Time-related OCT-A changes in preclinical retinopathy and their association with systemic factors

Background. Optical coherence tomography angiography (OCT-A) is a promising tool for the detection of microvascular impairment at the preclinical stage of diabetic retinopathy (DR). Evaluation of dynamic OCT-A changes and their association with systemic factors can help to reveal early biomarkers of DR progression.Aim: to evaluate time-related OCT-A changes and their association with systemic factors in type 1 diabetes mellitus (DM1) patients with no apparent DRMaterials and methods. 38 DM1 patients with no apparent DR and 39 healthy volunteers were included in the study. All participants underwent 7-fi eld fundus photography, OCT and OCT-A. We analyzed OCT-A parameters (foveal avascular zone (FAZ) area (mm2), acircularity index (AI), vessel density (VD), skeletonized density (SD)) as well as the results of blood and urea tests.Results. After one year of observation, AI was significantly higher (р = 0.005) and VD0–300 was signifi cantly lower in superfi cial vascular plexus (SVP, p < 0.0001) and deep capillary plexus (DCP, р = 0.032) in DM1 patients. We have also registered a positive correlation between AI and triglycerides (TG) level (r = 0.627, p = 0.007) as well as a negative correlation between ketones and VD (SVP VD0–300: r = –0.695, p = 0.030; intermediate capillary plexus (ICP, VD0–300: r = –0.551, p = 0.041; DCP, VD0–300: r = –0.704, p = 0.003; SVP, VD300–600: r = –0.853, p = 0.001).Conclusions. After one year of observation, we have registered an increase in AI level and a decline in VD in SVP and DCP which can be the earliest signs of DR progression. A signifi cant correlation between these parameters and systemic factors indicates their role as potential DR biomarkers

Exploiting Term Hiding to Reduce Run-time Checking Overhead

One of the most attractive features of untyped languages is the flexibility in term creation and manipulation. However, with such power comes the responsibility of ensuring the correctness of these operations. A solution is adding run-time checks to the program via assertions, but this can introduce overheads that are in many cases impractical. While static analysis can greatly reduce such overheads, the gains depend strongly on the quality of the information inferred. Reusable libraries, i.e., library modules that are pre-compiled independently of the client, pose special challenges in this context. We propose a technique which takes advantage of module systems which can hide a selected set of functor symbols to significantly enrich the shape information that can be inferred for reusable libraries, as well as an improved run-time checking approach that leverages the proposed mechanisms to achieve large reductions in overhead, closer to those of static languages, even in the reusable-library context. While the approach is general and system-independent, we present it for concreteness in the context of the Ciao assertion language and combined static/dynamic checking framework. Our method maintains the full expressiveness of the assertion language in this context. In contrast to other approaches it does not introduce the need to switch the language to a (static) type system, which is known to change the semantics in languages like Prolog. We also study the approach experimentally and evaluate the overhead reduction achieved in the run-time checks.Comment: 26 pages, 10 figures, 2 tables; an extension of the paper version accepted to PADL'18 (includes proofs, extra figures and examples omitted due to space reasons

Early functional and microcirculatory changes in patients with type 1 diabetes mellitus and no apparent diabetic retinopathy

BACKGROUND: Diabetic retinopathy (DR) is the leading complication of diabetes mellitus (DM) which is reported to affect more than one-third of the global diabetic population. Optical coherence tomography angiography (OCT-A) can help to reveal early biomarkers of DR to improve current diagnostic approach.AIMS: To evaluate early visual functions deficiency and OCT-A changes in patients with type 1 DM (T1DM) without clinical signs of DR.MATERIALS AND METHODS. 74 eyes of 40 T1DM patients with no apparent DR and 49 eyes of 28 healthy volunteers were included in the study. The mean duration of DM was 11,7 ± 6,1 years. All participants underwent standard ophthalmological examination, low-luminance visual acuity (LLVA) assessment, 7-field fundus photography, OCT and OCT-A. We analyzed LLVA deficit as a marker of visual function. For OCT-A scans we evaluated foveal avascular zone (FAZ) area (mm2), acircularity index (AI), vessel density (VD), skeletonized density (SD) and vessel diameter index (VDI) in superficial vascular plexus (SVP), intermediate capillary plexus (ICP) and deep capillary plexus (DCP).RESULTS: LLVA deficit was significantly higher in T1DM patients (0,16±0,05 vs 0,10±0,04, p<0,0001). We also detected a significant difference in AI level (11,47 ± 0,24 vs 1,31 ± 0,15, p<0,0001). VD was significantly lower in T1DM patients in SVP (25,37 ± 2,24%, vs 26,67 ± 1,81%, p=0,028) and DCP (17,22 ± 3,10 % vs 18,29 ± 1,95%, p=0,015)CONCLUSIONS: Our results demonstrate early visual functions deficiency and OCT-A changes at the preclinical stage of DR. The prognostic value of these findings will be studied during longitudinal observation

Эффекты фиксированных комбинаций ингаляционных кортикостероидов и длительнодействующих β2-агонистов при хронической обструктивной болезни легких

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Применение препарата атровент в лечении бронхообструктивных заболеваний на промышленных предприятиях

This study purposed research o therapeutic and protective effect of Atrovent (ipratropium bromide) in the group of workers and employees of textile manufacturing union in Vladimirskaya region.In accordance with the program of clinical and epidemiological examination at industry factories, that was elaborated in Science Research institute of Pulmonology, Russia, were examined 337 workers of manufacturing union «Textile». There were selected 25 persons to treat initials stages of bronchopulmonary diseases by Atrovent. The research of protective effect of Atrovent was realized on experimental group (12 persons). The results of one-year control the patients in both groups have been demonstrated in the article. High efficacy of medicine was proved by improvement of clinical characteristics and objectives changes of parameters of external respiration. It is concluded about necessity of more active and broad introduction of preventive programs with participation of Atrovent that provide good medicinal and prophylactic effect on initials stages of disease evolution especially.Целью настоящей работы явилось изучение лечебного и протективного эффекта препарата Атровент (ипратропиум бромид) в группе рабочих и служащих текстильного ПО Владимирской области.По программе клинико-эпидемиологического пульмонологического обследования на промышленных предприятиях, разработанной в НИИ пульмонологии М3 РФ, обследовано 337 работников ПО «Текстиль». Для лечения ранних стадий бронхолегочных заболеваний препаратом Атровент отобрана группа из 25 человек. Изучение протективного эффекта препарата проводилось на экспериментальной группе, состоявшей из 12 человек. В работе доложены результаты годичного мониторинга пациентов обеих групп. Показана высокая эффективность препарата с улучшением клинических характеристик, объективными изменениями параметров внешнего дыхания. Делается заключение о необходимости более активного и широкого внедрения превентивных программ с участием Атровента, дающего хороший лечебный и профилактический эффект, особенно на ранних стадиях развития заболевания

Multivariant Assertion-based Guidance in Abstract Interpretation

Approximations during program analysis are a necessary evil, as they ensure essential properties, such as soundness and termination of the analysis, but they also imply not always producing useful results. Automatic techniques have been studied to prevent precision loss, typically at the expense of larger resource consumption. In both cases (i.e., when analysis produces inaccurate results and when resource consumption is too high), it is necessary to have some means for users to provide information to guide analysis and thus improve precision and/or performance. We present techniques for supporting within an abstract interpretation framework a rich set of assertions that can deal with multivariance/context-sensitivity, and can handle different run-time semantics for those assertions that cannot be discharged at compile time. We show how the proposed approach can be applied to both improving precision and accelerating analysis. We also provide some formal results on the effects of such assertions on the analysis results.Comment: Pre-proceedings paper presented at the 28th International Symposium on Logic-Based Program Synthesis and Transformation (LOPSTR 2018), Frankfurt am Main, Germany, 4-6 September 2018 (arXiv:1808.03326

Заболевания щитовидной железы и первичная открытоугольная глаукома: есть ли связь?

PURPOSE: To investigate a possible association between reduced thyroid function and primary open-angle glaucoma (POAG) development.METHODS: A retrospective study included 71 patients (57 women, 14 men) in the POAG group and 76 patients (52 women, 24 men) in the control group. In the POAG group, the average patient age was 67.12±6.47 years and in the control group — 65.30±5.97 years (p>0.5). To evaluate the thyroid function, we assessed mean levels of thyroidstimulating hormone (TSH), free thyroxine (T4), anti-thyroid peroxidase antibodies and the endocrinologist’s report. Additionally, biochemical blood indicators were measured: levels of glucose, cholesterol, high and low density lipoproteins (HDL, LDL), and triglycerides (TG).RESULTS: Mean level of free T4 in the POAG group was significantly lower (15.05±2.2 pmol/l) than in the control group (20.65±14.5 pmol/l). Endocrine disorders were more often diagnosed in the POAG group: nodular goiter was observed in 25.35% of patients compared to 15.79% of the control subjects, chronic autoimmune thyroiditis — in 11.27% of patients and 6.58% of the control subjects. Diabetes mellitus was detected 3.7 times more frequently in the POAG group (9.86%) than in the control group (2.63%). Levels of cholesterol and TG tended to be higher in the POAG group. In 70.4% of patients, the level of cholesterol was above normal (compared to 63.2% of the control subjects) and in 12.7% of patients the TG level was above normal (compared to 7.9% of the control subjects).CONCLUSION: The results of our study suggest that hormonal profile changes in the thyroid gland can be associated with POAG development. Apparently, thyroid disorders may be considered as a potential risk factor of primary open-angle glaucoma development. ЦЕЛЬ. Изучить взаимосвязь нарушений гормонального профиля щитовидной железы с развитием первичной открытоугольной глаукомы (ПОУГ).МЕТОДЫ. В ходе ретроспективного исследования проанализированы показатели функции щитовидной железы и биохимические показатели крови у 71 пациента с ПОУГ (57 женщин и 14 мужчин) и 76 пациентов без ПОУГ (52 женщины и 24 мужчины), которые вошли в группу контроля. Средний возраст пациентов в группе ПОУГ составил 67,12±6,47 года, в контрольной группе — 65,30±5,97 года (p>0,5). Для оценки функционального состояния щитовидной железы были использованы лабораторные показатели: уровни тиреотропного гормона (ТТГ), свободного тироксина (Т4), антител к пероксидазе, а также заключение эндокринолога. Дополнительно анализировали уровень глюкозы, холестерина (ХС), липопротеидов (ЛП) высокой и низкой плотности, триглицеридов (ТГЦ).РЕЗУЛЬТАТЫ. У пациентов с ПОУГ выявлен значимо более низкий уровень свободного Т4 (15,05±2,2 пмоль/л), чем в контрольной группе (20,65±14,5 пмоль/л). В этой группе чаще диагностировали эндокринологические расстройства, в частности, заболевания щитовидной же- лезы: узловой зоб отмечен у 25,35% пациентов (в группе контроля — у 15,79%), хронический аутоиммунный тиреоидит — у 11,27% пациентов (в группе контроля — у 6,58%). При ПОУГ также в 3,7 раза чаще диагностирован сахарный диабет 2 типа (у 9,86% пациентов, в контрольной группе — у 2,63%). У пациентов с ПОУГ наблюдалась тенденция к более высокому уровню холестерина (ХС): этот показатель был выше нормы у 70,4% пациентов, в группе контроля — у 63,2%. Уровень триглицеридов (ТГЦ) был также выше нормы у 12,7% пациентов с ПОУГ, в группе контроля — у 7,9%.ЗАКЛЮЧЕНИЕ. Полученные результаты указывают на наличие взаимосвязи между изменениями гормонального профиля щитовидной железы и развитием ПОУГ. По-видимому, заболевания щитовидной железы могут рассматриваться как фактор риска развития ПОУГ.

Exploring the impact of the level of absorptive capacity in technology development firms

Absorptive capacity (ACAP) is widely recognized as an effective means of obtaining and sustaining a competitive advantage. Although ACAP was globally introduced decades ago, researchers from Central and Eastern Europe have since underestimated its importance. The research objective of this paper is to answer the following questions: how does the level of ACAP influence the performances of technology-driven firms, and how does it catalyse their innovation outputs? Furthermore, we argue that exporting technology-driven firms possess even higher levels of ACAP than those who are weak or not-at-all exporters. ACAP measured value is examined alongside the innovation outputs of firms and their business performance, with an extended focus on exporters. A selected population of >600 Croatian firms were asked to fill in the questionnaire. Out of the 103 firms that completed the survey, 45 were recognized as intensive technology development performers, and 34 were identified as large exporters. Both populations were tested against formulated hypotheses, ultimately proving that higher levels of ACAP can be seen to positively drive innovation performance which, notably, can be seen most clearly with exporters

EARLY PRESCRIPTION OF INHALATION CORTICOSTEROID IN BRONCHIAL ASTHMA

The article is devoted to the concept of early treatment of patients with intermittent and slight course of bronchial asthma with the use of fixed combinations of inhaled corticosteroids and long-acting beta2-agonists. It describes the basic pathophysiological and molecular mechanisms of this therapy, and the synergy of its components and the local anti-inflammatory effects. Considerable attention is paid to the justification of different strategies for the prescription of steroid-containing combinations as initial therapy: regular prescription of fixed doses, use of a single inhaler for maintenance and symptomatic therapy, including ICS for patients with intermittent and mild BA, abandonment of regular therapy and use of combinations only for therapy on demand. It is emphasized that the basis for the application of such a strategy is low adherence to regular ICS therapy in patients with rare symptoms and undesirability of complete withdrawal of low dose ICS in patients with the light course of the disease because of the high risk of exacerbations. Current evidence suggests that the concept of early prescription of combinations on demand allows combining symptomatic and anti-inflammatory therapy as part of the start of treatment of patients with mild bronchial asthma