bluuebunny/crossref_metadata_2025 huggingface dataset:
Activating Antibodies to The Calcium-sensing Receptor in Immunotherapy-induced Hypoparathyroidism
Authors: Lupi Isabella , Brancatella Alessandro , Cetani Filomena , Latrofa Francesco , Kemp E Helen , Marcocci Claudio
Published: February 2020

Context

Immune checkpoint inhibitors (ICIs), such as programmed cell death protein-1 (PD-1), programmed cell death protein-ligand 1 (PD-L1), and cytotoxic T lymphocyte antigen-4 (CTLA-4) monoclonal antibodies, are approved for the treatment of some types of advanced cancer. Their main treatment-related side-effects are immune-related adverse events (irAEs), especially thyroid dysfunction and hypophysitis. Hypoparathyroidism, on the contrary, is an extremely rare irAE.

Objectives

The aim of the study was to investigate the etiology of autoimmune hypoparathyroidism in a lung cancer patient treated with pembrolizumab, an anti-PD-1.

Methods

Calcium-sensing receptor (CaSR) autoantibodies, their functional activity, immunoglobulin (Ig) subclasses and epitopes involved in the pathogenesis of autoimmune hypoparathyroidism were tested.

Results

The patient developed hypocalcemia after 15 cycles of pembrolizumab. Calcium levels normalized with oral calcium carbonate and calcitriol and no remission of hypocalcemia was demonstrated during a 9-month follow-up. The patient was found to be positive for CaSR-stimulating antibodies, of IgG1 and IgG3 subclasses, that were able to recognize functional epitopes on the receptor, thus causing hypocalcemia.

Conclusion

The finding confirms that ICI therapy can trigger, among other endocrinopathies, hypoparathyroidism, which can be caused by pathogenic autoantibodies.
Short (175 mm) versus standard (220 mm) length intramedullary nail for trochanteric hip fractures: a randomized trial of 229 patients
Authors: Parker Martyn J. , Cawley Shirley
Published: February 2020

Aims

A lack of supporting clinical studies have been published to determine the ideal length of intramedullary nail in fixation of trochanteric fractures of the hip. Nevertheless, there has been a trend to use shorter intramedullary nails for the internal fixation of trochanteric hip fractures. Our aim was to determine if the length of nail affected the outcome.

Methods

We randomized 229 patients with a trochanteric hip fracture between two implants: a ‘standard’ nail of 220 mm and a shorter nail of 175 mm, which had decreased proximal angulation (4° vs 7°) and a reduced diameter at the level of the lesser trochanter. Patients were followed up for one year by a nurse blinded to the type of implant used to determine if there were differences in mobility and pain with two nail designs. Pain was assessed on a scale of 1 (none) to 8 (severe and constant) and mobility on a scale of 1 (full mobility) to 9 (immobile).

Results

The shorter nail did not require any reaming of the femur and was quicker to insert (mean difference 5.1 minutes; p < 0.001, 95% confidence interval (CI) of the difference 3.16 to 7.04). Those treated by the shorter nail were less mobile (mean difference in reduction in mobility score at one year 0.80; p = 0.007, 95% CI 1.38 to 0.22). In addition, there was a trend toward greater residual pain for those treated with the shorter nail, although this was not statistically significant (mean difference in pain score at one year 0.24; p = 0.064, 95% CI -0.01 to 0.49).

Conclusion

These results suggest that the increasing use of this very short intramedullary nail with its design modification may not be appropriate. Cite this article: Bone Joint J 2020;102-B(3):394–399
Effective treatment of single-stage revision using intra-articular antibiotic infusion for culture-negative prosthetic joint infection
Authors: Ji Baochao , Li Guoqing , Zhang Xiaogang , Wang Yang , Mu Wenbo , Cao Li
Published: February 2020

Aims

In the absence of an identified organism, single-stage revision is contraindicated in prosthetic joint infection (PJI). However, no studies have examined the use of intra-articular antibiotics in combination with single-stage revision in these cases. In this study, we present the results of single-stage revision using intra-articular antibiotic infusion for treating culture-negative (CN) PJI.

Methods

A retrospective analysis between 2009 and 2016 included 51 patients with CN PJI who underwent single-stage revision using intra-articular antibiotic infusion; these were compared with 192 culture-positive (CP) patients. CN patients were treated according to a protocol including intravenous vancomycin and a direct intra-articular infusion of imipenem and vancomycin alternately used in the morning and afternoon. In the CP patients, pathogen-sensitive intravenous (IV) antibiotics were administered for a mean of 16 days (12 to 21), and for resistant cases, additional intra-articular antibiotics were used. The infection healing rate, Harris Hip Score (HHS), and Hospital for Special Surgery (HSS) knee score were compared between CN and CP groups.

Results

Of 51 CN patients, 46 (90.2%) required no additional medical treatment for recurrent infection at a mean of 53.2 months (24 to 72) of follow-up. Impaired kidney function occurred in two patients, and one patient had a local skin rash. No significant difference in the infection control rate was observed between CN and CP PJIs (90.2% (46/51) versus 94.3% (181/192); p = 0.297). The HHS of the CN group showed no substantial difference from that of CP cases (79 versus 81; p = 0.359). However, the CN group showed a mean HSS inferior to that of the CP group (76 versus 80; p = 0.027).

Conclusion

Single-stage revision with direct intra-articular antibiotic infusion can be effective in treating CN PJI, and can achieve an infection control rate similar to that in CP patients. However, in view of systemic toxicity, local adverse reactions, and higher costs, additional strong evidence is needed to verify these treatment regimens. Cite this article: Bone Joint J 2020;102-B(3):336–344
Risk factors for surgery due to rotator cuff disease in a population-based cohort
Authors: Yanik Elizabeth L. , Colditz Graham A. , Wright Rick W. , Saccone Nancy L. , Evanoff Bradley A. , Jain Nitin B. , Dale Ann Marie , Keener Jay D.
Published: February 2020

Aims

Few risk factors for rotator cuff disease (RCD) and corresponding treatment have been firmly established. The aim of this study was to evaluate the relationship between numerous risk factors and the incidence of surgery for RCD in a large cohort.

Methods

A population-based cohort of people aged between 40 and 69 years in the UK (the UK Biobank) was studied. People who underwent surgery for RCD were identified through a link with NHS inpatient records covering a mean of eight years after enrolment. Multivariate Cox proportional hazards regression was used to calculate hazard ratios (HRs) as estimates of associations with surgery for RCD accounting for confounders. The risk factors which were considered included age, sex, race, education, Townsend deprivation index, body mass index (BMI), occupational demands, and exposure to smoking.

Results

Of the 421,894 people who were included, 47% were male. The mean age at the time of enrolment was 56 years (40 to 69). A total of 2,156 people were identified who underwent surgery for RCD. Each decade increase in age was associated with a 55% increase in the incidence of RCD surgery (95% confidence interval (CI) 46% to 64%). Male sex, non-white race, lower deprivation score, and higher BMI were significantly associated with a higher risk of surgery for RCD (all p < 0.050). Greater occupational physical demands were significantly associated with higher rates of RCD surgery (HR = 2.1, 1.8, and 1.4 for ‘always’, ‘usually’, and ‘sometimes’ doing heavy manual labour vs ‘never’, all p < 0.001). Former smokers had significantly higher rates of RCD surgery than those who had never smoked (HR 1.23 (95% CI 1.12 to 1.35), p < 0.001), while current smokers had similar rates to those who had never smoked (HR 0.94 (95% CI 0.80 to 1.11)). Among those who had never smoked, the risk of surgery was higher among those with more than one household member who smoked (HR 1.78 (95% CI 1.08 to 2.92)). The risk of RCD surgery was not significantly related to other measurements of secondhand smoking.

Conclusion

Many factors were independently associated with surgery for RCD, including older age, male sex, higher BMI, lower deprivation score, and higher occupational physical demands. Several of the risk factors which were identified are modifiable, suggesting that the healthcare burden of RCD might be reduced through the pursuit of public health goals, such as reducing obesity and modifying occupational demands. Cite this article: Bone Joint J 2020;102-B(3):352–359
Surgery for femoral metastases
Authors: Tanaka Atsushi , Katagiri Hirohisa , Murata Hideki , Wasa Junji , Miyagi Michihito , Honda Yosuke , Takahashi Mitsuru
Published: February 2020

Aims

The aim of this study is to evaluate the clinical results of operative intervention for femoral metastases which were selected based on expected survival and to discuss appropriate surgical strategies.

Methods

From 2002 to 2017, 148 consecutive patients undergoing surgery for femoral metastasis were included in this study. Prognostic risk assessments were performed according to the Katagiri and revised Katagiri scoring system. In general, the low-risk group underwent resection and reconstruction with endoprosthetic replacement (EPR), while the high-risk group underwent internal fixation (IF) and radiation therapy. For the intermediate-risk group, the operative choice depended on the patient’s condition, degree of bone destruction, and radio-sensitivity. Overall survival, local failure, walking ability, and systemic complications were evaluated.

Results

A total of 83 patients underwent EPR (low-risk, 23%; intermediate-risk, 60%; high-risk, 17%) and 65 patients underwent IF (low-risk, 0%; intermediate-risk, 32%; high-risk, 68%). The one-year survival rate was 71% for EPR and 15% for IF (p < 0.001). The one-year local failure-free survival was 93% for EPR and 67% for IF, and the two-year and five-year local failure-free survival for EPR were both 88% (p = 0.016). Although the ambulatory rate was 99% for EPR and 60% for IF, the median time to ambulation was shorter in the IF (EPR, 28 days, interquartile range (IQR) 25 to 35; IF, 23 days, IQR 18 to 28; p < 0.001) The cause of non ambulation was mainly due to progression of cancer (89%). The rate of systemic complications was comparable between the two groups (EPR, 18%; IF, 22%; p = 0.598).

Conclusion

Selective use of EPR where survival is expected to be good offers correspondingly good long-term results. IF is less invasive with shorter treatment period, which is beneficial for patients with short-term expected survival. Prognosis is an important indicator in selecting operative procedures for femoral metastasis. Cite this article: Bone Joint J 2020;102-B(3):285–292
Factors affecting the outcomes of tibiotalocalcaneal fusion
Authors: Pitts Charles , Alexander Bradley , Washington Joshua , Barranco Hannah , Patel Romil , McGwin Gerald , Shah Ashish B.
Published: February 2020

Aims

Tibiotalocalcaneal (TTC) fusion is used to treat a variety of conditions affecting the ankle and subtalar joint, including osteoarthritis (OA), Charcot arthropathy, avascular necrosis (AVN) of the talus, failed total ankle arthroplasty, and severe deformity. The prevalence of postoperative complications remains high due to the complexity of hindfoot disease seen in these patients. The aim of this study was to analyze the relationship between preoperative conditions and postoperative complications in order to predict the outcome following primary TTC fusion.

Methods

We retrospectively reviewed the medical records of 101 patients who underwent TTC fusion at the same institution between 2011 and 2019. Risk ratios (RRs) associated with age, sex, diabetes, cardiovascular disease, smoking, preoperative ankle deformity, and the use of bone graft during surgery were related to the postoperative complications. We determined from these data which pre- and perioperative factors significantly affected the outcome.

Results

Out of the 101 patients included in the study, 29 (28.7%) had nonunion, five (4.9%) required below-knee amputation (BKA), 40 (39.6%) returned to the operating theatre, 16 (15.8%) had hardware failure, and 22 (21.8%) had a postoperative infection. Patients with a preoperative diagnosis of Charcot arthropathy and non-traumatic OA had significantly higher nonunion rates of 44.4% (12 patients) and 39.1% (18 patients) (p = 0.016) and infection rates of 29.6% (eight patients) and 37% (17 patients) compared to patients with traumatic arthritis, respectively (p = 0.002). There was a significantly increased rate of nonunion in diabetic patients (RR 2.22; p = 0.010). Patients with chronic kidney disease were 2.37-times more likely to have a nonunion (p = 0.006). Patients aged over 60 years had more than a three-fold increase in the rate of postoperative infection (RR 3.60; p = 0.006). The use of bone graft appeared to be significantly protective against postoperative infection (p = 0.019).

Conclusion

We were able to confirm, in the largest series of TTC ankle fusions currently in the literature, that there remains a high rate of complications following this procedure. We found that patients with a Charcot or non-traumatic arthropathy had an increased risk of nonunion and postoperative infection compared to individuals with traumatic arthritis. Those with diabetes, chronic kidney disease, or aged over 60 years had an increased risk of nonunion. These findings help to confirm those of previous studies. Additionally, our study adds to the literature by showing that autologous bone graft may help in decreasing infection rates. These data can be useful to surgeons and patients when considering, discussing and planning TTC fusion. It helps surgeons further understand which patients are at a higher risk for postoperative complications when undergoing TTC fusion. Cite this article: Bone Joint J. 2020;102-B(3):345–351.
Rate and risk factors for wound complications after internal hemipelvectomy
Authors: Ogura Koichi , Boland Patrick J. , Fabbri Nicola , Healey John H.
Published: February 2020

Aims

Although internal hemipelvectomy is associated with a high incidence of morbidity, especially wound complications, few studies have examined rates of wound complications in these patients or have identified factors associated with the consequences. The present study aimed to: 1) determine the rate of wound and other complications requiring surgery after internal hemipelvectomy; and 2) identify factors that affect the rate of wound complications and can be used to stratify patients by risk of wound complications.

Methods

The medical records of 123 patients undergoing internal hemipelvectomy were retrospectively reviewed, with a focus on both overall complications and wound complications. Logistic regression analyses were performed to examine the association between host, tumour, and surgical factors and rates of postoperative wound complications.

Results

The overall rate of postoperative complications requiring surgery was 49.6%. Wound complications were observed in 34.1% of patients, hardware-related complications in 13.2%, graft-related complications in 9.1%, and local recurrence in 5.7%. On multivariate analysis, extrapelvic tumour extension (odds ratio (OR) 23.28; 95% confidence interval (CI), 1.97 to 274.67; p = 0.012), both intra- and extrapelvic tumour extension (OR 46.48; 95% CI, 3.50 to 617.77; p = 0.004), blood transfusion ≥ 20 units (OR 50.28; 95% CI, 1.63 to 1550.32; p = 0.025), vascular sacrifice of the internal iliac artery (OR 64.56; 95% CI, 6.33 to 658.43; p < 0.001), and use of a structural allograft (OR, 6.57; 95% CI, 1.70 to 25.34; p = 0.001) were significantly associated with postoperative wound complications.

Conclusion

Internal hemipelvectomy is associated with high rates of morbidity, especially wound complications. Several host, tumour, and surgical variables are associated with wound complications. The ability to stratify patients by risk of wound complications can help refine surgical and wound-healing planning and may lead to better outcomes in patients undergoing internal hemipelvectomy. Cite this article: Bone Joint J 2020;102-B(3):280–284
Ten techniques for improving navigated spinal surgery
Authors: Cawley Derek , Dhokia Rakesh , Sales James , Darwish Nagy , Molloy Sean
Published: February 2020

With the identification of literature shortfalls on the techniques employed in intraoperative navigated (ION) spinal surgery, we outline a number of measures which have been synthesised into a coherent operative technique. These include positioning, dissection, management of the reference frame, the grip, the angle of attack, the drill, the template, the pedicle screw, the wire, and navigated intrathecal analgesia. Optimizing techniques to improve accuracy allow an overall reduction of the repetition of the surgical steps with its associated productivity benefits including time, cost, radiation, and safety.

Cite this article: Bone Joint J 2020;102-B(3):371–375.
DSC/TG and SEM Studies of Synthesized Potassium Sulphamate (PS) and Potassium Dinitramide (KDN) Crystals
Authors: KUMAR Pratim , JOSHI Puran Chandra
Published: March 2020

In the present paper, thermal decomposition and crystal researches of synthesized potassium sulphamate (PS) and potassium dinitramide (KDN) crystals were studied using differential scanning calorimetry/ thermal gravimetry (DSC/TG) and scanning electron microscope (SEM) techniques, respectively. Initially, PS crystals were synthesized using sulphamic acid and potassium hydroxide pellets. Afterwards, PS crystals were used for synthesizing potassium dinitramide (KDN) crystals by the nitration of PS in sulfuric and nitric acid mixture. One sample of PS was used for studying DSC/TG curves, while three samples of KDN crystals were used for the studying DSC/TG curves. The three samples of KDN crystals which were used in the present studies are, a) stored KDN (1 month), b) stored KDN (2 months), and c) washed KDN. All the obtained DSC/TG curves of three KDN crystals are dissimilar to each other, and the probable reasons for this dissimilarity are discussed in the manuscript. For further clarifications, TG curve of KN was compared with the TG curves of three samples of KDN used in the present study. It was observed that, while storage, KDN slowly converts into KN with some rate which gradually changes the physical and chemical properties of KDN.
Assessment of diesel engine characteristics fuelled by Jatropha with tamarind seed oil biodiesel
Authors: GOPIDESI Radha Krishna , GANGOLU Nageswara Rao
Published: March 2020

The present experimentation is carried out on a diesel engine using biodiesel as a fuel. The combination of lemongrass and tamarind seed methyl ester has replaced the diesel at various percentages. This investigation used three blends of biodiesels i.e. 10% of mixed methyl ester and 90% of pure diesel (B10) similarly B20, and B30. From the obtained results it was observed the enhanced brake thermal efficiency (BTE) for biodiesel blends as compared to the diesel. The blend B20 shows enhanced BTE than other samples, being around 20% higher than the diesel. The biodiesel blends show a reduction in HC and CO emissions and enhancement in CO2 and NOX emissions than the diesel. The highest heat release rate observed for B20 at a crank angle of 355° is 68.77 J/deg.
Development and validation of constraints handling in a Differential Evolution optimizer
Authors: HOTHAZIE Mihai-Vladut , ICHIM Georgiana , PRICOP Mihai-Victor
Published: March 2020

Research work requires independent, portable optimization tools for many applications, most often for problems where derivability of objective functions is not satisfied. Differential evolution optimization represents an alternative to the more complex, encryption based genetic algorithms. Various packages are available as freeware, but they lack constraints handling, while constrained optimizations packages are commercially available. However, the literature devoted to constraints treatment is significant and the current work is devoted to the implementation of such an optimizer, to be applied in low-fidelity optimization processes. The parameter free penalty scheme is adopted for implementation, and the code is validated against the CEC2006 benchmark test problems and compared with the genetic algorithm in MATLAB. Our paper underlines the implementation of constrained differential evolution by varying two parameters, a predefined parameter for feasibility and the scaling factor, to ensure the convergence of the solution.
Tribological aspects of some biodegradable magnesium alloys
Authors: ISTRATE Bogdan , MUNTEANU Corneliu
Published: March 2020

In recent years, biodegradable alloys have made their presence felt in a wide variety of fields, such as aeronautics, automotive and medical fields. Biodegradable alloys are considered to be the 3rd generation of biocompatible alloys, replacing classic alloys such as stainless steels and Co-Cr alloys. The paper aims to study the structural aspect and identify some mechanical characteristics of magnesium-calcium alloys used as biodegradable materials in the medical field. It has been observed the formation of a eutectic compound at the limit of magnesium grains and the relative constant value of the apparent coefficient of friction with increasing Ca concentration.
Explaining disparities in BMI trajectories among older adults: a test of the double jeopardy and intersectionality hypotheses
Authors: Liew Hui
Published: February 2020

This study aims to assess how heterogeneity in BMI trajectories differs across birth cohorts, race/ethnicity, gender and the level of education in the United States of America. Specifically, it seeks to examine whether the combined effects of race/ethnicity, sex and education on the differences in the BMI trajectories reflect the processes associated with double jeopardy and/or intersectionality. The empirical work of this study is based on the 1992–2014 Health and Retirement Study (HRS). Findings from growth curve modelling provide partial support for the intersectionality hypotheses. Findings revealed that different dimensions of inequality (such as race/ethnicity, sex and education) interact and intersect with one another to influence longitudinal change in BMI. Health programmes to reduce, prevent, delay or reverse the progression of obesity among the elderly should pay particular attention to Black people, females and females from racial/minority groups (Black, Hispanic, Other).
Design and in-orbit test of a high accuracy pointing method in satellite-to-ground quantum communication
Authors: Zhang Liang , Dai Jiansheng , Li Changkun , Wu Jincai , Jia Jianjun , Wang Jianyu
Published: February 2020

To meet the requirement of high-accuracy pointing of quantum signals in satellite-to-ground quantum communication, this paper proposes a flexible satellite-based pointing method that changes the fine tracking point to solve the problem from point-ahead angle and ground beacon laser offset. This method does not require the use of a point-ahead mechanism and can detect the pointing angle in real time. Detailed algorithms and analysis are given. The method has been verified in orbit on the quantum science satellite Micius. The satellite-to-ground test results show that the quantum signal pointing accuracy is between 0.5∼1.0 µrad, which meets the efficiency requirements of satellite-to-ground quantum communication.
Efficient room-temperature terahertz detection via bolometric and photothermoelectric effects in EuBiTe3 crystal
Authors: Niu Yingying , Wang Yingxin , Wu Weidong , Wen Jianguo , Cheng Yayun , Chen Meng , Jiang Shoulu , Wu Dong , Zhao Ziran
Published: February 2020

We report on terahertz (THz) detectors with a high performance at room
temperature using EuBiTe3 crystals as the active material
under mechanisms of bolometric and photothermoelectric effects (PTE).
Our detectors have a simple structure and can achieve high
sensitivity, even without a coupling antenna and optimization of the
thermal environment. Under bias conditions, our results suggest that
the bolometric responsivities of the EuBiTe3 photodetector
at 1.84, 2.52, and 3.11 THz are 0.35, 0.88 and 1.32 A/W in air, and
the noise-equivalent power (NEP) are 43.6, 16.4, 10.9
nW/Hz1/2, respectively. Under unbiased condition, our
device exhibits excellent PTE response for THz detection. As a
self-powered photodetector, it exhibits NEPs as low as 4.3
nW/Hz1/2 in air and 300 pW/Hz1/2 in vacuum under
the illumination of 2.52 THz, respectively. In addition, in order to
optimize detector performance, it is worthy for considering
manufacturing two-dimensional(2D) structural devices for the layered
structure of EuBiTe3 crystal. Our devices provide an
exciting way toward developing efficient and high-performance room
temperature THz photodetectors.
A Importância da Influência do Profissional de Saúde no Aleitamento Materno / The Importance of Health Professional Influence on Breastfeeding
Authors: Bento Débora Aparecida Beneval , Oliveira Mardja Keyla Alencar de , Souza Maria Clara Torres e , Senhor Renata Francy Lucena , Alves Patricia Ferreira , Araujo Maria do Socorro Vandelande de , Bento Elizangela Beneval
Published: February 2020

O leite materno é o alimento básico para o recém-nascido. Ele oferece inúmeros benefícios fisiológicos, com adequadas quantidades de nutrientes, elementos imunogênicos que representam a primeira imunização passiva da criança. Contribui com benefícios a mãe, a criança, a família, e deve ser incentivado principalmente através de orientações e estratégias educativas durante os períodos pré e pós natais mediadas por equipe multidisciplinar de saúde. Uma combinação única de proteínas, lipídios, carboidratos, minerais, vitaminas, enzimas e células vivas, assim como benefícios nutricionais imunológicos, desenvolvimento, especialmente para o prematuro, devido a sua maior vulnerabilidade. Este trabalho teve como objetivo avaliar a prática de profissionais de saúde na promoção e no apoio à amamentação. O estudo trata-se de uma revisão integrativa da literatura, identificando as contribuições dos estudos referentes à aleitamento materno na literatura brasileira. A amamentação é influenciada pelo o ambiente, considera-se importante trabalhar nas instituições de saúde que atendem puérperas e RNs, nas unidades de alojamento conjunto e neonatal, e humanização em saúde. A pesquisa revelou que amamentação é um desafio para o profissional de saúde, e que estes precisam ser sempre capacitados para trabalhar a promoção do aleitamento materno.
DECLARE-TIMI 58 trial in the context of EMPA-REG OUTCOME and CANVAS
Authors: Shestakova Marina V.
Published: February 2020

The article discussed results of the DECLARE-TIMI 58 study in the aspects of the previously finished trials (EMPA-REG OUTCOME and CANVAS).
All three SGLT2i demonstrated the reduction of the risk of hospitalization for heart failure, as well as the risk of progression chronic kidney disease. At the same time, the patient populations are different. In EMPA-REG OUTCOME almost all the patients had previously diagnosed cardiovascular disease; in CANVAS 44.4% of patients did not have a confirmed cardiovascular disease, but had cardiovascular risk factors, and in DECLARE TIMI 58 there were 59% of such patients.
Assessment of the published data suggests that the risk of a combined cardiovascular endpoint, including death from cardiovascular causes, myocardial infarction, and stroke, seems to be most pronounced in patients who already have established cardiovascular disease, and this effect is achieved mainly by reducing cardiovascular mortality. In the population of patients with type 2 diabetes who do not have cardiovascular disease, but who have cardiovascular risk factors, this effect is not detected.
Contrary, risk-reduction of hospitalization for CHF and slowing the progression of CKD is manifested both in a population of patients with established cardiovascular disease and in the population of patients with multiple cardiovascular risk factors.
In this regard, DECLARE-TIMI 58, as well as previously published data, open up new option for an earlier start of SGLT-2i for primary prevention and/or slowing the progression of nephropathy, reducing the risk of heart failure, and its prevention, as well as reduction of cardiovascular morbidity and mortality in patients with type 2 diabetes, regardless of the presence or absence of cardiovascular pathology in the anamnesis.
Type 2 diabetes mellitus in elderly patients treated with endocrinologists in clinical practice
Authors: Biryukova Elena V.
Published: February 2020

A large-scale epidemic of type 2 diabetes mellitus (T2DM) is observed with advanced ageing worldwide. The prevalence of T2DM significantly increases with age. Therefore, this review aimed to summarise the data on T2DM in advanced and older aged patients. The primary geriatric syndromes, which should be considered for the management of older patients (cognitive impairment, sarcopenia, orthostatic hypotension, falls, urinary incontinence, senile asthenia, etc.), are presented. The causes of the high risk for hypoglycaemia in elderly patients are analysed. Improving the treatment for T2DM is a priority of modern medicine. Using antihyperglycaemic therapy is especially difficult in this population due to the high risk of hypoglycaemia and the multi-organ pathology leading to polypharmacy. Therefore, special attention is paid to treatment recommendations. Hypoglycaemic drugs used in elderly patients should be low risk of hypoglycaemia, without nephro- and hepatic toxicity, safe for cardiovascular organs, easy to administer. Furthermore, advantages and limitations of using various groups of hypoglycaemic drugs in elderly patients are discussed. DPP-4 inhibitors are also considered in detail. Modern data on mechanisms of hypoglycaemic action of DPP-4 inhibitors are presented. Possibilities of using sitagliptin in elderly patients were also considered. Finally, evidence-based studies demonstrating the obvious advantages of sitagliptin for the treatment of T2DM in the elderly and advanced aged population are discussed.
An economic value of the glycated hemoglobin test in diabetes mellitus type 2 diagnosis
Authors: Shestakova Marina V. , Kolbin Alexey S. , Karpov Oleg I. , Galstyan Gagik R. , Mayorov Alexander Y. , Arepeva Maria A. , Kurylev Aleksey A. , Proskurin Maxim A.
Published: February 2020

BACKGROUND: Diagnostic of diabetes mellitus type 2 (DM2T) in time is very actual for treatment and prevention of potential complications of illness. Fasting blood glucose test (FBG) is a widely used method of primary DM2T diagnose. Glycated hemoglobin (HbA1c) test is an alternative and used more rarely due to expensive.
AIM: Modelling of comparative expenditures for DM2T control in cases of primary diagnostic by HbA1c test or FBG test usage in 20-years horizon.
METHODS: Retrospective analysis of aggregated epidemiological Russian NATION study data in 810 patients with prediabetes and DM2T with both analysis performed, with sensitivity and specificity of each is detected. The simulation model of DM2T outcomes has been used for Health Technology assessment (direct and indirect costs of Diabetes control during 20 years). Three algorithms of the DM2T treatment were investigated for understanding of expenditures in case on diagnostic on-time and case of late verification with metformin, gliflozines, gliptins, Glucagon-like peptide-1 receptor agonists, basal insulin analogs and their combinations.
RESULTS: FBG test has more negative results for DM2T diagnostics in compare with HbA1c analysis (77,4% and 36,5% accordingly). Amount of false negative results in FBG test in 3 times more often occurred in comparison with HbA1c. HbA1c test in 3 times more precisely than FBG test for carbon metabolism abnormalities detection. Diagnostic in time with HbA1c test in compare with late process of illness detection by FBG can cut common expenditures on 26,3-27,7% depending on treatment option due to macrovasular complications decreasing. Disability rate is expected decrease on 21% to 20-th year in case of diagnostic with HbA1c performing instead FBG test.
CONCLUSION: HbA1c test has diagnostic advantages in compare with FBG test for primary investigation (dispanserization). Direct and indirect expenditures in average for one patient with DM2T on 20-years horizon including cost of drugs, analysis, complications, disabilities are less in case of diagnostic in time with HbA1c test in comparison with late diagnostics in case of FBG test execution.
Pilot study of the safety and efficacy of angiogenic therapy in diabetic foot syndrome
Authors: Plaksa Igor L. , Mzhavanadze Nina D. , Kalinin Roman E. , Suchkov Igor A. , Bakunov Michail U. , Krivichin Vyacheslav T. , Matveev Sergey A. , Isaev Artur A. , Deev Roman V.
Published: February 2020

BACKGROUND: The syndrome of diabetic foot remains the main cause of non-traumatic amputation of the lower extremity in the world. Even with the provision of comprehensive medical care in the conditions of a specialized center, 10-15% of patients do not succeed in healing the ulcerative defect due to the ischemic component.
AIMS: The objective of this study is evaluation of safety and efficacy of pl-VEGF165 transfer in patients with neuroischemic type of diabetic foot syndrome.
METHODS: The pilot study included 35 diabetic patients with neuroischemic foot ulcers (Wagner stage 1-2) who were not candidates for revascularization procedures (NCT02538705). The patients were closely monitored after repeated pl-VEGF165 intramuscular gene transfer (2,4 mg) at 1, 3, and 6 months after treatment. The primary efficacy endpoint was the surface area of the ulcers (sq.cm), the secondary endpoints were transcutaneous oxygen tension (Tcp02), ankle-brachial index (ABI), neuropathy disability score (NDS), neuropathy symptoms score (NSS), and Michigan neuropathy screening instrument (MNSI). Adverse events were monitored throughout the study.
RESULTS: The use of pl-VEGF165 as part of complex treatment allowed to achieve wound healing in 65,7% of patients with chronic ulcerative defects, the safety of the target limb was 84%. Carrying out therapeutic angiogenesis as a part of the combined therapy ensured a reduction in the average area of the resistant to treatment defects from 3.6 [1.0; 7.05] cm2 to 0.0 [0.0;2.0] cm2 (p=0,001), which correlated with an increase in the TcPo2 index by 15% from 35 [29.5; 40.5] to 40.5 [36.0; 46.5] mm Hg (p= p=0,005) and in the ABI by 16% from 0.96 [0.82;1.08] to 1.11 [0.85; 1.24] (p=0,062). The decrease in the signs of diabetic neuropathy was determined - the scores of NSS scales and VAT decreased from 6,5 [5.75; 8.0) to 6.0 [5.25; 7.0] (p=0,004) and from 9.0 [8.0; 13.5] to 8.0 [7.0; 12.7] (p=0,001), respectively. No adverse effects associated with the use of pl-VEGF165 were recorded.
CONCLUSIONS: Thus, preliminary results of the pilot study show that the use of pl-VEGF165 gene transfer in combination therapy allows for complete healing of neuroischemic diabetic foot ulcers in the majority of patients.
Aristotle on Self-Sufficiency, External Goods, and Contemplation
Authors: Gasser-Wingate Marc
Published: February 2020

Aristotle tells us that contemplation is the most self-sufficient form of virtuous activity: we can contemplate alone, and with minimal resources, while moral virtues like courage require other individuals to be courageous towards, or courageous with. This is hard to square with the rest of his discussion of self-sufficiency in the Ethics: Aristotle doesn‘t generally seek to minimize the number of resources necessary for a flourishing human life, and seems happy to grant that such a life will be self-sufficient despite requiring a lot of external goods. In this paper I develop an interpretation of self-sufficiency as a form of independence from external contributors to our activity, and argue that this interpretation accounts both for Aristotle‘s views on contemplation and for the role self-sufficiency plays in his broader account of human happiness.
Perception and Pluralism: Leibniz’s Theological Derivation of Perception in Connection with Platonism, Rationalism and Substance Monism
Authors: Robert Gastón
Published: February 2020

This article discusses Leibniz’s claim that every substance is endowed with the property of perception in connection with Platonism, rationalism and the problem of substance monism. It is argued that Leibniz’s ascription of perception to every substance relies on his Platonic conception of finite things as imitations of God, in whom there is ‘infinite perception’. Leibniz’s Platonism, however, goes beyond the notion of imitation, including also the emanative causal relation and the logical (i.e. definitional) priority of the absolute over the limited. It is proposed that Leibniz’s endorsement of Platonism, in conjunction with some rationalist elements of his philosophy, implies a monistic conception of particulars as modifications of a single substance. Following some scholars and opposing others, the article offers evidence that Leibniz accepted this implication during the last years of his Paris period. However, it is further argued that it was precisely the idea of perception as a property of every substance that allowed Leibniz to find a way out of monism after that period. More specifically, the article defends the view that what made room for ontological pluralism within Leibniz’s rationalist and Platonic outlook was the idea that perception is the property which constitutes the very being of substances: substancesaretheir perceptions.
The Kantian Capacity for Moral Self-Control: Abstraction at Two Levels
Authors: Vujoševiċ Marijana
Published: February 2020

As a rule, the Kantian capacity for self-control is interpreted as a kind of tool for compelling ourselves to act on the basis of the maxims we have adopted. To the extent that we merely acknowledge its role in following already-adopted maxims, however, we fail to capture the distinctive aspect of moral self-control identified by Kant. In this paper, I propose a fuller account of the Kantian capacity for moral self-control; I do so mainly by analyzing this capacity as our ability to “abstract from” various sensible impressions. This analysis shows that Kant’s conception of moral self-control involves two intimately related levels, which are subject to different criteria. Whereas the first level is connected to our ability to adopt moral maxims and requires that we abstract from all sensible impressions, the second is associated with our ability to follow these maxims and does not necessarily require this radical abstraction.
Legal Contests with Unilateral Delegation
Authors: Park Sung-Hoon , Lee Sanghack
Published: March 2020

We examine a legal contest in which only one litigant hires a delegate who expends his effort on behalf of the litigant. The delegation contract between the litigant and the delegate is either observable or unobservable. Comparing the equilibrium outcomes of the two legal contests, we derive the effect of the observability of the contract. We find that the favorite litigant and his delegate prefer the observable contract to the unobservable one. If the litigant is the underdog, however, there is conflict of interest between the litigant and his delegate as the litigant prefers the observable contract to the unobservable one while his delegate prefers the unobservable contract. We also show that the legal contest with the observable contract incurs more total expenditure than the legal contest with the unobservable contract if the litigant hiring the delegate is the favorite, and vice versa.
Psychotherapist’s empathic responses to client’s troubles telling/feelings talk in psychotherapy: A conversation analysis
Authors: Wu Yijin
Published: March 2020

Using the method of conversation analysis, this study has examined the sequential organization of empathic talk in psychotherapy, analyzed its turn design as well as investigated its variations on turn construction. The empathic sequence can be characterized as a four-part structure: (1) the therapist soliciting troubles/feeling telling from the client; (2) the client’s report on the troubles/feelings talk; (3) the therapist’s empathy, and (4) the client’s response. Moreover, in addition to its unmarked turn construction “empathic talk without prefacing”, this study has found empathic talk takes on other three types of turn construction including so-prefaced empathic talk, particle-prefaced empathic talk and particle(s)+so-prefaced empathic talk. The research findings could reveal the interactional details of empathy in psychotherapy and thus contributes to the understanding of the nature and process of psychotherapy and counselling.
Time, the deer, is in the wood: Chronotopic identities, trajectories of texts and community self-management
Authors: Bartlett Tom
Published: March 2020

This paper opens with a problematisation of the notion ofreal-timein discourse analysis – dissected, as it is, as if time unfolded in a linear and regular procession at the speed of speech. To illustrate this point, the author combines Hasan’s concept of “relevant context” with Bakhtin’s notion of the chronotope to provide an analysis of Sorley MacLean’s poemHallaig, with its deep-rootedness in space and its dissolution of time. The remainder of the paper is dedicated to following the poem’s metamorphoses and trajectory as it intertwines with Bartlett’s own life and family history, creating a layered simultaneity of meanings orienting to multiple semio-historic centres. In this way the author (pers. comm.) “sets out to illustrate in theory, text analysis and (self-)history the trajectories taken by texts as they cross through time and space; their interconnectedness with social systems at different scales; and the manner in which they are revoiced in order to enhance their legitimacy before the diverse audiences they encounter on their migratory paths.” In this process, Bartlett relates his own story to the socioeconomic concerns of the Hebridean island where his father was raised, and to dialogues between local communities and national and external policy-makers – so echoing Denzin’s call (2014.Interpretive Autoethnography (2nd Edition). Los Angeles: Sage: vii) to “develop a methodology that allows us examine how the private troubles of individuals are connected to public issues and to public responses to these troubles”. Bartlett presents his data through a range of legitimation strategies and voicing techniques, creating transgressive texts that question received notions of identity, authorship, legitimacy and authenticity in academia, the portals of power, and the routines of daily life. The current Abstract is one such example. As with the author’s closing caveat on the potential dangers of self-revelation, offered, no doubt, as a flimsy justification for the extensive focus in the paper on his own life as a chronotope, I leave it for the individual reader to decide if Bartlett’s approach is ultimately ludic or simply ludicrous.
Heterotopien des Feierns
Authors: Hoder Manuel
Published: February 2020

In so far as Arthurian narrative can be considered to be a utopian project, it converges in the festival motif at the Arthurian court. However, the festival ideal in particular is in danger of losing grip on reality as the process of literalizing Arthurian Romances advances. In this context the final festivities in the Arthurian Romances of the Pleier serve as a mediating principle. By connecting the leitmotifs of the histoire with his depiction of festivity scenes, the Pleier conceptualizes them as a space in which courtly norms are negotiated in a lively fashion. The festival scenes thus serve as venues for representation and reflection, thereby becoming ›heterotopias of celebrating‹.
Vulnerabilitätsmetaphern und Narrativierungsstrategien in den ›Offenbarungen‹ und der ›Vita‹ Elsbeths von Oye
Authors: Müller Mareike von
Published: February 2020

Due to highly unstructured, redundant, and ambiguous descriptions of bloody self-flagellations by the writing self, the ›revelations‹ of Elsbeth von Oye present themselves as a challenge for research. Elsbeth’s ›vita‹ however seeks to eliminate those bewildering elements and repositions many textual passages. Considering both texts, this article examines the approaches for narrative transformation as well as the deliberate refusal of making narrative sense. While the reorganization of the material in the ›vita‹ has a strong impact on the creation of a narrative sense, the ›revelations‹ seem to purposely decline narrative patterns to build a concept of holiness, which orientates towards legendary texts.
Estimation of the total antioxidant potential in the meat samples using thin-layer chromatography
Authors: Piszcz Paweł , Tomaszewska Magdalena , Głód Bronisław K.
Published: February 2020

There is limited literature on the antioxidative properties of food of animal origin. Measurements of antioxidative properties are usually performed using the reaction of reduction of colored 2,2-diphenyl-1-picrylhydrazyl (DPPH) radials. Changes of the DPPH color are tracked photometrically. These measurements are interfered by both, the tested samples and reduced DPPH. This study aims to demonstrate the ability to separate different forms of DPPH (DPPH•and DPPH-H) by thin-layer chromatography (TLC). Further, it has been practically applied in the study of the determination of antioxidative properties of the meat samples. It was found that TLC can be used for the separation of different forms of DPPH as well as for measurement of TAP (total antioxidant potential) values related to the DPPH•. The strongest antioxidant properties were observed for pork neck extracted in buffer pH 2 and for smoked salmon fish extracted in acetone, the lowest for veal and turkey fillet extracted in methanol.
Averages Along the Primes: Improving and Sparse Bounds
Authors: Han Rui , Krause Ben , Lacey Michael T. , Yang Fan
Published: February 2020

Consider averages along the prime integers ℙ given by

𝒜

N

f
(
x
)
=

N

-
1

∑

p
∈
𝕇
:
p
≤
N

(
log
p
)
f
(
x
-
p
)
.

{\mathcal{A}_N}f(x) = {N^{ - 1}}\sum\limits_{p \in \mathbb{P}:p \le N} {(\log p)f(x - p).}

These averages satisfy a uniform scale-free ℓ

p
-improving estimate. For all 1 < p < 2, there is a constant C

p
so that for all integer N and functions f supported on [0, N], there holds

N

-
1
/

p
′

‖

𝒜

N

f

‖

𝓁

p
′

≤

C

p

N

-
1
/
p

‖
f
‖

𝓁
p

.

{N^{ - 1/p'}}{\left\| {{\mathcal{A}_N}f} \right\|_{\ell p'}} \le {C_p}{N^{ - 1/p}}{\left\| f \right\|_{\ell p}}.

The maximal function 𝒜*
f = sup
N
|𝒜
N f | satisfies (p, p) sparse bounds for all 1 < p < 2. The latter are the natural variants of the scale-free bounds. As a corollary, 𝒜* is bounded on ℓ

p
(w), for all weights w in the Muckenhoupt 𝒜
p
class. No prior weighted inequalities for 𝒜* were known.
Evaluation of corrosion inhibition and adsorption behavior of Thymuszygis subsp. gracilis volatile compounds on mild steel surface in 1 m HCl
Authors: Ouknin Mohamed , Romane Abderrahmane , Ponthiaux Jean-Pierre , Costa Jean , Majidi Lhou
Published: February 2020

The inhibition effect ofThymus zygissubsp.gracilis(TZ) on mild steel corrosion in 1mhydrochloric acid has been investigated by weight loss measurements, surface analysis [scanning electron microscopy (SEM)-energy-dispersive X-ray (EDX), three-dimensional (3D) profilometry, and Fourier transform infrared analysis], potentiodynamic polarization, and electrochemical impedance spectroscopy (EIS). Gravimetric results indicate that TZ exhibits good inhibition efficiency of 80.40% attained at 3 g/l. Polarization measurements show that the studied inhibitor is a mixed type. EIS measurements revealed that the charge transfer resistance increases with increasing concentration of TZ, which suggests a Langmuir adsorption isotherm model. Based on SEM-EDX and 3D profilometry, it appears that the surface is remarkably improved in the presence of TZ oil compared to that exposed to the acid medium without TZ oil. From the obtained results, it can be concluded that this oil is a new natural substance that can be used against material corrosion in aggressive medium.