The risk of fragility fractures in new users of dipeptidyl peptidase-4 inhibitors compared to sulfonylureas and other anti-diabetic drugs: A cohort study

Published by Elsevier via http://dx.doi.org/10.1016/j.ces.2017.10.035 © 2017. This final version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/Aims Mixed evidence exists for the effect of incretin-based therapies on osteoporosis in type-2 diabetes. Therefore, we conducted a cohort study to determine the association between dipeptidyl peptidase-4 (DPP-4) inhibitors and common osteoporotic “fragility fractures” (upper extremity, hip, spine).Methods The UK-based Clinical Practice Research Datalink was used to identify adults without prior fractures receiving a new anti-diabetic drug or a new type-2 diabetes diagnosis between 2007 and 2016. The primary aim was to compare new-users of DPP-4 inhibitors versus new-users of sulfonylureas (SU). The association between DPP-4 inhibitors and incident fractures was estimated using Cox proportional hazards models. Deciles of high-dimensional propensity scores and other anti-diabetic drugs were used as covariates. Results We identified 7993 and 26,636 new-users of DPP-4 inhibitors and SUs, respectively. At cohort entry, the mean age was 58.8, 40% were female, mean diabetes duration was 1.3 years, and 42% had A1c > 9%. Over 9 years (mean follow-up = 1.2 years), the incident rate of fragility fractures was lower among DPP-4 versus SU users (3.0/1000 vs. 5.2/1000 person-years; P-value = 0.007). After adjustment, there was no statistically significant difference in fracture risk (hazard ratio adjusted, aHR = 0.80, 95%CI 0.51–1.24; P-value = 0.3125). In a secondary analysis, DPP-4 inhibitors were not associated with a difference in fracture risk compared to insulin (aHR = 0.91, 95%CI 0.40–2.09); however were associated with a lower fracture risk versus thiazolidinediones (aHR = 0.47, 95%CI 0.26–0.83). Sensitivity analyses supported findings. Conclusions DPP-4 inhibitors are not associated with an increased risk of fragility fractures compared with SUs or insulin; however, are associated with a lower risk versus thiazolidinediones.JMG is supported as a New Investigator Award from the Canadian Institute of Health Research (CIHR) and a Clinician Scientist Award from Diabetes Canada. JRD is supported by a CIHR fellowship in drug safety and effectiveness. SRM holds the Endowed Chair in Patient Health Management supported by the Faculties of Medicine and Dentistry and Pharmacy and Pharmaceutical Sciences at the University of Alberta, Edmonton, Alberta, Canada

Gr\"obner-Shirshov bases for Lie algebras over a commutative algebra

In this paper we establish a Gr\"{o}bner-Shirshov bases theory for Lie algebras over commutative rings. As applications we give some new examples of special Lie algebras (those embeddable in associative algebras over the same ring) and non-special Lie algebras (following a suggestion of P.M. Cohn (1963) \cite{Conh}). In particular, Cohn's Lie algebras over the characteristic $p$ are non-special when $p=2,\ 3,\ 5$. We present an algorithm that one can check for any $p$, whether Cohn's Lie algebras is non-special. Also we prove that any finitely or countably generated Lie algebra is embeddable in a two-generated Lie algebra

Professor I.Ya. Livshits and his contribution to the development of national neurosurgery

The article traces the professional path of Professor Lev Yakovlevich Livshits, assesses his scientific contribution to the development of national neurosurgery. The concept of minimally invasive surgical treatment of trigeminal nerve neuralgia, developed by L. Ya. Livshits, allowed developing an original method of puncture surgical treatment of pain syndrome by directed hydrothermal destruction of the sensitive trigeminal root. The concept of "growing radicalism" created by Professor L. Ya. Livshits allowed his students elaborating algorithms for treating severe chronic pain syndromes of any localization and etiology.</p

The history of the development of national traumatology on the example of medical and scientific activities of Saratov Research Institute of Traumatology and Orthopedics (SarNIITO) (1950-1980)

We outlined and described basic directions of national traumatology development at the period of 1950-1980 illustrated by the example of Saratov traumatological school, estimated the contribution of SarNIITO traumatologists into this development at the abovementioned period, depicted syna — one of the founders of acute trauma clinics.</p

Composition-Diamond Lemma for Tensor Product of Free Algebras

In this paper, we establish Composition-Diamond lemma for tensor product $k< X> \otimes k$ of two free algebras over a field. As an application, we construct a Groebner-Shirshov basis in $k \otimes k$ by lifting a Groebner-Shirshov basis in $k[X] \otimes k$, where $k[X]$ is a commutative algebra.Comment: 19 page

Subexponential estimations in Shirshov's height theorem (in English)

In 1993 E. I. Zelmanov asked the following question in Dniester Notebook: "Suppose that F_{2, m} is a 2-generated associative ring with the identity x^m=0. Is it true, that the nilpotency degree of F_{2, m} has exponential growth?" We show that the nilpotency degree of l-generated associative algebra with the identity x^d=0 is smaller than Psi(d,d,l), where Psi(n,d,l)=2^{18} l (nd)^{3 log_3 (nd)+13}d^2. We give the definitive answer to E. I. Zelmanov by this result. It is the consequence of one fact, which is based on combinatorics of words. Let l, n and d>n be positive integers. Then all the words over alphabet of cardinality l which length is greater than Psi(n,d,l) are either n-divided or contain d-th power of subword, where a word W is n-divided, if it can be represented in the following form W=W_0 W_1...W_n such that W_1 >' W_2>'...>'W_n. The symbol >' means lexicographical order here. A. I. Shirshov proved that the set of non n-divided words over alphabet of cardinality l has bounded height h over the set Y consisting of all the words of degree <n. Original Shirshov's estimation was just recursive, in 1982 double exponent was obtained by A.G.Kolotov and in 1993 A.Ya.Belov obtained exponential estimation. We show, that h<Phi(n,l), where Phi(n,l) = 2^{87} n^{12 log_3 n + 48} l. Our proof uses Latyshev idea of Dilworth theorem application.Comment: 21 pages, Russian version of the article is located at the link arXiv:1101.4909; Sbornik: Mathematics, 203:4 (2012), 534 -- 55

Lyndon-Shirshov basis and anti-commutative algebras

Chen, Fox, Lyndon 1958 \cite{CFL58} and Shirshov 1958 \cite{Sh58} introduced non-associative Lyndon-Shirshov words and proved that they form a linear basis of a free Lie algebra, independently. In this paper we give another approach to definition of Lyndon-Shirshov basis, i.e., we find an anti-commutative Gr\"{o}bner-Shirshov basis $S$ of a free Lie algebra such that $Irr(S)$ is the set of all non-associative Lyndon-Shirshov words, where $Irr(S)$ is the set of all monomials of $N(X)$, a basis of the free anti-commutative algebra on $X$, not containing maximal monomials of polynomials from $S$. Following from Shirshov's anti-commutative Gr\"{o}bner-Shirshov bases theory \cite{S62a2}, the set $Irr(S)$ is a linear basis of a free Lie algebra

Anti-commutative Groebner-Shirshov basis of a free Lie algebra

One of the natural ways to prove that the Hall words (Philip Hall, 1933) consist of a basis of a free Lie algebra is a direct construction: to start with a linear space spanned by Hall words, to define the Lie product of Hall words, and then to check that the product yields the Lie identities (Marshall Hall, 1950). Here we suggest another way using the Composition-Diamond lemma for free anti-commutative (non-associative) algebras (A.I. Shirshov, 1962)

Technological improvement of the Sorghum saccharatum syrup production by membrane technologies

Easy-to-handle and effective methods of juice clarification and concentration by membrane technologies are still under exploration. The current article presents results of research on the technological development of an alternative natural sweetener of high biological value and improved organoleptic properties. Sorghum saccharatum stem juice is used in research. It is pre-clarified enzymatically with α-amylase and glucoamylase, clarified by ultrafiltration, and concentrated by the direct contact membrane distillation in various temperature ranges. The study shows the efficacy of membrane methods for improving juice purity, total soluble solids (TSS), and total sugar (TS) content in the syrup obtained. Clarification depends on membrane characteristics at the beginning of the process, as there are no differences at the end of it. Juice concentration at high-temperature differences allows to accelerate the process by approx. 60% comparing to low-temperature differences. A lower temperature difference (∆Т = 20-30°С) in the concentration process results in a longer process and syrup acidisation, whereas a higher temperature difference (∆Т = 70°С) affects physicochemical properties of syrup due to local overheating and formation of Maillard reaction products. The juice concentration at ∆Т = 50-60°С allows to obtain high values of total soluble solids without significant degradation of physicochemical and organoleptic properties

The results of application of anterior cruciate ligament two-bundle plastics by synthetic implant in its complete tears

Objective: to improve surgical results of patients with complete tears of anterior cruciate ligament by synthetic implant Don-M. Materials and Methods. 7 patients with ACL complete tear who underwent two-bundle plastics with synthetic en-doprosthetic implant Don-M were investigated. Results. The application of ACL two-bundle plastics with synthetic Don-M implant allowed reaching complete knee joint stability during the first several hours after surgery and completely restore knee joint motion range in the course of 6 months. Conclusion. The application of ACL two-bundle plastics is anatomically justified and provides knee joint stability as well as early activation and rehabilitation opportunities