Why Are Outcomes Different for Registry Patients Enrolled Prospectively and Retrospectively? Insights from the Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF).

Background: Retrospective and prospective observational studies are designed to reflect real-world evidence on clinical practice, but can yield conflicting results. The GARFIELD-AF Registry includes both methods of enrolment and allows analysis of differences in patient characteristics and outcomes that may result. Methods and Results: Patients with atrial fibrillation (AF) and ≥1 risk factor for stroke at diagnosis of AF were recruited either retrospectively (n = 5069) or prospectively (n = 5501) from 19 countries and then followed prospectively. The retrospectively enrolled cohort comprised patients with established AF (for a least 6, and up to 24 months before enrolment), who were identified retrospectively (and baseline and partial follow-up data were collected from the emedical records) and then followed prospectively between 0-18 months (such that the total time of follow-up was 24 months; data collection Dec-2009 and Oct-2010). In the prospectively enrolled cohort, patients with newly diagnosed AF (≤6 weeks after diagnosis) were recruited between Mar-2010 and Oct-2011 and were followed for 24 months after enrolment. Differences between the cohorts were observed in clinical characteristics, including type of AF, stroke prevention strategies, and event rates. More patients in the retrospectively identified cohort received vitamin K antagonists (62.1% vs. 53.2%) and fewer received non-vitamin K oral anticoagulants (1.8% vs . 4.2%). All-cause mortality rates per 100 person-years during the prospective follow-up (starting the first study visit up to 1 year) were significantly lower in the retrospective than prospectively identified cohort (3.04 [95% CI 2.51 to 3.67] vs . 4.05 [95% CI 3.53 to 4.63]; p = 0.016). Conclusions: Interpretations of data from registries that aim to evaluate the characteristics and outcomes of patients with AF must take account of differences in registry design and the impact of recall bias and survivorship bias that is incurred with retrospective enrolment. Clinical Trial Registration: - URL: http://www.clinicaltrials.gov . Unique identifier for GARFIELD-AF (NCT01090362)

Cell wall components in torrefied softwood and hardwood samples

© 2015 Elsevier B.V. Torrefaction - the process of soft pyrolysis (200-300. °S(cyrillic)) in inert atmosphere - is considered to promote the usage of lignocellulosic biomass in various technologies. The initial raw material is not uniform in composition and we compared the effect of torrefaction on the samples of hardwood (birch) and softwood (pine). The major differences between the torrefied samples were observed between 225 and 250. °S(cyrillic) and were largely connected with different behavior of hemicelluloses. Monosaccharide analysis revealed the decrease in detectable xylose from 26% to 1% (250. °S(cyrillic)) of the raw sample in birch, and from 11% to 1%-in pine. Mannans were more resistant to degradation. Comparison of data from HPAEC, thermal analysis and IR-spectroscopy revealed that hemicelluloses are modified during torrefaction at 225-250. °S(cyrillic), rather than fully degraded and removed from the sample. This may lead to considerable modification of wood properties, more pronounced in hardwoods. The relative content of aromatic structures went up during torrefaction, part of the effect was due to condensation of modified carbohydrate units. Index of cellulose crystallinity increased in torrefied samples. The content of cellulose in birch samples remained the same as in raw sample up to 250. °S(cyrillic), while in pine it dramatically decreased after the torrefaction at 250. °S(cyrillic). Torrefaction at 300. °S(cyrillic) made the samples of hardwood and softwood very much alike. The perspectives of usage of hardwoods and softwoods torrefied at different temperatures are discussed

Key beliefs of the society regarding vaccination against the new coronavirus infection (Covid-19)

The aim of the study - to identify the knowledge and opinions of patients who have undergone NCVI, to determine ways to obtain information about immunization, to establish a change in patients' beliefs about the importance of vaccination after an illnessЦель исследования - выявить знания и мнения пациентов, перенесших НКВИ, определить способы получения информации об иммунизации, установить изменение убеждений пациентов к важности вакцинации после перенесённого заболевани

Combined modality treatment of early breast cancer. Literature review

The object of the study was to conduct a systematic literature review on combined modality treatment for early-stage breast cancer using postoperative and intraoperative radiation therapy, and consider new treatment approaches for early breast cancer.Material and Methods. The search for sources relevant to the review topic was carried out in the Medline, Cochrane Library, and Elibrary systems. A total of 905 studies on combination treatments for early breast cancer were identified, of which 43 were included in the review.Results. Data analysis showed that the rate of local relapses in early breast cancer was lower in patients who underwent breast-conserving surgery in combination with adjuvant radiation therapy than in patients without adjuvant radiation therapy. Research is ongoing on radiotherapy deintensification using intraoperative radiation therapy for patients at low risk of recurrence. Ongoing clinical trials support the omission of radiotherapy after breast-conserving surgery for elderly women with hormone receptor-positive early-stage breast cancer, who receive adjuvant endocrine therapy. Understanding the characteristics of the tumor process will allow us to personalize the treatment of patients with early breast cancer, reduce the risk of local relapses, and avoid unnecessary treatment-related complications.Conclusion. To improve survival in breast cancer patients is only possible by maximizing the tumor control. The effectiveness of adjuvant radiation therapy, which is an integral component in the combined modality treatment of early breast cancer, has been proven. However, third-generation studies discuss the feasibility of identifying a low-risk group of patients with a favorable clinical prognosis, who receive adequate endocrine therapy, and additional radiation do not provide a significant survival benefit

«The best teacher of the year» competition as an instrument of the University faculty competency formation and motivation management

Статья посвящена описанию разработанной Владивостокским государственным университетом экономики и сервиса технологии оценки и мотивации ППС. Важным элементом этой оценочно-развивающей технологии стал конкурс «Преподаватель года», призванный мотивировать преподавателей на активную работу и поощрять их за мастерство, компетентность и приверженность целям университета. В статье проанализированы использованные в конкурсе методы оценки качества деятельности ППС и описана модель компетенций преподавателя высшей школы, работающего в университете предпринимательского типа.The present article describes faculty evaluation and motivation technology, developed by Vladivostok State University of Economics and Service. «The best teacher of the year» competition became an important component of this evaluation-development technology. It is aimed to inspire teachers for active work as well as to encourage their mastership, expertise and loyalty to University goals. The present article analyses methods of faculty activity quality evaluation, used in the process of competition and describes the expertise model of high school teacher, working at entrepreneurial university

Subjective assessment of time intervals as a characteristic of the emotional stability in pediatricians of different profiles

The article outlines the results of an empirical study of acoustic and visual orientation in the time of pediatricians of different profiles as a characteristic of their emotional stability. It is shown that the individual's perception of time intervals (within 1 minute), being one of the most important functions of the brain, plays an important role in the level of adaptive potential and stress resistance of the individual in professional activitiesВ статье изложены результаты эмпирического исследования слуховой и зрительной ориентации во времени врачей-педиатров разного профиля как характеристика их эмоциональной устойчивости. Показано, что восприятия индивидом временных интервалов (в пределах 1 минуты), являясь одной из важнейших функций мозга, играет важную роль в уровне адаптационного потенциала и стрессоустойчивости личности в профессиональной деятельност

ЛИТИЙ КАК ФАКТОР СОПРЯЖЕНИЯ НАРУШЕНИЙ МИНЕРАЛЬНОГО И УГЛЕВОДНОГО ГОМЕОСТАЗА ПРИ ЗЛОКАЧЕСТВЕННЫХ НОВООБРАЗОВАНИЯХ ЭПИТЕЛИАЛЬНЫХ ТКАНЕЙ

The impact of changes in orientation of the metabolism of carbohydrates and minerals in the cell malignancy has been demonstrated in several studies. The aim of this study was to analyze the molecular mechanisms and relationship of carbohydrate and mineral homeostasis with the processes of carcinogenesis. Parameters of carbohydrate and mineral metabolism of blood were defined in 73 patients with malignant tumors of epithelial tissues and 31 healthy subjects. In the presence of malignant tumors of epithelial tissues there was a statistically significant increase in the levels of glucose and glycated hemoglobin in the early stages of the disease and the absence of them at stage IV of the disease. There were no statistically significant differences in the levels of C-peptide and immunoreactive insulin in blood samples of cancer patients, although they tended to increase compared with the control group. Analysis of the composition of macroelements at the early stages of carcinogenesis revealed a statistically significant reduction of sodium level in plasma which wasn’t observed at the terminal stage of the disease. The concentrations of potassium and chlorine tend to increase in cancer patients, but the differences between these parameters were not statistically significant. Concentrations of calcium and magnesium significantly increased in the presence of malignant tumors. Analysis of microelements in the blood plasma showed a decrease in the concentration of cuprum and lithium (in 2.5-5 times) and the growth of strontium concentrations. Lithium has multiple effects on the life of cells, affecting a number of elements of messengers, as well as being the link between the carbohydrate metabolism and cell malignancy. Disorders of mineral homeostasis are important element in the disintegration of the metabolic processes in carcinogenesisВлияние изменения направленности метаболизма углеводов и минерального обмена на малигнизацию клеток было наглядно показано в ряде работ. Целью данного исследования стал анализ молекулярных механизмов взаимосвязи углеводного и минерального гомеостаза с процессами канцерогенеза. Определяли параметры углеводного и минерального обменов крови у 73 больных злокачественными новообразованиями эпителиальных тканей и 31 практически здоровых лиц. При злокачественных новообразованиях эпителиальных тканей выявлено статистически значимое повышение уровней глюкозы и гликилированного гемоглобина на начальных стадиях заболевания при отсутствии такового при IV стадии заболевания. Статистически значимых отличий по уровням С-пептида и иммунореактивного инсулина в крови онкологических больных выявлено не было, хотя и наблюдалась тенденция к их повышению по сравнению с контрольной группой. При анализе содержания макроэлементов уже на начальных стадиях канцерогенеза обнаружено статистически значимое снижение уровня Na в плазме крови, не наблюдающееся при терминальной стадии. Концентрации K и Сl имеет тенденцию к повышению у онкологических больных, но различия этих показателей статистически не значимы. При злокачественных новообразованиях значимо повышается содержание Ca, Р, Mg. Анализ уровня микроэлементов в плазме крови показал снижение концентрации Cu, Li (в 2,5–5 раз), рост содержания Sr. Литий оказывает множественные эффекты на жизнедеятельность клеток, влияя на ряд элементов систем мессенджеров, а также являясь сопрягающим звеном между углеводным обменом и малигнизацией клеток. Нарушение минерального гомеостаза является значимым звеном в дезинтеграции метаболических процессов при канцерогенезе.