Rosiglitazone RECORD study: glucose control outcomes at 18 months

AIMS: To compare glucose control over 18 months between rosiglitazone oral combination therapy and combination metformin and sulphonylurea in people with Type 2 diabetes. METHODS: RECORD, a multicentre, parallel-group study of cardiovascular outcomes, enrolled people with an HbA(1c) of 7.1-9.0% on maximum doses of metformin or sulphonylurea. If on metformin they were randomized to add-on rosiglitazone or sulphonylurea (open label) and if on sulphonylurea to rosiglitazone or metformin. HbA(1c) was managed to < or = 7.0% by dose titration. A prospectively defined analysis of glycaemic control on the first 1122 participants is reported here, with a primary outcome assessed against a non-inferiority margin for HbA(1c) of 0.4%. RESULTS: At 18 months, HbA(1c) reduction on background metformin was similar with rosiglitazone and sulphonylurea [difference 0.07 (95% CI -0.09, 0.23)%], as was the change when rosiglitazone or metformin was added to sulphonylurea [0.06 (-0.09, 0.20)%]. At 6 months, the effect on HbA(1c) was greater with add-on sulphonylurea, but was similar whether sulphonylurea was added to rosiglitazone or metformin. Differences in fasting plasma glucose were not statistically significant at 18 months [rosiglitazone vs. sulphonylurea -0.36 (-0.74, 0.02) mmol/l, rosiglitazone vs. metformin -0.34 (-0.73, 0.05) mmol/l]. Increased homeostasis model assessment insulin sensitivity and reduced C-reactive protein were greater with rosiglitazone than metformin or sulphonylurea (all P < or = 0.001). Body weight was significantly increased with rosiglitazone compared with sulphonylurea [difference 1.2 (0.4, 2.0) kg, P = 0.003] and metformin [difference 4.3 (3.6, 5.1) kg, P < 0.001]. CONCLUSIONS: In people with diabetes, rosiglitazone in combination with metformin or sulphonylurea was demonstrated to be non-inferior to the standard combination of metformin + sulphonylurea in lowering HbA(1c) over 18 months, and produces greater improvements in C-reactive protein and basal insulin sensitivity but is also associated with greater weight gain

Letter Louise van Brunswijk-Wolfenbuttel to Ms Guicherit

Letter written in Berlin, 5 December 1807, by Louise van Brunswijk-Wolfenbuttel (1770-1819) to Ms Guicherit. Louise is the daughter of Willem V and sister to King Willem I of the Netherlands.One page hand written letter, dating 180

CMOS-compatible fabrication of metamaterial-based absorbers for the mid-IR spectral range

A CMOS-compatible approach is presented for the fabrication of a wideband mid-IR metamaterial-based absorber on top of a Si3N4 membrane, which contains poly-Si thermopiles. The application is in IR microspectrometers that are intended for implementation in portable microsystem for use in absorption spectroscopy. Although Au is the conventional material of choice, we demonstrate by simulation that near-perfect absorption can be achieved over a wider band when using the more CMOS-compatible Al. The absorber design is based on Al disk resonators and an Al backplane, which are separated by a SiO2 layer. The fabrication process involves the deposition of Al and SiO2 layers on top of a Si3N4 membrane, lithography and a lift-off process for patterning of the top Al layer.Electronic Instrumentatio

Fabrication Tolerance Sensitivity in Large-Area Mid-Infrared Metamaterial Absorbers

Metamaterial absorbers are photonic structures composed of an array of sub-wavelength metallic patterns. Results in literature are usually based on structures of nominal dimensions, despite the significant effect of fabrication tolerances on performance. This research aims to identify the main sources of uncertainty and to investigate their effect, notably that of an irregular surface quality (i.e., roughness) of the thin metallic layer and the lithography related variations in size and shape. The effect of the shape and positioning of the resonance peak was investigated and validated using mid-infrared metamaterial absorbers. This sensitivity analysis is essential to the batch fabrication of metamaterial absorbers for MEMS applications.Electronic InstrumentationMathematical Geodesy and Positionin