Comparative effectiveness of sitagliptin and vildagliptin in the management of patients with type 2 diabetes mellitus undergoing haemodialysis: an Indian rural tertiary care centre experience

Background: The prevalence of chronic kidney disease is increasing with diabetic nephropathy as the common underlying cause. Although numerous drugs are being used to improve glycaemic control, evidence in patients with diabetic nephropathy is sparse. The aim of the present was to evaluate the effectiveness of sitagliptin or vildagliptin addition on glycaemic control in patients with T2DM undergoing haemodialysis as part of their routine care in a rural tertiary care setting.Methods: Type 2 diabetic patients on maintenance haemodialysis as part of routine care and whose glycaemia was not controlled adequately and prescribed one of the oral gliptins once daily in addition to existing therapy for a period of 24 weeks were included in the present study. Effectiveness was assessed in terms of glycaemic control as measured by the change over time in glycated haemoglobin. Data analysis included glycated haemoglobin, body weight, serum creatinine, urine albumin creatinine ratio and the occurrence of hypoglycaemia.Results: Significant reduction in glycated haemoglobin values were noted after 24 weeks of therapy with gliptins similar to insulin glargine with a small weight loss. There was an insignificant decrease in the serum creatinine and urine albumin excretion levels after treatment with vildagliptin with Vildagliptin producing a slightly higher decrease but there was no correlation with changes in A1c levels. The overall incidence of adverse experiences was low and generally mild in both groups.Conclusions: In a group of Asian Indian patients with diabetic nephropathy due to T2DM undergoing haemodialysis in whom glycaemia was not controlled adequately, addition of gliptins helped to achieve glycaemic control to a similar extent as insulin glargine but with a marginal weight advantage

Reconfigurable nanophotonic devices using phase-change materials

This is the final version of the article. Available from E\PCOS via the URL in this record.Nanophotonic integrated circuits enable realizing functional optical devices using efficient design and fabrication routines. Their inherent stability and scalability makes them attractive for applications where optical signal processing is combined with coupling to external light stimuli. A majority of nanophotonic devices is, however, based on passive materials, which do not provide low-power tuning options or knobs for reconfigurability. We address this shortcoming by combining passive silicon nitride photonic devices with tunable phase-change materials [1]. Such a platform allows realizing both on-chip optical data storage [2] and active photonic components. Implementing on-chip photonic memories has been pursued for a long time, in particular for fabricating memory devices which are able to retain their state after the storage process. Photonic data storage would dramatically improve performance in existing computing architectures by reducing the latencies associated with electrical memories and potentially eliminating optoelectronic conversions. Furthermore, multi-level photonic memories with random access would allow for leveraging even greater computational capability. Thus far, photonic memories have been predominantly volatile, meaning that their state is lost once the input power is removed. We exploit hybrid photonic-phasechange materials to implement robust, non-volatile, all-photonic memories. By using optical near-field coupling within on-chip waveguides, we realize bit storage of up to eight levels in a single device that readily switches between intermediate states. We show that individual memory elements can be addressed using a wavelength multiplexing scheme. Such multi-level, multi-bit devices provide a pathway towards eliminating the von Neumann bottleneck and portend a new paradigm in all-photonic memory and non-conventional computing. We further show that such devices can be operated with short optical pulses, both for write and read operations

Accumulation-based computing using phasechange memories with FET access devices

Copyright © 2015 IEEE. Personal use of this material is permitted. Permission from IEEE must be obtained for all other uses, in any current or future media, including reprinting/republishing this material for advertising or promotional purposes, creating new collective works, for resale or redistribution to servers or lists, or reuse of any copyrighted component of this work in other works.Phase-change materials and devices have received much attention as a potential route to the realization of various types of unconventional computing paradigms. In this letter, we present non-von Neumann arithmetic processing that exploits the accumulative property of phase-change memory (PCM) cells. Using PCM cells with integrated FET access devices, we perform a detailed study of accumulation-based computation. We also demonstrate efficient factorization using PCM cells, a technique that could pave the way for massively parallelized computations.Engineering and Physical Sciences Research Council (EPSRC