The integrated cross sections of the
ep
→
e
π
+
n
,
ep
→
e
π
0
p
,
ep
→
eK
+
Λ, and
ep
→
eK
+
Σ
0
reactions are evaluated in the energy range of nucleon resonance excitation at photon virtualities
Q
...2
from 5 to 12 GeV
2
. These exclusive channels will be explored at photon virtualities
Q
2
> 5 GeV
2
for the first time in future experiments with the CLAS12 detector. The cross-section evaluation is based on the extrapolation of exclusive contributions to the inclusive structure functions
F
1
and
F
2
from a region of
Q
2
< 5 GeV
2
, in which the experimental data are available, to the region of higher
Q
2
. This evaluation of cross sections is of particular importance in the development of the program of experiments with the CLAS12 detector for studying the structure of the ground and excited nucleon states, which may reveal the dynamics of strong interactions in the nonperturbative regime.
Oral semaglutide is the first oral glucagon-like peptide-1 (GLP-1) receptor agonist for glycaemic control in patients with type 2 diabetes. Type 2 diabetes is commonly associated with renal ...impairment, restricting treatment options. We aimed to investigate the efficacy and safety of oral semaglutide in patients with type 2 diabetes and moderate renal impairment.
This randomised, double-blind, phase 3a trial was undertaken at 88 sites in eight countries. Patients aged 18 years and older, with type 2 diabetes, an estimated glomerular filtration rate of 30-59 mL/min per 1·73 m
, and who had been receiving a stable dose of metformin or sulfonylurea, or both, or basal insulin with or without metformin for the past 90 days were eligible. Participants were randomly assigned (1:1) by use of an interactive web-response system, with stratification by glucose-lowering medication and renal function, to receive oral semaglutide (dose escalated to 14 mg once daily) or matching placebo for 26 weeks, in addition to background medication. Participants and site staff were masked to assignment. Two efficacy-related estimands were defined: treatment policy (regardless of treatment discontinuation or rescue medication) and trial product (on treatment without rescue medication) in all participants randomly assigned. Endpoints were change from baseline to week 26 in HbA
(primary endpoint) and bodyweight (confirmatory secondary endpoint), assessed in all participants with sufficient data. Safety was assessed in all participants who received at least one dose of study drug. This trial is registered on ClinicalTrials.gov, number NCT02827708, and the European Clinical Trials Registry, number EudraCT 2015-005326-19, and is now complete.
Between Sept 20, 2016, and Sept 29, 2017, of 721 patients screened, 324 were eligible and randomly assigned to oral semaglutide (n=163) or placebo (n=161). Mean age at baseline was 70 years (SD 8), and 168 (52%) of participants were female. 133 (82%) participants in the oral semaglutide group and 141 (88%) in the placebo group completed 26 weeks on treatment. At 26 weeks, oral semaglutide was superior to placebo in decreasing HbA
(estimated mean change of -1·0 percentage point (SE 0·1; -11 mmol/mol SE 0·8) vs -0·2 percentage points (SE 0·1; -2 mmol/mol SE 0·8); estimated treatment difference ETD: -0·8 percentage points, 95% CI -1·0 to -0·6; p<0·0001) and bodyweight (estimated mean change of -3·4 kg SE 0·3 vs -0·9 kg SE 0·3; ETD, -2·5, 95% CI -3·2 to -1·8; p<0·0001) by the treatment policy estimand. Significant differences were seen for the trial product estimand: mean change in HbA
-1·1 percentage points (SE 0·1; -12 mmol/mol SE 0·8 versus -0·1 percentage points (SE 0·1; -1 mmol/mol SE 0·8; ETD -1·0 percentage points, 95% CI -1·2 to -0·8; p<0·0001); mean change in bodyweight -3·7 kg (SE 0·3) versus -1·1 kg (SE 0·3; ETD -2·7 kg, 95% CI -3·5 to -1·9; p<0·0001). More patients taking oral semaglutide than placebo had adverse events (120 74% of 163 vs 105 65% of 161), and discontinued treatment as a result (24 15% vs eight 5%). Gastrointestinal events, mainly mild-to-moderate nausea, were more common with oral semaglutide than with placebo. Three deaths occurred during the treatment period that were not condsidered to be treatment related, one in the semaglutide group and two in the placebo group.
Oral semaglutide was effective in patients with type 2 diabetes and moderate renal impairment, potentially providing a new treatment option for this population. Safety, including renal safety, was consistent with the GLP-1 receptor agonist class.
Novo Nordisk A/S.
Preliminary results from analyzing π
+
π
−
pair electroproduction on a proton bound in a deuteron are presented. Procedures for considering the Fermi motion of the initial proton in the deuteron and ...assessing the effects of interaction in the final states are developed. The yield of the reaction
ep
(
n
) →
e
′
p
′(
n
′)π
+
π
−
is obtained for the first time.
Methods for extracting nucleon resonance parameters from experimental data are reviewed. The formalism for the description of exclusive reactions of meson photo- and electroproduction off nucleons is ...discussed. Recent experimental data on exclusive meson production in the scattering of electrons and photons off protons are analyzed.
Preliminary results from analyzing π+π- pair electroproduction on a proton bound in a deuteron are presented. Procedures for considering the Fermi motion of the initial proton in the deuteron and ...assessing the effects of interaction in the final states are developed. The yield of the reaction ep(n) rarr e'p'(n')π+π- is obtained for the first time.
The contributions of exclusive π
+
n, π
0
p, and π
−
π
+
p channels to the inclusive structure function
F
2
(
x, Q
2
) are determined from the CLAS collaboration data analysis. Reliability of the ...CLAS data on the inclusive structure function and single-pion electroproduction channels is verified. The total contribution of the uninvestigated π
+
π
0
n and π
0
p channels to this function and the integrated cross sections of these channels at photon virtualities
Q
2
= 0.4 and 0.5 GeV
2
are predicted.
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