31

    Cordyceps, an entomopathogenic fungus, contains many health-promoting ingredients. Recent reports indicate that the consumption of cordyceps helps reduce blood-sugar content in diabetics. However, the mechanism underlying this reduction in circulatory sugar content is not fully understood. Methanolic extracts were prepared from the fruiting bodies of Paecilomyces tenuipes, and 4-beta acetoxyscirpendiol (4-ASD) was eventually isolated and purified. Na(+)/Glucose transporter-1 (SGLT-1) was expressed in Xenopus oocytes, and the effect of 4-ASD on SGLT-1 was analyzed utilizing a voltage clamp and by performing 2-deoxy-D-glucose (2-DOG) uptake studies. 4-ASD was shown to significantly inhibit SGLT-1 activity compared to the non-treated control in a dose-dependent manner. In the presence of the derivatives of 4-ASD (diacetoxyscirpenol or 15-acetoxyscirpendiol), SGLT-1 activity was greatly inhibited in an 4-ASD-like manner. Of these derivatives, 15-acetoxyscirepenol inhibited SGLT-1 as well as 4-ASD, whereas diacetoxyscirpenol was slightly less effective. Taken together, these results strongly indicate that 4-ASD in P. tenuipes may lower blood sugar levels in the circulatory system. We conclude that 4-ASD and its derivatives are effective SGLT-1 inhibitors.

  4. Sodium transport through the cerebral sodium-glucose transporter exacerbates neuron damage during cerebral ischaemia.

    Science.gov (United States)

    Yamazaki, Yui; Harada, Shinichi; Wada, Tetsuyuki; Yoshida, Shigeru; Tokuyama, Shogo

    2016-07-01

    We recently demonstrated that the cerebral sodium-glucose transporter (SGLT) is involved in postischaemic hyperglycaemia-induced exacerbation of cerebral ischaemia. However, the associated SGLT-mediated mechanisms remain unclear. Thus, we examined the involvement of cerebral SGLT-induced excessive sodium ion influx in the development of cerebral ischaemic neuronal damage. [Na+]i was estimated according to sodium-binding benzofuran isophthalate fluorescence. In the in vitro study, primary cortical neurons were prepared from fetuses of ddY mice. Primary cortical neurons were cultured for 5 days before each treatment with reagents, and these survival rates were assessed using biochemical assays. In in vivo study, a mouse model of focal ischaemia was generated using middle cerebral artery occlusion (MCAO). In these experiments, treatment with high concentrations of glucose induced increment in [Na+]i, and this phenomenon was suppressed by the SGLT-specific inhibitor phlorizin. SGLT-specific sodium ion influx was induced using a-methyl-D-glucopyranoside (a-MG) treatments, which led to significant concentration-dependent declines in neuronal survival rates and exacerbated hydrogen peroxide-induced neuronal cell death. Moreover, phlorizin ameliorated these effects. Finally, intracerebroventricular administration of a-MG exacerbated the development of neuronal damage induced by MCAO, and these effects were ameliorated by the administration of phlorizin. Hence, excessive influx of sodium ions into neuronal cells through cerebral SGLT may exacerbate the development of cerebral ischaemic neuronal damage. © 2016 Royal Pharmaceutical Society.

  5. Acute renal failure with sodium-glucose-cotransporter-2 inhibitors: Analysis of the FDA adverse event report system database.

    Science.gov (United States)

    Perlman, A; Heyman, S N; Matok, I; Stokar, J; Muszkat, M; Szalat, A

    2017-12-01

    Sodium-glucose-cotransporter-2 (SGLT2) inhibitors have recently been approved for the treatment of type II diabetes mellitus (T2DM). It has been proposed that these agents could induce acute renal failure (ARF) under certain conditions. This study aimed to evaluate the association between SGLT2-inhibitors and ARF in the FDA adverse event report system (FAERS) database. We analyzed adverse event cases submitted to FAERS between January 2013 and September 2016. ARF cases were identified using a structured medical query. Medications were identified using both brand and generic names. During the period evaluated, 18,915 reports (out of a total of 3,832,015 registered in FAERS) involved the use of SGLT2-inhibitors. SGLT2-inhibitors were reportedly associated with ARF in 1224 of these cases (6.4%), and were defined as the "primary" or "secondary" cause of the adverse event in 96.8% of these cases. The proportion of reports with ARF among reports with SGLT2 inhibitor was almost three-fold higher compared to reports without these drugs (ROR 2.88, 95% CI 2.71-3.05, p SGLT2-inhibitors was significantly greater than the proportion of ARF among cases with T2DM without SGLT2-inhibitors (ROR 1.68, 95% CI 1.57-1.8, p SGLT2-inhibitors, canagliflozin was associated with a higher proportion of reports of renal failure (7.3%), compared to empagliflozin and dapagliflozin (4.7% and 4.8% respectively, p SGLT2-inhibitors are associated with an increase in the proportion of reports of ARF compared to other medications. SGLT2-inhibitor agents may differ from one another in their respective risk for ARF. Copyright © 2017 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

  6. An overview of the effect of sodium glucose cotransporter 2 inhibitor monotherapy on glycemic and other clinical laboratory parameters in type 2 diabetes patients

    Directory of Open Access Journals (Sweden)

    Wang Y

    2016-07-01

    Full Text Available Yaowen Wang,1 Xueting Hu,2 Xueying Liu,3 Zengqi Wang2 1Department of Clinical Laboratory, Weifang People’s Hospital, 2Department of Clinical Laboratory, Weifang Traditional Chinese Hospital, Weifang, 3Department of Clinical Laboratory, The Third Hospital of Jinan, Jinan, People’s Republic of China Objectives: We aimed to determine the effect of sodium glucose cotransporter 2 (SGLT2 inhibitor monotherapy on glycemic and other clinical laboratory parameters versus other antidiabetic medications or placebo therapy in patients with type 2 diabetes mellitus. In addition, we aimed to investigate the risk of diabetic ketoacidosis associated with SGLT2 inhibitor therapy and evaluate its weight-sparing ability. Design: Meta-analysis. Materials and methods: PubMed and MEDLINE were searched to identify eligible studies up to December 2015. Randomized controlled trials that assessed the efficacy and safety of SGLT2 inhibitor monotherapy versus placebo therapy or active control were considered. The Cochrane Collaboration Risk of Bias Tool was used to evaluate quality and bias. The mean ­difference was used to evaluate the glycemic and other clinical laboratory parameters for SGLT2 inhibitor intervention versus control by drugs or placebo. Similarly, the risk ratio was used to assess adverse events, and the I2 was used to evaluate heterogeneity. Results: SGLT2 inhibitors significantly decreased glycated hemoglobin (HbA1c (P<0.001, weight (P<0.001, and the low-density lipoprotein/high-density lipoprotein ratio (P=0.03 compared with placebo therapy. No statistically significant changes were found in fasting plasma glucose, 2-hour postprandial glucose, or lipid parameters. Significant changes in the uric acid level were found for SGLT2 inhibitors versus placebo therapy (P=0.005 or active control (P<0.001. Although no significant change in levels of ketones occurred (P=0.93, patients receiving SGLT2 inhibitors were at greater risk of increased ketone bodies

  7. What Are the Risks and How Can I Find the Right Doctor for Me? (Refractive Surgery)

    Science.gov (United States)

    ... a result of treatment. Some patients develop debilitating visual symptoms. Some patients develop glare, halos, and/or ... eye not only causes discomfort, but can reduce visual quality due to intermittent blurring and other visual ...

  8. Recommended Types of Sunglasses

    Science.gov (United States)

    ... the same thing as 100 percent UV absorption. Ground and polished Some nonprescription glasses are ground and ... Polarized Polarized lenses cut reflected glare — sunlight that bounces off smooth surfaces like pavement, car windows, chromed ...

  9. External perforated Solar Screens for daylighting in residential desert buildings: Identification of minimum perforation percentages

    KAUST Repository

    Sherif, Ahmed; Sabry, Hanan; Rakha, Tarek

    2012-01-01

    and Saudi Arabia, result in the admittance of direct solar radiation, which leads to thermal discomfort and the incidence of undesired glare. One type of shading systems that is used to permit daylight while controlling solar penetration is " Solar Screens

  10. Dartmouth Atlas of Health Care

    Data.gov (United States)

    U.S. Department of Health & Human Services — For more than 20 years, the Dartmouth Atlas Project has documented glaring variations in how medical resources are distributed and used in the United States. The...

  11. Extension de l'anémometrie phase Doppler à la mesure d'indice de réfraction et développement de la Vélocimétrie Laser par Corrélation

    OpenAIRE

    Hespel , Camille

    2007-01-01

    The aim of numerical and experimental study presented in this thesis is to improve optical diagnostics in order to understand the atomization and evaporation processes. The size-velocity correlation is diluted medium is given by Phase Doppler Anemometry.The objective of simultaions is to examine the possibilty to extend the PDA by refractive index measurement.The proposed extension called Glare Spot phase Doppler Anemometry is based on the analysis of glare points of reflection and refraction...

  12. Safety of Sodium-Glucose Co-Transporter 2 Inhibitors during Ramadan Fasting: Evidence, Perceptions and Guidelines

    Directory of Open Access Journals (Sweden)

    Salem A. Beshyah

    2016-06-01

    Full Text Available Sodium-glucose co-transporter 2 (SGLT2 inhibitors are a new glucose-lowering therapy for T2DM with documented benefits on blood glucose, hypertension, weight reduction and long term cardiovascular benefit. They have an inherent osmotic diuretic effect and lead to some volume loss and possible dehydration. There is some concern about the safety of using SGLT2 inhibitors in Muslim type 2 diabetes mellitus (T2DM patients during the fast during Ramadan. Currently, there is a dearth of research data to help guide physicians and reassure patients.  One study confirmed good glycemic control with less risk of hypoglycemia and no marked volume depletion. Data in the elderly and in combination with diuretics are reassuring of their safe to use in Ramadan in general. SGLT2 inhibitor-related diabetic ketoacidosis has not been reported during Ramadan and is unlikely to be relevant. Survey of physicians revealed that the majority felt that SGLT2 inhibitors are generally safe in T2DM patients during Ramadan fasting but should be discontinued in certain high risk patients. Some professional groups with interest in diabetes and Ramadan fasting included SGLT2 inhibitors in their guidelines on management of diabetes during Ramadan. They acknowledged the lack of trial data, recommended caution in high risk groups, advised regular monitoring and emphasized pre-Ramadan patients’ education. In conclusion, currently, knowledge, data and experience with SGLT2 inhibitors in Ramadan are limited. Nonetheless, stable patients with normal kidney function and low risk of dehydration may safely use the SGLT2 inhibitors therapy. Higher risk patients should be observed carefully and managed on individual basis.

  13. Tectonics and oil and gas content in the northwest Pacific Ocean belt. Tektonika i neftegazonosnost' severo-zapadnoy chasti Tikhookeanskogo poyasa

    Energy Technology Data Exchange (ETDEWEB)

    Tyutrin, I.I.; Dunichev, V.M.

    1985-01-01

    Comparative characteristics are given for geological structure of Sakhalin, West Kamchatka, Anadyr and Khatyrskiy Basins of Chukotka allowing these territories to be classified as marginal, parts elevated above sea level of the Okhotomorskiy and Beringovomorskiy platforms. The neogenic deposits of the plate complex of the platform mantle are the most promising from the viewpoint of discovering hydrocarbon fields. At Sakhalin oil and gas have been extracted from Neogene deposits already for 50 years, at West Kamchatka the Kshukskiy gas field has been discovered, and oil and gas industrial influxes have been obtained in the Anadyr and Khatyr Basins. The Kurile Islands are viewed as a volcanic zone on the plate complex of the Okhotomorskiy platform. Geological data indicate continuation of the structures of the Okhotomorskiy platform to the east of the Kurile-Kamchatka deep-sea trough.

  14. The effects of sodium-glucose co-transporter 2 inhibitors in patients with type 2 diabetes

    DEFF Research Database (Denmark)

    Storgaard, Heidi; Gluud, Lise Lotte; Christensen, Mikkel

    2014-01-01

    INTRODUCTION: Sodium-glucose co-transporter 2 inhibitors (SGLT-2i) increase urinary glucose excretion through a reduced renal glucose reabsorption. We plan to perform a systematic review of SGLT-2i for treatment of type 2 diabetes. METHODS AND ANALYSIS: A systematic review with meta-analyses of r......INTRODUCTION: Sodium-glucose co-transporter 2 inhibitors (SGLT-2i) increase urinary glucose excretion through a reduced renal glucose reabsorption. We plan to perform a systematic review of SGLT-2i for treatment of type 2 diabetes. METHODS AND ANALYSIS: A systematic review with meta......-analyses of randomised clinical trials on SGLT-2i versus placebo, other oral glucose lowering drugs or insulin for patients with type 2 diabetes will be performed. The primary end point will be the glycated haemoglobin. Secondary end points will include changes in body weight, body mass index, fasting plasma glucose......, plasma cholesterol, kidney and liver blood tests, blood pressure and adverse events. Electronic (the Cochrane Library, MEDLINE, EMBASE and the Science Citation Index) and manual searches will be performed. Meta-analyses will be performed and the results presented as mean differences for continuous...

  15. Changes in glucose-induced plasma active glucagon-like peptide-1 levels by co-administration of sodium–glucose cotransporter inhibitors with dipeptidyl peptidase-4 inhibitors in rodents

    Directory of Open Access Journals (Sweden)

    Takahiro Oguma

    2016-12-01

    Full Text Available We investigated whether structurally different sodium–glucose cotransporter (SGLT 2 inhibitors, when co-administered with dipeptidyl peptidase-4 (DPP4 inhibitors, could enhance glucagon-like peptide-1 (GLP-1 secretion during oral glucose tolerance tests (OGTTs in rodents. Three different SGLT inhibitors—1-(β-d-Glucopyranosyl-4-chloro-3-[5-(6-fluoro-2-pyridyl-2-thienylmethyl]benzene (GTB, TA-1887, and canagliflozin—were examined to assess the effect of chemical structure. Oral treatment with GTB plus a DPP4 inhibitor enhanced glucose-induced plasma active GLP-1 (aGLP-1 elevation and suppressed glucose excursions in both normal and diabetic rodents. In DPP4-deficient rats, GTB enhanced glucose-induced aGLP-1 elevation without affecting the basal level, whereas metformin, previously reported to enhance GLP-1 secretion, increased both the basal level and glucose-induced elevation. Oral treatment with canagliflozin and TA-1887 also enhanced glucose-induced aGLP-1 elevation when co-administered with either teneligliptin or sitagliptin. These data suggest that structurally different SGLT2 inhibitors enhance plasma aGLP-1 elevation and suppress glucose excursions during OGTT when co-administered with DPP4 inhibitors, regardless of the difference in chemical structure. Combination treatment with DPP4 inhibitors and SGLT2 inhibitors having moderate SGLT1 inhibitory activity may be a promising therapeutic option for improving glycemic control in patients with type 2 diabetes mellitus.

  16. Characterization and comparison of sodium-glucose cotransporter 2 inhibitors: Part 2. Antidiabetic effects in type 2 diabetic mice

    Directory of Open Access Journals (Sweden)

    Atsuo Tahara

    2016-07-01

    Full Text Available Previously we investigated the pharmacokinetic, pharmacodynamic, and pharmacologic properties of all six sodium-glucose cotransporter (SGLT 2 inhibitors commercially available in Japan using normal and diabetic mice. We classified the SGLT2 inhibitors with respect to duration of action as either long-acting (ipragliflozin and dapagliflozin or intermediate-acting (tofogliflozin, canagliflozin, empagliflozin, and luseogliflozin. In the present study, antidiabetic effects of repeated administration of these SGLT2 inhibitors in type 2 diabetic mice were investigated. When repeatedly administered for 4 weeks, all SGLT2 inhibitors significantly exhibited antihyperglycemic, antihyperinsulinemic, and pancreas-protective effects, as well as insulin resistance-improving effects. When compared at doses producing comparable reduction in hyperglycemia across all drugs, the antidiabetic effects of ipragliflozin and dapagliflozin were more potent than those of the other four drugs, but these differences among the six drugs were not statistically significant. Further, an oral glucose tolerance test performed after repeated administration demonstrated significant improvement in glucose tolerance only with ipragliflozin and dapagliflozin, implying improved insulin resistance and secretion. Taken together, these findings demonstrate that, although all SGLT2 inhibitors exert antidiabetic effects in type 2 diabetic mice, these pharmacologic effects might be slightly superior with the long-acting drugs, which are able to provide favorable blood glucose control throughout the day.

  17. Efficacy and safety of sotagliflozin in treating diabetes type 1.

    Science.gov (United States)

    Rendell, Marc S

    2018-02-01

    Sotagliflozin is the first dual SGLT1/SGLT2 inhibitor developed for use in diabetes. Sotagliflozin blocks SGLT2 in the kidneys and SGLT1 in the intestines resulting in reduced early phase glucose absorption and increased blood levels of GLP-1 and PYY. Urinary glucose excretion is lower than with other agents as a result of decreased glucose absorption. The primary development effort to date has been in Type 1 diabetes. Areas covered: The published information on sotagliflozin is reviewed, along with the recent results of several pivotal Type 1 diabetes trials. Expert opinion: Sotagliflozin treatment lowers HbA1c and reduces glucose variability, with a trend to less hypoglycemic events. In the Type 1 trials, sotagliflozin treated individuals experienced DKA at a higher rate than placebo treated patients. An additional safety issue arises from the as yet unknown potential risks in women of child bearing potential in whom DKA is of utmost concern. The sotagliflozin development program has now been extended to trials in Type 2 diabetes, and long term studies will be needed to assess the benefits and risks of the agent in comparison to other currently marketed SGLT2 inhibitors.

  18. Sodium-Glucose Linked Cotransporter-2 Inhibition Does Not Attenuate Disease Progression in the Rat Remnant Kidney Model of Chronic Kidney Disease.

    Directory of Open Access Journals (Sweden)

    Yanling Zhang

    Full Text Available Pharmacological inhibition of the proximal tubular sodium-glucose linked cotransporter-2 (SGLT2 leads to glycosuria in both diabetic and non-diabetic settings. As a consequence of their ability to modulate tubuloglomerular feedback, SGLT2 inhibitors, like agents that block the renin-angiotensin system, reduce intraglomerular pressure and single nephron GFR, potentially affording renoprotection. To examine this further we administered the SGLT2 inhibitor, dapagliflozin, to 5/6 (subtotally nephrectomised rats, a model of progressive chronic kidney disease (CKD that like CKD in humans is characterised by single nephron hyperfiltration and intraglomerular hypertension and where angiotensin converting enzyme inhibitors and angiotensin receptor blockers are demonstrably beneficial. When compared with untreated rats, both sham surgery and 5/6 nephrectomised rats that had received dapagliflozin experienced substantial glycosuria. Nephrectomised rats developed hypertension, heavy proteinuria and declining GFR that was unaffected by the administration of dapagliflozin. Similarly, SGLT2 inhibition did not attenuate the extent of glomerulosclerosis, tubulointerstitial fibrosis or overexpression of the profibrotic cytokine, transforming growth factor-ß1 mRNA in the kidneys of 5/6 nephrectomised rats. While not precluding beneficial effects in the diabetic setting, these findings indicate that SGLT2 inhibition does not have renoprotective effects in this classical model of progressive non-diabetic CKD.

  19. Renal glucose handling in diabetes and sodium glucose cotransporter 2 inhibition

    Directory of Open Access Journals (Sweden)

    Resham Raj Poudel

    2013-01-01

    Full Text Available The kidneys play a major role in glucose homeostasis through its utilization, gluconeogenesis, and reabsorption via sodium glucose cotransporters (SGLTs. The defective renal glucose handling from upregulation of SGLTs, mainly the SGLT2, plays a fundamental role in the pathogenesis of type 2 diabetes mellitus. Genetic mutations in a SGLT2 isoform that results in benign renal glycosuria, as well as clinical studies with SGLT2 inhibitors in type 2 diabetes support the potential of this approach. These studies indicate that inducing glycosuria by suppressing SGLT2 can reduce plasma glucose and A1c levels, as well as decrease weight, resulting in improved β-cell function and enhanced insulin sensitivity in liver and muscle. Because the mechanism of SGLT2 inhibition is independent of insulin secretion and sensitivity, these agents can be combined with other antidiabetic agents, including exogenous insulin. This class represents a novel therapeutic approach with potential for the treatment of both type 2 and type 1 diabetes.

  20. Do sodium-glucose co-transporter-2 inhibitors prevent heart failure with a preserved ejection fraction by counterbalancing the effects of leptin? A novel hypothesis.

    Science.gov (United States)

    Packer, Milton

    2018-06-01

    Sodium-glucose co-transporter-2 (SGLT2) inhibitors reduce the risk of serious heart failure events in patients with type 2 diabetes, but little is known about mechanisms that might mediate this benefit. The most common heart failure phenotype in type 2 diabetes is obesity-related heart failure with a preserved ejection fraction (HFpEF). It has been hypothesized that the synthesis of leptin in this disorder leads to sodium retention and plasma volume expansion as well as to cardiac and renal inflammation and fibrosis. Interestingly, leptin-mediated neurohormonal activation appears to enhance the expression of SGLT2 in the renal tubules, and SGLT2 inhibitors exert natriuretic actions at multiple renal tubular sites in a manner that can oppose the sodium retention produced by leptin. In addition, SGLT2 inhibitors reduce the accumulation and inflammation of perivisceral adipose tissue, thus minimizing the secretion of leptin and its paracrine actions on the heart and kidneys to promote fibrosis. Such fibrosis probably contributes to the impairment of cardiac distensibility and glomerular function that characterizes obesity-related HFpEF. Ongoing clinical trials with SGLT2 inhibitors in heart failure are positioned to confirm or refute the hypothesis that these drugs may favourably influence the course of obesity-related HFpEF by their ability to attenuate the secretion and actions of leptin. © 2018 John Wiley & Sons Ltd.

  1. Optical functional performance of the osteo-odonto-keratoprosthesis.

    Science.gov (United States)

    Lee, Richard M H; Ong, Gek L; Lam, Fook Chang; White, Joy; Crook, David; Liu, Christopher S C; Hull, Chris C

    2014-10-01

    The aim of this study was to evaluate optical and visual functional performance of the osteo-odonto-keratoprosthesis (OOKP). Optical design and analysis was performed with customized optical design software. Nine patients with implanted OOKP devices and 9 age-matched control patients were assessed. Contrast sensitivity was assessed and glare effect was measured with a brightness acuity test. All OOKP patients underwent kinetic Goldmann perimetry and wavefront aberrometry and completed the National Eye Institute Visual Function Questionnaire-25 (NEI VFQ-25). Optical analysis showed that the optical cylinder is near diffraction-limited. A reduction in median visual acuity (VA) with increasing glare settings was observed from 0.04 logMAR (without glare) to 0.20 logMAR (with glare at "high" setting) and significantly reduced statistically when compared with the control group at all levels of glare (P < 0.05). Contrast sensitivity was significantly reduced when compared with age-matched controls at medium and high spatial frequencies (P < 0.05). Median Goldmann perimetry was 65 degrees (interquartile range, 64-74 degrees; V-4e isopters) and 69 degrees excluding 2 glaucomatous subjects. Several vision-related NEI VFQ-25 subscales correlated significantly with VA at various brightness acuity test levels and contrast sensitivity at medium spatial frequencies, including dependency, general vision, near activities and distance activities. The OOKP optical cylinder provides patients with a good level of VA that is significantly reduced by glare. We have shown in vivo that updates to the optical cylinder design have improved the patient's field of view. Reduction of glare and refinement of cylinder alignment methods may further improve visual function and patient satisfaction.

  2. Positioning of sodium-glucose cotransporter-2 inhibitors in national and international guidelines.

    Science.gov (United States)

    Morillas, Carlos

    2016-11-01

    Sodium-glucose cotransporter-2 inhibitors (SGLT2-i) selectively and reversibly inhibit sodium-glucose cotransporter-2 (SGLT2), promoting renal glucose excretion and reducing plasma glycaemia. By increasing renal glucose excretion, these drugs favour a negative energy balance, leading to weight loss. Their glucoselowering effect is independent of insulin. Although these drugs have only recently been developed, they have been included in all the main national and international guidelines since 2014. The present review summarises the most important recommendations on the use of SGLT2 in patients with DM2 contained in the most recently published guidelines and consensus statements. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  3. Approaching to DM2 through sodium-glucose cotransporter-2: does it make sense?

    Science.gov (United States)

    Segura, Julián

    2016-11-01

    The kidney is involved in glucose homeostasis through three main mechanisms: renal gluconeogenesis, renal glucose consumption and glucose reabsorption in the proximal tubule. Glucose reabsorption is one of the most relevant physiological functions of the kidney, through which filtered glucose is fully recovered, urine is free of glucose, and calorie loss is prevented. Approximately 90% of the glucose is reabsorbed in the S1 segment of the proximal tubule, where GLUT2 and SGLT2 transporters are located, while the remaining 10% is reabsorbed in the S3 segment by SGLT1 and GLUT1 transporters. In patients with hyperglycaemia, the kidney continues reabsorbing glucose, and hyperglycaemia is maintained. Most renal glucose reabsorption is mediated by the SGLT2 transporter. Several experimental and clinical studies suggest that pharmacological blockade of this transporter might be beneficial in the management of hyperglycemia in patients with type 2 diabetes. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  4. Passive water and ion transport by cotransporters

    DEFF Research Database (Denmark)

    Loo, D D; Hirayama, B A; Meinild, A K

    1999-01-01

    the Lp of control oocytes. Passive Na+ transport (Na+ leak) was obtained from the blocker-sensitive Na+ currents in the absence of substrates (glucose and GABA). 2. Passive Na+ and water transport through SGLT1 were blocked by phlorizin with the same sensitivity (inhibitory constant (Ki), 3-5 micro......1. The rabbit Na+-glucose (SGLT1) and the human Na+-Cl--GABA (GAT1) cotransporters were expressed in Xenopus laevis oocytes, and passive Na+ and water transport were studied using electrical and optical techniques. Passive water permeabilities (Lp) of the cotransporters were determined from......M). When Na+ was replaced with Li+, phlorizin also inhibited Li+ and water transport, but with a lower affinity (Ki, 100 microM). When Na+ was replaced by choline, which is not transported, the SGLT1 Lp was indistinguishable from that in Na+ or Li+, but in this case water transport was less sensitive...

  5. Evidence for the involvement of Ala 166 in coupling Na(+) to sugar transport through the human Na(+)/glucose cotransporter

    DEFF Research Database (Denmark)

    Meinild, A K; Loo, D D; Hirayama, B A

    2001-01-01

    . The affinity for Na(+) was unchanged compared to that of hSGLT1, whereas the sugar affinity was reduced and sugar specificity was altered. There was a reduction in the turnover rate of the transporter, and in contrast to that of hSGLT1, the turnover rate depended on the sugar molecule. Exposure of A166C......We mutated residue 166, located in the putative Na(+) transport pathway between transmembrane segments 4 and 5 of human Na(+)/glucose cotransporter (hSGLT1), from alanine to cysteine (A166C). A166C was expressed in Xenopus laevis oocytes, and electrophysiological methods were used to assay function...... to MTSEA and MTSET, but not MTSES, abolished sugar transport. Accessibility of A166C to alkylating reagents was independent of protein conformation, indicating that the residue is always accessible from the extracellular surface. Sugar and phlorizin did not protect the residue from being alkylated...

  6. Following the results of the EMPA-REG OUTCOME trial with empagliflozin, is it possible to speak of a class effect?

    Directory of Open Access Journals (Sweden)

    Ampudia-Blasco FJ

    2017-01-01

    Full Text Available Francisco Javier Ampudia‑Blasco,1 Irene Romera,2 Bernat Ariño,3 Ramón Gomis4 1Endocrinology and Nutrition Department, Clinic University Hospital Valencia, Valencia, Spain; 2Eli Lilly and Company España, Madrid, Spain; 3Boehringer Ingelheim España, Barcelona, Spain; 4Endocrinology Department, Hospital Clinic Barcelona, Barcelona, Spain Background: The recently published cardiovascular outcomes data for the first sodium–glucose cotransporter 2 (SGLT2 inhibitor, empagliflozin, have shown cardiovascular safety and additional benefits in patients with type 2 diabetes and established cardiovascular disease. Empagliflozin showed lower rates of death from cardiovascular causes or from any causes and lower hospitalization rates from heart failure compared with placebo, both in addition to standard care. This commentary discusses the existence of a possible class effect considering the available evidence described for other SGLT2 inhibitors. Main text: Empagliflozin, dapagliflozin and canagliflozin share the same mechanism of action, and it is a plausible hypothesis that some of the benefits of empagliflozin treatment could also be expected from other SGLT2 inhibitors. However, the rapid and persistent occurrence of cardiovascular benefits observed with empagliflozin and the different results shown by the three inhibitors in meta-analyses of some of their respective Phase II and III trials might suggest another possible mechanism of action, perhaps related to the different selectivity to inhibit SGLT-2 and other SGLT family members that these compounds present. Conclusion: There is still lack of evidence to answer whether the cardiovascular benefits observed with empagliflozin in the EMPA-REG OUTCOME study could be seen as a “class effect”, which is also attributable to dapagliflozin and canagliflozin. Keywords: cardiovascular, outcome studies, SGLT2 inhibitors, empagliflozin, dapagliflozin, canagliflozin

  7. Sodium-glucose cotransporter-2 inhibitors and cardiovascular outcomes in type 2 diabetes mellitus: A systematic review

    Directory of Open Access Journals (Sweden)

    Ziad G Nasr

    2017-01-01

    Full Text Available Sodium-glucose cotransporter - 2 (SGLT2 inhibitors are a novel class of anti-diabetics proven to reduce blood pressure, blood glucose and body weight. However, the long-term cardiovascular (CV safety implications of these agents remain unclear. This systematic review aimed to evaluate the available clinical trial evidence pertaining to long-term cardiovascular safety of SGLT2 inhibitors. The databases EMBASE and MEDLINE were searched. Randomized controlled trials assessing CV safety of SGLT2 inhibitors compared with placebo or anti-diabetic medications were included. Two investigators independently extracted study data and completed risk of bias assessments (sequence generation, allocation concealment, blinding, incomplete outcome data, or selective outcome reporting and other biases. Outcomes included CV death, myocardial infarction, and stroke. A total of 464 studies were identified in the electronic search and 14 from other sources. Sixteen randomized clinical trials were included after full-text review. All studies reported at least one of the pre-defined outcomes (CV death, myocardial infarction, and stroke. Nineteen CV deaths were reported in SGLT2 inhibitors groups versus 10 CV deaths in placebo or other comparator arms; numerically higher in the dapagliflozin arms. The number of CV events was numerically higher in SGLT2 inhibitor groups than in other arms. Risk of bias assessment showed mixed results, with overall quality assessments deemed unclear for 6 of 16 studies (37.5%. Findings showed CV outcomes do occur in patients taking SGLT2 inhibitors yet the clinical significance remains unclear. These results can be considered hypothesis generating, as studies were limited by inadequate power and/or follow-up time. Future longitudinal studies are needed to further assess the efficacy and safety profiles of these new agents before they become widely adopted in clinical practice.

  8. Effect of Sodium-Glucose Cotransport-2 Inhibitors on Blood Pressure in People With Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis of 43 Randomized Control Trials With 22 528 Patients.

    Science.gov (United States)

    Mazidi, Mohsen; Rezaie, Peyman; Gao, Hong-Kai; Kengne, Andre Pascal

    2017-05-25

    The sodium-glucose cotransporter 2 (SGLT2) inhibitors are a class of oral hypoglycemic agents. We undertake a systematic review and meta-analysis of prospective studies to determine the effect of SGLT2 on blood pressure (BP) among individuals with type 2 diabetes mellitus. PubMed-Medline, Web of Science, Cochrane Database, and Google Scholar databases were searched to identify trial registries evaluating the impact of SGLT2 on BP. Random-effects models meta-analysis was used for quantitative data synthesis. The meta-analysis indicated a significant reduction in systolic BP following treatment with SGLT2 (weighted mean difference -2.46 mm Hg [95% CI -2.86 to -2.06]). The weighted mean differences for the effect on diastolic BP was -1.46 mm Hg (95% CI -1.82 to -1.09). In these subjects the weighted mean difference effects on serum triglycerides and total cholesterol were -2.08 mg/dL (95% CI -2.51 to -1.64) and 0.77 mg/dL (95% CI 0.33-1.21), respectively. The weighted mean differences for the effect of SGLT2 on body weight was -1.88 kg (95% CI -2.11 to -1.66) across all studies. These findings were robust in sensitivity analyses. Treatment with SGLT2 glucose cotransporter inhibitors therefore has beneficial off-target effects on BP in patients with type 2 diabetes mellitus and may also be of value in improving other cardiometabolic parameters including lipid profile and body weight in addition to their expected effects on glycemic control. However, our findings should be interpreted with consideration for the moderate statistical heterogeneity across the included studies. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

  9. Effects of antidiabetic drugs on the incidence of macrovascular complications and mortality in type 2 diabetes mellitus: a new perspective on sodium-glucose co-transporter 2 inhibitors.

    Science.gov (United States)

    Rahelić, Dario; Javor, Eugen; Lucijanić, Tomo; Skelin, Marko

    2017-02-01

    Elevated hemoglobin A 1c (HbA 1c ) values correlate with microvascular and macrovascular complications. Thus, patients with type 2 diabetes mellitus (T2DM) are at an increased risk of developing macrovascular events. Treatment of T2DM should be based on a multifactorial approach because of its evidence regarding reduction of macrovascular complications and mortality in T2DM. It is well known that intensive glucose control reduces the risk of microvascular complications in T2DM, but the effects of antidiabetic drugs on macrovascular complications and mortality in T2DM are less clear. The results of recent trials have demonstrated clear evidence that empagliflozin and liraglutide reduce cardiovascular (CV) and all-cause mortality in T2DM, an effect that is absent in other members of antidiabetic drugs. Empagliflozin is a member of a novel class of antidiabetic drugs, the sodium-glucose co-transporter 2 (SGLT2) inhibitors. Two ongoing randomized clinical trials involving other SGLT2 inhibitors, canagliflozin and dapagliflozin, will provide additional evidence of the beneficial effects of SGLT2 inhibitors in T2DM population. The aim of this paper is to systematically present the latest evidence regarding the usage of antidiabetic drugs, and the reduction of macrovascular complications and mortality. A special emphasis is put on the novel class of antidiabetic drugs, of SGLT2 inhibitors. Key messages Macrovascular complications and mortality are best clinical trial endpoints for evaluating the efficacy of antidiabetic drugs. The first antidiabetic drug that demonstrated a reduction in mortality in the treatment of type 2 diabetes mellitus (T2DM) was empagliflozin, a sodium-glucose co-transporter 2 (SGLT2) inhibitor. SGLT2 inhibitors are novel class of antidiabetic drugs that play a promising role in the treatment of T2DM.

  10. Inhibition of renal glucose reabsorption as a novel treatment for diabetes patients

    Directory of Open Access Journals (Sweden)

    Eugenio Cersosimo

    2014-03-01

    Full Text Available The importance of the kidney in glucose homeostasis has been recognized for many years. Recent observations indicating a greater role of renal glucose metabolism in various physiologic and pathologic conditions have rekindled the interest in renal glucose handling as a potential target for the treatment of diabetes. The enormous capacity of the proximal tubular cells to reabsorb the filtered glucose load entirely, utilizing the sodium-glucose co-transporter system (primarily SGLT-2, became the focus of attention. Original studies conducted in experimental animals with the nonspecific SGLT inhibitor phlorizin showed that hyperglycemia after pancreatectomy decreased as a result of forced glycosuria. Subsequently, several compounds with more selective SGLT-2 inhibition properties (“second-generation” were developed. Some agents made it into pre-clinical and clinical trials and a few have already been approved for commercial use in the treatment of type 2 diabetes. In general, a 6-month period of therapy with SGLT-2 inhibitors is followed by a mean urinary glucose excretion rate of ~80 g/day accompanied by a decline in fasting and postprandial glucose with average decreases in HgA1C ~1.0%. Concomitant body weight loss and a mild but consistent drop in blood pressure also have been reported. In contrast, transient polyuria, thirst with dehydration and occasional hypotension have been described early in the treatment. In addition, a significant increase in the occurrence of uro-genital infections, particularly in women has been documented with the use of SGLT-2 inhibitors. Conclusion: Although long-term cardiovascular, renal and bone/mineral effects are unknown SGLT-2 inhibitors, if used with caution and in the proper patient provide a unique insulin-independent therapeutic option in the management of obese type 2 diabetes patients.

  11. Benefits and Harms of Sodium-Glucose Co-Transporter 2 Inhibitors in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis

    Science.gov (United States)

    Gluud, Lise L.; Bennett, Cathy; Grøndahl, Magnus F.; Christensen, Mikkel B.; Knop, Filip K.; Vilsbøll, Tina

    2016-01-01

    Objective Sodium-glucose co-transporter 2 inhibitors (SGLT2-i) are a novel drug class for the treatment of diabetes. We aimed at describing the maximal benefits and risks associated with SGLT2-i for patients with type 2 diabetes. Design Systematic review and meta-analysis. Data Sources and Study Selection We included double-blinded, randomised controlled trials (RCTs) evaluating SGLT2-i administered in the highest approved therapeutic doses (canagliflozin 300 mg/day, dapagliflozin 10 mg/day, and empagliflozin 25 mg/day) for ≥12 weeks. Comparison groups could receive placebo or oral antidiabetic drugs (OAD) including metformin, sulphonylureas (SU), or dipeptidyl peptidase 4 inhibitors (DPP-4-i). Trials were identified through electronic databases and extensive manual searches. Primary outcomes were glycated haemoglobin A1c (HbA1c) levels, serious adverse events, death, severe hypoglycaemia, ketoacidosis and CVD. Secondary outcomes were fasting plasma glucose, body weight, blood pressure, heart rate, lipids, liver function tests, creatinine and adverse events including infections. The quality of the evidence was assessed using GRADE. Results Meta-analysis of 34 RCTs with 9,154 patients showed that SGLT2-i reduced HbA1c compared with placebo (mean difference -0.69%, 95% confidence interval -0.75 to -0.62%). We downgraded the evidence to ‘low quality’ due to variability and evidence of publication bias (P = 0.015). Canagliflozin was associated with the largest reduction in HbA1c (-0.85%, -0.99% to -0.71%). There were no differences between SGLT2-i and placebo for serious adverse events. SGLT2-i increased the risk of urinary and genital tract infections and increased serum creatinine, and exerted beneficial effects on bodyweight, blood pressure, lipids and alanine aminotransferase (moderate to low quality evidence). Analysis of 12 RCTs found a beneficial effect of SGLT2-i on HbA1c compared with OAD (-0.20%, -0.28 to -0.13%; moderate quality evidence). Conclusion

  12. Protecting ecotourism resources in a time of rapid economic and environmental transformation in Asia

    Science.gov (United States)

    Alan Watson; Dave Ostergren; Peter Fix; Bill Overbaugh; Dan McCollum; Linda Kruger; Martha Madsen; He Yang

    2009-01-01

    In the Far East of Russia, similar to many places in Asia, ecotourism and the environment are in transition. A science team, cooperating with the United Nations Development Programme project "Demonstrating Sustainable Conservation of Biological Diversity in Four Protected Territories in the Kamchatka Region, Russian Federation," is working to provide vital...

  13. On the carcinogenic polycyclic aromatic hydrocarbon benzo(a)pyrene in volcano exhausts.

    Science.gov (United States)

    Ilnitsky, A P; Belitsky, G A; Shabad, L M

    1976-05-01

    The content of benzo(a)pyrene in the juvenile ashes of the volcano Tyatya (Kunashir Island, Kuriles) and in the soil, vegetation and volcanic mud collected near volcanos in Kamchatka was studied. It was concluded that volcanic activity does not play a large role in forming the background level of this carcinogen in the human environment.

  14. FEATURES OF GEODEFORMATION CHANGES OF NEAR SURFACE SEDIMENTARY ROCKS

    Directory of Open Access Journals (Sweden)

    I. A. Larionov

    2016-11-01

    Full Text Available The results of investigations of the deformation process in the near surface sedimentary rocks, which has been carried out in a seismically active region of Kamchatka peninsular since 2007,are presented. The peculiarity of the experiments on the registration of geodeformations is the application of a laser deformograph-interferometer constructed according to the Michelson interferometer scheme.

  15. GEOMAGNETICINDUCED CURRENTSIN ELECTRIC POWER SYSTEMS

    Directory of Open Access Journals (Sweden)

    A.S. Serovetnikov

    2013-12-01

    Full Text Available On the example of the local powergrid of Kamchatka shows the relationship between the magnitude of industrial current harmonics and variations of Earth’s magnetic field. Shows dependence of mechanism of geomagnetically induced currents creation from topology of powergrid.

  16. Russian eruption warning systems for aviation

    Science.gov (United States)

    Neal, C.; Girina, O.; Senyukov, S.; Rybin, A.; Osiensky, J.; Izbekov, P.; Ferguson, G.

    2009-01-01

    More than 65 potentially active volcanoes on the Kamchatka Peninsula and the Kurile Islands pose a substantial threat to aircraft on the Northern Pacific (NOPAC), Russian Trans-East (RTE), and Pacific Organized Track System (PACOTS) air routes. The Kamchatka Volcanic Eruption Response Team (KVERT) monitors and reports on volcanic hazards to aviation for Kamchatka and the north Kuriles. KVERT scientists utilize real-time seismic data, daily satellite views of the region, real-time video, and pilot and field reports of activity to track and alert the aviation industry of hazardous activity. Most Kurile Island volcanoes are monitored by the Sakhalin Volcanic Eruption Response Team (SVERT) based in Yuzhno-Sakhalinsk. SVERT uses daily moderate resolution imaging spectroradiometer (MODIS) satellite images to look for volcanic activity along this 1,250-km chain of islands. Neither operation is staffed 24 h per day. In addition, the vast majority of Russian volcanoes are not monitored seismically in real-time. Other challenges include multiple time-zones and language differences that hamper communication among volcanologists and meteorologists in the US, Japan, and Russia who share the responsibility to issue official warnings. Rapid, consistent verification of explosive eruptions and determination of cloud heights remain significant technical challenges. Despite these difficulties, in more than a decade of frequent eruptive activity in Kamchatka and the northern Kuriles, no damaging encounters with volcanic ash from Russian eruptions have been recorded. ?? Springer Science+Business Media B.V. 2009.

  17. Geografie na Kamčatce

    Czech Academy of Sciences Publication Activity Database

    Kolejka, Jaromír

    2009-01-01

    Roč. 114, č. 1 (2009), s. 73-74 ISSN 1212-0014 Institutional research plan: CEZ:AV0Z30860518 Keywords : geography * education/research * Kamchatka Subject RIV: DE - Earth Magnetism, Geodesy, Geography http:// geography .cz/sbornik

  18. Evaluation of OLED and edge-lit LED lighting panels

    Science.gov (United States)

    Mou, Xi; Narendran, Nadarajah; Zhu, Yiting; Freyssinier, Jean Paul

    2016-09-01

    Solid-state lighting (SSL) offers a new technology platform for lighting designers and end-users to illuminate spaces with low energy demand. Two types of SSL sources include organic light-emitting diodes (OLEDs) and light-emitting diodes (LEDs). OLED is an area light source, and its primary competing technology is the edge-lit LED panel. Generally, both of these technologies are considered similar in shape and appearance, but there is little understanding of how people perceive discomfort glare from large area light sources. The objective of this study was to evaluate discomfort glare for the two lighting technologies under similar operating conditions by gathering observers' reactions. The human factors study results showed no statistically significant difference in human response to discomfort glare between OLED and edge-lit LED panels when the two light sources produced the same lighting stimulus. This means both technologies appeared equally glary beyond a certain luminance.

  19. The influence of ambient light on the driver

    Science.gov (United States)

    Klinger, Karsten D.; Lemmer, Uli

    2008-04-01

    Increasingly, cars are fitted with interior ambient lighting which is switched on while driving. This special kind of interior light emphasizes the interior design of the car, it makes a car look special and gives the buyers a new option to personalize their automobiles. But how does ambient interior light influence the driver? We conducted a series of over 50 tests to study the influence of interior ambient light on contrast perception under different illumination levels, colors and positions of the illuminated areas. Our tests show that in many cases the ambient lighting can improve the visual contrast for seeing objects in the headlamp beam. But the test persons mentioned that the tested brightness looked too bright and that they felt glared. The measured values instead proved that no disability glare exists. Therefore, provided that the drivers can adjust the intensity of the ambient light to avoid glare, the ambient light has no negative effect on the drivers' contrast perception.

  20. Study on acute toxicity of anti-vertigo granule on mice

    Science.gov (United States)

    Wen, Zhonghua; Hao, Shaojun; Xie, Guoqi; Li, Jun; Su, Feng; Liu, Xiaobin; Wang, Xidong; Zhang, Zhengchen

    2018-04-01

    To observe the effect of anti - glare particles on acute toxicity of mice. Methods: 40 male and female mice weighing 18 - 21 g were randomly divided into anti - glare granule group and normal saline control group. The maximum volume of anti - glare particles (0.94 g/ml) was administered before the experiment. Results: the oral toxicity of the suspension was very small. The maximal concentration of mice was given at the maximum volume of gastric perfusion, and it was given three times in 1st. The cumulative maximum tolerance dose was 112.8g/kg per day. The dose was 226 times of clinical dosage and no death was found in mice. Conclusion: the toxicity of Kangxuan granules is very small and it can be considered safe in clinical use.

  1. Daylighting, Space, and Architecture: A Literature Review

    Directory of Open Access Journals (Sweden)

    Dalia Hafiz

    2015-12-01

    Full Text Available Daylighting dynamism and constant change can characterize buildings and spaces with a living quality that cannot be achieved with any other design element. However, daylighting can create unwanted lighting conditions in the visual field causing discomfort and glare. This may affect the performance of building occupants such as workers or students. Consequently, designing for daylighting needs a good understanding of daylighting. Designers can rely on information from simulation software to re-imagine the space, especially to examine possible unexpected visual discomfort conditions.This paper aims to represent different visual comfort evaluation methods that can help decision-makers make better informed decisions. Different definitions and structures associated with daylight and glare are examined. It also presents a review of the literature of previous research conducted on daylighting, visual comfort analysis and glare studies.

  2. Validation of the Five-Phase Method for Simulating Complex Fenestration Systems with Radiance against Field Measurements

    Energy Technology Data Exchange (ETDEWEB)

    Geisler-Moroder, David [Bartenbach GmbH, Aldrans (Austria); Lee, Eleanor S. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Ward, Gregory J. [Anyhere Software, Albany, NY (United States)

    2016-08-29

    The Five-Phase Method (5-pm) for simulating complex fenestration systems with Radiance is validated against field measurements. The capability of the method to predict workplane illuminances, vertical sensor illuminances, and glare indices derived from captured and rendered high dynamic range (HDR) images is investigated. To be able to accurately represent the direct sun part of the daylight not only in sensor point simulations, but also in renderings of interior scenes, the 5-pm calculation procedure was extended. The validation shows that the 5-pm is superior to the Three-Phase Method for predicting horizontal and vertical illuminance sensor values as well as glare indices derived from rendered images. Even with input data from global and diffuse horizontal irradiance measurements only, daylight glare probability (DGP) values can be predicted within 10% error of measured values for most situations.

  3. Night driving simulation in a randomized prospective comparison of Visian toric implantable collamer lens and conventional PRK for moderate to high myopic astigmatism.

    Science.gov (United States)

    Schallhorn, Steven; Tanzer, David; Sanders, Donald R; Sanders, Monica; Brown, Mitch; Kaupp, Sandor E

    2010-05-01

    To compare changes in simulated night driving performance after Visian Toric Implantable Collamer Lens (TICL; STAAR Surgical) implantation and photorefractive keratectomy (PRK) for the correction of moderate to high myopic astigmatism. This prospective, randomized study consisted of 43 eyes implanted with the TICL (20 bilateral cases) and 45 eyes receiving conventional PRK (VISX Star S3 excimer laser) with mitomycin C (22 bilateral cases) for moderate to high myopia (-6.00 to -20.00 diopters[D] sphere) measured at the spectacle plane and 1.00 to 4.00 D of astigmatism. As a substudy, 27 eyes of 14 TICL patients and 41 eyes of 21 PRK patients underwent a simulated night driving test. The detection and identification distances of road signs and hazards with the Night Driving Simulator (Vision Sciences Research Corp) were measured with and without a glare source before and 6 months after each procedure. No significant difference was noted in the pre- to postoperative Night Driving Simulator in detection distances with and without the glare source between the TICL and PRK groups. The differences in identification distances without glare were significantly better for business and traffic road signs and pedestrian hazards in the TICL group relative to the PRK group whereas with glare, only the pedestrian hazards were significantly better. A clinically relevant change of Night Driving Simulator performance (>0.5 seconds change in ability to identify tasks postoperatively) was significantly better in the TICL group (with and without glare) for all identification tasks. The TICL performed better than conventional PRK in the pre- to postoperative Night Driving Simulator testing with and without a glare source present. Copyright 2010, SLACK Incorporated.

  4. Efficacy and safety of canagliflozin when used in conjunction with incretin-mimetic therapy in patients with type 2 diabetes

    NARCIS (Netherlands)

    Fulcher, G.; Matthews, D. R.; Perkovic, V.; de Zeeuw, D.; Mahaffey, K. W.; Mathieu, C.; Woo, V.; Wysham, C.; Capuano, G.; Desai, M.; Shaw, W.; Vercruysse, F.; Meininger, G.; Neal, B.

    Aims: To assess the efficacy and safety of canagliflozin, a sodium glucose co-transporter 2 (SGLT2) inhibitor, in patients with type 2 diabetes enrolled in the CANagliflozin cardioVascular Assessment Study (CANVAS) who were on an incretin mimetic [dipeptidyl peptidase-4 (DPP-4) inhibitor or

  5. Cardiovascular effects of sodium glucose cotransporter 2 inhibitors

    Directory of Open Access Journals (Sweden)

    Santos Cavaiola T

    2018-04-01

    Full Text Available Tricia Santos Cavaiola, Jeremy Pettus Division of Endocrinology and Metabolism, University of California San Diego, San Diego, CA, USA Abstract: As the first cardiovascular (CV outcome trial of a glucose-lowering agent to demonstrate a reduction in the risk of CV events in patients with type 2 diabetes mellitus (T2DM, the EMPAgliflozin Removal of Excess Glucose: Cardiovascular OUTCOME Event Trial in Type 2 Diabetes Mellitus Patients (EMPA-REG OUTCOME® trial, which investigated the sodium glucose cotransporter 2 (SGLT2 inhibitor empagliflozin, has generated great interest among health care professionals. CV outcomes data for another SGLT2 inhibitor, canagliflozin, have been published recently in the CANagliflozin CardioVascular Assessment Study (CANVAS Program, as have CV data from the retrospective real-world study Comparative Effectiveness of Cardiovascular Outcomes in New Users of Sodium-Glucose Cotransporter-2 Inhibitors (CVD-REAL, which compared SGLT2 inhibitors with other classes of glucose-lowering drugs. This review discusses the results of these three studies and, with a focus on EMPA-REG OUTCOME, examines the possible mechanisms by which SGLT2 inhibitors may reduce CV risk in patients with T2DM. Keywords: canagliflozin, cardiovascular outcomes, dapagliflozin, empagliflozin, mechanisms, sodium glucose cotransporter 2 inhibitors

  6. Rationale, design and baseline characteristics of the CANagliflozin cardioVascular Assessment Study-Renal (CANVAS-R) : A randomized, placebo-controlled trial

    NARCIS (Netherlands)

    Neal, Bruce; Perkovic, Vlado; Matthews, David R.; Mahaffey, Kenneth W.; Fulcher, Greg; Meininger, Gary; Erondu, Ngozi; Desai, Mehul; Shaw, Wayne; Vercruysse, Frank; Yee, Jacqueline; Deng, Hsiaowei; de Zeeuw, Dick

    Aims: The primary aim of the CANagliflozin cardioVascular Assessment Study-Renal (CANVAS-R) is to determine whether the favourable effects of inhibition of the sodium glucose co-transporter 2 (SGLT2) on blood glucose, blood pressure and body weight are accompanied by protection against adverse renal

  7. Cardiovascular effects of sodium glucose cotransporter 2 inhibitors

    Science.gov (United States)

    Cavaiola, Tricia Santos; Pettus, Jeremy

    2018-01-01

    As the first cardiovascular (CV) outcome trial of a glucose-lowering agent to demonstrate a reduction in the risk of CV events in patients with type 2 diabetes mellitus (T2DM), the EMPAgliflozin Removal of Excess Glucose: Cardiovascular OUTCOME Event Trial in Type 2 Diabetes Mellitus Patients (EMPA-REG OUTCOME®) trial, which investigated the sodium glucose cotransporter 2 (SGLT2) inhibitor empagliflozin, has generated great interest among health care professionals. CV outcomes data for another SGLT2 inhibitor, canagliflozin, have been published recently in the CANagliflozin CardioVascular Assessment Study (CANVAS) Program, as have CV data from the retrospective real-world study Comparative Effectiveness of Cardiovascular Outcomes in New Users of Sodium-Glucose Cotransporter-2 Inhibitors (CVD-REAL), which compared SGLT2 inhibitors with other classes of glucose-lowering drugs. This review discusses the results of these three studies and, with a focus on EMPA-REG OUTCOME, examines the possible mechanisms by which SGLT2 inhibitors may reduce CV risk in patients with T2DM. PMID:29695924

  8. Benefits and Harms of Sodium-Glucose Co-Transporter 2 Inhibitors in Patients with Type 2 Diabetes

    DEFF Research Database (Denmark)

    Storgaard, Heidi; Gluud, Lise L; Bennett, Cathy

    2016-01-01

    OBJECTIVE: Sodium-glucose co-transporter 2 inhibitors (SGLT2-i) are a novel drug class for the treatment of diabetes. We aimed at describing the maximal benefits and risks associated with SGLT2-i for patients with type 2 diabetes. DESIGN: Systematic review and meta-analysis. DATA SOURCES AND STUDY......, ketoacidosis and CVD. Secondary outcomes were fasting plasma glucose, body weight, blood pressure, heart rate, lipids, liver function tests, creatinine and adverse events including infections. The quality of the evidence was assessed using GRADE. RESULTS: Meta-analysis of 34 RCTs with 9,154 patients showed...... to low quality evidence). Analysis of 12 RCTs found a beneficial effect of SGLT2-i on HbA1c compared with OAD (-0.20%, -0.28 to -0.13%; moderate quality evidence). CONCLUSION: This review includes a large number of patients with type 2 diabetes and found that SGLT2-i reduces HbA1c with a notable...

  9. Is it Time to Transform Our Treatment Of Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Michael Nauck

    2013-10-01

    Full Text Available This meeting comprised two sessions: the morning session centred around glucagon-like peptide-1 receptor (GLP-1R agonists and SGLT-2 inhibitors, a new class of glucose-lowering compounds, while the afternoon session focused on new results of cardiovascular safety studies with diabetes medications, with special attention to the SAVOR-TIMI trial of saxagliptin.

  10. Inhibition of sodium glucose cotransporter-I expressed in Xenopus laevis oocytes by 4-acetoxyscirpendiol from Cordyceps takaomantana (anamorph = Paecilomyces tenuipes).

    Science.gov (United States)

    Yoo, Ocki; Lee, Dong-Hee

    2006-02-01

    Cordyceps contains many health-promoting constituents. Recent studies revealed that the fruiting body of cordyceps significantly alleviates hyperglycemia which usually accompanies diabetes mellitus. The mechanism of the anti-hyperglycemic effect by cordyceps, however, is not fully understood. In this study, methanolic extracts were prepared from fruiting bodies of Paecilomyces tenuipes, and 4-beta acetoxyscirpendiol (ASD) was eventually purified from the extracts. The Na+/ glucose transporter-1 (SGLT-1) was expressed in Xenopus oocytes, and the effect of ASD on it was analyzed using voltage clamp and 2-deoxy-D-glucose (2-DOG) uptake studies. Fluorescence microscopy was performed to monitor the effect of ASD on glucose uptake using HEK293 cells expressing recombinant SGLT-1. ASD inhibited SGLT-1 activity, and its two derivatives (2-acetoxyscirpenol and 15-acetoxyscirpendiol), were also effective; 15-acetoxyscirepenol was as inhibitory as ASD while diacetoxyscirpenol had less effect. Thus, the ASD in P. tenuipes may play an important role in lowering blood sugar in the circulatory system along with its derivatives as specific inhibitors of SGLT-1.

  11. Isolation and in silico evaluation of antidiabetic molecules of Cynodon dactylon (L.).

    Science.gov (United States)

    Annapurna, Hasthi V; Apoorva, Babu; Ravichandran, Natesan; Arun, Kallur Purushothaman; Brindha, Pemaiah; Swaminathan, Sethuraman; Vijayalakshmi, Mahadevan; Nagarajan, Arumugam

    2013-02-01

    Cynodon dactylon is a potential source of metabolites such as flavanoids, alkaloids, glycosides and β-sitosterol and has been traditionally employed to treat urinary tract and other microbial infections and dysentery. The present work attempts to evaluate the activity of C. dactylon extracts for glycemic control. Aqueous extracts of C. dactylon analyzed by HPLC-ESI MS have identified the presence of apigenin, luteolin, 6-C-pentosyl-8-C-hexosyl apigenin and 6-C-hexosyl-8-C-pentosyl luteolin. Evaluation of hypoglycemic activity through an extensive in silico docking approach with PPARγ (Peroxisome Proliferator-Activated Receptor), GLUT-4 (glucose transporter-4) and SGLT2 (sodium glucose co-transporter-2) revealed that luteolin, apigenin, 6-C-pentosyl-8-C-hexosyl apigenin, 6-C-hexosyl-8-C-pentosyl luteolin interact with SGLT2. Interactions of these molecules with Gln 295 and Asp 294 residues of SGLT2 have been shown to compare well with that of the phase III drug, dapagliflozin. These residues have been proven to be responsible for sugar sensing and transport. This work establishes C. dactylon extract as a potential SGLT2 inhibitor for diabetic neuropathy thus enabling a possibility of this plant extract as a new alternative to existing diabetic approaches. Copyright © 2012 Elsevier Inc. All rights reserved.

  12. Dapagliflozin Compared to DPP-4 inhibitors is Associated with Lower Risk of Cardiovascular Events and All-cause Mortality in Type 2 Diabetes Patients (CVD-REAL Nordic)

    DEFF Research Database (Denmark)

    Persson, F; Nyström, Thomas; Jørgensen, Marit Eika

    2018-01-01

    AIMS: To compare the sodium glucose-cotransporter-2-inhibitor (SGLT-2i) dapagliflozin versus dipeptidyl peptidase-4 inhibitors (DPP-4i) regarding risk associations of MACE (nonfatal myocardial infarction, nonfatal stroke or cardiovascular [CV] mortality), hospital events for heart failure (HHF), ...

  13. Color change at the push of a buttom; Farbwechsel auf Knopfdruck

    Energy Technology Data Exchange (ETDEWEB)

    Mortimer, Roger J. [Loughborough Univ. (United Kingdom)

    2013-05-15

    Materials with electrically switchable color open up many fascinating application possibilities - from the glare protection on low-cost displays to adaptive camouflage. Electrochromic materials can be electrically switched between different colors back and forth. The effect is based on a change of light absorption by current induced oxidation and reduction processes. Meanwhile electrochromic materials cover the entire color spectrum. In addition, the electrochromic materials are inexpensive and consume little power. This makes them attractive for many applications. However, their response times are still relatively long. The first commercial products include mirrors with automatic anti-glare and aircraft windows that can be darkened electrically.

  14. The role of empagliflozin in the management of type 2 diabetes by patient profile

    Directory of Open Access Journals (Sweden)

    Hedrington MS

    2015-05-01

    Full Text Available Maka S Hedrington, Stephen N Davis Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA Abstract: Current recommendations for the management of type 2 diabetes mellitus (T2DM include patient-centered approach, ie, targeting glycemic control based on patient and disease characteristics. Ten different classes of oral and injectable anti-hyperglycemic agents have been developed for T2DM, including the newest class – sodium–glucose cotransporter 2 (SGLT2 inhibitors. Four members of the class with comparable glycemic efficacy and side effects have gained approval in the US and the rest of the world. This review covers empagliflozin – third approved SGLT2 inhibitor in the US. The drug has shown rapid absorption reaching peak levels in ~2 hours and an elimination half-life of ~13 hours. Empagliflozin is a highly selective SGLT2 inhibitor with 2600-fold higher affinity for SGLT2 compared with SGLT1. Oral administration results in a dose-dependent inhibition of the transporters with increased urinary glucose excretion and resultant reduction in plasma glucose. Its efficacy and safety have been shown in a number of studies conducted in many countries. Across the trials, significant improvements in primary and secondary efficacy end points have been demonstrated, including reductions in HbA1c (~-0.8%, fasting plasma glucose (~-2 mmol/L, body weight (~-2 kg, and blood pressure (systolic -4 mmHg and diastolic -2 mmHg. Similar to other SGLT2 inhibitors, empagliflozin does not increase the risk for hypoglycemia, and the most commonly reported side effects are urinary and genital tract infections. Although empagliflozin can be used as the first-line monotherapy, its current place in the treatment of T2DM appears to be as an add-on to other oral anti-hyperglycemic agent(s or insulin at any stage of the disease. Keywords: anti-hyperglycemic agents, diabetes, glucose, SGLT2

  15. Comparative effectiveness of oral antidiabetic drugs in preventing cardiovascular mortality and morbidity: A network meta-analysis.

    Directory of Open Access Journals (Sweden)

    Gyeongsil Lee

    Full Text Available In the Guidance for Industry from the Food and Drug Administration in 2008, excess cardiovascular risk should be ruled out in trials of all new antidiabetic drugs; however, relatively few studies have focused on cardiovascular safety with antidiabetic drug use. We aimed to examine mortality and cardiovascular risk using a network meta-analysis. We searched the Medline, Embase, Cochrane, and ClinicalTrials.gov registry databases in March 2016 to identify randomized controlled trials reporting cardiovascular risk with the following oral antidiabetic drugs: metformin, sulfonylureas, thiazolidinedione (TZD, dipeptidyl peptidase-4 (DPP4 inhibitors, and sodium-glucose co-transporter-2 (SGLT2 inhibitors. We assessed the differences in the risks of all-cause mortality, cardiovascular-related mortality, acute coronary syndrome (ACS, and myocardial infarction (MI among antidiabetic drugs with fixed effect models for direct pairwise comparisons and Bayesian network meta-analyses to integrate direct and indirect comparisons. Of the 101,183 patients in 73 randomized controlled trials, 3,434 (3.4% died. The relative risks of all-cause mortality with SGLT2 inhibitor use were 0.68 (95% credible interval: 0.57-0.80, 0.74 (0.49-1.10, 0.63 (0.46-0.87, 0.71 (0.55-0.90, and 0.65 (0.54-0.78, compared with placebo, metformin, sulfonylurea, TZD, and DPP4 inhibitor, respectively. The relative risks of cardiovascular-related mortality with SGLT2 inhibitor use were 0.61 (0.50-0.76, 0.81(0.36-1.90, 0.52(0.31-0.88, 0.66(0.49-0.91, and 0.61(0.48-0.77, compared with placebo, metformin, sulfonylurea, TZD, and DPP4 inhibitor, respectively. The relative risks of ACS with SGLT2 inhibitor use was consistent with that of all-cause mortality. SGLT2 inhibitor use was associated with a lower risk of ACS than the other OADs and placebo. The relative risks of MI with SGLT2 inhibitor use were 0.77 (0.63-0.93 and 0.75 (0.60-0.94, compared with placebo and DPP4 inhibitor, respectively. The

  16. Empagliflozin in the treatment of type 2 diabetes: evidence to date

    Directory of Open Access Journals (Sweden)

    Shubrook JH

    2015-10-01

    Full Text Available Jay H Shubrook,1 Babak Baradar Bokaie,2 Sarah E Adkins31Primary Care Department, Clinical Research and Diabetes Services, Touro University College of Osteopathic Medicine, Vallejo, CA, USA; 2The Diabetes Institute at Ohio University, Ohio University, Athens, OH, USA; 3Pharmacy Practice and Administration, College of Pharmacy, Ohio State University, Athens, OH, USA Abstract: In the last decade, researchers have gained a greater understanding of the pathophysiologic mechanisms of type 2 diabetes as a chronic and progressive disease. One of the more recent treatment targets is the kidney. The kidneys become maladaptive in diabetes by increasing the reabsorption of glucose above the normal physiologic renal threshold. This discovery has led to the development of the sodium/glucose cotransporter 2 inhibitors (SGLT2. These agents readjust the renal threshold for glucose reabsorption to a lower level and decrease glucose reabsorption, while increasing urinary glucose when the glucose is above the renal threshold and subsequently lowering plasma glucose. The mechanism of action of the SGLT2 inhibitors is insulin independent, which makes them a novel treatment of diabetes. At the time of preparation of this manuscript, there were three SGLT2 inhibitors available in the US. This manuscript focuses on empagliflozin, the newest SGLT2 inhibitor, the trials in its development, and the clinical data available to date. Further, the authors propose future applications of empagliflozin, including in the treatment of type 1 diabetes, and its potential role in renoprotection. Keywords: SGLT-2 inhibitors, empagliflozin, type 2 diabetes, kidneys, type 1 diabetes, glucosuria

  17. An evidence-based practice-oriented review focusing on canagliflozin in the management of type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Messana JA

    2017-02-01

    Full Text Available Joseph A Messana,1 Stanley S Schwartz,2,3 Raymond R Townsend1 1Nephrology Division, Perelman School of Medicine, University of Pennsylvania, 2Main Line Health, 3Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA Abstract: Caring for patients with type 2 diabetes mellitus (T2DM has entered an era with many recent additions to the regimens used to clinically control their hyperglycemia. The most recent class of agents approved by the Food and Drug Administration (FDA for T2DM is the sodium–glucose-linked transporter type 2 (SGLT2 inhibitors, which work principally in the proximal tubule of the kidney to block filtered glucose reabsorption. In the few years attending this new class arrival in the market, there has been a great deal of interest generated by the novel mechanism of action of SGLT2 inhibitors and by recent large outcome trials suggesting benefit on important clinical outcomes such as death, cardiovascular disease and kidney disease progression. In this review, we focus on canagliflozin, the first-in-class marketed SGLT2 inhibitor in the USA. In some cases, we included data from other SGLT2 inhibitors, such as outcomes in clinical trials, important insights on clinical features and benefits, and adverse effects. These agents represent a fundamentally different way of controlling blood glucose and for the first time in T2DM care to offer the opportunity to reduce glucose, blood pressure, and weight with effects sustained for at least 2 years. Important side effects include genital mycotic infections and the potential for orthostatic hypotension and rare instances of normoglycemic ketoacidosis. Active ongoing clinical trials promise to deepen our experience with the potential benefits, as well as the clinical risks attending the use of this new group of antidiabetic agents. Keywords: SGLT2, canagliflozin, review, outcomes, type 2 diabetes mellitus 

  18. Stimulation of Na+/K+ ATPase activity and Na+ coupled glucose transport by β-catenin

    International Nuclear Information System (INIS)

    Sopjani, Mentor; Alesutan, Ioana; Wilmes, Jan; Dermaku-Sopjani, Miribane; Lam, Rebecca S.; Koutsouki, Evgenia; Jakupi, Muharrem; Foeller, Michael; Lang, Florian

    2010-01-01

    Research highlights: → The oncogenic transcription factor β-catenin stimulates the Na + /K + -ATPase. → β-Catenin stimulates SGLT1 dependent Na + , glucose cotransport. → The effects are independent of transcription. → β-Catenin sensitive transport may contribute to properties of proliferating cells. -- Abstract: β-Catenin is a multifunctional protein stimulating as oncogenic transcription factor several genes important for cell proliferation. β-Catenin-regulated genes include the serum- and glucocorticoid-inducible kinase SGK1, which is known to stimulate a variety of transport systems. The present study explored the possibility that β-catenin influences membrane transport. To this end, β-catenin was expressed in Xenopus oocytes with or without SGLT1 and electrogenic transport determined by dual electrode voltage clamp. As a result, expression of β-catenin significantly enhanced the ouabain-sensitive current of the endogeneous Na + /K + -ATPase. Inhibition of vesicle trafficking by brefeldin A revealed that the stimulatory effect of β-catenin on the endogenous Na + /K + -ATPase was not due to enhanced stability of the pump protein in the cell membrane. Expression of β-catenin further enhanced glucose-induced current (Ig) in SGLT1-expressing oocytes. In the absence of SGLT1 Ig was negligible irrespective of β-catenin expression. The stimulating effect of β-catenin on both Na + /K + ATPase and SGLT1 activity was observed even in the presence of actinomycin D, an inhibitor of transcription. The experiments disclose a completely novel function of β-catenin, i.e. the regulation of transport.

  19. Stimulation of Na{sup +}/K{sup +} ATPase activity and Na{sup +} coupled glucose transport by {beta}-catenin

    Energy Technology Data Exchange (ETDEWEB)

    Sopjani, Mentor [Department of Physiology, University of Tuebingen (Germany); Department of Chemistry, University of Prishtina, Kosovo (Country Unknown); Alesutan, Ioana; Wilmes, Jan [Department of Physiology, University of Tuebingen (Germany); Dermaku-Sopjani, Miribane [Department of Physiology, University of Tuebingen (Germany); Faculty of Medicine, University of Prishtina, Kosovo (Country Unknown); Lam, Rebecca S. [Department of Physiology, University of Tuebingen (Germany); Department of Molecular Neurogenetics, Max Planck Institute of Biophysics, Frankfurt/Main (Germany); Koutsouki, Evgenia [Department of Physiology, University of Tuebingen (Germany); Jakupi, Muharrem [Faculty of Medicine, University of Prishtina, Kosovo (Country Unknown); Foeller, Michael [Department of Physiology, University of Tuebingen (Germany); Lang, Florian, E-mail: florian.lang@uni-tuebingen.de [Department of Physiology, University of Tuebingen (Germany)

    2010-11-19

    Research highlights: {yields} The oncogenic transcription factor {beta}-catenin stimulates the Na{sup +}/K{sup +}-ATPase. {yields} {beta}-Catenin stimulates SGLT1 dependent Na{sup +}, glucose cotransport. {yields} The effects are independent of transcription. {yields} {beta}-Catenin sensitive transport may contribute to properties of proliferating cells. -- Abstract: {beta}-Catenin is a multifunctional protein stimulating as oncogenic transcription factor several genes important for cell proliferation. {beta}-Catenin-regulated genes include the serum- and glucocorticoid-inducible kinase SGK1, which is known to stimulate a variety of transport systems. The present study explored the possibility that {beta}-catenin influences membrane transport. To this end, {beta}-catenin was expressed in Xenopus oocytes with or without SGLT1 and electrogenic transport determined by dual electrode voltage clamp. As a result, expression of {beta}-catenin significantly enhanced the ouabain-sensitive current of the endogeneous Na{sup +}/K{sup +}-ATPase. Inhibition of vesicle trafficking by brefeldin A revealed that the stimulatory effect of {beta}-catenin on the endogenous Na{sup +}/K{sup +}-ATPase was not due to enhanced stability of the pump protein in the cell membrane. Expression of {beta}-catenin further enhanced glucose-induced current (Ig) in SGLT1-expressing oocytes. In the absence of SGLT1 Ig was negligible irrespective of {beta}-catenin expression. The stimulating effect of {beta}-catenin on both Na{sup +}/K{sup +} ATPase and SGLT1 activity was observed even in the presence of actinomycin D, an inhibitor of transcription. The experiments disclose a completely novel function of {beta}-catenin, i.e. the regulation of transport.

  20. Alaska - Russian Far East connection in volcano research and monitoring

    Science.gov (United States)

    Izbekov, P. E.; Eichelberger, J. C.; Gordeev, E.; Neal, C. A.; Chebrov, V. N.; Girina, O. A.; Demyanchuk, Y. V.; Rybin, A. V.

    2012-12-01

    The Kurile-Kamchatka-Alaska portion of the Pacific Rim of Fire spans for nearly 5400 km. It includes more than 80 active volcanoes and averages 4-6 eruptions per year. Resulting ash clouds travel for hundreds to thousands of kilometers defying political borders. To mitigate volcano hazard to aviation and local communities, the Alaska Volcano Observatory (AVO) and the Institute of Volcanology and Seismology (IVS), in partnership with the Kamchatkan Branch of the Geophysical Survey of the Russian Academy of Sciences (KBGS), have established a collaborative program with three integrated components: (1) volcano monitoring with rapid information exchange, (2) cooperation in research projects at active volcanoes, and (3) volcanological field schools for students and young scientists. Cooperation in volcano monitoring includes dissemination of daily information on the state of volcanic activity in neighboring regions, satellite and visual data exchange, as well as sharing expertise and technologies between AVO and the Kamchatkan Volcanic Eruption Response Team (KVERT) and Sakhalin Volcanic Eruption Response Team (SVERT). Collaboration in scientific research is best illustrated by involvement of AVO, IVS, and KBGS faculty and graduate students in mutual international studies. One of the most recent examples is the NSF-funded Partnerships for International Research and Education (PIRE)-Kamchatka project focusing on multi-disciplinary study of Bezymianny volcano in Kamchatka. This international project is one of many that have been initiated as a direct result of a bi-annual series of meetings known as Japan-Kamchatka-Alaska Subduction Processes (JKASP) workshops that we organize together with colleagues from Hokkaido University, Japan. The most recent JKASP meeting was held in August 2011 in Petropavlovsk-Kamchatsky and brought together more than 130 scientists and students from Russia, Japan, and the United States. The key educational component of our collaborative program

  1. Communicative Competence and General Studies in English in ...

    African Journals Online (AJOL)

    It is no more a hidden fact that students admitted into our universities and other tertiary institutions are quite deficient in the use of English. The incidence of examination malpractice is so glaring in our secondary school system that the result from the various examinations conducted in these schools are everything but ...

  2. Harassment: Imaginings.

    Science.gov (United States)

    Wilt, Judith

    1993-01-01

    Imagines the role of the male college professor in view of the erotic and sexual nature of his subjectivity and the glaring possibilities of sexual misconduct with students. Outlines some experiences related to the sexual harassment policies of one private college. (HB)

  3. Dendrohyrax arboreus

    African Journals Online (AJOL)

    with red paper to reduce glare, were automatically switched on at dusk and off at dawn. A minimum-maximum thermo- ... Eight categories of behaviour patterns were recognized: (i) Resting; lying in various positions within or .... Communication in the bat-eared fox Otocyon mega/otis. Symposium on Animal Communication, ...

  4. 77 FR 4014 - Takes of Marine Mammals Incidental to Specified Activities; Physical Oceanographic Studies in the...

    Science.gov (United States)

    2012-01-26

    ... vessel, sea state, visibility, and sun glare; 2. Species, group size, age, individual size, sex (if...) involved; Fate of the animal(s); and Photographs or video footage of the animal(s) (if equipment is... Resources, NMFS within 24 hrs of the discovery. The Navy will provide photographs or video footage (if...

  5. Worker cooperatives with particular reference to Malta : an educationist's theory and practice

    NARCIS (Netherlands)

    G. Baldacchino (Godfrey)

    1990-01-01

    textabstractThe issue of worker cooperation remains at the top of the agenda for workplace organization today, although the history of worker (or producer) cooperatives is littered with failures. Yet, despite the glaring and disappointing evidence, the establishment of cooperative forms of work

  6. Leading Causes of Blindness

    Science.gov (United States)

    ... have cataracts. They are the leading cause of blindness in the world. By age 80, more than half of all people in the United States either will have a cataract or have had cataract surgery. Common symptoms are: Blurry vision Colors that seem faded Glare Not being able to ...

  7. 42 CFR 37.50 - Interpreting and classifying chest roentgenograms.

    Science.gov (United States)

    2010-10-01

    .... 37.50 Section 37.50 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Office, 1750 New York Avenue, NW., Washington, DC 20006 (Phone: 202/376-2315). (d) In all view boxes used... kept clean; (4) The unit shall be so situated as to minimize front surface <