Los desafíos de protección de la movilidad

Es fácil decir que las personas que huyen de Siria deben permanecer en campamentos o ciudades satélites, pero las personas se trasladan por diversas razones, por lo que los programas y servicios deben adaptarse para ayudarles

Breaking the Negative Cycle: Exploring the Design Space of Stratification for First-Class Datalog Constraints

The ?_Dat calculus brings together the power of functional and declarative logic programming in one language. In ?_Dat, Datalog constraints are first-class values that can be constructed, passed around as arguments, returned, composed with other constraints, and solved. A significant part of the expressive power of Datalog comes from the use of negation. Stratified negation is a particularly simple and practical form of negation accessible to ordinary programmers. Stratification requires that Datalog programs must not use recursion through negation. For a Datalog program, this requirement is straightforward to check, but for a ?_Dat program, it is not so simple: A ?_Dat program constructs, composes, and solves Datalog programs at runtime. Hence stratification cannot readily be determined at compile-time. In this paper, we explore the design space of stratification for ?_Dat. We investigate strategies to ensure, at compile-time, that programs constructed at runtime are guaranteed to be stratified, and we argue that previous design choices in the Flix programming language have been suboptimal

Restrictable Variants: A Simple and Practical Alternative to Extensible Variants (Artifact)

In this artifact, we provide an implementation of the ?^res_var calculus, as described in the related article. The implementation is an extension of the Flix programming language compiler, supporting restrictable variants and the two partial pattern-matching constructs: choose and choose-?. The artifact consists of the extended Flix compiler, a Visual Studio Code extension supporting common IDE features such as syntax highlighting and type hovering, and a collection of Flix files demonstrating the use of restrictable variants. The Flix files correspond to examples presented in the paper. Users are invited to modify the Flix files in order to observe the influence of their changes on the inferred types in the provided programs

Restrictable Variants: A Simple and Practical Alternative to Extensible Variants

We propose restrictable variants as a simple and practical alternative to extensible variants. Restrictable variants combine nominal and structural typing: a restrictable variant is an algebraic data type indexed by a type-level set formula that captures its set of active labels. We introduce new pattern-matching constructs that allows programmers to write functions that only match on a subset of variants, i.e., pattern-matches may be non-exhaustive. We then present a type system for restrictable variants which ensures that such non-exhaustive matches cannot get stuck at runtime. An essential feature of restrictable variants is that the type system can capture structure-preserving transformations: specifically the introduction and elimination of variants. This property is important for writing reusable functions, yet many row-based extensible variant systems lack it. In this paper, we present a calculus with restrictable variants, two partial pattern-matching constructs, and a type system that ensures progress and preservation. The type system extends Hindley-Milner with restrictable variants and supports type inference with an extension of Algorithm W with Boolean unification. We implement restrictable variants as an extension of the Flix programming language and conduct a few case studies to illustrate their practical usefulness

Skeletal Fragility in Type 2 Diabetes Mellitus

Type 2 diabetes (T2D) is associated with an increased risk of fracture, which has been reported in several epidemiological studies. However, bone mineral density in T2D is increased and underestimates the fracture risk. Common risk factors for fracture do not fully explain the increased fracture risk observed in patients with T2D. We propose that the pathogenesis of increased fracture risk in T2D is due to low bone turnover caused by osteocyte dysfunction resulting in bone microcracks and fractures. Increased levels of sclerostin may mediate the low bone turnover and may be a novel marker of increased fracture risk, although further research is needed. An impaired incretin response in T2D may also affect bone turnover. Accumulation of advanced glycosylation endproducts may also impair bone strength. Concerning antidiabetic medication, the glitazones are detrimental to bone health and associated with increased fracture risk, and the sulphonylureas may increase fracture risk by causing hypoglycemia. So far, the results on the effect of other antidiabetics are ambiguous. No specific guideline for the management of bone disease in T2D is available and current evidence on the effects of antiosteoporotic medication in T2D is sparse. The aim of this review is to collate current evidence of the pathogenesis, detection and treatment of diabetic bone disease

Alendronate Use and Risk of Type 2 Diabetes:A Nationwide Danish Nested Case-Control Study

OBJECTIVE: A link has been proposed between glucose homeostasis and bone metabolism. Bisphosphonates are first-line treatment of osteoporosis, and we aimed to investigate whether the risk of developing type 2 diabetes was associated with prior use of alendronate. RESEARCH DESIGN AND METHODS: We conducted a population-based nested case-control study through access to all discharge diagnoses (ICD-10 system) from the National Danish Patient Registry along with all redeemed drug prescriptions (ATC classification system) from the Health Service Prescription Registry. All cases with a diagnosis of type 2 diabetes between 2008 and 2018 were matched on sex and age with 3 randomly selected controls by incidence-density sampling. Exposure was defined as ever use of alendronate and further grouped as effective and compliant use. ORs were calculated by conditional logistic regression analysis with adjustment for several confounders and test for trend for dose-response relationship. RESULTS: We included 163,588 patients with type 2 diabetes and 490,764 matched control subjects with a mean age of 67 years and 55% male subjects. The odds of developing type 2 diabetes were lower among ever users of alendronate (multiple adjusted OR: 0.64 [95% CI 0.62-0.66]). A test for trend suggested a dose-response relationship between longer effective use of alendronate and lower risk of type 2 diabetes. CONCLUSION: These results suggest a possible protective effect of alendronate in a dose-dependent manner against development of type 2 diabetes

The Efficacy of Alendronate Versus Denosumab on Major Osteoporotic Fracture Risk in Elderly Patients With Diabetes Mellitus:A Danish Retrospective Cohort Study

OBJECTIVE: Patients with diabetes mellitus have an increased risk of fractures; however, the underlying mechanism is largely unknown. We aimed to investigate whether the risk of major osteoporotic fractures in diabetes patients differs between subjects initiated with alendronate and denosumab, respectively. METHODS AND RESEARCH DESIGN: We conducted a retrospective nationwide cohort study through access to all discharge diagnoses (ICD-10 system) from the National Danish Patient Registry along with all redeemed drug prescriptions (ATC classification system) from the Health Service Prescription Registry. We identified all subjects with a diabetes diagnosis between 2000 and 2018 and collected data on the first new prescription of anti-osteoporotic treatment between 2011 and 2018. Exposure was defined as either alendronate or denosumab treatment initiated after diabetes diagnosis. Outcome information was collected by identification of all major osteoporotic fracture (MOF) diagnoses, i.e., hip, spine, forearm, and humerus, from exposure until 2018 or censoring by emigration or death. The risk of fracture was calculated as hazard ratios (HR) using multiply adjusted Cox proportional models with death as a competing risk. RESULTS: We included 8,745 subjects initiated with either alendronate (n = 8,255) or denosumab (n = 490). The cohort consisted of subjects with a mean age of 73.62 (SD ± 9.27) years, primarily females (69%) and suffering mainly from type 2 diabetes (98.22%) with a median diabetes duration at baseline of 5.45 years (IQR 2.41–9.19). Those in the denosumab group were older (mean 75.60 [SD ± 9.72] versus 73.51 [SD ± 9.23] years), had a higher proportion of women (81% versus 68%, RR 1.18 [95% CI 1.13–1.24], and were more comorbid (mean CCI 2.68 [95% CI 2.47–2.88] versus 1.98 [95% CI 1.93–2.02]) compared to alendronate initiators. In addition, denosumab users had a higher prevalence of previous fractures (64% versus 46%, RR 1.38 [95% CI 1.28–1.48]). The adjusted HR for any MOF after treatment initiation with denosumab was 0.89 (95% CI 0.78–1.02) compared to initiation with alendronate. CONCLUSION: The risk of incident MOF among subjects with diabetes was similar between those initially treated with alendronate and denosumab. These findings indicate that the two treatment strategies are equally effective in preventing osteoporotic fractures in subjects with diabetes