A 26-week, placebo- and pioglitazone-controlled monotherapy study of rivoglitazone in subjects with type 2 diabetes mellitus

AIMS

To evaluate the efficacy and safety of rivoglitazone, a peroxisome proliferator-activated receptor γ agonist in the thiazolidinedione class, in subjects with suboptimally controlled type 2 diabetes mellitus (T2DM).

METHODS

Subjects aged ≥18 years with T2DM and haemoglobin A1c (HbA1c) >7.0% and ≤8.5%, who were treatment naïve or receiving a non-thiazolidinedione antidiabetes monotherapy, entered a 2-week washout and single-blind placebo run-in period and were then randomized 2 : 4 : 11 : 11 to double-blind treatment with placebo, rivoglitazone 1.0 mg/day, rivoglitazone 1.5 mg/day, or pioglitazone 45 mg/day, for 26 weeks.

RESULTS

A total of 1912 subjects received placebo (n = 137), rivoglitazone 1.0 mg (n = 274), rivoglitazone 1.5 mg (n = 750) or pioglitazone (n = 751). Rivoglitazone 1.5 mg was statistically superior (p = 0.0339) and rivoglitazone 1.0 mg was non-inferior (p = 0.0339) to pioglitazone in reducing HbA1c from baseline (changes of -0.7%, -0.4% and -0.6%, respectively). Rivoglitazone also significantly reduced fasting plasma glucose from baseline (p < 0.0001). Rivoglitazone significantly improved estimates of insulin sensitivity, high-density lipoprotein cholesterol levels, and other metabolic and inflammatory biomarkers. Rivoglitazone was generally well tolerated at both doses, with treatment-emergent adverse event (TEAE) rates similar to pioglitazone. The most common drug-related TEAEs were peripheral oedema (active, 5.2-6.2%; placebo 0.7%), increased weight (active, 1.6-3.1%; placebo, 0%) and pitting oedema (active, 1.3-2.2%; placebo, 0%).

CONCLUSIONS

In subjects with suboptimally controlled T2DM, rivoglitazone 1.5 mg was associated with statistically superior glycaemic control to pioglitazone 45 mg, while rivoglitazone 1.0 mg was non-inferior; the safety profiles of the two drugs appeared similar.

Search for new physics in the multijet and missing transverse momentum final state in proton-proton collisions at √s = 7 TeV

A search for physics beyond the standard model is performed in events with at least three jets and large missing transverse momentum produced in proton-proton collisions at a center-of-mass energy of √s=7 TeV. No significant excess of events above the expected backgrounds is observed in 4.98 fb(-1) of data collected with the CMS detector at the Large Hadron Collider. The results are presented in the context of the constrained minimal supersymmetric extension of the standard model and more generically for simplified models. For the simplified models of gluino-gluino and squark-squark production, gluino masses below 1.0 TeV and squark masses below 0.76 TeV are excluded in case the lightest supersymmetric particle mass is below 200 GeV. These results significantly extend previous searches.

Measurement of the pseudorapidity and centrality dependence of the transverse energy density in Pb-Pb collisions at √(s(NN))=2.76 TeV

The transverse energy (E(T)) in Pb-Pb collisions at 2.76 TeV nucleon-nucleon center-of-mass energy (√(s(NN)) has been measured over a broad range of pseudorapidity (η) and collision centrality by using the CMS detector at the LHC. The transverse energy density per unit pseudorapidity (dE(T)/dη) increases faster with collision energy than the charged particle multiplicity. This implies that the mean energy per particle is increasing with collision energy. At all pseudorapidities, the transverse energy per participating nucleon increases with the centrality of the collision. The ratio of transverse energy per unit pseudorapidity in peripheral to central collisions varies significantly as the pseudorapidity increases from η=0 to |η|=5.0. For the 5% most central collisions, the energy density per unit volume is estimated to be about 14 GeV/fm(3) at a time of 1 fm/c after the collision. This is about 100 times larger than normal nuclear matter density and a factor of 2.6 times higher than the energy density reported at √(s(NN))=200 GeV at the Relativistic Heavy Ion Collider.

Search for a W' or techni-ρ decaying into WZ in pp Collisions at sqrt[s] = 7 TeV

A search is performed in pp collisions at sqrt[s]=7  TeV for exotic particles decaying via WZ to final states with electrons and muons. The data sample corresponds to an integrated luminosity of approximately 5  fb(-1). No significant excess is observed in the data above the expected standard model background. Upper bounds at 95% confidence level are set on the production cross section of the W' boson described by the sequential standard model and on the W' WZ coupling. W' bosons with masses below 1143 GeV are excluded. Limits are also set in the context of low-scale technicolor models, under a range of assumptions concerning the model parameters.

Search for a light pseudoscalar Higgs boson in the dimuon decay channel in pp collisions at √s = 7 TeV

The dimuon invariant mass spectrum is searched in the range between 5.5 and 14 GeV for a light pseudoscalar Higgs boson a, predicted in a number of new physics models, including the next-to-minimal supersymmetric standard model. The data sample used in the search corresponds to an integrated luminosity of 1.3 fb(-1) collected in pp collisions at √s = 7 TeV with the CMS detector at the LHC. No excess is observed above the background predictions and upper limits are set on the cross section times branching fraction σ × B(pp→a→μ(+)μ(-)) in the range of 1.5-7.5 pb. These results improve on existing bounds on the abb coupling for m(a) < m(Υ(1S)) and are the first significant limits for m(a) > m(Υ(3S)). Constraints on the supersymmetric parameter space are presented in the context of the next-to-minimal model.

Measurement of the electron charge asymmetry in inclusive W production in pp collisions at sqrt[s]=7 TeV

A measurement of the electron charge asymmetry in inclusive pp→W+X→eν+X production at sqrt[s]=7  TeV is presented based on data recorded by the CMS detector at the LHC and corresponding to an integrated luminosity of 840  pb(-1). The electron charge asymmetry reflects the unequal production of W(+) and W(-) bosons in pp collisions. The electron charge asymmetry is measured in bins of the absolute value of electron pseudorapidity in the range of |η|<2.4. The asymmetry rises from about 0.1 to 0.2 as a function of the pseudorapidity and is measured with a relative precision better than 7%. This measurement provides new stringent constraints for parton distribution functions.

Search for new physics with same-sign isolated dilepton events with jets and missing transverse energy

A search for new physics is performed in events with two same-sign isolated leptons, hadronic jets, and missing transverse energy in the final state. The analysis is based on a data sample corresponding to an integrated luminosity of 4.98 fb(-1) produced in pp collisions at a center-of-mass energy of 7 TeV collected by the CMS experiment at the LHC. This constitutes a factor of 140 increase in integrated luminosity over previously published results. The observed yields agree with the standard model predictions and thus no evidence for new physics is found. The observations are used to set upper limits on possible new physics contributions and to constrain supersymmetric models. To facilitate the interpretation of the data in a broader range of new physics scenarios, information on the event selection, detector response, and efficiencies is provided.

Partial splenic artery embolization for thrombocytopenia and uncontrolled massive ascites after liver transplantation

Thrombocytopenia (platelet < 60,000/mm(3)) and uncontrolled massive ascites (ascitic fluid > 1000 mL/d over 10 days) after liver transplantation (OLT), although uncommon, usually represent serious complications. Splenectomy is a useful treatment despite its many side effects. Recently, partial splenic artery embolization (PSAE) is considered to be a nonsurgical, less invasive treatment. In this study, we retrospectively reviewed the results of PSAE after OLT. Between October 2008 and February 2010, 11 patients underwent PSAE after OLT due to thrombocytopenia (n = 6) or refractory ascites (RA; n = 5). Six patients (54.5%) were males and 3 (27.3%) were children. The primary liver disease was virus-related liver cirrhosis (n = 6), biliary atresia (n = 3), fulminant hepatitis (n = 1), or alcoholic liver cirrhosis (n = 1). Seven grafts were from living and four from deceased donors. The major axial size of spleen was 12.1 to 23.4 cm and its average embolized volume, 76.4% (range = 70%-80%). As the result, the platelet count significantly increased after PSAE in all patients maintaining values greater than 100,000/mm(3) in four thrombocytopenic patients (66.7%). Cases of RA showed marked decreases after PSAE (100%). The follow-up was 6 to 28 months. After PSAE, patients experienced abdominal pain (n = 9, 81.8%), fever (n = 2, 18.2%), and abdominal distension (n = 2, 18.2%). However, there was no serious complication after PSAE such as splenic abscess, rupture, pancreatic infarction, sepsis, or death. In conclusion, PSAE was effective and safe and can be the choice for thrombocytopenia or RA related to hypersplenism after OLT.

The fate of Treponema denticola within human gingival epithelial cells

Treponema denticola is one of the major pathogens associated with chronic periodontitis. Bacterial invasion into gingival tissues is a critical process in the pathogenesis of periodontal disease. We recently reported that T. denticola can invade gingival epithelial cells. The aim of this study is to determine the fate of internalized T. denticola in gingival epithelial cells. Immortalized human gingival epithelial HOK-16B cells were infected with 5- (and 6-) carboxy-fluorescein diacetate succinimidyl ester (CFSE)-labeled live or heat-killed T. denticola for 24 h, and the presence of bacteria inside the cells was confirmed by confocal microscopy. Live T. denticola, but not heat-killed bacteria, invaded HOK-16B cells. Confocal microscopy also revealed that internalized T. denticola rarely colocalized with either endosomes or lysosomes. Transmission electron microscopy of infected cells showed that intracellular T. denticola was localized inside endosome-like structures. Although a culture-based antibiotics protection assay could not detect viable intracellular T. denticola 12 h after infection, a substantial number of bacteria were observed by confocal microscopy and weak expression of bacterial 16S ribosomal RNA was detected 48 h after infection. In addition, flow cytometric analysis of HOK-16B cells infected with CFSE-labeled T. denticola showed no loss of fluorescence over 48 h. Collectively, T. denticola invades gingival epithelial cells and remains within the host cells for many hours by resisting endolysosomal degradation. These findings may provide new insight into the role of T. denticola in the pathogenesis of periodontitis.

Dimensionality driven spin-flop transition in layered iridates

Using resonant x-ray diffraction, we observe an easy c-axis collinear antiferromagnetic structure for the bilayer Sr3Ir2O7, a significant contrast to the single layer Sr2IrO4 with in-plane canted moments. Based on a microscopic model Hamiltonian, we show that the observed spin-flop transition as a function of number of IrO2 layers is due to strong competition among intra- and interlayer bond-directional pseudodipolar interactions of the spin-orbit entangled J(eff)=1/2 moments. With this we unravel the origin of anisotropic exchange interactions in a Mott insulator in the strong spin-orbit coupling regime, which holds the key to the various types of unconventional magnetism proposed in 5d transition metal oxides.

Azimuthal anisotropy of charged particles at high transverse momenta in Pb-Pb collisions at sqrt[s(NN)] = 2.76 TeV

The azimuthal anisotropy of charged particles in Pb-Pb collisions at sqrt[s(NN)]=2.76  TeV is measured with the CMS detector at the LHC over an extended transverse momentum (p(T)) range up to approximately 60  GeV/c. The data cover both the low-p(T) region associated with hydrodynamic flow phenomena and the high-p(T) region where the anisotropies may reflect the path-length dependence of parton energy loss in the created medium. The anisotropy parameter (v2) of the particles is extracted by correlating charged tracks with respect to the event-plane reconstructed by using the energy deposited in forward-angle calorimeters. For the six bins of collision centrality studied, spanning the range of 0-60% most-central events, the observed v2 values are found to first increase with p(T), reaching a maximum around p(T)=3  GeV/c, and then to gradually decrease to almost zero, with the decline persisting up to at least pp(T)=40  GeV/c over the full centrality range measured.

Evidence for CP violation in the decay D+ → K(S)(0)π+

We observe evidence for CP violation in the decay D+ → K(S)(0)π+ using a data sample with an integrated luminosity of 977  fb(-1) collected by the Belle detector at the KEKB e+ e- asymmetric-energy collider. The CP asymmetry in the decay is measured to be (-0.363±0.094±0.067)%, which is 3.2 standard deviations away from zero, and is consistent with the expected CP violation due to the neutral kaon in the final state.

Search for dark matter and large extra dimensions in pp collisions yielding a photon and missing transverse energy

Results are presented from a search for new physics in the final state containing a photon (γ) and missing transverse energy (E[combininb /](T)). The data correspond to an integrated luminosity of 5.0 fb(-1) collected in pp collisions at √[s]=7 TeV by the CMS experiment. The observed event yield agrees with standard-model expectations for the γ+E[combininb /](T) events. Using models for the production of dark-matter particles (χ), we set 90% confidence level (C.L.) upper limits of 13.6-15.4 fb on χ production in the γ+E[combininb /](T) state. These provide the most sensitive upper limits for spin-dependent χ-nucleon scattering for χ masses (M(χ)) between 1 and 100 GeV. For spin-independent contributions, the present limits are extended to M(χ)<3.5 GeV. For models with 3-6 large extra dimensions, our data exclude extra-dimensional Planck scales between 1.64 and 1.73 TeV at 95% C.L.

Observation of a new Ξb baryon

The observation of a new b baryon via its strong decay into Ξ(b)(-) π(+) (plus charge conjugates) is reported. The measurement uses a data sample of pp collisions at sqrt[s] = 7 TeV collected by the CMS experiment at the LHC, corresponding to an integrated luminosity of 5.3 fb(-1). The known Ξ(b)(-) baryon is reconstructed via the decay chain Ξ(b)(-) → J/ψΞ(-) → μ(+) μ(-) Λ(0) π(-), with Λ(0) → pπ(-). A peak is observed in the distribution of the difference between the mass of the Ξ(b)(-) π(+) system and the sum of the masses of the Ξ(b)(-) and π(+), with a significance exceeding 5 standard deviations. The mass difference of the peak is 14.84 ± 0.74(stat) ± 0.28(syst) MeV. The new state most likely corresponds to the J(P) = 3/2(+) companion of the Ξ(b).

Observation of new resonant structures in γγ → ωϕ, ϕϕ, and ωω

The processes γγ → ωϕ, ϕϕ, and ωω are measured using an 870  fb(-1) data sample collected with the Belle detector at the KEKB asymmetric-energy e+ e- collider. Production of vector meson pairs is clearly observed and their cross sections are measured for masses that range from threshold to 4.0 GeV. In addition to signals from well established spin-zero and spin-two charmonium states, there are resonant structures below charmonium threshold, which have not been previously observed. We report a spin-parity analysis for the new structures and determine the products of the η(c), χ(c0), and χ(c2) two-photon decay widths and branching fractions to ωϕ, ϕϕ, and ωω.