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The increase in air traffic and space flights, the rising cargo volumes and passenger numbers all set complex research and applied scientific tasks and therefore pose more complex requirements for obtaining up-to-date information on the system parameters and on the environment in which they function. After the advent of IoT platforms, their use in all areas of technology has been growing rapidly, as for instance in data collection and processing systems that are fully applicable to aviation needs. One of the major problems in the building of new systems or upgrading existing ones in line with current trends is the high cost of the innovations and the long time before their implementation. In line with the current trends in aviation, this paper proposes an approach for unified modules comprising a large set of possible sensors operating on a wireless standard for transmitting information and connected in a single and cost-effective network and with minimal time for construction, upgrading and renovation.

Aims: Investigating whether and to what extent changes in glomerular hemodynamic parameters, beyond glomerular hyperfiltration, could predict glomerular filtration rate (GFR) decline in hypertensive, non-proteinuric type 2 diabetic patients. Materials and methods: We estimated baseline afferent (Ra) and efferent (Re) arteriolar resistances and glomerular hydrostatic pressure in 60 consecutive patients from DEMAND study, using the Gomez’ equations. Baseline renal plasma flow was measured by para-aminohippurate plasma clearance, and GFR was measured by iohexol plasma clearance at baseline and every 6 months for a median of 4.0 years [IQR 3.5–4.0 years]. Patients with a GFR decline > or ≤ 3 mL/min/1.73 m2/year were categorized as “Progressors” and “Non-progressors,” respectively. Predictors of GFR decline were studied by univariable and multivariable logistic regression analysis. Results: •The GFR declined by a median [IQR] of 4.06 [5.46–2.00] mL/min/1.73 m2/year in the study group as a whole and by 5.35 [6.60–4.48] mL/min/1.73 m2/year and 1.71 [2.14–1.33] mL/min/1.73 m2/year in Progressors and Non-progressors, considered separately. Progressors had a higher baseline Ra (3487.3 ± 1349.3 dyne•sec•cm−5 vs. 2877.0 ± 668.9 dyne•sec•cm−5, p < 0.05) and higher Ra/Re ratio (1.4 ± 0.5 vs. 1.1 ± 0.3, p < 0.01) than Non-progressors. At multivariable logistic regression analysis, Ra/Re ratio and arterial hypertension duration were independently associated with GFR decline (odds ratio [95% CI] 8.50 [1.56–46.28] and 1.14 [1.01–1.28]), respectively. Conclusions: Increased Ra/Re ratio and arterial hypertension duration predict early GFR decline in hypertensive non-proteinuric type 2 diabetic patients. These findings could be explained by glomerular hypoperfusion and chronic ischemic injury related to pre-glomerular arteriolar narrowing. Clinical trial registration: DEMAND, NCT00157586, September 12, 2005.

In-depth analysis of publications worldwide related to the possibilities for dimming LED sources and lighting systems. practical research has been conducted in LED lighting systems controlled by DALI and zigbee protocols. With the help of network analyzers and a goniophotometer, energy and lighting characteristics were obtained by dimming various Led sources. The study and study of the operational characteristics of controllable LED lighting systems is essential for improving their energy efficiency.

in this paper an instrumental and analytical inspection of various characteristics and indicators of a complex “coastal station-ship” was carried out in order to establish the compatibility of operation of these facilities. the analysis makes it possible to check the extent to which the regulatory requirements of international and national standards are met.

Aims: To evaluate whether angiotensin-converting enzyme (ACE) inhibitor and angiotensin II receptor blocker (ARB) combination therapy is more nephroprotective than ACE inhibitor or ARB monotherapy in people with type 2 diabetes and overt nephropathy. Materials and methods: In this prospective, randomized, open, blind-endpoint phase III trial sponsored by the Italian Drug Agency, 103 consenting patients with type 2 diabetes, aged >40 years, with serum creatinine levels 159 to 309 μmol/L, spot morning urinary albumin–creatinine ratio > 1000 mg/g (or > 500 mg/g in those on ACE inhibitor or ARB therapy at inclusion) were stratified by centre and randomized to 4.5-year treatment with valsartan 320 mg/d (n = 36), benazepril 20 mg/d (n = 34) or halved doses of both medications (n = 33). The primary endpoint was end-stage renal disease (ESRD). Modified intention-to-treat analyses were performed. Results: Recruitment took place between June 2007 and February 2013 at 10 centres in Italy and one in Slovenia. A total of 77 participants completed the study and 26 were prematurely withdrawn. During a median (interquartile range) of 41 (18–54) months, 12 participants on benazepril (35.3%) and nine on combination therapy (27.3%) progressed to ESRD, versus five on valsartan (13.9%). Differences between benazepril (hazard ratio [HR] 3.59, 95% confidence interval [CI] 1.25–10.30; P = 0.018) or combination therapy (HR 3.28, 95% CI 1.07–10.0; P = 0.038) and valsartan were significant, even after adjustment for age, gender and baseline serum creatinine, systolic blood pressure and 24-hour proteinuria (HR 5.16, 95% CI 1.50–17.75, P = 0.009 and HR 4.75, 95% CI 1.01–22.39, P = 0.049, respectively). Adverse events were distributed similarly among the groups. Conclusions: In people with type 2 diabetes with nephropathy, valsartan (320 mg/d) safely postponed ESRD more effectively than benazepril (20 mg/d) or than halved doses of both medications.

Background: \ud Microalbuminuria is an early sign of kidney disease in people with diabetes and indicates increased risk of cardiovascular disease. We tested whether a urinary proteomic risk classifier (CKD273) score was associated with development of microalbuminuria and whether progression to microalbuminuria could be prevented with the mineralocorticoid receptor antagonist spironolactone.\ud \ud Methods: \ud In this multicentre, prospective, observational study with embedded randomised controlled trial (PRIORITY), we recruited people with type 2 diabetes, normal urinary albumin excretion, and preserved renal function from 15 specialist centres in ten European countries. All participants (observational cohort) were tested with the CKD273 classifier and classified as high risk (CKD273 classifier score >0·154) or low risk (≤0·154). Participants who were classified as high risk were entered into a randomised controlled trial and randomly assigned (1:1), by use of an interactive web-response system, to receive spironolactone 25 mg once daily or matched placebo (trial cohort). The primary endpoint was development of confirmed microalbuminuria in all individuals with available data (observational cohort). Secondary endpoints included reduction in incidence of microalbuminuria with spironolactone (trial cohort, intention-to-treat population) and association between CKD273 risk score and measures of impaired renal function based on estimated glomerular filtration rate (eGFR; observational cohort). Adverse events (particularly gynaecomastia and hyperkalaemia) and serious adverse events were recorded for the intention-to-treat population (trial cohort). This study is registered with the EU Clinical Trials Register (EudraCT 20120-004523-4) and ClinicalTrials.gov (NCT02040441) and is completed.\ud \ud Findings: \ud Between March 25, 2014, and Sept 30, 2018, we enrolled and followed-up 1775 participants (observational cohort), 1559 (88%) of 1775 participants had a low-risk urinary proteomic pattern and 216 (12%) had a high-risk pattern, of whom 209 were included in the trial cohort and assigned to spironolactone (n=102) or placebo (n=107). The overall median follow-up time was 2·51 years (IQR 2·0–3·0). Progression to microalbuminuria was seen in 61 (28%) of 216 high-risk participants and 139 (9%) of 1559 low-risk participants (hazard ratio [HR] 2·48, 95% CI 1·80–3·42; p

Context Acetyl-l-carnitine (ALC), a mitochondrial carrier involved in lipid oxidation and glucose metabolism, decreased systolic blood pressure (SBP), and ameliorated insulin sensitivity in hypertensive nondiabetic subjects at high cardiovascular risk. Objective To assess the effects of ALC on SBP and glycemic and lipid control in patients with hypertension, type 2 diabetes mellitus (T2D), and dyslipidemia on background statin therapy. Design After 4-week run-in period and stratification according to previous statin therapy, patients were randomized to 6-month, double-blind treatment with ALC or placebo added-on simvastatin. Setting Five diabetology units and one clinical research center in Italy. Patients Two hundred twenty-nine patients with hypertension and dyslipidemic T2D >40 years with stable background antihypertensive, hypoglycemic, and statin therapy and serum creatinine, In a prospective randomized controlled trial in 229 patients with hypertension and T2D, 6-month oral acetyl-L-carnitine (1000 mg twice daily) or placebo treatment had similar effects on blood pressure, metabolic control, lipids, and GFR.

In individuals with type 2 diabetes with abdominal obesity, hyperfiltration is a risk factor for accelerated glomerular filtration rate (GFR) decline and nephropathy. In this academic, single-center, parallel-group, prospective, randomized, open-label, blinded end point trial, consenting patients with type 2 diabetes aged >18 years, with waist circumference >94 (males) or >80 (females) cm, serum creatinine 120 mL/min) than nonhyperfiltering patients and was associated with BMI, waist circumference, blood pressure, heart rate, HbA1c, blood glucose, LDL-to-HDL cholesterol ratio, C-reactive protein, angiotensin II, and albuminuria reduction and with increased glucose disposal rate (measured by hyperinsulinemic-euglycemic clamps). Protein and sodium intake and concomitant treatments were similar between the groups. CR was tolerated well. In patients with type 2 diabetes with abdominal obesity, CR ameliorates glomerular hyperfiltration, insulin sensitivity, and other cardiovascular risk factors, effects that might translate into long-term nephro- and cardioprotection.

Summary Background Effective reduction of albuminuria and blood pressure in patients with type 2 diabetes who have nephropathy is seldom achieved with available treatments. We tested the effects of treatment of such patients with daglutril, a combined endothelin-converting enzyme and neutral endopeptidase inhibitor. Methods We did this randomised, crossover trial in two hospitals in Italy. Eligibility criteria were: age 18 years or older, urinary albumin excretion 20–999 μg/min, systolic blood pressure (BP) less than 140 mm Hg, and diastolic BP less than 90 mm Hg. Patients were randomly assigned (1:1) with a computer-generated randomised sequence to receive either daglutril (300 mg/day) then placebo for 8 weeks each or vice versa, with a 4-week washout period. Patients also took losartan throughout. Participants and investigators were masked to treatment allocation. The primary endpoint was 24-h urinary albumin excretion in the intention-to-treat population. Secondary endpoints were median office and ambulatory (24 h, daytime, and night-time) BP, renal haemodynamics and sieving function, and metabolic and laboratory test results. This study is registered with ClinicalTrials.gov, number NCT00160225. Findings We screened 58 patients, of whom 45 were enrolled (22 assigned to daglutril then placebo, 23 to placebo then daglutril; enrolment from May, 2005, to December, 2006) and 42 (20 vs 22) were included in the primary analysis. Daglutril did not significantly affect 24-h urinary albumin excretion compared with placebo (difference in change −7·6 μg/min, IQR −78·7 to 19·0; p=0·559). 34 patients had complete 24-h BP readings; compared with placebo, daglutril significantly reduced 24-h systolic (difference −5·2 mm Hg, SD 9·4; p=0·0013), diastolic (–2·5, 6·2; p=0·015), pulse (–3·0, 6·3; p=0·019), and mean (–3·1, 6·2; p=0·003) BP, as well as all night-time BP readings and daytime systolic, pulse, and mean BP, but not diastolic BP. Compared with placebo, daglutril also significantly reduced office systolic BP (–5·4, 15·4; p=0·028), but not diastolic (–1·8, 9·9; p=0·245), pulse (–3·1, 10·6; p=0·210), or mean (–2·1, 10·4; p=0·205) BP, and increased big endothelin serum concentration. Other secondary outcomes did not differ significantly between treatment periods. Three patients taking placebo and six patients taking daglutril had mild treatment-related adverse events—the most common was facial or peripheral oedema (in four patients taking daglutril). Interpretation Daglutril improved control of BP in hypertensive patients with type 2 diabetes and nephropathy and had an acceptable safety profile. Combined endothelin-converting enzyme and neutral endopeptidase inhibition could provide a new approach to hypertension in this high-risk population. Funding Solvay Pharmaceuticals.

In patients with diabetes, impaired ADAMTS13 (a disintegrin and metalloprotease with thrombospondin type 1 repeats, member 13) proteolysis of highly thrombogenic von Willebrand factor (VWF) multimers may accelerate renal and cardiovascular complications. Restoring physiological VWF handling might contribute to ACE inhibitors’ (ACEi) reno- and cardioprotective effects. To assess how Pro618Ala ADAMTS13 variants and related proteolytic activity interact with ACEi therapy in predicting renal and cardiovascular complications, we genotyped 1,163 normoalbuminuric type 2 diabetic patients from BErgamo NEphrologic DIabetes Complications Trial (BENEDICT). Interaction between Pro618Ala and ACEi was significant in predicting both renal and combined renal and cardiovascular events. The risk for renal or combined events versus reference Ala carriers on ACEi progressively increased from Pro/Pro homozygotes on ACEi (hazard ratio 2.80 [95% CI 0.849–9.216] and 1.58 [0.737–3.379], respectively) to Pro/Pro homozygotes on non-ACEi (4.77 [1.484–15.357] and 1.99 [0.944–4.187]) to Ala carriers on non-ACEi (8.50 [2.416–29.962] and 4.00 [1.739–9.207]). In a substudy, serum ADAMTS13 activity was significantly lower in Ala carriers than in Pro/Pro homozygotes and in case subjects with renal, cardiovascular, or combined events than in diabetic control subjects without events. ADAMTS13 activity significantly and negatively correlated with all outcomes. In patients with diabetes, ADAMTS13 618Ala variant associated with less proteolytic activity, higher risk of chronic complications, and better response to ACEi therapy. Screening for Pro618Ala polymorphism may help identify patients with diabetes at highest risk who may benefit the most from early reno- and cardioprotective therapy.

Current therapies for chronic obstructive pulmonary disease (COPD) focus on the improvement of clinical symptoms via the use of bronchodilators: β(2)-adrenoreceptor agonists and muscarinic (M3) acetylcholine receptor antagonists. The combination of inhaled corticosteroids (ICSs) and long-acting β(2) agonists (LABAs), or LABAs and anticholinergics has become an efficient alternative to single therapies. These combinations consist of a LABA and an ICS together with an anticholinergic, such as ipratropium or tiotropium.This review summarizes the latest thinking and findings on the usefulness of triple therapy in the treatment and management of COPD. Drawing on commercial, clinical, scientific and intellectual property data and publications, it aims to provide an overview to understand the efficacy and need for COPD triple therapy. The reader will gain an in-depth view of the triple therapy approach in managing COPD, existing molecules in the market or in development as well as new chemical entities. Clinical evidence in support of triple therapy, formulations and products are also discussed.There is limited documented clinical evidence for the use of triple therapy in COPD, reflected in the lack of commercial activity in the field. The future for the management of COPD may lie with triple therapy, but may equally rest on a better understanding of the disease and subsequent development of new chemical entities, such as dimer molecules, longer-acting β-agonists and antimuscarinics.

This paper briefly describes a new initiative dedicated to licensing of renewables, then moves on to some of the issues and challenges in the establishment and licensing of renewable technologies, an area currently of great interest from scientific, socio-political and commercial points of view. The authors expand on presentations and discussions at the Licensing Executives' Society 2008 Annual Conference in London, UK.

OBJECTIVE—In patients with type 2 diabetes, left ventricular hypertrophy (LVH) predicts cardiovascular events, and the prevention of LVH is cardioprotective. We sought to compare the effect of ACE versus non-ACE inhibitor therapy on incident electrocardiographic (ECG) evidence of LVH (ECG-LVH). RESEARCH DESIGN AND METHODS—This prespecified study compared the incidence of ECG-LVH by Sokolow-Lyon and Cornell voltage criteria in 816 hypertensive type 2 diabetic patients of the Bergamo Nephrologic Diabetes Complications Trial (BENEDICT), who had no ECG-LVH at baseline and were randomly assigned to at least 3 years of blinded ACE inhibition with trandolapril (2 mg/day) or to non-ACE inhibitor therapy. Treatment was titrated to systolic/diastolic blood pressure RESULTS—Baseline characteristics of the two groups were similar. Over a median (interquartile range) follow-up of 36 (24–48) months, 13 of the 423 patients (3.1%) receiving trandolapril compared with 31 of the 376 patients (8.2%) receiving non-ACE inhibitor therapy developed ECG-LVH (hazard ratio [HR] 0.34 [95% CI 0.18–0.65], P = 0.0012 unadjusted, and 0.35 [0.18–0.68], P = 0.0018 adjusted for predefined baseline covariates). The HR was significant even after adjustment for follow-up blood pressure and blood pressure reduction versus baseline. Compared with baseline, both Sokolow-Lyon and Cornell voltages significantly decreased with trandolapril but did not change with non-ACE inhibitor therapy. CONCLUSIONS—ACE inhibition has a specific protective effect against the development of ECG-LVH that is additional to its blood pressure–lowering effect. Because ECG-LVH is a strong cardiovascular risk factor in people with hypertension and diabetes, early ACE inhibition may be cardioprotective in this population.

Microalbuminuria is a risk factor for renal and cardiovascular disease. A role for insulin resistance in the pathogenesis of microalbuminuria has been suggested but is still unproven. In this case-control, cross-sectional study, we compared glucose disposal rate (GDR), measured by hyperinsulinemic-euglycemic clamp, in 50 pairs of matched type 2 diabetic patients with micro- or normoalbuminuria (main study) and in 29 matched pairs of diabetic patients with macro- or microalbuminuria (substudy). In the main study, GDR was ∼25% lower in micro- than in normoalbuminuric patients (5.20 ± 1.91 vs. 6.86 ± 2.88 mg · kg−1 · min−1, P < 0.05) and was independently associated with microalbuminuria (P = 0.002), with each 1 mg · kg−1 · min−1 decrease predicting ∼40% increased prevalence (odds ratio 1.37 [95% CI 1.14–1.70]). Microalbuminuria was threefold more frequent in patients with GDR ≤7.50 ± 2.56 mg · kg−1 · min−1 than in those with higher GDR (60% vs. 20%, P < 0.005). In the substudy, GDR in macro- and microalbuminuric patients was comparable (5.52 ± 2.56 vs. 5.16 ± 1.61 mg · kg−1 · min−1) and independent of macroalbuminuria. GDR was significantly correlated with urinary albumin excretion rate in the main study (P = 0.004) but not in the substudy (P = 0.60). In type 2 diabetes, more severe insulin resistance is independently associated with microalbuminuria. Longitudinal studies are needed to clarify the role of insulin resistance in the pathogenesis of microalbuminuria and related complications.

In this cross-sectional, case-control study we explored the association of proliferative diabetic retinopathy (PDR) with insulin resistance (IR) in type 2 diabetics with serum creatinine less than 2.0 mg/dl. For each PDR case, one reference case with background diabetic retinopathy (BDR) and two controls without retinopathy were identified. IR was evaluated by hyperinsulinemic euglycemic clamp; retinopathy was evaluated by indirect ophthalmoscopy and photography. Patients were matched by age, gender, and body mass index. PDR patients (n = 28) had higher IR and low-density lipoprotein cholesterol and triglyceride levels than BDR patients (n = 29), but comparable levels of glycosylated hemoglobin. Compared with patients without retinopathy (n = 58), those with PDR had higher IR, low-density lipoprotein cholesterol, and albuminuria (P < 0.05); those with BDR had higher glycosylated hemoglobin (P < 0.05), but comparable IR. At multivariate regression analysis, IR was the only independent marker of PDR among patients with retinopathy (P = 0.016). IR also retained its independent predictive value at multiple comparison among all groups (by Kruskal-Wallis test, P = 0.019). In type 2 diabetes, IR is an independent specific marker of proliferative retinopathy that may characterize patients at increased risk for blindness who may benefit most from early screening and therapeutic intervention. Longitudinal studies are needed to evaluate the role of IR in the pathogenesis of proliferative retinopathy.

The possibility of electrochemical oxidation of Pb2+ to PbO2 as a method of isolation of lead in low concentrations in copper and silver matrixes was studied. Suitable electrolysis cell was developed and the influence of various factors (electrode surface and state, reaction time, temperature, electrolyte volume, acidity, concentration of indifferent electrolyte, stirring rate and current density) on the efficiency of the process was evaluated. The accuracy and reproducibility of the method were estimated by determination of the quantity of lead in SRMs by inductively coupled plasma atomic emission spectrometry (ICP-AES) and atomic absorption spectroscopy (AAS). By means of ICP-mass spectrometry (MS), the lead isotopic ratios in SRMs were determined.

WATER systems around the world are under increasing pressure due to demands from continued industrialisation and urbanisation; growing populations; and increasing pressure on agricultural systems. This is driving the early stages of a revolution in the technologies and business models used in the water industry. Desalination is already part of this mix, but could the technologies' high demand for energy open up a new market for renewable energy technologies?

With the evolution of the internet the loading speed of the web pages has become a vital factor for their success. A few hundred milliseconds difference in the response time are enough for visitors to choose one page instead of its competitors. This paper describes the increasing demand for faster loading webpages and the need of methods for optimization of the web code in order to increase their speed. It describes the process of loading webpages in browser and lists several methods for front-end performance optimization. The understanding of the loading process allows the correct identification of the parts that can be affected and improved. It also helps for understanding the effect of these methods and the cases when they can be applied. Although the total effect of the optimization depends on the specific webpage the appliance of these rules does not only reduce the page loading speed but it also affects the total bandwidth and load of the web server.

OBJECTIVE To assess the effects of inhibited gastrointestinal cholesterol absorption in statin-treated dyslipidemic patients. RESEARCH DESIGN AND METHODS In a multicenter prospective randomized double-blind placebo-controlled trial, we primarily compared by ANCOVA the effect of 2-month ezetimibe (10 mg/day) or placebo therapy on LDL cholesterol serum levels in 108 type 2 diabetic patients with albuminuria 135 mg/dl despite simvastatin treatment (40 mg/day). RESULTS Unlike placebo, ezetimibe decreased LDL cholesterol from 99 ± 31 to 66 ± 22 mg/dl, total cholesterol from 162 ± 36 to 124 ± 30 mg/dl, and apolipoprotein B from 83 ± 22 to 64 ± 18 mg/dl (P < 0.0001 for all changes versus placebo). A total of 72 and 17% of patients on ezetimibe or placebo achieved LDL levels CONCLUSIONS Adding ezetimibe to simvastatin therapy helps to improve the pro-atherogenic lipoprotein profile in type 2 diabetic patients who fail to reach recommended lipid targets with statin therapy alone.

Effects of copper or zinc (0, 25, 50, 100, 200 and 400 mg kg−1) on soil containing an indigenous nematode community were examined in a greenhouse in the presence or absence of ryegrass (Lolium perenne L.). Increasing Cu and Zn additions had negative effects on the total abundance, average number of taxa, proportion of plant feeding nematodes, proportion of omnivorous and carnivorous nematodes, nematode taxa from c-p groups 4 and 5 and the Maturity Index, both in the presence and absence of L. perenne. At intermediate Cu or Zn concentrations of 25–200 mg kg−1, certain taxa had higher absolute abundances than in the control, which indicated indirect effects. The effects of similar Cu or Zn additions were less extreme in the presence than in the absence of L. perenne. These results imply that the presence of vegetation influences the ecotoxicological effect of pollutants. The risk assessment of pollutants could increase its realism by the inclusion of the response of communities of soil organisms in the presence of plants.

We present the time series analysis of photoelectric photometry at the 0.75m APT at Fairborn Observatory, Arizona. We found no variability which exceeds an amplitude of 1.3 mmag for the seven targets.

Objectives Over the past 20 years, the inhalation drug delivery industry has undergone a quiet revolution after the phasing out of the chlorofluorocarbon propellants used to formulate pressure-metered dose inhalers (pMDIs). This review looks back to the creative landscape of those 20 years through a study of patent application trends. To this end, an analysis of the hydrofluoroalkane pMDIs patent landscape was undertaken. Methods A statistical analysis demonstrates that 20 years after the introduction of hydrofluoroalkanes in the inhalation delivery field, the original patent applications are coming to the end of their legal life. Key findings Detailed analysis revealed that, from a total of 971 of the patents identified, up to 2.3% will expire within the next 5 years, rising to up to 7.3% in the next 10 years. The UK and USA were the main patent destinations and locations of inventive activity, as measured by patent filing location. Interestingly, the UK was the first destination and location of inventive activity in Europe, largely due to the activity of GlaxoSmithKline, followed by Italy, thanks to the work of Trinity-Chiesi. The analysis also showed that patent assignees are not always major pharmaceutical companies, with suppliers of propellants, as well as companies without major inhalation activity (such as Novadel), making substantial contributions to the landscape. Conclusions These developments may have a significant impact on innovation trends and key company activity around novel pMDI formulations, in particular for generics manufacturers.

OBJECTIVE To describe the prevalence and determinants of hyperfiltration (glomerular filtration rate [GFR] ≥120 mL/min/1.73 m2), GFR decline, and nephropathy onset or progression in type 2 diabetic patients with normo- or microalbuminuria. RESEARCH DESIGN AND METHODS We longitudinally studied 600 hypertensive type 2 diabetic patients with albuminuria RESULTS Over a median (range) follow-up of 4.0 (1.7–8.1) years, GFR declined by 3.37 (5.71–1.31) mL/min/1.73 m2 per year. GFR change was bimodal over time: a larger reduction at 6 months significantly predicted slower subsequent decline (coefficient: −0.0054; SE: 0.0009), particularly among hyperfiltering patients. A total of 90 subjects (15%) were hyperfiltering at inclusion, and 11 of 47 (23.4%) patients with persistent hyperfiltration progressed to micro- or macroalbuminuria versus 53 (10.6%) of the 502 who had their hyperfiltration ameliorated at 6 months or were nonhyperfiltering since inclusion (hazard ratio 2.16 [95% CI 1.13–4.14]). Amelioration of hyperfiltration was independent of baseline characteristics or ACE inhibition. It was significantly associated with improved BP and metabolic control, amelioration of GDR, and slower long-term GFR decline on follow-up. CONCLUSIONS Despite intensified treatment, patients with type 2 diabetes have a fast GFR decline. Hyperfiltration affects a subgroup of patients and may contribute to renal function loss and nephropathy onset or progression. Whether amelioration of hyperfiltration is renoprotective is worth investigating.

There are no adequate studies that have formally tested the performance of different estimating formulas in patients with type 2 diabetes both with and without overt nephropathy. Here we evaluated the agreement between baseline GFRs, GFR changes at month 6, and long-term GFR decline measured by iohexol plasma clearance or estimated by 15 creatinine-based formulas in 600 type 2 diabetics followed for a median of 4.0 years. Ninety patients were hyperfiltering. The number of those identified by estimation formulas ranged from 0 to 24:58 were not identified by any formula. Baseline GFR was significantly underestimated and a 6-month GFR reduction was missed in hyperfiltering patients. Long-term GFR decline was also underestimated by all formulas in the whole study group and in hyper-, normo-, and hypofiltering patients considered separately. Five formulas generated positive slopes in hyperfiltering patients. Baseline concordance correlation coefficients and total deviation indexes ranged from 32.1% to 92.6% and from 0.21 to 0.53, respectively. Concordance correlation coefficients between estimated and measured long-term GFR decline ranged from -0.21 to 0.35. The agreement between estimated and measured values was also poor within each subgroup considered separately. Thus, our study questions the use of any estimation formula to identify hyperfiltering patients and monitor renal disease progression and response to treatment in type 2 diabetics without overt nephropathy.

Diabetic retinopathy is the most common microvascular complication of diabetes mellitus and is the leading cause of blindness amongst working-age adults in Western countries. Large observational and randomized studies have consistently shown that optimal blood glucose and blood pressure control is the key component of intervention strategies aimed to halt or regress the disease, and limit the risk of progression to the proliferative stage, with consequent visual loss up to blindness in most severe cases. Amelioration of dyslipidemia by statins, especially if combined with fenofibrate, may also ameliorate retinopathy in line with a potential pathogenic role of hyperlipidemia. Recently, evidence has also emerged that renin-angiotensin system (RAS) inhibitors may electively prevent or delay progression of retinopathy, possibly because of specific protective effect against the structural and functional retinal changes sustained by local RAS activation. Thus, metabolic and blood pressure control by RAS inhibition is to prevent or limit the onset of retinopathy and its progression towards visual-threatening stages. Topic treatment with anti-vascular endothelial growth factor (VEGF) agents is emerging as a treatment option for retinopathy in advanced stages to limit the need for laser photocoagulation. This option however should be considered with caution due to the risk of systemic adverse events.

Based on 19 spectrograms with a dispersion of 17.5 A/mm, line spectrum variations in the CP2 star HD 5797 are studied. Equivalent width and central depth measurements show that intensities of 34 unblended lines vary with an amplitude of about 2 times for Fe, Ti and Sr lines, and 2.5 times for Cr lines. A search for improved period of the star has been carried out. The obtained new value is:P = 68.255 ± 0.004 days. An attempt to give a qualitative explanation of the photometric behaviour is made.

The observed hydrogen-line profiles of four λ Boo type stars— HD 111786, HD 125162, HD 179791 and HD 192640 are presented. Existence of two separate groups based on the shape of these lines is confirmed. Radial velocity (Vr = −5 ± 3 kms−1) and projected rotational velocity (vsini = 130 ± 10 kms−1) for HD 111786 are measured.

Based on high resolution spectroscopic observations hydrogen-line profiles of six λ Bootis stars: HD 31295, HD 101108, HD 105058, HD 106223, HD 142703 and HD 183324 are presented. Peculiar line profiles with weak cores and broad but shallow wings are found for four of the stars. Influence of metallicity parameter [Z/H] and effective temperature on the appearance of the observed hydrogen lines is discussed.

Background. The effect of angiotensin converting enzyme inhibitors (ACEi) on regression of retinopathy in type 2 diabetics is still ill defined.Methods. We compared the incidence of retinopathy regression in 90 hypertensive type 2 diabetics randomized to at least 3-year blinded ACEi with trandolapril (2 mg/day) or non-ACEi therapy who had preproliferative or proliferative retinopathy at baseline.Results. Over a median (interquartile range) follow-up period of 35.8 (12.4–60.7) months, retinopathy regressed in 27 patients (30.0%). Regression occurred in 18 of 42 patients (42.9%) on ACEi and in 9 of 48 (18.8%) on non-ACEi therapy (adjusted for predefined baseline covariates HR (95% CI): 2.75 (1.18–6.42),P=.0193). Concomitant treatment with or without Non-Dihydropyridine Calcium Channel Blockers (ndCCBs) did not appreciably affect the incidence of retinopathy regression.Conclusions. Unlike ndCCB, ACEi therapy may have an additional effect to that of intensified BP and metabolic control in promoting regression of diabetic retinopathy.

This report describes the phenomenon of convergence in communications and audiovisual content markets and determines its impact on regulations and market governance. It draws useful lessons from approaches applied in the U.S., U.K., and South Korea.

BACKGROUND: The multicenter double-blind, randomized Bergamo Nephrologic Diabetes Complications Trial (BENEDICT) was designed to assess whether angiotensin-converting-enzyme inhibitors and non-dihydropyridine calcium-channel blockers, alone or in combination, prevent microalbuminuria in subjects with hypertension, type 2 diabetes mellitus, and normal urinary albumin excretion. METHODS: We studied 1204 subjects, who were randomly assigned to receive at least three years of treatment with trandolapril (at a dose of 2 mg per day) plus verapamil (sustained-release formulation, 180 mg per day), trandolapril alone (2 mg per day), verapamil alone (sustained-release formulation, 240 mg per day), or placebo. The target blood pressure was 120/80 mm Hg. The primary end point was the development of persistent microalbuminuria (overnight albumin excretion, ≥20 μg per minute at two consecutive visits). RESULTS: The primary outcome was reached in 5.7 percent of the subjects receiving trandolapril plus verapamil, 6.0 percent of the subjects receiving trandolapril, 11.9 percent of the subjects receiving verapamil, and 10.0 percent of control subjects receiving placebo. The estimated acceleration factor (which quantifies the effect of one treatment relative to another in accelerating or slowing disease progression) adjusted for predefined baseline characteristics was 0.39 for the comparison between verapamil plus trandolapril and placebo (P=0.01), 0.47 for the comparison between trandolapril and placebo (P=0.01), and 0.83 for the comparison between verapamil and placebo (P=0.54). Trandolapril plus verapamil and trandolapril alone delayed the onset of microalbuminuria by factors of 2.6 and 2.1, respectively. Serious adverse events were similar in all treatment groups. CONCLUSIONS: In subjects with type 2 diabetes and hypertension but with normoalbuminuria, the use of trandolapril plus verapamil and trandolapril alone decreased the incidence of microalbuminuria to a similar extent. The effect of verapamil alone was similar to that of placebo.

Since 2010, a program to explore new eclipsing binary systems identified from STEREO photometry has been in progress. Our first results are presented here: light curves and high resolution spectra taken with Coudé spectrograph (National Astronomical Observatory Rozhen) and ARC Échelle spectrometer (ARCES, Apache Point Observatory).

We present here the systematic study of the chemical abundances of Am stars in order to search for possible abundance anomalies driven by tidal interaction in these binary systems. These stars were put into the context of Am binaries with 10 < Porb < 180 d and their abundance anomalies discussed in the context of possible tidal effects. There is clear anti-correlation of the Am peculiarities with v sin i. However, there seems to be also a correlation with eccentricity and orbital period.

Increased total plasma homocysteine (tHcy) level—secondary to excessive alcohol intake, cigarette smoking, or deficiency of methylene-tetrahydrofolate reductase—is one new identified risk factor for atherosclerotic cardiovascular diseases and for macrovascular complications of diabetes (1,2). Homocysteine (Hcy)-induced vascular damage is probably initiated by reactive oxygen species formed during Hcy auto-oxidation in plasma and results in decreased nitric oxide production, platelet activation, impaired arterial vasodilatation, and isolated systolic hypertension (1). To assess whether hyperhomocysteinemia is also an independent risk factor for microvascular complications, we cross-sectionally studied the relations among tHcy levels, diabetic retinopathy (diagnosed by indirect ophtalmoscopy and retinal photography), insulin sensitivity and glomerular filtration rate (measured by euglycemic-hyperinsulinemic clamp and unlabeled iohexol …

We have presented an optical monitoring of 3C 273, the first quasar discovered fifty years ago. It does not show variability both on intra-night and long-term time scales. To facilitate the further monitoring of 3C 273, we compiled the available calibrations of the comparison stars in its field into a mean sequence.

International audience; We present the first results of a magnetic survey of main sequence A and late B stars with NARVAL, the new generation spectropolarimeter available at Telescope Bernard Lyot at Pic du Midi Observatory. We observed 3 HgMn stars, 12 Am stars and the only Ap star for which no Zeeman detection was obtained with MuSiCoS. If we combine our results with those of our previous survey of weak magnetic fields in spectroscopically selected Ap/Bp stars we get the following situation: - Ap/Bp stars: all these stars appear to host a detectable magnetic field. A threshold dipolar magnetic field of 300 G appears to exist, below which fields are very rare and perhaps altogether absent. - Am and HgMn stars: no magnetic field is detected up to now for the 15 observed stars. An accuracy down to 0.3 G (respectively 1 G) is reached on longitudinal magnetic field measurements for Am (respectively HgMn) stars. We propose a possible interpretation of the observed threshold field which naturally explains the magnetic dichotomy: there exists a critical field strength above which stable magnetic configurations exist and below which any large scale field configuration is destroyed by some instability.