Decrease of cardiovascular risk in patients with type 2 diabetes: review of the common strategies and clinical studies

Military Medical Academy of S.M. Kirov, Saint-Petersburg, Russia Recent clinical trials about the cardiovascular safety of empagliflozin and liraglutide demonstrated a convincing lowering effect on mortality from cardiovascular causes among the patients with type 2 diabetes. These findings resulted in many questions about why this phenomenon was seen in two drugs with widely different mechanisms of functioning. It is important to note that the glucose-lowering effect was moderate, although a feature seen in both empagliflozin and liraglutide was their ability to increase insulin sensitivity. In many fundamental studies, this feature was associated with a reduction of cardiovascular risks. Insulin resistance, which has always been a pathophysiological base for the development of cardiovascular disease in patients with type 2 diabetes, is a topic for this report. Different methods to manage insulin resistance, including lifestyle changes, drug treatment and metabolic surgery, are discussed. Furthermore, the most common features of glucose-lowering drugs are analysed, including protective effects for cardiovascular outcomes in patients with type 2 diabetes presented in randomised clinical trials. Studies include the United Kingdom Prospective Diabetes Study (UKPDS), PROspective pioglitAzone Clinical Trial In macroVascular Events (PROactive), Insulin Resistance Intervention After Stroke (IRIS), Liraglutide Effect and Action in Diabetes: Evaluation of Cardiovascular Outcome Results (LEADER) and the Empagliflozin Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients (EMPA-REG OUTCOME). The current study shows that the potential to reduce the risk of cardiovascular disease is determined not only by effective lowering of glucose but also by the ability to lower insulin resistance, which causes a paradigm shift in the management of type 2 diabetes

SGLT2 inhibitors and kidneys: mechanisms and main effects in diabetes mellitus patients

Type 2 diabetes mellitus (T2DM) is the cause of the development of diabetic nephropathy — a complication that determines the high degree of disability and mortality of such patients. Until recently, approaches to normalizing glucose levels did not have a significant possibility of influencing the outcome of kidney damage in diabetes. Type 2 sodium glucose cotransporter inhibitors (SGLT2) are a new class of glucose-lowering drugs that improve glycemic control due to an insulin-independent mechanism of action associated with increased urinary glucose excretion. The review provides an analysis of the results of studies on the assessment of nephroprotective actions — one of the pleiotropic actions of this drugs group. These materials show the properties of SGLT2 inhibitors to reduce the risk of developing and the progression of albuminuria, to save glomerular filtration rate, to reduce the frequency of end-stage renal disease and the need for renal replacement therapy in patients with T2DM. The article gives and analyzes the currently existing hypotheses of the mechanism of action of these glucose-lowering drugs. The risk of the most common renal complications with the use of SGLT2 inhibitors is considered. The practical aspects of the use of SGLT2 inhibitors in modern algorithms for the care of patients with T2DM are indicated, as well as the prospects for new randomized clinical trials

Field camera unit of the WSO-UV mission

The main instrument of the space mission "Spectr-UF" (World Space Observatory-Ultraviolet) is a large space telescope to work in the UV wavelength domain (115 - 310 nm). The WSO-UV telescope feeds in its focal plane two main instruments: unit of spectrographs WUVS, and field camera unit FCU, as well as Fine Guidance System (FGS). The imaging instrument FCU onboard WSO-UV will be the first UV camera to be flown to a geosynchronous orbit. Here we provide a brief description on updated FCU instrument and its current status

Teaching Engineering Ethics. .pdf

The following is a presentation for our Engineering Ethics class at the New Jersey Institute of Technology.  We explored various methods of integrating ethics into engineering curriculum.  Our research also includes means of assessing ethics related courses.  Our research culminates in what we believe to be the ideal engineering ethics course

Electron paramagnetic resonance study of Ce doped partially stabilized ZrO2 crystals

ZrO2 (PSZ) solid solutions crystals stabilized with yttrium and cerium oxides have been studied using electron paramagnetic resonance (EPR) in the X and Q ranges. Zr3+ have been observed centers in the as-annealed ZrO2 crystals stabilized only by yttrium oxide (2.8 mol% Y2O3). Another type of paramagnetic-O-centers appear as a result of CeO2 addition to ZrO2 crystals along with yttrium oxide. To estimate the concentration of Ce3+ ions in PZS crystals, we recorded the EPR spectra in the presence of a reference at 7 K. Paramagnetic Ce3+ ions have been identified and their relative amount in the PSZ crystals before and after high-temperature heat treatment has been assessed. Annealing in air leads decreases the concentration of Ce3+ ions for all the test compositions and changes the color of the crystals from red to white. After annealing of the sample 2.0Y0.8Ce3Zr, the amount of paramagnetic Ce3+ ions decreased approximately twofold. Paramagnetic centers from Ce3+ have not been detected in the specimen with a low cerium content of 0.1 mol% after annealing which indicates the complete transition of Ce3+ to the Ce4+ state. We show that the forming cerium paramagnetic centers are bound by strong exchange interactions. No angular dependence of the EPR lines of the paramagnetic Ce3+ cations on the applied external magnetic field has been observed. Probable origin of the absence of angular dependence is that the impurity rare-earth ions are located close to one another, forming impurity clusters with an effective spin of Seff=1/2

Deposition rate effect on microstructure and perpendicular magnetic anisotropy of iron films prepared by ion-beam-assisted deposition

Thin films of iron with different thickness (⁓40-300 nm) were deposited on quartz and silicon substrates by using ion beam assisted deposition (IBAD) technique. The influence of film thickness and deposition rate on microstructure, magnetic phase composition and perpendicular magnetic anisotropy (PMA) of iron films were studied by electron microscopy, X-ray diffraction, Mössbauer spectroscopy, vibrating-sample magnetometry and differential thermomagnetic analysis. Shown, that phase composition and magnetic properties of films depend substantially on the deposition rate, and, in fact, don't depend on both film thickness and the type of substrate. The strong PMA is observed in iron films formed at low (~3 nm/min) and medium (~10 nm/min) deposition rates only. The microstructure is characterized by the presence of nanocrystalline grains of α-Fe phase, as well as a significant fraction of disordered iron phase and nonmagnetic oxide phase of FeO (up to 20%). The FeO phase occurs due to the reaction of iron atoms with the residual atmosphere of the vacuum chamber. Moreover, significant positive deformation (about 3%) of crystal lattice of α-Fe grains was observed. The effect of deposition rate on the crystallinity, phase composition and PMA in thin iron films we associate with the features of the IBAD process.108860-1-108860-

Revaccination in Age-Risk Groups with Sputnik V Is Immunologically Effective and Depends on the Initial Neutralizing SARS-CoV-2 IgG Antibodies Level

Vaccination against COVID-19 has occurred in Russia for more than two years. According to the Russian official clinical guidelines to maintain tense immunity in the conditions of the ongoing COVID-19 pandemic, it is necessary to use booster immunization six months after primary vaccination or a previous COVID-19 contraction. It is especially important to ensure the maintenance of protective immunity in the elderly, who are at risk of severe courses of COVID-19. Meanwhile, the immunological effectiveness of the booster doses has not been sufficiently substantiated. To investigate the immunogenicity of Sputnik V within the recommended revaccination regimen and evaluate the effectiveness of booster doses, we conducted this study on 3983 samples obtained from individuals previously vaccinated with Sputnik V in Moscow. We analyzed the level of antibodies in BAU/mL three times: (i) six months after primary immunization immediately before the booster (RV), (ii) 3 weeks after the introduction of the first component of the booster (RV1), and (iii) 3 weeks after the introduction of the second component of the booster (RV2). Six months after the primary vaccination with Sputnik V, 95.5% of patients maintained a positive level of IgG antibodies to the receptor-binding domain (RBD) of SARS-CoV-2. The degree of increase in the specific virus-neutralizing antibodies level after revaccination increased with a decrease in their initial level just before the booster dose application. In the group of people with the level of antibodies up to 100 BAU/mL six months after the vaccination, a more than eightfold increase (p p p p < 0.05), regardless of the previous COVID-19 infection. Thus, revaccination is most effective in individuals with an antibody level below 500 BAU/mL, regardless of the vaccinee age and COVID-19 contraction. For the first time, it has been shown that a single booster dose of the Sputnik vaccine is sufficient to form a protective immunity in most vaccinees regardless of age and preexisting antibody level