ST Group Research Articles

Effect of Hydrothermal Degradation on Flexural Fatigue Strength of Various Cubic-Containing Translucent Zirconia.

The aim of this study is to investigate the fatigue and hydrothermal degradation behavior among the cubic-containing translucent yttrium oxide stabilized tetragonal zirconia polycrystal (Y-TZP). Four groups of commercial Y-TZP (T, ST, XT, and P), containing different amount of cubic crystal, were examined. Artificial aging was accomplished by autoclaving at 122°C under 2 bar pressure for 8 hours. Fatigue simulation parameters were set using an axial 50 N load, a total of 240,000 cycles. Flexural fatigue strength was evaluated. Two-way analysis of variance with Tukey's honestly significant difference test was used to determine the difference in fatigue strength values between various type of zirconia materials within control and aging with a significant level of 5%. Weibull analysis was conducted on the fatigue strength data. All groups showed the mean flexural fatigue strength had no significant difference in hydrothermally aged specimens compared with specimens without aging (p = 0.154). Group T showed significantly higher flexural fatigue strength followed by group ST, XT, and P. Group XT and P showed no significant difference in strength value (p > 0.05). Group T demonstrated a lower probability of failure than group ST, XT, and P whether with or without aging. Weibull modulus in group T and ST with aging condition was increased and higher than all the experimental groups. Cubic-containing zirconia materials (group ST, XT, and P) exhibited lower flexural fatigue strength than non-cubic 3Y-TZP zirconia (group T). However, various cubic-containing translucent zirconia was assumed to have high resistance to hydrothermal degradation.

Design of an RCT on cost-effectiveness of group schema therapy versus individual schema therapy for patients with Cluster-C personality disorder: the QUEST-CLC study protocol

BackgroundGiven the high prevalence of Cluster-C Personality Disorders (PDs) in clinical populations, disease burden, high societal costs and poor prognosis of comorbid disorders, a major gain in health care can be achieved if Cluster-C PDs are adequately treated. The only controlled cost-effectiveness study published so far found Individual Schema Therapy (IST) to be superior to Treatment as Usual (TAU). Group ST (GST) might improve cost-effectiveness as larger numbers can be treated in (>50%) less time compared to IST. However, to date there is no RCT supporting its (cost-) effectiveness. The overall aim of this study is to assess the evidence for GST for Cluster-C PDs and to improve treatment allocation for individual patients. Three main questions are addressed: 1) Is GST for Cluster-C PDs (cost-)effective compared to TAU? 2) Is GST for Cluster-C PDs (cost-) effective compared to IST? 3) Which patient-characteristics predict better response to GST, IST, or TAU?MethodsIn a multicenter RCT, the treatment conditions GST, IST, and TAU are compared in 378 Cluster-C PD patients within 10 sites. GST and IST follow treatment protocols and are completed within 1 year. TAU is the optimal alternative treatment available at the site according to regular procedures. Severity of the Cluster-C PD is the primary outcome, assessed with clinical interviews by independent raters blind for treatment. Functioning and wellbeing are important secondary outcomes. Assessments take place at week 0 (baseline), 17 (mid-GST), 34 (post-GST), 51 (post-booster sessions of GST), and 2 years (FU). Patient characteristics predicting better response to a specific treatment are studied, e.g., childhood trauma, autistic features, and introversion. A tool supporting patients and clinicians in matching treatment to patient will be developed. An economic evaluation investigates the cost-effectiveness and cost-utility from a societal perspective. A process evaluation by qualitative methods explores experiences of participants, loved ones and therapists regarding recovery, quality of life, and improving treatment.DiscussionThis study will determine the (cost-)effectiveness of treatments for Cluster-C PDs regarding treatment type as well as optimal matching of patient to treatment and deliver insight into which aspects help Cluster-C-PD patients recover and create a fulfilling life.Trial registrationDutch Trial Register: NL9209. Registered on 28-01-2021,

Minimality of topological matrix groups and Fermat primes

Our aim is to study topological minimality of some natural matrix groups. We show that the special upper triangular group ST+(n,F) is minimal for every local field F of characteristic ≠2. This result is new even for the field R of reals and it leads to some important consequences. We prove criteria for the minimality and total minimality of the special linear group SL(n,F), where F is a subfield of a local field. This extends some known results of Remus–Stoyanov (1991) and Bader–Gelander (2017).One of our main applications is a characterization of Fermat primes, which asserts that for an odd prime p the following conditions are equivalent:(1)p is a Fermat prime;(2)SL(p−1,Q) is minimal, where Q is the field of rationals equipped with the p-adic topology;(3)SL(p−1,Q(i)) is minimal, where Q(i)⊂C is the Gaussian rational field.

Modified technique of tumor traction in endoscopic submucosal dissections in the stomach (ex vivo study)

Background : the method of endoscopic submucosal dissection (ESD) allows to remove large neoplasms of the GI tract enblock, which significantly reduces the risk of local tumor recurrence. However, ESD method is technically complicated with high risk of surgical complications. Aim : to modify ESD traction technique and evaluate its efficiency. Materials and methods: experimental comparative study on biological preparations (pig stomachs). 144 ESD with three different methods were performed: the 1 st group—standard ESD method (n-48); the 2 nd —ESD with the method of traction with the clip and thread (n-48); the 3 rd —ESD with a modified method of tumor traction (n-48). Results : the shortest time to submucosal dissection was 4.89 min [2–12] in the 3 rd group, and 13,27 [4–31] min and 9,37 [4–26] min in the 1 st and 2 nd , respectively (p = 0,05). Total operative time in the 3 rd was 21,10 [12–31] min, in the 1 st 23.85 [12–48] min, and in the 2 nd —25.56 [13–49] min, p = 0.002. The max dissection speed was 0.48 [0.20–1.27] (min/cm 2 ) in the 3 rd group, 0.94 [0.47–2.06] (min/cm 2 ) and 1.48 [0.56–4.10] (min/cm 2 ) in the 2 nd and 3 rd , respectively, p=0.003. HM0 was 89.6% [43/48] in group 1, 93.7% [45/48] in the 2 nd , and 100% [48/48] in the 3 rd , p>0.05. Muscle layer damage during submucosal dissection was 25% [12/48] in the 1 st , 6.25% [3/48] in the 2 nd and 12.5% [6/48] in 3 rd , p=0.389. Conclusion : the modified traction method during endoscopic submucosal dissection allows to visualize submucosa layer better, to increase dissection speed thus reducing total time of the operation and time of submucosal dissection.

Early changes in myocardial stunning and biomarkers after ST-elevation myocardial infarction compared to the takotsubo syndrome

Abstract Background Takotsubo syndrome (TS) and ST-elevation myocardial infarction (STEMI) are both characterized by sudden cessation of myocardial contractions (myocardial stunning) as well as elevation of cardiac troponins and B-type natriuretic peptides (BNP). Whereas STEMI results in variable degrees of necrosis and persistent cardiac dysfunction, TS results in little to any necrosis and full recovery of cardiac function. No “head-to-head” comparison of the temporal resolution of myocardial stunning and serum biomarkers in STEMI versus takotsubo has been done. Purpose To compare the time course of the recovery of cardiac function and serum biomarkers over the acute and subacute phases of takotsubo and STEMI, with patients with STEMI further subdivided into anterior and non-anterior STEMI. Method The Stunning In Takotsubo and Acute Myocardial Infarction (STAMI) study is a prospective, multi-center study that enrolls patients with TS or STEMI without known pre-existing cardiac dysfunction. Echocardiography, laboratory testing (including troponins and NT-proBNP), and ECG are acquired within 4 hours after acute coronary angiography and at 24±6, 48±12, 72±12 hours and 7±1, 14±2, and 30±2 days. The primary endpoint is the proportion of reversible myocardial akinesia resolved after 72 hours (Figure 1), as determined by echocardiography. Secondary endpoints include troponin-I, troponin-T, and NT-proBNP. Results Preliminary results from 155 patients with STEMI (78 anterior STEMI and 77 non-anterior STEMI) and 32 patients with TS are presented in Figure 1. Mean (SD) age was similar for patients with takotsubo (67±14), anterior STEMI (68±11), and non-anterior STEMI (68±10). All 3 groups showed substantial recovery of cardiac function over the course of the study, with the most pronounced recovery of cardiac function in TS. Compared to both STEMI groups, the TS group also had lower troponin-I to troponin-T ratio, and higher NT-proBNP (Figure 2). The proportion of reversible akinesia that had recovered at 72 hours was similar in patients with TS, anterior STEMI and non-anterior STEMI (p=0.8414). Conclusion The STAMI study will provide the comprehensive assessment of cardiac function and serum biomarker profile of patients with takotsubo and STEMI over the early course of the disease. Preliminary data from the study suggest that early myocardial functional recovery is more substantial but follows a similar time-course in takotsubo and STEMI. The differences in the magnitude of troponin elevation after takotsubo versus STEMI were more pronounced for troponin-I than T. Funding Acknowledgement Type of funding sources: Public grant(s) – EU funding. Main funding source(s): ERC - European Research Council

Traditional Modified Brostrom vs Suture Tape Ligament Augmentation for Chronic Lateral Ankle Instability: A Cost-Effectiveness Analysis

Category: Sports; Ankle; Other Introduction/Purpose: Surgical treatment of chronic lateral ankle instability (CLAI) with the Modified Brostrom-Gould (MB) procedure and suture tape ligament augmentation (+ST) has proven to be biomechanically and clinically successful. A concern regarding the MB + ST procedure is increased surgical costs and additional operating room time. To date, there are no available studies in the literature evaluating the cost-effectiveness of suture tape ligament augmentation of the Modified Brostrom-Gould procedure. The purpose of the present study is to evaluate and report the cost-effectiveness of the Modified Brostrom-Gould procedure, with and without suture tape ligament augmentation. Methods: This study followed the consensus-based recommendations made by the Panel on Cost-Effectiveness in Health and Medicine. The base case was assumed to be a healthy individual with symptomatic CLAI following recurrent ankle sprains requiring surgical intervention. The standard MB technique utilized two 2.4 mm BioComposite SutureTak anchors for direct anatomic repair of the disrupted anterior talofibular and calcaneofibular ligaments. This treatment was then compared to the Modified Brostrom-Gould procedure with the addition of suture tape ligament augmentation (MB + ST). A Markov Model was designed to evaluate the cost-effectiveness of the MB + ST procedure. Model input variables and parameters were derived from a prospective randomized clinical study which described the rate of return to previous activity level at 26 weeks postoperatively for the MB and MB + ST groups. Direct and indirect surgical costs were incorporated into the model to provide an accurate financial assessment of both procedures. Results: When only direct surgical costs were considered, the total cost of MB was $2,318.88 and the total effectiveness was 0.91 quality-adjusted-life-years (QALY) over the 26-week period. The total cost for MB + ST was $4,004.93 and the total effectiveness was 0.98 QALY's. Patients in the MB + ST group spent, on average, $1,686 more than those in the MB group, with a higher quality of life by 0.07 QALYs. To evaluate the impact of indirect surgical costs, a sensitivity analysis was performed which measured the additional costs associated with physical therapy and time off work. Patients in the MB group incurred an increased physical therapy cost of $4,212 assuming 4.2 extra weeks of treatment. Assuming those in the MB group returned to full duty work 4.2 weeks later than those in the MB + ST group, this resulted in a net loss of approximately $5,413.80 in wages. Conclusion: In the early postoperative period following lateral ligament reconstruction for CLAI, MB + ST technique yields a higher quality of life and lower overall expense despite a higher direct surgical cost when compared to MB alone. The cost effectiveness of the MB + ST technique was further supported through a sensitivity analysis which revealed that as indirect surgical costs were incorporated into the model, MB + ST became an even more cost effective option. This cost-effectiveness analysis adds to the growing literature in support of suture tape augmentation for the Modified Brostrom-Gould procedure.

The growth of Tate–Shafarevich groups in cyclic extensions

Let $p$ be a prime number. Kęstutis Česnavičius proved that for an abelian variety $A$ over a global field $K$, the $p$-Selmer group $\mathrm {Sel}_{p}(A/L)$ grows unboundedly when $L$ ranges over the $(\mathbb {Z}/p\mathbb {Z})$-extensions of $K$. Moreover, he raised a further problem: is $\dim _{\mathbb {F}_{p}} \text{III} (A/L) [p]$ also unbounded under the above conditions? In this paper, we give a positive answer to this problem in the case $p \neq \mathrm {char}\,K$. As an application, this result enables us to generalize the work of Clark, Sharif and Creutz on the growth of potential $\text{III}$ in cyclic extensions. We also answer a problem proposed by Lim and Murty concerning the growth of the fine Tate–Shafarevich groups.

Comparison of the accuracy between conventional and various digital implant impressions for an implant-supported mandibular complete arch-fixed prosthesis: An in vitro study.

This in vitro study compared the accuracy between conventional and different intraoral scanner impression methods and stereophotogrammetry term of 3D deviation for a complete mandibular edentulous arch with 5 placed implants. An edentulous mandibular model was prepared with three straight and two 17° angled screw-retained abutments screwed on implants. Different impression techniques were compared: one conventional impression, CO (open-tray splint impression coping, Polyether), three groups of intraoral scanners, TS (Trios 4), IT (iTero Element 2), and PS (Primescan), and one stereophotogrammetry, PIC (Precise Implants Capture). An extraoral scanner (E4 scanner) was used to digitize the reference model as a control group. Scan body positions were compared with 3D deviation by using a 3D analysis software program (Geomagic ControlX 2020.1.1) with the best-fit alignment technique. The accuracy of the scan bodies' position of each impression technique between each group area was analyzed using one-way ANOVA followed by Scheffé's comparison test for trueness and precision. (α = 0.05). Statistical 3D deviations of the whole scan body were found among the CO, TS, PS, IT, and PIC groups for both trueness (p < 0.05) and precision (p < 0.05). PIC showed the least 3D deviation of trueness (48.74 ± 1.80µm) and precision (5.46 ± 1.10µm), followed by TS, PS, IT, and CO. CO had the highest 3D deviation of trueness (141 ± 5.58µm) and precision (40.4 ± 1.3.39µm), which was significantly different from PIC, TS, and PS. For completed-arch digital implant impressions, stereophotogrammetry has shown better accuracy than other digital and conventional impression techniques, especially in terms of precision. The highest 3D deviation was found in the conventional splint open-tray impression technique.

On binary quartics and the Cassels–Tate pairing

We use the invariant theory of binary quartics to give a new formula for the Cassels–Tate pairing on the 2-Selmer group of an elliptic curve. Unlike earlier methods, our formula does not require us to solve any conics. An important role in our construction is played by a certain K3 surface defined by a (2, 2, 2)-form.

The étale Brauer-Manin obstruction to strong approximation on homogeneous spaces

It is known that, under a necessary non-compactness assumption, the Brauer-Manin obstruction is the only one to strong approximation on homogeneous spaces X X under a linear group G G (or under a connected algebraic group, under assumption of finiteness of a suitable Tate-Shafarevich group), provided that the geometric stabilizers of X X are connected. In this work we prove, under similar assumptions, that the étale-Brauer-Manin obstruction to strong approximation is the only one for homogeneous spaces with arbitrary stabilizers. We also deal with some related questions, concerning strong approximation outside a finite set of valuations. Finally, we prove a compatibility result, suggested to be true by work of Cyril Demarche, between the Brauer-Manin obstruction pairing on quotients G / H G/H , where G G and H H are connected algebraic groups and H H is linear, and certain abelianization morphisms associated with these spaces.

Isometric Knee Muscle Strength and Patient-Reported Measures Five Years after Anterior Cruciate Ligament Reconstruction: Comparison of Single versus Dual Autograft Hamstring Tendon Harvesting.

There is some controversy regarding the use of one or two hamstring tendons for anterior cruciate ligament reconstruction (ACLR). In this study, two cohorts of 22 male patients underwent an ACLR with hamstring tendon autografts. One cohort was reconstructed through an all-inside technique with the semitendinosus tendon (ST group) and the other with the semitendinosus and gracilis tendons (ST-G group). Anterior tibial translation (ATT), Lysholm, and IKDC scores were assessed preoperatively and five years postoperation. Additionally, isometric knee muscle strength was manually measured in both groups and in another cohort of 22 uninjured control male subjects five years after the operation. There were no significant differences in ATT and Lysholm scores between the operated groups. The IKDC score was lower in the ST-G group than in the ST group—9.57 (CI 14.89–4.25) (p < 0.001). No significant differences between injured and uninjured knees were detected in hamstring to quadriceps ratio strength and quadriceps limb symmetry index of the two operated groups, but the hamstring limb symmetry index was significantly lower in the ST-G group than in the ST and control groups. This study shows that using an ST-G autograft for ACLR yielded less flexor strength and worse results in some patient-reported outcome measures (PROM) than using an ST autograft five years after the operation. The observed results let us suggest that the use of one autograft hamstring tendon for ACLR is clinically preferable to the use of two hamstring tendons.

Explicit realization of elements of the Tate–Shafarevich group constructed from Kolyvagin classes

We consider the Kolyvagin cohomology classes, associated to an elliptic curve E/{mathbb Q}, from a computational point of view. We explain how to go from a model of a class as an element of (E(L)/pE(L))^{mathrm {Gal}(L/{mathbb Q})}, where p is prime and L is a dihedral extension of {mathbb Q} of degree 2p, to a geometric model as a genus one curve embedded in mathbb { P} ^{p-1}. We adapt the existing methods to compute Heegner points to our situation, and explicitly compute them as elements of E(L). Finally, we compute explicit equations for several genus one curves that represent non-trivial elements of , for p le 11, and hence are counterexamples to the Hasse principle.

Intubation in Swine: What Recumbency to Choose?

Simple SummaryWhether a pig should be placed on its back or sternum to facilitate endotracheal intubation is currently not known and a subject of debate. Enrolling participants with different clinical anaesthesia backgrounds, we aimed at assessing which recumbency (dorsal versus sternal) is advantageous, and if operator experience can influence the results. Using objective and subjective outcomes, we found that sternal recumbency is advantageous if compared to dorsal, but that this is true only for operators lacking experience in anaesthetising animals. Experts’ confidence in intubating various animal species with different techniques probably minimized the influence of recumbency.Endotracheal intubation (ETI) is challenging in pigs. We compared the number of attempts and time to perform ETI, and the subjective perception of ease, while the animal was positioned in dorsal (DR) or sternal (SR) recumbency, as well as assessed whether operator experience influences the outcome. Participants were divided into three groups: undergraduates (ST; veterinary students), graduates (GR; veterinarians without specific anaesthesia training) and experts (EX; veterinary anaesthesia intern/resident and diplomate of the European College of Veterinary Anaesthesia and Analgesia). Each participant intubated one freshly euthanised pig in DR and ST. Number of attempts and time to correctly perform ETI, number of oesophageal intubations and answers to Likert-scale questions on larynx visualization and ease of endotracheal tube introduction and advancement were recorded. Thirty-three participants were enrolled (15 ST, 10 GR and 8 EX). Less attempts (p = 0.002) and time (p = 0.002) to correctly perform ETI were needed in SR for the ST group. In 21/119 and 5/48 ETI attempts, oesophageal intubation was performed in DR and SR, respectively. Larynx visualization (p < 0.001) and endotracheal tube introduction (p < 0.001) were perceived as easier in SR for the ST group. No difference between recumbencies was found in perceived ease to advance the endotracheal tube. For inexperienced operators, intubation in SR can be recommended.

The geometric distribution of Selmer groups of elliptic curves over function fields

Fix a positive integer n and a finite field {mathbb {F}}_q. We study the joint distribution of the rank {{,mathrm{rk},}}(E), the n-Selmer group text {Sel}_n(E), and the n-torsion in the Tate–Shafarevich group as E varies over elliptic curves of fixed height d ge 2 over {mathbb {F}}_q(t). We compute this joint distribution in the large q limit. We also show that the “large q, then large height” limit of this distribution agrees with the one predicted by Bhargava–Kane–Lenstra–Poonen–Rains.

Spatiotemporal characteristics of lower back muscle fatigue during a ten minutes endurance test at 50% upper body weight in healthy inactive, endurance, and strength trained subjects.

In modern developed societies, heavy physical demands are decreasing and getting replaced by longer periods of static, low-exertion activities such as sitting or standing. To counteract this lack of physical activity, more and more people are engaging in physical activity through exercise and training. Virtually opposite training modalities are endurance and strength. We asked if back muscle endurance capacity is influenced by training mode. 38 healthy male subjects (age range 19–31 years, mean age 22.6 years) were investigated: sedentary (Control, n = 12), endurance trained (ET, n = 13), and strength trained participants (ST, n = 13). They underwent a ten-minutes isometric extension task at 50% of their upper body weight. Surface EMG was measured in the low-back region utilizing quadratic 4*4 monopolar electrode montages per side. Relative amplitude and mean frequency changes were analysed with respect to electrode position and group during the endurance task. Eight ST subjects failed to complete the endurance task. Relative amplitude and frequency changes were largest in the ST group, followed by Control and ET groups (amplitude: F 6.389, p 0.004, frequency: F 11.741, p<0.001). Further, independent of group largest amplitude increase was observed for the most upper and laterally positioned electrodes. Mean frequency changes showed no systematic spatial distribution pattern. Although, in the light of an aging population, strength training has its merits our results question the functional suitability of frequent and isolated high-impact strength training for everyday endurance requirements like doing the dishes. Fatigue related amplitude elevations are systematically distributed in the back region, showing least fatigue signs for the most caudal and medial, i.e. the lumbar paravertebral region.

Effects of Repetitive Transcranial Magnetic Stimulation on Gait and Postural Control Ability of Patients with Executive Dysfunction after Stroke.

Objective: To assess the effects of repetitive transcranial magnetic stimulation (rTMS) on the gait and postural control ability of patients with executive dysfunction (ED) after stroke. Methods: A total of 18 patients with ED after stroke were randomly assigned into two groups, including an experimental group and a sham group. Patients in both groups received routine rehabilitation therapy, and patients in the experimental group underwent rTMS on the left dorsolateral prefrontal cortex (DLPFC) for 2 weeks (5 HZ, 80%MT, 1200 pulses). In the sham group, patients experienced sham stimulation treatment, in which the coil was placed vertically with the head. Before and after treatment, patients in both groups were subjected to Montreal cognitive assessment (MoCA) scoring, Fugl–Meyer assessment of lower extremity (L-FMA), Stroop color-word test (SCWT), gait analysis, foot plantar pressure test, 10-m walking test (10MWT), Berg balance scale (BBS), and timed up and go test (TUGT). In the SCWT, it was attempted to record the time of each card (SCWT-T), the correct number (SCWT-C), Stroop interference effect-time (SIE-T), and SIE correct count (SIE-C). The TUGT was categorized into four stages: getting up (GT), walking straight (WT), turning around (TT), and sitting down (ST), in which the total time of TUGT was calculated. Results: After two weeks of treatment, the evaluation indexes were improved in the two groups, some of which were statistically significant. In the experimental group, SCWT-T, SIE-T, SIE-C, GT, WT, TT, ST, and TUGT were significantly improved after treatment (p < 0.05). SCWT-C, L-FMA score, 10MWT, GT, WT, stride length, step width, foot plantar pressure, pressure center curve, and activities of daily living were not statistically different from those before treatment (p > 0.05). After treatment, SCWT-T, SIE-C, SIE-T, BBS score, TT, and ST in the experimental group were significantly shorter than those before treatment, with statistical differences (p < 0.05). Compared with the sham group, SCWT-C, L-FMA score, 10MWT, GT, WT, TUGT, stride length, step width, foot plantar pressure, pressure center curve, and motor skills were not significantly improved (p > 0.05). Conclusion: It was revealed that post-stroke rTMS treatment of patients with ED could improve executive function, improve postural control function, and reduce the risk of falling. In addition, rTMS of DLPFC could be a therapeutic target for improving postural control ability and reducing the risk of falling.

Analysis of the femoral neck from rats in the periestropause treated with oxytocin and submitted to strength training.

Among the interventions used to prevent osteoporosis in female organisms, strength training (ST) and oxytocin (OT) stand out, as a promising hormone with anabolic action on bone. This study aimed to verify whether the combined action of OT and ST, compared to isolated interventions, potentiates the bone remodeling process of the femoral neck of Wistar rats during periestropause. Forty Wistar rats (18months) with irregular estrous cycle were randomly distributed into groups: 1-Vehicle (Veh; NaCl 0.15mol/L ip); 2-Oxytocin (Ot; 134μg/kg/ip); 3-Strength training (St); 4-Ot+St. The animals of the 1, 2 and 4 groups received two intraperitoneal injections with an interval of 12h every 30days, totaling 8 injections at the end of the experimental period (18 to 21months). The animals in the St and Ot+St groups performed ST on a ladder 3 times a week, maximal voluntary carrying capacity (MVCC) test monthly. After 120days, the animals were euthanized; the femur was collected for analysis of biomechanical testing, densitometry, bone microtomography, Raman spectroscopy, tissue PCR, and blood for analysis of bone biomarkers, liver damage, and oxidative stress. The main effects in the Ot group were observed in the maximum load and energy in the compression testing (femoral head), and stiffness and energy in the three-points bending testing (femur diaphysis). In addition, the main effects occurred on the bone mineral density (BMD), cortical thickness (Ct.Th), number of pores (Po.N), polar moment of inertia (J), trabecular thickness (Tb.Th), and connectivity density (Conn.Dn), Bone alkaline phosphatase (Alp), Tumor necrosis factor receptor superfamily member 11b (Opg), Tumor necrosis factor ligand superfamily member 11 (Rankl) and Cathepsin K (Ctsk) expression. There was an effect in the tartrate-resistant acid phosphatase (TRAP) and alkaline phosphatase (ALP). In the St group, the main effect was observed on the energy (compression and the three-points bending), stiffness, aBMD, BMD, cortical bone area (Ct.Ar), Po.N, trabecular bone volume (BV/TV), Tb.Th and in the mineralization ratio (ѵ1PO4/proline), Runt-related transcription factor 2 (Runx2), Bone morphogenetic protein 2 (Bmp2), Alp, Osteopontin/secreted phosphoprotein 1 (Opn/Spp1), Opg, Tumor necrosis factor receptor superfamily member 11ª (Rank), Rankl, Ctsk expression. There was an effect in the TRAP and ALP. The interaction in the combination of therapies in the Ot+St group was verified in energy to maximum load (compression and three-points bending testing), stiffness, BMD, Ct.Th, J, Tb.Th and ѵ1PO4/proline. In the gene analysis there was interaction in the Runx2, Osterix/Sp7 transcription factor (Osx/Sp7), Bmp2, Alp, Osteocalcin/Bone gamma-carboxyglutamate protein (Ocn/Bglap), Opg, Rankl and Acid phosphatase 5, tartrate resistant (Trap/Acp5) expression. In addition, the combination of OT and ST resulted in a higher maximum load compared to the Veh group, with higher BV/TV than the Ot group, higher Rankl and Ctsk expression than Veh and Ot groups, and lower Po.N and lower activity of TRAP than the other groups. In oxidative stress, total antioxidant capacity (TAC) was lower. These results showed that the combination of interventions is a promising anabolic strategy for the prevention of osteoporosis in the period of periestropause, standing out from the effects of isolated interventions.

The 2-parity conjecture for elliptic curves with isomorphic 2-torsion

The Birch and Swinnerton–Dyer conjecture famously predicts that the rank of an elliptic curve can be computed from its L -function. In this article, we consider a weaker version of this conjecture called the parity conjecture and prove the following. Let E 1 and E 2 be two elliptic curves defined over a number field K whose 2-torsion groups are isomorphic as Galois modules. Assuming finiteness of the Shafarevich–Tate groups of E 1 and E 2 , we show that the Birch and Swinnerton-Dyer conjecture correctly predicts the parity of the rank of E 1 × E 2 . Using this result, we complete the proof of the p -parity conjecture for elliptic curves over totally real fields.

On genus one curves violating the local-global principle

For any number field not containing Q(i), we give an explicit construction to prove that there exists an elliptic curve defined over this field such that its Shafarevich-Tate group is nontrivial.

Clinical efficacy of hemoperfusion with a cytokine adsorbent in norepinephrine-resistant septic shock: protocol for the CLEANSE randomized clinical trial

Background: Due to the pivotal role of inflammatory cytokines in sepsis, hemoperfusion with cytokine adsorbents may lead to better outcomes. Although previous studies showed inconclusive results, proper patient selection and timing of hemoperfusion may lead to improved survival. Objectives: To examine whether patients with septic shock requiring high-dose vasopressors undergoing add-on hemoperfusion with a cytokine adsorbent have better clinical outcomes than those treated with standard treatment alone. Methods: This is a multi-center, randomized controlled study in 2 tertiary care centers. 206 patients with septic shock receiving norepinephrine of 0.2 mcg/kg/min or higher are randomized to receive either standard treatment combined with 3-hour sessions of hemoperfusion with cytokine adsorbent for two consecutive days (HP group) or standard treatment alone (ST group). The primary outcome is 28-day mortality. Secondary outcomes include hospital and ICU mortality, shock reversal, vasoactive-inotropic score (VIS), organ support-free days, interleukin-6 levels, as well as safety data. Conclusions: This study will provide information to guide the use of hemoperfusion with a cytokine adsorbent in patients with septic shock.