Autonomic neuropathy predisposes to rosiglitazone-induced vascular leakage in insulin-treated patients with type 2 diabetes: a randomised, controlled trial on thiazolidinedione-induced vascular leakage

Contains fulltext : 88447.pdf (publisher's version ) (Closed access)AIMS/HYPOTHESIS: The mechanism of fluid-related complications caused by thiazolidinedione derivatives is unclear. One potential mechanism is thiazolidinedione-induced arterial vasodilatation, which results in vascular leakage and a fall in blood pressure, normally counterbalanced by sympathetic activation and subsequent renal fluid retention. We hypothesised that thiazolidinedione-induced vascular leakage will be particularly prominent in patients with autonomic neuropathy. METHODS: We conducted a randomised, double-blind, placebo-controlled, parallel study in 40 patients with type 2 diabetes on insulin treatment recruited from a university medical centre. The randomisation was performed by a central office using a randomisation schedule. Both treatment groups, placebo (n = 21) and rosiglitazone (n = 19), were stratified for sex and level of autonomic neuropathy as assessed by Ewing score (or=2.5). We investigated the effects of 16 weeks of treatment with rosiglitazone 4 mg twice daily on vascular leakage (transcapillary escape rate of albumin, TERalb), body weight, extracellular volume and plasma volume. RESULTS: Thirty-nine patients were included in the analysis. In patients with high Ewing scores (n = 16), rosiglitazone increased TERalb significantly (DeltaTERalb: rosiglitazone +2.43 +/- 0.45%/h, placebo -0.11 +/- 0.15%/h, p = 0.002), while rosiglitazone had no effect in the patients with low Ewing scores (n = 23). Rosiglitazone-induced increases in TERalb and Ewing score at baseline were correlated (r = 0.65, p = 0.02). There was no correlation between Ewing score and rosiglitazone-induced changes in fluid variables. One subject was withdrawn from the study because of atrial fibrillation. CONCLUSIONS/INTERPRETATION: Rosiglitazone may increase vascular leakage in insulin-treated patients with type 2 diabetes with autonomic neuropathy. Autonomic neuropathy did not exaggerate rosiglitazone-induced fluid retention. Therefore, autonomic neuropathy should be considered as a risk factor for thiazolidinedione-induced oedema, not for thiazolidinedione-induced fluid retention. TRIAL REGISTRATION: ClinicalTrials.gov NCT00422955. FUNDING: GlaxoSmithKline.1 september 201

Exploring the role of instrument design and instrument interaction for eco-innovation: a survey-based analysis of renewable energy innovation in Germany

Empirical research on eco-innovation has produced a substantive body of literature on the relevance of regulation for stimulating such innovation. Much of this work on the role of policy for eco-innovation relies on econometric analyses of company survey data. In this regard, the eco-innovation module introduced in 2008/9 in the Community Innova-tion Survey serves as an important data source that has helped improve our under-standing of the role of environmental and innovation policy for eco-innovation in the Eu-ropean Union (EU). However, so far, this data source has provided only limited oppor-tunities to generate insights into the role of instrument design and instrument interaction for eco-innovation. In this chapter, we present a first attempt to measure such aspects in a company innovation survey based on the example of renewable energy innovation in Germany. In particular, we explore to what extent the design of the German Renewa-ble Energy Sources Act (and the interaction of its feed-in tariffs with the EU emissions trading system) correlates with innovation in renewable power generation technologies. We find instrument design features but not instrument type to be related to eco-innovation. In addition, our exploratory study provides evidence for an interaction effect between climate policy and renewables support policy. Based on these findings, we discuss implications for future research on the role of policy in eco-innovation

The sequence and analysis of a Chinese pig genome

<p>Abstract</p> <p>Background</p> <p>The pig is an economically important food source, amounting to approximately 40% of all meat consumed worldwide. Pigs also serve as an important model organism because of their similarity to humans at the anatomical, physiological and genetic level, making them very useful for studying a variety of human diseases. A pig strain of particular interest is the miniature pig, specifically the Wuzhishan pig (WZSP), as it has been extensively inbred. Its high level of homozygosity offers increased ease for selective breeding for specific traits and a more straightforward understanding of the genetic changes that underlie its biological characteristics. WZSP also serves as a promising means for applications in surgery, tissue engineering, and xenotransplantation. Here, we report the sequencing and analysis of an inbreeding WZSP genome.</p> <p>Results</p> <p>Our results reveal some unique genomic features, including a relatively high level of homozygosity in the diploid genome, an unusual distribution of heterozygosity, an over-representation of tRNA-derived transposable elements, a small amount of porcine endogenous retrovirus, and a lack of type C retroviruses. In addition, we carried out systematic research on gene evolution, together with a detailed investigation of the counterparts of human drug target genes.</p> <p>Conclusion</p> <p>Our results provide the opportunity to more clearly define the genomic character of pig, which could enhance our ability to create more useful pig models.</p

A Framework for Developing and Assessing Eco-innovations

This chapter presents a framework entitled “ECORE,” which aims to assist in developing and assessing radical eco-innovations. Our proposed framework seeks to address theoretical gaps and unresolved problems from three research fields – eco-innovation, quality management, and life cycle assessment. ECORE synthesizes ideas and concepts from these three fields into a set of key principles and practices that can further integrate sustainability into business practices. These key principles are based on the idea that stakeholder interactions should form the basis of eco-innovation, that a life cycle perspective should be adopted in the design stage of eco-innovation, and that stakeholder needs must be translated into eco-innovation characteristics throughout the design process. We illustrate our framework with a hypothetical example that focuses on reducing the environmental impacts of carbonated beverage consumption. The chapter concludes by presenting the views of practitioners that were invited to provide feedback on our proposals

Who needs CSR? the impact of corporate social responsibility on national competitiveness

The link between corporate social responsibility (CSR) and competitiveness has been examined mainly at the business level. The purpose of this paper is to improve conceptual understanding and provide empirical evidence on the link between CSR and competitiveness at the national level. We draw on an eclectic-synthetic framework of international economics, strategic management and CSR literatures to explore conceptually whether and how CSR can impact on the competitiveness of nations, and test our hypotheses empirically with a sample of 19 developed countries over a 6-year period. Our evidence suggests that CSR can make a significant positive contribution to national competitiveness, as measured by national living standards. We also find that countries with a relatively low innovation record can benefit more, as compared to highly innovative countries, by implementing nationwide CSR-based positioning strategies