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The essay proposes an interpretation of the eulogy of Symeon’s Miscellany considering not only the cultural context of the First Bulgarian Empire at the beginning of the tenth century, but also the historical situation and the literary production of the seventies and eighties of the previous century when the Greek original of the Miscellany known by the name of the Soterios was conceived in Constantinople. This eulogy helps us to better understand the reasons that led to the creation of the Slavic version of this anthology at the time of Symeon. In the Constantinopolitan environment, this anthology was conceived as an adequate tool of the kind required by monks and priests engaged in the education of the laity, with particular focus on the foundations of orthodox doctrine. In the new environment the initiative was taken by Tsar Symeon, who – on the strength of his theological training – assumed a decisive role while occupying the throne by taking responsibility for directly instructing the Bulgarian aristocracy, fully exploiting a tool in the Slavic language that would have been very useful.

Brief introduction to the Thematic Block Lexicon of the Slavic Bible and Its Meaning for the History of Slavic Manuscript Tradition

A renewed interest in lunar exploration with the focus on establishing a constant human presence on the Moon calls for developing new lunar human landing systems (HLS) which would deliver the crew from the prospective Lunar Gateway station to the surface of the Moon and back. Over the years, different human lunar lander architectures were proposed and multiple architecture studies were performed. However, those studies are relevant to the specific assumptions and lunar architectures proposed at the time of conducting the study. Since the current vision for lunar exploration includes new features, such as having the Lunar Gateway and switching to reusable systems, there is a need for a new HLS architecture study. Such studies are being performed by private companies; however, those are rarely publicly available. The goal of this paper is to address this gap and provide a publicly available architectural analysis within the current views on the future human lunar exploration. We assume the Lunar Gateway in an L2 near rectilinear halo orbit and a landing site at the lunar South Pole; the number of HLS crew of 4; the surface stay time of ~7 days, the payload mass delivered to the surface of 500 kg, and the payload mass returned from the surface of 250 kg. A set of parametric models including an HLS model and an HLS program cost model is developed for the analysis. 39 architectures with varying number of stages (1, 2, and 3 stages) and propellant combinations (LOX/LH2, LOX/CH4, and MMH/NTO) are explored. The Pareto analysis shows that there is a difference between typical performance trends for expendable and reusable architectures. For expendable architectures, the 2-stage option seems to be the most advantageous while, for reusable architectures, the 1- and 3-stage options are either comparable or win over the 2-stage option even for the number of system uses as low as 3. In terms of the propellant combinations, pure LOX/LH2 or combined LOX/LH2/LOX/CH4 architectures dominate the tradespace. Assuming that the inter-stage propellant compatibility is a preferred option for systems refueling from the Gateway, 1-stage and 3-stage all LOX/LH2 architectures are identified as the likeliest candidates to have lowest HLS-related production and launch costs. Further cost analysis of those two architectures shows that the 1-stage HLS wins over the 3-stage system in terms of the overall HLS program cost if a long-term exploration program (on the order of tens of missions) is assumed.

The article suggests that the female protagonist of the Lamentation, supposedly written in the mid-17th century, is an allegorical personifi cation of «power», a woman named Vasilija, dressed in widowhood and surrounded by wild beasts. Her lamentation contains numerous references to the prophecies of the Old Testament prophets. The character evokes the image of the «virgin caste» of Pauline origin (2 Cor. 11, 1–2), used by Savonarola in his canzone De Ruina Ecclesiae. Maxim elaborates this Savonarolian model, taking into account the canzone De Ruina Mundi, on the basis of a complex and neatly orchestrated biblical exegesis that highlights the allegory not only in relation to the Russian State, but as projected on the universal history, illustrating the relationship between earthly power and the «kingdom of heaven» in eschatological terms.

Book Review

Maximus the Greek (c. 1470-1555/1556), one of the most influential members of the Greek diaspora in Russia, arrived in Moscow from Constantinople with an official delegation (1518) and remained there until his death at the time of Ivan the Terrible. It was only in the second half of the last century that it was discovered Maximus the Greek must be identified with Michael Trivolis, a young Greek humanist educated in Florence at the end of the 15th century. Like many of his contemporaries, Trivolis had been influenced by the preaching of Girolamo Savonarola. Systematic research on the relation between the work of Savonarola and the humanists close to him and the writings of Maximus the Greek has not yet been conducted, but the data collected to date allow us to establish a close relationship within the context of certain religious, philosophical, and social themes. The examination of a text dedicated to the exercise of power by emperors and princes, the Discourse more extended, written by Maximus the Greek by the time of Ivan the Terrible, shows not only direct correlations with some of Savonarola’s cantos, but also the presence of images and themes from Dante Alighieri’s Divine Comedy and Cristoforo Landino’s Comento, starting with the idea of empire. The collections of Maximus the Greek’s writings, in which this Discourse appears, were widely disseminated, and left a deep mark on Russian culture.

La biographie de Maxime le Grec montre combien il est difficile de classer ce personnage qui a traverse a plusieurs reprises les frontieres politiques, culturelles et linguistiques de l’Europe. Les principales etapes de son parcours sont desormais bien connues : enfance et education byzantine a Arta, puis a Corfou (jusqu’a 1491/1492) ; formation a Florence a l’ecole des meilleurs humanistes, marquee par la rencontre avec le predicateur dominicain Savonarole, l’esprit reformateur le plus fasci...

I. La formation en Grece et la periode florentine (1492-1503) Originaire d’Arta en Epire, Michel Trivolis commence ses etudes a Corfou (possession venitienne) qu’il quitte en 1491 pour suivre a Florence son mentor, Jean Lascaris (1445-1534). Il reste dans la capitale toscane plus de dix ans (1492-1503), y copie de nombreux manuscrits grecs, en compagnie du Cretois Marc Musurus (v. 1470-1517). Il frequente le Studium Florentinum, dit aussi Academie neoplatonicienne, ou enseignent Lascaris et A...

The study briefly illustrates some features of the scholar's research on the lexicon of the Gospel manuscript tradition, emphasizing the role of the Greek text and the distinction between textual and lexical variants.

This paper investigates how different Hybrid Agile Product Development Process (hybrid PDP) architectures affect project performance in space hardware development. The performance benchmark of alternative hybrid Agile PDPs offers valuable information for structuring Minimum Viable Products in order to meet customer needs while improving effectiveness and efficiency of the PDP. We propose a modeling framework to simulate iterations through the product development process, and therefore optimize tasks definition in Agile frameworks while accounting for product interdependencies between components, subsystems and relevant lifecycle processes such as assembly, integration, testing, procurement, and validation. The framework has been verified on a case study of an undisclosed telecommunication payload hosted onboard a nanosatellite mission. The results provide an initial understanding of the applicability of Agile methods to the co-development of complex engineering systems based on experimental data (notably tasks, task durations, dependencies, and cost) that have been collected on the field as well as simulation outputs. The model we propose also represents an effective decision making support instrument to evaluate the programmatic and technical tradeoffs.

Slavonic pilgrimage literature is an interesting example of the widespread knowledge of apocryphal literature not only through the written tradition, but also through the mediation of the Palestine liturgical tradition and oral legends. The collective memory of Slavia Orthodoxa was formed, therefore, not only on the basis of familiarity with the Holy Scriptures, but also through liturgical tradition and oral legends attested in a complex of “holy books” where the apocryphal and legendary motifs enrich and complete the understanding of sacred history characters and events.

This review paper analyzes technology trends observed in New Space missions, using a patent analytics approach. The analysis is complemented with a literature review of the subjects identified. The main objective of this review is to draw a comprehensive picture of technology trends in New Space and to discuss potential scenarios for further development of this novel type of missions. Building on the existing scientific literature, we survey alternative definitions and then propose our own definition of New Space missions as synthesis of the ongoing debate in the field. We identified more than two hundred organizations active in the development of both upstream and downstream products and services for New Space missions. Using a commercially available patent analytics tool, we collected 933 patents protecting technologies disclosed by those organizations. We used the Latent Dirichlet Allocation (LDA), a topic modeling algorithm, to analyze patents' data and to identify the underlying structures in New Space's technology trends. Ten major topics have been identified respectively named “Remote sensing & image acquisition”, “Flying/launch systems”, “Telecommunication systems”, “Constellation management”, “Digital Processing Architectures”, “Image analysis”, “Manufacturing process & materials”, “Feature recognition and extraction”, “Antenna systems”, and “Space platforms”. A deeper analysis of patents' claims revealed a core cluster defined as “data cluster” including data analysis topics (Remote sensing & image acquisition, Image analysis, and Feature recognition and extraction), data transmission topics (Telecommunication systems and Antenna systems from both hardware and software perspective) and related enabling technologies such as constellation management. Based on this analysis, the evolution of data cluster related technologies is surveyed in order to review the current technology state of the art as well as identifying potential areas that will benefit the most from further technology developments to improve New Space missions’ performance. Lastly, we identify technology trends for future New Space development based on the insights obtained by the synthesis of our literature and patent survey. We discuss the key directions for future development emerging from our review, such as the use of commercial off the shelf components, the increasing use of miniaturized technology, and software defined technology.

This study offers a synthetic view of the relationship of the Eastern Slavic world, in particular Russia, with Humanism and the Renaissance, indicating new paths of research on the identity formation of Muscovy and the Russian Empire in the European context. In particular, we focus on the arrival of Sophia Palaiologina in Moscow, on the activities of Maximus the Greek in Russia, and on the idea of Rome and Moscow in the 16th century.

Data is the most valuable asset in space. It is produced by communicating and observing payloads, then downlinked to ground stations, and eventually delivered to the users, who generate information and insights from it. This paper explores an alternative avenue for the exploitation of space data, with the concept of Space Cloud. The space cloud is an orbiting cloud computing infrastructure providing in-orbit data storage and processing services. The idea is to enable on-orbit decision making including reactive planning and scheduling decisions, as well as complex resource management in space networks. The space cloud is the missing element to enable efficient and reliable intersatellite connectivity on top of which a whole new set of services and opportunities can be built in a similar fashion to what happened for the Internet during the 1990s. Building on previous work by the authors, this paper illustrates new efforts for the development of the space cloud concept through the demonstration of optical communication technology as a backbone for cloud computing in space. We illustrate how optical communications technology is an enabler of future space clouds.

We present the preliminary results of our investigation on the effectiveness of the Serum methodology for Agile development of space hardware. We analyze the development process of a hardware payload that is part of a host nanosatellite mission composed of two 6U CubeSats (30cm x 20cm x 10cm). The host mission is a collaboration with several partners including academia and small and medium enterprises. Scrum is a product development process created as a faster, more effective way of developing software. The goal of our investigation is to understand whether and by how much the same Scrum principles that proved successful in software can be adopted vis-a-vis in hardware projects. We also intend to identify the fundamental challenges in such an approach for space missions. In the host mission, Scrum has been adopted for the development of the payload subject to the investigation. The paper introduces the ongoing development process and identifies Scrum-related challenges internal to the payload development and challenges related to the coordination of the process with partners adopting established development processes. The paper identifies opportunities of future work for the fine tuning of Agile development methodologies in space projects and illustrates key statistics that have been collected throughout the development so far.

espanolSe presentan los resultados obtenidos en la construccion de normas actualizadas del Test de Matrices Progresivas de Raven, Escala General, para la ciudad de La Plata, Argentina; y su comparacion con las obtenidas en los anos 1964 y 2000. Con ese proposito se selecciono una muestra de 1049 sujetos de ambos sexos, de 13 a 18 anos de edad, alumnos de educacion secundaria. El instrumento fue administrado colectivamente y sin limite de tiempo. Los resultados se analizaron en tres grupos de edad y se compararon con los baremos anteriores. Se observo que a mayor edad de los sujetos, su rendimiento es mejor. La variabilidad de los puntajes es similar en los grupos de edad. En relacion con la tipificacion del ano 2000, en la que se constato el efecto Flynn respecto de las normas de 1964, aparece un amesetamiento y leve descenso de los puntajes directos necesarios para alcanzar el rendimiento promedio. Asimismo se observaron diferencias en el orden de dificultad entre las series de la prueba. El conjunto de estos resultados confirman la necesidad de actualizacion de los baremos y de las caracteristicas del material de prueba, a los fines de una evaluacion precisa EnglishThe current paper presents the results of the construction of valid and updated norms for Raven’s Standard Progressive Matrices, in the city of La Plata, Argentina, and compares them with norms obtained in the years 1964 and 2000 in order to observe score trends. For this purpose a sample of 1049 subjects of both sexes, 13-18 years old, high school students were selected. The test was administered collectively, without time limit. Data was split into three age groups and results were compared withnorms from 1964 and 2000. It was also noticed that as age increases, subjects performance tend to improve. The scores variability is similar in all age groups. A slight decrease of the direct scores needed to reach an average performance was observed, when compared to those from 2000, which were the norms where the Flynn effect was first noted after 1964 and show a plateau effect in direct scores. It was also noticed that as age increases, subjects performance tend to improve. The scores variability is similar in all age groups. Also differences in the order of difficulty between test series were observed. All these results confirm the need for updating of the scales and the characteristics of the test material for the purposes of an accurate assessment

Este texto tiene como objetivo generar las condiciones de discusión en torno a las escenas que vivimos en el marco del aislamiento social obligatorio a causa del Covid-19. Nuestro principal interés reside en habilitar, desde los estudios de género y disidentes (en diálogo con la filosofía, las ciencias sociales y la comunicación), un debate con respecto a la [re]precarización que el colectivo LGBT+ atraviesa en el contexto de la pandemia. Para ello, nos centramos, a la luz de los debates candentes que se promueven desde las voces intelectuales con reconocimiento internacional, en ejes como (1) las vidas precarias y las vidas susceptibles de dañabilidad en un sistema capitalista, colonial-moderno y cis-hetero; (2) la tensión, en el plano jurídico-político, entre redistribución y reconocimiento, señalando el derecho a la salud como eje central de disputa en el contexto pandémico; y (3) la bio[hetero]politización de nuestras existencias disidentes. El fin último de este material es colaborar en la formulación de modos de inteligibilidad que permitan la emergencia de nuevos interrogantes para la habilitación, conformación y reconfiguración de estrategias de intervención colectiva.

Both startups and traditional space industry are exploring new business opportunities and new engineering approaches in what is becoming known now as New Space.

Speaking at the IV International Congress of Slavists in Moscow (1958) on the Second South Slavic influence in Rus’, Dmitrij Lichačëv presented his ideas on an “Eastern European Pre-Renaissance”. Lichačëv’s thesis received some criticism from the young Riccardo Picchio, who was then developing the idea of an “Orthodox Slavic revival (rinascita)”. This article revisit the debate between these two important scholars, taking into account both subsequent developments in the research of each and more recent studies on the topic.

In recent years, the engineering community realized the potential for additive manufacturing (AM) to be a game-changer in product development. Nevertheless, it is not yet possible to fully take advantage of this technology because it implies a different approach to engineering design. The dependencies of AM on related technologies, such as material modeling, design tools, computing, and process design represent a challenge for engineers. A comprehensive system engineering approach is needed to address the introduction of AM in new design projects. This article proposes a systems design approach to evaluate the use of AM in the development of new systems at the early stage of design. The methodology aims to provide a preliminary estimation of performance, cost, and time of parts manufactured using additive techniques. The article introduces a set of design drivers and criteria to standardize the design process and support the manufacturing technique decision-making process. The methodology is experimentally tested and validated by evaluating tradeoffs for two different case studies considering different engineering parameters. The analysis of the results shows a good consistency between framework predictions and experimental evidence, with an uncertainty level lower than 5%. The reliability of obtained results is discussed.

About 40% of diabetic patients with asymptomatic coronary artery disease (CAD) are missed on the basis of the current screening guidelines. Erectile Dysfunction (ED) is a powerful marker of asymptomatic CAD. Aim of the study is to evaluate whether ED can improve the effectiveness of the current guidelines for the screening of CAD in diabetes. From among 299 consecutive men with newly diagnosed type 2 diabetes without any apparent vascular complication, 293 (mean age 56.6 ± 5.9 years) were enrolled. Among them, 219 did not have myocardial ischemia (NO CAD group) and 74 men had a coronary stenosis angiographically proven (CAD group). Five risk factors (RFs) of the current screening guidelines (hypertension, dyslipidemia, family history for CAD, smoking e micro/macroalbuminuria) and ED were assessed. ED was significantly more prevalent in the CAD than in the NO CAD group (37.8 versus 15.1%; P

This chapter presents a literature overview of the student voice in higher education, the main results from a three-year research project conducted at five Italian universities with the aim of investigating students’ voices in higher education and how they offer insight into fostering Faculty Development

In recent years, the engineering community realized the potential of additive manufacturing (AM) technology to be a game changer in product development and manufacturing. The capability of AM to build tailored products within short lead-time can make it a key contributor to Industry 4.0 in a lean manufacturing perspective.

Some studies observed an association between erectile dysfunction (ED) and coronary artery disease (CAD) extent in the general population, but others did not. There are no specific studies in diabetic populations. The aim of the present study was to evaluate whether ED is correlated with the extent of angiographic CAD in a large group of type II diabetic patients. We recruited 198 consecutive type II diabetic males undergoing an elective coronary angiography to evaluate chest pain or suspected CAD. Presence and degree of ED were assessed by the International Index Erectile Function - 5 (IIEF-5) questionnaire. ED was considered present, when IIEF-5 score wasor =21. Moreover, each domain of IIEF-5 was considered. Angiographic CAD extent was expressed both by the number of vessels diseased and by the Gensini scoring system. The percentage of subjects with ED was significantly higher (45.8 versus 15.8%; P=0.0120) in patients with (n=179) than in those without (n=19) significant angiographic CAD (stenosis of the lumenor =50%). No significant association of CAD extent with presence of ED, total IIEF-5 score and each domain of IIEF-5 was observed. Our study shows that ED was significantly more prevalent in type II diabetic males with angiographic CAD than in those with normal arteries. However, no correlation was found between the extent of angiographic CAD and the presence or the severity of ED.

Le volume de P. Gonneau et A. Lavrov est un evenement majeur dans le panorama des etudes sur l’Europe orientale et meriterait une reflexion bien plus structuree qu’un compte rendu, limite par definition. Cette œuvre offre une synthese de l’histoire de l’Europe orientale de l’apparition des Ros ou Varegues dans le monde slave occidental a l’arrivee au pouvoir de Pierre le Grand et elle est destinee non seulement aux specialistes, mais aussi, plus generalement, a tous ceux qui s’interessent a l’h...

Holy Scriptures and patristic exegesis in Old Church Slavonic sources. Some methodological reflections The study analyzes some biblical and patristic quotations in Cyrillo-Methodian sources and the contents of Symeonic Florilegium, the first Slavic miscellany of patristic writings, and suggests some methodological reflections for the study of the church fathers presence at the origins of Slavonic literary culture

The study aims to read the biography of Maximus the Greek in the light of the culture of humanism and the Christian renewal movements taking place between fifteenth and sixteenth century, and to highlight his role as educator in Russia. The ecclesiastic hierarchy tried to come to terms with his authoritative personality, making the most of his work to counter the influence of the Western world. At the same time, they kept him under strict control, while he intervened against anything that might undermine the authentic Christian and the monastic tradition.

PurposeThe purpose of this paper is to explore the contribution of conversation as an element of interaction that occurs in a hairdressing service encounter with the aim of seeking to understand variations in conversation between “short” and “long‐term” clients; how conversation contributes to the development of “commercial friendships”; and how relationships develop through conversation.Design/methodology/approachQuota sampling is used to select eight hairdressing service encounters in one Australian salon for recording and subsequent interviews with clients. Quotas address gender and duration of continued patronage. Conversations and interviews were analysed thematically and using conversation analysis.FindingsThe progress and evolution of conversations varied between short and long‐term customers; topics also varied by this classification as well as gender. Conversation played an important function with respect to building friendship with the service provider; conversation also assisted in the development of long‐term relationships.Research limitations/implicationsApart from the small sample, the study was highly contextualised because it investigated encounters in a single hairdressing salon and explored perceptions of the service conversation from the perspective of only one party to the conversation, the client.Practical implicationsThe findings point out the important role non‐task conversation can play in retaining customers in people‐processing services. Service providers perhaps can achieve more to improve the service experience and satisfaction of customers by placing less emphasis on the need for physical resources or promotion, instead focussing on the intangible of improving the conversation skills of their providers. More non‐task conversation and less task‐related talk may also facilitate a closer relationship between hairdresser and client. Further research on the nature and role of conversation during service encounters should offer guidance for improving the conversation skills of service providers and in improving customer retention.Originality/valueThis study specifically focuses on the role and nature of non‐task conversation as a specific aspect contributing to a customer's service encounter experience in a people processing service.

Erectile Dysfunction as a Predictor of Cardiovascular Events and Death in Diabetic Patients With Angiographically Proven Asymptomatic Coronary Artery Disease: A Potential Protective Role for Statin...

Comment persuader sans tomber dans la tromperie ou dans la seduction? Quelle place joue la persuasion dans notre connaissance, au niveau du savoir acquis et du processus d'apprentissage? Tout d'abord, lorsque persuasion et vraisemblance concernent le domaine de l'opinion, deux criteres contribuent a eviter l'erreur: d'une part les endoxa, qui au-dela de leur statut vraisemblable appartiennent aux croyances propres d'une societe donnee, et d'autre part l'exigence d'une intention bonne, critere significatif en dialectique dans son opposition a la sophistique, mais factice en rhetorique en raison de la finalite persuasive de celle-ci. Ensuite, persuasion et vraisemblance ont un statut different dans la science generale de l'etant et dans la science particuliere des principes de chaque discipline scientifique, et dans cette derniere lorsqu'elles concernent le contenu ou la methode. De plus, le credit accorde a la science est specifique en raison de l'objet et de la nature de la connaissance scientifique. Finalement, la place de la persuasion dans l'opinion et dans la science se traduit par les differentes declinaisons du rapport a autrui.

Este trabajo presenta los resultados obtenidos en la construcción de normas válidas y actualizadas del Test de Matrices Progresivas de Raven, Escala General, para la ciudad de La Plata, Argentina; y realiza una comparación con las normas obtenidas en 1964 y 2000 a fin de observar la tendencia de los puntajes. Se seleccionó una muestra de 1001 estudiantes de ambos sexos y provenientes de distintos establecimientos de educación secundaria, con edades comprendidas entre los 13 y 18 años. El instrumento fue administrado de manera colectiva, en grupos-clase, con presencia del examinador, sin límite de tiempo para su ejecución, de manera tal que permitiera evaluar la capacidad intelectual sin la intervención de la velocidad en la tarea. Los resultados obtenidos se analizaron dividiéndolos en tres grupos por edad (i.e., 13-14 años, 15-16 años, 17-18 años), y se compararon con los baremos de 1964 y 2000. Se observó un leve descenso de los puntajes directos necesarios para alcanzar el rendimiento promedio, respecto de las puntuaciones obtenidas en la tipificación del año 2000, en la que se constató el efecto Flynn respecto de las normas de 1964. Esta tendencia está en consonancia con investigaciones recientes realizadas en otros países, que muestran un amesetamiento de los puntajes. Un segundo aspecto observado, fue que a medida que aumenta la edad de los sujetos, el rendimiento es mejor. La variabilidad de los puntajes es similar entre los tres grupos de edad analizados.

Few and conflicting data are available in the literature on the association between Lp(a) levels and the severity of coronary artery disease (CAD) in diabetic patients. In addition, no studies took into account the role of apo(a) polymorphism. The purpose of the present study was to analyse the association of the degree of coronary atherosclerosis with Lp(a) levels and apo(a) polymorphism in a large group of type 2 diabetic patients.The study population consisted of 227 consecutive type 2 diabetic patients undergoing a routine coronary angiography to evaluate chest pain or suspected CAD. The patients were subdivided into four subgroups according to the number of coronary arteries diseased: normal arteries (n=26), mono-vessel disease (n=67), bi-vessel disease (n=54) and multi-vessel disease (n=80).Lp(a) levels (normal arteries: 14.6+/-19.6 mg/dl; mono-vessel disease: 19.0+/-16.4 mg/dl; bi-vessel disease: 19.3+/-15.1 mg/dl; multi-vessel disease: 26.5+/-16.8 mg/dl; p0.001) and the percentages of patients with at least one isoform of low molecular weight (normal arteries: 23.1%; mono-vessel disease: 38.8%; bi-vessel disease: 75.9%; multi-vessel disease: 81.2%; p0.001) were significantly correlated with increasing number of coronary vessels diseased. Multiple logistic regression analysis showed that both Lp(a) levels (OR: 1.31; 95% CI: 1.02-4.11) and apo(a) polymorphism (OR: 3.43; 95% CI: 1.67-7.05) were independent predictors of CAD severity.Our data suggest that Lp(a) levels and apo(a) polymorphism may be reliable predictors of CAD severity in type 2 diabetic patients.

Background— Erectile dysfunction (ED) is associated with coronary artery disease (CAD). In diabetic patients, CAD is often silent. Among diabetic patients with silent CAD, the prevalence of ED has never been evaluated. We investigated whether ED is associated with asymptomatic CAD in type 2 diabetic patients. Methods and Results— We evaluated the prevalence of ED in 133 uncomplicated diabetic men with angiographically verified silent CAD and in 127 diabetic men without myocardial ischemia at exercise ECG, 48-hour ambulatory ECG, and stress echocardiography. The groups were comparable for age and diabetes duration. Patients were screened for ED using the validated International Index of Erectile Function (IIEF-5) questionnaire. The prevalence of ED was significantly higher in patients with than in those without silent CAD (33.8% versus 4.7%; P =0.000). Multiple logistic regression analysis showed that ED, apolipoprotein(a) polymorphism, smoking, microalbuminuria, HDL, and LDL were significantly associated with silent CAD; among these risk factors, ED appeared to be the most efficient predictor of silent CAD (OR, 14.8; 95% CI, 3.8 to 56.9). Conclusions— Our study first shows a strong and independent association between ED and silent CAD in apparently uncomplicated type 2 diabetic patients. If our findings are confirmed, ED may become a potential marker to identify diabetic patients to screen for silent CAD. Moreover, the high prevalence of ED among diabetics with silent CAD suggests the need to perform an exercise ECG before starting a treatment for ED, especially in patients with additional cardiovascular risk factors.

Metabolic syndrome is a cluster of risk factors, such as central obesity, dyslipidemia, glucose intolerance, hypertension, related to insulin resistance. In HIV patients insulin resistance and several metabolic abnormalities of the metabolic syndrome have been described, but few and conflicting studies have investigated the behaviour of blood pressure. The aims of the present study were to evaluate the prevalence of hypertension in a large group of HIV-patients on highly active antiretroviral therapy (HAART) and to investigate the relationship between hypertension, metabolic syndrome and insulin resistance.Case control study.We enrolled 287 HIV-positive patients on HAART (mean age 41.1 +/- 7.5 years) and 287 age- and sex-matched controls. Insulin resistance was estimated by the homeostasis model insulin resistance assessment (HOMA) index. Metabolic syndrome was defined according to the European Group for the Study of Insulin Resistance.HIV patients showed a prevalence of subjects with hypertension (34.2 versus 11.9%; P0.0001) and metabolic syndrome (33.1 versus 2.4%; P0.0001) higher than controls. HOMA was higher in HIV-patients than controls (3.3 +/- 1.2 versus 2.0 +/- 0.9; P0.0001). HOMA (3.7 +/- 1.0 versus 3.1 +/- 1.2; P0.001) and the prevalence of subjects with the metabolic syndrome (64.3 versus 16.9%; P0.0001) were greater in HIV-patients with than in those without hypertension. Multiple logistic regression analysis showed that family history of hypertension (odds ratio [(OR): 8.73; 95% confidence interval (CI): 4.31-17.70; P0.0001], metabolic syndrome (OR: 6.79; 95% CI: 3.27-14.10; P0.0001), lipodystrophy (OR: 4.80; 95% CI: 2.43-9.85; P0.0001) and HOMA (OR: 4.13; 95% CI: 1.14-14.91; P0.05) were predictors of hypertension in HIV-patients.The present study shows that hypertension is frequent in HIV patients on HAART and that hypertension appears to be linked to insulin resistance; in particular, hypertension seems to be a part of the metabolic syndrome.

Apolipoprotein(a) [apo(a)], the specific apolipoprotein of lipoprotein(a), is characterized by a high degree of genetic polymorphism. Recent studies have shown that apo(a) polymorphism may represent a powerful independent cardiovascular risk factor. Indeed, an association between apo(a) polymorphism and coronary artery disease (CAD) has been documented both in the general population and among subjects at high cardiovascular disease risk, such as hypertensive, uremic, hypercholesterolemic, and diabetic patients. In addition, apo(a) polymorphism seems to correlate well with age of onset and severity of CAD. Nevertheless, at present, some problems prohibit the utilization of apo(a) polymorphism in clinical practice. Indeed, apo(a) phenotyping methods are not standardized, and there is not a cutoff of apo(a) polymorphism for clinical purposes. Moreover, large prospective studies should confirm the predictive value of apo(a) polymorphism for CAD. When the above problems are solved, apo(a) polymorphism could be a reliable tool to discriminate subjects with genetic predisposition to CAD among people with a family history of CAD and among patients with diseases representing a high cardiovascular risk, such as hypercholesterolemia, hypertension, diabetes, and uremia.

OBJECTIVE—In patients with uncomplicated diabetes, there is low probability of finding significant coronary artery disease (CAD) by noninvasive tests. Therefore, screening for its presence is not justified, and it is important to find reliable predictors of silent CAD to identify patients with uncomplicated diabetes for further screening. The relationship between lipoprotein(a) [Lp(a)], apolipoprotein(a) [apo(a)] polymorphism, and silent CAD has never been studied. We investigated the association of Lp(a) and apo(a) polymorphism with angiographically documented asymptomatic CAD in type 2 diabetic patients without evident complications. RESEARCH DESIGN AND METHODS—A total of 1,323 diabetic patients without any clinical and electrocardiographic evidence of CAD were evaluated. Of 121 patients with highly positive results of exercise electrocardiography (ECG) (n = 30) or positive results on exercise thallium scintigraphy (n = 91), 103 subjects showed angiographically documented CAD (CAD group). Of 1,106 patients with negative results on exercise ECG, 103 subjects without CAD (NO CAD group) were selected and matched by age, gender, and duration of diabetes to patients in the CAD group. In patients in the NO CAD group, results of exercise ECG, 48-h ambulatory ECG, and stress echocardiography were negative for CAD. RESULTS—The CAD group had higher Lp(a) levels (21.7 ± 17.7 vs. 15.2 ± 19.0 mg/dl; P = 0.0093) than the NO CAD group, and a percentage of subjects had at least one small apo(a) isoform (68.9 vs. 29.1%; P = 0.0000) higher than the NO CAD group. Logistic regression analysis showed that apo(a) phenotypes (odds ratio [OR] 8.13, 95% CI 3.65–21.23), microalbuminuria (5.38, 2.44–11.88), smoking (2.72, 1.31–5.64), and Lp(a) levels (2.41, 1.15–5.03) were predictors of asymptomatic CAD. CONCLUSIONS—Our investigation reports the first evidence of an independent association of Lp(a) and apo(a) polymorphism with asymptomatic CAD. This suggests that Lp(a) levels and apo(a) phenotypes could be used together with other risk factors as markers of asymptomatic CAD in patients with diabetes.

Objective To investigate on Brachial Artery Diameter enlargement in postmenopausal women with Metabolic Syndrome. Methods 294 women were admitted and classified in two groups according to the presence of Metabolic Syndrome. Serum glucose, insulin, lipid profile, carotid arteries and Brachial Artery Diameter were measured. Results Subjects with Metabolic Syndrome had the following different parameters in comparison to subjects without Metabolic Syndrome: Brachial Artery Diameter, Common Carotid Artery Diameter, IMT, and age. In a multivariate regression analysis Brachial Artery Diameter resulted correlated to age and presence of Metabolic Syndrome, among the Metabolic Syndrome components HDL was the only one to be associated to artery diameter. Furthermore, artery diameters increased with the increasing number of Metabolic Syndrome components. Conclusion Brachial Artery Diameter enlargement was found in postmenopausal women with Metabolic Syndrome. Arterial enlargement seems to be a systemic process occurring in response to some factors involved in atherosclerosis and not a focal change.

Resume Une observation rare, d’hypercalcemie severe survenant au cours d’un lupus erythemateux dissemine (LED) est rapportee. A l’admission, une jeune femme presente une hypercalcemie severe et une photosensibilite. Il n’y a pas suffisamment de criteres pour poser le diagnostic de LED. Toutes les causes d’hypercalcemie ont ete eliminees. Les radiographies osseuses sont normales. Un an plus tard, le diagnostic de LED est certain. De plus, une demineralisation osseuse severe et diffuse et des deformations thoraciques sont apparues. Le traitement du LED a permis de normaliser la calcemie. Une discrete elevation de la calcemie survient lors des poussees de LED. L’hypothese emise est que l’hypercalcemie des patients suivis pour LED pourrait etre due a la presence d’anticorps activateurs, antirecepteurs de la PTH. Cette observation fait penser que chez les patients avec une hypercalcemie severe associee au LED, le diagnostic et le traitement precoces du lupus pourraient prevenir la perte de masse osseuse. Chez ces patients la prevention de la perte de masse osseuse est importante. En effet une demineralisation severe pourrait favoriser les deformations osseuses et les fractures ; de plus, elle pourrait representer un serieux obstacle a l’utilisation de doses adaptees de corticoides pour le traitement du lupus.

We investigated Lp(a) levels and apo(a) polymorphism in relation to the severity of coronary artery disease, expressed both by the number of coronary arteries stenosed and three different coronary scoring systems. In a sample of 267 patients with coronary artery disease, a Mono-, Bi- or Multi-vessel coronary stenosis was documented by angiography. Twenty-five apo(a) isoforms were detected by a high resolution phenotyping method. Lp(a) levels did not show any differences among subgroups of patients. Both the percentage of apo(a) isoforms of low molecular weight (

To investigate plasma concentrations of lipoprotein(a) [Lp(a)] and apolipoprotein(a) [apo(a)] polymorphism in relation to the presence of microvascular and neurological complications in type 1 diabetes mellitus, 118 young diabetic patients and 127 age-matched controls were recruited. Lp(a) levels were higher in patients than in controls, but the apo(a) isoforms distribution did not differ between the two groups [higher prevalence of isoforms of high relative molecular mass (RMM) in both groups]. Microalbuminuric patients had Lp(a) levels significantly greater than normoalbuminuric patients, and normoalbuminuric patients showed higher Lp(a) levels than controls. Patients with retinopathy or neuropathy showed similar Lp(a) levels to those without retinopathy or neuropathy. No differences in apo(a) isoforms frequencies were observed between subgroups with and without complications (higher prevalence of isoforms of high RMM in every subgroup). However, among patients with retinopathy, those with proliferative retinopathy had higher Lp(a) levels and a different apo(a) isoforms distribution (higher prevalence of isoforms of low RMM) than those with non-proliferative and background retinopathy (higher prevalence of isoforms of high RMM). Our data suggest that young type 1 diabetic patients without microalbuminuria have Lp(a) levels higher than healthy subjects of the same age. Lp(a) levels are further increased in microalbuminuric patients. High Lp(a) levels and apo(a) isoforms of low RMM seem to be associated with the presence of proliferative retinopathy, but have no relation to neuropathy.

Les recits de pelerinage en Terre sainte sont un des principaux moyens de diffusion de motifs apocryphes dans Ie monde slave. On trouve dans ces recits a la fois des citations precises et des allusions a la litterature apocryphe. La presente contribution dresse l'inventaire de ces citations et allusions (pour la periode allant jusqu'au XVe s.).

AIM The purpose of the study was to investigate lipoprotein (a) (Lp(a)) levels and apolipoprotein (a) (apo(a)) phenotypes, and their relationship with a family history of coronary heart disease (CHD) in patients with essential hypertension (EH). METHODS One hundred and eight newly diagnosed patients with mild to moderate EH and 159 controls were studied. Lp(a) levels were determined with an ELISA method. Apo(a) isoforms were identified by a capillary immunoblotting technique. RESULTS Lp(a) levels and frequency distribution of apo(a) isoforms did not show significant differences between patients and controls. Lp(a) levels in hypertensives with a family history of CHD were significantly higher than in those without a family history of CHD (P < 0.01). Hypertensives with a family history of CHD showed significantly different frequencies of apo(a) isoforms to those without a family history of CHD (P < 0.05). In EH patients with a family history of CHD, apo(a) isoforms of low molecular weight (MW) had a higher prevalence (62.6%), while in hypertensives without a family history of CHD, apo(a) isoforms of high MW were prevalent (81.6%); the difference between the two subgroups was significant (P < 0.001). Multivariate analysis showed that both Lp(a) levels and apo(a) isoforms of low MW are significant variables in distinguishing between the subgroups. CONCLUSIONS Lp(a) levels and apo(a) phenotypes do not differ between hypertensives and controls. High Lp(a) levels and apo(a) isoforms of low MW are strongly associated with a family history of CHD in hypertensives. The quantification of Lp(a) levels and the characterization of apo(a) phenotypes may be used for assessment of familial predisposition to CHD in hypertensives.